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Mr. Paul Tyler (North Cornwall): My hon. Friend will know that, on behalf of my North Cornwall constituents, I warmly support all the points that he has made. He referred to the county council. Can he confirm that, at the council's meeting yesterday, it agreed to make representations to the Secretary of State for Health to reverse the shortfall in funding for the NHS? The vote was unanimous, with the exception of the Labour group. It is important to make it clear that it is not only my constituents and I who support my hon. Friend's points but--to all intents and purposes--the people of Cornwall.
Mr. Taylor: It is a shame that the Labour group did not support the motion, but one understands the constraints it felt because the party is now in government. At local level, many Labour party members have campaigned to save local services and the hon. Member for Falmouth and Camborne (Ms Atherton) has supported the services in her constituency. The vote may not have been unanimous at the county council, but the Minister of State should be under no illusions about the views of his supporters.
That is the situation faced by inhabitants of Cornwall, before we even consider the latest round of threatened cuts. The service strategy on which we are being consulted proposes the closure of four community hospitals and the maternity unit at Penrice, as well as the axing of a further 129 beds. That is not the end of the story. Other services such as rheumatology are to be restricted.
The health authority has been a dealt a dead man's hand. It must choose between the provision of acute and non-acute services; between emergency treatment and preventive treatment; and between one vital local hospital and another. Clearly, that is unacceptable, so it is a relief to discover that, for the first time in a long time--as we try to pick a way through this mire of bed cuts, budget cuts and increasing waiting lists--we in Cornwall have a sympathetic ear at the Department of Health. It is a relief because it is vital that we develop a clear strategy for dealing with the crisis that is swamping health services in Cornwall.
The Minister may say that the reaction is not just sympathy and that things have changed. Well, they have changed a bit. It is true that, for the first time, next year's NHS funding will make an allowance for our scattered geography. An element of allowance has been allowed for our extra ambulance service mileage. That is a significant step forward and more than was achieved under the previous Administration. Naturally, having argued for it, I welcome it.
However, I hope that the Minister agrees with me that the increase is in no way enough. Other formula changes have actually cut our allocation. Overall, the effect on the provision of cash for the NHS in Cornwall was to raise the formula allocation by just 0.01 per cent. In other words, for every £100 Cornwall previously received for our NHS, we have gained just 1p next year. Even taking that increase together with the extra national NHS funding announced for next year--in which we will share--we are only £400,000 better off than previously expected. That money is welcome, but against the prospect of £5 million cuts it will do no more than help save perhaps a few threatened services. It will not come close to sorting out the major part of the cuts, let alone the general underfunding of the NHS in Cornwall, which the community health council put at £10 million even before the cuts.
I suggest that we must focus on three key areas. The first priority must be to make clear, in the public's mind and our own, the lines of responsibility for the closing of the community hospitals in Cornwall. It has been widely reported that the chairman of the health authority would close the hospitals regardless. That has been an unfortunate misrepresentation of what was said and has served to muddle the debate. The health authority has made it quite clear, while making no guarantees about the security of individual services, that, if extra money was on offer, it would revisit and change the proposals in its consultation document.
Ms Candy Atherton (Falmouth and Camborne):
I welcome the debate, because it addresses an important issue for the people of Cornwall. There has been a debate about exactly what the chief executive and the chairman of the health authority have said. Both the hon. Gentleman and I remember a meeting with those two gentlemen at which I explicitly asked, "If there was no financial problem for Cornwall and the Isles of Scilly, would you propose to close the four hospitals?" My office has a complete note of the meeting and both the chairman and the chief executive replied, categorically, "Yes." I hope that other hon. Members will confirm that. The chief
Mr. Taylor:
My understanding is that the chairman and chief executive have always said that they believe changes are needed. That is not the same as saying that they would close everything that it has been proposed should close. Indeed, they would look to open other services to replace some of those that might have closed.
Mr. Patrick Nicholls (Teignbridge):
Will the hon. Gentleman give way?
Mr. Taylor:
I cannot give way, because I am running out of time. I do not want to cut the Minister's reply too short.
To make the position clear, I shall quote the chief executive's letter of 18 November, which states:
Our second priority must be to make up the short-term funds that the health authority is so desperately lacking. John Banham has today proposed a 12-month moratorium. It is no good being told that the Government hope to help in the long run, if hospitals are closed this spring. Once shut, everybody knows that they will not open again. The voters of Cornwall resoundingly rejected the party of health cuts at the general election. They expect, and deserve, the NHS locally to be saved, just as the Prime Minister promised it would be before election day.
Given the Chancellor's announcement yesterday that there are funds to accommodate a cut to a 10p starting rate of income tax from April, resources are obviously available. The Chancellor also said that he has funds to cut business taxes to the lowest in Europe, so there must be even more resources available. The right hon. Gentleman has the option of using just a fraction of those funds to stop the closures. Lack of funds is not now--if it ever was--an excuse. Even if the funding were not permanent, it would give the health service the chance to find other solutions and win long-term extra funding.
Our third priority must be to establish a fairer way of distributing resources for the long term, so that such a crisis never returns. It is not just a question of Cornwall's rurality. Cornwall's services also suffer, as has already been indicated, by reason of its large coastline. Given the nature of that coastline, a journey to a place 10 minutes away as the crow flies can take four times that long once the streams, creeks and rivers that interrupt road and rail links are circumnavigated. Our people are a long way from district general hospitals--as much as 70 miles in some cases.
Cornwall provides a real example of the crucial need for fundamental reform of the needs assessment of our heath authorities. It cannot be right that the net effect of the formula changes is that Cornwall should get just 1p in every £100 to address those geographical problems. By introducing any help at all, it is true that the Government have made a step in the right direction, but there is still a long way to go. I believe that Ministers recognise that and I hope that that recognition will be backed by real resources.
The local medical committee sums the situation up in its press statement of 20 November:
"I am purported to have said that if the Health Authority had limitless funds, we would still look to close all 4 hospitals which our consultation document proposes should be closed--I have never made such a statement."
However, the biggest element of confusion in the whole sorry mess is the assertion that the health authority could somehow take that decision unilaterally. As the Minister is fully aware, the final decision to close hospitals will be taken nationally, irrespective of the wishes of the chief executive. It is for the Secretary of State to decide the ultimate fate of Cornish hospitals. Indeed, the Secretary of State accepted that when Cornish Members of Parliament met him two weeks ago. There should be no confusion on the point.
"The LMC on behalf of GPs throughout Cornwall and the Isles of Scilly believes that it is not possible to take £5 million funding out of local health services provision without causing severe and enduring damage.
In other words, Ministers will have to choose in the spring, for the decision will be theirs: cut our NHS in Cornwall in one way or another, or find us extra resources--in the short term to keep the hospitals open, and in the long term to create a fair funding system.
GPs are unhappy with the Health Authority's current proposals to achieve these savings. We remain convinced that reducing the total number of hospital beds in the county can only increase the existing bed crisis in the District General Hospitals at Treliske, Derriford and Barnstaple. However, we believe any alternative scheme to make the same savings may have an equal or even more damaging effect upon patient care."
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