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Mr. Lang : On behalf of my hon. Friends, I am happy to welcome the hon. Member for Kincardine and Deeside (Mr. Stephen) to the House, and to congratulate him on his success in the by-election. We look forward to his participation in our affairs, and wish him a fulfilling time during his time in the House--however long or short that may be.
I have already spelt out in great detail the criteria that I shall apply when considering Foresterhill's application for trust status. It is a complex and detailed process, which deserves such treatment. Of course I take account of feeling in the area ; but, as I said earlier, I also take account of the way in which feeling has been influenced by the misleading statements that have been put about over recent months.
I have no doubt that trust status for hospitals can be an enormous success, as it has proved to be south of the border. It can create the opportunity for local management to bring the delivery of health care closer to the people whom it serves, and give it freedom to run its own affairs. I shall take careful account of all aspects of the application before reaching a decision.
Mr. McAvoy : I am surprised at the remarks of the hon. Member for Gordon (Mr. Bruce). In my constituency the Rutherglen Liberal Democrats supported the privatisation of care for the elderly. When will the dogmatic Secretary of State for Scotland realise that the people of Scotland see NHS trusts as the thin edge of the wedge for privatisation of the health service, and that they do not want them?
Mr. Lang : Far from being dogmatic, our objective is to achieve the best possible delivery of health care through a health service that continues to be free at the point of delivery to patients. There is mounting evidence from south of the border that trust status has helped the hospitals that have achieved it to improve their delivery of health care and to expand the services that they can offer. If that is the case I imagine that more Scots will wish to take advantage of trust status. I read with interest in today's edition of The Courier and Advertiser, Dundee that the Dundee royal infirmary and Kings Cross hospital are beginning to consider the possibility of applying.
Mr. John Marshall : Will my right hon. Friend confirm to those who indulge in unnecessary and unwarranted smear campaigns that NHS trust hospitals are treating 10 per cent. more patients than were being treated a year ago? Will not people in Scotland quickly benefit from having several NHS trust hospitals?
Mr. Lang : I am grateful to my hon. Friend for his view of the position south of the border. I was interested to see that the mid-Cheshire hospitals are increasing their eye
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services by up to 50 per cent., that for Manchester central hospitals a day-care centre for cataract surgery has opened, and that in south Devon 67 new posts are to be created. Plainly, many of the hospitals south of the border that have applied for trust status are making considerable advances in the delivery of patient care.Mr. Dewar : The right hon. Gentleman has said that in reaching his decision he would have to take account of the quality of the representations. Does he think that such an argument will help him, given that the objections come from the doctors, nurses and auxiliaries, who are themselves the health of the hospital, and who will be responsible for its continuing health? Is the right hon. Gentleman aware of the theory that he would be happy to drop the whole unhappy business, but that his Minister responsible for health takes a different view? Is it right that the future of the hospitals should depend on an undignified ideological tug-of-war in the Scottish Office bunker? When will the right hon. Gentleman summon up the courage to make a decision on the applications?
Mr. Lang : The hon. Gentleman overlooks the fact that the applications originate from the people who run the hospitals, because of the advantages that are to be had, through local management, for local people. That must be borne in mind. There is nothing doctrinaire about our approach to the matter. We are concerned to continue to build on our magnificent record in improving the delivery of health care. As I have said, I shall consider each application on its merits and according to the criteria. I shall make an announcement as soon as I reach a decision.
Tower Blocks
13. Mr. Sillars : To ask the Secretary of State for Scotland what proposals he has for assisting councils to increase security in high tower block housing.
Lord James Douglas-Hamilton : My right hon. Friend takes the question of security in high-rise housing very seriously. Expenditure needs, including measures to improve security in high-rise tower blocks, are taken fully into account in the distribution of housing revenue account capital allocations and housing support grant.
Mr. Sillars : Is the Minister aware that most people who live in that type of accommodation do not believe that the Government take the problem seriously enough, and that we now urgently require either a direct grant or an allowance for capital borrowing to provide concierge-type services in high tower blocks in Glasgow and other parts of Scotland? Is the hon. Gentleman aware that old people in places such as Ibroxholm Oval are now sitting in their houses paralysed with fear, because they are the targets of the criminal element in our communities? They are the most vulnerable people. They are afraid to stay in in case their doors are kicked in, but they are also afraid to go out in case their homes are done in while they are out. Will the Minister pay more urgent attention to the problem? It now requires Government action.
Lord James Douglas-Hamilton : I am well aware that two of the three tower blocks in Ibrox in the hon. Gentleman's constituency--Iona court and Broomloan court--have concierge services that are working extremely well. The further expansion of that excellent scheme has a
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great deal to recommend it, but the hon. Gentleman must make representations to Glasgow district council, which has been allocated more than £101 million this year in respect of housing revenue account for capital investment. I should also make it clear that, in recent days, we have allocated further sums of more than £9 million for Scotland, in addition to the £4 million allocated for specific projects for homelessness, which we think will also assist. I recommend that the hon. Gentleman take the matter up with his council.Mr. Maxton : Does the Minister agree, therefore, that the concierge scheme introduced by Glasgow district council, involving controlled entry and video surveillance, is proving successful in the 80 blocks in which it has so far been operated? Is not it a disgrace, however, that the concierge service has been developed entirely out of Glasgow district council resources and that no money for it has come from the Scottish Office? Is not it also true that, next year, its further development will be restricted to three more blocks, whereas there are 170 tower blocks in Glasgow in which it has not yet been developed? Is not it now time that the Minister acted to solve the problems of high-rise blocks?
Lord James Douglas-Hamilton : We shall, of course, take these matters into account before making the provisional allocations in December. The hon. Gentleman is absolutely right to say that the schemes have been highly successful, but I take issue with him on his assertion that the matter should be taken out of the hands of the district council and placed in the hands of the Scottish Office. It is much better that the district council should have the responsibility for choosing its own priorities. I repeat that I shall bear in mind the hon. Gentleman's remarks before we make our allocations.
Nurses
14. Mr. Ron Brown : To ask the Secretary of State for Scotland how many student nurses qualified in Scotland last year ; and how many secured permanent employment within the national health service.
Mr. Michael Forsyth : In the year ending March 1991, 2,917 students in Scotland qualified for registration as first level nurses. Approximately 4,500 qualified nurses have secured employment in the national health service in Scotland during that period.
Mr. Brown : Is not it clear that many qualified nurses are not getting jobs in the health service? That is disgraceful because we know that, if resources were made available to extend the Royal hospital for sick children in Edinburgh and provide the promised new hospital in Leith, many more nurses and other medics could be employed to provide the service that they are trained to provide. If the Government claim that the health service is safe in their hands, will they do something about it and provide the resources, so that hospitals--particularly in the Edinburgh area--are given the back-up that they deserve?
Mr. Forsyth : I suspect that the hon. Gentleman had framed his supplementary before hearing my answer to his question, in which I made it clear that the number of nurses who were employed during that period was far greater than the number who qualified. The hon. Gentleman will be aware that, under this Government, the
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number of nurses employed in Scotland has increased by one third. That is a magnificent record. Moreover, their pay has increased by 40 per cent., whereas it went down by 25 per cent. when the Labour Government were in office.National Health Service Trusts
16. Mr. Foulkes : To ask the Secretary of State for Scotland what meetings he has had with hon. Members on each of the proposals for setting up national health service trusts.
Mr. Lang : There have been no formal meetings with hon. Members on proposals for setting up national health service trusts.
Mr. Foulkes : Why is the Secretary of State afraid to meet Ayrshire Labour MPs? Is it because we will point out that the consultants, general practitioners, radiographers, physiotherapists, occupational therapists, the Ayrshire local health council, all four district councils and the four Members of Parliament who bothered to make a submission were against the proposal to opt out--that all those 200 submissions were against it? It is an insult to all the people who made the submissions for the Secretary of State to suggest that all those professionals are accepting misleading statements and that the quality of their submissions is not as good as those of the handful of people in favour. Will the right hon. Gentleman now throw off the veto of his Minister of State and have the courage to meet us to argue and discuss the case?
Mr. Lang : Neither I nor my colleagues are afraid of the hon. Member for Carrick, Cumnock and Doon Valley (Mr. Foulkes) or his hon. Friends who represent Ayrshire, however much they may frighten each other. There is a statutory procedure laid down for the consultation process. I am in no doubt about the hon. Gentleman's views as he has tabled parliamentary questions on the matter, he took part in the debate on the regulations on 1 May, he spoke in the Scottish Grand Committee on 9 July and he submitted his views in the consultation process. It would be inequitable to those who take a contrary view to that of the hon. Gentleman if I were to see him exceptionally, in addition to all the other representations that I have received from him, now that the consultation period is over and I am reaching a conclusion on the matter.
Hypothermia
17. Mr. Dunnachie : To ask the Secretary of State for Scotland what assessment he has made of the resource implications for the health service in Scotland of the incidence of hypothermia in the winter months.
Mr. Michael Forsyth : The NHS is very conscious of the potential for an increased incidence of hypothermia in the winter months and health board plans take account of the need to provide a higher level of services in winter.
Mr. Dunnachie : I thank the Minister for his reply, but is it not about time that something was done to help senior citizens and the long- term sick? Every year we read about people who have died as a result of hypothermia or from a disease caused by hypothermia, but nothing is done. Every year people are asked to write in and beg for money.
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Is it not time that the Government got off their behinds and made it compulsory for a payment to be made every year to every senior citizen in this land?Mr. Forsyth : The Labour party cannot hold a candle to the Government's record in terms of helping elderly people with the costs of heating. The hon. Gentleman would do well to familiarise himself with the keep warm this winter campaign run by the Scottish Office which has received every support from local authorities the length and breadth of Scotland.
NHS Trusts
18. Mr. Darling : To ask the Secretary of State for Scotland if he will list the hospitals in respect of which he has received an expression of interest in opting out or establishing a national health service trust.
Mr. Forsyth : Three hospital units have applied for NHS trust status --South Ayrshire, the Royal Scottish national hospital and the Foresterhill hospitals group. In addition, formal expressions of interest have been received from the Victoria infirmary, Glasgow, the West Grampian hospitals unit, the Princess Margaret Rose hospital in Edinburgh, and Lothian college of nursing and midwifery.
Mr. Darling : Can the Minister justify the payment of more than £234,000 of public money to accountants, bureaucrats and consultants to prepare opting-out submissions when that money can be better used to reduce waiting lists or to make a donation to the appeal for the Royal hospital for sick children in Edinburgh instead of being used to propagate Tory party propaganda which is not wanted by the people of Scotland and which would damage the health service in Scotland? What possible justification can the Minister have for that other than his trying to pursue a policy which is completely discredited north and south of the border?
Mr. Forsyth : The moneys provided for the preparation of NHS trust proposals are in addition to the moneys provided for patient care. If the hon. Gentleman were interested in patient care, instead of opposing NHS trust proposals in principle, he would look at the merits of the proposals and decide whether they should go ahead on the basis of the interests of patient care--and that is precisely what my right hon. Friend will do. If the hon. Gentleman cares to consider examples from south of the border, he will see that trusts there are cutting waiting lists, employing more doctors, treating more patients and providing a wider range of services at times convenient to patients. It is sheer dogma by the Labour party to reject them out of hand without even considering individual applications.
Mr. Gerald Howarth : May I endorse most vigorously what my hon. Friend has just said about the benefits of NHS trusts operating within the health service. There are two trusts in my constituency that offer improved patient care and have taken on more staff. Is it not time that Scotland was able to enjoy the benefits of improved patient care that NHS trusts offer patients in England and Wales?
Mr. Forsyth : My hon. Friend is right. I hope everyone in Scotland understands the position of all the Opposition parties. Even if an NHS trust can be demonstrated to be
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in the interests of patients to reduce waiting lists and provide a better quality of service, they would reject it because they put politics before patients.Scottish Government
19. Mr. Galloway : To ask the Secretary of State for Scotland what recent representations he has received on the subject of Scottish government ; and if he will make a statement.
Mr. Allan Stewart : A range of representations has been received on the subject of Scottish government.
Mr. Galloway : Now that the Government's risible rump of 10 Scottish Members of Parliament has been reduced to the nefarious nine, and now that the Secretary of State for Scotland and virtually every one of that nefarious nine trembles on the edge of the abyss of a total
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political wipeout in Scotland, will the Government finally see the sense of coming to the negotiating table and talking about Scottish government? If not, how few Tory Members do there need to be in Scotland before it is accepted that the status quo is no longer tenable?Mr. Stewart : This Government will fight the next general election as a Conservative and Unionist Government. On the by-elections, Langbaurgh strongly suggests that the Labour party will not have the chance to implement its half-baked proposals for a Scottish Assembly, as proposed by the Scottish Constitutional Convention--it would increase taxes, be a constitutional impossibility and lead to constant feuding between Westminster and Edinburgh. That is no answer to Scotland's problems or opportunities. Of course, there is a constitutional choice for the people of Scotland--it is between the Union and independence.
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