NHS (Charitable Trusts Etc) Bill

Sheryll Murray Excerpts

Friday 22nd January 2016 Commons Chamber

[Michael Tomlinson]

I certainly would not agree that my hon. Friend’s experience is mediocre—quite the opposite. I understand the thrust of his point, but I disagree, because at a time when politics can be seen to be remote it is important that the public are engaged in these debates. I also think it would be wrong to say Ministers’ minds are closed. I am sure those on the Front Bench this morning would agree that Ministers’ minds are not, and should not be, closed—certainly not before a public consultation.

[Mrs Sheryll Murray (South East Cornwall) (Con)]

May I repeat a question already asked: who would finance the public consultations? Would it be the charitable trust, the Government, or local government? Will my hon. Friend expand on that?

[Michael Tomlinson]

The point about cost is important. At the end of the day it would have to come from taxpayers, which I accept is a challenge and a potential disadvantage. My argument is that in the principle of a public consultation the advantages outweigh the disadvantages.

[Mrs Murray]

What is my hon. Friend’s estimate of the consultations’ cost to the taxpayer? Has he done any analysis of how many consultations there might be, and of their cost?

[Michael Tomlinson]

Again, I do not have those figures to hand. My hon. Friend is right to raise this because it is an issue of concern; cost must always be borne in mind, but, as I have said, I am speaking to the principle, and unfortunately I do not have the specific figures she asks for.

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[Michael Tomlinson]

Again, I am grateful for the intervention and understand the point being made, but I disagree with my hon. Friend. Although this is technical in nature, I believe the principle of public consultation would be beneficial to the wider public. It would be curious to be opposed to public consultation, certainly in principle, given that this Bill is a product of just such a consultation.

Let me give one further example of public consultations attracting wide support. Many in this House, on both sides of the Chamber, have been fighting for fairer funding.

[Mrs Sheryll Murray]

I completely agree with my hon. Friend that most of us would support adequate public consultation, but I am concerned that we do not know how much cost we will burden the taxpayer with. I press him again: how many consultations does he envisage? What would the cost be?

[Michael Tomlinson]

Once again, I am grateful for the intervention, but, with respect, may I say that my hon. Friend is merely repeating a point that she made before? As I explained, I do not have those figures to hand and so, with regret, I cannot give her a specific figure. I understand the general thrust of the point she makes, but I respectfully disagree with it and am giving a further example in relation to fairer funding, with which I think she will agree. I refer to the successful campaign for fairer funding for our schools, where there will be a period of public consultation following it.

[Mrs Murray]

Is my hon. Friend indicating that local authorities would have to bear the cost?

[Michael Tomlinson]

Again, with respect to my hon. Friend, may I say that she is repeating a point she made before? I did accept that this money would have to come out of the public purse, but I am seeking to persuade her and other hon. Members that the benefits of public consultation will outweigh the costs. I am giving a good example, or at least I hope I am, about fairer funding. I hope she will agree that having fought and campaigned for fairer funding for our schools, for example, those in Dorset and Poole, which are grossly underfunded, it is right that the public and the stakeholders are consulted. It is right that parents, local authorities, school governors and the general public are consulted, and I encourage everyone to respond to that consultation to ensure that we—

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[Kit Malthouse]

Yes. I am trying to get to a position where we can have confidence in the governance of charities, and confidence that when things go wrong, there are appropriate mechanisms for someone to step in and deal with things quickly. My point is that in the case of national health service charities—that is what people think of them as—at some point, the Secretary of State will be asked to sort out problems.

We have to remember that there are practicalities involved in this. If the Secretary of State is unable to take control of the board and replace the trustees, he or she cannot get immediate access to the bank account. They cannot get anybody to sign a mandate to allow them to control the money, or even to freeze the account to stop money flowing in or out. When this hospital pass, this UXB or unexploded bomb of a hospital charity that has behaved badly or got into trouble, perhaps through no fault of its own, lands in the lap of a Secretary of State, whoever it may be—it could be one of us here on these Benches in the future, perhaps—the inability to step in and take control will have a significant political, and indeed financial, impact. That might impact on the care that takes place on the ward.

[Mrs Sheryll Murray]

My hon. Friend has cited one charity as an example, but does he have any recent information about any NHS hospital charities or NHS charitable trusts on which he is basing his assumptions?

[Kit Malthouse]

I do not, and the reason is that the Secretary of State currently has control of the appointment of trustees. That is exactly why. If I were Secretary of State—I assume that the same is true of the current Secretary of State and past Secretaries of State—I would be very careful about who I appointed, so that I was sure that I was handing that fiduciary duty to people whom I trusted and who had an element of accountability to me.

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[Kit Malthouse]

My hon. Friend makes a mistake. I did not object to the time; my hon. Friend the Member for Horsham (Jeremy Quin) objected to time possibly being used on these matters. I am perfectly happy. I think that the Bill is very good and I support its broad thrust.

[Mrs Sheryll Murray]

Will my hon. Friend confirm that, when he said that the Bill relates to a single NHS charity, he was referring to one clause? It would help if he clarified that because I got the impression that he said that the Bill related to one specific NHS charity.

[Kit Malthouse]

My hon. Friend is right. I correct myself. One clause relates to Great Ormond Street and the rest of the Bill clears up some anomalies. The debate is not about Great Ormond Street’s requirements, but about other ancillary bits in the Bill. One wonders whether the rest of the Bill could have been included in the Charities (Protection and Social Investment) Bill, and we could have had a short measure about Great Ormond Street, but that is a matter for the Bill’s promoter and sponsors.

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[Kit Malthouse]

No, I am not being pessimistic. I am, I hope, exhorting a message of confidence and optimism that we as politicians should have some sense of belief in what we do. We take our chances—sadly, only once every five years now, rather than once every random number of years—and have confidence. Like my hon. Friend, I want to be a champion for the power and the outlook of this House, so that we do not have to go out and consult constantly, that we are based in a philosophy of which we are sure, and that people understand why our decisions are made given what they have seen of that philosophy.

[Mrs Sheryll Murray]

My hon. Friend mentions his experience in previous roles of engaging in unnecessary and lengthy consultation procedures. How much of a financial burden does he feel they have been on the taxpayer?

[Kit Malthouse]

I cannot give my hon. Friend an exact figure, but it is enormous. Many, many hundreds of millions, if not billions, have been spent on consultation where, broadly, minds were made up beforehand. I well remember, back in 2002, the then Mayor of London, Ken Livingstone, consulting on bringing in the congestion charge. He, of course, had already made the decision. In fact, during the consultation the gantries to put the cameras in were already going up. Of course, the response from the public came back overwhelmingly against—nobody wanted it. We could all see the disaster it would be, not least because it was not a congestion charge but a tax on central London. He just shoved it in anyway.

I led the judicial review against the congestion charge in the High Court and sadly failed. The only chink in the armour we could find was the environmental audit, which was useful to me then but is a vehicle that Ministers and other politicians go through to tick the box. We find ourselves, as a country, in this enormous box-ticking exercise. So uncertain are we of what we should and should not do, and so wary are we of the vagaries of public opinion and fashion, that we feel the need to consult constantly.

The wider point is that it communicates to the public an uncertainty about political institutions and therefore undermines respect for them. When people talk about the politicians they respect, they always talk about—even though they did not agree with him—the great Labour Member, Tony Benn. Tony Benn always used to say, “Say what you mean and mean what you say.” I do not think Tony Benn ever consulted about anything in his entire life. He had his beliefs pretty much set at an early age and he delivered them. Everybody knew where he stood. Our former great leader, Margaret Thatcher, was exactly the same. A lack of consultation with her party colleagues might have done for her in the end, but consultation on the broad thrust of policy was anathema to her. She displayed and promoted what she believed. On that note, I commend my amendments to the House.

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[Wendy Morton]

My hon. Friend is correct that my Bill is the result of public consultation, as I will expand upon later.

Schedule 1 already makes a range of amendments to primary legislation consequential to the removal of the Secretary of State’s powers in England to appoint trustees to NHS bodies and to appoint special trustees, and it would be unusual to consult the public on regulations making such consequential changes. Proper scrutiny of such consequential amendments would be undertaken by Parliament. That is the main reason I do not support his amendment even though it is a valid discussion point.

I will move now to those amendments that relate to the appointment of trustees. My hon. Friend the Member for North West Hampshire has clearly given a lot of thought to my Bill and introduced some very worthy and interesting amendments. I wish to make it clear, however, that I do not wish to swap the letterbox of Aldridge-Brownhills for that of North West Hampshire, given the apparent tone of much of the mail that he receives, and neither would I wish to go camping with his family—the thought of my sleeping bag being laid on concrete does not appeal. I would prefer something more comfortable. Even a field would be preferable—ideally undercover.

The removal of the Secretary of State’s powers to appoint trustees is central to my Bill. Having him appoint trustees makes it difficult for these NHS bodies to demonstrate visible independence from Government in the eyes of potential donors. That cuts to the heart of my Bill. Having read and considered the amendments carefully, and having listened to this debate, I struggle to see how they would work on a technical level. The current power is to appoint trustees to particular NHS bodies or to appoint special trustees, not, as the amendments suggest, to appoint trustees to NHS charitable trusts. They therefore seek to re-establish a power that does not currently exist in such a form. I know that the Bill at times gets very technical, but we have to keep coming back to what it sets out to do and the consultation it came from. Similarly, the amendments seeking to retain the Secretary of State’s power to appoint trustees in particular circumstances, when there is a commitment to remove them, are not appropriate.

Before I talk further about amendments relating to trustees, it is important to remind ourselves of the background to clause 1, which I have alluded to before. The Bill concerns the removal of the Secretary of State’s powers to appoint. Since 1973, the Secretary of State has had powers to appoint so-called special trustees to manage charitable property on behalf of hospital boards. In 1990, powers for the Secretary of State to appoint trustees in relation to NHS trusts were enacted, and have since been extended to other NHS bodies. These powers are now set out in the National Health Service Act 2006, as amended.

My private Member’s Bill fulfils a commitment made by the Government subsequent to the Department of Health review and consultation—there is that word again—in 2012, which covered the governance of NHS charities. As a result, NHS charities will be allowed to convert to independence and the Secretary of State’s powers to appoint trustees will be removed at the earliest opportunity. That is what my Bill is designed to achieve.

[Mrs Sheryll Murray]

In the light of what my hon. Friend has said, are not some of the amendments completely unnecessary, because consultation has already taken place? Is that correct?

[Wendy Morton]

Absolutely. As I am explaining, the amendments, worthy of consideration though they be, are not necessary in the light of the research I have done, and they would fundamentally change the objectives of the Bill.

The amendment to make

“provision for one trustee to be appointed by the NHS institution…for whose benefit the charitable trust exists”

is an interesting one, but again I do not believe it necessary. Under the new independent charity model there can be a “blend of trustees”, meaning there can be a link to the hospital—on the proviso that the NHS members remain in the minority. That is important. When we are seeking to move away from Secretary of State appointments to a more independence model for special charities, it is the word “independence” that is crucial. These charities are seeking to be independent of Government for fundraising and many other purposes.

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[Kevin Foster]

I am conscious of the time, so I shall be careful not to be either repetitive or irrelevant, and to confine my remarks to the amendments. I should make it clear at the outset that, while I respect the points of passion—and fashion—that have been made in support of them, I do not think that any of them would enhance the Bill.

Amendment 4 deals with public consultation. We surely do not want to ask people to comment on a matter that has already been decided, or in circumstances in which a response to a consultation will not make any real difference to the outcome—other than, as was pointed out by my hon. Friend the Member for South East Cornwall (Mrs Murray), potentially helping to take funds away from either the charity and its objectives or the Department of Health, which is paying for the consultation.

As several Members said, nothing is more likely to build public cynicism about politics than the idea that people have been asked to comment on something and their comments will then be virtually ignored. I can think of an example in local government. A council wanted to reduce free weekend parking, because that had been a manifesto commitment and the council had been returned with a majority. However, it then had to engage in a legal public consultation to find out whether motorists objected to the idea of free parking at the weekend, as opposed to the idea of paying for it. That was absolute nonsense. Several thousand pounds were wasted on advertising in the local press with public notices, and, funnily enough, no motorist wrote in saying, “Do you know what, I would actually like to pay two quid next time I park.”

We should not introduce measures that will engender cynicism. We should not say that a measure has been decided on and announced, but will be subject to a consultation; nor should we provide for a consultation on a matter that is highly technical, and with which very few people will be able to engage. When I was preparing for the Second Reading debate and for today’s Report stage, I found myself burrowing into a huge amount of detail. I do not see how a consultation would be effective.

[Mrs Sheryll Murray]

With individual consultations as well, there is no guarantee we are going to reach everyone. I remember when a consultation was entered into on whether Cornwall should have a unitary council, and the company used admitted in the end that it had not reached all the households concerned, so a lot of people were missed. This is one of the downsides of consulting on individual things.

[Kevin Foster]

My hon. Friend makes excellent points about the difficulties in reaching everyone. In the consultation that created Cornwall Council, there was a major discussion to be had on, I believe, six district councils and one county council being merged into one. There was significant media coverage on, for instance, BBC “Spotlight” and BBC Radio Cornwall, but still, even after all that, some people will have said, “I didn’t know the consultation was going on,” or “I didn’t know exactly what the nature of the consultation was.”

I sat through discussions about future local government structures, including referendums on an elected mayor, during my time in the midlands. People could, I think, engage with some things—for example, planning decisions or social services decisions—but in terms of how a local charity board is structured at the local hospital, and who can make appointments, how they are structured and the process gone through to make them, I cannot see many people saying, “I want to go out to talk about that on a Tuesday night in mid-February.”

If we are having consultations, they should be meaningful. On the question of what is “appropriate”, we should be asking what the appropriate stage is of decision making for each item. As I have argued in the Chamber before, on major constitutional change—the voting system for this House, for instance, or whether we abolish, or significantly change, the other place—we would probably at least need a manifesto commitment, and without that people should be directly asked for their consent to make that change. In terms of the fundamental constitution, it should have the direct consent of the people, therefore. At the other end of the spectrum, however, none of us would argue that the things that this House deals with through secondary legislation would be appropriate subjects for public referendums.

We should ask what the appropriate process is, and in this case the appropriate level of consultation would more be along these lines: “Yes, the charities should talk to each other and, yes, they should go through the normal process to appoint trustees by speaking to their members, but they do not necessarily have to host a public meeting to discuss that.” If this amendment were passed, there would be the nonsense that these particular charities would be required to go through a public consultation, yet the vast majority of charities in this country, who are regulated under the normal method for charities, would not have to do so. I recognise the intention of my hon. Friends the Members for Erewash (Maggie Throup) and for Mid Dorset and North Poole (Michael Tomlinson) in wanting people to be able to engage with the NHS and its services, but this amendment is not the right way of going about it.

On amendments 1, 3 and 2, tabled by my hon. Friend the Member for North West Hampshire (Kit Malthouse), I found the level of doom and disaster that was presented as possibly affecting these particular NHS charities quite interesting. If anyone listening is thinking of becoming a trustee, they might be slightly put off from doing so when they hear all the things that could possibly happen to them as a member of the board of trustees of one of these charities. I am not at all convinced that we need special provision in this Bill for these charities, rather than the wealth of charitable legislation that we already have, including a Bill currently before this House to change that legislation.

I do not think these amendments would tackle the issues, and worst of all they still give the idea that the Secretary of State is in control of a charity. As I said on Second Reading, at the heart of this Bill is independence. It is about these charities not being seen as an arm’s length part of the Department of Health—not being seen as government by the back door.

[Kevin Foster]

My hon. Friend is right. The whole point of the Bill is to free these charities from being, in effect, arm’s length parts of the Government. If we say, “We want to free you, but now we want to pop back in the Secretary of State having specific powers that do not apply to any other charities”, that is not a coherent argument and it would not produce coherent legislation. Hon. Members may have concerns about how charities are regulated and whether someone can go off to the Seychelles with the money, but that is a debate about the wider system of charity regulation in this country. They should not seek to put something specific into this Bill that adds another layer of bureaucracy for the charities involved, given that the whole point of the Bill is to get shot of such bureaucracy. I am not persuaded by those amendments.

Amendment 9 deals with the NHS logo. It was put forward eloquently by my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), but, sadly, I will not be joining in the fashion of supporting it. I appreciate that the bodies it deals with are working closely with the NHS, but so, too, do other charities. For example, the Torbay Hospital League of Friends has its own logo and it successfully raises money for Torbay hospital. The name makes it obvious what it is linked with.

[Mrs Sheryll Murray]

We could extend that point even further. A lot of the surgeries in my constituency have “friends of the surgery” organisations. Are we saying that they should be allowed to use the NHS logo, too? Where does this end?

[Kevin Foster]

I thank my hon. Friend for that good point. Once we start on the principle of these changes, where do we stop? Karing, a charity in my constituency—it is in Preston, in Paignton—is very closely linked with a local doctor’s surgery, and it was lucky enough recently to have had its new base opened by Esther Rantzen. It is not, however, part of that surgery. Clearly, the two work together, with Karing supporting and providing great services, giving real benefits to local people, but, crucially, it is not part of the business that is the surgery, nor is it part of the business that is the NHS. That is where the logo point comes in.

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[Mrs Sheryll Murray]

I will be as brief as possible, Madam Deputy Speaker. I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on her expert stewardship in guiding the Bill through Report to Third Reading.

I must declare a special interest as a former doctors’ receptionist in my constituency for more than 20 years. I witnessed several occasions when patients needed treatment that was not classed as a priority, but was naturally very important to them. This is where NHS charities can play, and have played, a vital role.

I also pay tribute to the Seafarers Hospital Society and commend the work it does. It was established about 200 years ago and still provides services to seafarers and fishermen at the Dreadnought unit in St Thomas’s hospital, just across the Thames. It provides vital services for those very brave men who operate in very dangerous conditions.

We must not forget the wonderful work, which many Members have mentioned today, of the leagues of friends, which provide comfort and support to patients and their families, often at difficult times in their lives. Staff in my South East Cornwall constituency and across the country benefit considerably from their work.

I want briefly to mention the way in which the family of one of my constituents benefited directly from the amazing work of Great Ormond Street’s charitable fund. It meant that essential treatment was provided to their daughter at a critical time. I put on the record my thanks to Great Ormond Street Hospital Children’s Charity and to the hospital and its staff for their work at what was a very difficult time for that young lady and for improving her life so considerably.

There are some outstanding NHS charities in the south-west. Obviously, I could not sit down without mentioning the fantastic work of Cornwall Partnership NHS Financial Trust charitable fund and Plymouth Hospitals General Charity, which enables Plymouth Hospitals NHS Trust to improve services for patients, many of whom are my constituents.

To conclude, I warmly welcome the Bill and offer my support and congratulations to my hon. Friend the Member for Aldridge-Brownhills. Her vision and tenacity will help NHS charities to continue, thrive and evolve.