To ask the Secretary of State for Health if he will make a statement on the operation of hospital trusts.

There is increasing independent evidence that the first trusts are proving that bringing management back into the hospitals is already bringing benefits to patients and staff. Waiting times are coming down in most places and staff report improved management and job satisfaction.

When the Secretary of State made his recent announcement in the House of the second wave of trust applications and approved in principle applications for the four London teaching hospitals he said that, in the interim, until the review was completed, they would benefit from the advantages that could flow from greater local hospital management devolution. If that is a benefit short of trust status, why is it necessary to force through trust status while encouraging local hospital management and in so doing to bring the assets, the buildings and the personnel out of local health service management? Why is that superior simply to having better efficiency through greater local management?

It is not difficult to explain. Some of the benefits of devolved management can be achieved without full trust status, but, for local management, one of the major gains of full trust status is full control of capital. That is one reason why hospitals seek it. I hope that the hon. Gentleman is clear on that matter.

Does my right hon. Friend agree that it is significant that the two major hospitals in Kidderminster district health authority have increased the number of in-patients treated over the past eight years by 14 per cent? The health authority, one of the 30 most efficient in the country, is consulting on third-wave trust status because it believes that it can give a better service to patients and local people on that basis. Does not that contrast with the recent comment by the general secretary of the Institute of Health Service Managers on the Labour party's plans for the health service? She said that they were an unworkable mess.

I agree with my hon. Friend. Labour's role in all this is somewhat disreputable. I draw the attention of my hon. Friend to the recent threats issued by the Labour party candidate in Orkney and Shetland, who said that, by doing this, it could certainly be argued by an incoming Labour Administration that you had contributed to your own redundancy. As my hon. Friend pointed out, Labour played a disreputable role in relation to trusts. When I drew the attention of the Leader of the Opposition to a previous threat of this kind, made by the hon. Member for Coventry, South-East (Mr. Nellist), the right hon. Gentleman withdrew it at once. I hope that the Opposition chief spokesman on health matters will withdraw this similar threat today.

Will the Secretary of State think for a moment about the effects of NHS trusts on the low-paid hospital staff, who are just as essential as medical staff in the running of the hospital? I am thinking of domestics, porters and maintenance staff, who are grossly underpaid and who are suffering badly as a result of administration of hospital trusts and the attempts to break away from the national negotiating machinery.

I would strongly argue that the national negotiating machinery has, over the years, delivered low pay to such people. The increased flexibility of NHS trusts will allow them to pay more where the local markets can afford it and I predict that this will increase the pay of the lower-paid staff in such hospitals. That is why, to the embarrassment of the Labour party, some of the local branches of those unions are beginning to support trusts.

When it comes to Opposition claims about NHS trusts, should not we bear in mind that, two years ago, the hon. Member for Livingston (Mr. Cook) was telling everyone that general practitioner contracts would result in less time being spent with patients? That turned out to be untrue, so why should we now believe these spurious scares about NHS trusts leading to privatisation? Is not the truth of the matter that the hon. Gentleman is interested only in using his spurious scares to frighten the sick and the vulnerable for his own party ends?

The scares that the Labour party tried to run on these matters have rebounded on it. I remind the hon. Member for Livingston (Mr. Cook)—he seems not to wish to rise on these matters—that the letter from the Labour party candidate to the trust applicant reads: Were you to do this"— continue with the trust— in the face of so much opposition, it could certainly be argued by an incoming Labour Administration that you had contributed to your own redundancy. When I drew the attention of the Leader of the Opposition to previous threats of that sort, he wrote as follows: Of course I can confirm that there will be absolutely no action of this kind. The hon. Member for Livingston must respond to these scares. Indeed, they are worse than scares, they are threats.

Will the Secretary of State confirm—[HON. MEMBERS: "Answer!"] If Conservative Members paid attention to the issue they would know that my hon. Friend the Member for Livingston (Mr. Cook) repudiated the threat last week.

Will the right hon. Gentleman confirm that the majority of first-wave trusts face serious financial problems? How much will he spend to bail out the first-wave trusts so that they do not end the first financial year in deficit?

I am sorry that the Labour party's chief spokesman on health did not rise to respond to these matters. He should stand up and repudiate the threat in the House.

The hon. Member for Peckham (Ms. Harman) is completely wrong on the facts. If she wishes to attach herself to the scare, I am delighted. As I have said, she will find that she is completely wrong.