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authority is examining the way in which these acute services are provided in three hospitals--the Blackburn royal infirmary, Queen's Park hospital and Accrington Victoria. It should be noted that the district is currently achieving the highest ever levels of acute and other services. Since 1982, in-patient treatments have increased by 10 per cent., out-patient treatments by 15 per cent. and day cases by 20 per cent.

The question remaining is why the role of Accrington Victoria hospital should be reviewed. I am advised by the district general manager that the Accrington Victoria hospital lost its accreditation for the medical training of pre-registration junior doctors in November 1988, among other reasons, because there were not sufficient senior doctors with time available to give supervision to their junior colleagues. That arose in part because their duties were split between the three acute hospitals that I have mentioned.

I am further advised that representatives of the Royal College of Surgeons will be visiting the hospital in December--as my hon. Friend said--to consider whether the number and type of surgery cases dealt with there can any longer justify the hospital's accreditation for the training of senior house officers. The question arises whether the cases dealt with at the hospital include a sufficient number of major trauma cases to provide a broad range of experience for senior house officers. One of the criteria that the Royal College of Surgeons may well use is the existing size and scope of services at the hospital--doubtless a function of past decisions about what should be provided at the hospital. It is the proper job of the royal college to review the present range of services to see whether appropriate experience is being gained.

Against that background of changed requirements, developments elsewhere in the district and the consequences of the loss of accreditation, it was clearly the duty of the district health authority to consider what future services should be provided at the Accrington Victoria. The district health authority held a public meeting in Hyndburn on 16 May 1989 and further discussions on the provision of acute services followed in July and September. The district authority resolved that proposals to develop a community hospital at Accrington Victoria should be pursued.

That option, considered by the authority in September 1989, envisaged the transfer from Accrington Victoria of 25 surgical beds and an equal number of orthopaedic beds and the transfer in of a day hospital for the elderly and, possibly, an associated day centre for the elderly. The renal unit, out-patient clinic, minor injuries unit and existing beds for the elderly would be retained at Accrington Victoria. I have noted the possibility of Accrington

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Victoria becoming a community hospital and the fact that the district health authority's proposal envisages the future long-term use of the hospital for community services. I think that that will greatly reassure local residents.

The first of two assurances that I want to give my hon. Friend is that in the event of any proposal to reorganise services at Accrington Victoria or to close the hospital completely, the proposal must come to Ministers for final decision if the community health council objects. The process of considering the future deployment of services has only just begun, but if the CHC objects to any proposal concerning the reorganisation of services-- I am advised that there is no prospect of the closure of the hospital--that proposal must come to Ministers.

I do not want to go into the merits of the case for centralising the acute services at Blackburn Royal infirmary and maternity and gynaecology services at Queen's Park hospital. That decision is essentially a local matter. The services are for people in the Blackburn area, and their views must be heard. I do not think that the authority can be faulted for its openness in setting out the issues in papers considered by the authority and discussed in public.

I remind my hon. Friend of the three key issues that have emerged in this debate. First, it must be remembered that, since 1978-79, the Government have increased resources for the North Western region by 13 per cent., and the increase next year for the NHS as a whole will be 3.4 per cent. in real terms. The exact amount for the North Western region and the Blackburn authority has yet to be decided. Secondly, major developments in the region and in Blackburn at the Queen's park hospital are at the highest ever level, and inevitably require the review of existing patterns of service elsewhere in the authority area. Thirdly, the district authority should, as far as possible, be left to arrive at local solutions that meet the financial targets that have been set, but match as closely as possible the needs of the local population.

I come now to my second assurance. Although I have no desire to interfere with the proper local management of the Health Service, I can assure my hon. Friend that I shall come to visit his constituency and the hospital service there before any final decisions are taken. I do that not in a spirit of wanting to interfere with the district or the region but to express, with my hon. Friend, my interest in and dedication to the improvement of services for his constituents, as for the entire population of the country, in an improved quantity and quality of services in the NHS.

Question put and agreed to.

Adjourned accordingly at four minutes to Eleven o'clock.

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