Health Bill [HL]

I wish to make only two very quick points at this stage. The noble Lord, Lord Campbell-Savours, brought to life again for those of us who had the misfortune to be there, the battles of 2002. The fact that we ended up with such rigid agreements that many years after the fact are slightly absurd is entirely down to the way in which foundation trusts were introduced and sold by the Government. One of the key things that the Government did was to impress upon us all that foundation trusts would be liberated from the strictures of the NHS by having new freedoms. One of those new freedoms was that they would not be answerable in the same way as existing trusts. I return to the opening, very tentative statement of the noble Baroness about the three conditions that she wanted: private patient work would not damage NHS patients; private patient work would benefit NHS patients; and there would have to be approval by governors for a significant increase in private work. I do not agree with the second point, because I do not think that that is sufficient accountability. I say to the noble Baroness that we are now five years into the existence of foundation trusts. It is high time for there to be a thorough review of the way in which they now work in the NHS. They are part of the NHS family, but we need to look in the round at what cost and what benefit they are to the rest of the NHS. The noble Baroness is slightly premature in picking one particular aspect of foundation trusts and trying to change that; that is wrong. If she were to persist in doing that, I suggest to her that to satisfy those people who continue to have misgivings about an age-old problem in the NHS—not whether there are private patient treatments but how there are private patient treatments—there would have to be this: foundation trusts would have to accept the same principles, the same underpinning criteria, for selection for their agreement to private patient work, and they ought to be willing to give the same level of disclosure and accountability as other trusts. That is the level playing field that I would like us to examine before we go any further down either the road of the noble Lord, Lord Campbell-Savours, or the road of the noble Baroness, Lady Meacher.