NHS (Charitable Trusts Etc.) Bill

Antoinette Sandbach Excerpts

Friday 6th November 2015 Commons Chamber

[Wendy Morton]

That is a very good question. Quite simply, the charity would not be able to complete the move to independence, so the hospital would have to run two charities: one would be the independent arm; the other would be the existing one into which the royalties from “Peter Pan” would be transferred. That would mean a duplication of work, and more bureaucracy. When the charity goes out to raise funds, it needs to provide certainty to the public.

[Antoinette Sandbach (Eddisbury) (Con)]

Earlier, my hon. Friend mentioned the Alder Hey Children’s Charity, which is the key leading charity in the north-west and provides the same sort of support to children. Does she agree that families feel a great sense of ownership over their local hospital, which gives them such support, and therefore they might be much more willing to fund-raise for an independent charity that was seen as physically separate from the board of the hospital or the NHS trust?

[Wendy Morton]

When it comes to hospitals, we all have our own personal stories on which to draw and our own personal experiences. The British public are very generous in donating to many different causes, and certainly to local hospitals. The move to independence will help to attract some of the bigger corporate donations, and enable the hospital to work and compete alongside other charities. It makes them operate more independently and less bureaucratically in today’s world, which is very different from that which existed when the trusts were first formed.

On my visit to Great Ormond Street, it was clear to me that the legacy of J.M. Barrie lives on. Where else in the world could we find a boardroom named after a fairy, Tinker Bell? No one can fail to be touched by the commitment and dedication of the staff there. Great Ormond Street hospital has been constantly evolving since opening in a Georgian townhouse in 1852. Today, it is halfway through an ambitious, 20-year redevelopment programme to rebuild two thirds of the hospital site. The charity is working to deliver new facilities appropriate to world-class paediatric care, research and education. It is the largest dedicated funder of paediatric research in the UK, and that is something of which we should all be proud.

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[Kevin Foster]

My hon. Friend is absolutely right. In my constituency, for example, we have many people over the age of 60 who have retired from professional careers. They reach the point in life where they wish to retire from full-time work, but they still have skills and abilities that they want to offer, and might be thinking about a social rather than a financial reward. Having more flexibility in the charities’ structures means that they can bring in more of those people. People who might be slightly reticent about being appointed by the Secretary of State, perhaps because of their previous job, might be delighted to be involved in an independent charity that is committed solely to its objects.

[Antoinette Sandbach]

The risk attached to the appointment by the Secretary of State is the perception that it might be a political appointment when it is actually an independent appointment. That is what the Bill removes.

[Kevin Foster]

I could not have put it better myself. My hon. Friend is right that although the Secretary of State might appoint someone independent with skills and abilities such that they become a trustee by another route, the fact that they are appointed by the Secretary of State makes it appear that they are the Government’s person, even if they are diametrically politically opposed to the Government of the day. I am sure that the Minister will be able to think of examples of Government appointments who are not the most supportive of the current Administration.

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[Mr Rees-Mogg]

Madam Deputy Speaker is giving me one of her looks. As much as I would like to discuss reform of the House of Lords, I would be ruled out of order. If my hon. Friend will forgive me, I must get back to jobbery, because jobbery and avoiding jobbery are at the heart of the Bill.

I was explaining how jobbery, when it starts, is not a deliberate corruption. It is merely the recognition that it just would not do to appoint somebody on the other extreme of politics. We can hear Sir Humphrey going to the Secretary of State and saying, “It would be a little brave, Minister, to appoint such a person who is on so different a wing from you.” The next time an appointment comes up, there is the thought, “Well, if I couldn’t appoint someone who was actively opposed, perhaps I should really only appoint people who are on my side”—in other words, our mates and friends. Thus we get to the heart of jobbery. Appointments are made purely because of somebody’s political colour and context.

In the primary care trust in Bath and North East Somerset which preceded the current organisations a local Conservative had a judicial review against the previous Labour Government to get himself appointed as its chairman, because he was the most qualified person and had been refused only on the basis that he was a Conservative. Therefore, the idea that jobbery has completely left the system is false, and so too is the idea that Governments are so high and mighty and Olympian in their decision making that they do not descend to mere political jobbery.

[Antoinette Sandbach]

My hon. Friend might like to know that examples of jobbery abound in Wales. It might be useful to look at some of the appointments made by the Welsh Government to the various public bodies.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I must remind the hon. Lady for the sake of good form—I appreciate that she has not been in the House for very long so I am not reprimanding her—that she must address her remarks not to the hon. Gentleman, but to the Chair.

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[Antoinette Sandbach (Eddisbury) (Con)]

I am grateful for the opportunity to take part in the debate. I am pleased to follow my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), who spoke with characteristic authority, certainly educating the newer Members, among whom I count myself.

I support the Bill introduced by my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton). She cited the hospital that serves my constituency in Eddisbury, the Alder Hey hospital, as an example of successful independence from the NHS trust. To show how valuable that is, the hospital moved in October to new premises and became Alder Hey in the Park, a brand new £237 million hospital with 270 beds and 16 brand new operating theatres equipped with state-of-the-art technology. It treats 275,000 children across the north-west and north Wales, and is as important a centre for children’s health, medicine and research as Great Ormond Street in London.

The charitable part of Alder Hey became independent in the way proposed by the Bill in April. The charity has contributed £20 million for equipment in Alder Hey hospital, and because it is independent it is separate from the hospital board. In my previous role, I had experience of cases in which the hospital board and the NHS charity were integrated, and in which the charity did not have the independent thinking that is clearly demonstrated by the Alder Hey charity and the other six charities referred to by my hon. Friend in her eloquent explanation of the Bill. It is clearly a vital step for those bigger charities to achieve perceived independence.

[Kevin Foster]

It will be not just independence but the flexibility to bring in different skills and talents that will benefit the charity, its objectives and, ultimately, patients.

[Antoinette Sandbach]

I entirely agree with my hon. Friend. One important step being taken by Alder Hey is in ground-breaking research, and the charity allows it to get funding that will help in those aims.

The new facilities at Alder Hey are extraordinary, designed in part by former child patients. A group of children aged 10 to 22 who had stayed in the hospital contributed towards the design of the new Alder Hey in the Park. I invite Members from across the House to consider visiting the hospital to see the invaluable work that it does. As my hon. Friend the Member for Aldridge-Brownhills said, funding from NHS charities contributes to innovation and research.

[Kit Malthouse]

Perhaps I should declare an interest. I was born in Alder Hey hospital and had a myringotomy there when I was eight—a surgical procedure where the eardrum is taken out to drain excess fluid. Grommets are now used instead.

On independence, one thing that is critical to the success of charities is the tax relief that they attract, which is a serious incentive for donors. Does my hon. Friend agree that if a charity has its trustees appointed by the Secretary of State and is working closely with, in effect, an organ of the state, an NHS hospital, there might be some question about whether that charity should be entitled to tax relief, given that it is effectively part of the state, and that the move to greater independence is likely to make any challenge to that status recede?

[Antoinette Sandbach]

Indeed. My hon. Friend the Member for North East Somerset made a similar point. It is important that that independence is seen, is effective and is understood in the public domain. Sadly, there are some examples of NHS charities that are deeply influenced by their boards and are not seen to be independent in the way that my hon. Friends described.

Some £2 billion worth of assets are under the control of NHS charities and there is a combined annual income of about £30 million. These are significant sums which, as has been pointed out, are intended for the benefit of patients, and should not go into administration and the endless accounts and tick box exercises that are required if two parallel charities are run side by side. The Charities Commission has great expertise in the oversight of charities and in ensuring that charities’ income goes to the appropriate causes for which they were set up.

My hon. Friend the Member for Aldridge-Brownhills made an important point about the unlimited liability of charitable trustees, which is a very big personal risk. If anything goes wrong, such as some awful fraud, charitable trustees with unlimited liability have personal liability and could lose their homes and everything they own. As a result, some people are unwilling to become trustees of such charities. My hon. Friend’s Bill allows some protection, if trusts choose to have it, giving trustees limited liability. That is likely to broaden the range of people prepared to take on these roles.

It has been noted that this is trustees week, and a constituent of mine, Jeannie France-Hayhurst, is a trustee of the Alder Hey charity who provides a great deal of service. I know that she would encourage and would want others to encourage people from a wide range of backgrounds and a broad range of experience to get involved in their local charities.

In my constituency, Eddisbury, we have two good examples of local charities. One is the Tarporley War Memorial hospital, which was set up many years ago. It is independent of the NHS and is entirely funded by the community through charitable fundraising and charitable giving. That is exactly the type of activity that my hon. Friend the Member for North East Somerset was talking about, allowing communities to come together and work to deliver services in their area. The hospital specialises in the rehabilitation of the elderly, intermediate care and palliative care. It has 17 beds and is extremely well supported in my constituency. There is a wonderful double-decker bus that drives around with vintage clothing for sale. The bus parks in towns and villages in my constituency on a set day every week—in effect, a mobile shop to which members of the public can come. It is a wonderful sight and is entirely staffed by volunteers, like much of the other fundraising that goes on to support Tarporley War Memorial hospital. It is a great example of an independent charity that can support the delivery of NHS functions.

The hospital is used by local GPs to provide clinics closer to those who need their services. Staff from the local hospitals, such as the Leighton hospital and the Countess of Chester hospital, can travel to Tarporley War Memorial hospital and provide outreach services such as maternity services, dressings clinics and minor injuries treatment. It is a great example of how an independent charity can stand on its own two feet and provide great support and services to the local community.

The other charity in my constituency which exemplifies that is St Luke’s hospice, which is based in Winsford. It describes itself as a small hospice with a big heart, and I can vouch for that. It, too, is looking at ways of extending the palliative care that it provides and broadening the services that it delivers in the local community. It has fantastic outreach services which support those who are frail, those with failing health, those who are ageing, dying or grieving, and those who have dementia. It has broadened its remit from palliative care and is looking at how it can deliver services closer to constituents’ homes. I commend the hospice for its work. I know that my hon. Friend the Member for Weaver Vale (Graham Evans), who is not here today, has fundraised extensively to support St Luke’s hospice, as have many other neighbouring Members of Parliament who know the invaluable service that it delivers locally.

[Craig Williams (Cardiff North) (Con)]

My constituency has a number of hospices and charities—Velindre cancer centre and George Thomas hospice—to which I could apply my hon. Friend’s comments about those in her constituency. I know that she has experience in the Welsh political environment, as do I. Does she agree that it is refreshing to see, I hope, this Government and this Parliament giving away power over the appointment of trustees?

[Antoinette Sandbach]

I am grateful to my hon. Friend for raising that matter. He will be aware of the extensive issues at the Betsi Cadwaladr University Health Board, where at times there have been appointments that could be characterised as highly political. Indeed, an individual described as “the axeman” was recently appointed. Given the threat to maternity services at the hospital—my hon. Friend the Member for Vale of Clwyd (Dr Davies) and I have campaigned for them to be retained—I am well aware of those concerns.

[Albert Owen]

The hon. Lady is right to point to Alder Hey’s excellent record. It covers north Wales and my constituency, so I have been there on many occasions. There are trustees from Wales on English hospital boards, and the difficulty with recent legislation is that we do not know whether their role will continue. Welsh trustees on English boards and their Members of Parliament will have difficulty in future. Is she as concerned as I am about that, and does she agree that we need further clarification?

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[Antoinette Sandbach]

I am grateful to the hon. Gentleman for raising that point, because one issue with the service reorganisation in north Wales is that the new SuRNICC centre—the sub-regional neonatal intensive care centre—has not yet been built. It was due to be completed by next March, but the first sod has not even been dug out of the ground. Instead, because of the threat to maternity services in north Wales, very sick babies are having to travel over the border to Leighton hospital in Cheshire in order to access the services they need.

The wonderful thing about an independent charity is that, when it comes to appointing trustees, there are no limitations based on where they live or anything of that nature. Trustees should be independent, free-thinking, able to provide good advice and genuinely committed to the charity for which they act, as they have heavy legal responsibilities. I certainly do not imagine that there would be any discrimination on the basis of nationality.

[Albert Owen]

The point I was making is that under English votes for English laws, Welsh Members of Parliament with constituents who are trustees on English boards will not be allowed to vote on legislation affecting them. It might be a technical point, but it is hugely important to my constituents.

[Antoinette Sandbach]

I am so grateful to the hon. Gentleman for making that point, because health services that my constituents access are affected by decisions taken in Wales. The threat to maternity services in north Wales will have a direct impact on the resources of the county of Cheshire and Leighton hospital, yet they have no say in those decisions—even the hon. Gentleman has no say—because they are taken in Cardiff.

[Kevin Foster]

It is very tempting to go down that path and discuss various issues relating to devolution, but I am conscious, Madam Deputy Speaker, that to do so would not be in order. Does my hon. Friend agree that the benefit of the Bill is that it would make the charities independent so that they can select who is best to be on their board of trustees from the whole area, regardless of politics or boundaries?

[Antoinette Sandbach]

That is precisely why I support the Bill, and it is no doubt why my hon. Friend the Member for Aldridge-Brownhills has attracted support from so many Members today. The crucial matter is independence. Unfortunately, in my previous role I had experiences that went the other way when independence was lacking, and that had a negative impact on outcomes for my constituents.

[Mr Howarth]

Will the hon. Lady give way?

[Antoinette Sandbach]

I am afraid not, because I must make some progress.

Alder Hey hospital has been leading the way with regard to what is now happening at Great Ormond Street hospital. I completely support the aims of the Bill relating to the intellectual property rights for “Peter Pan”. That situation is almost unique. The advantage of the Bill, as hon. Members have pointed out, is that successful authors who might wish to allow their rights to go to a local children’s hospital, or indeed other health services, could have confidence that they would be leaving them to an independent charity without any perception of political appointment or interference. I hope that will encourage other authors to consider supporting the great research and work done at Great Ormond Street hospital and Alder Hey hospital when making bequests.

Peter Pan said it best:

“All you need is faith, trust and a little bit of pixie dust.”

I suspect that in this case we need faith, trust and a little bit of Wendy dust. If we can humbly sprinkle a little of our Wendy dust, we can use this Bill to sort out the legislative mess for the children at Great Ormond Street hospital and, I hope, the other 16 charitable trusts to which my hon. Friend the Member for Aldridge-Brownhills referred.