"Working for Patients"

HC Deb 23 May 1989 vol 153 cc783-6

3. Mr. Hardy

To ask the Secretary of State for Health what is the total number of representations received by his Department since the publication of "Working for Patients" which express criticism or anxiety in regard to present Government health policies.

The Secretary of State for Health (Mr. Kenneth Clarke)

So far, I have received more than 5,500 representations on the White Paper, "Working for Patients". Many ask questions, many support all or some of the proposals, and some refer only to specific aspects. It is not possible to distinguish the letters in the way that the hon. Member suggests.

Mr. Hardy

Does the Minister expect to receive more letters, not just about resources and the apparent commitment to destabilise the service but in response to yesterday's announcement, which seems to reveal an assumption that a captain of industry is very much in a part-time position, while nurses are so busy caring, in a way that the Government do not reveal, that they cannot be spared to serve on the policy decisions board of the NHS?

Mr. Clarke

The people who will be given much more local responsibility for managing and delivering the service will be encouraged to see that we are able to recruit to the policy board the services of some high-powered and successful people with experience of large organisations. We also have an important job of nursing management to do. That is why there is a director of nursing on the management executive who is charged with that part of the management responsibility that has to be done from the centre.

Sir Geoffrey Finsberg

In the correspondence that my right hon. and learned Friend is receiving, is he getting the sort of letters that many of us are getting from elderly patients who are being scared by the British Medical Association, through their doctors, with the most vicious lies and propaganda? What does he intend to do to make the BMA realise that it has a duty not to scare patients?

Mr. Clarke

I have written to every general practitioner pointing out that the leaflets that they were distributing were inaccurate and untrue. I hope that many have withdrawn them as a result, but I cannot approach every GP who uses the tactics described by my hon. Friend. It is grotesquely unfair to make such claims to elderly and vulnerable patients in pursuit of some perceived interest. Now that we have settled the GP contract, I hope that there will be much less of that, and much more of the sensible discussion that I have made it perfectly clear that I am open to having with the BMA.

Mr. Fearn

Can the Minister confirm that among those representations and anxieties, many members of the nursing profession have written pointing out that no one from their profession has been elected to the board that he has announced? Why did he not make a statement to the House about that board? Also, what representations has he received from medical secretaries who are having a tough time at the moment?

Mr. Clarke

I have not yet received many letters from nurses about the make-up of the policy board. As their general secretary has written to me, I shall no doubt be receiving some more, but they will be given the same explanation—that the policy board is not a representative committee. [Interruption.] Looking back, I believe that it was an extremely bad tradition of the Health Service that everything had to be subjected to a committee consisting of one doctor, one nurse, one administrator and one treasurer, so that prolonged multi-disciplinary deliberations took place before, in most cases, no decisions were reached. The policy board is charged with the overall strategy for the service. On the executive charged with the management responsibilities it is essential to have a director of nursing, and we have such a director.

Mr. Andrew Mitchell

Will my right hon. and learned Friend commend the approach taken by the general manager of the Queen's medical centre in Nottingham, who said that his hospital was extremely interested in becoming an NHS trust hospital so long as that was in the interests of the patients whom it served? Is not that a constructive approach to the White Paper and one which contrasts substantially with the general approach taken by the BMA?

Mr. Clarke

I agree entirely, and I believe that the decision has been supported by the majority of the medical staff at the Queen's medical centre. I take that as an expression of interest because potentially the proposal could benefit patients. I agree with the general manager that after a great deal more discussion, which has to take place, the decision as to whether the hospital becomes self-governing will depend on whether that is in the interests of the patients, the hospital and the staff.

Mr. Turner

Has the Secretary of State seen the open letter published in the Wolverhampton Express and Star last week from more than 50 per cent. of Wolverhampton consultants, saying that they could not now guarantee the inhabitants of Wolverhampton a comprehensive health service due to lack of resources and threatened ward closures? What has the Secretary of State to say about that parlous affair?

Mr. Clarke

I am afraid that in all branches of politics and public life it is easier to get people to sign round robins and petitions than to give serious views and discussion. I cannot think that the majority of Wolverhampton consultants believe such nonsense.

Mr. Turner

They signed it.

Mr. Clarke

There is nothing in the White Paper to justify making such alarmist allegations to the population of Wolverhampton.

Mr. Hayes

Does my right hon. and learned Friend agree that it is time for the hyperbole and scaremongering by the BMA to stop because it is very confusing for patients and adds nothing to the debate? As a conciliatory gesture, is my right hon. and learned Friend prepared to meet the BMA without any preconditions whatever just to talk about the proposals which will help patient care?

Mr. Clarke

When the BMA announced last week that it wished to meet me for discussions, I announced my readiness to have such discussions. The precondition has to be that we all agree on the aim of improving the National Health Service. I look forward to the BMA putting forward positive ideas for improving the National Health Service. I am still waiting for a date to be arranged for the discussions. It is a great pity that after announcing its wish to talk about the proposals, the BMA has now started publishing whole-page newspaper advertisements containing a great list of blatant untruths, which I do not think for one moment that the BMA believes but which are designed merely to frighten patients in the hope that that will somehow strengthen the BMA's bargaining power in discussions with me.

Mr. Robin Cook

What representations did the Secretary of State receive to the effect that what the Health Service needed was three industrialists all clutching their private medical cover? Is he aware that the chief contribution of Sir Graham Day and Bob Scholey to the public sector has been in closing large chunks of it and privatising what was left? Is that why they have been chosen to run the Health Service? How could the Secretary of State find places for four business men on the health policy board but no room for even one nurse? Have not those who know how to care for patients got at least as much to offer the Health Service as those who know only how to read a balance sheet and close a factory?

Mr. Clarke

It is a serious criticism of the hon. Gentleman that he reminds me so much of his hon. Friend the Member for Oldham, West (Mr. Meacher) reacting to the Griffiths report on general management in the Health Service four or five years ago. The hon. Gentleman talked a lot of nonsense about supermarkets and how the proposals were not suitable, but the hon. Member for Livingston (Mr. Cook) knows that he would not wish to reverse the great management improvements introduced by Sir Roy Griffiths from Sainsbury's. He knows that a giant organisation requires people able to cope with providing leadership and guidance for managers who will be charged with such great responsibility in the service. The hon. Gentleman should not resort to such populist nonsense when his own proposals are simply that every health authority should be dominated by local councillors and trade unionists, who I suppose he imagines will bring a dynamic new improvement to the way in which care is delivered.

Mrs. Maureen Hicks

Would my right hon. and learned Friend like to hazard a guess as to how many of the innocent patients who are writing to us as a result of being lobbied by rather unprofessional and unscrupulous doctors— [Interruption.]—have any comprehension of the true nature of our reforms? Rather than feeding patients a diet of misinformation, would not doctors be better advised to tell them the true facts and acknowledge the Government's responsibility in overhauling a National Health Service system which was creaking under the strains and demands placed on it?

Mr. Clarke

I have had the same experience as my hon. Friend. There is one village in my constituency from which I keep receiving letters, mainly from worried and elderly people, beginning "I agree with my doctor that" and then giving some nonsense description of the White Paper. I am having to write to reassure those people. That is in contrast with the large meetings that I have had in the past week —there were two in Yorkshire and one last night in Winchester—which were attended by many general practitioners and where there was much criticism, I concede, but much constructive discussion as well. It is ridiculous that when we agree with the profession that we want to make a better National Health Service for cur patients, some GPs have to resort to the low-level propaganda from which my hon. Friend and I have suffered.