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Private Sector (NHS)

I, too, congratulate my hon. Friend the Member for North Durham (Mr. Jones) on securing this important debate. I shall try not to take nine minutes for my speech like the hon. Member for Banbury (Tony Baldry). Like many on the Labour Benches, I am a zealous supporter of the NHS. I believe that as far as possible all its services should be provided by NHS staff and facilities. However, I recognise that in 1997 we inherited a situation in which the capacity of the NHS had been diminished. By and large, my constituents want to be treated quickly, effectively and as close to home as possible. Like many Labour Members, I accepted that there was a case in the short term for exploiting the surplus capacity—I stress surplus—in the private sector at marginal cost, but we have gone far beyond that. 19 Oct 2005 : Column 279WH There has been a ten-fold increase in the amount of NHS-funded care provided by the private sector. I shall focus on one practical example of how the proposed second-wave independent sector treatment centre for West Yorkshire might adversely affect the NHS in Leeds, and therefore my constituents. We have an acute trust that has suffered from a chronic deficit for many years; it is attempting to address that challenge. That is not to say that there have not been major improvements since 1997. We have 850 more nurses, 125 more consultants and180 new junior doctors, and waiting times and waiting lists have fallen appreciably. However, these enormous gains are often overshadowed by the short-term measures that are necessary to address the deficit. The advent of independent sector treatment centres has provided some short-term gains in terms of reducing waiting lists and times, but we appear to be moving into an era where the private sector is simply being grown for its own sake, as my hon. Friend has already suggested. The goalposts have been moved; they have been widened as a target for the private sector and narrowed as a target for the NHS. I understand that the Department of Health carried out an assessment of contestability in West Yorkshire and has concluded that we need more of it. Will the Minister comment on that? We already have contestability in Leeds. The Leeds PCTs are commissioning more activity from outside the Leeds acute trust than ever before, which represents a £14 million reduction in that trust's income. The Secretary of State has approved a strategic outline case for a new children and maternity hospital, to be built at St. James's hospital in Leeds. That is a very welcome and long-overdue move, but its progress depends on the trust being able to put together a successful outline business case. The trust therefore obviously needs to maximise its income. It has made allowances for the loss of commissioning from the local PCTs and for the proposed second-wave treatment centre, but there are real concerns if its income diminishes further. I was very concerned to discover that the proposed second-wave treatment centre for West Yorkshire is to have a guaranteed minimum income of £45 million, underwritten for each of its first five years. Where is the contestability in that?