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Private Sector (NHS)

I am a charitable individual, and I understand my hon. Friend's interpretation, but I did start by saying that I understand that there has been an assessment. Otherwise, I agree that the argument is based purely on dogma. As I said, the £45 million, which is underwritten for each of its first five years, is £20 million more than the figure given in the earlier proposal, which incidentally 19 Oct 2005 : Column 280WH the trust supported on the basis that it was intended to help the delivery of the 18-week access targets by 2008. One is bound to ask where the money for that underwriting is coming from, and, again, how that relates to contestability. Ironically, it now appears that the treatment centre will not be available until after 2008, so that any extra capacity that it provides will not contribute to achieving access targets by 2008. The trust has also been asked which specialties that it currently provides might be transferred to the new independent sector treatment centre. Transferred work, of course, does not represent an increase in capacity. It goes without saying that to acquiesce would be suicidal for the trust. The trust must retain and maximise its income in order to address its deficit and to compile a robust outline business case for the children's hospital. When a hospital loses patients, the drop in its income will generally be greater than its drop in expenditure because of the national tariff process. I conclude my remarks with these few comments. I leave it to other colleagues to paint the wider picture of concerns about the promotion of the private sector, but I share their fears, which I am sure more of them will express, that it will leave the NHS with the most costly and complex cases and emergency work, that it will lead to higher cost, that it will divert staff and distort work force planning, that it will redistribute existing workloads rather than increase capacity, and that ultimately it will reduce choice by threatening existing providers, such as the Leeds acute trust. That is without even mentioning the current proposals for PCTs. Ideally, therefore, the impact of this drive towards the private sector and its longer-term effects should be properly evaluated, and the first wave should be properly assessed before we move to the second. If Ministers are not inclined to do that, at least the potentially damaging aspects of the initiative, which I have tried to tease out today, should be fully explored.