HL Deb 20 June 1988 vol 498 cc493-6

2.43 p.m.

Lord Molloy asked Her Majesty's Government:

When they expect to publish their review of the National Health Service.

Lord Skelmersdale

My Lords, we are continuing to examine the options for improving the National Health Service, and will be bringing forward our proposals in due course.

Lord Molloy

My Lords, will the House be provided with an opportunity to examine the review when it is published? Will the review include not only nurses and doctors but hospital ancillary and support staff, who are important as has been acknowledged by COHSE, the BMA and the Royal College of Nursing? They firmly believe that ancillary and support staff should feature in the review as their status at the moment does not encourage recruitment.

Lord Skelmersdale

My Lords, not only has the role of support staff been appraised and recognised by the bodies to which the noble Lord refers; it has also been recognised by the Government. I say again today that the health service would not function without the loyal support of the support staff. As to what will happen when there is a resolution of the review, my right honourable friend the Secretary of State for Social Services has made it clear that Parliament will be informed, but that he cannot say what supporting documentation will be around at that time.

Lord Mellish

My Lords, it is on that point that many of us are concerned and worried. I talk as someone who, like most in the House, strongly supports the National Health Service. Is the Minister aware that when the National Health Service first came into being there were no such things as heart transplants, or hip replacements and so on? Medicine has moved on. There has been a tremendous change, which is why I welcome the review. I find it bewildering that the Minister will not issue documentation showing what the changes are and why he will be doing whatever he is going to do.

Lord Skelmersdale

My Lords, I do not know why the noble Lord finds the matter bewildering. Incidentally, I agree totally with the premise upon which he based his question. However, as far as I know, no decisions on publication are ever made by any government anywhere in the world until after they have decided what is to go into such a presumed publication.

Lord Auckland

My Lords, is my noble friend aware that there has been a surfeit of National Health Service reviews under all governments and that some of them have not been satisfactory? Nevertheless, is my noble friend also aware, as I am sure he is, that great anxiety is felt among those currently working in the National Health Service, who wish to know what their situation is? The words "in due course" may be good parliamentary language, but they are not entirely satisfactory to all those who work in the health service.

Lord Skelmersdale

Yes, my Lords, I accept my noble friend's comments on that matter. That is why we intend to get on with the review. Equally, it is such an important subject that we do not intend to rush the review.

Lord Ennals

My Lords, I share the concern expressed by the noble Lord, Lord Auckland. Will the Minister explain why his right honourable friend the Secretary of State has been giving nods and winks in advance about certain attitudes taken within the review body, such as his support for the proposal for tax relief for those who opt out of the National Health Service? Is it wise to start giving hostages to fortune in advance of the decisions being taken?

Lord Skelmersdale

My Lords, my right honourable friend has, to my knowledge, been extremely careful about what he has said. The fact that the press has read far more into what he said has obviously confused the noble Lord.

Lord Ennals

My Lords, I heard what the Secretary of State said with my own ears. It was clear. Was it not plain that he was taking a clear position indicating what was happening within the review body? I put my question again: is that wise?

Lord Skelmersdale

My Lords, I am interested to hear that the noble Lord heard my right honourable friend's speech. I must confess that I did not, but I read it. I have read all his speeches on this subject extremely carefully. I do not believe that he made the type of suggestions which the noble Lord has attributed to him.

Lord Nugent of Guildford

My Lords, does my noble friend agree that if my right honourable friend the Secretary of State did not include in the review a careful consideration of what part the private health sector could play in the total national sector he would be defective in his review?

Lord Skelmersdale

My Lords, yes, I agree entirely with my noble friend. One of the reasons why I agree is that if one compares the percentage of GDP spent on health in this country with that spent in the other industrialised nations, one will find that the extra health care finance provided is to a great extent made up by the private sector.

Lord Marsh

My Lords, does the Minister agree that whether or not his right honourable colleague referred to tax relief in private health insurance, it is still a good idea?

Lord Skelmersdale

My Lords, I did not say that he did not refer to it. He has been referring, as have I and my colleagues, to the various suggestions that are in the public domain, which often come from worthy individuals and public bodies. If there is a debate, clearly one must take notice of the points made in that debate.

Lord Cledwyn of Penrhos

My Lords, as this will be the most important review since the National Health Service was established 40 years ago, will the Minister convey to his right honourable friend that in the view of most Members of this House all relevant information should be published so that the British public can come to their own conclusions?

Lord Skelmersdale

Yes, my Lords, of course.

Lord Molloy

My Lords, will the Minister convey to his right honourable friend the need for proper and exacting qualifications for chiropodists? There are many problems facing Britain's foot hospitals, such as the London Foot Hospital in Fitzroy Square. If these matters are not in the review, can the Minister help the chiropodists by seeing that they are put in the review?

Finally, the all-party Social Services Committee has an overwhelming majority of Conservative MPs, who have said over the past six years that the NHS has been underfunded. Will their views also be taken into full consideration?

Lord Skelmersdale

My Lords, as I have made clear on numerous occasions, the review is more general than the noble Lord, Lord Molloy, seems to think. It will have an effect, if it goes through as we all expect, on each individual branch and part of the health service. Nonetheless, it is difficult to see what effect it will have on chiropodists, general practitioners or others.

As regards the second part of the noble Lord's question, I shall do everything in my power to make that point of view widely known.