Previous SectionIndexHome Page


Sir Brian Mawhinney: Will the hon. Gentleman give way?

Mr. Michael: I have only a few minutes in which to try to deal with all the issues covered by a range of hon. Members.

My hon. Friend the Member for Hayes and Harlington (Mr. McDonnell) referred to the death of "Ricky" Reel. I know that the Metropolitan police will take account of my hon. Friend's comments in their ongoing investigation and will provide any further information about that death.

14 Nov 1997 : Column 1207

It is clearly important that the police work closely with relatives. However, the case is currently under consideration and still awaiting a coroner's inquest.

Many contributions from both sides--to which I should love to be able to refer in detail--reflected a common theme of the police and local community working together. I welcome that approach, particularly from so many new Members of Parliament. The formula for finances to which I have referred requires greater transparency and more predictability. If they know where they are from one year to the next, the police can plan for the future. We will consider that. My right hon. Friend the Home Secretary will say more about it shortly.

The hon. Member for Ryedale asked why we were having this debate. It is to debate the Commissioner's report on last year. We will debate the financing of the police for London and all the other areas of the country, including the hon. Gentleman's constituency and mine, in the very near future. I welcome the way in which he summed up his speech, and his emphasis on the very positive contribution made by the police. It is the responsibility of the police to keep the peace. Catching criminals is important, but keeping the peace and reducing crime are the objectives which we should share with them, and the objectives which all colleagues should share with the Commissioner--

It being half-past Two o'clock, the motion for the Adjournment of the House lapsed, pursuant to the Standing Order.

FINANCE AND SERVICES COMMITTEE

Ordered,


14 Nov 1997 : Column 1208

Hospitals (South-West London)

Motion made, and Question proposed, That this House do now adjourn.--[Mr. Robert Ainsworth.]

2.30 pm

Mr. Edward Davey (Kingston and Surbiton): I am grateful to you, Mr. Deputy Speaker, for this opportunity to raise a matter of crucial importance to my constituents.

Although the state of local hospital services has been an issue of concern in Kingston and Surbiton for some time, the current London hospital review and the south-west London review have brought matters to a head. This debate therefore is extremely topical, and the Minister's reply will be much studied by all who care about the health service in south-west London.

I am delighted to see my hon. Friends the Members for Richmond Park (Dr. Tonge) and for Sutton and Cheam (Mr. Burstow) in their places. I know that they wish to let the Minister know of their concerns--and those of their constituents--in their parts of south-west London.

I should like to place it on record that the hon. Member for Putney (Mr. Colman) and my hon. Friend the Member for Twickenham (Dr. Cable) wanted to be here today to make similar points, but other pressing engagements have prevented them from attending.

The previous Government bear a heavy responsibility for the pressures and difficulties faced by hospitals in south-west London. Not only do we suffer from the underfunding that was the hallmark of Conservative NHS policy, but innumerable reviews, followed by indecision, have left a legacy of uncertainty and doubt over the future of some hospital services, in particular Queen Mary's hospital in Roehampton.

Uncertainty always causes problems in any institution: staff wonder whether their jobs are safe, many leave, morale sinks and, in a hospital setting, patient care is inevitably put at risk. In the Conservatives' NHS, with the chaos of the internal market, such uncertainty has proved even more damaging. Neighbouring trusts look at nearby hospitals with a question mark over their future and wonder whether they can increase their own income by appropriating some of the threatened hospital's patients. Trained staff are wooed. GPs are contacted. Press releases are sent out. Instead of a rational, planned NHS, we have a chaotic, anarchic one. An uncertain situation becomes an unstable situation.

Queen Mary's hospital, Roehampton is experiencing just such problems with staffing. On general medical wards, the vacancy rate is currently between 40 and 50 per cent., compared with a typical rate of just 20 per cent. Of those vacancies, 70 per cent. are filled by nursing staff who have some knowledge of the hospital. However, 30 per cent. are filled with agency nurses who do not, which is not satisfactory for the hospital management.

The new Government have now to deal with this inherited mess. Indeed, they have started. They have set up the London hospital review and have found at least a little more money for the NHS. We welcome both steps, although the Minister will not be surprised to hear that we wanted more spent on the health service for this year and next.

My aim in seeking this debate was not, however, to focus on the reviews or the argument over NHS spending.

Mr. Paul Burstow (Sutton and Cheam): Does my hon. Friend share my concern that the 1.35 per cent. increase

14 Nov 1997 : Column 1209

provided to Merton, Sutton and Wandsworth health authority is inadequate and will lead to cuts in community health care services such as foot care and continence care, which will simply store up greater costs for the future both in the NHS or shunt costs on to social services? Does he agree that that represents a false economy?

Mr. Davey: I agree with my hon. Friend and I share his concerns. I am aware of the cuts that have been experienced by the local health authority in his constituency, which are similar to those that have been experienced in mine. We shall be grateful if the Minister will comment.

My primary objective is to focus attention on the transition period before Ministers can implement fully the decisions that they will take after the review and consultation period ends. I am especially concerned about patient safety during the transition period. I hope that the Minister will be able to give the House and my constituents assurances on patient safety when he replies.

I shall detail the problem. Hospital services at Queen Mary's have been in decline for some time. Local health authorities, faced with severe financial problems caused by the previous Government, have been forced to reconfigure services away from the hospital. There has been increasing concern that patient care in some services is no longer adequate at Queen Mary's.

The royal colleges have already withdrawn accreditation from Queen Mary's for the training of junior doctors in the accident and emergency department both as a result of financial pressures and as a result of new research that shows that patient care is vastly improved by specialisation, which requires large clinical teams--which are currently not available at Queen Mary's.

The danger now is that the royal colleges will withdraw accreditation from Queen Mary's in other areas, including general medicine. If they do that, junior doctors will not be able to train at the hospital. With no junior doctors, many key hospital services will be forced to close. The consequent loss of beds to the local hospital service would be large. It would be extremely difficult for nearby hospitals to cope, especially if they were not given adequate time to prepare. I understand from medical staff locally that there is a serious possibility, verging on certainty, that the royal colleges will withdraw accreditation from Queen Mary's next August. That is the key date that Ministers must bear in mind.

Whatever the outcome of the review of hospital services in south-west London, whatever the consultation process produces and whatever decisions are made by Ministers, the royal colleges' decision on accreditation is likely to go ahead from August next year.

It could be argued that Ministers could still pre-empt the royal colleges with oodles of cash to turn round services. Indeed, many of us would like to see significant injections of cash to do just that. My hon. Friend the Member for Richmond Park has campaigned furiously for many years for just that to happen. Liberal Democrats throughout the region have supported such campaigns, but will such moneys be forthcoming now? They should, but when we are debating patient safety there is no other place to live than in the real world of the Chancellor's published spending plans. The right hon. Gentleman's current plans provide no scope for the type of sums that would be required.

14 Nov 1997 : Column 1210

If the Minister is so minded, however, I hope that he will confirm that Queen Mary's will not close and that even under current spending plans this historic hospital will continue to provide vital and modern hospital services--even if he is unable to guarantee sufficient funds to restore it to its former glory.

The proposal in the south-west London review to continue hospital services at Queen Mary's should be seen as the very minimum, given current spending plans, that Ministers should support. The key issue is that if substantial new sums are not provided after the review, the royal colleges are virtually certain to withdraw accreditation next August. That would mean a huge reduction in the number of hospital beds in south-west London from that date.

Faced with that possibility and the real danger to patients' lives that would ensue, it is incumbent on health managers and health Ministers to plan to reduce or eliminate the risk of massive, destructive and dangerous bed shortages next summer.

Local hospital managers at Kingston have drawn up contingency plans. They have worked out precisely how they could provide temporary additional beds as quickly as possible. Those beds would be needed if Kingston had to meet the demand that would follow if Queen Mary's lost its accreditation, but even these plans would take 26 weeks to implement.

Hospital managers cannot even begin to implement such contingency plans until the end of the three-month statutory consultation period in February or March next year. There could be a judicial review if the Minister pre-judged the review and acted earlier, even if the need for contingency plans has been sparked off by the likely actions of the royal colleges rather than by the review.

A 26-week lead-in time for the provision of temporary beds starting from the end of February would take us to August, which is just when the beds crisis is forecast to blow up. Will the beds be ready by August? Perhaps. Maybe. If there is no slippage, or if nothing goes wrong. That is the nub of my concern: perhaps is not good enough. Lives could be put at risk if beds were not available. We should not run our health service in that way.

My main request is simple. Will the Minister ensure that proper contingency plans are in place and will be given Government backing, financial or otherwise, if their implementation proves to be necessary after the reviews? Will he ensure that such plans can be implemented before August if necessary?

I am delighted to inform the Minister that the local Conservative-controlled neighbourhood committee has acted responsibly: last night, it gave planning consent to the hospital's proposals for a temporary beds unit. All local parties are acting responsibly to ensure that the potential risks are tackled. I hope that the Minister, on behalf of the Government and the Labour party, will assure the House that he will play his part, so that no major reduction in beds at Queen Mary's will occur unless and until alternative facilities are open at Kingston hospital and ready to meet the demands of the locality.

Will the Minister detail for me as clearly as possible the timetable for receipt of the reviews and the subsequent consultation period and the timing of announcements of decisions following consultation? Will he assure me that his diary and those of his ministerial colleagues will be

14 Nov 1997 : Column 1211

cleared for the days directly after the end of the consultation period so that they can give their urgent and undivided attention to these decisions? Decisions should be implemented and any necessary transitional arrangements should be established as soon as possible.

Will the Minister prevail on the Secretary of State to ensure that if a few decisions prove extremely difficult following the consultation, they will not be allowed to delay other decisions that hospital managers will need to be taken to prepare transitional arrangements? I cannot overemphasise the time factor. If we are to avoid a potential catastrophe some time next year, Kingston hospital must be supported so that it can provide enough temporary beds within an extremely limited time frame.

Finally, I urge the Minister, when he and his colleague consider the reviews, to back the case for major capital investment at Kingston hospital. It is a superb hospital. It serves a population of more than 300,000: it currently has 440 beds with a full range of diagnostic and treatment services and clinical support. It achieves one of the highest levels of day surgery care in the country and has introduced changes to create larger specialist teams, as required by the royal collages and as recommended in the Calman report, but Kingston hospital's buildings can no longer cope. Even if no patients were transferred to it from other hospitals as a result of decisions taken following the reviews, there would still be an urgent need for major capital build, such as a new accident and emergency wing, expansion of the maternity unit and new elective surgery units, to name but three.

The staff at Kingston hospital are tremendous. They perform magnificently, often under pressure. The management is innovative and committed to the best for the NHS. Will the Minister therefore give me an assurance that Kingston hospital has his backing and that it has a major role to play in south-west London in the long term?


Next Section

IndexHome Page