§ 11. Dr. Andrew Murrison (Westbury)If he will make a statement on his plans for expanding the role played by private health care providers in the NHS. [19665]
§ The Secretary of State for Health (Mr. Alan Milburn)Next year, the national health service is expected to double the number of operations carried out in the private sector on NHS patients.
§ Dr. MurrisonI thank the Secretary of State for that reply. Last year, NHS Estates and the Community Hospitals Association began work on a joint investigation 711 styled "Models of Ownership for Community Hospitals". Will the right hon. Gentleman comment on that work and will he undertake to put it in the public domain?
§ Mr. MilburnI am not aware of the particular report or research that the hon. Gentleman mentions, but I shall be happy to examine it if he would care to send me the details.
On community hospitals and community ownership, it is important that, as we move towards a more decentralised and more devolved NHS, we strengthen the relationships between local communities and the local hospitals and the local health service that are there to serve.
§ Dr. Phyllis Starkey (Milton Keynes, South-West)My patients who have been treated for cataracts on the NHS but in a local private clinic are grateful that that capacity has been used. However, there are concerns about potential conflicts of interest arising when consultants operate in one place on both private sector and NHS patients and when consultants refer patients to one sector or the other. Will the Secretary of State assure me that such conflicts of interest will be investigated and that they will not be allowed to arise?
§ Mr. MilburnIf my hon. Friend's constituents have raised specific concerns, I shall be very happy to consider them. It is important that such conflicts of interest do not arise and that the appropriate safeguards are in place. However, if we can use the additional spare capacity available in private sector hospitals for the benefit of NHS patients—whether to provide cataract or cardiac operations—it is sensible to take the position that that is precisely what we should do provided that safeguards are in place, that we have the appropriate clinical standards and and that we obtain good value for money for the taxpayer.
§ Dr. Julian Lewis (New Forest, East)Given that the BUPA hospital in Redhill is negotiating with the NHS to set up a dedicated surgical centre to provide for an anticipated 5,000 hip and knee replacement operations, will the Secretary of State tell us whether the medical staff carrying out those operations will be employed by BUPA or by the NHS?
§ Mr. MilburnI think that the hon. Gentleman will be aware that negotiations are currently taking place and that they are going extremely well. I hope that we can resolve them satisfactorily from both points of view before too long. The arrangement that we have in mind is for BUPA to continue to employ its own staff. It may have a limited number of medical staff on its books and it will certainly have some nursing staff. The intention is for NHS doctors, nurses and other staff to work in the current private hospital on NHS terms and conditions, but they will be managed by BUPA.
Today, the hospital almost exclusively treats patients according to their ability to pay. If negotiations go well, in a year's time, it will be exclusively treating patients, not according to the size of their wallets, but according to the scale of their needs.
§ Mrs. Gwyneth Dunwoody (Crewe and Nantwich)Will the Secretary of State set in place a monitoring system that will ensure that the patients treated in the 712 private sector receive clinical care of a standard that they expect at the time of their operations? Many of them are subsequently readmitted to NHS hospital beds thus costing the service a great deal of money.
§ Mr. MilburnWe will continue to monitor all those issues. As I said, it is important that both patients and taxpayers receive a good deal. I can give my hon. Friend the assurance that not only will we seek to drive a good financial bargain for the taxpayer but, even more important, we shall want to ensure that, if people are treated in a private hospital or a NHS hospital, they will be provided with the highest clinical standards possible.
§ Dr. Liam Fox (Woodspring)It is only a matter of weeks since the Secretary of State told us at Health questions that, by and large, in our country
we thankfully have one monopoly provider and that is the NHS. As a long as a Labour Government are in power that will remain the position."—[Official Report, 26 June 2001; Vol. 370, c. 500.]Given that, this week, he does not want a monopoly NHS and that he has been specific about doubling the number of operations carried out for the NHS in the private sector, will he tell us how much that will cost? What will he say to the patients who, for the past five years, have therefore needlessly be denied wider access to care because of his pointless dogma?
§ Mr. MilburnIn terms of cost, the hon. Gentleman is well aware that I told the Select Committee on Health about a month ago that we would make about £40 million available precisely to fund more operations, using the spare capacity of private sector hospitals to treat NHS patients. That is double the level provided last year. If local primary care trusts want to contract for more operations from private sector providers, that is a matter for them. The great divide between the Labour party and the Conservative party is not whether the NHS patient is treated in an NHS hospital or a private sector hospital; it is whether we provide them with more choices, which is what we want to do, or impose more charges on them, which is what the hon. Gentleman wants to do.
§ Dr. FoxThe great division is not between our parties; it is between members of the Government. The Secretary of State said that he wanted a hypothecated health tax, and the Chancellor said no way. The Prime Minister wanted European Union spending levels, and the Chancellor said forget it. The Secretary of State wanted an NHS monopoly, the Prime Minister wanted no barriers to delivery, but the Chancellor simply wants to get closer to Downing street. When the Secretary of State is not consulted about announcements and called useless and sidelined, who in the Government—if anyone—is making health policy?
§ Mr. MilburnI am not sure how the hon. Gentleman's question is relevant to use of the private sector. If we can take advantage of spare private sector capacity in BUPA hospitals, General Healthcare Group hospitals and BMI Healthcare hospitals for the benefit of NHS patients, that is precisely what we will do. At the same time, we will continue to invest extra resources in NHS hospitals. The great divide is between the Labour Government saying that there should be more investment and the hon. Gentleman's party saying that there should be less.