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1.41 pm

The Minister of State, Department of Health (Mr. Alan Milburn): It is always a pleasure to reply to the hon. Member for East Surrey (Mr. Ainsworth), on this and other issues. As he said, I get to deal with many fun issues in the House, but this is not one of them. It is a serious matter, which is of concern to him and his constituents.

As the hon. Gentleman rightly said, community hospitals are a valued part of the national health service in many parts of the country. Patients often value them because they tend to deliver services in a friendly and homely way, which makes change extremely difficult. Change is not peculiar to this Government, or to the previous Government; it is endemic in the national health service, and it affects community hospitals just as it affects other parts of the service.

The hon. Gentleman is a strong supporter of Oxted and Limpsfield community hospital in his constituency, and I understand his concerns, which have also been expressed to me by local people and organisations. He will recall that I met representatives of the East Surrey community health council and the Save Oxted Hospital action group some months ago. Perhaps it would be useful if I recount how we got to the present position, and where things stand in trying to answer the hon. Gentleman's six questions.

In the first place, changes were necessary in the area, because, as the hon. Gentleman rightly said, health needs were changing, and it is broadly agreed that the hospital is in a poor state of repair. The local health authority has a responsibility to ensure that it makes the best use of the public money that it receives. It decided that it would be more cost-effective and appropriate to modern health care facilities to consider a new building in Oxted, rather than upgrading the present building.

As the hon. Gentleman knows, the proposal was to provide out-patients, minor injuries, X-ray, diagnostic and physiotherapy services in a brand new NHS facility. Changes would also be made to the number of beds available--acute beds would be transferred to East Surrey hospital, and beds available for the less acutely ill would be purchased from a private nursing home and managed by local general practitioners.

As the hon. Gentleman said, following East Surrey community health council's objections to the health authority's recommendations following consultation, I considered those proposals late last year, bearing in mind all that had been said locally. When I made my decision to approve the proposals by East Surrey health authority for the re-provision of Oxted hospital, I did so on two firm conditions, and I expect those conditions to be fulfilled in full. The first was that a viable private sector nursing home partner could be found; the second that adequate provision should be made at East Surrey hospital in Redhill to absorb the likely number of elderly patients being admitted there from the Oxted area.

I asked for an implementation plan from East Surrey health authority, and I subsequently extended the deadline for the production of that plan by two months, to the end of May, to enable further local discussions to take place. The appearance on the scene of a potential local benefactor might be a help, but it has certainly also been a hindrance in delaying the implementation of the overall plan.

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I made my decision because the proposals will provide modern, high-quality health care for people living in south Tandridge. There would be flexibility, with local GPs managing the beds; and acutely ill elderly people, who need consultant care in the best possible modern setting, would have a full range of back-up facilities available, which might not always be available in that sort of setting.

With regard to the private sector partner, I understand that a number of expressions of interest have been received from nursing home providers by Surrey and Sussex Healthcare NHS trust, which are subject to further discussion, and those debates continue. To build a new nursing home on the existing hospital site, a land swap will be necessary, so that the existing hospital can stay open until the new facilities are ready. I understand that discussions are taking place with Tandridge district council about the land swap.

Alternatively, the existing hospital could be closed and demolished, and a nursing home built on the existing site. If that option were chosen, I understand that the health authority would purchase beds from existing nursing homes in the Oxted area, which would be used until the new nursing home was available on the Barnett Shaw site. I will say in a moment what I expect Tandridge district council to do to be helpful.

As the hon. Gentleman knows, at present GPs have access to six beds in Oxted hospital. As a result of local concerns expressed during the consultation exercise, the health authority helpfully increased its planned re-provision from six to 10 beds, giving the GPs an increase in access to local services. I hope that he also thinks that helpful. The use of a nursing home, which is likely to have around 40 beds in total, is designed to give maximum flexibility to accommodate local needs. Therefore, 10 GP beds in the nursing home is the minimum guaranteed future commitment. If the local primary care group can arrange treatment and care differently for its patients, it may be able to care for more patients in the new facilities in Oxted, subject, of course, to other demands, such as emergencies.

On the condition concerning capacity at East Surrey hospital--another important matter that the hon. Gentleman raised, and about which I am concerned--the regional office of the NHS executive is closely monitoring the plans by the Surrey and Sussex Healthcare NHS trust for the reconfiguration of services at the acute hospitals at Crawley and Redhill. The plans will now need to take full account of changes to service levels at Oxted and access for patients in their areas. Once finalised, those plans will be subject to full consultation.

Two further issues warrant a mention. First, the re-provision is being planned at the same time as a new, modern, primary health centre is being developed in Oxted. That will provide high-quality primary care facilities for patients in the centre of the town, and will complement the hospital re-provision. The GPs in the town will have access to a range of new, high-quality primary, community and nursing home facilities, all of them readily accessible to the local population. As the local practices develop into a primary care group, they will be able to have more say in the way in which those facilities are used for their patients. Frankly, it will be for

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GPs to take those decisions, not bureaucrats sitting in health authority offices; I hope that the hon. Gentleman welcomes that sort of development.

There will be more flexibility for patients to be supported in their own homes, with the back-up of local, low-tech beds, and barriers between health and social care will be overcome, which is crucial, particularly to deal with the complex problems that many elderly patients often face. They require the support not merely of NHS services, but of social and housing services. The new primary care groups and the facilities that are being provided in the area will all help to that end. The availability of nursing home beds in Oxted will support primary care, and will therefore be an important element in the development of services for local people.

Secondly, since making my decision at the end of last year, a possible benefactor has emerged to provide a donation towards the re-provision of services, as the hon. Gentleman said. That was discussed locally, but initially no consensus could be reached on what form alternatives might take--the health authority listened carefully to the benefactor's views, but declined the offer. Since then, the health authority and representatives of the benefactor have had further discussions to establish whether a donation could be used to augment the proposed NHS in-patient provision.

Irrespective of whether charitable funding is available, the hon. Gentleman should be reassured that the people of Oxted will continue to have access to high-quality NHS-funded health care. I know that negotiations are progressing in, I hope, the spirit of co-operation that we are striving to encourage in the NHS. The best solution for people in the area is for local agreement to be reached about the future of their local services. I cannot say when the negotiations will finish, as I am not party to them.

The hon. Gentleman's first question concerned the financial background. I do not have the information with me, so I hope that, as he suggested, he will allow me to write to him on that. I know the concern that has been expressed locally, and I shall be happy to address that directly.

I hope that the hon. Gentleman is reassured by the fact that the implementation plan that is now in place will result in new in-patient, out-patient and therapy facilities, as well as a minor injuries service, being available in Oxted by the summer of 2001. The time scale and detail of the re-provision depend crucially, as he rightly said, on the planning decisions taken by Tandridge district council. The local authority will no doubt be mindful of the need for a rapid decision to allay the concerns of local people about the future of health services in the town, and I hope that it has listened to what both the hon. Gentleman and I have said today.

I have had a significant number of representations about the matter, and I stress that the final form of the re-provision--which depends on a number of factors that I have outlined; the hon. Gentleman knows the background to them--will be for local people and organisations to agree, albeit within the caveats that I set out in my approval of the plan. I shall not be revisiting my original decision, which I expect to be implemented in full.

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I assure the hon. Gentleman that the South Thames regional office will be responsible for ensuring that the detail of the scheme accords with the terms of my approval of the Oxted and Limpsfield hospital re-provision scheme. The regional office is keeping a close eye on the matter, and I am sure that officials there will be helpful in answering any of his detailed concerns. If he has further difficulties,

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I should be happy to deal with them personally, but I hope that I have been able to deal with the majority of the concerns that he has raised today.

It being before Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.

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