House of Commons Hansard Debates for 5 Apr 1995

Mrs. Barbara Roche (Hornsey and Wood Green): May I first join the congratulations to the hon. Member for Harrow, East (Mr. Dykes) on his success in gaining this evening's Adjournment debate the day after the secretive announcement about hospital changes in London, which included announcements about Edgware general hospital, and the day on which the Secretary of State had to be brought to the House, to use the rather colourful expression of one of my hon. Friends, kicking and screaming to account for herself.

I represent the constituency of Hornsey and Wood Green in north London. It is in the borough of Haringey, which adjoins Barnet. It is fair to say that in north London, certainly in the boroughs of Barnet, Enfield and Haringey, what happens in one of those boroughs certainly has a knock-on effect on health provision in the other boroughs.

Today we are debating the proposed closure of the accident and emergency facilities at Edgware general hospital. In Haringey and Enfield we were much concerned about the possible amalgamation of the accident and emergency facilities between the North Middlesex and Chase Farm hospital. We were aware that there could have been a knock-on effect on Barnet. When we consider what is happening in one area of north London, we should be mindful that a much wider area might be affected, so it is extremely important that we are having this debate this evening.

Let me say something about accident and emergency facility in a hospital. The hon. Member for Hendon, North (Sir J. Gorst) put his finger on it when he said that in essence they are the life blood of a hospital. If the accident and emergency unit is closed it signals the death knell of a hospital. That has happened in many of our hospitals, of which Bart's is a good example.

Something that has distressed me, both today and on other occasions when London Members of Parliament, from both sides of the House, have come together to discuss health issues, is the apparent anti-London bias among some Conservative Members. There is a feeling that London is well provided for. That is not the case. Indeed, what we have heard tonight about the future of Edgware general hospital shows that it is not over-provided for.

In the context of the wider picture, I draw attention to the Whittington and North Middlesex hospitals and the consequences for them of the proposed closure of the accident and emergency unit at Edgware. I am extremely worried about the effects of that. Hon. Members have referred to the traffic problems in London, about the problems of having to travel some distance to a hospital and about the problems of the London ambulance service. I do not need to remind hon. Members about the difficulties and problems of the London ambulance service, which all Members, of whatever political persuasion, recognise. The Department of Health has shown a gross lack of management of that service. It has not given proper support to the excellent men and women who work for that service--a service to which we, as Londoners, owe such a great debt.

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I end by referring to our responsibilities as Members of Parliament. The hon. Member for Hendon, North (Sir J. Gorst) touched on that. We all owe a duty to our constituents, no matter which party we represent. Week in, week out, at our constituency surgeries and in our postbags, we receive representations from our constituents. We come to this place not just to have the pleasure of listening to our colleagues or to the sound of our own voices; we are here as the voice of our constituents.

In London, as elsewhere, local people have a great attachment to their local hospitals. They identify with them. The great difficulty with health provision, and this is not often recognised by the Government or the bureaucrats, is that part of getting well and of feeling well cared for is not just the excellent professional care that people receive in their local hospitals, it is how people feel about the hospital itself. It is how the family--husband, wife, son or daughter--feel about it. Most important, it is what the community feels about the hospital. That is absolutely vital.

It appears that in dealing with Edgware general hospital, the Government, once again, have not taken into consideration the feelings of local people and those who use our local facilities. I urge the Government to think about the consequences for the Whittington and North Middlesex hospitals and also to think again about all the central London hospitals that have been so badly affected by the Government's policies.

7.14 pm

Mr. Nicholas Brown (Newcastle upon Tyne, East): At lunchtime today, I had the great privilege of representing the parliamentary Labour party when meeting a delegation of very young constituents of the hon. Member for Harrow, East (Mr. Dykes), who had come to the entrance of the House to ask us to save their hospital. I understand that most of those young children had been born in that hospital. They had spent time preparing leaflets and making a banner and badges to set out the case for their local hospital. They had obviously been encouraged to do so by their teachers and parents, but their strength of feeling about the hospital was made clear to me and to their local Members of Parliament, who are all Conservative Members.

I congratulate the hon. Member for Harrow, East on having secured this important debate. I congratulate his colleagues the hon. Members for Hendon, North (Sir J. Gorst), for Hendon, South (Mr. Marshall), and for Finchley (Mr. Booth) and the right hon. Member for Brent, North (Sir R. Boyson). It was not easy for them to make the important contributions that they have made today. It is not easy to speak in a manner that will not find favour with one's Front Bench. It requires courage to do that and I congratulate them on it. I recognise the case that they are making, which is not for a change, but for a review; a ministerial reflection. That case has been well made today.

I agree with my hon. Friend the Member for Hornsey and Wood Green (Mrs. Roche) that the manner of the announcement yesterday left just about everything to be desired. It was sneaked out in a written answer. The range of changes announced to the hospital service in London was so significant that it merited a statement in the House. Indeed, the private notice question to which the Secretary of State had to respond today--she came here because

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she had to, not because she wanted to--the number of interventions that were made and the fact that some hon. Members were still rising at the end of a generous hour's questioning show how strong the feeling is on both sides of the House.

That strength of feeling transcends party politics. Every Member of Parliament, regardless of party affiliation, wants to do his best for the constituents who elected him to come to this place to represent them. I congratulate both Conservative Members and Labour Members on doing just that. The Secretary of State for Health has done herself no good--nor, indeed, the office that she holds--by perpetually sneaking out difficult announcements under the cover of some other statement. Yesterday, it was the statement on the report of the Privileges Committee; not long ago the announcement of the increase in prescription charges was sneaked out on the day of the Northern Ireland announcement. That is no way to serve democracy and I deplore it.

This debate is important because it enables the House again to express its view--a virtually united view--to the Under-Secretary of State for Health. He can be in no doubt about the strength of feeling or the sincerity of the local Members of Parliament. It was deplorable that they were laughed at by the Government Whip. This is not a laughing matter. The constituents of those Conservative Members take it very seriously indeed. Those hon. Members perfectly properly have done what they should do: represented their constituents' views. That should have the sympathy of the House; it certainly should not be treated as a laughing matter.

The Secretary of State has never provided a debate on any health issue in Government time. Any such debate has always had to have been dragged out of the Department by a Member or it has been provided through an Opposition Supply Day. The narrow issue, although there is a wider context, is the plan to close the accident and emergency unit at Edgware general hospital. The claim is that the geographically nearby Barnet hospital will be able to cope.

The piecemeal way in which decisions have been made in London is deeply flawed. London will rue the day that those decisions are implemented. Of course, the points made about traffic issues are well taken, especially in the context of the shortcomings of the London ambulance service. To say that those facilities will be replaced with primary health care eventually is just not good enough. Local people and their elected representatives rightly worry that they will lose the accident and emergency service, and that primary health care will, at best, come later. I notice that the Secretary of State has not been forthcoming about how much is to be spent. More important, she has not been forthcoming not only about how much revenue expenditure is to be committed, but about when it will be committed. That failure to make a definite statement is clearly fuelling the uncertainty, as well it might.

Further investment in primary health care is right for London, but it will not lead to a reduction in the demand for secondary care. An increase in primary care may stimulate demand for secondary care and for the sort of services that are provided at Edgware general hospital. My hon. Friend the Member for Hornsey and Wood Green made the good point that the loss of an accident and emergency unit was the thin end of the wedge, and that the general closure of the hospital would not be far behind.

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As my hon. Friend the Member for Lewisham, West (Mr. Dowd) said, this exercise is driven by financial considerations. No one could have taken any comfort from the light statement that the Secretary of State made about the revenue issues involved in that exercise. Hon. Members have made the point about consultation. If one is to consult local people, one should do it in a meaningful way. One should be willing to listen to what they have to say. However, in the whole debate on secondary health care in London, no evidence exists of the Department listening to anyone. Clinicians, managers, local people, their elected representatives and members of local authorities are screaming at the Government to think again. When the parliamentary Opposition say to the Government, "Think again", they satirise our position as requiring a review of a review. I have said this before and I make no apologies for saying it again. If one is going in the wrong direction, there is no shame in pausing, thinking and saying, "Perhaps we ought to turn around". That is the position that the Government find themselves in today. I urge the Minister to listen to what just about everyone is saying to the Department. I urge it to come out of its ivory tower, and to mix with real people rather than a handful of professional advisers.

Sir John Gorst: As the hon. Gentleman is talking about listening, may I tell him that, when the regional health authority finally considered the matter, the admiral of the fleet who chairs that organisation said--I cannot vouch for this, but I have been informed that it is so--that it was a meeting in public, but not a public meeting.

Mr. Brown: That is a new concept to me. The Government are clearly doing to the national health service what they have done to the Royal Navy, and they are using the same people to do it. Representing Swan Hunter shipyard, I speak with some feeling.

The exercising of political judgment is the real issue. The Secretary of State and her team of Ministers do not seem able to do that. They rely on specialist advisers. They do not allow anyone else to put a point across to them, no matter how widely the public support that point. They make decisions and do not have the courage to announce them proudly in the House of Commons, or in any other forum where they can be criticised, and then they seem to be slightly resentful of the fact that they are eventually dragged here to explain what on earth they think they are doing.

That is a hopeless state of affairs. The only way out of it is an independent review, which should be conducted not by the Government's political opponents--although that may happen soon enough--but by an independent body that can take evidence. The people who serve on it should be respected across the professions as well as local communities. A post- Tomlinson reassessment is needed because much of the evidence on which Tomlinson was founded is deemed by many people to be so deeply flawed.

I congratulate the hon. Member for Harrow, East on securing the debate. I assure him that I support his request for a review.

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7.24 pm

The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville): I congratulate my hon. Friend the Member for Harrow, East (Mr. Dykes) on bringing this debate before the House. I have no doubt as to the great sincerity with which he has done that, or about the feelings that the matter has engendered in his constituents and in those of my hon. Friends. I congratulate all those who have spoken and, in particular, with one exception, I commend them on the brevity of their speeches. I welcome the fact that the debate has attracted expert witness from as far away as Lewisham and Newcastle. I have no doubt about the importance of the matter raised by my hon. Friend the Member for Harrow, East.

I should like to make one important point first. Edgware hospital will not close. As has been said, it will continue as a major provider of health care in the region. I shall briefly run through the matters that will be out for consultation, but, at Edgware hospital, there is likely to be a great range of out-patient services, rehabilitation, mental health facilities and palliative care, not forgetting minor accident treatment, which is likely to be used by many people--a large proportion of those now using the accident and emergency department.

I have been asked about beds.

Mr. Nicholas Brown: Will the Minister give way?

Mr. Sackville: I think that I shall continue. The hon. Gentleman has already intervened at some length in the debate.

Currently, there are 747 beds in the Wellhouse Trust, excluding psychiatry. Following the changes, the potential capacity is 635, a reduction of 112. The House might like to know that, since the publication of the consultation document, an additional 50 beds have been opened at Northwick Park hospital, with additional plans already in hand for a further 62. An extra ward of 24 beds has already been brought into use at the Royal Free hospital, and the provision of an extra 44 beds in existing wards has been made.

Sir John Gorst: Listening to my hon. Friend, I wonder whether he knows or recognises the difference between when someone is ill or has some slight infirmity that requires hospital treatment, and when someone is traumatised by a sudden accident or heart attack? What an accident and emergency unit does is at the heart of what reassures people. He is telling us that all the peripheral things will be there. He is missing the point of the whole debate.

Mr. Sackville: I was seeking to answer a specific question about in- patient beds. I shall talk later about A and E departments and 999 attendances.

I repeat what my right hon. Friend the Secretary of State for Health has said. The A and E department will not close until new facilities are in place--that is to say, an expanded modern A and E department at Barnet general hospital. Part of the £29 million phase 1a extension at that hospital will include new theatres, wards and other facilities and, of course, bringing the minor accident treatment service at Edgware into operation.

If I were asked briefly to give the reasons that have led to those proposals and the decision, I should divide them into two parts. First, it is true that we want services to be

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provided more efficiently in the whole region. We are constantly faced with the need to provide health services efficiently. There is indeed a financial aspect to this. There is no doubt that there is a subsidy to the local area which, to a great extent, is a result of the fact that we are currently providing acute services at two hospitals. All hon. Members who have spoken tonight know that this has been presented as an on-going problem which will probably get worse unless some action is taken.

Secondly, as has been mentioned, there are clinical reasons for the decision. We do not want any duplication of specialty services; we want modern facilities of a certain size so that the correct number of patients pass through, thus enabling us to provide, where possible, not only a consultant-led service but a consultant-provided service. We have heard too many stories recently about things going wrong in the NHS in the absence of consultants. That is particularly true of accident and emergency services where, whether or not it is possible to achieve this in the short term, we aim to provide 24-hour consultant cover. One cannot always expect junior doctors to provide the same level of expertise as doctors with years of experience. Accident and emergency departments in particular--although it is to a certain extent true of other specialities--need a certain flow of patients. It is no good providing a very specialised service--the accident and emergency service is now recognised as such--if the doctors and nurses involved do not see enough cases to develop the expertise to deal with, for example, head injuries. One needs a service that is large enough to develop expertise, or one runs the risk of having unsafe services because for too much of the time one would be running them with too low a grade of medical staff and with staff who do not have sufficient exposure to special problems to be able to offer the best that is available today.

Mr. John Marshall: Does my hon. Friend accept that the accident and emergency department at Edgware hospital is very heavily utilised?

Mr. Sackville: Yes. I believe that it has a volume in excess of 40,000 attendances a year and that something in the order of 25 "999" ambulances use it. It does not have 24-hour consultant cover. We are not aiming for the American model of trauma centres, but we at least want to ensure that anyone who attends an accident and emergency department as an emergency is seen by a consultant. That must be our aim because it can make an enormous difference to the outcomes. Certainly, we have to count beds and consider questions of access and distance, but, at the end of the day, it is the outcomes that are enormously important. That is what the service is all about. I am well aware of the concern felt by many hon. Members about transport. I can confirm that it will be kept under review. The district health authority and the trust will want to ensure that the necessary action is taken where transport facilities are inadequate. The issue of "999" ambulances is of grave concern to the public and has already been mentioned once or twice this evening. The London ambulance service has had problems that are unique to the capital. Of the 35-plus services in England, only the London ambulance service has failed to get anywhere near its target time. The target

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time involves responding to 90 to 95 per cent. of calls within 14 or 19 minutes, depending on whether the service involved is a rural or urban one.

I am glad to be able to make it clear that there has been a very marked improvement in recent months in the London ambulance service's performance from what I admit was a very low base. Not long ago, we were talking about performance figures of only 50 per cent. or just over. Recently, the figure has been 76 per cent., and the latest figures reveal that targets were reached in 74 per cent. or 75 per cent. of cases, which is a favourable development. I suspect that there is now a very much better atmosphere between management and staff than that which bedeviled the service.

Mr. Marshall: In effect, my hon. Friend is saying that the target is not hit in one in four cases. Does he accept that, if that rate continued, the proposal would be unacceptable?

Mr. Sackville: As my right hon. Friend the Secretary of State said, we would expect a further improvement in performance. I can report to the House that there are already plans for extra resources to go directly into the Barnet and Edgware area. In fact, the local health authority is putting an extra £320,000 into local ambulance cover and two extra standby points for "999" ambulances have been provided. Detailed work has recently been carried out into the journey times of the London ambulance service and it has been calculated that, with the extra resources, the average call-to- hospital time for Brent and Harrow residents would decrease by between one and two minutes with an increase for Barnet residents of just under half a minute compared with current performance. That is the effect that the extra resources, quite apart from the overall increases in performance, would have on journey times. I think that that is encouraging.

Mr. Dykes: In view of the distance between Barnet hospital, Edgware hospital, the Royal Free and the Northwick Park hospital, that input of two additional ambulances will be wholly inadequate.

Mr. Sackville: The question of ambulance cover and where ambulances are stationed has to be worked out on the basis of the demand at different times of the day and the week. We have to leave it to the London ambulance service to make those dispositions, but we demand that the service not only provides additional resources to cover that area but that it makes an overall improvement in performance of the sort that has been achieved all over the country. The London ambulance service is funded at the same level as, or even better than, any other urban ambulance service. There is no reason on earth why it should not achieve the very high standards of many of the county ambulance services, which are probably as high as any in Europe. We look to the service to do just that.

Primary care is fundamental to all our arrangements.

Mr. Booth: Before my hon. Friend moves on to another subject, may I draw him a little further on transport? He said that he would keep it under review, but does he accept that, unless he has expert advice or an independent inquiry, as suggested by the hon. Member for

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Newcastle upon Tyne, East (Mr. Brown), there will be nothing to review because his Department is not responsible for transport?

Mr. Sackville: Access to hospitals is fundamental to any monitoring of the performance of those hospitals and especially that of accident and emergency departments. I assure my hon. Friend that the matter will not be forgotten or ignored.

I deal now with primary care because, clearly, all those matters involving the configuration of acute services and hospital services in our major city need to be accompanied by improvements in primary care, in GP services and in community services. I well understand that those improvements are needed.

My right hon. Friend the Secretary of State for Health said, somewhat hesitantly--I will say it more robustly--that there would be £15 million of new, special funding spent over five years for primary care in the Edgware area. Current projects, to give an example, include the extension of home nursing for people who are terminally ill. There have been improvements in GP surgeries and there is an outreach ophthalmology clinic. Further planned projects include improved community therapy services, increases in the number of community nursing staff and a new GP surgery in Burnt Oak.

Mrs. Roche: Can the Minister tell me what community therapy services and community nurses have to do with the closure of an accident and emergency facility?

Mr. Sackville: I was making a general point about improvements in community and primary services. These are specially funded services rather than just what is normally provided by the health authority and the FHSA.

Mr. John Marshall: My hon. Friend has said that there will be an extra £15 million over five years. How much of that is coming in the current financial year?

Mr. Sackville: My hon. Friend has defeated me there. I shall have to write to him on that point.

Sir John Gorst: This is precisely the point that many of us have been making. The announcement has been made and no plans exist. The Minister does not even know the position.

Mr. Sackville: The hon. Gentleman is being unfair. We have to assume that the statement about £15 million over five years suggests that there will be fairly level spending over that period. I am sure that he is right to try to--

Mr. Nicholas Brown: Is not the Minister really saying that once the savings have been realised from the closure of the accident and emergency unit, they will then be ploughed back into primary care?

Mr. Sackville: I am not saying that at all. Primary care is already being improved in London, as it is all over the country because new primary facilities are provided everywhere. I have opened many new GP surgeries and community centres in the past two and a half years. The money is extra money from a special fund aimed at improving community and primary services in the area.

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A more general point, which has been made several times, concerns the way in which the changes were announced. I must correct the hon. Member for Hornsey and Wood Green (Mrs. Roche), who said that my right hon. Friend the Secretary of State came kicking and screaming to the House. I was here and I saw her neither kick nor scream during any part of the day. She answered a number of questions extremely convincingly.

On the question of whether my right hon. Friend should have made a statement--much has been made of this--all that I can say, speaking as a north-western Member, not a London Member, is that I have been involved in many major changes in the health service involving the closure of hospital facilities. They are always accompanied, as in this case, by major redevelopments of modern facilities. On no occasion have we made a statement on the subject to the House. I agree that this is a major package of changes, but I believe that there is not, formally speaking, any precedent for making a statement for the agreement of proposals for the reconfiguration of hospital services. It has never been suggested during the two and a half years in which I have been involved in dozens of such proposals.

Sir John Gorst: May I offer a different point of view to my hon. Friend? If the Birmingham theatre closed, I would not expect the nation to have a statement from the Secretary of State for National Heritage. However, if Covent Garden opera house was to be closed, I would expect the Secretary of State to come to talk about it. What has happened here is that two of the monuments of our medical service--Bart's and Guy's--are to be closed in a most surreptitious fashion, with no statement. I honestly believe that it is wrong for the Minister to say that just because no statements are made about Birmingham, no statements should be made about the cathedrals of the medical world.

Mr. Sackville: That is the sort of elitism to which we in the north- west have to listen a great deal. I am not particularly convinced by that argument. These are matters that have been discussed widely in the House and elsewhere over recent weeks and months.

Mr. Dowd: That may have been the Minister's judgment before. He must, however, have noticed, because he sat loyally through the private notice question this afternoon, that it ran for one hour and four minutes, yet there were still at least half a dozen Conservative Members waiting to get in. Does that not now, post hoc, suggest to him that the decision not to present the proposals as a statement was a miscalculation? Will he bear that in mind if something like this happens in future? Let us hope that no such thing happens.

Mr. Sackville: I note that Madam Speaker granted a private notice question; that is a matter for the Chair. I also note that yesterday, she did not grant a private notice question on the subject. This is not a matter I want to go into further.

Although I welcome very much the fact that the subject has been so ably aired by my hon. Friend the Member for Harrow, East, I ask him to read Hansard and to reconsider some of his remarks about my hon. Friend the Member for Gedling (Mr. Mitchell), the Government Whip. He may find that he went a little far, especially as he was

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talking about an hon. Member who, by long convention of the House, was not able to answer the charges made against him.

Sir Rhodes Boyson: Even at this stage, the Minister must be aware of the depth of feeling on the matter. It should and must be looked at again, and it should be thrashed out. At the moment, it is a question of saying that the proposals will take effect in two years' time; there is time. I presume that the two years apply because there will be two years of consultation. We have had none yet.

Mr. Sackville: Uncomfortable as many of these decisions are, a decision has to be reached in these cases. I do not like being here at the Dispatch Box having to defend this decision because, like many decisions over much-loved local hospitals, it is not popular. People do not like it and they fear the worst as a result of hearing that local health facilities will be closed. I absolutely accept that there are grave concerns. On the other hand, I have spelt out some of the reasons why we have had to arrive at this decision. I have spelt out some of the factors that should reassure people that there will be no closure of the A and E, for example, until new facilities are in place.

As I have already told the House, I have been involved in several such decisions. No one ever likes them. The local health managers and often--it is true in this case--some or all of the clinicians agree with the decision; very few other people do because it is natural that people do not want health services to change. From our point of view, as those responsible for trying to provide a consistent health service around the country, we have to make changes. We have to modernise and we have to concentrate services from two or three places, sometimes into one, simply to provide them not only efficiently, but well and safely. I would not pretend that this decision is popular.

I regret very much that, from the tone of the debate, I and my right hon. Friend the Secretary of State have apparently failed to convince the local Members of Parliament. I can tell them that we have considered these matters carefully. We are quite certain, as are all the others who work in the health service who have contributed to this decision, that the proposals will provide over the area as a whole a better and more modern health service.

Sir John Gorst: It is possible that the House might take a different view--we hoped that my hon. Friend the Minister might have taken such a view, but he has not so far suggested that. If the proposals were to be vetoed by the House on a vote, what would be the position in relation to the London closures? We should know that because it is important when deciding how to treat any vote on the subject.

Mr. Sackville: That is a procedural matter and it involves health considerations that go much wider than the subject of the debate. While I understand my hon. Friend's question, I am sure that he will forgive me if I

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do not attempt to answer it. All that I can say is that I believe that we have made the right long-term decision for the overall good of health care in the area. We have to make many such decisions. I resent the suggestion of my hon. Friend the Member for Harrow, East that this is an example of the health service being unsafe in our hands. If we took no such decisions, never made any major changes to hospital provision and went on exactly as we were, we would probably have very few new hospitals, and would be treating fewer patients rather than more, and at greater cost. That is not a recipe for the NHS to be safe in anyone's hands.

Mr. Dykes: I am grateful to my hon. Friend. I think that he misunderstood--I specifically paid tribute to the need for the Government to have disciplined financial management over all matters and all installations in the national health service. I have always supported that policy in general, and think that everybody should do so. I thought that we had made our views crystal clear and I am sorry that my hon. Friend does not seem to be grasping the reality. The perception is wrong; the public do not trust the process. I am sad and regret having to say that they do not feel that they can accept my hon. Friend's assurance that the consultations have been genuine. The Government have been going through pretend motions, then ignoring and dismissing the views and the thousands of opinions, including expert medical ones. The trouble is that the Government never reassure the public in respect of any such instances. That is why we continue to fight in this case to see whether the process has been genuine and other opinions against the closure of the accident and emergency unit have been heeded. Why should they not be heeded? Why should not the Government say that they disagree with the regional health authority and will keep the facilities open because the hospital is needed?

Mr. Sackville: The Government find themselves agreeing with the regional health authority that we have to make the changes in order to provide an efficient, safe and high-quality health service over the area.

If, over the past few years, we had not made any decisions about hospital provision--many of them unpopular--we would not be treating 120 patients for every 100 that we treated four or five years ago. We would not have better outcomes--

Mr. Nicholas Brown: Will the Minister give way?

Mr. Sackville: No, I shall not as I am just about to finish my speech.

It is sometimes necessary to take decisions which may not always be popular, but which we know to be in the best interests of providing a modern health service in the long term. The decision that we are discussing is no exception.

Question put and agreed to.

Adjourned accordingly at eight minutes to Eight o'clock, till Tuesday 18 April.

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