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Baroness Cumberlege: My Lords, if an NHS hospital has a private wing, it is treated totally differently. We ensure that waiting lists are strictly controlled and that no NHS patient is disadvantaged because there is a private wing. I would add that the income to the NHS from providing private services is enormous and that helps NHS patients.

Baroness Jay of Paddington: My Lords, I am very sorry to come back to the Minister, but if the department does not know the position regarding the distribution of waiting lists and beds, as the Minister suggested in her reply to my noble friend Lord Winston, it is difficult to understand how there can be a nationally rational plan for distributing resources in the way she now suggests. Surely one of the problems is that individual trusts wish to make a profit from private patients on their premises and do not clear the waiting lists by using those beds. That is happening particularly in London.

Baroness Cumberlege: My Lords, if they do so they are contravening the guidance. I would want to know individual cases if the noble Baroness feels that is happening.

Baroness Gardner of Parkes: My Lords, is my noble friend aware that in the Royal Free, of which I

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am chairman, we have a private floor which contributes enormously in income to the National Health Service, but if we need beds for National Health Service patients, they are given those private beds?

Baroness Cumberlege: My Lords, I am grateful to my noble friend for that detailed advice.

Lord Winston: My Lords, I should like to come back to my original Question. In the case of one trust I know NHS patients are being treated for orthopaedic and plastic surgery. The private hospital has to pay extra for the anaesthetist who anaesthetises those patients. The problem is that one cannot have an anaesthetist being on call in an NHS hospital and at the same time operating in a private hospital. Consequently, there is some extra cost to the NHS. Is the Minister aware of that problem?

Baroness Cumberlege: My Lords, we have been determined to reduce the waiting times for patients. I suspect that the noble Lord is referring to the Hammersmith, in which he works. There are 53 patients now being treated at the Royal Masonic Hospital who were on the waiting list at the Hammersmith. I am sure that if he spoke to those patients, they would be extremely grateful to know that they are getting immediate treatment in very good surroundings.

Baroness Hooper: My Lords, does my noble friend agree that private hospitals still provide a very small percentage of healthcare treatment in this country? To my memory it is about 10 per cent. of healthcare. Does she further agree that this treatment provides an important competitive edge for the National Health Service?

Baroness Cumberlege: My Lords, my noble friend is right. This subject comes back to the philosophical point: what is the National Health Service? The National Health Service is one free at the point of delivery to those in clinical need regardless of their means to pay. We totally adhere to that principle. Whether people are treated in a National Health Service Hospital or a private hospital, as long as they get the treatment quickly, the quality is high and the service is efficient, they are very grateful, in my experience, to be treated.

Westminster City Council: Barratt Review

3.25 p.m.

Lord Williams of Elvel asked Her Majesty's Government:

    Whether, and if so what, sanctions are available against those members of Westminster City Council who decided that homeless families should be accommodated in dangerous premises.

The Minister of State, Department of the Environment (Earl Ferrers): My Lords, in cases of maladministration, impropriety or illegality on the part of local authority members, the action taken can cover

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investigations by the local government ombudsman, action by the independent external auditor, which could include sanctions of surcharging and disqualification from council membership, and a full range of penalties where criminal acts have been proved in the courts.

Lord Williams of Elvel: My Lords, I am grateful to the noble Earl for that response, as far as it goes. I am not sure that the Government have yet been seized of the seriousness of the scandal that is reported in the Barratt Review of Westminster City Council's activities. Is the noble Earl aware that on page 37 of his report Mr. Barratt says:


    "This review will make very disturbing reading for anyone concerned about the observance of proper standards in the provision of public services"?

If the Government are as concerned as we are about the observance of proper standards, will they now institute a more detailed inquiry as recommended by Mr. Barratt to establish individual responsibilities in this matter, particularly in the light of the comment that the councillors' decisions were influenced by considerations of party advantage?

Earl Ferrers: My Lords, Mr. Barratt, a former chief executive of Cambridgeshire County Council, was appointed by Westminster City Council to look into the matter. He concluded that the council had failed to exercise proper standards of management of the asbestos but found no evidence of any intent by any person deliberately to endanger the health of tenants. I understand that both political parties on the council were completely unaware that the procedures to deal with asbestos were not properly enacted. Expert medical opinion commissioned by the council said:


    "Asbestos is unlikely to have been present in sufficient quantities to have been a significant health risk".

Westminster City Council has passed the report to the district auditor and it is up to him to decide whether to take action.

Lord Bruce of Donington: My Lords, will the noble Earl give the House a formal undertaking on behalf of the Government that in the event of legal proceedings or tribunal proceedings being instituted in this matter following the reports of the District Auditor and Mr. Barratt Her Majesty's Government will not seek to protect the evidence that may be required from government departments and Ministers who may be involved by the issue of public interest immunity certificates?

Earl Ferrers: My Lords, that is a remarkable question. This is a sensitive area. It is not for the Government to intervene. It is for the auditor to take such action as he wishes to take as he thinks is appropriate. If it ever were to come--and I doubt whether it would--to a court case, the Government would act with strict propriety, as I expect would any other participant so involved.

Lord Dean of Beswick: My Lords, is the Minister aware that before the reorganisation of local government in 1974 under Mr. Heath certain council officers had

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statutory duties that transcended their responsibilities to elected members? I am referring to the former medical officers of health and the then chief public health inspectors who are now known as chief environmental officers. If they were deemed to be acting for the health of the community they could make their own decisions irrespective of the council. Can the Minister say whether those statutory duties have been removed from the successors of those officers following local government reorganisation? If they have not been removed, and these officers carried out their functions, this kind of activity could not have happened. If they have been removed, would it not be a good idea to give back the authority to those officers so that they can deal with councillors who are prepared to behave in this manner?

Earl Ferrers: My Lords, I reject the noble Lord's question, particularly the last part of it. He has assumed that councillors have acted in a way that they should not have done. A lot of things happened 20 years ago, and they may be different now. But the fact is that the relevant people, such as the executives of the council, have responsibilities. Ultimately, it is for the local councillors to accept responsibility for the actions of their council. As I understand it, the noble Lord is suggesting, and I reject, that local councillors prevented the executives from carrying out the work that they should have rightly carried out.

Lord Williams of Elvel: My Lords, is the noble Earl aware that Mr. Barratt reports at page 5 of the document,


    "My unsuccessful attempts to obtain help from some of those who were senior officers involved in the affairs under review give me no confidence that this could be achieved without compulsion of witnesses"?
Information was suppressed. Will the noble Earl give the House an assurance that senior officers involved in this business will be allowed to give proper evidence?

Earl Ferrers: No, my Lords, because it is not the responsibility of government. The noble Lord need not shake his head in despair. He asked me whether the Government will do something and I say that they will not because it is not our responsibility. We do not have the power. There are independent powers to do what is necessary. The auditor has independent powers and he has the information. He has the report and if he considers it appropriate to take action, he will do so.


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