Primary Care Trusts

Again, I am grateful for the fact that there has been local consultation. Clearly, the Government need to take this into account. My hon. Friend the Minister will be pleased that the hon. Member for Eddisbury has complimented the Government on what they have been doing in the Cheshire area in that short intervention. It is pleasing that the Government have followed the Committee’s advice in taking a more consultative approach and that in some areas they have listened to the wishes of local communities. However, the Government have not published the advice they received from the expert panel. This leads to the accusations that this form of consultation was not transparent. Lord Warner gave us a commitment to publish all information submitted to the external panel as soon as possible. We are now at the end of June and we still have not got to that stage. It may be historical, but there may be lessons to be learned from what the expert panel wanted to do and what the reconfiguration ended up with. That is something that I would like to look at. I now move onto the other area of provider functions. The Government have responded to the Committee’s concerns by stating quite categorically that they will not instruct PCTs to divest themselves of service provision, and"““nor will we impose any timetable.””—[Official Report, 10 January 2006; Vol. 441, c. 598W.]" However the White Paper ““Our health, our care, our say””, published in January 2006, instructs PCTs to review all its services in 2007 and says that where services are not sufficiently qualitative, PCTs will be expected to look for alternative providers, including private sector organisations. That is on pages 172 and 174 of the White Paper. There are concerns that PCTs will be pressurised into tendering out some services which they currently provide directly in order to stimulate competition in the primary care sector. Further assurance is required that PCTs will be allowed to make independent decisions about the future provision of primary and community service. When we first talked about the implications of moving from working for an NHS provider to an independent provider, we asked some fundamental questions. First, we asked Lord Warner about what happens to someone’s pension. I do not want to get into a debate about local government pensions or NHS pensions today as we seem to be doing that every other day in this place, but it is a fundamental issue. If I were changing my employment—certainly at this point in my life—I would want to know exactly what was going to happen to my pension. Many other people would too. In the first session we took with Lord Warner and a senior civil servant, they were unable to convince us that they had looked at this in any way at all. They said that it may be covered by TUPE or that it may not. As a member of the Liaison Committee, I asked the Prime Minister what would happen to people’s NHS pensions under these circumstances. It was only when I received a letter from him that we eventually came to know the truth. This will be an issue if we are to see this method of travel succeed; we were told by Ministers that providing would travel further out into the independent sector than it does now. As I suggested earlier, the Committee did not look at that; we did not say whether it was a good or bad thing. I have discussed this with other organisations as we were told it would be a road of travel. Issues such as terms and conditions and in particular, pensions, are also important. I talk a lot to the independent sector now—not just in Westminster, but on visits to where my PCT gets its independent sector care from; the charitable sector. If one considers the interaction with the national health service, there is no longevity in terms of contracts or anything else. If that is the preferred route, there will be a lot of debate in this country about how such a route could be travelled. The Government may think that they can just contract with providers in constituencies such as mine, but there are very few independent providers in such constituencies. We were taking evidence earlier today in the Health Committee when I was explaining that even the NHS has not been a brilliant provider of services in my constituency. Doctor-patient ratios have been some of the highest in England and Wales for many years; in fact, for decades. Health inequalities are massively greater than in quite a lot of other constituencies, yet, in my personal view, the NHS on the ground is not at the level it should be. If we are going down that road, that is fine, but the Government need to ensure that people will be travelling down that road with them as well. You will be pleased to know that I am going to stop now, Miss Begg. I know that other people want to talk about the specifics of what has been happening and what is likely to happen in October this year in terms of the reconfiguration of PCTs and SHAs. We will obviously be keeping a watch on how that affects, or may affect, health care in our communities, in the months to come. It is crucial that when we go down roads such as this, particularly given the reaction from the NHS in July of this year, we get it right and we improve health care. On occasions, the two Front Benches might agree, and it is good that they have done so on this matter. I have said this before, but it is a fool’s dream to think that we are going to stop the NHS being a political football in this place. However, it would be better for the health service and for our constituents if we did.