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10.21 pm

Mr. David Lidington (Aylesbury): I am grateful to Madam Speaker for allowing me this opportunity to initiate a short debate on the future of Stoke Mandeville hospital in my constituency.

Stoke Mandeville is known nationally and internationally as the home of the national spinal injuries centre, but to people living in Aylesbury and the surrounding areas it is much more than that. It is a medium-sized acute hospital which serves the local population with a wide range of medical services. Its patients come from Buckinghamshire and parts of Bedfordshire, Hertfordshire and Oxfordshire. The hospital also provides specialist services in plastic surgery and ophthalmics to patients from other parts of the country.

Many men and women are treated at Stoke Mandeville. Each year it treats about 32,000 in-patients. Some 140,000 people attend as out-patients, and about 44,000 people attend the accident and emergency unit. The need for the hospital is not diminishing--far from it. Its catchment area is growing significantly. That is particularly true of Aylesbury, where significant new residential development is planned over the next two decades, but it is also true of some of the smaller settlements served by Stoke Mandeville, such as Princes Risborough, in my constituency, and Haddenham, in the constituency of my hon. Friend the Member for Buckingham (Mr. Bercow).

There is strong local support for Stoke Mandeville and the work that it carries out. That will, perhaps, be signified tomorrow when, I am delighted to say, the Prime Minister's wife will visit the hospital to open the new computerised tomography scanner, which has been made possible by money raised through voluntary contributions and donations from local people.

If I feel strongly about the future of Stoke, it is not just because it is of vital importance to the people whom I represent but because it is my local hospital, the hospital where my four sons were born, and on which I and my family personally rely. Its medical reputation is high, but that is not matched by the quality of the buildings.

Stoke was originally built in 1942 to provide temporary wartime accommodation, and those wartime units are still substantially in use today. Since then, there has been piecemeal development of variable quality, but it has included some first-class modern facilities, notably the maternity unit, which is probably the part of the hospital with which I have become most familiar over the past few years.

One result of the piecemeal development is that we now have a hospital which sprawls over 90 acres of land. It is larger than most teaching hospitals in the country, probably in western Europe. Many of the buildings are obsolete, and the site and the buildings are inefficient. The costs of treatment at Stoke are inflated by the overheads: maintenance, heating, cleaning and others, which are needed because of the inefficiency and the obsolescence of the buildings.

There is not only financial inefficiency but clinical inefficiency. That is, perhaps, best illustrated by the example of the paediatric unit, which is a third of a mile

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from the main operating theatres. It takes a minimum of several minutes to take a sick child from paediatrics to theatre, or to bring in staff or emergency equipment to the paediatric unit from elsewhere.

It is to the hospital's credit that, despite those handicaps, it has met both its financial and patient charter obligations year on year. I place on the record a tribute to all the hospital staff for that achievement. It is worth noting that the chief executive of Stoke Mandeville was asked by the regional office to chair the Anglia-Oxford working party on cutting waiting lists and ending bed blocking. Stoke's success in delivering high-quality medical care has been recognised by the NHS at regional level.

The need for redevelopment at Stoke Mandeville has been recognised since the 1970s. Various schemes have been proposed and, for different reasons, have foundered. At one time, the development of the new city of Milton Keynes and the urgency of its need for medical facilities took precedence in the decisions of the Government of the day. Subsequent schemes were shelved because of national financial pressures.

Mr. Brian White (Milton Keynes, North-East): Will the hon. Gentleman give way?

Mr. Lidington: No, but I should be happy to leave time for the hon. Gentleman to speak later.

Another scheme was approved by the Department in June 1994, but that in turn was delayed when the private finance initiative scheme was introduced. A still later scheme was delayed last year when the newly elected Government decided to alter the rules on PFI.

I mention all that not because I see much point in going over old ground in detail tonight, but because some account of the history is necessary to explain the depth of feeling among my constituents about the importance of a project that is now being promoted by the trust and Buckinghamshire health authority, and to explain the feeling of cynicism among hospital staff and local GPs, who doubt whether the much-needed redevelopment will ever happen.

I have had extensive discussions in recent months, not only with the trust management but with Buckinghamshire health authority, the chief funder of the hospital, and with the Oxford-Anglia regional office. I am grateful for the patience and courtesy with which all those concerned have always listened to my representations, and for the seriousness with which they have engaged in the arguments that I have put on behalf of my area. Both the regional office and Buckingham health authority have told me firmly that they are committed to the successful redevelopment of Stoke Mandeville hospital.

There seems to be local agreement on the continuing need for an acute hospital in Aylesbury, and on the fact that that requires the redevelopment of Stoke Mandeville. There is also recognition, acknowledged by the trust management as well as the health authority and the regional office, that the new Stoke Mandeville must reflect in its configuration changes in medical treatment that have taken place in recent years and are forecast to continue. Those include the trend towards day surgery and increased specialisation, and are illustrated by the implementation of, for example, the Calman report on cancer care.

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Stoke is looking actively to develop constructive partnerships with other hospitals, both within Buckinghamshire and in Oxford and Milton Keynes. The present proposals, which were endorsed this week by Buckinghamshire health authority, would involve building a new paediatric unit, a new ward block and changes to the theatre complex at the hospital. The number of beds would be reduced from 510 to 443, but day case places would rise from 23 to 30.

The plans provide for the hospital to treat about the same number of patients in the future as it treats today. They incorporate a partnership agreement with South Buckinghamshire NHS trust and the Aylesbury Vale community healthcare trust. The total cost would be about £23.2 million. The changes would bring significant clinical and financial benefits. Clearly, our constituents who use Stoke Mandeville would benefit from the provision of modern facilities that can deliver state-of-the-art medical care into the 21st century. The national health service as a whole also stands to gain a significant financial benefit.

The proposed plans would release revenue savings of more than £3 million a year. I note that the hon. Members for Milton Keynes, North-East (Mr. White) and for Milton Keynes, South-West (Dr. Starkey) are present. The release of revenue savings from a successful development at Stoke Mandeville is of vital importance to Buckinghamshire health authority if it is to meet its strategic commitment to shifting extra funding to GPs in Milton Keynes. Urban problems in that town have stimulated a need for medical care which has not been adequately met in the past.

Like the hon. Members who represent Milton Keynes, I will tussle over formulae and over my own patch, but it is recognised that Milton Keynes needs extra funding, and the release of those revenue savings is one way of achieving that objective.

Dr. Phyllis Starkey (Milton Keynes, South-West): Do I take it that the hon. Gentleman accepts that the underfunding of Milton Keynes by about £4 million this year, as highlighted by the Buckinghamshire health authority, is justified? Does he recognise that mid-Buckinghamshire has been overfunded by about £5 million? He refers to the benefits for the whole of Buckinghamshire of the undoubted revenue savings from a developed Stoke Mandeville. Does he accept that it is important for Stoke Mandeville to be developed as part of the acute services strategy agreed by the health authority for all the hospitals in Buckinghamshire? The development of Stoke Mandeville should not create a hospital that is larger than the acute services strategy foresees, because that would entail continuing excess spending in mid-Buckinghamshire, which would prevent north Buckinghamshire from receiving the money.

Mr. Lidington: I agree with the hon. Lady's last point to some extent. The plan that has been endorsed by the trust management and by Buckinghamshire health authority is in line with that acute services strategy.

I would take issue with the hon. Lady over her assertion that mid-Buckinghamshire has been overfunded. This is not the occasion to go into the historical factors at work within the county and the application of the York formula to some county units. The hon. Lady and the hon. Member for

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Milton Keynes, North-East, and his predecessor, Mr. Peter Butler, argue the case passionately on behalf of Milton Keynes. Irrespective of what happens in the rest of Buckinghamshire, on the figures that I have seen, Milton Keynes has a good case for extra funding. As I said, the successful completion of the scheme at Stoke Mandeville is one way of helping to achieve that objective.

It is not only the revenue savings that are at stake. Surplus land worth £10 million at the minimum would be released by the redevelopment of Stoke Mandeville. That money could be ploughed back into health care either in our part of the country or elsewhere: that would be up to the Minister and his colleagues to decide. The NHS can ill afford to lose such a financial benefit. I hope that that entices the Minister and the regional office to look favourably on the scheme.

I want to put two brief questions to the Minister that he may reflect on if he cannot reply in detail now. The first is about the status of the £23.2 million bid. As I understand it, bids below a certain level fall to the regional office to decide, and bids above, perhaps at £25 million, must go to Ministers for a central decision. Can the Minister clarify that?

The second question is about interim strategic support, which was intended to tide Stoke Mandeville over until the rebuilding. It is due to end in 1999, and the earliest date at which new buildings can come into use is 2003.

Both the health authority and the regional office have told me that they continue to look actively for solutions. I hope that the Department will keep an open mind on whether to address the problem by arranging a deal with the potential private-sector partner, or to consider ways in which it and the NHS can cope with it. It is a real problem, but a time-limited one once the redevelopment is approved.

The original intention was that the sale of the land owned by the Department would part-fund the Stoke Mandeville project. I understand that that will not now happen, but I hope that it will still be possible for the departmental land to be developed in conjunction with the trust-owned land. Both parties might well benefit from a scheme that could take place at the same time, and be attractive to the same private-sector partner.

Finally, let me make a plea that, if it is humanly possible, work on the paediatric unit should be brought forward to the earliest possible date. I explained earlier about the particular needs of paediatric patients. I hope that, either through a deal involving the land or through the terms of the contract with the private-sector partner, we can find a way of advancing the provision of a modern paediatric unit much closer to the operating theatres.

I am grateful for the opportunity that I have been given. When my hon. Friend the Member for Buckingham and I met the Minister last year, he listened to us with great courtesy and gave us a good deal of time. I thank him for his serious interest in the project in recent months, and I look forward to his reply.


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