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6.6 pm

Mr. Julian Brazier (Canterbury): I welcome the opportunity to debate bed closures and to support the Opposition motion. I thank my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) for her support for my local hospital, Kent and Canterbury, which is faced with a rundown virtually to cottage hospital status if East Kent health authority's proposals are adopted. Just last week our community health council stated that those proposals were unacceptable in their present form.

East Kent health authority has repeatedly failed to identify the aim of its proposals. It keeps quoting a view with which everyone agrees--that working practices and configurations must change as patients' requirements and expectations rise--but nowhere has it identified a clear objective. In its consultation document it rules out money as the main driving force, and instead refers vaguely to

One of the two principal bodies responsible for policing doctors' training and working practices, the Royal College of Physicians, stated at the outset that it disagreed with the proposals, and local representatives of the Royal College of Surgeons have more recently given a clean bill of health to local acute hospitals and stated that they do not see the need for the proposals. Why does not the Department tell EKHA to go back and think again about proposals that have generated tens of thousands of objections from the community?

East Kent has recently suffered from bed shortages, so it beggars belief that the closure of nearly 400 beds at the hospital and a large number at Dover is proposed. Even meeting EKHA's reduced bed totals under the proposal would mean expanding bed provision at Ashford and Thanet, despite recruiting shortages in Thanet.

Mr. Roger Gale (North Thanet): My hon. Friend is aware that an almost certain consequence of Kent and Canterbury's proposals would be the transfer of cancer care

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to Canterbury and the closure of the unit at Maidstone. I cannot believe that my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) would welcome that on behalf of her constituents. More important, the proposal would lead inexorably to the closure of Faversham hospital, Whitstable and Tankerton hospital, Queen Victoria hospital, Herne Bay hospital and Deal hospital and the downgrading of the Buckland hospital in Dover--a town larger than Canterbury.

I do not believe that my constituents in Herne Bay would welcome the loss of beds in the Queen Victoria or Herne Bay, or the loss of facilities there and the potential for the development of telemedicine. Does my hon. Friend believe that his constituents would welcome such a loss at the Whitstable and Tankerton hospital?

Mr. Brazier: The Kent and Canterbury proposals--which I support--do not include downgrading the cancer facility in Maidstone. Rather, they make it quite clear that we need both facilities in Kent: one to cover the east and one to cover the west. They do not challenge any community hospitals and they certainly do not threaten the Whitstable and Tankerton hospital, whose support group is also championing the cause of Kent and Canterbury hospital.

As well as threatening a large reduction in bed numbers in East Kent at a time of bed shortages, East Kent health authority's proposals threaten our five regional specialties. The cancer care facility at Kent and Canterbury was one of only three last year to win a charter mark for excellence. If that unit were closed, it would move out of East Kent, resulting in some 20,000 patient visits each year for radiotherapy alone to Maidstone--which has the closest alternative unit. That would have knock-on effects for people awaiting treatment in Maidstone. Renal and haemophilia treatment, neurophysiology and neonatal intensive care would also have to leave Kent and Canterbury, and some services would leave East Kent. EKHA has admitted that the destruction and rebuilding of those teams elsewhere involves considerable risk. However, as the community health council points out, the health authority has done no proper risk analysis of its proposals.

The loss of access to a broad range of other acute medical services is also a cause of huge disquiet in the community. Almost all individual responses to EKHA's proposals from outside the Isle of Thanet--which comprises less than a quarter of the population--have opposed the changes. For the people who live in the Canterbury city council area, which on its own has a larger population and a larger elderly population than the Thanet district council area, and in the constituency of my hon. Friend the Member for Faversham and Mid-Kent (Mr. Rowe) and for the tens of thousands of people who live in small villages in other districts that are served by Kent and Canterbury--Canterbury is the hub of the bus system for the whole of east Kent--the proposals represent a serious threat.

Any private sector organisation that invested heavily in two sites--an acute hospital was built recently in Thanet and many millions of pounds have been invested in regional specialties at the Kent and Canterbury in the past few years--and then said that it had to close one or other of those facilities would be reasonably expected to take some trouble over its financial estimates.

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East Kent health authority, however, submitted its estimates for changes in cancer care without consulting Maidstone, although Maidstone will be pivotal to the health authority's cancer proposals. EKHA appears to have ignored the costs of redundancy payments to consultants, nurses and other staff who may choose not to move to another location, and its proposals appear to have built in nothing for the extra ambulance costs involved in moving more people greater distances. Above all, the health authority's wholly unrealistic bed numbers make the financial side of the proposal laughable.

Closure of Kent and Canterbury would mean that East Kent would lose a hospital which, partly because of its proximity to the university and the extra educational and training facilities that it provides, has proved extremely effective in attracting talent to the region. It has proved possible to utilise talents across all three major acute sites by working together on the children's site. That would not be possible if we lost the middle site in the region; the extended distance and the additional time that it would take to travel between Ashford and Thanet would make joint working impractical.

I hope that East Kent health authority will see sense. I hope that, at its meeting in a few days' time, it will reconsider and not seek to drive through its proposal--and I am delighted that Canterbury and Thanet community health council has made clear its intention to refer the matter to the Secretary of State if EKHA persists. I hope that the Secretary of State will listen hard to the counsel not only of several Conservative Members but of the hon. Member for Sittingbourne and Sheppey (Mr. Wyatt), who participated in a recent delegation to Downing street on the subject. I hope that the Secretary of State will throw out this dreadful proposal that threatens to do much damage to the people of East Kent.

6.14 pm

Ms Rosie Winterton (Doncaster, Central): I am grateful for the opportunity to participate in this debate. We all know from our postbags the anguish that is caused to people awaiting NHS treatment. I have personal experience of that as my father has been waiting some months for a knee operation, and I am aware of how waiting can put people's lives on hold. It affects not only the person awaiting treatment, but his or her family. That is why I think that the Government's commitment to reducing waiting lists is so important.

Doncaster health authority in my constituency has warmly welcomed the Government's initiative. Even though the health authority already has the smallest number of people waiting more than 12 months for treatment in the Trent region, the extra £1.7 million that the authority has been allocated has allowed it to agree a waiting list target of 4,600 to be achieved by the end of March next year.

My hon. Friend the Member for Rother Valley (Mr. Barron) referred to the importance of going back to 1991 when examining the whole picture regarding waiting lists, but I am happy to go back to 1997. In April of that year, the waiting list was 5,773. That means that, by next year, the waiting list will have been cut by 1,200. My health authority also expects that substantial progress will be made in reducing the waiting list by September this year. The built-in incentive of receiving £170,000 on top of the funds already allocated has concentrated minds on making real progress in reducing waiting lists. That can only benefit my constituents.

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We cannot look at the waiting lists initiative in isolation. My hon. Friend referred to the health action zones, and Doncaster is a part of one. The zones enable the health authority and local social services departments to work together on several initiatives, particularly tackling the effects of industrial diseases and the problem of teenage pregnancies. My hon. Friend the Member for Harrow, West (Mr. Thomas) referred to the partnership between social services and the health service. I believe that it is vital to get the balance right, as that is the way forward when it comes to improving health services.

Doncaster has also been awarded pilot status as part of the healthy schools initiative, which will allocate an extra £150,000 to schools to enable them to introduce health initiatives. We have made excellent progress with the establishment of primary care groups, which will reduce the fragmentation and division caused by the previous Government's policies and allow the greater planning of patient services by general practitioners in my area, who have welcomed the initiative. Substantial progress is being made in improving health care.

Operations will always be cancelled because of emergency cases, which are beyond the control of doctors and hospitals. However, I think that better information could be provided to patients about the reason for operation cancellations. Too often, the letters that are sent out are quite brusque and do not include further dates when people might expect their operations to be carried out. I hope that my right hon. Friend the Secretary of State will be able to give an assurance that we can address such matters.

I have received a number of complaints about general practitioners who, without giving any real reason, refuse to take pensioners on to their lists. People sometimes get the impression that there are GPs who cherry-pick their patients, refusing those who need what they think might be expensive care. Would my right hon. Friend consider some form of appeal system against that happening, or at least ensure that more information is given about why someone is refused treatment? People feel resentful when they are taken off a list or not taken on one without the reason being explained to them.

Before the general election last year, I visited my local hospital. Staff morale was at all-time low and the management was in despair. A few weeks ago, I returned to the hospital to present the staff awards. The atmosphere was completely different. The mood of the staff and of management was so much more upbeat. There was absolute certainty that the extra resources allocated to Doncaster health authority would have a great impact on reducing waiting lists. Having that as a long-term objective is something of which the Labour Government can be proud. It will make a real difference to many of my constituents and I am proud to be associated with any initiative in that regard, as I am proud to see a Secretary of State who has the guts to do something about reducing waiting lists.

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