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Mr. Brian Sedgemore (Hackney, South and Shoreditch): I warmly congratulate the Secretary of State on today's statement and applaud the fact that he has assembled a first-class review panel, which will command the confidence not only of the House but of Londoners and of people in the rest of the country. Will he arrange for a copy of his statement to be sent to Colonel Boorman, the chairman of the Royal Hospitals NHS trust--because that man, white with rage, has pledged himself to close Bart's, regardless of what civil servants, Ministers and perhaps even the review panel may wish to do?
Mr. Dobson: I thank my hon. Friend who, like the right hon. Member for Cities of London and Westminster (Mr. Brooke), has campaigned long and hard to save Bart's. I undertake to carry out his request to send my statement to all those concerned.
Mr. Simon Hughes (Southwark, North and Bermondsey): I thank the Secretary of State for his statement--unlike his predecessor but one, who made hers in writing. I also congratulate him on his choice of panel members. I share the views expressed that they are
an entirely suitable group. The timetable envisaged is properly balanced between a need for deliberation and a need for speed.
I have three specific questions. First, does the Secretary of State's statement mean that all the undertakings given by his predecessor as Labour health spokesman, on what will be reviewable, will be honoured? Secondly, in places such as Edgware and Barnet, will he undertake that, between now and consideration of the review by Ministers later in the year, there will be no further reductions in beds or services? Thirdly--inevitably, this point has a constituency dimension, but it is also of much wider interest--will he confirm that the panel will have the authority to review the transfer of services from Guy's hospital, which would mean a reduction in the number of beds from about 1,000 to about 100 and the closure of the A and E department? Will all transfers not yet acted on but which are part of a plan be capable of review and a different decision?
Mr. Dobson:
I should make it clear that our promise at the election was that there would be no further hospital closures in London, and no hospital closures will take place during the period of the review. We did not promise to stop all change in London, some of which is having to be carried out on the advice of the professions, which say that, in certain circumstances, the services being provided in some hospitals are not safe for patients. Everyone will understand that I would not wish to overrule the professional judgment of doctors who believe that a particular unit is no longer capable of delivering the service to which people are entitled. As the hon. Gentleman knows, we have already set in train a special review of provision in Edgware, and we can deal with that at greater length at some other time.
I cannot give the undertaking that there will not be continuing transfers of functions between one hospital and another. Everyone knows that there is no proposal to close either Guy's or St Thomas's. The intention is to make sure that each particular specialty is concentrated in one hospital or the other, which is only right. There is a swap mechanism in operation--St Thomas's is getting some of the stuff from Guy's and Guy's is getting some of the stuff from St. Thomas's. Again, I am not prepared to say that I shall interfere with that process if it is generally judged that it will bring about the larger specialist units on which top-quality specialist treatment and research depend.
Mr. Tony Colman (Putney):
I thank my right hon. Friend for his statement and welcome the review, especially its concentration on Queen Mary's university hospital, Roehampton. That hospital had many of its services cruelly taken away by the previous Government on 1 April and has suffered review after review over many years. The people of Putney and Roehampton and the long-suffering nurses and doctors of the hospital need to have some certainty about their future. Last month, a quite separate review was announced by the region of the services between Kingston hospital and Queen Mary's university hospital. May I have an assurance that the
Mr. Dobson:
The object of having the advisory panel is to try to sort out many contentious issues and get advice from professional people of great integrity. There is a vast amount of uncertainty about the future of Queen Mary's, Roehampton and other hospitals round about. We want the panel to clarify the situation, but I cannot predict what it will say, because one cannot tell people of this eminence what their conclusions will be. The whole point of having such people is that they are entitled to make their own professional judgment.
Some statutory procedures for consultation in the area covered by Queen Mary's university hospital, Roehampton and associated hospitals will continue during the review, but the consultation process itself will be reviewed by the advisory panel. We cannot simply announce a stop on everything, because that would mean delays in some changes that are vital to improve the quality of health care in London.
Mr. Bernard Jenkin (North Essex):
Will the right hon. Gentleman assure the House that neither he nor any of his Government colleagues made any effort to give better notice of his statement to Labour Members than to London Conservative Members?
Mr. Dobson:
Yes, I can give that undertaking. We warned as many Members from all parties as it was humanly possible to do. That is not a task for civil servants, so it was carried out by my political adviser and one of my parliamentary colleagues. We did not get through to quite all Labour colleagues nor to all Conservative Members, but we certainly got through to some.
Mr. Jeremy Corbyn (Islington, North):
I welcome the Secretary of State's announcement, especially in respect of the team of people who are to undertake the review. Will the review include issues such as poverty in London and the way in which calculations of expenditure for each district health authority are made? It is my impression that such calculations often do not take account of the number of transient and homeless people or, indeed, the travel-to-work people in particular districts, which means that expenditure on health is underestimated in those areas. Will the team be able to make recommendations on the future government of London and the role that it would have in health planning and its relationship with local government?
Finally, will my right hon. Friend confirm that the examination of the future of Bart's hospital will include consideration of new A and E provision? At the moment, there are intolerable waits at all neighbouring A and E departments because of the closure of the A and E department at Bart's last year.
Mr. Dobson:
As usual, my hon. Friend makes a number of informed and valid points. The panel will certainly be considering provision in London in the light of the Government's commitment to improve public health, not just through the health service but through a wide variety of measures, including the building of decent homes.
As for the role or otherwise of a Greater London authority, that is something that is still being discussed. As my hon. Friend knows, I have some sympathy with the proposition, although it may not eventually be Government policy--I am talking about all sorts of things, which may not ultimately be Government policy.
My hon. Friend asked about the restoration of previous A and E services at Bart's. Nothing is outside the terms of reference of the panel, but I should not like to raise any false hopes or, for that matter, any false despair about the changes proposed at Bart's.
Mr. Paul Burstow (Sutton and Cheam):
I hope that the review will include consideration of co-ordination between social services and health services. The present lack of co-ordination means that many people are left vulnerable and unable to get decent services. As a first step, will the Secretary of State tell the House that he will honour a commitment made by the right hon. Member for Islington, South and Finsbury (Mr. Smith) that social services committee members will be appointed to the boards of NHS trusts and health authorities in London, so that co-ordination can be improved now?
Mr. Dobson:
I mentioned the improved co-ordination between national health service and social services departments, and where it is good in various parts of London, it is very, very good, and where it is bad it is horrid. We have to bring the rest up to the standard of the best. As to how we bring that about, regardless of the membership of trusts or health authorities and cross-membership, the crucial thing is to get the officials working together. People at member level may have a role, but they are not the ones who can turn good intentions into good organisation--that needs top-quality management, both in the national health service and in local authorities.
Mr. Mike Gapes (Ilford, South):
I welcome my right hon. Friend's statement. His comments about Oldchurch will be received with great delight by many east London residents, particularly my constituents in Ilford, who would suffer grievously from the closure of the accident and emergency department at Oldchurch and the consequences that that would have for King George hospital, which is already at bursting point and suffering an intolerable crisis.
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