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NHS: Hospitals

Volume 730: debated on Thursday 8 September 2011


Asked by

To ask Her Majesty’s Government what meetings they have held with private companies concerning the management of NHS hospitals; and what was the outcome of any such meetings.

My Lords, as part of standard policy development, officials in the Department of Health met UK-based companies and one international health expert to hear their experiences of intervening to improve underperforming organisations. These were background sessions to inform policy development. Any decisions to involve organisations such as the independent sector or foundation trusts in running NHS hospitals would be locally led. In all cases, staff will remain within the NHS and assets owned by the NHS.

Is there any suggestion by the Government of cutting staff or wage levels, thus putting greater emphasis on raising revenue rather than patient care, which we regard as highly important? This policy represents, does it not, the decline of the NHS rather than its reform?

I am not sure what policy the noble Lord is referring to. There is certainly no concerted policy to decrease the pay levels of NHS staff. That is something we take very seriously. The proper remuneration of NHS staff, and their motivation, is of central importance to the well-being of patients. No, we are not diluting the NHS; the whole point of the Government’s programme is to bolster and boost the sustainability of the NHS for the long term.

Does my noble friend accept that productivity in the NHS has been absolutely abysmal over recent years and that the private sector, if it comes in to run hospitals better, may be able to raise it?

My noble friend is right. The statistics for the productivity of the NHS over the past 10 or 12 years show that it has actually gone down by about 3 per cent in total. We certainly think that the private sector has a role to play in places where it can introduce the higher quality of service that patients actually want. There is no question, however, of the Government forcing private enterprise into health services where it is not wanted and not in the interest of patients.

My Lords, within England there are already several NHS-badged private hospitals. Can my noble friend tell the House how many of these establishments were set up by the previous Government and how many of their employees are non-UK nationals?

My Lords, I am grateful to my noble friend for that question. I am sorry to say that I do not have those figures in front of me, but she is absolutely right to make the point that the independent sector treatment centres introduced by the previous Government were a perfectly proper move to increase choice for patients, and in many cases we have seen the quality of care in those hospitals encourage the NHS to raise its own game. Competition on that basis is highly beneficial.

Will the Minister say what assessment has been made of the causes of low productivity in the NHS?

My Lords, it is clear that one of the causes was that the previous Government—for all the right reasons, I have to say—injected very large sums of additional money into the health service, but alongside that there was no commensurate increase in activity. A lot of the additional money went into settling pay claims. That is not to decry the many benefits that arose from the additional money, but the net effect was a decline in productivity.

Does the Minister agree that there are dangers in sweeping statements on how NHS hospitals perform and that they perform badly, because that is not the case? In many instances, not just in my own hospital—Barnet and Chase Farm—the improvement in hospital services over the past years has been incredible. Does he also agree that there are already strong and widespread relationships with the private sector in NHS hospitals and that the challenge is for NHS hospitals to be better than private hospitals so that people will choose to go to their local hospital?

The noble Baroness is right to pull me up. If I implied that the NHS was across the board providing a lower standard of care than the private sector, I apologise because that is certainly not the case. There are some shining examples of care delivered by the NHS. However, as she will know, not all hospital trusts are as good as hers. Some give us cause for concern in a clinical sense, and they need to be challenged sometimes on the way they look at quality. That is going on at the moment with the quality, innovation, productivity and prevention programme that she will know very well.

My Lords, let us get this Question back to transparency. Over a year ago, David Cameron, the Prime Minister, said:

“Greater transparency across Government is at the heart of our shared commitment to enable the public to hold politicians and public bodies to account”.

That is the point of my noble friend’s Question. I would like an assurance from the Minister that minutes and discussions are available at local and national level on the public record of meetings with private and independent healthcare providers.

My Lords, the origin of this Question was, I believe, a freedom of information request that was replied to by my department. The background is that we have a small handful of hospitals that will struggle to achieve foundation trust status in their own right. I suggest that civil servants have to be allowed to have potentially helpful conversations with those who have experience of turning around financially challenged organisations. That is the background. We are perfectly transparent about that situation, as were the Government of which the noble Baroness was a member.