§ Miss Hoey
As the Secretary of State's attempts to use cuts to persuade hospitals to opt out were repudiated by 80 per cent. of the staff at St. Thomas's voting against opting out last week, will he take immediate steps to reverse the underfunding of West Lambeth health authority? Is he aware that next week it will be taking decisions to cut another 160 beds, to cut out-patient services and to cut the number of people who can use the accident service? Is he further aware of the strong feeling on the matter, and will he assure the House that St. Thomas's will be taken off the list of hospitals that can opt out—[HON. MEMBERS: "Too long."]—and ensure that it is not allowed to wither away from being a fine hospital?
§ Mr. Clarke
That question started on a rather extraordinary premise, and I am afraid that the end of it was almost inaudible. There is no question of cuts in West Lambeth health authority. Its funding increased by 7 per cent. in real terms this year and it is treating the planned number of patients. Most people attribute its difficulties to financial mismanagement. Indeed, I have seen letters from the hon. Lady complaining about the position in West Lambeth, in which she mentioned financial mismanagement, which no doubt is why she welcomes the fact that the regional health authority has asked John Barnes to study it. No one has made an application for self-governing status, but there will be full public consultation if St. Thomas's makes such an application. We shall then consider the proposals for patient services and for better financial management.
§ Mr. Bowis
We have the highest regard for people working in the Health Service, but does my right hon. and 996 learned Friend agree that the purpose of hospitals is to benefit patients, not staff? Does my right hon. and learned Friend agree that where a hospital trust is established, it will be because the flexibility and autonomy of such a trust will be in the interests of patients?
§ Mr. Clarke
I agree with my hon. Friend. Only one judgment should be made on an application for NHS trust status—whether the application is in the interests of the hospital unit, particularly the interests of the patients and the population whom it serves. Staff views are extremely relevant and cannot be disregarded, but the proper way to test those views is to consult staff and the general public when there is a formal proposition. The ballots that are being held about propositions that are not yet forthcoming are somewhat pointless.
§ Mr. Robin Cook
Why does not the Secretary of State admit that he cannot sell the idea that their hospitals should go it alone? Is not he aware that it is not just West Lambeth, but there have now been dozens of ballots of staff and of patients, and that he has not won a single one? Is he aware that the average "No" vote across the London hospitals is 89 per cent? Is it not time that he paused to reflect that it is just possible that nine out of 10 people who work in the Health Service are right and that it is just possible that he might be wrong? Why, therefore, does he not now—[HON. MEMBERS: "Ask a question."] I am asking a question. If hon. Members will wait, I shall ask the question and I should prefer it if the Secretary of State would answer. Is it not time that the Secretary of State dropped his deeply unpopular proposal to make hospitals opt out, which the next Labour Government will reverse?
§ Mr. Clarke
The hon. Gentleman is a bit stuck to find anything to say about National Health Service policy as he has no policy of his own and he is rather repeating his comments last week about our policies at great length. The fact is that we do not yet have any propositions for self-governing hospitals and NHS trusts. When we accept firm applications, we shall have proper public consultations, setting out the pros and cons for patient services, for staff interests and for everything else. There have been places where the staff have voted in favour of being interested in self-governing status, but sensible judgments can be made only after proper public consultation on a serious proposition. For the hon. Gentleman to run ballots or to start saying that he will repeal all my proposals—because after two years he still cannot think of any of his own—is not, at this stage, to make a sensible contribution to events.
§ Mr. Speaker
I again appeal to the House to ask single questions. We then get briefer answers and proceed with greater speed down the Order Paper.