NHS Trusts: Ballots (Hansard, 4 June 1990)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, applications for NHS trust status will not be invited until Parliament has approved the necessary legislation. Staff and the local community will then have an opportunity to express their views on individual proposals to the region concerned before any formal applications are made. We are nevertheless aware that ballots canvassing the views of various interests have taken place, but we have consistently made clear that it would not be appropriate for changes in management of NHS services to be subject to such ballots.

§ Lord Ennals
My Lords, the Minister is saying that the initial application does not require consultation with those concerned. Will she confirm that in every case where hospitals expressed an interest in becoming self-governing, either there has been no effective consultation or, if there has been a ballot, all of them by a large majority have gone against the proposal? If, as the Minister said, consultation is 1076 part of the Government's proposals, how will it take place?

§ Baroness Hooper
My Lords, I emphasise that no formal applications have been received. The expressions of interest to which the noble Lord refers varied greatly and there have been a large number of them. Clearly they are not the objects of consultation. When consultation takes place it will be after formal applications are invited. It will take place in the usual way and regions will invite comments.

§ Lord Molloy
My Lords, will the noble Baroness say whether, if a hospital which has opted out of the NHS should find itself in financial difficulties, some kind of government support will be forthcoming to prevent the closure of that hospital?

§ Baroness Hooper
My Lords, I am grateful to the noble Lord, Lord Molloy, for giving me the opportunity to repeat that there is no question of any hospital opting out of the National Health Service. Those hospitals that apply for National Health Service trust status will remain fully within the National Health Service as they are at present. If for some reason National Health Service trust status does not prove suitable in the long run, there will be every possibility for a hospital to return to being directly managed by the health authority.

§ Lord Stallard
My Lords, the Minister says that the commission is to ask for comments. Are those comments to be limited to hospital staff or will they be addressed to a wider catchment area of patients within the hospital region?

§ Baroness Hooper
My Lords, it is intended that not only staff but also local communities will have an opportunity to express their views.

§ Lord Stoddart of Swindon
My Lords, is the noble Baroness aware that when I and others wished to amalgamate the water services of Reading, Berkshire and South Oxfordshire we had to conduct two town meetings and a town poll before that could be done? Would it not be fairer to the people using the hospital services—the consumers—that they should be consulted in a ballot throughout the area for which this form of administration is proposed?

§ Baroness Hooper
My Lords, there has already been much publicity regarding these expressions of interest. As yet formal applications have not been invited. There is no doubt that everybody concerned will be aware of what is happening in their locality.

§ Baroness Nicol
My Lords, when the Minister said that the local community will be consulted, what did she mean? What method of consultation will be used? It was not clear from her answer.

§ Baroness Hooper
My Lords, as I said, when formal applications are prepared regions will ensure that they are given local publicity and will seek the views of all those with an interest, including health authorities, staff, patients, GPs, CHCs and the local 1077 community. All those views will be taken together and considered by the Secretary of State alongside the application.

§ Baroness Nicol
My Lords, I am sorry to persist, but when the Minister says "patients" does she mean patients in the hospital at that time or prospective patients? How are they to be reached?

§ Baroness Hooper
My Lords, when I say "patients" I mean patients in hospitals, GPs' patients on registered lists and patients in the local community, who, after all, are part of the community.

§ Lord Ennals
My Lords, while associating myself totally with the view that the community should have an opportunity of expressing its views and that those views should be reflected in decisions, perhaps I may ask whether the Government are faced with a difficult timetable. From what the Minister says, all that has happened so far is that interest has been expressed. The Bill will presumably become law at some time. How will the consultation take place in order for the Bill to take effect on 1st April next year? Is that really possible?

§ Baroness Hooper
My Lords, the White Paper and the first working paper were issued in February 1989. An initial guide was then published in July 1989 and an executive letter was distributed in August 1989. It has been made clear in the guidance that consultation should take place over a three-month period. I should add that a compendium guide is planned for issue in the autumn of this year. All that guidance, taken together, should give plenty of advice or how the matter should be taken, how the consultation should take place and, I believe, give adequate time for that consultation.