§ Mr. Kenneth Clarke
Self-governing NHS hospital trusts will remain firmly within the NHS, but they will have far more freedom to take their own decisions on the matters that affect them most without detailed supervision from my Department and the health authorities. This will give a better quality service and encourage other hospitals to raise the quality of their services.
§ Mr. Gale
Can my right hon. and learned Friend tell us what further steps his Department intends to take to rebut the black propaganda being peddled by the Opposition and ram home to the public the fact that the Health Service reforms, while they may not be welcomed by every leader of every Health Service union, are designed to improve patient care, which is what the Health Service is there for?
§ Mr. Clarke
I am grateful to my hon. Friend and I will take every opportunity to do that. In fact, I am today launching a small newspaper advertising campaign to bring home to the public the improvements in the family doctor service that will result from the new general practitioner contract that the House has approved.
§ Mr. Canavan
Is the Secretary of State aware of the case of the Royal Scottish National hospital, which is home to about 800 mentally handicapped patients, where in a recent ballot of employees more than 95 per cent. rejected the management's proposal for opting out? How can the Government justify going ahead with such damaging proposals when they have been so resoundingly rejected by the overwhelming majority of staff involved in the front line of patient care? The only people who seem to support opting out are a few pen-pushing bureaucrats with no first-hand experience of patient care.
§ Mr. Clarke
Scotland has a fully devolved system of Government and that is a responsibility of my right hon. and learned Friend the Secretary of State for Scotland.[Interruption.] The Under-Secretary of State for Scotland, my hon. Friend the Member for Stirling (Mr. Forsyth), is present and if it were in order I am sure that he would reply in connection with the hospital to which the hon. Gentleman referred.
I am familiar with other ballots that were organised in several English hospitals for which I am responsible. On the whole, at this stage, they are something of a waste of time. What usually happens is that the local council, the Labour party or the trade unions begin by giving a preposterous description of the proposals to the staff and then take a ballot in which the staff say they do not like that rather unpleasant description of the proposals. When we have proper applications for self governing status as hospital trusts, which I shall receive and welcome after the House has given assent to the necessary legislation next summer, there will be full public consultation about what is proposed for the hospital and the improvements in the services that the hospital can offer to the patients as a result of self government. At the moment, the political ballots are distracting attention from the real work of getting ahead with the preparations.
§ Mr. Pawsey
May I offer my right hon. and learned Friend my thanks for two things? [HON. MEMBERS: "Too many."] There would be more—
§ Mr. Pawsey
First, I thank my right hon. and learned Friend for approving additional consultants for the Rugby health authority and for giving the green light for self-governing status for St. Cross hospital. Does he accept that both those things are warmly welcomed and will do much to improve the quality of health care in the Rugby area?
§ Mr. Clarke
I am grateful to my hon. Friend. I think that when people encounter what is happening to the Health Service nowadays they feel similar reactions to the new units opening across the country and to the expansion of patient services that is taking place. I contrast my hon. Friend's question with questions asked by Opposition Members who represent districts that have had huge increases of resources for their hospitals and huge increases in the number of patients treated yet who continue to raise obscure points which they claim show that the service is going into reverse.
§ Ms. Harman
If the right hon. and learned Gentleman believes that opting out is in the patients' interest and that patients should have a choice, why, as Secretary of State, has he not arranged that in each of the 79 areas patients 824 should have a say through a ballot? Has he made arrangements for them to have a say in any of the 79 areas that are applying to opt out?
§ Mr. Clarke
I have repeatedly explained that we have no applications and we shall have no applications until the summer of next year. When the applications come in they will be worked up with details of what is proposed and the plans for the development of service that the sponsors propose. I have always said—indeed, the White Paper says—that at that stage there will be full public consultation. At the moment all that is being arranged is absurd political propaganda by the Labour party followed by local ballots asking selective and tendentious questions. There will be more serious public consultation when the applications come in.