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Mr. Hutton: I should like briefly to respond to some of the points made in the debate after I made my initial speech.

I pay a very warm tribute to every hon. Member who has spoken in the past three hours or so. All debates about the national health service are high-quality debates. We in this place care about the national health service. I know that that is true of all my hon. Friends, but I ask them to recognise that it is true of Ministers too. We care about the national health service, which is why are making proposals to help improve and sustain the direction of travel that we have set in the NHS plan and beyond. Let us be clear about that.

It is deeply depressing to see some of the Lib Dem amendments to which the hon. Member for Oxford, West and Abingdon (Dr. Harris) spoke tabled by someone occupying his space on the political spectrum. He wants to remove the provisions about direct elections to the boards of governors of NHS foundation trusts. I know that some of my hon. Friends would also like that to happen, but I have to say to him and to them that it would be entirely contrary to the spirit and intent of these proposals. A model of governance and representation that involves people being appointed to NHS trusts is no longer acceptable in the society in which we live. Let us have some democracy, but let us have some effective accountability as well.

4.15 pm

New clause 9 deals with patients forums. I fully understand the concerns expressed by the hon. Member for Oxford, West and Abingdon and others—for example, by my hon. Friend the Member for Bedford (Mr. Hall), who has played a distinguished role in this House in championing the cause of community health councils and the role of patients. However, the Government's arrangements for NHS foundation trusts extend beyond the current requirements for consultation and involvement. Primary care trust patients forums and the Commission for Patient and Public Involvement in Health will provide an additional means for independent patient involvement in the work of NHS foundation trusts. It is not the case that there will be no independent voice or opportunity for patients to be involved in the work of NHS foundation trusts. The patients forums established for primary care trusts will have that overview role. Nor is it the case, in relation to the comments of the hon. Member for Wyre Forest (Dr. Taylor), that there is no role for the overview and scrutiny committees of local authorities, whose role is protected in the Bill. I am afraid that those arguments have little or no substance.

Let us also be clear about amendment No. 400, which would remove the cap on private charges altogether, replacing it with a system that would at best be a woolly attempt to give priority to the needs of NHS patients,

8 Jul 2003 : Column 975

but is clearly not a mechanism that is capable of being applied to any extent in the practical environment of the NHS. It is impractical, impossible to operate and riddled with contradictions—no change there as regards the Liberal Democrats.

On new clause 36, the points made by the hon. Member for South Cambridgeshire (Mr. Lansley), which were picked up by the hon. Member for Cheadle (Mrs. Calton) and the hon. Member for Wyre Forest, suggest that there has been some misunderstanding of the Government's proposals. Under the new clause, an NHS foundation trust and another NHS foundation trust or an NHS trust may make a joint application to the regulator for authorisation as a new NHS foundation trust. In every other sense, we have simply mirrored the current provisions in the Bill on the principal application to become an NHS foundation trust. There is nothing different about the process at all.

On the group of amendments, including new clause 60, that were moved by my hon. Friend the Member for Cardiff, Central (Mr. Jones), I am confident that nothing in the Bill changes or adversely affects the way in which Welsh patients are treated in NHS foundation trusts established in England. I say this to my hon. Friend, because I respect and value his counsel: my colleagues and I are prepared to have another look at the Bill to make absolutely sure that the assurances that we gave in Committee and on the Floor of the House are fully honoured. I hope that my hon. Friend will be satisfied with that.

We are reaching the conclusion of this debate—which by common consent represents an important and seminal moment in this Parliament—as regards how we take forward improvements in the national health service. We have set out a clear prospectus today. This is not about competition, privatisation or two tiers: it is about taking forward traditional NHS values and applying them in the new world and new society in which we live. No one who is treated at an NHS foundation trust will be charged for that treatment. The standards that are set will be national: my right hon. Friend the Secretary of State will ensure that that is so. These are sensible reforms that will take forward a better basis and a more solid foundation on which we can build genuine and strong public support for public services. I urge my hon. Friends to support the Government in the Lobby.

Question put, That the amendment be made:—

The House divided: Ayes 251, Noes 286.

Division No. 280
[4:19 pm


AYES


Abbott, Ms Diane
Ainsworth, Peter (E Surrey)
Allan, Richard
Amess, David
Ancram, rh Michael
Arbuthnot, rh James
Atkinson, David (Bour'mth E)
Austin, John
Bacon, Richard
Baker, Norman
Baldry, Tony
Barker, Gregory
Barnes, Harry
Baron, John (Billericay)
Beith, rh A. J.
Bellingham, Henry
Bennett, Andrew
Bercow, John
Beresford, Sir Paul
Berry, Roger
Best, Harold
Blunt, Crispin
Boswell, Tim
Bottomley, Peter (Worthing W)
Brady, Graham
Brake, Tom (Carshalton)
Brazier, Julian
Breed, Colin
Brooke, Mrs Annette L.
Browning, Mrs Angela
Bruce, Malcolm
Burnett, John
Burns, Simon
Burnside, David
Burstow, Paul
Butterfill, John
Cable, Dr. Vincent
Calton, Mrs Patsy
Cameron, David
Campbell, Gregory (E Lond'y)
Campbell, rh Menzies (NE Fife)
Carmichael, Alistair
Cash, William
Caton, Martin
Chapman, Sir Sydney (Chipping Barnet)
Chope, Christopher
Clapham, Michael
Clappison, James
Clarke, Tony (Northampton S)
Clifton-Brown, Geoffrey
Coleman, Iain
Collins, Tim
Connarty, Michael
Cook, Frank (Stockton N)
Corbyn, Jeremy
Cran, James (Beverley)
Davey, Edward (Kingston)
Davidson, Ian
Davis, rh David (Haltemprice & Howden)
Dobbin, Jim (Heywood)
Dobson, rh Frank
Dodds, Nigel
Donaldson, Jeffrey M.
Doughty, Sue
Duncan, Alan (Rutland)
Duncan Smith, rh Iain
Dunwoody, Mrs Gwyneth
Efford, Clive
Ellman, Mrs Louise
Etherington, Bill
Evans, Nigel
Ewing, Annabelle
Fabricant, Michael
Fallon, Michael
Field, Mark (Cities of London & Westminster)
Fisher, Mark
Flight, Howard
Flynn, Paul (Newport W)
Forth, rh Eric
Foster, Don (Bath)
Fox, Dr. Liam
Francois, Mark
Gale, Roger (N Thanet)
Garnier, Edward
George, Andrew (St. Ives)
Gerrard, Neil
Gibson, Dr. Ian
Gidley, Sandra
Gillan, Mrs Cheryl
Gray, James (N Wilts)
Grayling, Chris
Green, Damian (Ashford)
Green, Matthew (Ludlow)
Greenway, John
Grieve, Dominic
Gummer, rh John
Hague, rh William
Hammond, Philip
Harris, Dr. Evan (Oxford W & Abingdon)
Harvey, Nick
Havard, Dai (Merthyr Tydfil & Rhymney)
Hawkins, Nick
Heald, Oliver
Heathcoat-Amory, rh David
Henderson, Doug (Newcastle N)
Hendry, Charles
Heyes, David
Hinchliffe, David
Hoban, Mark (Fareham)
Hoey, Kate (Vauxhall)
Hogg, rh Douglas
Hopkins, Kelvin
Horam, John (Orpington)
Howard, rh Michael
Howarth, Gerald (Aldershot)
Hoyle, Lindsay
Hughes, Simon (Southwark N)
Humble, Mrs Joan
Hunter, Andrew
Jack, rh Michael
Jackson, Glenda (Hampstead & Highgate)
Jackson, Robert (Wantage)
Jenkin, Bernard
Johnson, Boris (Henley)
Jones, Helen (Warrington N)
Jones, Lynne (Selly Oak)
Keen, Alan (Feltham)
Keetch, Paul
Kennedy, rh Charles (Ross Skye & Inverness)
Key, Robert (Salisbury)
Kilfoyle, Peter
King, Andy (Rugby)
Kirkbride, Miss Julie
Kirkwood, Sir Archy
Knight, rh Greg (E Yorkshire)
Laing, Mrs Eleanor
Lait, Mrs Jacqui
Lamb, Norman
Lansley, Andrew
Laws, David (Yeovil)
Leigh, Edward
Letwin, rh Oliver
Lewis, Dr. Julian (New Forest E)
Lewis, Terry (Worsley)
Liddell-Grainger, Ian
Lidington, David
Lilley, rh Peter
Lloyd, Tony (Manchester C)
Llwyd, Elfyn
Loughton, Tim
Luff, Peter (M-Worcs)
McCafferty, Chris
McDonnell, John
Mackay, rh Andrew
Maclean, rh David
McLoughlin, Patrick
Mahon, Mrs Alice
Malins, Humfrey
Maples, John
Marsden, Paul (Shrewsbury & Atcham)
Mates, Michael
Maude, rh Francis
May, Mrs Theresa
Mercer, Patrick
Mitchell, Andrew (Sutton Coldfield)
Moore, Michael
Moss, Malcolm
Mudie, George
Murrison, Dr. Andrew
Naysmith, Dr. Doug
Oaten, Mark (Winchester)
O'Brien, Stephen (Eddisbury)
Öpik, Lembit
Osborne, George (Tatton)
Ottaway, Richard
Page, Richard
Paice, James
Paisley, Rev. Ian
Paterson, Owen
Pickles, Eric
Portillo, rh Michael
Prentice, Gordon (Pendle)
Price, Adam (E Carmarthen & Dinefwr)
Prisk, Mark (Hertford)
Pugh, Dr. John
Purchase, Ken
Randall, John
Redwood, rh John
Reid, Alan (Argyll & Bute)
Rendel, David
Robathan, Andrew
Robertson, Angus (Moray)
Robertson, Laurence (Tewk'b'ry)
Robinson, Mrs Iris (Strangford)
Robinson, Peter (Belfast E)
Roe, Mrs Marion
Ruffley, David
Russell, Bob (Colchester)
Salmond, Alex
Sanders, Adrian
Savidge, Malcolm
Sawford, Phil
Sedgemore, Brian
Selous, Andrew
Shephard, rh Mrs Gillian
Shepherd, Richard
Short, rh Clare
Simmonds, Mark
Simpson, Keith (M-Norfolk)
Skinner, Dennis
Smith, Geraldine (Morecambe & Lunesdale)
Smith, Sir Robert (W Ab'd'ns & Kincardine)
Spelman, Mrs Caroline
Spicer, Sir Michael
Spink, Bob (Castle Point)
Spring, Richard
Steinberg, Gerry
Streeter, Gary
Stunell, Andrew
Swire, Hugo (E Devon)
Syms, Robert
Tapsell, Sir Peter
Taylor, David (NW Leics)
Taylor, Ian (Esher)
Taylor, John (Solihull)
Taylor, Dr. Richard (Wyre F)
Taylor, Sir Teddy
Thomas, Simon (Ceredigion)
Thurso, John
Tonge, Dr. Jenny
Tredinnick, David
Turner, Andrew (Isle of Wight)
Turner, Dr. Desmond (Brighton Kemptown)
Tyler, Paul (N Cornwall)
Tyrie, Andrew
Walley, Ms Joan
Wareing, Robert N.
Waterson, Nigel
Watkinson, Angela
Webb, Steve (Northavon)
Weir, Michael
Wilkinson, John
Willetts, David
Williams, Betty (Conwy)
Williams, Hywel (Caernarfon)
Wilshire, David
Winterton, Sir Nicholas (Macclesfield)
Wishart, Pete
Wood, Mike (Batley)
Yeo, Tim (S Suffolk)
Young, rh Sir George

Tellers for the Ayes:


Mr. George Stevenson and
Angela Eagle


NOES


Adams, Irene (Paisley N)
Ainger, Nick
Ainsworth, Bob (Cov'try NE)
Alexander, Douglas
Allen, Graham
Anderson, rh Donald (Swansea E)
Anderson, Janet (Rossendale & Darwen)
Armstrong, rh Ms Hilary
Atkins, Charlotte
Bailey, Adrian
Banks, Tony
Barron, rh Kevin
Beard, Nigel
Beckett, rh Margaret
Begg, Miss Anne
Beggs, Roy (E Antrim)
Benn, Hilary
Betts, Clive
Blackman, Liz
Blair, rh Tony
Blears, Ms Hazel
Blunkett, rh David
Boateng, rh Paul
Bradley, rh Keith (Withington)
Bradley, Peter (The Wrekin)
Bradshaw, Ben
Brennan, Kevin
Brown, rh Gordon (Dunfermline E)
Brown, rh Nicholas (Newcastle E Wallsend)
Brown, Russell (Dumfries)
Browne, Desmond
Bryant, Chris
Burden, Richard
Burnham, Andy
Caborn, rh Richard
Cairns, David
Campbell, Alan (Tynemouth)
Campbell, Mrs Anne (C'bridge)
Campbell, Ronnie (Blyth V)
Caplin, Ivor
Casale, Roger
Cawsey, Ian (Brigg)
Challen, Colin
Chapman, Ben (Wirral S)
Chaytor, David
Clark, Mrs Helen (Peterborough)
Clark, Dr. Lynda (Edinburgh Pentlands)
Clarke, rh Charles (Norwich S)
Clarke, rh Tom (Coatbridge & Chryston)
Clwyd, Ann (Cynon V)
Coaker, Vernon
Coffey, Ms Ann
Cohen, Harry
Colman, Tony
Cook, rh Robin (Livingston)
Cooper, Yvette
Corston, Jean
Cousins, Jim
Cranston, Ross
Crausby, David
Cruddas, Jon
Cummings, John
Cunningham, rh Dr. Jack (Copeland)
Cunningham, Jim (Coventry S)
Cunningham, Tony (Workington)
Darling, rh Alistair
David, Wayne
Davies, rh Denzil (Llanelli)
Davies, Geraint (Croydon C)
Dawson, Hilton
Denham, rh John
Dhanda, Parmjit
Donohoe, Brian H.
Doran, Frank
Dowd, Jim (Lewisham W)
Eagle, Maria (L'pool Garston)
Edwards, Huw
Ennis, Jeff (Barnsley E)
Farrelly, Paul
Field, rh Frank (Birkenhead)
Fitzpatrick, Jim
Fitzsimons, Mrs Lorna
Flint, Caroline
Follett, Barbara
Foster, rh Derek
Foster, Michael (Worcester)
Foster, Michael Jabez (Hastings & Rye)
Foulkes, rh George
Francis, Dr. Hywel
Gapes, Mike (Ilford S)
Gardiner, Barry
Gilroy, Linda
Godsiff, Roger
Goggins, Paul
Griffiths, Jane (Reading E)
Griffiths, Nigel (Edinburgh S)
Grogan, John
Hain, rh Peter
Hall, Mike (Weaver Vale)
Hall, Patrick (Bedford)
Hanson, David
Harman, rh Ms Harriet
Harris, Tom (Glasgow Cathcart)
Healey, John
Henderson, Ivan (Harwich)
Hendrick, Mark
Hepburn, Stephen
Heppell, John
Hermon, Lady
Hesford, Stephen
Hewitt, rh Ms Patricia
Hill, Keith (Streatham)
Hodge, Margaret
Hood, Jimmy (Clydesdale)
Hoon, rh Geoffrey
Hope, Phil (Corby)
Howarth, rh Alan (Newport E)
Howarth, George (Knowsley N & Sefton E)
Howells, Dr. Kim
Hughes, Beverley (Stretford & Urmston)
Hughes, Kevin (Doncaster N)
Hurst, Alan (Braintree)
Hutton, rh John
Iddon, Dr. Brian
Ingram, rh Adam
Irranca-Davies, Huw
Jackson, Helen (Hillsborough)
Jamieson, David
Johnson, Alan (Hull W)
Johnson, Miss Melanie (Welwyn Hatfield)
Jones, Jon Owen (Cardiff C)
Jones, Martyn (Clwyd S)
Jowell, rh Tessa
Joyce, Eric (Falkirk W)
Kaufman, rh Gerald
Keeble, Ms Sally
Keen, Ann (Brentford)
Kelly, Ruth (Bolton W)
Kennedy, Jane (Wavertree)
Kidney, David
King, Ms Oona (Bethnal Green & Bow)
Knight, Jim (S Dorset)
Kumar, Dr. Ashok
Ladyman, Dr. Stephen
Lammy, David
Lawrence, Mrs Jackie
Laxton, Bob (Derby N)
Lazarowicz, Mark
Lepper, David
Leslie, Christopher
Levitt, Tom (High Peak)
Lewis, Ivan (Bury S)
Liddell, rh Mrs Helen
Linton, Martin
Love, Andrew
Lucas, Ian (Wrexham)
McAvoy, Thomas
McCabe, Stephen
McCartney, rh Ian
McDonagh, Siobhain
MacDonald, Calum
MacDougall, John
McFall, John
McGuire, Mrs Anne
McIsaac, Shona
McKechin, Ann
McKenna, Rosemary
McNamara, Kevin
McNulty, Tony
MacShane, Denis
Mactaggart, Fiona
McWalter, Tony
McWilliam, John
Mahmood, Khalid
Mallaber, Judy
Mandelson, rh Peter
Mann, John (Bassetlaw)
Marris, Rob (Wolverh'ton SW)
Marsden, Gordon (Blackpool S)
Marshall, David (Glasgow Shettleston)
Martlew, Eric
Meale, Alan (Mansfield)
Merron, Gillian
Michael, rh Alun
Milburn, rh Alan
Miliband, David
Miller, Andrew
Moffatt, Laura
Mole, Chris
Moonie, Dr. Lewis
Moran, Margaret
Morley, Elliot
Morris, rh Estelle
Mountford, Kali
Mullin, Chris
Munn, Ms Meg
Murphy, Denis (Wansbeck)
Murphy, Jim (Eastwood)
Murphy, rh Paul (Torfaen)
Norris, Dan (Wansdyke)
O'Brien, Bill (Normanton)
O'Brien, Mike (N Warks)
O'Hara, Edward
O'Neill, Martin
Osborne, Sandra (Ayr)
Palmer, Dr. Nick
Pearson, Ian
Pickthall, Colin
Pike, Peter (Burnley)
Plaskitt, James
Pollard, Kerry
Pond, Chris (Gravesham)
Pound, Stephen
Prentice, Ms Bridget (Lewisham E)
Prescott, rh John
Primarolo, rh Dawn
Prosser, Gwyn
Purnell, James
Quinn, Lawrie
Rammell, Bill
Rapson, Syd (Portsmouth N)
Raynsford, rh Nick
Reed, Andy (Loughborough)
Reid, rh Dr. John (Hamilton N & Bellshill)
Robertson, John (Glasgow Anniesland)
Roche, Mrs Barbara
Rooney, Terry
Roy, Frank (Motherwell)
Ruane, Chris
Ruddock, Joan
Russell, Ms Christine (City of Chester)
Ryan, Joan (Enfield N)
Salter, Martin
Sarwar, Mohammad
Shaw, Jonathan
Sheerman, Barry
Sheridan, Jim
Simon, Siôn (B'ham Erdington)
Singh, Marsha
Smith, rh Andrew (Oxford E)
Smith, Angela (Basildon)
Smith, Jacqui (Redditch)
Smith, John (Glamorgan)
Soley, Clive
Southworth, Helen
Spellar, rh John
Starkey, Dr. Phyllis
Stewart, Ian (Eccles)
Stinchcombe, Paul
Stoate, Dr. Howard
Strang, rh Dr. Gavin
Straw, rh Jack
Stringer, Graham
Sutcliffe, Gerry
Tami, Mark (Alyn)
Taylor, rh Ann (Dewsbury)
Taylor, Dari (Stockton S)
Thomas, Gareth (Clwyd W)
Thomas, Gareth (Harrow W)
Timms, Stephen
Todd, Mark (S Derbyshire)
Touhig, Don (Islwyn)
Trickett, Jon
Turner, Dennis (Wolverh'ton SE)
Turner, Neil (Wigan)
Twigg, Derek (Halton)
Twigg, Stephen (Enfield)
Tynan, Bill (Hamilton S)
Vaz, Keith (Leicester E)
Ward, Claire
Watson, Tom (W Bromwich E)
Watts, David
White, Brian
Whitehead, Dr. Alan
Wicks, Malcolm
Wills, Michael
Wilson, Brian
Winnick, David
Winterton, Ms Rosie (Doncaster C)
Woodward, Shaun
Woolas, Phil
Wray, James (Glasgow Baillieston)
Wright, Anthony D. (Gt Yarmouth)
Wright, David (Telford)
Wright, Tony (Cannock)
Wyatt, Derek

Tellers for the Noes:


Paul Clark and
Mr. Fraser Kemp

Question accordingly negatived.

8 Jul 2003 : Column 979

Dr. Fox: On a point of order, Madam Deputy Speaker. Could you use your offices to get a quick breakdown of the vote, so that the House can see how many Scottish Members were used to force through legislation that does not apply to their constituencies?


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