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8.50 pm
Mr. Gerry Steinberg (City of Durham): I want to discuss two topics that have resulted from the NHS reforms; and to be very parochial. The first is the new district hospital for Durham; the second is the shortage of hospital beds in Durham.
The project for the new hospital was promised more than 20 years ago. The old area health authority and the North-West Durham health authority had had the lowest capital expenditure in the whole northern region. In the early 1990s, therefore, it was agreed to build a new district general hospital. In February 1992, when the choosing of a site for the new hospital was proving difficult, the then chairman of the North regional health authority, Peter Carr, wrote to me as follows:
Since then, the Government have refused to build any new hospital buildings out of public sector funds and have turned to their so-called private finance initiative, which is a complete and utter failure. At the moment, the PFI is nothing but a con trick--a promise of new hospitals which just do not happen.
In 1994, the Minister for Health told me that, since the launch of the PFI in 1992, the NHS had been encouraged to exploit the benefits of collaboration with the private sector. He continued by saying that, increasingly, the private sector is bringing in its innovation, dynamism and experience to the NHS, to improve services and get better value for money. Perhaps the same Minister tonight will tell me where there has been a successful PFI incorporating these conditions: it is certainly not in Durham. I am led to believe that there is not one in the whole country either. Indeed, the Library told me this morning that no building work had started on any scheme, and that there was no date set for any to start.
I was originally told that the preferred bidder and the business case would be finalised by the end of 1994; yet today, at the beginning of 1997, we have not even reached that stage. Is that an example of the success of the private finance initiative?
In 1996, the trust told me that the full business case had been prepared, and that--in conjunction with County Durham health authority--the preferred option would be forwarded to the Treasury for final approval. We are still waiting. The trust continues to claim that this is quicker and more efficient than building in the public sector; and
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The cost of the PFI process so far has been well over £1 million; this cost has been incurred just by the procedure, nothing else. Meanwhile, the trust's financial position has worsened. More than 50 beds have been closed; theatre sessions have been reduced; targets have been set; and there are limits for certain operations. The trust was told that it had to save £2 million during the current financial year. Those measures are a direct result of financial pressures, but they are also in line with the trust's long-term strategy for the new district general hospital in Durham.
In 1996-97, there is a £2 million loss of revenue. In 1997-98, a further £2 million loss is projected. For 1998-99, another £1 million loss is projected. Even with all these savings, there is still no guarantee of a new hospital being built. An interim rationalisation plan continues in place--the running down of services in the sister hospital at Shotley Bridge, and the transfer of services to Dryburn in Durham.
The situation in October was so grave that I received a letter from the consultant dermatologist, Mr. Ive, and signed by another eight senior consultants at the hospital. It concerned the acute crisis in medical services in north Durham. He said:
I do not blame the hospital trust or County Durham health authority, although both could have acted slightly differently at times. The fault clearly lies with the Government, and with the health reforms that have created this appalling mess. I blame privatisation and the breaking up of the health service.
As for building the new district general hospital, things go from bad to worse. Last September, the director of technical and leisure services for Durham city council contacted me by letter. He informed me that senior members and officers of the council had met representatives of the North Durham Acute Hospitals trust, the health authority and representatives of Consort Healthcare, which is the PFI partner of the authority. He wrote:
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The trust was adamant that it was blackmailing no one, but was simply requesting that the land be built on to make extra money to help fit the hospital out. However, the presentation which the hospital trust gave the local authority made it clear that there was an attempt to influence the council's decision on whether to grant planning permission on the basis that the hospital would not be built. It said:
I shall now deal with the lack of beds in the hospital. In 1995, prior to the cost improvement measures taken in the hospital, there were 670 beds. At one stage before that, there were 900 beds. There are now 580 beds. The original outline business case, which was approved in December 1994, gave the PFI bid a figure of 565 beds. We are now told that the trust has undertaken a fundamental review of bed numbers and the number of beds in the new PFI bid has been cut to 454.
The trust tells us that that is all that is necessary. I neither accept nor believe that. The drastic cut in the number of beds has taken place simply because of the amount of cash available under the PFI bid. If we ever get a hospital, it will not have enough beds. How on earth can a new hospital with 454 beds cope when the present hospital with 580 beds cannot cope?
Morale is so low among consultants in the hospital that many are thinking of leaving. When I discussed the matter with a consultant, he said: "There is a smell of decline." What are we coming to when a consultant says that there is a smell of decline in a hospital? The interim rationalisation programme has made virtually no savings, and straight cuts will have to be made over the next three years. Cuts totalling some £8.6 million--15 per cent. of the budget--are now forecast. That is even higher than originally thought.
If the PFI bid cannot produce more than 450 beds, it is not worthy, and should be looked at again. The brand new state-of-the-art hospital that has been described, with 450 beds, will be unable to cope.
Although I have been receiving complaints from my constituents over the past year or so about the lack of beds, in the space of a week, I have been contacted on two separate occasions about the lack of beds in the hospital.
On one occasion, Mrs. Budd, a constituent of mine, had been on a waiting list for a serious operation. She was twice given a date and, on both occasions--once in October and once in November last year--her operation was cancelled and no further date was offered to her. She was informed that her operation had been cancelled because, although the consultant could do the operation,
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A further appalling case was brought to my attention at the beginning of January. Mr. Taylor, an 84-year-old from my constituency, was admitted to hospital for treatment, but, unfortunately, no beds were available. Eventually, he was found a bed, but he tragically died some days later. The coroner was so concerned about this case that in court he advised the man's family to contact their Member of Parliament, because, he said, the case was so serious. The hospital is currently investigating the case.
The twist in the tail is that the chief executive of the trust, Mr. Brian Waite, the most vociferous supporter of the PFI bid, has done a runner. I am told that he has gone to a job with neither promotion prospects nor a wage increase. He has gone to Carlisle. Who would go to Carlisle when he could stay in Durham? I should have thought that Mr. Waite would have wanted to wait for the PFI bid to be completed and see his dream come to fruition. Perhaps he thought that, by the time that happened, he would have retired and might need a bed in a geriatric unit in Durham, which would not be available because all the beds would have been closed. That is probably why he has gone.
"You can be assured that the new hospital will be constructed. The capital funds have been set aside and the Durham project is top of our priority list."
Five years later, we still have no new district general hospital, and I am not confident that we will ever get it.
"There is a great danger of a collapse of general medicine, including cardiology and heart attacks in North Durham, as a result of a halt being called to a process of site rationalisation, whereby Shotley bridge was going to gradually decant into Dryburn. The situation has gone so far that we are now unable to recruit junior staff to Shotley Bridge beyond February and the Post Graduate Dean would certainly not allow junior staff to work there beyond that time."
What a dreadful situation for the health service in Durham to be in.
"It is apparent that for the hospital to be built and fitted out, the PFI partners wish to raise finances by the utilisation of surplus land on the Dryburn site for a retail development. Senior members are concerned that the City Council will be faced with the proposal for inappropriate development to finance a funding gap to provide a much needed district general hospital. They feel that the citizens of Durham should not be required to make such a choice, nor would they be able to recommend that they do so."
In effect, it was being requested that a supermarket be built in the hospital grounds in one of the most sensitive parts of Durham--a suggestion both stupid and unreasonable. I immediately made my position clear on this issue, and said that I would not support such a supermarket development on the hospital site and would
"Funding issues: funding shortfall exists. Not possible to realise full extent of service provision. More existing buildings retained and new buildings left as a shell until cash available. Disposal of surplus land necessary. Complete scheme relies on maximum return on surplus land. Food retail development is only solution for surplus land to bridge the gap."
It was clear that, unless the trust obtained planning permission to build a retail development, our district general hospital was threatened. That is what the PFI means--no new facilities unless the private sector can make a killing.
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