§ 4. David Taylor (North-West Leicestershire)What representations he has received on his proposals to involve the private sector in the management of NHS hospitals. [34703]
§ The Secretary of State for Health (Mr. Alan Milburn)I have received a number of representations, and announced earlier this month the establishment of a register of interested organisations and individuals who come from a wide variety of backgrounds and are capable of turning around performance in the small minority of the worst-performing local health services.
§ David TaylorIs not the theory that the private sector can successfully manage large acute NHS hospitals utterly perverse? Does my right hon. Friend understand why so 547 many Labour Back Benchers are deeply unhappy with his proposal to introduce commercial hit squads as an advance guard for covert privatisation? Does he agree that the real wreckers of the NHS are not the failed administrators but the cynical promoters of the private finance initiative and management madness of the sort announced in the House six weeks ago?
§ Mr. MilburnNo one on the Government Front Bench thinks that the private sector is a panacea for the problems in the NHS, but we intend to use it when it can bring expertise or resources to help improve services. My hon. Friend will be interested in the announcement that I made in early February about the first wave of so-called franchising. New management will be brought in to help turn around poor performance. I stress again that the people being brought in to help with the small minority of poorly performing trusts have some NHS experience. They have a track record of proven success in delivering improved NHS services.
I urge my hon. Friend to accept that we should not simply close our minds to the idea of harnessing managerial experience—as long as it is good and in keeping with the public service ethos—wherever we can obtain it. We do not have a monopoly of wisdom in the NHS. If we can get good managers from local government, the voluntary sector or even from parts of the private sector, we should use them.
§ Dr. Evan Harris (Oxford, West and Abingdon)Will the Secretary of State admit that he had no clinical outcome data to justify his labelling the hospitals as failing, and that the hospitals were not failing hospitals but scapegoat hospitals? On the day when the right hon. Gentleman announced the franchise plan, two hospitals that I visited—at Portsmouth, and Ashford and St. Peter's—were told that their performances merited two stars, even on the right hon. Gentleman's flawed performance indicators. Are not the hospitals involved facing problems of capacity owing to the scandal of bed blocking and nurse vacancies, which undermine capacity? Would it not be better for the Secretary of State to take expert advice to tackle the problems of capacity? If the private sector managers were from MFI and were able to bring beds with them they might be able to do some good—they will make no difference otherwise.
§ Mr. MilburnThe hon. Gentleman's jokes are about as good as his policy—
§ Dr. Liam Fox (Woodspring)Better.
§ Mr. MilburnThe hon. Gentleman says they are better. I have two things to say about different performance in the NHS. First, every patient knows that there are some first-class hospitals delivering high-quality services. Often, they stand cheek by jowl with other hospitals that are not capable of delivering the same quality, even though they are dealing with precisely the same problems with the labour market, deprivation, health and capacity. The fundamental difference between such hospitals is management organisation, although culture and attitude sometimes play a part.
If the hon. Member for Oxford, West and Abingdon (Dr. Harris) does not recognise that, he should listen to those Back-Bench Liberal Democrat Members who are 548 prepared to listen to that proposition. For example, the hon. Member for Yeovil (Mr. Laws), who is sitting behind the hon. Gentleman, said of his party's policies:
Many of our policies are out of date, a legacy of past commitments, endlessly carried forward year after year rather than representing the sort of priorities which we might arrive at logically.Indeed, the hon. Gentleman went on to say that Liberal policies were alienating key voters. I think that all hon. Members will express some sympathy for that opinion.
§ Dr. Howard Stoate (Dartford)My right hon. Friend the Secretary of State will be aware that the Darent Valley hospital in my constituency is one of those being franchised out. The interim management led by Sue Jennings are already making an appreciable difference to the way in which the hospital is run, and improvements are noticeable all around. Will my right hon. Friend tell the House how the franchising system is running, and whether he believes that the system will finally bring the problems in the Dartford and Gravesham acute trust to an end? Will we be able to look forward to stability and improving standards in the future?
§ Mr. MilburnI am grateful for the support that my hon. Friend has given, in pretty difficult circumstances, to that hospital and to social services in the Dartford and Gravesham area. Some very real problems exist. They are partially problems of capacity and cash, but as my hon. Friend and other clinicians in the local community have recognised, they are also problems of management and organisation. If we can bring in some new blood from elsewhere in the NHS, and use that expertise for the benefit of patients in the area, that would be a sensible thing to do. I hope that the new management team that we will bring in before too long will help to turn around the performance of what has been a difficult hospital to manage. Patients there have not always had the services that they need. My hon. Friend knows as well as I do that good leadership in a hospital, just like good leadership in a school, is crucial to that hospital or school's success. I hope that by bringing in some new leadership, we can make a difference.
§ Mr. Peter Lilley (Hitchin and Harpenden)Is the Secretary of State aware that people in my constituency do not care whether managers are private sector or public sector managers so long as they are competent? We are relieved and grateful that his Minister overruled the decision of local managers to close the maternity and children's units at Hemel Hempstead general hospital and decided to try and keep them open. However, is not that decision a vote of no confidence, echoing the vote of no confidence in local management by all parties on St. Albans district council? Local managers have made it more difficult to keep those units alive by their decision to announce a closure, leading to the resignation of large numbers of staff and the biggest nurse shortages in any county in the country.
§ Mr. MilburnI shall certainly not stand here and condemn local management out of hand when I do not know the facts. I shall be very happy to look into the right hon. Gentleman's allegations. However, managing any public service, particularly the national health service, 549 is not an easy job. It is pretty difficult. It would be helpful if Conservative Members got behind some of our people rather than always running them down.
§ Mr. Tony McWalter (Hemel Hempstead)Further to that question, will my right hon. Friend accept my congratulations on the tremendous work done by his colleague Lord Hunt for the Hemel Hempstead hospital and the special care baby unit in using the hospital to set up a pilot scheme looking at a national framework for neonatal services? Many of the local health service managers performed outstandingly well when it came to supporting Lord Hunt and arriving at that excellent decision.
§ Mr. MilburnI can only agree with my hon. Friend. It is often difficult when changes are proposed in local health services. I know that my hon. Friend has been concerned about the local situation; he has been to see me about it as well as my noble Friend Lord Hunt. I hope that the solution that we have come up with will be good for staff in the local hospitals as well as the patients who use the services.