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Private Finance Initiative

15. Mr. Letwin: To ask the Secretary of State for Health if he will make a statement about his plans for the private finance initiative in the NHS. [418]

Mr. Dobson: Five years ago, the Tory Government declared their plans to get private finance to fund hospital building projects. Five years later, however--if you will excuse the expression, Madam Speaker--not a sod has been turned and not a brick has been laid.

We have introduced a Bill in the House of Lords to clear up any doubts about NHS trusts having the legal power to enter into private finance initiative

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commitments. Once that is through, we hope to be able to get ahead with schemes that have been held up under the previous Government. We have inherited a queue of 59 such schemes.

Mr. Letwin: I thank the Secretary of State for his reply. Will he elucidate further, for those of us inexperienced in such matters in the House, whether it is merely an oversight that clause 1(5) of the Bill to which he referred clearly permits the wholesale privatisation of all clinical services or whether it is part of the new Government's radical Thatcherite agenda?

Mr. Dobson: We have made it quite clear that we shall not have clinical services involved in PFI agreements. When the Bill comes to this House from the House of Lords, if the hon. Gentleman wishes to move an amendment to make that clear, I shall consider it carefully.

Mr. Ronnie Campbell: Will my right hon. Friend look into private finance as it affects non-clinical services? My local hospital in Wansbeck is on the verge of a deal, but those working in non-clinical services are worried about their jobs, conditions and wages. Will those services be included in the so-called sell-off?

Mr. Dobson: I must make it clear to my right hon. and hon. Friends and, indeed, to everyone that it is not a sell-off: it is a method of getting private finance to build national health service hospitals which will be run by the national health service. We shall do what we can--not just through the national health service, but through other changes in employment law--to ensure that staff are protected.

Mr. Yeo: I congratulate the right hon. Gentleman on his appointment as Secretary of State. Will he now confirm that the prospects for the private finance initiative under the new Government have been largely destroyed by the ill-conceived and probably unlawful attempts of his Treasury colleagues to impose a retrospective tax on private investors in a range of essential industries?

Mr. Dobson: If the number of merchant banks that have been knocking on our doors asking us to go ahead with the private finance initiative that the last Government delayed so much is any indication, the onset of the windfall tax has not put them off: they think that they can make some money out of it and that the national health service can benefit at the same time. One would have thought that the clowns who were in office before us would have sorted things out before now.

Donor Organ Shortage

16. Mr. Dalyell: To ask the Secretary of State for Health what estimate he has made of the current shortage of kidney and other donor organs. [419]

Ms Jowell: Some 2,800 organ transplants were performed in the United Kingdom in 1996. More than half

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of them involved the transplantation of kidneys. Some 6,000 people are currently awaiting organs, 5,000 of them for kidney transplants.

The shortfall of organs is due in part to the great success of advances in medicine and public health which mean that fewer people are dying, for instance, in road accidents, and people are recovering from catastrophic illnesses which even a short time ago would have led to their deaths.

Mr. Dalyell: Would Ministers be sympathetic to an amendment of the Human Tissue Act 1961 along opting-out lines?

Ms Jowell: I pay tribute to my hon. Friend's long-standing interest in and concern about the issue. We are very aware of the stress suffered by patients who have to wait a long time for transplants and, like my hon. Friend, we would like the supply of organs to increase. Transplantation is a sensitive issue and approaches to organ donation must command public confidence. We shall therefore be discussing the means of increasing the number of organs available with interested organisations such as the UK Transplant Support Service Authority, the medical profession, transplant co-ordinators and patients' organisations such as the British Kidney Patients Association and the National Kidney Federation. That would be our preferred approach to dealing with the shortfall of organs at this stage.

Mr. Soames: I congratulate the hon. Lady on her new post. Does she agree that the system of advertising for organ donors has been extremely successful and has commanded the confidence of nearly everyone in the country? She is right to refer to the importance of that. Does the hon. Lady also agree that it is very important for the advertising campaigns to continue? Will she take a fresh look to see whether a more novel approach could be instituted to establish further the confidence that is needed throughout the population to ensure a full and proper supply of organ donors for the future?

Ms Jowell: Advertising is one part of the strategy that we would want to assess for increasing the availability of organs for transplant, but I repeat that any steps that we take must command public confidence and there must be a broad public consensus in their favour.

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Health and Social Services Authorities

18. Mr. Hinchliffe: To ask the Secretary of State for Health what proposals he has to clarify the specific responsibilities of health and social services authorities. [421]

Mr. Boateng: We are committed to a long-term care charter defining the standards and services that people are entitled to expect from health, housing and social services. In addition, the examination of services for the elderly will consider a range of issues connected with the funding of long-term care. In the meantime, we expect health authorities to continue the good work that they are doing, together with social services, to ensure that they deliver their continuing care responsibilities.

Mr. Hinchliffe: I welcome my hon. Friend to his new brief. In the short time for which he has held that brief, has he had an opportunity to study the issue of boundary disputes between health and social services authorities about, for example, the question of bathing people at home? Does he agree that it is ludicrous for elderly and disabled people to be the subject of disputes about whether they require a "social" bath or a "nursing" bath when all that they need at their age is a bath? Does my hon. Friend agree that the most appropriate response is to establish a single agency competent to deal with all community care needs?

Mr. Boateng: My hon. Friend has considerable experience in this area, which we value enormously, and we certainly recognise his point. It is important for local authorities and the health service to work together to deliver high-quality care to those who need it. We have already begun to talk to the Local Government Association and the National Health Service executive to deal precisely with the matter that my hon. Friend raises. The real concern of the elderly and vulnerable people out there is not so much who pays for it or who does it as whether it is done adequately, on time and with the quality that is necessary for the best possible treatment. Those are the criteria that we shall use. We shall concentrate not on demarcation lines between the NHS and social services but on how to guarantee the best possible treatment for those who need it, and we shall take that forward as a matter of urgency.

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Bank of England and Financial Regulation

Madam Speaker: Statement by the Chancellor of the Exchequer.

Mr. Kenneth Clarke (Rushcliffe): On a point of order, Madam Speaker.

Madam Speaker: Order. The right hon. and learned Gentleman understands that points of order come after statements.

Mr. Clarke: The point of order is relevant to the timing of the statement. I ask for your ruling on the procedure that will cover the delivery of statements to the House in this Parliament. This will be the first statement in the present Parliament. In the past, the convention has been that advance copies of statements are made available to the Opposition about half an hour before their delivery. It has also been the convention that the annunciator shows a clear description of the contents of a statement. [Hon. Members: "No."] Oh, yes.

On this occasion, I am sure that my opposite numbers in the Liberal Democrat party and in the nationalist parties have had the experience that I had. At 16 minutes past 3, an extremely lengthy statement was delivered to the Opposition Whips Office. The scope of the statement extends far beyond the "Bank of England", which is how it is described on the annunciator, and covers reform of the entire Financial Services Act 1986 and the regulatory system for insurance and financial services as well as banking.

May we have your ruling, Madam Speaker, or perhaps a statement from the Government, about the way in which Parliament is to be treated in future on these matters, and whether this is to be typical of the way that the House is to be informed of decisions?


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