§ 11. Mr. Macdonald
To ask the Secretary of State for Health if he will make a further statement on his review of the National Health Service.
§ Mr. Kenneth Clarke
Excellent progress is being made on the implementation of the proposals set out in the White Paper "Working for Patients". I am confident that our proposals will lead to an even better service for patients.
§ Mr. Macdonald
Will the Secretary of State take the opportunity of the Health Service review to review also the financial position of Project 2000 nurses who have to work under the fear that bursaries will be transferred to loans? Will he say something to allay the fears of those nurses?
§ Mr. Clarke
We have made wholly reasonable provision for the bursaries of Project 2000 nurses. I think that my proposals have been welcomed by the Royal College of Nursing. We have no intention of moving student nurses to the loans proposal and intend to continue to provide for them by bursaries. We are almost exclusively the sole employer of trained nurses and it makes no sense to introduce the loan scheme to student nurses in the National Health Service.
§ Mr. Yeo
Will my right hon. and learned Friend join me in condemning the British Medical Association and those of its members who are maliciously suggesting that they may run out of money when they have to prescribe drugs for their patients? The main objective of that campaign appears to be to frighten patients into opposing the Government's reforms.
§ Mr. Clarke
I very much hope that all GPs have now stopped doing that because I know that until recently some were saying that rather vigorously to their patients. The BMA has now accepted that there was never any question of refusing necessary treatment or drugs for patients. Obviously, it is quite wrong for individual patients to be 826 frightened by people who still persist in that misunderstanding. No doubt in some cases it was merely misunderstanding.
§ Mrs. Margaret Ewing
Contrary to the Secretary of State's earlier statement, may I assure him that, unfortunately, we in Scotland do not have a devolved system of government? Is he aware that the Scottish Office, which has responsibility for the provision and administration of the Health Service in Scotland, has advised that there will be no separate legislation on the reforms? Who will take the decisions about the Health Service in Scotland? Will it be the Secretary of State for Health or the Scottish Office?
§ Mr. Clarke
If I might give the perspective of an English Minister, I can assure the hon. Lady that Scotland has a fully devolved Health Service. I have absolutely no responsibilities for Scotland and I take no decisions about the Scottish Health Service at any time. Those decisions are in the hands of my right hon. and learned Friend the Secretary of State for Scotland. He and I both need changes in the legislative framework before we can implement the reforms that have been put forward in the White Paper. The way in which the reforms are carried out in Scotland will be wholly the responsibility of my right hon. and learned Friend the Secretary of State for Scotland.
§ Dame Elaine Kellett-Bowman
In the review of the National Health Service, from which my constituents will benefit substantially when money follows the patient, will my right hon. and learned Friend bear in mind that in my constituency we have many elderly people and two very old mental deficiency hospitals for which more funds are required? Will he please see that enough money is pushed into the north-west so that we can have a generous allocation for those services?
§ Mr. Clarke
In my opinion all parts of the National Health Service will benefit from the new system because we will be matching resources more closely to the delivery of expanding services in the manner that my hon. Friend rightly described as money following the patient. Lancaster will benefit particularly because at the moment it draws in many patients from outside its district boundaries for which no adequate financial provision is made under our present arrangements. It will be important to distribute money to the district health authorities which will have to make decisions about where to put the money in order to get the service that they require in a way that reflects the make-up of the population, demographic trends and so on of each district. They should certainly bear in mind the age structure in Lancaster to which my hon. Friend refers.