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Mr. Speaker : Order. I do not know what the excitement is about. Come on, please.
Mr. Hayes : Why does my right hon. Friend think that the Opposition oppose NHS trusts when trusts treat more patients, waiting lists are falling and the overwhelming majority of NHS consultants support trusts? Is it because the real opposition comes from the Confederation of Health Service Employees and the National Union of Public Employees, which put pay before patients? Is not it good to see the unions here today keeping an eye on their investments?
Mr. Waldegrave : It is genuinely surprising that the Labour party is so adamantly opposed to what is a sensible
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devolution of management to the hospitals. It is also foolish of the union leaderships concerned to oppose these developments. We are already seeing in some trust hospitals a recognition that we have too many low-paid people in the NHS, which we have, and a search for greater and more flexible ways of dealing with pay, which is to the benefit of those very people. I suspect that we shall see that opposition crumbling too, at least from the grass roots, as the doctors' opposition has crumbled so far.Mr. Dave Nellist (Coventry, South-East) : May I give the apology of my hon. Friend the Member for Coventry, North-East (Mr. Hughes), whose brother-in-law died earlier this morning, in whose constituency Walsgrave hospital is located and on whose behalf as well as my own I ask the following question? What guarantee can the Secretary of State give us that, after opt-out, Walsgrave hospital will remain a hospital? Is he aware of what happened to the last hospital to move from NHS control four years ago- -Whitley geriatric hospital in my constituency--which we were told at the time would always remain a facility for the frail elderly in Coventry?
Two weeks ago the managers of that hospital submitted a planning application to knock it down and build a supermarket. Is the Secretary of State aware that nobody in Coventry wants Walsgrave hospital to leave NHS control and that none of the doctors and none of the people of Coventry voted for it? The sooner we get a general election to stop him and his like playing politics with our health service, the better.
Mr. Waldegrave : The hon. Member was one of those who wrote disgraceful, intimidatory letters to the management of the local hospital, which were disowned by the leader of his party and, more slowly, by his Front-Bench representative on health, the hon. Member for Livingston. The hon. Gentleman should be careful about talking about playing politics with these matters. His story shows one rather obvious point--that, since 1948, some hospitals have indeed closed, and that sometimes it is right to sell their land and to reinvest in hospitals elsewhere. That has nothing to do with trust status or anything else. If the hon. Gentleman is now trying to scare his constituents into the belief that the Walsgrave hospital will close, he is going even further than the Opposition Front-Bench spokesman, which is perhaps not unusual.
Mr. Tony Marlow (Northampton, North) : Is it not the case that, by putting responsibility for decision-making and management close to the patient, hospital management trusts will become more flexible and efficient, so we shall get more care for the cash? I understand that the Labour party cannot provide any more cash for the health service until it gets growth. As it is likely to achieve less growth than we would, is it not the case that, under a Labour Government, there would be no improvement in the health service? The hon. Gentleman, the Dr. Goebbels of Livingston, has not a leg to stand on.
Mr. Waldegrave : It is true that our party has given the NHS a bigger share of a bigger national product than did the Labour party when it was in power. The hon. Member for Livingston has at no time been able to respond to the challenges from me, the British Medical Association or
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anybody else, about what his figure is. We know that that is because his financial colleagues have not given him permission to say anything whatever, as they know that they have no such pledge to make.Mr. Peter L. Pike (Burnley) : Will the Secretary of State say just whom he takes notice of in his consultation exercise? Obviously, he wholly ignores the public of Burnley, Pendle and Rossendale, where 80 per cent. of the consultants and 90 per cent. of general practitioners voted against the proposal and only one member of the community health council voted in favour of trust status. Who on earth does he take notice of?
Mr. Waldegrave : First, of the leadership who submitted the application for trust status and whether they can demonstrate overall that they have support in the hospital. I am sure that the hon. Gentleman will join me in wishing that NHS trust well. It is a good hospital now, and it will become even better.
Mr. Michael Morris (Northampton, South) : Will my right hon. Friend clarify whether the criteria for the third phase will be the same as for the first and second phases or whether we shall learn from the experiences of those two phases and, if necessary, modify the basis of the third phase? May I congratulate my right hon. Friend on his philosophy of devolved management? Nevertheless, will he recognise that some institutions and hospitals may not wish to go as far as trust status, but may want devolved management? Will he address that problem?
Mr. Waldegrave : It is indeed true that the applications are voluntary and that remains the case. I am sure that the hon. Member for Livingston will be glad to see that his right hon. and learned Friend the Member for Monklands, East (Mr. Smith) and his hon. Friend the Member for Derby, South (Mrs. Beckett) are now in the Chamber to hear what he has to say about expenditure. Perhaps we will now learn a little bit more about it.
Mr. Stuart Bell (Middlesbrough) : Will the Secretary of State note that the people of Cleveland have heard the Prime Minister and the Secretary of State say that there will be no privatisation of the hospital service? However, they will note that, in the second wave of trusts announced today, there will be an NHS trust for North Tees, South Tees and the Cleveland ambulance service. The right hon. Gentleman will be aware that our trust port, the Tees and Hartlepool, which has served our community since 1966, is about to be privatised through Government legislation. Is it any wonder that the people of Cleveland do not believe the statements of the Government on the trusts when they see what is happening to their trust port?
Mr. Waldegrave : It is exactly that kind of bogus analogy that has confused and scared people. A large number of ports have always been in the private sector. We have made it perfectly clear that social care, hospital care and health care will remain provided by the NHS and always will be. I am surprised at the hon. Member for Middlesbrough (Mr. Bell) for making such an analogy, which comes close to the type of misleading statement that we have had from the hon. Member for Livingston. I should have thought that, after the hammering that the Opposition have had in the past few days, they would back off from making such analogies.
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Mr. Kenneth Hind (Lancashire, West) : I should like to congratulate my right hon. Friend on selecting the Wrightington hospital to become an NHS trust. No doubt my right hon. Friend will be aware that one of the first actions to be taken will be the appointment of a new upper-limb orthopaedic surgeon and medical team. They will assist in reducing our waiting lists in the north-west, although my right hon. Friend will be aware that they have already been greatly reduced. The waiting list now stands at 10 weeks operating time only for the entire region.
Mr. Waldegrave : My hon. Friend is entirely right. Every example of improved health service care in an NHS trust will give the lie to the campaign that the Opposition have waged. They should look with some nervousness to the next few months as we see steadily improving health care in those trusts, because every time that happens, their scares will be disproved.
Mrs. Alice Mahon (Halifax) : May I tell the Secretary of State how sorry I am that he has not learnt anything from the fiasco of the first wave of trusts? However, I am sorry not for him but for the elderly and the sick who will suffer as he continues to damage the health service.
The Secretary of State has told the House that all trusts are accountable to him. If so, will he tell us why an important circular on the decontamination of equipment used for HIV patients and hepatitis B patients is marked "for action" by health authorities only and "for information" only for the trusts? Today I received a letter from the right hon. Gentleman's Department in which it was admitted that
"operationally independent bodies are not bound"
by such circulars.
If the right hon. Gentleman is in control of trusts and they are accountable to him, why is that important circular not a must for the trust hospitals? Is it because the right hon. Gentleman is not really in control and those trusts intend to opt out of the NHS? As far as this circular is concerned, they already have done.
Mr. Waldegrave : I have tried to explain these matters to the hon. Lady in the Select Committee over some considerable time, but clearly I have not made much headway. The hospitals will remain within the NHS, as she knows very well ; they are subject to NHS policy, as she also knows very well.
Mr. Paul Marland (Gloucestershire, West) : Is my right hon. Friend aware that his announcement today that the Gloucestershire ambulance trust will be given permission to go ahead will put a spring in the steps of all those involved in the service? For my right hon. Friend's edification and that of the Opposition, may I say that I was involved with the preparation of that trust application. The Gloucestershire ambulance service is convinced that, as a trust, it will be able to provide a better service at less cost to the NHS. That will mean more money for the care of patients.
Mr. Waldegrave : What my hon. Friend says is absolutely right. As I have said before to other hon. Members, in the ambulance service we will see some of the most interesting and innovative developments in all the trusts. The trust applications from that service have been pursued with particular enthusiasm by the people working in it.
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Mr. Henry Bellingham (Norfolk, North-West) : In welcoming today's announcement to include King's Lynn and Wisbech NHS hospital trust, may I ask the Secretary of State whether he is aware that that application had broad support from the overwhelming majority of consultants, doctors and management, as well as an overwhelming majority of NUPE members?
Mr. Waldegrave : What my hon. Friend says about his constituency's trust is true, and it is true in the case of many other trusts, too. That is not the only matter at which I looked. I considered the overall balance of benefit for the hospital, and it was by judging those matters in a wider round that I could approve so many trusts. The support in the case of my hon. Friend's trust was indeed widespread.
Mr. Eddie Loyden (Liverpool, Garston) : May I ask the Secretary of State to answer a question that he has not yet answered? Approaches were made to him about St. Paul's hospital in Liverpool by two Chairmen of Select Committees, the CHC, myself as a patient, and another patient at St. Paul's. Bearing in mind the fact that the CHCs have a constitutional right to represent patients' interests at those meetings, who does the Secretary of State regard when he takes the final decision if he ignores such approaches to him? What criteria did he consider before accepting the decision of the area health authority against the background of the patients' approaches?
Mr. Waldegrave : I know that the hon. Gentleman was unhappy with the decision. However, he knows that my hon. Friend the Under-Secretary of State and I met the CHC and him and his colleagues. Those decisions are often difficult but we believe that we took the best advice with strong clinical backing before making our decision. But I recognise that it was unwelcome to the hon. Gentleman.
Mr. Alan Meale (Mansfield) : May I remind the Minister of all the derogatory remarks that he made earlier about the trade union movement, which represents hundreds of thousands of people within the health service? It represents far more people than any Member of Parliament, including the right hon. Gentleman. When he says that it is a disgrace that so many people are on low pay in the health service, may I remind him that the Government have been in office for 13 years? Why have they done nothing about that problem instead of privatising the health service?
Mr. Waldegrave : The hon. Gentleman is very unwise to use that phrase, which he knows to be false. The fact that there are so many low- paid people in the health service should make them consider whether the structure of trade unionism which has represented them for all those years has delivered much to them.
Mr. Roger Gale (Thanet, North) : Would my right hon. Friend find time to add his good wishes to those already expressed by the Minister of State on the retirement of the unit general manager at Thanet district hospital? My right hon. Friend will know that Dr. Voysey ended 30 years of dedicated service to the health service, both as a doctor and a consultant, by preparing the hospital for full district hospital status and trust status. Will he ensure that her aspirations can be realised by her successor as quickly as possible?
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Mr. Waldegrave : I give my hon. Friend the assurance that, although I did not judge that application to be ready yet, I hope that it will be very shortly.Several Hon. Members rose --
Mr. Speaker : The choice is very difficult. The hon. Member from Scotland.
Mr. Tom Clarke (Monklands, West) : Thank you, Mr. Speaker. I am sure that Scotland will have noticed your choice.
The Secretary of State referred to his evidence to the Select Committee on Health, but has he given some thought to other people's evidence? For example, has he considered the Chairman's draft report before the 20 pages were torn out? If so, what did he feel about the quality of evidence from Bradford, Leeds and Lewisham, which showed that the business plans bore little resemblance to what happened thereafter? There was no mention of bailing out. In view of the shambles that was made known to the Select Committee, should not the Secretary of State at least have hesitated before making a statement today containing the same mistaken policies?
Mr. Waldegrave : I know that the hon. Gentleman hopes for a shambles because he hopes to make political capital out of it, but there is no such shambles. As for the first part of his question, I cannot comment on the internal discussions of a Select Committee.
Mr. Roger Sims (Chislehurst) : My right hon. Friend will understand that there will be a deep sense of disappointment among those who worked so hard to prepare the proposals for the Bromley acute unit, only to find that they have been refused. That sense of disappointment will be felt particularly deeply by our new chairman and manager, who are committed to the proposals because they feel that they would be in the patients' best interests. Can my right hon. Friend assure me that officials of the executive will be available to give
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advice and assistance to the authority to enable it to ensure that the proposals are of a standard to enable the Secretary of State to approve them in the third wave?Mr. Waldegrave : That application was greatly strengthened during the past year ; it was very nearly there, and I am certain that it will be ready for approval by next year. I understand that it must be disheartening for the team, but I hope very much that it will continue to work to bring the benefits of NHS trust status to its hospital and the patients who will use it. I am sure that the proposals will be approved in due course.
Mr. Huw Edwards (Monmouth) : Does the Secretary of State appreciate that those at Nevill Hall hospital in my constituency last month decided that they would not apply for it to be granted trust status because they believe that, within the NHS, they provide a high quality of service that cannot be enhanced by trust status? They also consulted hospital staff, who were overwhelmingly opposed to trust status. I invite the Secretary of State to come to my constituency and share a public platform with me to debate the health changes.
Mr. Waldegrave : I should of course be delighted to do so, and if the hon. Gentleman writes to me, I shall see if I can find a date. The hon. Gentleman has, unfortunately, torpedoed a main part of the argument advanced by the Labour party's Front-Bench spokesmen, to which he cannot have been paying very close attention. Their argument was that hospitals were being forced to apply ; the hon. Gentleman has just shown that that is not so.
Several Hon. Members rose --
Mr. Speaker : Order. I am sorry, but we must move on. I shall keep a careful list of those Members who were not called. I hope that the debate to which the hon. Member for Monmouth (Mr. Edwards) has just referred will take place in the House rather than in his constituency.
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Standing Order No. 20 Applications
4.32 pm
Mr. Speaker : I wish to make a short statement about applications for debates under Standing Order No. 20.
It is well known that I take the view that this valued right to address me on an urgent topical matter for three minutes at an extremely busy time of day is too precious to be put at risk by abuse.
I am fully aware that the House some years ago declined to accept a Procedure Committee recommendation that the Speaker should be given a formal power to decline to hear applications that have no relation to the purpose of the Standing Order. Nevertheless, I do consider it my duty to protect this opportunity in the interests of Back Benchers. I have stated already this year on several occasions that it cannot be right that I should be obliged to listen to applications that do not--in the words that I used--even get to first base.
Applications must relate to specific, important and urgent matters that involve ministerial responsibility. If I receive applications that totally fail to meet those criteria, I shall continue to advise Members to seek other ways of raising such matters. I make this statement today because, since the House returned, I have received a spate of irrelevant applications, and I wish it to be known that I shall continue to apply this policy to Members in all quarters of the House, in the interests of the House.
Points of Order
4.33 pm
Mr. Donald Dewar (Glasgow, Garscadden) : On a point of order, Mr. Speaker. We have just had a lengthy statement about hospitals seeking so- called trust status in England. The Secretary of State for Scotland has not come to the Dispatch Box. I contacted his office yesterday and again this morning, in vain--he remains mute and incommunicado. He should end the damaging uncertainty that is sapping the morale of the health service in Scotland. He should be here to explain what is to happen to the Royal Scottish National hospital at Larbert, the South Ayrshire general hospital and Foresterhill hospital.
That is particularly urgent because this morning the chairman of Grampian health board confirmed that Foresterhill's application to opt out will go ahead. The argument that he put was poverty stricken ; he admitted that Foresterhill will be a monopoly supplier and that the internal market was therefore irrelevant. He relied on a series of unsubstantiated claims and pious hopes, and he conceded that the staff, patients and local community were united in opposition to a policy which they believe will undermine the hospital.
Mr. Speaker : Order. The point of order must be addressed to me. This is not a matter for me. I have no idea whether a statement about Scotland will be made, but no doubt it may be.
Mr. Dewar : Further to that point of order, Mr. Speaker. I do not want to delay the House ; I was merely drawing attention to the fact that a specific event has occurred in Scotland today--the decision to go ahead with the Foresterhill opt-out. That is why it is important to hear the Government's position. On behalf of my colleagues in
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Scotland, I believe that I am entitled to ask you, Mr. Speaker, to use your good offices to see whether we can get some explanation of the Government's position.This policy is opposed by everyone--even by many Conservatives in the north -east of Scotland and in other parts of the country--yet the Secretary of State seems determined to hide away from
responsibilities that are fairly and squarely his. He cannot do that. He cannot skulk even until polling day in the Kincardine and Deeside by- election--
Mr. Speaker : Order. I think I have the point. I notice the Government Deputy Chief Whip just coming back into the Chamber ; I know that he was present when the matter was raised, and I am sure that he will have heard it.
Mr. Barry Jones (Alyn and Deeside) : On a point of order, Mr. Speaker. The Pembrokeshire health authority has applied to become an opt- out national health service trust. A number of other hospitals and health service units in Wales have expressed a similar interest. Given the massive and understandable concern throughout Wales, where is the Secretary of State for Wales? We want some light to be shed on his plans for a much loved and highly valued service. It is wrong, Sir, that he has not come to the House to face questioning by my hon. Friends, and we demand that you help us to bring him here to answer for his policies.
Mr. Speaker : I am sure that that will have been heard. There may be some statements about this tomorrow.
Several Hon. Members : On a point of order, Mr. Speaker.
Mr. Speaker : Order. This is an Opposition day, and these points will take up time. I will take Mrs. Ewing first.
Mrs. Margaret Ewing (Moray) : Thank you, Mr. Speaker. I seek your advice and help in the matter of the accountability of the Scottish Office to Members elected from Scottish constituencies.
As you are well aware, hospitals in Scotland are seeking trust status. Reports say that there is a division of opinion between the Minister responsible for health in Scotland and the Secretary of State for Scotland. Surely the House can find some method by which that Minister and the Secretary of State can be asked to report to Members on their opinions and to offer their guidance on these critical matters to do with the health service in Scotland.
Mr. Speaker : Again, that is not a matter of order for me, but the hon. Lady has made her point.
Several Hon. Members rose --
Mr. Speaker : Order. I think that I had better take Mr. Jones first.
Mr. Ieuan Wyn Jones (Ynys Mo n) : On a point of order, Mr. Speaker. We have had an opportunity this afternoon to hear from the Secretary of State for Health about a number of expressions of interest in England. Unfortunately, all that we in Wales can do to discover which hospitals might want to express interest is to read our newspapers. Should not the Secretary of State come to the House to tell us so that we do not have to read our papers?
Mr. Speaker : The hon. Member and the House know my strongly held views about that. The answer is yes.
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Mr. George Foulkes (Carrick, Cumnock and Doon Valley) : I am grateful to you, Mr. Speaker ; I appreciate your views, and you are always helpful to us.On behalf of Labour Members from Ayrshire, I wrote to the Secretary of State for Scotland asking whether we could go to see him to express our deep concern, on behalf of almost all the people of Ayrshire, about the proposals for Ayr hospital, Biggart hospital and Ballochmyle hospital to opt out. But the Minister of State, not the Secretary of State, wrote back refusing to allow us to see the Secretary of State. Is there any way in which you, Sir, can help to ensure that we have access to the Secretary of State? If he is not prepared to come to the House, we are prepared to go and see him.
Mr. Speaker : That is, as I think they say in Scotland, outwith my responsibilities.
Mr. Robert Hughes (Aberdeen, North) : I am grateful to you, Sir, as this is a matter of some importance.
Exactly a week ago--minus 20 minutes--the 90-day consultation period in relation to the Foresterhill hospital application for opt-out status ended. Only this morning, Grampian health board recommended that the application be granted.
In the intervening seven days, before the Secretary of State has even seen the responses to the consultations, and even in advance of Grampian health board arriving at a decision, Scottish Office officials have been widely quoted in the Scottish press as saying that the Minister of State will approve the application. That must be in breach of the rules of this House and of the statute.
Mr. Speaker : I do not think that it is in breach of the rules of the House. I do not know whether there will be a Scottish statement or a statement by the Secretary of State for Wales, but the point has been made. It may well be, because this is an Opposition day, that there was concern that time would be taken by such statements.
Mr. Peter L. Pike (Burnley) : I wish to raise a point of order arising from the statement by the Secretary of State for Health. The Secretary of State requested permission to make that statement to the House, and you, Mr. Speaker, granted permission. Judging by the number of hon. Members who sought to ask questions on the statement, it dealt with an issue of great importance. If you had been in Lancashire this morning, Mr. Speaker, you would have got the news about Burnley health care unit because a fax was issued by the chairman-designate of the health care unit, Mr. Rawson--
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Mr. Speaker : Order. What has this to do with me?
Mr. Pike : My point of order is that--
Mr. Speaker : Order. If the hon. Gentleman alleges that information is given to people outside the House before it is given to us, he knows my strongly held views on the matter. However, it is not my responsibility and it is not a matter of order in the Chamber.
Mr. Pike : You are therefore saying, Sir, that it is your practice to deprecate such a practice by a Secretary of State. Should not the Secretary of State and the chairman-designate do the honourable thing and resign because of this insult to the House?
Several Hon. Members rose --
Mr. Speaker : Order. I think that I had better take one point of order from the Government side.
Mr. Donald Thompson (Calder Valley) : Would it not have been easier for you, Mr. Speaker, to take a series of three-minute applications under Standing Order No. 20 ? That would have saved the House from listening to so much rubbish.
Mr. Speaker : That might have been easier. Such proceedings bring the House into disrepute and take up time on a busy day.
Mr. Dave Nellist (Coventry, South-East) rose --
Mr. Speaker : I think that the hon. Gentleman intends to oppose the ten-minute Bill.
Mr. Nellist : This is on a point of order of which I have given you notice, Mr. Speaker. Have you received from the Secretary of State for Energy a request to make a statement on the disgraceful announcement at lunchtime on the closure of Coventry colliery at Keresley with the loss in my city of 1,300 jobs ? If such a statement were made, do you agree that it would be totally in order to point out that the problem is due not to the failure of Coventry miners to dig coal but to the tightening ratchet of the Government's economic targets ? If they get their way, it will mean that the 200 pits that existed in 1979 could be down to Rothschilds' 14. If the miners want to oppose this closure they know that they have my whole- hearted support.
Mr. Speaker : That is not a matter for me.
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Disqualification of Elected Persons
4.43 pm
Mr. Roger King (Birmingham, Northfield) : I beg to move, That leave be given to bring in a Bill to disqualify from membership of the House of Commons or local authorities any person who is sentenced to a term of imprisonment.
That is the short title of the Bill, but its basic aims are to permit the immediate disqualification from office of a Member of Parliament or local government councillor who has been imprisoned for knowingly, deliberately and publicly defying the laws of the land and, thus, the will of Parliament.
It is necessary to make two distinctions. The Bill is not directed at any individual hon. Member. It is a modest measure and I seek no retrospective legislation. Of course, in part it is motivated by the recent celebrated case of the hon. Member for Liverpool, Broadgreen (Mr. Fields), who is in his place. He has paid his dues as the law stands and my prime intention is to avoid a repetition of that case. Secondly, the Bill does not seek to disqualify any councillor or hon. Member found guilty of an offence and subsequently sentenced to a period in custody where it is clear that that person has not actively campaigned to break the law. A remedy for that already exists under the Representation of the People Act 1991 under which an hon. Member can be disqualified when imprisoned for a period exceeding 12 months. However, the law is much less clear for local councillors. Hon. Members know only too well that events can overtake some of us in a way that was never premeditated or foreseen and certainly never publicly campaigned about. One is reminded of an hon. Member being apprehended for driving while intoxicated and perhaps as a result being liable to imprisonment. The Bill does not cover such a situation, because the hon. Member would not have campaigned and asked other hon. Members and everyone in the land to join him in his drinking and driving. The Bill distinguishes between that type of offence and one in which an elected representative positively campaigns on a platform of deliberate and provocative disobedience of the law of the land.
All hon. Members have a right to disagree ; that is our heritage. But we also have a duty to set an example and uphold the law. We express our feelings in the House and do not do so outside, goading our fellow citizens to disobey the law. The same is true of councillors. They are entitled to free expression but never to the right to break the law and remain in a position of continuing influence.
Few of us can have remained unaffected by the hon. Member for Broadgreen. True to his word and to his pledge to his constituents, he has resolutely fought against the introduction of the poll tax. Failure to pay and to obey the law laid down by the House resulted in his imprisonment. Then we read that it was business as usual from the depths of the prison. I admire the hon. Gentleman for his nerve and effrontery, but it makes me angry to know that defiance of the law that was knowingly and deliberately undertaken has had little impact on his job prospects, although, of course, his party affiliation is under some examination. Could a police officer who openly challenges the law and is imprisoned remain a serving officer? Of course not. Would not a solicitor be
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