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Nhs Staff (Resources And Decision Making)

Volume 404: debated on Tuesday 29 April 2003

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What plans he has to devolve resources and decision making to front-line staff. [109800]

Power and resources are being devolved to the NHS front line. The old health authorities and regional offices have gone, and new primary care trusts are now in place, which control three quarters of the total NHS budget so that local services can be shaped better to meet the needs of local communities.

Does my right hon. Friend accept that to create a world-class health service we need both investment and reform? Investment is running at record levels. Is it not now time to try to influence, involve and empower all members of the NHS team in taking forward our health service?

I very much agree with my hon. Friend. Clearly, record resources are now going into the national health service, and we have the fastest-growing health service of any major country in Europe, after many decades, including under the previous Government, during which investment was cut back rather than increased. As my hon. Friend rightly says, we need reforms in the system as well as resources, and now is not the time to take our foot off the accelerator of reform. With the extra resources going in, we need to see as much pace on reform. In particular, we need to ensure that we get the balance right in relation to standards being set nationally to guarantee equity in the system, about which we have done a lot over recent years, with national standards and national systems of inspection. Ultimately, however, neither I nor this place delivers health care: it is delivered out there in local communities by local members of staff. Those people, both in the community and among members of staff, should be empowered.

But does the Secretary of State acknowledge that, two weeks ago, Dr. Ian Bogle of the British Medical Association said that new evidence showed that 80 per cent. of doctors had not seen any improvement as a result of the increased NHS spending, and that excessive national targets were preventing additional money from reaching the front line of health care? Does he agree that it is not surprising that the general public have lost confidence that the Labour Government are capable of delivering a first-class NHS?

Of course, Dr. Bogle is a member of the NHS modernisation board, which produced its recent annual report. I do not know whether the hon. Lady has had an opportunity to look at that annual report, but among other things it said that the money was getting through to the front line. Indeed, it went on to say that the NHS was turning the corner. Clearly, there are problems that are still outstanding, but the only way of addressing them is to continue reforms in the national health service and continue putting resources into it, and not to do what the hon. Lady and her party propose, which is to cut NHS budgets by 20 per cent.

Is not my right hon. Friend the Secretary of State anxious that his proposals for foundation hospitals may reduce the improvements that primary care trusts are bringing in representing local communities and that "agenda for change" has the potential to bring in terms of NHS staff pay?

No, I am not anxious about that, for a number of reasons. First, for the very first time under the NHS foundation trust proposals—I think my hon. Friend has seen a copy of the Bill that has now been published—primary care trusts will be represented on the board of governors of NHS foundation trusts, thereby strengthening the link between primary and secondary care, which I know is what she is keen to see, as I am too. I think she is further aware that, in addition to the safeguards already in the Bill, I have given a guarantee that the "agenda for change" pay system, which we have negotiated with the NHS trade unions—to which I am pleased to say both the Royal College of Nursing and the Royal College of Midwives, have given the go-ahead in ballots by votes of 80 per cent. and 90 per cent.—will apply across every part of the national health service, including in NHS foundation trusts.

Does the Secretary of State agree that what most people want to see in terms of resources in the front line is a full range of complementary and alternative therapies? May I take this rare opportunity to congratulate him on his announcement over Easter of £1 million to go into research and development in relation to complementary therapies? Can he explain why that news came out over Easter, as the bank holiday weekend is traditionally used to put out bad news? Is it because he is acutely embarrassed that it has taken the Government so long to see the light, and the need for a greater use of complementary and alternative therapies in the health service?

I know that the hon. Gentleman has a certain regard for complementary therapies. I do not think that they are the talk of the pubs and the clubs in my constituency, but they may well be in his. One of the reasons why we gave the go-ahead for the additional £1 million was in the very real hope that he would not raise this issue at every single Question Time. Alas, my hopes have been dashed.

The NHS is refusing to spend £30,000 for a bone marrow transplant programme for my constituent, Diana Fildes, who has Crohn's disease. Will the devolving of resources start to help people such as Diana in the future? Is it not a mammoth task for family, friends and former pupils to have to seek to raise £30,000 in funding for private treatment? What have we got a health service for if not for that?

I am not aware of the case that my hon. Friend has raised but, if he passes me details, I will be more than happy to look into it and to come back to him.

In making the changes in the NHS, it is important that we get the balance right. It is obviously important—I think that most people would agree on this—that we should have national standards and some national targets in place precisely to ensure that there is equity in the system. None of us—at least on the Labour Benches—wants to go back to the days when, for example, cancer drugs were available in one part of the country but not in another. Equally, having put those national standards and national systems of inspection in place, it must be right that we give both the people who are responsible for delivering the care and the communities that receive it a greater say in how those services are provided to local communities. That is what primary care trusts are about arid it is what NHS foundation trusts in time will be about, too.