HC Deb 12 December 1989 vol 163 cc597-9W
19. Mr. Ashton

To ask the Secretary of State for Health if he will make it his policy to hold a referendum in health authority areas which propose to opt out of their local hospitals.

Mr. Kenneth Clarke

The Government do not consider that it would be sensible for the proposed management changes in the NHS to be the subject of any ballot. There is no question of any hospital opting out of the NHS.

118. Mr. Dykes

To ask the Secretary of State for Health if he will give his latest assessment of the expert and lay public support for his National Health Service modernisation proposals.

Mr. Kenneth Clarke

I have been greatly encouraged by the constructive support that I have received for the proposed improvements to the Health Service. Many of the individual letters I have received from members of the public endorse some or all of the proposals. The proposals are being increasingly backed by members of the health professions. The Health Reform Group, recently formed under the chairmanship of Professor Richard Lilford, is a good example of medical support for the reforms. The long established Hospital and Consultants Association has publicly disassociated itself from and disapproved of the BMA's campaign against the reforms. The National Association of Health Authorities has always given general support to our proposals.

72. Mr. Shersby

To ask the Secretary of State for Health what representations he has received from the Health Reform group, under the chairmanship of Professor Richard Lilford, concerning the proposals contained in the White Paper on reform of the National Health Service.

Mr. Kenneth Clarke

I have received representations on the detail of the reform process by the Health Reform Group. A meeting between Ministers and the group is planned early in the new year when further contributions from members of the group will be received.

I am pleased to welcome the formation of this and indeed any Group of those working within the health Service who wish to propose constructive dialogue on the detail of Health Service reforms.

46. Mr. Maples

To ask the Secretary of State for Health if he will make a statement on progress on the implementation of National Health Service reforms.

73. Mr. Quentin Davies

To ask the Secretary of State for Health what progress is being made on the implementation of the proposed reforms of the National Health Service.

Mr. Kenneth Clarke

We are making good progress in putting into action the changes outlined in the White Paper "Working for Patients". I am confident that the NHS will be ready to implement the basic elements of the new and better systems of matching growth and resources with expansion of patient services by April 1991 once Parliament approves the necessary legislation. We have made £82 million available to finance progress towards implementation this year with a further £257 million available for initiatives in 1990–91.

We have issued detailed guidance on many subjects including the new contracting system for all district health authority hospitals and community units and on education and training for non-medical staff. We shall be publishing shortly a GP fund holder programme which will give more details about the operation of a GP practice fund.

We have recently launched a project to support district health authorities in detailed work in developing the key role which DNA's will have under the new system of identifying and obtaining the best pattern of services which will most effectively meet all the health needs of the population they serve.

We have received more than 180 expressions of interest from potential NHS hospital trusts. Seventy nine of them are proceeding towards being the first wave of applicants for trust status within the NHS in April 1991 and I expect many more to be ready for later waves of applicants in future years.

We have made £2 million available for implementation of medical audit this year. A £4.5 million scheme has been launched to develop information technology skills. Demonstration projects, aimed at improving the quality of care and services to patients, have been announced for five out-patient departments. The principles of general management are being introduced into the family practitioner committee system.

Good progress is also being made in relation to medical education and research. As I explained in a speech on 10 July, since sent to all hospital doctors, I intend to take powers to ensure, for instance the continuation of high standards of undergraduate, postgraduate and continuing medical education and research in all NHS hospitals. I will also ensure that postgraduate training posts are provided in NHS hospital trusts in accordance with the national objectives set out in "Achieving a Balance". Medical education and research will be further enhanced by the proposed increase in the service increment for teaching (SIFT) to meet 100 per cent. of the median excess costs of teaching hospitals. This will be distributed by Regions in consultation with universities.

The National Health Service and Community Care Bill is now before the House.

41. Mr. Ian Taylor

To ask the Secretary of State for Health if he will make a statement about the units which have applied to become National Health Service hospital trusts.

Mr. Kenneth Clarke

No units will apply for NHS trust status until Parliament has approved the necessary legislation.

38. Mrs. Rosie Barnes

To ask the Secretary of State for Health what criteria he intends to use in assessing applications by district health authority units, hospitals and related services for self-governing status when such applications if successful would result in all of a district health authority services becoming self-governing.

Mr. Kenneth Clarke

No units will apply for NHS trust status until Parliament has approved the necessary legislation. The key criteria were set out in working paper No. 1, "Self-governing Hospitals" and the outline application document circulated under EL(89)MB/148, which has been placed in the Library, set out the criteria in more detail. Each application will be judged on its own merits taking into account local circumstances. It may be sensible for services in some relatively small, cohesive districts to apply for trust status as a single entity. In any such case I would need to consider the overall size and manageability of the proposed trust; the extent to which services and management were integrated; the implications for patient choice and competition; and the views of staff and local people.

28. Mr. Baldry

To ask the Secretary of State for Health whether there are any experiments taking place to assess how the proposed National Health Service reforms would work.

Mrs. Virginia Bottomley

The Health Service is undertaking a wide range of projects designed to inform the implementation of the Government's proposals to improve services.