| Previous Section | Index | Home Page |
Mr. Roger Casale (Wimbledon): I know Kingston hospital well. It is close to my constituency and my mother worked there for many years, playing a small part in contributing to the fine reputation it now enjoys. Many of my constituents use Kingston hospital and I am aware of the knock-on effect of potential further closures at Queen Mary's. Will the hon. Member applaud the fact that the Government have immediately given £12 million to Merton, Sutton and Wandsworth health authority--considerably more than could have been expected under the previous Government's projections? Is it not now the task of local Members of Parliament in that health authority area, which includes my constituency and--
Mr. Deputy Speaker (Mr. Michael Lord): Order. This is an Adjournment debate in which time is limited. The hon. Gentleman ought to stop there.
Mr. Davey: Of course new money is welcome, but there will still be a financial deficit in that health authority next year which will cause problems. The Government have a problem. They have to pick up the pieces left by their predecessors. I wish them well, but I urge them to realise that, in south-west London, they must act promptly and decisively if patient safety is to be maintained next year.
2.45 pm
Dr. Jenny Tonge (Richmond Park): The previous Government should die with "Queen Mary's" etched on their collective heart, and I am grateful to you, Mr. Deputy Speaker, for allowing me to say that in the House of Commons. Queen Mary's is a spacious site and was once a fine hospital with easy access from all parts of south-west London and the suburbs.
The previous Government chose to build that white elephant the Chelsea and Westminster hospital in central London, where it was not needed, and ignored the potential of the Queen Mary's site and that hospital'slinks with the Westminster hospital. The previous Government's internal market followed and went in for the kill. The stronger management at Kingston hospital--which is also excellent--got the contracts for treatment.
The Parliamentary Under-Secretary of State for Health (Mr. Paul Boateng):
This has been a worthwhile debate and has involved more contributors than is normal for an Adjournment debate. It has been helpful that there has been unanimity across the Chamber between Liberal Democrat and Labour Members on an issue of obvious concern to constituency Members of Parliament and to my Department. Conspicuous by their absence are representatives of the Tory party, who must take the lion's share of blame for the situation that exists in south-west London.
The House owes the hon. Member for Kingston and Surbiton (Mr. Davey) a debt of gratitude for bringing this matter before us. I commend him and others--including my hon. Friend the Member for Putney (Mr. Colman) and, of course, the hon. Member for Richmond Park (Dr. Tonge)--for raising the matter in the past with my hon. Friend the Minister of State.
The problems have not appeared overnight--we know their origins and have heard them discussed today. They have led to a situation in which the health service has been fragmented and in which south-west London has been put in a difficult position as a result of decisions made by the last Government. We have inherited a poisoned legacy in this regard, and we must build on the undoubted consensus that exists among those who represent south-west London, among its people and among the dedicated hard-working national health service staff to maintain the expertise, commitment and historic traditions of service to local people in these facilities. By building on that we should ensure that we create a health service of which we can be justifiably proud.
I welcome the frank debate on these issues in local communities. We have been anxious to ensure that we are a listening Government. That is why my right hon. Friend
the Secretary of State for Health visited local hospitals in the summer to learn at first hand about the problems. He discussed the issues fully and frankly with clinicians, staff and the unions and with representatives of the local community, including the League of Friends of Queen Mary's. I pay special tribute to its voluntary effort on behalf of the hospital.
We acted. We provided extra money for both health and social services, to ensure that local services were strengthened, particularly at Kingston hospital where pressure was already building as a result of the interim measures that were taken locally in April to maintain clinically safe services. Genuine consultation is now under way to establish the best way forward for long-term services in south-west London. We are committed to the integrity of that consultation, and that imposes a real discipline on Ministers because we must ensure that nothing that we say or do prejudges the outcome of that consultation.
It is important to consider in more detail the local scene.Clinical quality requires a minimum workload. In the acute hospital setting, without a minimum workload doctors cannot be properly trained; senior doctors cannot maintain expertise; and clinical teams will not be large enough to allow doctors to sub-specialise to provide 24-hour specialist cover, or to allow sensible working hours for junior staff. That has been the problem afflicting south-west London--too many hospitals are trying to provide too many services for the size of the population that they serve.
Sadly, the problem is by no means unique in the NHS. As the hon. Members for Richmond Park and for Kingston and Surbiton said, the fault lies entirely at the door of the iniquitous internal market. We have to cope with hospital being set against hospital. We have a job to do and are in the process of doing it across the party political divide to rehabilitate the concept of co-operation in contrast to the policies of confrontation and competition which characterised the previous regime.
We understand and appreciate the royal colleges' concern about the viability of some services at Queen Mary's hospital and Kingston hospital. That led to a local short-term clinical review and the reorganisation of services at Queen Mary's, Kingston and St. George's hospitals. That was necessary and it was done. In this context, it is important to appreciate the role of the royal colleges. It is not about them deciding the future of the hospital but about recognising their role and responsibility.
The Specialist Training Authority is legally responsible for approving hospital posts for training purposes and for safeguarding the standards of postgraduate medical training in the UK. The royal colleges advise the STA and do work on its behalf, but decisions rest with the STA which includes NHS and patient representatives. That provides an important degree of consistency and excellence across a large number of medical specialties. It is right for that to be so. We do not wish to see doctors trained in less than satisfactory environments. It is right for the STA to insist that hospital posts meet certain safeguards if they are to be accredited for training junior doctors. That is the background against which decisions have to be taken and the issue has to be addressed.
Clearly, the south-west London review is vital. It reflects concerns that the reorganisation of hospital services should always promote patient safety. The hon. Member for Kingston and Surbiton expresses concerns--understandably, this is at the forefront of his mind and it should be at the forefront of all our minds--that we should do all we can to safeguard patient safety. That is what it is all about--putting patients first.
A reorganisation of hospital services has taken place. Clearly, the arrangements are not ideal, but they provide some time for more robust and satisfactory arrangements to be worked out. We have set up the review group to take that forward. It is representative of the local health community because we want to ensure that the serious attention to the problems in south-west London, which have proved so intractable, is informed by local concerns.
It is important also that the approach is consistent with what is happening elsewhere in London. That is why Sir Leslie Turnberg is overseeing the situation in south-west London and we have been keeping a close eye on progress.
The hon. Gentleman asks for specific reassurances. Consultation on the proposed service changes in south-west London commenced on 3 November and will close on 26 January. I expect the health authority to reach a formal decision on consultation in mid-February. We expect to receive Sir Leslie Turnberg's review shortly. The review and the Government's response to it will be published in due course.
The hon. Gentleman asked about Ministers' availability and the attention that they will pay to these issues. He requested that we keep diaries free immediately after the consultation. I understand that concern. He should know that we are concerned that all interested parties should make their views known during the consultation, so that they can be taken properly into account and given the serious attention that they warrant. He and all hon. Members should know that, by tradition in the House, the Minister's door is open to them. He and his colleagues are welcome to make their views known. The ministerial team is available to hon. Members and I have no doubt that he will use that access.
It is important that, in taking this process forward, we preserve the integrity of the consultation. We need to hear, and we do take into account, local people's deep concern after many years of uncertainty and diligent campaigning on their part to secure what they perceive as necessary services. I cannot comment in any detail on the subject matter of the consultation. I must not prejudge its outcome, but the hon. Gentleman can be assured there will be no asset stripping.
We will ensure that local services deliver the goods and we have made available the resources to ensure that, in coming months, winter pressures are coped with. Robust contingency plans have been drawn up to sustain services at Queen Mary's. They are aimed at ensuring the continuing confidence of general practitioners and of the public, and to prevent additional emergency admissions being diverted to Kingston during this period. We are determined to ensure that the pressures of the winter are met in a way that puts the patient first.
It would be wrong to speculate about the future, but let me assure the hon. Gentleman that, although it is important that we have a debate, and that there is a debate locally, about service configuration, we will ensure that
the NHS Executive works closely with the trust and with the local health service to protect the interests of patients, to put them first and to build together, based on consensus, openness and a true understanding of the challenges that face the health service, a health service of which we can all be justifiably proud. Of that, he need have no doubt.
I thank the hon. Gentleman and all hon. Members for their contribution to ensure that we achieve just that. It is a great challenge, but the interests of patients demand that we be up to it. I have no doubt that the Government will be up to it and will ensure that patient safety, welfare and interest always come first.
Question put and agreed to.
14 Nov 1997 : Column 1215Adjourned accordingly at one minute to Three o'clock.
| Index | Home Page |