HL Deb 29 October 1990 vol 522 cc1692-4

2.53 p.m.

Lord Ennals asked Her Majesty's Government:

What are the criteria on which the Secretary of State for Health will judge applications for NHS trust status and what weight will he give to expressions of opinion by doctors and nurses working in the National Health Service and to the views of the local communities concerned.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)

My Lords, the key criteria in assessing National Health Service trust applications will be tangible benefits to patients and improvements in the quality of the services offered; strong leadership and effective management; involvement of senior professional staff, including clinicians, in management; and financial viability. My right honourable friend the Secretary of State will take account of views expressed by all those with an interest, including health authorities, staff, patients, GPs, community health councils and the local community.

Lord Ennals

My Lords, I am grateful to the Minister for saying that her right honourable friend will take those interests into consideration. Is she aware that, in a very large number of districts where health service managers are seeking to opt out of district health authority control, polls have been held of consultants, local GPs and a cross-section of local opinion and that in the vast majority of cases there is massive opposition? Is it the intention of the Secretary of State to force NHS trusts on unwilling consultants, doctors, nurses and their patients, thus creating conflict and antagonism within a service that is already hard pressed?

Baroness Hooper

My Lords, I am very well aware that the noble Lord and his party are keen to whip up enthusiasm against National Health Service trusts. Such ballots as have been held nearly all ask different questions and apply to different constituencies. We have consistently made clear that it would not be appropriate to hold ballots on applications for trust status. Such applications will include complex and detailed proposals on service management and personnel matters. It would not be right to attempt to reduce those matters to a form which could be used as the basis of a ballot; nor would it be right effectively to give any one group a power of veto over a trust application. The Secretary of State will decide whether an application for trust status should be approved on the merits of the individual application and in the light of the views of all those concerned.

Lord Ennals

My Lords, it is not just a question of prejudice. It is a question of judgment.

Baroness Oppenheim-Barnes

My Lords, is my noble friend aware that it is very difficult to consult the community since one cannot define the community? Will she take it from me that what people want is a free, comprehensive hospital service which uses its resources effectively and efficiently and therefore gives a better service? Is that not precisely what these trusts are designed to do?

Baroness Hooper

My Lords, I am grateful to my noble friend. It is indeed an efficient and effective service that we seek. I remind noble Lords that National Health Service trusts will remain firmly within the National Health Service. I emphasise that consultation is built into the process.

Lord Molloy

My Lords, is the noble Baroness aware that the point of my noble friend's Question was to make certain that the answer she gave showed that all those involved in creating the new National Health Service trust hospitals had been taken into consideration? Can she say whether representatives of the majority of the people whom she mentioned are directly opposed to what the Government propose? If so, will their views prevail? Will she confirm that when they have made their points it will not, because the Government continue to ignore them, have been a waste of time?

Baroness Hooper

My Lords, in preparing formal applications regions have ensured that they have been given local publicity. They have sought the views of all those with an interest, including, as I said, health authorities, staff, patients, GPs, community health councils and the local community. All those views will be taken into account by my right honourable friend the Secretary of State when he considers the application.

Baroness Robson of Kiddington

My Lords, does the Minister agree that in this country we are very lucky to have an enormous amount of voluntary service given to hospitals? Although it is argued that it is difficult to consult the community, does she further agree that consulting voluntary associations which work in hospitals, such as the leagues of hospital friends, the WRVS and the Red Cross, would give a very good overall view of the feelings of the community?

Baroness Hooper

My Lords, yes indeed. I am happy to reassure the noble Baroness that those are exactly the kinds of organisation that we expect will have an input. We have made it clear that consultations should take place over a three-month period, and therefore there is time to obtain an input from all those interested.

Lord Nugent of Guildford

My Lords, will my noble friend tell the House whether the Secretary of State will take into account the degree to which the individual hospital has been able to develop the resource management initiative—in other words, to modernise its management—before it can qualify to become a self-governing trust?

Baroness Hooper

My Lords, the financial viability of the unit concerned will be of extreme importance. Clearly those which have made considerable progress with the resource management initiative will be in an advantageous position.

Baroness Masham of Ilton

My Lords, will the community health councils have the same rights in visiting trust hospitals as they do for non-trust hospitals?

Baroness Hooper

Yes, my Lords, both types of hospital remain fully in the National Health Service.