HC Deb 26 April 1994 vol 242 cc90-1
4. Ms Quin

To ask the Secretary of State for Health what new proposals she has regarding the public accountability of NHS trusts.

Mrs. Virginia Bottomley

National health service trusts are fully accountable to me, through the NHS executive, for the delivery of health care and for the effective use of resources available to them. The new codes of conduct and accountability that I shall publish on 28 April will further strengthen trusts' accountability both to me and to the public. The codes will keep public service values at the heart of the operation and management of the NHS.

Ms Quin

Will the new rules allow community health councils to be represented on trust boards? Can the Secretary of State explain why my local community health council in Gateshead has for two years been denied access to the NHS trust and has even been denied observer status? Does she agree that that contradicts any idea of proper public accountability?

Mrs. Bottomley

I regret that the hon. Lady's community health council is perpetuating a party political vendetta against the establishment of the trust in the hon. Lady's constituency, which is performing outstandingly, with some of the best out-patient waiting times and patients charter achievements. The hon. Lady's community health council has been offered a great number of arrangements short of actually becoming a member of the trust board: it has been offered a meeting in the autumn to discuss the year ahead; it is invited to a further meeting in the spring to finalise plans in detail, to a meeting in the summer to review progress and to bi-monthly meetings with the chairman and the chief executive, quite apart from other visiting rights. It is time for it to forget the past and work for the future.

Madam Speaker

Mr. Nicholas Winterton.

Hon. Members

Wake up.

Mr. Nicholas Winterton

I am sorry, Madam Speaker, but there is another Winterton in the House and I misheard.

I accept what my right hon. Friend the Secretary of State has said—that the public accountability of NHS trusts is adequate and satisfactory—but does not she accept that the real problem lies with district health authorities, which are not in any way accountable to the public? They force policies upon the trusts which, in many cases, are unwilling to accept them because the DHAs are not accountable to the public in the same way as the trusts.

Mrs. Bottomley

The task for district health authorities is to ensure that they communicate effectively with local people. They have to assess need and set priorities, and it is important that they work closely with local authorities and Members of Parliament and with all those in the community who feel strongly about the delivery of health care. The distinction between the purchaser and the provider is now well established and, thankfully, is the subject of agreement on both sides of the House.

Mr. Blunkett

How are we to hold the Secretary of State to account when she has every intention of bailing out of her present job? Which of the shambolic changes with which she has been associated over the past four and a half years has contributed most to her decision to go?

Mrs. Bottomley

I have a great sense of achievement. Beyond our expectations, we now have 419 NHS trusts and 1 million more patients are now treated than were treated before the NHS reforms. Child immunisation is up to 90 per cent. and 80 per cent. of out-patients and people at A and E departments are being seen within half an hour. Those were all targets that we set the health service; we are delivering them effectively and I want us to do even better. I ask the Labour party why the hon. Gentleman feels unable to speak on London health services in the debate that is to be held this week. That is the question that we want answered.

Mr. Rowe

Does my right hon. Friend agree that what the public really want to know about national health service trusts is how well they are doing, and will she make absolutely certain that she encourages them to publish the good news, such as the £45 million investment in the Medway trust and the state-of-the-art oncology unit in the Maidstone trust?

Mrs. Bottomley

There has been a transformation in the amount of information available about how hospitals work —an annual report, an annual meeting, accounts that have to be audited and the business plan—quite apart from the codes of conduct and accountability that I am announcing today. My hon. Friend rightly refers to his own trust, but almost every trust in the country has seen great progress. Trusts are better for staff and patients.