NHS (Charitable Trusts Etc.) Bill

Maggie Throup Excerpts

Friday 6th November 2015 Commons Chamber

[Wendy Morton]

My hon. Friend makes a valid point. I shall explain that a little more later, but the Bill is about creating independence while maintaining accountability. I believe that we are looking for a route to enable these charities to move forward and to be on a more level playing field with some of the big charities operating across the country. Let us not forget that this is something that they have been asking for.

Collectively, across the country, about 260 charities exist to receive and manage charitable funds on behalf of NHS bodies. I am sure that everyone in the House would agree that they do fantastic work and that many Members are aware of local hospital charities in their constituencies. My preparation for this Bill made me think back to when my sister, who was five or six at the time, spent six weeks in the local NHS hospital and my mum was able to stay near the hospital thanks to accommodation that was provided either by a “friends of” organisation or a local charity that provided that sort of sheltered accommodation. Without that, she would have had to make the long journey to and fro every day. I am sure it made a huge difference, not only to her, but to the whole family.

Hon. Members will be interested to learn that just over £345 million was raised by these charities in the past financial year, supporting patients and staff right across the country. I am sure everyone in this House would agree that they make an outstanding contribution and are deserving of our support. Members may be asking why it is necessary to legislate, and that is a perfectly good question. It is one that I have asked, and I now wish to answer it. In simple terms, the Bill is good housekeeping; it is a matter of follow through. The charitable environment has moved on and there is a need to provide certainty in an already complex world and a complex structure. The Bill seeks to remove the Secretary of State for Health’s powers to appoint trustees, so it will draw that process to a conclusion. The Bill is overdue and it makes sense.

Currently, 16 NHS charities have trustees appointed by the Secretary of State for Health and are directly affected by the Bill. They are bound by charity law and NHS legislation. They are currently unincorporated and their trustees have unlimited liability. This means that the 16 NHS charities will choose either to revert to a corporate trustee model, meaning that the board of the NHS body for which the trustees were appointed acts as trustee of the charitable funds, which is how many NHS charities already successfully operate today, or, as many of the 16 have indicated they would like to do, they can convert to become independent charities without Secretary of State-appointed trustees.

[Maggie Throup (Erewash) (Con)]

As I understand it, some NHS charities have already converted to independent status. Will my hon. Friend expand on what benefits they have gained from doing that?

[Wendy Morton]

I will come on to deal with some of those benefits later. Anyone would think my hon. Friend had read my speech, because the next words on it are “six charities”. I can assure you, Mr Speaker, that no one has seen it. Six charities have already completed the transition to independence. They include Barts Charity, which raises money for Barts Health NHS Trust, including St Bart’s hospital. That was the first to convert to an independent model. The others are Alder Hey in Liverpool; Birmingham Children’s Hospital Charity, which is close to my constituency; and Guy’s and St Thomas’. The Royal Brompton & Harefield Hospital Charitable Fund has also become an independent charity. They are all able to benefit from greater independence and less bureaucracy.

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[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.

[Maggie Throup]

How much does the charity raise each year? Obviously, it does fantastic work, as we have been hearing, and I wonder what the total figure is.

[Wendy Morton]

In a nutshell, the figure is significant, and I will come on to that shortly.

The charity funds vital support services that care for the child and often the whole family: financial advice, parental accommodation, as well as spiritual support and helping families to stay together and manage their lives during what can be very difficult and trying times.

The Great Ormond Street hospital charity has a large number of donors, individual companies and, I am told, celebrities who support their work. On fundraising, Members will be interested to know that the charity raised £80,981,000 in the financial year 2014-15—an increase on the previous financial year—so the figure is indeed significant.

One of the most generous donors in its history is, of course, J.M. Barrie. As the Great Ormond Street Hospital Children’s Charity is keen to take advantage of the opportunity to move to independent status, specific legislation is required to provide for the rights to the “Peter Pan” royalties to be given to the new charity. The idea of royalties being paid to a charity is not unusual in itself. As we approach the run-up to Christmas, I am reminded of songs recorded for charity where royalties go into charitable trusts, but the relationship between Great Ormond Street hospital and “Peter Pan” is different. It is already a unique situation, and a unique solution is required to enable the rights to the crucial royalties to be given to the Great Ormond Street Hospital Children’s Charity, so that Great Ormond Street hospital can continue to benefit from the generous J.M. Barrie bequest.

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[Anne Marie Morris]

Mr Speaker, this is such a fascinating subject that I want to ensure it gets the air time it deserves. I know that my hon. Friends also have a lot to say. I am sure that we will manage to have an interesting and long debate.

[Maggie Throup]

Does my hon. Friend agree that we must get things right not just because of the financial implications for the charity, but because of the charity’s reputation?

[Anne Marie Morris]

My hon. Friend makes a crucial point. Reputation is critical. The changes that we are making today will add to the charity’s reputation and help it to raise further funds for what is a worthwhile cause.

If I may, I will continue to explain the fascinating history of Great Ormond Street hospital, the contribution it has made to our country, and why the Bill is so important and valuable and has my support and that of the Government, despite the hospital’s humble beginnings. Just as you arrived, Madam Deputy Speaker, I was explaining that the hospital originally had just 10 beds and two doctors, and was situated in a 17th-century townhouse. It has constantly redeveloped itself to ensure that it is suitable for the treatment of modern illnesses as medicine develops.

Before the inception of the NHS in 1948, Great Ormond Street was a voluntary hospital that ran fundraising campaigns to expand its size from the 1850s onwards. Because private fundraising was strongly regulated, it was owing to the support of people such as Barrie who left legacies to the hospital that it was able to develop the highest standards.

Throughout its history, the hospital has been at the forefront of numerous breakthroughs in paediatric healthcare, such as appointing the first consultant paediatric surgeon, Denis Browne, in 1928; opening the UK’s first heart and lung unit in 1947; opening the UK’s first leukaemia research unit in 1961; pioneering the first heart and lung bypass machine for children in 1961; performing the first successful bone marrow transplant in Britain in 1979; undertaking the world’s first stem cell-supported trachea transplant in a child in 2010; becoming Europe’s first children’s hospital to offer a portable haemodialysis service in 2010; and opening the Newlife birth defects research centre in 2012, which is Europe’s first research centre to tackle birth defects.

Great Ormond Street hospital would not be able to make such advances without the relevant and up-to-date equipment it has. Thanks to its supporters, it is able to provide its patients with leading-edge equipment, so that its exceptional doctors and nurses can improve diagnosis and treatment, and continue to provide children with the world-class care they need. In one notable instance, a 15-year-old machine developed an unrepairable fault and had to be replaced in 2012. If the funds to upgrade it had not been available, the hospital would have had to continue to refer patients elsewhere for imaging, which would have been inconvenient for families and costly to the hospital.

The equipment owned by the hospital includes specialist X-ray equipment, such as cone beam CT technology, which can take high-quality 3D images with less radiation than a standard CT scanner. The ultrasound equipment in the Dubowitz neuromuscular centre is used to assess about 350 patients each year and helps clinicians to make a faster and more accurate diagnosis of conditions such as muscular dystrophies, myopathies and motor neurone disease. Nutritional equipment includes equipment that can help patients, such as premature babies, those in intensive care, or those receiving treatment for gastrointestinal conditions or cancer. Because those patients are in a fragile state or receiving strong medication, they need a precise recipe with the right balance of fluids and nutrients, and the hospital is able to provide it.

[Maggie Throup]

My hon. Friend has explained precisely why Great Ormond Street hospital needs extra charitable money. It carries out fantastic work that is over and above the work found in so many other hospitals, and it is renowned across the world for its work. Whatever money it can raise through charitable donations is important.

[Anne Marie Morris]

As ever, my hon. Friend makes an important point. It is right that the money goes towards new, far-reaching, novel pieces of equipment and medical solutions, which are exactly what we need in this country. We should be proud of that and do everything we can to enable the hospital to gain as much funding as possible.

The hospital is able to facilitate a number of different wards for a number of different treatments, and that is due to the continued contribution from donations and legacies. Barrie’s contribution has been so significant over the years that, fittingly, there is a Peter Pan ward—I am sorry that there is not yet a Wendy ward, but I am sure we can do something about that.

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[Maggie Throup (Erewash) (Con)]

I am delighted to contribute to today’s debate on such an important issue, and I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on deciding to raise it in this place and to make these changes, which I am pleased to support.

Our nation would be a poorer place without the thousands of charities and their trustees who contribute their time and their expertise without fear or favour. As we have heard, this is trustees’ week, so it is appropriate to debate this issue today. Close to my heart are the many hospital-related charities that play such an important role in supporting our free-at-the-point-of-care national health service that has served us so well. It is vital that such charities are allowed to conduct their good work with as few barriers as possible.

The current structure of NHS charitable trust status has three main disadvantages. First, potential donors may perceive that the charities lack independence from government. Secondly, being bound by legislation prevents the charities from adopting different legal forms specific to their needs, particularly those offering limited liability. Thirdly, the Charity Commission believes that dual regulation under both NHS and charity legislation makes it difficult for NHS charities to achieve and demonstrate independence. It is therefore vital that NHS charities have the opportunity to move to independent charity status.

In my constituency, I have many charities that support the work of the NHS in some way, but today I want to highlight just two of them. First, Ilkeston community hospital league of friends is a dedicated group of people who do everything from making cups of tea for visitors and taking the newspaper trolley around the wards to holding extremely successful spring, summer and Christmas fairs. A recent bed push up Ilkeston’s main street, Bath street—and when I say up, I mean up the hill—raised over £1,400. These events raise valuable additional funding providing for those added extras that make such a difference to my community hospital. This has included a scanner for the Val Jackson scanner suite at Ilkeston hospital, and the list goes on and on.

Secondly, I have an amazing hospice, Treetops Hospice Care, located at Risley, but serving the wider community across Derbyshire and parts of Nottinghamshire. Only the other day, we heard a very powerful speech in this place by my hon. Friend the Member for Lewes (Maria Caulfield)about the importance of palliative care. Treetops Hospice Care is a bit unusual as it does not have any beds, but provides all its end-of-life care and support in the community. As we heard on Wednesday, up to 70% of people want to die in their own homes, yet only 30% manage to have their wishes fulfilled. The invaluable care in the community that Treetops provides is helping my constituents to fulfil their wishes, which must be comforting for their families at such a difficult time. Treetops is innovative in its fund raising, too, holding everything from dog shows and vintage fairs to car boot sales and a sponsored bike ride taking in all the different charity shops that make a contribution—and I am pleased to say that I took part on a tandem.

My constituents and the wider population give generously and freely to both Ilkeston community hospital league of friends and to Treetops Hospice Care. These two charities are not bound by the legislation that the NHS charities in question are today.

As previously mentioned, the Bill takes away one of the barriers to maximising donations for the NHS charities in question. It removes the Government’s involvement, as it removes the role of the Secretary of State in appointing trustees. This move will enable potential donors to know that the NHS charity is truly independent from the Government.

I now wish to talk specifically about Great Ormond Street hospital. I have visited this amazing hospital on numerous occasions in a professional capacity, so I felt touched by the descriptions that my hon. Friend the Member for Aldridge-Brownhills and the hon. and learned Member for Holborn and St Pancras (Keir Starmer) provided of their visits to this amazing hospital. Like them, I felt very privileged to have seen a small part of its ground-breaking work and the care that is given there. Only yesterday, we heard about the one-year old girl, Layla Richards, now in remission from leukaemia as the result of innovative gene editing, creating designer white blood cell treatment. That really was fantastic news—both for Layla and her family.

[Bob Stewart]

I have to declare an interest, as my wonderful daughter-in-law, Nicola Stewart, is a nurse at Great Ormond Street. I just want to confirm and support everything my hon. Friend is saying about the dedication of the nurses and doctors at Great Ormond Street hospital.

[Maggie Throup]

I thank my hon. Friend, and I completely agree that every doctor and nurse, and every NHS worker goes beyond the call of duty—not just at Great Ormond Street, but in hospitals throughout the country. We owe a great debt of gratitude to them for the work they do.

J. M. Barrie made a very generous and powerful donation when he gifted the rights from “Peter Pan” to Great Ormond Street Hospital Children’s Charity. I am sure the renowned author would be cheering from the Gallery, if he could, to hear that his wishes are to be continued through the mechanisms of this Bill.

[Mr Jacob Rees-Mogg (North East Somerset) (Con)]

Mr Barrie had better not cheer from the Gallery; if he did, he would be ruled out of order.

[Maggie Throup]

I bow to my hon. Friend’s greater knowledge of this place.

It is only right that every effort is made to ensure that the moneys available through the rights are used for the original intended purpose. I am sure that the parents and patients at this world-leading hospital will be backing this Bill, as they can see and experience first-hand how important additional charitable donations are to the workings of this hospital. The Bill provides for much-needed changes to legislation, and I will support it in the Lobby today.

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[Simon Hoare]

I am grateful for your ruling, Madam Deputy Speaker—and I am drawing my remarks to a close.

I also think that the Bill is helpful in terms of general governance. As has been noted, Great Ormond Street currently operates two charities side by side. That requires two reports to the Charity Commission, two sets of audited accounts, and a duplication of arrangements involving busy people who could, quite properly, be engaging in other activities to raise funds.

[Maggie Throup]

It is not just about the duplication of effort but about the fact that money that has been spent on creating the accounts and on the bureaucracy could have been spent on the work that the charities carry out.

[Simon Hoare]

My hon. Friend is an energetic champion of deregulation and trying to cut away as much red tape as possible. I am sure that the electorate of Erewash are delighted by that. I agree with her entirely that this could free up not just time but valuable funds for a more health-related purpose.

My hon. Friend the Member for Aldridge-Brownhills has delivered the Bill with great clarity. In this day and age, it is interesting and unusual when any Secretary of State is prepared to see power taken away from them. The Bill champions the cause of localism and local involvement, which is a good thing. Although the Bill cannot prove this of itself, there might well be opportunities to raise additional funds from trusts if potential donors understand that the trust is separate from, and not appointed by, Whitehall and Westminster, and that they can donate with confidence and comfort because the Charity Commission’s rules of governance for charitable trusts are writ large within the Bill as safeguards to ensure that any moneys raised are used for their proper purpose. I support the Bill entirely.

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[Maggie Throup]

Does my right hon. Friend agree that we are richer as a nation because of the unique combination of our free-at-the-point-of-care NHS and all the charities that support it, which all come together to make us bigger and better?

[Alistair Burt]

Yes. I do not think I am trespassing on any party political ground in saying that we should recognise that people’s desire to give is built on more than just paying their taxes; it is built on an innate desire to help their communities and their neighbours. That is an instinct that cannot and should not be stopped, and it will always find its way into other areas where there are services funded by the state, but it adds a dimension that is very special. Each is valuable in its own way, and my hon. Friend is right to draw attention to that.

My hon. Friend the Member for Yeovil (Marcus Fysh) spoke of his young days visiting hospitals as the son of a paediatrician. My dad, who might be watching this debate, is a retired general practitioner and I also remember visiting hospitals with him. Perhaps, like me, the sight of needles and machines that go “ping” were sufficient to put my hon. Friend off going into medicine, which means he has ended up in the same place as me. Those days, however, were valuable and we are grateful to all those who work in the health service and have made a contribution. As a senior paediatrician, my hon. Friend’s father will have certainly done a lot of good throughout his career.

My hon. Friend the Member for North Dorset (Simon Hoare) also supported the change in the law and invited us to comprehend the risks involved in various trustees supporting Lucky Lad at Uttoxeter. Unfortunately, my brief does not extend to whether that is common practice among trustees or whether it was a major inspiration for the Bill, but my hon. Friend made his point well and it is covered by what we will go on to do.

My hon. Friend the Member for Torbay (Kevin Foster) spoke of the importance—he has also just mentioned this in his intervention—of recognising that Great Ormond Street hospital serves so many of us. He also spoke of the Torbay Hospital League of Friends and its “This is critical” campaign, which is a perfect example, as my hon. Friend the Member for Erewash has said, of a combination of people who recognise that funds are available through the national health service, but who want to make an extra contribution on top of that. We wish that and similar campaigns well.