NHS Trusts (Hansard, 16 April 1991)

§ 7. Mr. Ground
To ask the Secretary of State for Health what progress has been made with NHS trusts since 1 April.

§ Mr. Waldegrave
A total of 57 hospitals and other units became fully operational NHS trusts on 1 April. A further 130 hospitals and units have expressed an interest in becoming trusts by April 1992.

§ Mr. Ground
Does my right hon. Friend agree that threats to the career prospects of national health service managers who recommend trust status for their hospitals represent an unacceptable threat to the independence of those managers and should be condemned whenever they are made? Does my right hon. Friend have an example of such threats in the form of a letter written to the manager of the Walsgrave hospital in Coventry by two Labour Members?

§ Mr. Waldegrave
I am sorry to say that such a letter was written. I am happy to say that, when I drew it to the attention of the Leader of the Opposition, he immediately repudiated the views of the two Coventry Members concerned. The hon. Member for Livingston (Mr. Cook) has, however, made similar threats himself. He owes the House an endorsement of the repudiation of the views of the hon. Members concerned and the withdrawal of his own threats, made last year, about the renewal of contracts after an election.

§ Mr. Nellist
If the Secretary of State wishes to make light of the matter, let me tell him that this is just one example of how deep anger already runs in Coventry among thousands of people who are not prepared to allow the hospital to be taken, over their heads, on the first step towards privatisation and got rid of. It is a publicly funded hospital, to provide whose equipment not a single family in Coventry has not bought a raffle ticket in the past 10 years.
If the concept of dismissal worries the Secretary of State so much, may I make him on offer? I will withdraw that word, and instead suggest to my hon. Friends on the Front Bench that, after the general election, we require everyone who runs a hospital in Britain to stand for election, so that the staff, the patients and the people of Coventry can sack him instead.

§ Mr. Waldegrave
The idea of elected brain surgeons is engaging.
I do not take the matter at all lightly; nor does the Leader of the Opposition, who, on the same day that I wrote to him, replied: I regard all such threats to be as meaningless as they are objectionable. Let me draw the attention of the hon. Member for Livingston to his own threat, when he warned managers that they should remember that their contracts would not be up for renewal until after the next general election.

§ Mr. Hayes
Never mind what the hon. Member for Coventry, South-East (Mr. Nellist) says, although his threats are bad enough. It is a different matter when the Opposition health spokesman threatens not to renew the contracts of managers who assist the Government's proposals.
Does my right hon. Friend agree with an editorial in the Health Service Journal, which is not exactly a hotbed of high Toryism? Let me paraphrase it—

§ Mr. Speaker
Order. The hon. Gentleman must paraphrase it.

§ Mr. Hayes
I will, Mr. Speaker. I would never quote directly. [Interruption.] I am going to paraphrase the article. Hon. Members are not listening. This is outrageous interference in NHS management".

§ Mr. Speaker
Order. That sounds like a quotation to me.

§ Mr. Waldegrave
The bellowing from below the Gangway represents the only support that the hon. Member for Coventry, South-East (Mr. Nellist) is receiving from his own side; he has been repudiated by his leaders. It is evidence of the weakness of Opposition Members' position. This is a serious matter. To threaten any public servants in such a way is no part of our traditions and should be repudiated by the House.

§ Mr. Beggs
When a local community is entirely opposed to a health board's proposals to downgrade the status of a local hospital, will that hospital still have the right to seek trust status?

§ Mr. Waldegrave
Yes. There is no reason why such a hospital should not make an application for trust status. It would be considered alongside all the other applications, according to the published criteria, but hospitals have a perfect right to seek such status.

§ Mr. John Greenway
Would not it be helpful if patients in any district hospital could be asked a question about the future of that hospital, free from the political interference by the Labour party and its attempts to dissuade them by perpetrating myths about my right hon. Friend's reforms? No hospital is being asked to opt out of the NHS. What is on the agenda is the prospect of more local control and accountability in the health service for the better delivery of patient care.

§ Mr. Waldegrave
My hon. Friend is entirely right. A general practitioner was quoted in The Guardian—not usually a supporter of my party—as saying that the current anger of people in the streets was directed at those who had scared them with stories about what the reforms meant, all of which have now turned out to be false.

§ Mr. Robin Cook
I fully associate myself with the repudiation by the leader of my party of the remarks made in relation to that hospital—

§ Mr. Andrew Mitchell
Do not be so nasty to the Coventry Members.

§ Mr. Cook
There was nothing nasty about the repudiation and I fully associate myself with it. I am also delighted to take this opportunity to reassure all national health service managers that there will be no problem over renewing the contracts of those managers who serve the next Labour Government as loyally as they have served this Government.
However, the Secretary of State's claims about the accountability of these trusts would be more credible had he not stuffed their boards with people who know little about the national health service and who represent no one in the local community. How does he justify the fact that he has appointed a majority of business men to those trusts and that the largest business interest is property development? Although managers will be safe from action by us after the next election, does the Secretary of State accept that we shall replace those people who were appointed as members of trust boards and health authorities with people who live in the area, who use the health service and who are committed to restoring it as a public service?

§ Mr. Waldegrave
I think I hear the hon. Gentleman repudiating his own words, which it is right that he should do. He threatened managers' contracts. The hon. Gentleman shakes his head, but he knows that he said that. It was reported at the time—[HON. MEMBERS: "What is wrong with that?"]—His hon. Friends ask what is wrong with that. That is the voice of the true Labour party. The hon. Gentleman also criticises the appointment of people with business experience to hospital management boards. This great public service can well use the experience of managers of other large organisations in order to deploy most effectively the skills of NHS professionals.