HC Deb 21 July 1989 vol 157 cc422-4W
Mr. Favell

To ask the Secretary of State for Health what representations he has received on those of his proposals in "Working for Patients" designed to reduce waiting times for patients; and if he will make a statement.

Mr. Mellor

The proposals in the White Paper to improve the quality of service including the reduction of waiting times have been generally welcomed.

Mr. Winnick

To ask the Secretary of State for Health how many meetings of medical and non-medical staff he has addressed at those hospitals about which health authorities have expressed interest in opting out of the existing National Health Service management structure; and what plans he has to address such meetings in the near future.

Mr. Mellor

We have held a national conference in London and seven regional conferences for NHS staff from units which have expressed an interest in self-government. My right hon. and learned Friend the Secretary of State has addressed five of these meetings and I have addressed three. My right hon. and learned Friend has also spoken to staff on an ad hoc basis in a number of individual hospitals and will continue to do so over the coming months.

Mr. Winnick

To ask the Secretary of State for Health if he will name the medical organisations which have been critical of his proposals for hospitals to opt out of the existing National Health Service management structure; and if he will further set out the substance of their criticism.

Mr. Mellor

Many of the medical organisations who have commented on the White Paper have questions or concerns about the possible effects of hospitals becoming self governing within the National Health Service. These relate to the mechanisms for achieving high quality medical education and research, the means of ensuring the provision of comprehensive services and the effects of the hospitals's freedom to set pay and conditions. We believe these are based on groundless misapprehensions about our intentions.

On 10 July my right hon. and learned Friend the Secretary of State spoke to an audience of senior doctors and gave assurances about the safeguarding of medical education and research. We intend to take reserve powers to ensure that undergraduate, post graduate and continuing medical education are provided in self-governing hospitals. We have already announced that the service increment for teaching (SIFT) will be enhanced to meet the costs of hospitals which support undergraduate medical education and the service costs of research.

District health authorities will have the responsibility of providing a comprehensive and cohesive range of conveniently sited, high quality services for their resident population. In doing this they will make full use of available facilities whether in health authority-managed hospitals, self-governing hospitals or the private sector. Health authorities will therefore ensure that there is no fragmentation of services.

Self-governing hospitals will be able to set their own pay and conditions but the discipline of contract funding is likely to ensure that they offer rates of pay which are broadly in line with those in the Health Service as a whole.

Mr. Winnick

To ask the Secretary of State for Health if he will receive a deputation concerning proposals for opting out of hospitals in the borough of Walsall.

Mr. Mellor

No. This would not be helpful at this early stage. But I shall take into consideration the views of all those with an interest when assessing applications for hospitals to become self-governing.

Mr. Winnick

To ask the Secretary of State for Health (1) if he will request the Electoral Reform Society to conduct ballots in those areas where it is suggested that hospitals should opt out of the existing National Health Service management structure;

(2) if the Government will ask local authorities to conduct ballots on the same basis as in local and national elections in order to determine the level of support for hospitals to opt out of the existing National Health Service management structure.

Mr. Mellor

No.

Mr. Winnick

To ask the Secretary of State for Health if he will set out the future timetable when it is suggested by health authorities that hospitals may opt out of the existing National Health Service management structure; and when he expects to make the first decisions on opting out.

Mr. Mellor

We intend that, subject to the passage of the necessary legislation, the first self-governing hospitals will be established in April 1991. The Department will issue further information about the application process later this year.

Mr. Winnick

To ask the Secretary of State for Health if those hospitals which opt out of the existing National Health Service management structure will be under the same obligation to admit patients as at present.

Mr. Mellor

A decision by an individual NHS hospital to opt for self-governing status, will not alter in any way its obligations to admit patients requiring treatment. It will be in no sense different in this respect to a directly-managed hospital. Emergency treatment and admissions will be provided by all hospitals with the requisite facilities. Elective admissions will be provided within the contractual frameworks that have been agreed.

Mr. Winnick

To ask the Secretary of State for Health what representations he has received proposing that balloting should occur before hospitals opt out of the existing National Health Service management structure.

Mr. Mellor

We have received representations on this subject from a number of hon. Members, community health councils and other representative organisations and from individual members of the public.