§ 7. Sir Hector Monro
To ask the Secretary of State for Scotland what initiatives are planned to improve patient care in the national health service in Scotland.
§ Mr. Michael Forsyth
New initiatives such as heart-lung transplant surgery, the helicopter ambulance service, the provision of nuclear magnetic resonance scanners and the introduction of a cochlear implant service are some of the examples of innovation in the health service to build on the Government's outstanding record.
§ Sir Hector Monro
Does my hon. Friend agree that the substantial extra funding awarded to the Dumfries and Galloway area health board will enable it to improve patient care substantially in the coming year? Will he congratulate the board—and, in particular, Dr. Christopher Isles—on the introduction of a new renal dialysis unit in Dumfries, which will benefit local patients enormously?
§ Mr. Forsyth
I agree with my hon. Friend and pay tribute to the work being done by the board. I had the opportunity to meet some of its staff recently. My hon. Friend is right to highlight the progress being made in bringing kidney dialysis to patients in rural areas. That is part of a general policy that has been implemented in the Borders, preventing patients from having to travel long distances.
When we conducted a survey of patient satisfaction a couple of years ago, the Dumfries and Galloway health board emerged with one of the highest scores. I am sure that that is because management, doctors and staff are so committed to its purpose, which is to improve patient care.
Mr. Robert Hughes
I welcome the medical innovations described by the Minister, but why is he putting all that at risk by persisting with the completely discredited policy of allowing hospitals to opt into the NHS trust system? Will not the finances of trusts effectively be controlled from the centre? Their only freedom will be to seek permission to spend money from the Scottish Office, rather than deal with the matter locally through the health boards. Why, despite the widespread and total rejection of the scheme, do the Minister and the Government persist in acting against medical and public opinion?
§ Mr. Forsyth
Every time the hon. Gentleman says that there is no interest in the scheme, we seem to receive another application. Six hospitals throughout Scotland have now expressed interest. The proposal for Forresterhill in Aberdeen has come from consultants and management, because they believe that it will result in improved patient care. Once the Scottish Office has received a proposal, my right hon. Friend the Secretary of State will examine it and decide whether to give it the go-ahead on the basis of whether it will improve patient care.
The hon. Gentleman is quite wrong about the ability of hospitals to spend money without Scottish Office approval. The whole point of self-governing hospitals in the NHS trust system is that they will be free to make decisions at local level that would otherwise have been made over their heads. I am sorry that the hon. Gentleman is so opposed to the idea of giving local communities a chance to run and manage their hospitals.
§ Sir Michael McNair-Wilson
I welcome any news from my hon. Friend about the extension of dialysis treatment for kidney patients. Is he aware, however, that a kidney patient on dialysis who is given erythropoetin will become almost as well as a normal man? Can he assure me that Scotland has enough funds to provide that drug for every renal patient who could benefit from it?
§ Mr. Forsyth
I know my hon. Friend's interest in the matter and I am happy to give him the assurance that he seeks. Notwithstanding reports that have appeared in some sections of the media, the position is clear: if a consultant believes that the drug should be prescribed, it should be prescribed, and the resources must be found to pay for it. I have corresponded with the hon. Member for Dundee, West (Mr. Ross) about this, and the position is on record.
§ Mr. Galbraith
Was not the Minister entirely wrong to say that expressions of interest in trust status are coming from hospitals? In fact, they are coming from a small clique within those hospitals. Has the Minister not read what was said recently by John Cooper, chief executive of the Royal Free hospital, an opting-out hospital, in London? He said:All elements of financial management are being effectively controlled centrally. The only freedom we have is freedom to ask permission, and we can do that already.Opting-out hospitals are run not by the health boards but by accountants in the Scottish Office.
§ Mr. Forsyth
I am interested by the implication of the hon. Gentleman's question. I take it that, if self-governing status indeed means that decisions are made at local level, the hon. Gentleman will support it. I am happy to assure him that there is no question of self-governing hospitals' 273 being managed centrally. The whole point is that they will have contracts with the health boards and will remain a part of the NHS, and that doctors and management will have an opportunity to run them locally. What I said earlier was that the proposals for NHS trusts were coming from doctors and management who believed that it would improve patient care. I believe that those proposals should be evaluated on the basis of their merits, not on the basis of Labour party dogma.