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8.15 pm

Mr. Hilton Dawson (Lancaster and Wyre): As we are discussing a health Bill, it occurs to me that the life style here is incredibly unhealthy, what with spending the night in one's office and five hours on the Benches. I was wondering where the pain in my neck was coming from, but then I realised that it was from listening to absurdities about the Conservative party riding to the rescue of community health councils.

Quite a few colleagues have come out as former members of CHCs. I used to be a very junior and inexperienced member of Lancaster CHC. At no point during my eight years in that body did the local Conservative Member of Parliament talk to me about health issues, and I certainly did not see her at any of the meetings or demonstrations that we organised. I was not conscious of her support for us as we tried to fight off the rundown of vital health service resources in Lancaster, the disastrous introduction of market orientation, the removal of local representatives from any positions of influence and the barring of the CHC from doing its job effectively.

We should acknowledge that this is a good and important Bill. It is another example of the Government making public-private partnerships work, with the new investment in family doctor premises. The emphasis on

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bringing together health and social services in a coherent way has been welcomed by almost everyone who has spoken on the issue. We need greater incentives in the NHS to support the best-performing hospital and community trusts, and there should be more intervention.

We have not had full acknowledgment of the major step forward that the Bill takes to provide free nursing care in nursing homes, benefiting about 35,000 of the most needy and vulnerable people in the country. In May 1997, my constituency embodied some of the worst features of both urban and rural deprivation, and I am extremely pleased to see the new measures to attract GPs to under-doctored and deprived rural areas. The Government are trying to bring fair funding to the NHS. In the two rural health authority areas in my constituency, that can only be for the good. There is no doubt that many people in rural communities lost out badly in the past. I also welcome the new GP's contract.

The great thing about the Bill and the NHS plan is embodied in the quote that I offered the hon. Member for Sutton and Cheam (Mr. Burstow) a few minutes ago:

I agree that it should probably refer to people--

That quote is from the core principles of the NHS plan.

We heard a lot of nonsense from the hon. Member for Southend, West (Mr. Amess) about who did not agree with that plan, but there has been clear acknowledgement of its importance. Almost every reputable health-based organisation has signed up to the fundamental principles of the new future of the NHS.

The following quote is also significant to me:

That is what a doctor said to me when I visited the Royal Lancaster infirmary in my constituency. Incidentally, on the same day my right hon. Friend the Secretary of State announced an extra £800,000 for intensive care services at that excellent hospital.

We are getting the major investment that the health service has needed for many years. There is to be an increase of one third in real terms in NHS funding in the next five years, but we also need the radicalism to transform an institution--albeit a beloved one--that has become ossified because it has been underfunded and neglected. We need to change its structures, its systems, its strategies, its policies, its practice and all its myriad ways of getting on with the job to meet the needs and preferences of individual patients, their families and their carers. The tremendous radicalism of that change of emphasis, that fundamental transformation in the way in which we want the national health service to work has been overlooked throughout this debate.

Mr. Hammond: The hon. Gentleman seems to have moved slightly off the point. I should be grateful if he would clarify whether he supports the Government's proposal to abolish CHCs in England, or whether he opposes it. In my winding-up speech, I shall want to do a

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tally of hon. Members who have spoken on each side of that argument and the hon. Gentleman's position is a little ambiguous.

Mr. Dawson: The hon. Gentleman should possess his soul in patience. I shall come to that in due course.

Mr. Bercow: We cannot wait.

Mr. Dawson: Good.

The Government are embarking on a radical agenda that promises to put behind us the medical model of the NHS, which sees patients as collections of symptoms rather than unique individual human beings. The new measures will bring the NHS into the modern world. One of my constituents, a GP, told me:

The new plan is so radical that some of the NHS's best friends do not appreciate what is being undertaken. That is understandable because CHCs in particular had to fight for the principles of the NHS against the policies of the Conservative Government. As they had to defend vital services from the cuts imposed by the previous Administration and try to protect and preserve local quality services that were under threat for so long, many of my constituents who are involved in CHCs remain in a very defensive mode. That certainly applies to some of the dedicated, experienced people who fought the depredations of the Conservatives for so long. However, we cannot hold up CHCs as paragons of perfect performance within the NHS because, no matter how experienced, qualified, able and articulate people were, they were shouting from the sidelines and their efforts made very little difference against the will of the previous Government, who were trying to run down the NHS.

We need far more effective ways of involving patients in the future of the NHS. It is the statutory duty of all elements of the NHS to consult people and it is now important to wrap the service around the fundamental principle of patients' needs.

Mr. Bercow: I am grateful to the hon. Gentleman for giving way because a cloud of ambiguity continues to overhang his view of the future of community health councils. Does he now regret signing the motion commending the work of community health councils on 13 December?

Mr. Dawson: I do not regret that for an instant. I thought that I had made it perfectly clear that I think that community health councils have done a remarkable job. Since I signed that motion, the Government's vision of the future of patient involvement and patient empowerment--[Interruption.] Opposition Members may scoff, but it has been obvious from what we have heard during the past few painful hours that they have no vision for the future of the NHS and have given it little thought. As usual, they are jumping on one nonsensical bandwagon that years of their failure to support CHCs cannot possibly justify.

The new care trusts provide an opportunity to bring the civilising values of social work to the health service. As someone who cannot bear petty squabbles about

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organisational boundaries, special pleading about who does what, jobsworths, bureaucrats, pedants and bores, I look forward to the new discipline of community trusts looking at what is in patients' best interests, what works, how we can do better and a fundamental raising of standards, bringing parties together, joining up policies and making things work better.

I am delighted at the end of preserved rights. There can be no more grievous misnomer than preserved rights for the penury inflicted on very old people whose money has all gone and whose income support has failed to keep up with the changes. Such people have been left in an extremely vulnerable position.

The Government need to listen to the words of my hon. Friend the Member for Wakefield (Mr. Hinchliffe), especially on free personal care; he made an excellent speech. I have previously pointed out that residential care for older people is extremely important; we need high standards in the quality of such care. It must be seen as a positive choice for older people. We shall not achieve the quality and consistency that we need if personal care has to be paid for while nursing care is free. There is an inconsistency and illogicality in that position and I urge the Government to reconsider the matter.

A considerable amount of money is involved. If we are ever unfortunate enough to suffer again under a Conservative Government, that money plainly would not be in the system. However, the money could be invested to improve the quality of care offered, to ensure that boundaries are broken down and that the logic of the partnership approach is allowed to operate.

The Bill is visionary. The Government are visionary on the NHS and so much else--

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. The hon. Gentleman has had his time.

8.30 pm

Mr. Stephen O'Brien (Eddisbury): In some respects I am glad to follow the hon. Member for Lancaster and Wyre (Mr. Dawson)--not least because my mother was a theatre sister at Lancaster infirmary, which gives me some insight into the workings of the NHS from the point of view of one generation. Furthermore, I am married to a nurse, which gives me an insight into the present workings of the NHS.

NHS patients in south, west and mid-Cheshire, in the area encompassed by my Eddisbury constituency, have been well served by the Cheshire Central community health council and the Chester and Ellesmere Port CHC on the relatively few occasions when patient care has gone wrong, or has appeared to do so. In the 16 months since I had the privilege to be elected to the House, I have come to know of the excellent, fair and, above all, independent work of the CHCs--not least from the many constituents who have ensured that I have been informed about it.

I hasten to add that that is no argument for preserving CHCs in aspic: it is common ground between us that they need to be developed, expanded and supported, as many hon. Members have pointed out, including the hon. Member for Salford (Ms Blears) during a Westminster Hall debate; I think the word that the hon. Lady used was "evolving". However, as far as I have been able to determine, there has been no Back-Bench agreement about scrapping the CHCs.

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The Government's NHS plan exercise, in which they received a derisory number of responses to their rushed pretence at consultation--a hallmark of the Labour Government and a matter to which I shall return--included no reference to the possibility of scrapping CHCs, let alone a proposal to do so. When the Government announced on the internet the abolition of CHCs--at paragraph 10.27 of the NHS plan--there was consternation and despair, not only, naturally enough, among the CHCs' employed staff and volunteers, but among patients, trusts, doctors and nurses. That was certainly true in my area.

In the light of the early-day motions that have been tabled during the past few years in support of CHCs--we have just heard about one of them--and knowing, from his agent's letter, of the Prime Minister's views, I challenged the right hon. Gentleman to drop his plans to scrap community health councils. He said that he was

Given the events of the preceding months, that gave rise to immediate and real hope among CHCs, patients and NHS staff.

The House can imagine my surprise when, on the following Monday, I received a letter from the Prime Minister, extraordinarily addressing me as "Dear Stephen", in which he wrote:

He then rabbited on with the usual guff for a few more pages, concluding:

On which occasion--15 November or 20 November--was the Prime Minister telling the truth? That same week, we were informed--

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