§ 1. Mr. David Cameron (Witney)What recent representations he has received from NHS trusts about the Government's plan for foundation hospitals; and if he will make a statement. [129948]
§ The Secretary of State for Health (Dr. John Reid)My ministerial colleagues and I have had a number of discussions with the chairs and chief executives of NHS trusts, and this dialogue will continue.
§ Mr. CameronI thank the Secretary of State for that answer. If foundation status is really about giving hospitals greater freedom, will he look again at the strict rule under which no hospital can increase its income from private patients? Is he aware that Nuffield Orthopaedic hospital in Oxford, where NHS patients will always come first, has used private income to subsidise the NHS and help to pay for investment? It wants to continue to do so, but the base year is very restrictive. Will the Secretary of State ensure that foundation status will not make things worse in that regard?
§ Dr. ReidI know that the hon. Gentleman takes a deep interest in health care and the health service. He will understand that we are trying to achieve a balance between the power that we decentralise and the maintenance of a balanced benefit for all the people of this country through the national health service. The cap that has been put on the proportion of patients who 702 can be treated privately in the new foundation hospitals is intentionally set to be fair to the vast majority who rely on the NHS. It will be fixed as a percentage of the income derived from private patient activity that applied to each NHS foundation trust in the financial year ending April 2003. That will ensure that the cap applies fairly to all trusts, irrespective of when they make the transition to NHS foundation trust status.
§ Mr. Gordon Prentice (Pendle)What representations has the Secretary of State received about the Government's proposals, which I think are very opaque? Will people be able to vote if they have paid £1, or if they have pledged to pay £1? What estimates have NHS trusts made about the likely turn-out in the elections?
§ Dr. ReidDiscussions are under way in this House and in another place about the exact details, but let me make it clear that it is a good thing that we should reduce the amount of diktats from the centre and pass more control to people in local areas. If we are truly going to have a national health service capable of meeting the differentiated needs, ambitions and expectations of 60 million of our fellow citizens today, we shall have to decentralise. I commend to my hon. Friend the authority on these matters who said that he was deeply conscious that one of the great dangers of a Government health service was over-centralisation, and that the wider the decentralisation that could be achieved, the better it would be for everyone. That authority was, of course, the founder of the national health service, Nye Bevan, speaking in 1946.
§ Mrs. Patsy Calton (Cheadle)Does the Secretary of State intend to ensure that the regulator gives precise instructions about the cap? Clause 15 of the Health and Social Care (Community Health and Standards) Bill, which is currently going through the other place, has confused people with regard to the capping of private health care. As it stands, the clause does not insist that the regulator should cap private health care.
§ Dr. ReidI think that this issue is pretty clear to everyone, whatever opinion they may hold, except the Liberal Democrats. If the hon. Lady can show me anyone outside the Liberal Democrats who is confused about it, I will certainly consider their case. This is, however, a refreshing change for me. Having listened all week to objections from the trade unions, the producers organised, it is nice to hear the comments of the Lib Dems—the producers disorganized.