HC Deb 25 July 1989 vol 157 cc843-5
7. Mrs. Mahon

To ask the Secretary of State for Health if he has issued any guidance to health authorities on balloting National Health Service staff or members of the public on whether they agree with proposals to allow National Health Service hospitals to opt out.

Mr. Kenneth Clarke

No National Health Service hospitals are going to opt out of the National Health Service.

Mrs. Mahon

Is the Secretary of State aware of the overwhelming wall of hostility against his proposals for futuristic private hospitals? If the right hon. and learned Gentleman believes that his proposals have the support of doctors, nurses, patients and the public, why does he not put them to the test by balloting Health Service workers and the public? He has spent enough taxpayers' money trying to sell that rotten idea.

Mr. Clarke

Recently, the hon. Lady, together with some of her colleagues, gatecrashed a meeting that I was holding with the staff of various hospitals in Leeds. The hon. Lady and her friends found themselves listening to a very serious discussion about the potential benefits of self-government for hospitals and units in the Leeds area, and found it so daunting that they left after a little while. If the hon. Lady and her friends had stayed, they would have understood my proposals more clearly. Clearly, the hon. Lady still does not understand them—and obviously she is not ready herself, let alone her constituents, to cast a vote on the matter. If we receive any applications for self-governing status from NHS hospitals, as I am sure that we shall in due course, we will consult most thoroughly—as we always do on any serious proposal.

Mr. Hayes

Does my hon. and learned Friend agree that balloting hospitals and the community would be as ludicrous as it would be unworkable? Does he agree that it would divide communities and hospitals, and divert valuable time and resources away from the Health Service?

Mr. Clarke

I am accused of challenging one or two of the Health Service's traditions, but I am not very much in favour of traditions that lead to inefficiency. However, I cannot recall a single occasion in the past 40 years when anyone has suggested that managerial changes should be the subject of a local ballot. At this stage, people should concentrate on seriously studying the Government's proposals, and wait to see what applications are made and what would be the benefits to the patients concerned.

Mr. Galbraith

I presume that when the Government presented their proposals they discussed the decision that the managers and consultants involved would determine whether hospitals should opt out of local health authorities, and that the local community would be considered. If the majority of consultants in a hospital were opposed to that hospital's opting out, would it still be able to do so?

Mr. Clarke

I have never used the phrase "opt out". It has not featured in any of my documents or speeches. The self-governing hospitals, like other hospitals, will look to the district health authorities for funds, as money comes with the patients referred by those authorities.

Let me suggest again that the description of the proposal that we have heard is based on misunderstanding, or is misleading. We shall consult in the ordinary way when applications are made, but I do not believe that such matters can be decided sensibly by means of a yes or no vote among any particular section of staff, or in any other part of the community. Those responsible will put forward considered applications that will be examined in the same way as any other important changes in the service.

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