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Mr. Simon Hughes: There was a recommendation that the panel should examine the bed issue. The Minister said that that work has already started. Does he have any idea when he will receive recommendations on bed numbers and the implications of those numbers?

Mr. Milburn: I do not, but I shall let the hon. Gentleman know as soon as I do. If he contacts my office, we can arrange a response.

My hon. Friend the Member for Wimbledon (Mr. Casale) spoke about the sheer size of London and the problems that that creates. Our capital city has a unique health service, which has unique problems in serving massive health needs. We are determined specifically to tackle London's deprivation and inequalities. The fact is that 40 per cent. of Londoners are among the most deprived 10 per cent. of our country's population. Sir Leslie and his team rightly highlighted the special needs of many groups in London, such as elderly people, the mentally ill, ethnic minorities, homeless people, refugees and asylum seekers. We have to translate our good intentions for those groups into action.

Mr. Wilkinson: From the Minister's statement today, may we have confidence that there will never be a translation of financial resources out of London into the provinces? The old resource allocation working party system did the health service in London great damage.

Mr. Milburn: If the hon. Gentleman will bear with me for a moment, I am about to deal with the resource allocation issue, partly in response to the issues raised by my hon. Friend the Member for Wimbledon.

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The action necessary to deal with problems cannot occur without partnership. Working together in partnership, across boundaries, is vital if we are to improve services, improve the health of Londoners and--most important--tackle the appalling health inequalities that scar our capital city. We are therefore fostering co-operation in the NHS, by getting rid of the internal market introduced by the Tories when in government. To tackle those inequalities, we are also breaking down the Berlin walls between health and social care, the NHS and local authorities, and the public and voluntary sector.

New ways of joint working are being pioneered in London's two health action zones--which represent a recognition of the fact that the job of improving health is one for local government, employers, community organisations and the NHS. Such an approach to partnership is in line with the Turnberg recommendations.

Mr. Gareth R. Thomas: Will my hon. Friend mention the widely supported proposals on pooling health and social services budgets?

Mr. Milburn: My hon. Friend raises an important point. We will soon produce a consultation document on how to ensure greater flexibility in the provision of health and social care services--for the benefit of patients, especially those who are at the interface of those services, such as elderly people, people with metal health problems and people with disabilities. The document will deal with the pooled budget issue.

The Government accepted all the Turnberg recommendations, and we have acted quickly to create a programme to implement them. We will deliver better services for Londoners through investment and modernisation. The two go together.

We are committed, first, to sustained investment in health services and facilities in London. Since we came to power--to contradict the hon. Member for Rutland and Melton--the Government have invested £300 million in London's national health service. Last year, £26 million went to the capital, to ease pressures on health and social services provision. This year, £48 million has been targeted specifically at lowering waiting lists in London. As a consequence of the tough targets that we have set ourselves in reducing waiting lists, by March 1999 London's national health service should have more than 10,000 fewer patients waiting for treatment than the record level of March 1997 which we inherited from the Tories.

The extra money for this year includes £30 million targeted on primary care, mental health, intermediate care and community services. We will provide at least an additional £140 million of investment in those services for London over the lifetime of this Parliament.

Today's debate has rightly concentrated on London's hospitals. However, primary care is the primary point of contact with the NHS for the overwhelming majority of Londoners. As we know, there is much to commend primary care services in the capital. However, there is also much that is wrong with the services, which we are determined to put right.

My hon. Friend the Member for Upminster (Mr. Darvill) and the hon. Member for Southwark, North and Bermondsey mentioned the problem of recruiting a sufficient number of general practitioners in the capital.

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We fully endorse the need for Londoners to receive their fair share of GPs. A national group--which includes Professor Jarman, who was a member of Sir Leslie's team--is working to identify a formula that would accord every area its proper share of family doctors. The results should be available in the summer.

Ms Hodge: Is consideration being given to introducing salaried general practitioners in those London areas where it is extremely difficult to recruit people into general practice?

Mr. Milburn: I assure my hon. Friend that we have successfully reached an agreement with the British Medical Association, and have--for the first time in the history of the NHS--introduced a salaried doctors scheme, which I believe will be the way forward in many areas where it is currently difficult to recruit GPs. The scheme will bring new, younger and energetic GPs into general practice, which will be a great improvement in primary care in many parts of London.

My hon. Friend the Member for Wimbledon asked about resource allocation, and how we can ensure that London receives its fair share of resources. As he knows, a working group is dealing with the matter and will report later this year. I expect that its recommendations will be implemented in the next financial year.

As part of a modernisation programme, there is more investment in London's front-line health services. Moreover, that money for front-line services is backed by capital investment, as we cannot build a 21st-century NHS in London in 19th century hospitals. The Turnberg report paved the way for £800 million of new investment to build more new, modern hospitals and to improve existing ones--such as at the West Middlesex, University College hospital, King's and St. George's. It paved the way also for a proper, 21st-century hospital in Whitechapel. Furthermore, we are not only saving Bart's--which the previous Government intended to close--but giving it a great future.

There will also be a great future as a local community hospital for Queen Mary's hospital, Roehampton. Five years of uncertainty is at an end. Queen Mary's will have a robust and healthy future, providing services for local people into the next century. I pay tribute to the work done by my hon. Friend the Member for Putney and by the hospital league of friends. Most of all, I pay tribute to the work done by the hospital's staff, who have ensured that services are delivered throughout a most difficult period of uncertainty and confusion--which is now at an end. Our plans will give staff and the local community a new hospital for a new century.

We have also endorsed the London review recommendation that a new hospital should be built in the Oldchurch area. The Havering Hospitals NHS trust is producing a strategic outline case for that investment. We expect the case for making the investment to be a strong one. If it is, the trust will be able to take forward procurement in 1999.

My hon. Friend the Member for Upminster expressed concern about the Harold Wood site. Harold Wood's future will have to be considered in the light of the Oldchurch development. Similarly, I assure my hon. Friend the Member for Ilford, North (Ms Perham) that plans for the new hospital will take account of the

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relatively new facilities at King George's hospital, and that clinicians from King George's are actively involved in helping to plan services at the new hospital.

I am aware that, because of work done by the trust, submissions on Guy's and St. Thomas's will be made to me. I also realise that the hon. Member for Southwark, North and Bermondsey has an alternative proposal. As I said when I met him, I should be more than happy to consider his proposal. I should be happy to meet him again, if he thinks that that is necessary.

I also assure the hon. Member for Rutland and Melton that Hammersmith is a very important hospital and that it has a secure future. However, we have to assess how best it should play its part in delivering local health services within the overall context of services in west London. That is why we are reviewing services in the area and the Hammersmith is part of that review.

Those are all far-reaching changes for London's NHS, which will not be easy to achieve and which will require time and careful management. We have faced difficult decisions and an unenviable legacy from our predecessors of uncertainty and failure, but we are making considerable progress, with new hospitals being built, extra cash being invested and a new direction for London's health service being implemented. There is a long way to go to deliver the first-class NHS that the Government want to be available throughout London, but we have made a good start and we are determined to make rapid progress. We believe that Londoners deserve no less.


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