HC Deb 10 June 1991 vol 192 cc585-7
3. Mr. Alan W. Williams

To ask the Secretary of State for Wales if he will make a statement on the progress of applications from those hospitals in Wales which have made approaches to the Welsh Office demonstrating their interest in acquiring trust status.

4. Mr. Hind

To ask the Secretary of State for Wales how many applications and expressions of interest in national health service trust status he has received; and if he will make a statement.

8. Mr. Grist

To ask the Secretary of State for Wales what representations he has had for hospitals in Wales to apply for trust status.

Mr. Nicholas Bennett

To date, only Pembrokeshire district health authority has submitted an expression of interest and made clear its intention to apply to become a trust on 1 April 1992.

Mr. Alan W. Williams

Has the Minister—evidently he has not—learnt the lessons of the Monmouth by-election which are that the people of Wales do not want hospitals to opt out and that they do not want market forces introduced into and the creeping privatisation of the health service? Has the Minister thought about those issues? If so, will he put a halt to his programme of hospitals opting out?

Mr. Bennett

It is clear that the hon. Gentleman has not learnt the lesson of the Monmouth by-election—that one cannot continue to retell untrue stories to the people of Wales. No hospital in Wales may opt out of the national health service. They all remain national health service hospitals, free at the point of delivery and generally paid for out of taxation.

Mr. Rowlands


Mr. Bennett

The hon. Gentleman says "generally", but, of course, NHS hospitals already charge for some services, for example, prescriptions. That has always been the case. The new scheme of national health service trust hospitals will provide greater independence and flexibility for hospitals in Wales and it should be welcomed. I shall welcome any applications for trust status that may be made.

Mr. Hind

Does my hon. Friend agree that the Welsh people should not be frightened by the untruths and lies about national health service trusts which were pumped out during the Monmouth by-election? Does he agree that much of the Opposition's criticism about the trusts has related to the centre of London, which as we all know, is over-provided with hospital facilities and cannot be regarded as a measure for the rest of the country? Inevitably, when the internal market was applied, district health managers realised that they could provide the same services in the local district general hospital without sending their patients to London and they realised that the service could be provided more cheaply, more efficiently and free at the point of delivery in a hospital run by their own staff.

Mr. Bennett

As usual, my hon. Friend puts his finger right on the central point of the argument. It is true that London has special problems as a result of the over-provision of teaching hospitals. I recall that in 1977 the Labour party introduced a reallocation of resources working party to move resources from London to the regions and to hospitals such as those in Wales. I congratulate my hon. Friend on recognising that important point.

Mr. Grist

Is my hon. Friend aware that the hon. Member for Alyn and Deeside (Mr. Jones) is reported as going round Wales trying to scare electors into misunderstanding the nature of hospital trusts? Does my hon. Friend think either that the hon. Gentleman is plain ignorant of what the trusts involve or that he is grubbing round for the most disreputable sort of electoral support?

Mr. Bennett

I hope that it is the former, but I have my suspicions. The Labour party's attitude is also based on trying to scare people into believing that national health service hospitals will be privatised. It is clear that that is not true. All the hospitals in England that have become NHS trusts are national health service hospitals, free to the patient and paid for out of the generality of taxation.

Mr. Ieuan Wyn Jones

In a vast geographical area such as north Wales where there are only three district general hospitals, is not the concept of choice of hospital almost meaningless? As the Government's plans for trusts are based on the claim that they provide a choice for the patient, is not that another example of the Government's flight from reality in Wales? The plans should be abandonded. They are a waste of everybody's time and money.

Mr. Bennett

The hon. Gentleman is wrong. Patients in north Wales choose between the different hospitals already available—I hope to see an increase in patient movements between different hospitals. They also use hospitals in Cardiff and different regional treatment centres. Patients already go further afield if they want specialist treatment. I want the internal market in the health service to operate as quickly and effectively as possible. If one has such a market, competition, choice and a better quality of service result. That is the lesson that we have learnt from many years of studying free enterprise industries as opposed to nationalised industries.

Mr. Edwards

Will the Minister agree to meet the hospital consultants at Nevill Hall who, last week, expressed their deep anxiety about the whole concept of trust status? They believe that the principles of the NHS are being violated as a result of the policy.

Mr. Bennett

The hon. Gentleman is simply wrong. I met the consultants of that hospital on 15 May and was able to reassure many of them about the basic principles of the scheme. It is for the health authority and the unit general manager to discuss with and explain to those consultants the principles behind the reforms. If Nevill Hall chooses to take the trust option it will remain an NHS hospital. If the hon. Member for Merthyr Tydfil and Rhymney (Mr. Rowlands) does not understand the difference between what happened under the nationalised industries, which provided poor service—

Mr. Rowlands

Free enterprise is privatisation.

Mr. Bennett

One should study that analogy in terms of the quality of service provided under free enterprise. Within the state-owned NHS I want the same quality of service as that provided by free enterprise companies.

Mr. Michael

Given the nonsense that has been spouted at the Dispatch Box by the Minister, does he accept that the people of Wales are right to be frightened at having him as the Minister responsible for health? If the Minister will not listen to the fair criticism that the Labour party has made of his daft idea of hospital trusts and if he will not accept the truth from us—it has been given to him unstintingly—he should heed the advice offered by the South Wales Argus. Before the Monmouth campaign that paper said: This thinly-disguised policy of putting cash before patients is already starting to make political waves and we predict that the storm is still brewing. Does he accept that that storm is still in its early days? Does he accept that that storm and the people's dislike of the opt-out policy, which he is encouraging in Wales, will sweep him and his Government from power?

Mr. Bennett

The hon. Gentleman continues to try to misrepresent to the people of Wales the reality of the facts. No hospital will opt out of the NHS—it cannot under the Act of Parliament under which NHS trusts were established. The only money that will move around is that attached to the patient. It will be patient demand, supported by that from his doctor, which in future will ensure that we get the best quality of service—not decisions taken by management, as in the past. The money will follow the patient and that is how it should be.