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8.17 pm
Sir Roger Sims (Chislehurst): I cannot possibly claim to have the detailed understanding of the implications of the Bill that the hon. Member for Southwark and Bermondsey (Mr. Hughes) has just so effectively demonstrated, but the House will be aware of my especial interest in Guy's hospital. I have worked with the hon. Gentleman for the past two or three years in an endeavour to retain Guy's hospital in its present form and largely on its present site.
My right hon. Friend the Member for City of London and Westminster, South (Mr. Brooke), in explaining the proposals in the Bill, sought to emphasise that the proposals for the combined medical schools are separate from the hospital, which is administered by the local NHS hospital trust. That may be so technically, but I put it to him that they are closely linked in practical terms. The public perception is that hospitals and teaching schools are one and the same.
I believe that the proposals to transfer a substantial number of medical services from the Guy's site to theSt. Thomas's site are flawed. I said in a debate that I initiated in the House about 18 months ago that I thought that the Secretary of State's decision was based on inadequate and inaccurate information. No evidence has emerged since then to cause me to change that view. I urge my hon. Friend the Minister for Health to reconcile his opposing positions: on the one hand, he advocates the Bill and all that it implies and, on the other, he is involved in implementing the proposals to merge Guy's andSt. Thomas's and to transfer services.
In my brief contribution, I emphasise the points made by the hon. Member for Southwark and Bermondsey. If much of the teaching is to occur on the Guy's site, it is difficult to justify moving so many of the medical facilities and the patients to the St. Thomas's site. That is not logical. If we are to develop a fine medical school on the Guy's site, patients are an essential part of the learning process. It seems extraordinary to try to develop teaching facilities on the Guy's site while transferring medical facilities and the patients to another site.
Mr. Don Foster (Bath):
I come to the debate with a completely open mind on the rights and wrongs of the proposed move. Having listened to the contributions by the right hon. Member for City of London and Westminster, South (Mr. Brooke) and my hon. Friend the Member for Southwark and Bermondsey (Mr. Hughes) and the brief but plangent contribution by the hon. Member for Chislehurst (Sir R. Sims), I remain fairly open-minded about our approach to the issue.
My hon. Friend and the hon. Member for Chislehurst asked important questions which must be answered before a final decision is taken. For example, my hon. Friend referred in passing to the important issue of the private finance initiative and the role that it must play in funding some of the proposed work if the merger goes ahead. I do not know whether my hon. Friend is aware that there is considerable confusion about the role of the PFI in the education sector.
There has been interesting correspondence between the Department for Education and Employment and the Treasury on that matter. The Department believes that the PFI should be in addition to the normal capital allocation procedures, whereas the Treasury views it as a substitute for those procedures. There is clearly a difference of opinion that will have implications for whether funds will be available to ensure that the required capital work takes place.
I was interested in the remarks of the right hon. Member for City of London and Westminster, South, who referred to the longevity of his constituency and to some of his predecessors. He is in the Chamber and may be interested to learn that my constituency dates back at least as long as his. I also have some interesting forebears. In the 1800s, the local Member of Parliament, Mr. A. J. Roebuck, was the first hon. Member to propose the state funding of education in this country.
If Mr. Roebuck were here today, he would be interested to listen to our debate on the funding of medical and dental education. He would have noticed the interesting timing of today's debate. Many people who are concerned about higher education in general, and about dental and medical education in particular, will arrive at the Palace of Westminster tomorrow to express their real concerns about existing funding difficulties in those areas. We are discussing the merger of two institutions that may require additional funding of £140 million or possibly more in the context of significant cuts in higher education funding. Therefore, we must ask: will that money be available?
This debate takes place within the context of real concern about the present funding of clinical and academic education. Mr. Deputy Speaker, I am sure that you are aware that universities' capital incomes were slashed by about 31 per cent. in last November's Budget. There was an overall funding cut of 5 per cent. and at least a suggestion that further cuts would follow. Those capital cuts came on top of a 28 per cent. real terms reduction in funding per student in the past six years.
Those figures are clearly important to the debate, as we are told that the proposals will save money. We are told that they are driven largely by the savings that may accrue from economies of scale. However, we know that the proposals will cost a great deal of money initially and no evidence has yet been produced of any savings in the long term. Before the House passes the Bill, hon. Members
must receive a clear answer on whether money will be made available to fund the up-front costs of the merger. Clear evidence must be produced that economies of scale will produce savings that will not prove detrimental to the quality of future medical and dental education.
People with those concerns may well look back to other mergers that have taken place, for example in the 1970s, when Bart's was told to merge with Queen Mary's. It was told that funds would be withheld from it if the merger did not go ahead. It went ahead, but none of the money that was promised to fund the merger was made available until about 12 or 13 years later, in 1985. We must be absolutely sure that the funding will be made available in this case. I hope that the right hon. Member for City of London and Westminster, South will say what assurances the Government have given him that funds will be made available.
I have also said that it is important that we are given a clear sign that there will be economies of scale to save money, but in a way that will not be harmful to dental and medical education in this country. One concern which has not so far been expressed is with the way in which cuts may be made that will have a direct effect not only on medical and dental education but on the medical and dental care of people in London.
There was some interesting correspondence recently between the Minister of State, Department for Education and Employment--the hon. Member for Mid-Worcestershire (Mr. Forth)--senior people within the Committee of Vice-Chancellors and Principals and medical schools around the country. For example, in the middle of May this year, the chairman of the CVCP's medical committee wrote to the Minister expressing considerable concern that the Department for Education and Employment had been quoted as saying that there was
That is why it was so pleasing that the Minister for Health talked about his acknowledgment of the links between teaching, research and patient care. If the merger is to go ahead, we need an assurance that it not only will bring about improvements in the teaching and medical side of dentistry but will not in any way harm patient care for people in the capital.
Mr. Simon Hughes:
My hon. Friend will be aware, as I am, that one of the great concerns outside is that there will not be sufficient medical or dental students, as in many other professions. One important factor in establishing confidence is that students should have confidence in their choice of institution, feel keen to go there and believe that it is a place where they want to study, and that they do not go off and do something else.
Does my hon. Friend agree--
Madam Deputy Speaker (Dame Janet Fookes):
Order. The hon. Gentleman is making a very long intervention.
Mr. Hughes:
I shall shorten the last sentence, Madam Deputy Speaker.
"no direct link between the level of university grants and the delivery of NHS patient services".
The chairman went on to describe what he saw as an "inextricable triad" of teaching, research and patient care. Yet, in subsequent correspondence, the Minister seemed not to accept the intricate link between the two.
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