Wiltshire Health Services debate - Lib Dem MP calls for accountable local decision-making

10.47.00pm BST (GMT +0100) Wed 26th Apr 2006

House of Commons ( Westminster Hall) - Debate on Health Services (Wiltshire)

Steve Webb, Liberal Democrat Shadow Health Secretary

Mr Webb said, 'I want to address important issues about health care in Wiltshire, but I have to say that I find it gut-wrenching to hear the Conservative party talk about the NHS in the terms we have heard this afternoon, when they opposed £8 billion of the money that is currently being spent. When I intervened on the hon. Gentleman on that point, he said, "The Liberal Democrats say spend some more money". But he proceeded to say, "We only get £900 or so per head in Wiltshire. If only we got what they got in Sedgefield, it would all be fine." He appears to be looking in two different directions at once. Either he thinks that Wiltshire needs more money, or he does not.'

'To be fair, the hon. Member for North Wiltshire mentioned one clear waste of money, which has been the process of going from health authorities to primary care groups to primary care trusts to the reinvention of health authorities, which is pretty much the same as the number you first thought of. That process has cost a lot of money. No one could dispute that. That money would have been better spent on front-line patient care. We hear the comments made, but there are practically no suggestions. There is no suggestion of an overall increase in NHS funding in comparison with present levels as far as I can see. There is a suggestion that Wiltshire and other areas get more and the north of England gets less.'

'My final observation is about national and local decision making. The people of Wiltshire should frame the health services for Wiltshire. There must be national standards and a national context, but, as far as possible, decision making should be local. It should be local and democratically accountable, not, as the hon. Member for Salisbury said, performed by non-executive directors who have been told to keep their heads down, and whom nobody elected and nobody can get rid of. That is where I differ from the Government, who claim to devolve, but keep the power in the centre and set so much of the local framework that there is little local discretion. It is also where I differ from Conservative Members, whom I do not think want elected, democratic accountability in the national health service. Again, when given the opportunity to introduce it, they did not.'

'If local decisions are taken about the national health service, as they should be, elected, not appointed, people should oversee them. I am not clear whether that is the Conservative party's position, and I hope that their spokesman will clarify it.'