Yeo `well-equipped' for tough new task

MERGING two of the most high-profile, high-spending portfolios – Health and Education – might be seen as a radical or even foolhardy step by the Conservatives.

But newly appointed Shadow Health and Education Secretary TIM YEO says there are many similarities between the two. KATY EDWARDS spoke to him in his third week in post.

FEWER targets, greater freedom from Whitehall control and more power for frontline staff – such is new Shadow Health and Education Secretary's vision for both public services under a Conservative Government.

Rather than downgrading two key policy areas, Tim Yeo said, merging the two vast briefs has paved the way for policies straddling both portfolios.

He claimed health and education have much in common – not least a shared mismanagement by the current administration.

Mr Yeo, who has been MP for Suffolk South sin 1983, said: "There are some themes that are common to both. I believe very strongly that people in Suffolk and elsewhere are entitled to health care free of charge at the point of use – based on the needs of the patients and not on their ability to pay.

"The same principle applies to education. In both services, we have some very frustrated professionals. Doctors, nurses and teachers who have been trained, sometimes at quite considerable cost to the tax payer, who aren't able to use their skills and training in the way that they want."

A key faultline, threatening both services, Mr Yeo claimed, was the unprecedented amount of non-frontline staff currently in post.

"In both health and education, we have too many bureaucrats," he said.

"The amount of staff working in education and not teaching or in healthcare and not tending to patients, is rising too fast."

Another offender was Labour's current obsession with targets: "There are too many targets set by ministers in London which then prevent them from responding to the needs of the patients and pupils," he said.

He added it was "intolerable" that targets should have come to interfere with the clinical management of patients in a hospital setting. He gave a "perverse" consequence of targets as the example of patients being kept waiting in ambulances in A&E forecourts to avoid them registering on the waiting times target radar.

Mr Yeo said: "It is absolutely wrong that because a minister has set a target to reduce waiting lists doctors aren't able to see the patients who most need their treatment. If the NHS is to develop it's got to be run in a way that is less centralised and allows individuals to make decisions on the basis of what they recognise as local need."

He said he did recognise the need for patients to be informed about the performance of their local hospital but that he hoped that could be done without creating a "target culture".

Now we know some of his grievances, what of his proposals? How will Mr Yeo prevent the crippled NHS from limping into an early grave?

Vis-à-vis the Government's controversial plans for foundation hospitals, Mr Yeo said that under a Tory Government, all hospitals would be allowed local control (not just those that have been classed as "top-performing").

They would also have far more freedom than the current legislation, finally agreed last week under the Health and Social Care Bill, would allow.

He said: "Foundation Hospitals was a proposal which, when it started almost two years ago under Alan Milburn (former Health Secretary) was quite a good idea. Unfortunately, the Government has lost its way and the original idea of making the hospitals genuinely independent has been abandoned.

"The material that has been formally approved is very watered down and leaves (the hospitals) very much under the control of ministers, particularly via the new regulator. It doesn't leave them free to raise money for new investment, which, I believe, should be one of the key characteristics of genuinely independent foundation hospitals."

He added: "We also think the management structure is so confused, it may almost be unworkable."

Another argument, frequently pitched against the idea, is that it will create a "two tier" health service.

Mr Yeo said: "We fear the 25 foundation hospitals will become a first class and that other hospitals will find it harder to get money for new investment. The danger is that this disparity will get worse, rather than better. Close to home, we have Addenbrooke's and Papworth Hospitals that are both going to be in the first wave (of foundation hospitals). I've nothing against them and it is great from their point of view but the danger is that the variation will get bigger and hospitals like Ipswich and Colchester may find they lose out when they are trying to get approval for new investment schemes. I am very concerned about the effect this will have on patients in East Anglia."

Mr Yeo does however hold with the original principles of Mr Milburn's proposal – that of securing greater freedom from Whitehall control.

He said: "I believe in it very strongly indeed. I believe it must be the right way forward. I've seen the damage which greater ministerial control inflicts on hospitals.

"We want to see not just a favoured few enjoying this freedom but to extend it to all acute hospitals."

But what of the freedom to borrow and the question of who would pick up bill if hospitals overspend?

"The need for financial discipline remains, even if the hospital is independent," Mr Yeo said.

"The management would have to show or persuade the lender of the sense of whatever scheme it may be – if they want to invest in another ward, for example. They would have to look at that case on the basis of what it would do for their local community and the services it could provide. It wouldn't remove the discipline. It would mean that decisions would be made on the basis of merit.

"I have faith in the professionals. They do a tremendous job, often in extremely difficult conditions. They do need to have support and to be able to get on with their jobs."

Mr Yeo recognised the potential of private health provision to relieve the burden on the NHS, although would not say exactly what direction Tory health policy was likely to take, in that respect.

"We will be setting out our health policies in detail over the coming year," he revealed.

"Counties with better health outcomes usually have bigger independent provision of healthcare alongside whatever the state provides.

"We see nothing wrong in saying to people that if they want to use the independent healthcare they should be able to do so without any penalty."

The Tory offer of cash vouchers (the patient's passport) – allowing patients to spend their NHS entitlement in the private sector, however, did not seem to sit easily with their proposal for education vouchers. Parents would not be permitted to use the £3,500 to subsidise private school fees.

Mr Yeo responded: "We don't think the same principles have to apply in precisely the same way in education. With schools, the number of pupils remains the same in total. There is no waiting list of people trying to get in. It is a different situation.

"One of the advantages of allowing people to move into the independent sector in healthcare is to free up space, releasing beds."

From stressing the similarities between his two hats, Mr Yeo acknowledged that taking on two such formidable briefs would not be a case of simply applying policies across the board.

"There are some differences. I will be working on these policies. They are not absolutely set in concrete. I have only been in the job for three weeks now. With the team I've not got, I shall be looking at these policies and we shall refine these details."

Mr Yeo said his professional background has given him an interest in both fields – as a former chief executive of the Spastics' Society and chairman of The Children's Trust, he laid claim to direct experience of health and education.

Of his new dual-responsibility, he said: "It is a big task, but I do believe I've come to it well-equipped."

On the subject of tuition fees, it had been suggested that Mr Yeo would remove the Tory opposition to top-up fees. But, he revealed, he would fight Mr Blair's proposals to allow universities to charge up to £3,000, unveiled in the Queen's Speech this week.

Describing the move as a "kind of education tax", Mr Yeo said: "You have to think of the burden that places on students. It is going to make life very difficult for them, putting them further into debt. We suspect not all of the money charged by the Government will get to the universities anyway."