National Health Service Hospitals (Opting Out) (Hansard, 21 March 1990)

§ Mr. Martin Redmond (Don Valley)

I beg to move, That leave be given to bring in a Bill to provide that a referendum shall be held in a health authority area on any proposal that a hospital in that area should opt out of the National Health Service. The Government are steering through Parliament a Bill that will bring fundamental change to the National Health Service in Britain—a Bill for which they have no mandate. Not least of the changes is that hospitals—indeed, whole health authorities—will be allowed, even encouraged, to opt out of local NHS control and assume self-governing status. This is an example of the Government's blind commitment to the market and to competition, regardless of how unsuitable or inapplicable the free market in health care may be.

I call on the House to support my proposal for a referendum to be held in all areas where there have been expressions of interest in opting out. If the result should be against opting out, the wishes of the local community and staff should be heeded, and expressions of interest withdrawn.

Hon. and right hon. Members will be aware already of the grave misgivings of the medical profession about the changes and about the consequences that they will have for national health care provision in Britain. These misgivings, among the medical and nursing professions, among Health Service ancillary staff and among patients and the general public have manifested themselves as outright opposition to the Government's proposals for opting out.

Opposition has been expressed by members of local health authorities. Indeed, in my part of the world—Don Valley—health authority members have voted against expressions in favour of opting out from managers at Doncaster royal infirmary and Mexborough Montagu hospital. Despite this, the unit managers insist on going ahead with their plans. They have no plans to ask the people of Doncaster or NHS staff what they think.

Plans for opting out are not opposed just by health authority members. Doncaster metropolitan borough council commissioned a MORI poll of the town to test public opinion. I have the results here. On the question of opting out, 68 per cent. were strongly opposed, and only 4 per cent. showed strong support. It is worthy of note that opposition was strongest among the users of the local hospitals, among the less well-off and among the elderly. They know, as Opposition Members know, that they will be the ones who lose as a result of this headlong rush into commercialised health care.

I do not wish to give the impression that Doncaster is isolated in its opposition. That would be far from true. We have ample evidence from around the country that there is strong opposition to the plans for the future of the National Health Service, in particular to the opt-out proposals. I use advisedly the phrase "the future of the National Health Service". Some would argue that, in the face of the National Health Service and Community Care Bill, the very future of the National Health Service, free at the point of need and funded from general taxation, is questionable.

Unlike the Labour Government of 1945, who brought the NHS into being and who had a mandate from the 1122 electorate to do so, this Government have no mandate for the introduction of opted-out hospitals. Nowhere in the Conservative party's election manifesto were these changes mentioned. Nowhere have the Government tested public opinion. Nowhere have we seen overwhelming support for their proposals. What we have seen is concerted opposition to opting out from all sectors of the community and from all sectors of National Health Service staff, with the notable exception of the unit and district general managers who are on short-term, performance-related contracts.

Even among the latter group there have been instances where managers have abided by the wishes of their local health authority members and ceased work on the preparations for opting out. Throughout the country, the views of health authority members, community health councils, staff, patients and the public are being ignored—not by accident or omission but by deliberate policy.

The Secretary of State for Health apparently believes that those who oppose the Government's plans are mistaken. If he thinks that he can dismiss the views of medical staff, patients and the public, and if he thinks that he can continue to denigrate their views and opinions, it is he who is mistaken. There is strong and widespread opposition to the Government's opt-out plans. I have evidence of ballots of staff and local communities who time and again have rejected the introduction of competition into health care provision.

I shall identify just a few examples. In North Tyneside, where the whole health authority expressed an interest in opting out, 97 per cent. were against; in Reddish, 81 per cent. were against; in York district hospital, 91 per cent. were against; in Plymouth health authority, 75 per cent. of the consultants were against. I could go on. The House knows, and the Minister knows, that there are many such examples.

It is interesting for the House to note that, out of a staff of 3,500 balloted in North Tyneside, 2,500 returned their ballot papers. Even if all those unreturned ballot papers were counted as votes in favour of opting out, the result would still show a majority against. Even using the Government's own peculiar criteria for ballots, as demonstrated by the housing action trust ballots, the result is still the same—opposition.

I know that the Secretary of State and his supporters will dismiss the ballot results as meaningless. It has been said that the question asked determines the answer. I challenge the Secretary of State to frame a question that will not elicit an overwhelming majority against the opt-out proposals. I strongly support the statements made in Committee by my hon. Friend the Member for Peckham (Ms. Harman) that the questions are not biased and that public opinion is against the Bill.

The Government maintain that the proposed changes to the fabric of the National Health Service will increase patient choice. We hear a great deal about choice. Working papers on the National Health Service and Community Care Bill point that there should be consultation before any self-governing trust is formed. This consultation will, however, be limited.

I urge hon. Members to support my proposals for local referendums. Some would say that they are modest. I know that several local authorities have called for a national referendum on the Government's proposals. The idea is not new, nor is it unusual. We have had a 1123 referendum in this country before, and it is common in other European countries to hold a referendum on a specific issue.

The Government have stated that they are committed to the development of decision making in the National Health Service. They want to make hospitals more responsive to local needs. Surely the logical step would be to elicit the views of those most directly involved—the staff, the patients and the community. I urge hon. Members of all parties to support my proposals for local referendums to allow British people to choose whether their local hospitals should be allowed to become self-governing trusts, to decide about competition in health care and opting out of local health authority control and to withdraw expressions of interest when the people have said quite clearly, "We are not interested in opting out." I move my Bill for the sake of democracy.