(14 years, 5 months ago)
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I can categorically give the hon. Gentleman an assurance that at the appropriate time, before the announcement, I will make sure that my office contacts all three hon. Gentlemen present to ensure that they have advance notice of it.
On the question of foundation status, the hon. Member for Harrow West raised the possibility of North West London Hospitals NHS Trust attaining foundation status. The Government strongly support all trusts that aspire to that aim. Foundation-trust status enables the local NHS to develop stronger connections with communities, so that health care better reflects patient needs. It also creates the conditions for improving performance, which can only benefit patient care. More than half of all eligible NHS trusts are now foundation trusts, but we want to go further. We want to reduce Government control over the health service and set trusts free to innovate and take decisions based on what is right for their local populations. That includes North West London Hospitals NHS Trust.
The trust serves its population well and delivers good-quality care, as the hon. Member for Harrow West mentioned, but to step up to this new challenge, the trust needs to establish a solid financial foundation and needs to gain the support of GPs and commissioners. Bearing that in mind, I understand that the trust is likely to apply to become a foundation trust in 2012, and I wish it well in its application.
I am grateful to the Minister for giving way; he has been most generous. He talked about building the confidence of local commissioning GPs. My understanding is that under his Department’s new arrangements, the ring-holder for the GP commissioning groups set up under the auspices of Brent primary care trust—I am sure the same applies in Harrow also—will no longer be the primary care trust. How does he propose that those groups of private businesses avoid the risk of being providers of services that they commission? Who will hold the ring, as the PCTs used to do?
The hon. Gentleman is tempting me to go down a path that it would be unwise to go down at this stage. The reason I say that, and why I will not be tempted, is that as he is probably aware, my right hon. Friend the Secretary of State and my ministerial colleagues are doing a considerable amount of work putting together and fleshing out our vision for the NHS, not only for the next five years but thereafter—a vision that puts patients at the heart of the NHS and that is driven by the needs and improved care standards of patients. It would be inappropriate and wrong of me to succumb to temptation and to start to unveil, in this august debate, what my right hon. Friend the Secretary of State will announce in due course. The only good news that I can give the hon. Gentleman is that he will not have long to wait before all these mysteries are explained to him, and I am confident that he will be reassured and pleased by what my right hon. Friend the Secretary of State has to say.
My hon. Friend raises an interesting point. It is true, as I hope I have explained, that there have been challenges for the North West London Hospitals NHS Trust with regard to its finances in recent years. However, as I explained—I will go into more detail on this later—measures are being put in place to seek to minimise the problems. I can assure my hon. Friend that when it comes to dealing with PCTs, trusts and the finances, I do not recognise the word “manipulate” as being in the lexicon. Everything is done to ensure that the maximum amount of money is made available to PCTs and trusts, to ensure that we protect front-line services, and to provide the best health care possible for my hon. Friend’s constituents and those of all hon. Members throughout the country.
I wish to correct any suggestion that Brent PCT is in any way financially embarrassed. [Interruption.] My hon. Friend the Member for Harrow West (Mr Thomas) wishes to correct any such suggestion for Harrow as well. Three years ago, Brent PCT was running a deficit of more than £20 million. It took the necessary measures, and that deficit has now been turned into a surplus of £12 million.
I appreciate what the hon. Gentleman says. I am sure that my hon. Friend the Parliamentary Secretary, Cabinet Office, will have taken that on board, and the record will certainly reflect the accurate assessment that the hon. Member for Brent North makes of the situation. However, it is fair to say, particularly in the case of the constituency of the hon. Member for Harrow West, that there has been a problem with the finances. As I said earlier, the requests for a loan and for money that are being considered reflect a need to bring finances into better alignment without affecting front-line services. I am hopeful—probably a bit more than that—that, with the actions that have been taken and the proposals that are awaiting decisions, there will be positive movement.
I come to the point raised by the hon. Member for Harrow West about new hospital build. He mentioned his desire to see completely new build at Northwick Park. As he knows, plans were put forward in 2004 to build a brand new £305-million hospital for his constituents. In 2005, at an early stage of the business case and planning application processes, the plans for the scheme were put on hold by the trust and the local PCTs due to concerns about their affordability. After more than a year on hold, the proposals were formally cancelled by the Department in the summer of 2008. That is standard procedure for schemes that are not progressing and that have been put on hold for a specified period of time. I am afraid that those limitations remain. While the trust is working hard to achieve financial stability, I regret to say that it is still a long way from realistically being able to afford such a large building project.
The hon. Gentleman also raised the issue of designating Northwick Park hospital a major acute centre within the context of the north-west London sector review. The proposals, which I understand are still at a very early stage of development, would need to pass the Secretary of State’s four tests. They would need the support of GP commissioners; the support of the local community; to be evidence-based; and to develop patient choice. That relates to the decision that the Secretary of State took a few weeks ago to strengthen the criteria for considering any reconfiguration by placing more emphasis on gaining support following full consultations with GPs, clinicians and local stakeholders. I am sure that the hon. Gentleman, being a reasonable man, would accept that that is a sensible improvement, with regard to seeking to reconfigure health patterns throughout the country and to ensure that the local community and the clinicians and GPs who deliver the services have more say and influence over what happens.
The hon. Gentleman requested a commitment from me, but there is not a lot that I can tell him at present, because the proposals are at such an early stage. What I can tell him—I hope this will go some way towards reassuring him—is that all proposals, when put together as a final package for consideration, will be fully considered in the context of the Secretary of State’s criteria, and a decision will be taken at the appropriate time.