HC Deb 09 December 1997 vol 302 cc785-6
7. Mr. Tyler

If he has reached conclusions on the amalgamation of (a) health authorities and (b) trusts; and if he will make a statement. [18233]

Mr. Dobson

The Government have no national blueprint for mergers between health authorities or between NHS trusts. We would seek to encourage mergers of both where that is in the interests of health care in the localities concerned.

Mr. Tyler

I accept that the Secretary of State would not wish to impose amalgamations, but will he encourage amalgamations where small trusts are presently duplicating their administrative costs? If so, will he give some indication of how quickly he would expect savings to take place, especially bearing in mind his comments earlier when he referred to the need to expand front-line services and to encourage the creation and maintenance of local community hospitals? In Cornwall, as the Secretary of State knows, we are currently addressing that problem.

Mr. Dobson

I am a great believer in horses for courses. In many parts of the country, it is right to amalgamate smaller trusts—perhaps two or three smaller trusts or a couple of small trusts with a bigger trust—but in other parts of the country local people and clinicians and, for that matter the NHS regional management, are convinced that keeping some of the smaller trusts in existence may protect services that would otherwise not get the attention they deserve. When proposals come to me, I will assess them against the needs of the people in the area.

Mr. Nicholas Winterton

Does the Secretary of State accept that the East Cheshire NHS trust has been an outstanding success, not only because of its leadership and the superb support of the executive staff but because it is a united trust that deals with the range of NHS services, including acute services, community services and mental health services. That has been to the advantage of people in Macclesfield. I had a tremendous battle a few years ago to maintain a united trust against what was then the wisdom of separate trusts for virtually every arm of the health service.

Mr. Dobson

The hon. Gentleman reinforces the point that I wish to make. People in east Cheshire are obviously well suited by the present arrangements, but people in other parts of the country do not fancy that arrangement and I do not wish to force it down their throats. As for conventional wisdom, over the years I have observed that it may be conventional but it is seldom wisdom.

Mr. Gunnell

Is it not a bit much for the hon. Member for North Cornwall (Mr. Tyler) to whinge about the NHS when my right hon. Friend has provided £10 million extra for health services in Cornwall this year and next? My right hon. Friend knows of the excellent proposal for the merger of two trusts in Leeds, on which all the Members of Parliament for Leeds have been consulted. What criteria will he use to judge whether the merger should go ahead? I hope, however, that he will comment first on the whingeing by the hon. Member for North Cornwall.

Mr. Dobson

My hon. Friend has been in politics as long as I have and he knows that gratitude is the last thing to expect. Every time I come into the Chamber I expect Opposition Members to rise in grateful thanks for the extra funds that we have provided, but I am disappointed.

As a distant observer, I always thought that the merger of the two acute trusts in Leeds was a good idea and I was surprised that, when everyone in Leeds had agreed to it, my Conservative predecessor turned it down. I shall be not unfavourably disposed to the proposition when it comes forward again from the people of Leeds.