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8.19 pm
Dr. Charles Goodson-Wickes (Wimbledon): Until the hon. Member for Hackney, South and Shoreditch (Mr. Sedgemore) enlightened me, I did not think that I had much in common with the Leader of the Opposition. I now find that both he and I had children born at St. Bartholomew's hospital, which proves two things. We both know a good hospital when we see one and we both believe in the national health service because, for those Members who are not aware of the fact,St. Bartholomew's has never had any private beds. I was trained and I worked in the hospital as a clinician, and I am proud of its record and all that it stands for.
The Government's reforms, particularly those since 1991, have been a great success and are a cause for rightful celebration after 50 years of the NHS. I never believed that, in my professional life, the health service could claim to be world class and decentralised, with emphasis on primary care teams. For proof of the success, one need look no further than the Opposition's typical hypocrisy on all the reforms over which they have fought so vigorously. Will they abolish NHS trusts? Of course not. Will they abolish general practitioner fundholding? Of course not.
I read the words of the hon. Member for Islington, South and Finsbury (Mr. Smith), soothing members of the British Medical Association--again I declare an interest--and telling us all that he is not a revolutionary. If he is ever lucky enough to hold office, he may tinker around the edges, but I suspect that the whole thing is an absolute farce and that he and his party will, in effect, continue the reforms that the Government have ably put in place.
The ultimate test is always whether patients have benefited. The answer, of course, is that they have. The figures are absolutely irrefutable. Since the reforms, patient treatments--I think that they are called episodes in modern parlance--have increased vastly, by around 1 million. Waiting lists have been reduced to their lowest level ever. All that has been achieved in the context of the oft-derided patients charter.
During the summer recess, I found myself on the receiving end in Odstock hospital, in the constituency of my hon. Friend the Member for Salisbury (Mr. Key). I cannot speak highly enough of the treatment that I received. There was none of the hanging around that I remember so well as a medical student, clinician and patient. My condition was hardly life threatening, but I was whisked from accident and emergency into theatre within an hour. On the ward, I saw nurse teamwork, which I had not always seen in the past, and excellent liaison between nurse teams as they came on and off duty.
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When I was discharged from hospital--I am sure every hon. Member knows that I and my family have always been NHS patients--I was admirably looked after by my local GP fundholding practice, by its district nurse and by the community pharmacist. That was an index of what the reforms have achieved: efficiency in a caring atmosphere.
In my constituency, no less than 79 per cent. of patients are covered by GP fundholding practices. The borough of Merton, in which my constituency lies, is arguably the best served in London by NHS trust hospitals. Perhaps the service is equivalent to anything in any conurbation in the world, even though none of the four hospitals is actually situated in the borough. My hon. Friend the Minister and his colleagues, however, will be aware of recent consternation in south-west London. Merton, Sutton and Wandsworth health authority, recognised by the Under-Secretary of State for Health, my hon. Friend the Member for Orpington (Mr. Horam), as not a profligate one, reported a financial crisis in the offing. Its proposals to counteract the potential crisis were alarming.
For instance, there was talk of non-urgent elective surgery being savagely reduced--not stopped, as the Labour Front-Bench spokesman said earlier. Inevitably, that would mean the return of longer waiting lists, which not only goes profoundly against everything that the Government have achieved, but is clearly unacceptable to patients and their families, and puts an extra financial burden on the social security budget. That litany of events has therefore caused much concern in my constituency and in the constituencies of many of my hon. Friends and of Opposition Members.
My right hon. Friend the Secretary of State for Health was generous with his time in listening to our concerns. I trust that that generosity will be matched by my right hon. Friend the Chief Secretary when he responds--as I speak, he probably has responded. I hope that my constituents' understandable alarm will not be prolonged beyond next week's Budget statement, after which, clearly, rapid executive decisions will have to be made as to how funds are applied.
I recognise that, in winding up the debate, my hon. Friend the Minister cannot give assurances, but I emphasise the number of meetings that we have had on an all-party basis. We have had meetings with representatives from St. George's hospital, St. Helier hospital, Kingston hospital, Queen Mary's hospital, Roehampton, and Merton, Sutton and Wandsworth health authority, its chairman and its chief executive. They have already--I congratulate them on this--found efficiency gains of some £5 million, but further savings that have been asked for of £9 million are, I believe, impractical. They have a genuine case. I hope that my right hon. Friend the Secretary of State for Health has been able to pass on our concerns to his Treasury colleagues.
After that acute problem has been solved--I am confident that it will be--it would be prudent for my hon. Friends to revisit the issue of the calculation of the capitation formula for resource allocation. We all know that such formulae are beset with difficulties. In Merton, we have had awful problems with the standard spending assessment. That has affected, for instance, teachers' pay because Merton is neither a truly inner nor a truly outer London borough. All hon. Members know how complex
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From the point of view of my constituents, I can never contemplate surrendering the potentially bright future of Nelson hospital, which is bang in the middle both of my constituency and of the borough, and for which many of us have fought so hard and so long to ensure that it has a vigorous future in Merton. It absolutely epitomises the return of the cottage hospital. We have heard talk of cottage hospitals being closed. I am delighted to tell the House that I have received assurances from the St. Helier NHS trust that, despite its financial difficulties, it believes that plans for Nelson hospital can go ahead. That will be cause for much celebration in my constituency.
Even Nelson hospital, with its proud record as a hospital in Merton, will give due deference to St. Bartholomew's hospital, for which the hon. Member for Hackney, South and Shoreditch has been such a doughty fighter. For too long, I have had to live with a sense of terrible guilt about what was done to the hospital. I believe that an academic and medical act of vandalism has been carried out on that hospital, after its nearly nine centuries of being in the forefront of delivering medical care, often to the most needy people in a part of London that was never particularly privileged.
During the consultation period, in February 1995, I expressed in writing to East London and The City health authority my gut feeling that the new buildings at the Royal London hospital might never appear, or not appear to the extent that was predicted. I very much hope that I am wrong, but I suspect that my worst fears will prove to be true because of financial demands or for other very practical reasons.
I profoundly regret that I was persuaded to vote in favour of the reconstruction and the effective movement on to one site of Bart's and the Royal London hospitals. In the context of party unity, I suppose that we must all trim occasionally. I am certainly ashamed, however, that I rationalised my vote on the basis that there was never an undertaking from the Opposition that they would reverse the decision.
I am even more aggrieved that one of the arguments made about closing Bart's, to reassure me and those of my hon. Friends who had doubts about it, centred on the issue of accident and emergency facilities for the City of London. I remember being reassured by former occupants of my right hon. Friend the Secretary of State's office that I need have no worries, because there would be adequate cover from the accident and emergency unit at Guy's hospital. We all know what has happened since then. It seems inevitable that the accident and emergency department at Guy's will be closed and shifted to St. Thomas's hospital. Therefore, the entire argument proved to be entirely bogus. One day, I suspect that the House and those who made the decision will come to regret it.
Now there is at least some light on the horizon. I do not expect that I shall be able to make entirely common cause with the hon. Member for Hackney, South and Shoreditch, but, in the past, I have criticised the City of London for being less than vigorous in its defence of St. Bartholomew's hospital. It is quite extraordinary that a body of that strength and antiquity should appear to be so inhibited in protecting such a unique--I use the word in its proper sense--hospital. Now we may be able to
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While a decision is awaited on the private finance initiative application, which the hon. Member for Hackney, South and Shoreditch mentioned, the waters continue to be muddy. I do not pretend to the House that I can predict the outcome. Perhaps we shall end up with a dual-site option, with some specialist units continuing at Bart's, or perhaps there will be a completely new and exciting opportunity for an innovative model on the Bart's site, where the public-private interface will work. It has even been suggested that there might be a private provider that will provide a community centre or even contract back into the NHS. That type of synergy sounds like a very exciting possibility. An accident and emergency department could even be reintroduced with private funding.
Those proposals could be a blueprint for the future. I do not say that any of them are in a final stage of formulation, but I beg my hon. Friend the Minister to assure the House that, whatever happens to the Bart's site in the future, he will properly involve the Royal Hospital of St. Bartholomew Charitable Foundation, the aims of which are
None of us can predict with any certainty how the NHS will develop and what administrative, financial and political factors may guide it. In the future, I believe that there may even be fewer tiers. The Government have done admirable work in reducing tiers in the NHS, and there may be further radical moves that they could make. An NHS executive, for example, could deal directly with NHS trust hospitals, which might provide greater flexibility and responsiveness, always with the patients' needs at the forefront.
One matter about which I am absolutely certain is that the Labour party will always prove to be the old guard, dragging its feet until it sees that the reforms make sense. Labour Members cannot bring themselves to admit that the changes make sense and congratulate the Government on what they have achieved. That is the pattern of what has happened over the past 17 or 18 years.
"To establish on the Barts site an Independent Charitable Hospital and a Medical School of International standing",
so that the fine traditions of that hospital can continue in a manner that is best suited to the century ahead.
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