House of Commons Hansard Debates for 20 Nov 1996 (pt 18)

1.44 pm

Rev. Ian Paisley (North Antrim): This is a very serious matter for the hon. Member for East Londonderry (Mr. Ross) and for myself. I remind the Minister that large sums were spent through the Province on a promise that the Waveney hospital in Ballymena would be the main acute hospital in the area. The tragedy is that, with the closing of the hospital in Ballycastle and the rundown of the hospital in Ballymena, there is currently no acute service hospital nearer than Antrim for my constituents. If the Causeway hospital does not go ahead, all the people, from as far north as Ballycastle, will have to travel to Antrim.

This is a very serious matter, and all of us are seriously concerned about it. We thought that we had it resolved by the promise of a new hospital in the hon. Gentleman's constituency but on the periphery of my own. It was called the Causeway because it was to serve both communities. As the hon. Gentleman said, Minister after Minister--the right hon. Member for Richmond and Barnes (Mr. Hanley), the Earl of Arran, Baroness Denton and the hon. Member for North-East Cambridgeshire (Mr. Moss), who will reply today--gave us assurances on two occasions.

There are serious questions that the Minister must answer today. First, why all the reviews? It seems strange that one review is carried out in September 1994 and another in October 1994. Why? No other new hospital in our country has had such treatment. The hon. Gentleman is right: people are saying that there is discrimination in this case. This has not happened in the other new hospitals built. An appraisal was carried out in 1995. In June 1996, there was yet another. Why all these appraisals, when it was decided that the hospital was needed and that it would be built?

Then, of course, we have the fact that the Causeway hospital development group met monthly for four years. It has had 49 meetings. Now there is a question mark over the whole affair. What about the promises made to the medical staff, and the rationalisation that was necessary for the configuration of the new hospital?

Rev. Martin Smyth (Belfast, South): The hon. Gentleman speaks of rationalisation. Does he recall that, between 1982 and 1986, the Northern Ireland Assembly agreed that rationalisation should proceed? At that time, as Chairman of the Finance Committee, I asked whether slippage money could be used for rationalisation, and millions were returned to the Treasury.

Rev. Ian Paisley: I recall that very well, because it was a matter about which people were urgently concerned. Promises were made to staff, particularly consultant medical staff, on the radical changes that were to take place because of the new hospital.

20 Nov 1996 : Column 955

Will the Minister confirm that the Causeway hospital site cost £0.85 million, the Causeway laboratory £1.89 million, the advanced siteworks £1.18 million and the main project £2.4 million? What is the estimated cost of the total upgrading of the present facilities if the delay is lengthened? Has the commissioning team been stood down? Have officers' leases ended? If the design team is stood down, will its members seek compensation? What is the position on putting out tenders? When will tenders be issued?

I know that the Minister is concerned about the matter--he is not unsympathetic. However, we must answer to our constituents, and we need answers today at the Dispatch Box.

1.50 pm

The Parliamentary Under-Secretary of State for Northern Ireland (Mr. Malcolm Moss): I am grateful to the hon. Member for East Londonderry (Mr. Ross) for the opportunity to outline the Government's record and position in relation to the Causeway hospital. I recognise that the matter is close to his heart. Similarly, I know that the hon. Member for North Antrim (Rev. Ian Paisley) is committed to the project. Perhaps more importantly, I am aware of the concerns of the local population from the range of correspondence which has come to me recently.

As the hon. Members helpfully explained, the campaign for a new hospital serving the Causeway area has been active for many years. In 1976, the Northern health and social services board set out its strategy for the development of acute hospital services. It was based on the provision of two modern hospitals to rationalise and concentrate services from a range of small dispersed units which were in poor condition and hopelessly ill equipped to meet the needs of modern clinical practice and standards of care.

A new area hospital at Antrim is to serve primarily the southern part of the board area, and the northern end of the board area is to be served by a new hospital in the Coleraine area, which would enable rationalisation of the Coleraine, Route, Robinson and Dalriada hospitals.

As hon. Members are aware, the first element of the strategy was finally achieved--after a slight delay--with the opening of the Antrim area hospital by the Secretary of State in 1993. The development of services in Causeway was planned to follow upon completion of the new Antrim hospital. From 1988 on, the Northern board appointed management consultants to look at the options. The then unit management and Coopers and Lybrand were involved, and, after considerable analysis, in December 1991 the Government approved and accepted the option to build a new hospital on a green-field site at Lodge road, Coleraine.

Shortly after that, in January 1992, my predecessor, my right hon. Friend the Member for Richmond and Barnes (Mr. Hanley), announced the timetable for the project. It was envisaged that detailed planning and design would commence in 1994, with the major construction phase beginning in 1997 and the project to be completed by 2000. The speed with which the result of the option appraisal was translated into a programme of action with supporting funding reflected the Government's priority for, and commitment to, the project.

20 Nov 1996 : Column 956

Over the past four years, the local population has seen that commitment demonstrated by physical investment. The proposed site was purchased at a cost of £0.85 million, and the first and essential stage of the development, the new area laboratory, was built on the site at a cost of £2.7 million. It became operational in 1994. Those investments, plus expenditure on landscaping and initial design fees, bring the total spend to date to £8.35 million. I hope that hon. Members will agree that that represents a considerable investment already in the light of pressures on public expenditure and the competing investment priorities.

At the same time, it is important to ensure that the original case for such major investment remains valid over the necessarily lengthy planning period. The acute sector has seen many changes in the past decade: productivity has increased significantly, and clinical practice has seen the expansion of day surgery. Hon. Members may recall that, in 1993, the Public Accounts Committee examined acute hospital provision in Northern Ireland. In the memorandum of reply to the Committee, my Department gave a commitment that all proposals for major investment would be kept under constant review and the underlying assumptions would be tested before any final decisions were taken.

As the Minister responsible for health and personal social services in Northern Ireland, I am keen to endorse that commitment to ensure that what is built at Causeway and elsewhere is demonstrably what is needed, and no more than that. Therefore, at my request, earlier this year the health and social services executive asked the Causeway trust to review the case supporting the investment. In the light of the new regional strategy that I issued in July, I was particularly anxious to ensure that investment in a new hospital in Coleraine was consistent with the vision for acute hospital services set out in that strategy. The trust was therefore asked to ensure that the investment was acceptable and affordable to the principal purchaser, the Northern board.

I am pleased to record that the trust tackled that exercise in a rigorous and comprehensive manner, submitting a detailed review carried out by Coopers and Lybrand. The Causeway trust board has acted with commendable professionalism, urgency and diligence, and I take this opportunity to thank the chairman, the chief executive and board members for their co-operation throughout.

As a result, the executive identified a number of issues as requiring clarification by the trust and the board. The trust again dealt with them expeditiously and, as a result, the executive wrote to the trust on 5 November to inform it that the case for the investment had been revalidated. The executive advised the trust that, because of the additional costs involved with a redesign, it would not be economic--I confirm the hon. Gentleman's earlier comments--to seek a reduction in the project design.

As hon. Members are probably aware, the Government have reaffirmed the need for the new Causeway hospital to provide a locus for the acute services to the local population in the next century. The matter now rests with me in terms of a decision on the next stage of the project. Hon. Members will be aware of the pressures on public expenditure in general. My right hon. and learned Friend the Secretary of State will soon announce decisions on public expenditure in Northern Ireland following the Chancellor's Budget statement. Hon. Members will

20 Nov 1996 : Column 957