HC Deb 24 February 1998 vol 307 cc159-61
5. Ms McCafferty

What new statutory duties he intends to introduce in the NHS relating to partnership. [29317]

Mr. Dobson

The previous Government's policy set doctor competing against doctor and hospital competing against hospital. We believe that that was wasteful and bad for patients, and so do most of the 1 million people who work in the health service. It is better for patients when all parts of the health service work together instead of working against one another. That is why we intend to make partnership the statutory duty of every part of the national health service.

Ms McCafferty

In a modern and dependable health service, should not everyone work together and learn from each other? Is he aware that, in one hospital, nurses were warned against disclosing information relating to improvements in treatment, because it might jeopardise the hospital's competitive edge? Does that not sum up the gulf between the Government's new agenda for health and the tired old dogma of the Tories?

Mr. Dobson

I can confirm what my hon. Friend has said. When I had the privilege of presenting awards to nurses for nursing innovation, a number of the teams which won the awards told me that their local managements had instructed them not to disclose innovations because that might undermine the competitive edge of their hospital, as against the one down the road. When I informed the former president of the Royal College of Surgeons, he said that people performing cardiac surgery had been given the same message by some stupid managements.

Mr. Simon Hughes

What partnership deal will the Secretary of State offer the additional 54,700 people who joined the waiting lists in the last quarter, and the 1.25 million who are now on waiting lists for NHS treatment? Given that the Government started with a patients charter that still is not honoured—not everyone is receiving treatment within 18 months—and given that the early pledge to reduce waiting lists by 100,000 has turned into an early policy to increase them by 100,000, is not the only way forward to impose a statutory duty on the Secretary of State to reduce waiting lists? That might allow him to go to the Chancellor of the Exchequer to get the money to bring down waiting lists—not just to reduce them by 100,000, which is almost nothing, but to make a radical reduction in the number of people out there who are waiting for treatment in the NHS.

Mr. Dobson

As I have made clear in the House many times since we took office, I told people working in the national health service that their first priority for this winter was to work together to use the extra money that we were finding to cope with the winter pressures. If that had consequences for waiting lists, I should take responsibility for giving the guidance. I do take that responsibility; equally, I am sure that we shall discharge our promise to reduce hospital waiting lists, before the next general election, to a level lower than those that we inherited.

When it comes to money, this year and next year we are spending far more than the Liberals said was needed at the last general election.

Ms Hewitt

May I draw my right hon. Friend's attention to the excellent bid for health action zone status submitted by the city of Leicester? Will he take this opportunity to congratulate the partnership that has been established by Leicestershire health authority, Leicester city council, community groups and, more recently, private business—not only on the quality of their bid, but on the progress that they have already made towards improving primary health care in very disadvantaged communities?

Mr. Dobson

As my hon. Friend will know, we have received a good many bids for action zone status, and we shall be able to organise only about 10 or a dozen pilot schemes, so I cannot give any promises at the Dispatch Box. I believe that the Minister of State, my hon. Friend the Member for Darlington (Mr. Milburn), is meeting Leicestershire Members later today to discuss various matters. I certainly congratulate people working in the health service in Leicester, both in the hospital sector and in the primary community and mental health services, on the massive contribution that they have been making and on the way in which they have been working together. That should be an example to everyone.

Mr. Nicholls

Does the Secretary of State not realise that the existing successful partnerships on which the White Paper sought to build—fundholding practices—are successful precisely because they are voluntary? Is that not why the British Medical Association poll of general practitioners showed that less than one third believed that the changes that are outlined in the White Paper would improve the delivery of primary care, while more than half said that they would not be willing to take part in a local primary care group? Unless the right hon. Gentleman believes that shotgun marriages are the way to wedded bliss, what possible sense is there in dragooning MPs into partnerships that they have not been prepared to form voluntarily?

Mr. Dobson

I suspect that the hon. Gentleman is talking about GPs rather than MPs. Frankly, I am not sure that the lot opposite would qualify even as dragoons, but we have made our position clear. We have consulted the various professions and our proposals broadly command their support. Before we implement the changes, we are consulting further on the detail, but it is entirely indicative that the Tory Front-Bench team are harking back to yesteryear. The divisions that they deliberately introduced between fundholding GPs, other GPs and hospital doctors are the way of the past; we propose a way for the future.

Mr. Blizzard

Are not community health councils important partners in the NHS? Will my right hon. Friend confirm that they will continue to have a key role in the health service, as mapped out in the White Paper? Is not the great strength of CHCs their ability to relate to the communities that they serve; they do not have to serve vast geographical areas? Will he confirm that that will continue? Does he expect primary care commissioning groups to work closely with CHCs?

Mr. Dobson

I expect everybody to work closely with community health councils. On size, it varies from place to place. For example, Leeds, which will have the biggest health trust in the country when it is amalgamated, is covered by just one CHC. For some strange reason, the Leeds-wide community health council did not want the two trusts to merge so that it had a Leeds-wide trust. I am not quite sure whether I follow its logic, hut we value CHCs' work. As some sign of that, I believe that my visit to their annual conference last year was the first for more than a decade by a Secretary of State for Health.