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NHS Trust Debts

No, that is being over-simplistic. Monitor has demonstrated that it can look at organisations’ conditions and financial health in a way that makes less of an imposition on the conduct of their core business and interferes less with it. So far, therefore, that is the better model. What is certain is that the Secretary of State and her Ministers must be held to account for the deficits, the failure to solve the problem and, in particular, trying to mask that problem through savage cuts to front-line patient services. I hope, therefore, that the Minister will acknowledge that the disaster that has been created and perpetuated could be mitigated by ensuring that the Government at least think about RAB. On the ““Today”” programme of 11 December 2006, the Secretary of State said that RAB"““is not causing the overspending””." However, in evidence to the Health Committee inquiry on NHS deficits, on 21 November 2006, she said that"““whereas the application of RAB to hospital trusts might have been appropriate in the old days what we and the Audit Commission found was it was not consistently applied as between one region and another or one Trust and another. It is not consistent with payment by results and the new financial regime we are putting in place and it cannot be applied to foundation trusts. For all of those reasons we all agreed that it needed to be looked at.””" It is hardly surprising that NHS finances are in such a parlous state if the Secretary of State herself does not know what the system should be. In November last year, she vowed to take responsibility for solving the deficits. Therefore, I hope that the Minister will tell us whether he or any Labour Minister—particularly the Secretary of State—will take responsibility. The fundamental point is to recognise that there cannot be simplistic write-offs. There must be a planned approach that does not simply cater arbitrarily to the Secretary of State’s convenience, but which is rather more focused on ensuring that the core business of delivering front-line patient services to, for instance, the constituents of the hon. Member for Northavon, is not affected. A proper business and financial plan must be put in place in recognition of the fact that the accumulated deficits must be paid back over time. The proposal to look at that issue should be explored. The Opposition, who do not have the resources available to Ministers, have not been able to examine it, so it would be helpful if the Government said that they are genuinely considering the opportunity of exploring how public dividend capital and the dividends paid out of it could contribute to finding the solution.