HC Deb 24 February 2004 vol 418 cc128-30
5. Mr. David Chaytor (Bury, North) Lab)

What plans he has to increase local democratic accountability within the NHS. [155722]

The Minister of State, Department of Health (Ms Rosie Winterton)

The Government are increasing democratic accountability in the NHS by giving elected councillors powers to review and scrutinise health services and establishing the direct elections of governors by local people, patients and staff in NHS foundation trusts.

Mr. Chaytor

May I tell my hon. Friend about the excellent work done by the local authority in my constituency through its health scrutiny committee, which is now regularly interviewing senior management of the acute trust and primary care trust? Does she accept that scrutiny committees have a major role to play and that there is scope to increase their powers as time goes by? Does she further accept, however, that the effectiveness of those committees is variable in different parts of the country? Does she think that there is a case to review formally the functioning of scrutiny committees after a suitable period of time—perhaps 24 or 36 months—with a view to improving further the democratic accountability of the NHS in the next Parliament?

Ms Winterton

I am well aware of the work being carried out by the committee in my hon. Friend's constituency. I know that it has taken a particular interest, for example, in mental health services. The overview and scrutiny committees have real powers to require information from the NHS and to require attendance by senior officers at their meetings. What is important is that we make sure that the type of activity that is going on in his constituency is replicated elsewhere. That is why I announced recently something like £2.5 million for the Centre for Public Scrutiny, so that it can look at bringing together local councillors on the committees to examine how the activities that his committee may be undertaking can be used as examples elsewhere. In some areas, those Committees have not been as strong as perhaps they are in his area. We are therefore looking at how we can spread that power to make sure that all are able to take advantage of the new powers given to them.

Mr. Nigel Evans (Ribble Valley) (Con)

When will taxpayers in my constituency have a greater say over the level of services that they receive in their area? To give one perfect example, someone who has just moved back into my constituency after six years and has tried to register with an NHS dentist has been told that there are no NHS dentists in the Ribble Valley area and that he would have to do a round trip of more than 70 miles with his family to get one. What accountability will there be on behalf of those who provide such services to ensure that people who pay large, increasing sums of money for the NHS, including the 1 per cent. increase in national insurance contributions, get the level of service for which they are paying?

Ms Winterton

Overview and scrutiny committees can look into the provision of dentistry at local level. Moreover, from next year we shall commission dentistry at local level, which means a radical overhaul of the current system. That will ensure that decisions on local priorities and local expenditure can be made by local people. All trusts will of course be overseen by patients forums.

Roger Casale (Wimbledon) Lab)

Along with investment and reform, will not increasing the power of patients and the public and strengthening their voice in the reshaping of health services become one of the strongest drivers of sustained improvements in the NHS? Will my hon. Friend join me in thanking community groups, members of the public and Sutton and Merton primary care trust in my constituency? They have joined forces in an innovative way to reshape plans for the new Nelson hospital in the constituency. Will my hon. Friend confirm that that is the kind of work that she wants to see taking place throughout the country?

Ms Winterton

I am extremely impressed by the work that my hon. Friend has helped to lead in his constituency, to bring about patient and public involvement. There is indeed an increasing demand from local people for more information about why decisions are made at local level, and what priority is given to different funding streams. We are enabling that to become a reality for the first time, and we want what is happening in my hon. Friend's constituency to be replicated elsewhere.

Mr. Patrick McLoughlin (West Derbyshire) (Con)

What is the estimated cost of elections to foundation hospitals?

Ms Winterton

That will depend on the number of people who sign up for the nomination process. In some areas at least 9,000, or 10,000, are signing up for the wider elections to each foundation hospital trust. The elections to the board of governors will then take place. It will be up to each area to decide how the elections should be conducted, and the proposals will be put to the independent regulator to ensure that the procedure is adequate and that enough funds are available.

Helen Jones (Warrington, North) Lab)

Does my hon. Friend agree that proper democratic accountability must rest on the provision of accurate information? Will she give serious attention to the refusal of my local strategic health authority to release a document concerning the management of the Mersey regional ambulance service? How can we improve services if the NHS continues to rest on a culture of secrecy, and will not release documents concerning public bodies paid for with public money?

Ms Winterton

My hon. Friend is right:information should be released whenever possible. That is important not only in terms of accountability to patients, but in terms of transparency when it comes to the way in which public money is spent. I understand that my hon. Friend will shortly be meeting the Under-Secretary of State for Health, my hon. Friend the Member for Welwyn Hatfield (Miss Johnson). Perhaps she will raise the matter then.

Mr. Andrew Lansley (South Cambridgeshire) (Con)

The Minister will recall that during the progress of the Health and Social Care (Community Health and Standards) Bill, Conservative Members pressed for local accountability to be vested in primary care trusts. That is the obvious place to start in determining local priorities in response to local people. The Secretary of State has told us that 75 per cent of NHS funds are allocated to PCTs. When will the Minister and her colleagues, having previously resisted local ownership and accountability for PCTs, do a U-turn on that as well, and offer such accountability?

Ms Winterton

We have already introduced one of the biggest shake-ups in terms of patient involvement in the NHS. Not only do we have the appropriate systems in the foundation trusts. but every PCT now has a patients forum. It is important to give them time to take root and work properly. We have also introduced patient advice and liaison systems, and an independent complaints system. This is not the time to shake all that up. We want to ensure that it beds down and that the patients forums work effectively, as they have already begun to do. We can then consider any further changes that may be necessary in the future