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Health Authorities and Trusts (Amalgamation)
7. Mr. Tyler: If he has reached conclusions on the amalgamation of (a) health authorities and (b) trusts; and if he will make a statement. [18233]
Mr. Dobson: The Government have no national blueprint for mergers between health authorities or between NHS trusts. We would seek to encourage mergers of both where that is in the interests of health care in the localities concerned.
Mr. Tyler: I accept that the Secretary of State would not wish to impose amalgamations, but will he encourage amalgamations where small trusts are presently duplicating their administrative costs? If so, will he give some indication of how quickly he would expect savings to take place, especially bearing in mind his comments earlier when he referred to the need to expand front-line services and to encourage the creation and maintenance of local community hospitals? In Cornwall, as the Secretary of State knows, we are currently addressing that problem.
Mr. Dobson: I am a great believer in horses for courses. In many parts of the country, it is right to amalgamate smaller trusts--perhaps two or three smaller trusts or a couple of small trusts with a bigger trust--but in other parts of the country local people and clinicians and, for that matter the NHS regional management, are convinced that keeping some of the smaller trusts in existence may protect services that would otherwise not
get the attention they deserve. When proposals come to me, I will assess them against the needs of the people in the area.
Mr. Nicholas Winterton: Does the Secretary of State accept that the East Cheshire NHS trust has been an outstanding success, not only because of its leadership and the superb support of the executive staff but because it is a united trust that deals with the range of NHS services, including acute services, community services and mental health services. That has been to the advantage of people in Macclesfield. I had a tremendous battle a few years ago to maintain a united trust against what was then the wisdom of separate trusts for virtually every arm of the health service.
Mr. Dobson: The hon. Gentleman reinforces the point that I wish to make. People in east Cheshire are obviously well suited by the present arrangements, but people in other parts of the country do not fancy that arrangement and I do not wish to force it down their throats. As for conventional wisdom, over the years I have observed that it may be conventional but it is seldom wisdom.
Mr. Gunnell: Is it not a bit much for the hon. Member for North Cornwall (Mr. Tyler) to whinge about the NHS when my right hon. Friend has provided £10 million extra for health services in Cornwall this year and next? My right hon. Friend knows of the excellent proposal for the merger of two trusts in Leeds, on which all the Members of Parliament for Leeds have been consulted. What criteria will he use to judge whether the merger should go ahead? I hope, however, that he will comment first on the whingeing by the hon. Member for North Cornwall.
Mr. Dobson: My hon. Friend has been in politics as long as I have and he knows that gratitude is the last thing to expect. Every time I come into the Chamber I expect Opposition Members to rise in grateful thanks for the extra funds that we have provided, but I am disappointed.
As a distant observer, I always thought that the merger of the two acute trusts in Leeds was a good idea and I was surprised that, when everyone in Leeds had agreed to it, my Conservative predecessor turned it down. I shall be not unfavourably disposed to the proposition when it comes forward again from the people of Leeds.
Influenza Inoculations
8. Mr. Sheerman: What restrictions are currently imposed on the availability of free influenza inoculations for the public. [18234]
Ms Jowell: Free influenza immunisation is recommended for people with underlying conditions that put them at most risk of serious illness or death should they develop flu and for people who live in nursing homes, residential homes and other long-stay facilities. Influenza immunisation is not routinely recommended for fit and healthy adults and children.
Mr. Sheerman: My hon. Friend will know that, in an average year, 4,000 people die of flu and that in an epidemic year--such as 1989--up to 30,000 die. We have heard suggestions that a particularly nasty epidemic is on
its way from Hong Kong. Is she aware that only 3 million--half of the 6 million vulnerable people in this country--have taken their flu jabs? Would it not be a good idea to promote immunisation, because we can prevent many deaths this winter and stop a great cost to the NHS?
Ms Jowell: I entirely agree with my hon. Friend, who will be glad to hear that, so far, a record 7.1 million doses of flu vaccine have been distributed. Efforts have been made by the chief medical officer to ensure that all GPs and practice nurses are aware of the importance of making flu vaccine available to people who are vulnerable and at risk of suffering serious illness if they contract flu. The drive to maximise the number of people vaccinated this winter against flu is further evidence of the Government's determination to do what works for patient care, based on the evidence of what works as part of delivering a modern and dependable national health service.
Kidderminster District General Hospital
9. Mr. Gill: What representations he has received regarding the future of Kidderminster district general hospital. [18235]
Mr. Boateng: The Department has received a number of letters from members of the public, councillors and local Members of Parliament on the future of Kidderminster hospital and health services in Worcestershire generally. As part of its strategic review of services across the whole county, Worcestershire health authority will conduct a formal public consultation during which all of these representations will be taken into account.
Mr. Gill: The Minister will recognise that any proposal to close accident and emergency services at Kidderminster hospital would be a devastating blow to all those people in north Worcestershire and in my constituency in south Shropshire who are served by the 1,230 members of staff at that excellent hospital, which provides 27 medical services. Does he agree with the hon. Member for Wyre Forest (Mr. Lock), who said in a press release 12 months ago:
- "It is a simple matter of funding. We will only prevent further cuts at Kidderminster if the Government provides enough money to the Health Authority to fund the hospital"?
Mr. Lock: Does my hon. Friend agree that there is considerable anger among the people of Worcestershire who have learnt that the Tory-appointed former health authority was overspending by £8 million to £9 million a year and has run up debts of between £18 million and £23 million--debts that this Government and the new health authority must sort out? That is another example of our having to sort out somebody else's mess. Does he accept that there is concern in Wyre Forest that GPs--who are part of a commissioning group whose proposals
include the retention of the accident and emergency centre--have not even had their proposal put on the drawing board for the proposed consultation? Will he see whether that proposal can be included in the forthcoming consultation on the reconfiguration of services?
Mr. Boateng: My hon. Friend makes his point well. It is important that the consultation is wide ranging and takes into account all representations. GPs have an important contribution to make and I look forward enormously to considering their representations on this important issue. Bearing in mind the state of the finances of Worcestershire health authority, I hope that he welcomes the additional £1.5 million that the new Labour Government have made available to the authority to cope with winter pressures. That is the difference between the Labour Government and the Conservatives; they mismanage, but we manage more effectively.
NHS Building Projects
10. Mr. Gale: How many NHS building projects costing over £1 million have been completed since 1979. [18236]
Mr. Dobson: The national health service reported the completion of capital schemes costing more than £1 million only between 1980 and 1985.
Mr. Gale: Will the right hon. Gentleman acknowledge that £25 million of the money spent during that period was spent creating a full district hospital and 24-hour accident and emergency service at the hospital in Margate that proudly bears the name of Queen Elizabeth the Queen Mother? Will he join me in congratulating the medical staff, nurses and administration team who have achieved a state-of-the-art hospital that serves the people of Dover, Deal, South Thanet, North Thanet, Herne Bay and other areas of south Kent? Will he take the earliest opportunity to ensure that the work of that hospital is not only continued but enhanced?
Mr. Dobson: Given the state of my voice, I will not risk repeating a Cook's tour of Kent. I would like to congratulate the staff of the national health service in every part of the country who have kept the faith and kept us reasonably well and healthy for all these years. I hope that they will be able to continue to do so.
Mr. Martlew: Going back to the original question, is the Secretary of State aware that since 1979 the people of Carlisle have been waiting for a new district general hospital, which was cancelled four times under the previous Government? The go-ahead was given only when we got this new Labour Government. We have started work on the site and the people of Carlisle will have a brand new hospital for the millennium.
Mr. Dobson: I agree entirely with my hon. Friend and I am only sorry that I was unable to attend and, so to speak, cut the first sod.
Mr. Lansley: Given that the level of capital investment in the national health service is important--I am sure the Secretary of State agrees--will he explain why his Department issued a press release on 29 October stating that the level of capital investment in the NHS next year
would rise by 2.3 per cent. in real terms, when, as the Department now admits, that was incorrect and the level of investment will rise by only 2.3 per cent. in cash terms?
Mr. Dobson: It is certainly the case, on the basis of the figures in that press release, that the increase is in cash terms, and I apologise for that. In all the years that I was in opposition, I issued thousands of figures and only once got one wrong. In government, I do not intend to issue information that is wrong. We are taking steps to ensure that it does not happen again.
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