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Mr. Win Griffiths (Bridgend): First, I pay tribute to the civil servants in the Welsh Office, and to the managers, medical staff and others at all levels in the health service in Wales for the immense efforts that they have put into the reconfiguration process, which has been incredibly important. It is estimated that it will save between £7 million and £10 million by the end of this Parliament. Given the small adjustments that have been made in individual proposals, will there be any effect on those savings? My trust was confident that it could do better in savings terms than the figures in the proposals.
It is very important that we get the message across that permanent savings from administration will go directly to patient care. Will my right hon. Friend confirm and underline that the future of hospital and community services in the health service in Wales will, in the near future, lie in the hands of local health groups, doctors, nurses, midwives and local authority representatives, who will have the job of seeing how hospital services fit into the new health service in Wales?
Mr. Michael:
I join my hon. Friend in paying tribute to those people who are going through a difficult process, and who worked closely with him during his period as the Minister with responsibility for health in Wales. I repeat my tribute to my hon. Friend for the hard work that he undertook in difficult circumstances. It is always more difficult to start when one is clearing up a mess than if one is starting from a strong position. Frankly, the former is where we found ourselves 18 months ago.
I am confident that the adjustments will not cause a problem in relation to savings. In Powys, the health authority has given the assurance that the necessary savings can be effected in ways that it is happy to achieve itself. I am certain that the dismemberment of the Llandough trust in order to put it back together again in a couple of years as part of stage 2 would have been an expensive way of doing a job badly. I am confident that the savings will not be any lower as a result of the decisions on Cardiff and the Vale of Glamorgan.
We will look specifically at Ceredigion in light of our decision, but I hope that my intention can be carried through and that we can strengthen partnership and co-operation between Ceredigion and other trusts to make sure that difficulties are not caused. I underline the point that savings are to be diverted back into health care, and I am sure that all my hon. Friends want to see that happen.
Finally, I can give my hon. Friend the answer he is looking for in relation to community services. It is very important that there is a proper balance between hospital and community services, which must be integrated and complementary. My hon. Friend is right to stress that the future is in the hands of local health groups, which will bring a new degree of accountability at the most local level. That matches the developments that will take place in the coming year, when the overall strategic accountability will be in the hands of the new elected Assembly for Wales.
Mr. Lembit Öpik (Montgomeryshire):
May I offer the Secretary of State and his Minister my profound gratitude
Does the Secretary of State agree that while this decision may not please everyone in Wales, few in Powys will be disappointed? Does he agree that it was somewhat mean-spirited of the hon. Member for Ribble Valley (Mr. Evans) to seek the negatives and to make irrelevant party political points at a time when it is important for us to recognise that the decisions have been altered according to the consultation process that involved effort on both sides? That process has led ultimately to a pleasing result in terms of the modification of the plans.
The Secretary of State mentioned the need for Powys to achieve savings, and that has been mentioned on a number of occasions. Will he accept my assurance that I and my hon. Friend the Member for Brecon and Radnorshire will honour the commitment to work with Powys health trust to ensure that those savings are found--recognising, none the less, that the process presents us with a further challenge that we must not avoid?
More broadly, there will be debates and concerns in other parts of Wales, especially about the financial savings that must be found. Does the Secretary of State agree none the less that the Powys decision should be regarded as an example of what can be done when parties listen and work together--[Interruption.]--when the public are genuinely consulted and, perhaps most importantly, when the public interest is put above party political concerns, in this case leading to the maintenance of a health service that is loved by the people of Powys and highly respected by all those who have cause to use it?
Mr. Michael:
I welcome the hon. Gentleman's remarks. To those Conservative Members who mocked some of his points, let me say that I welcome his reasonable approach. This is the new politics: to disagree when there are things to disagree about, but to agree when we can agree. In particular, I would stress the importance of one thing that he said: it is a matter of integrity that he acknowledged the fact that there are difficult decisions for Powys Health Care trust to take in order to make the savings that will be necessary for it to deliver on its promises.
I have heard Labour party and trade union voices arguing in the same direction as the hon. Gentleman and the hon. Member for Brecon and Radnorshire (Mr. Livsey). I look to Members of Parliament, local authorities, trade union representatives and others to help to deliver on the promises that have been made. I am
convinced that, with a reasonable and co-operative approach, we can achieve an outcome that is satisfactory for everybody.
Mr. Deputy Speaker (Sir Alan Haselhurst):
Order. I have given some leeway to Front Benchers and to the former Health Minister in Wales, but I now appeal for shorter questions and answers, as we have other important business to cover.
Mr. Alan Williams (Swansea, West):
I accept entirely the logic of the proposals for Swansea, which reflect the consultation that was held in the area. Is my right hon. Friend aware that the new trust will start with an enormous problem, with the overhanging shadow of the £8 million debt that Morriston will bring? If the new trust is not to start in an atmosphere of cutting and holding back on developments, we must deal with the debt. Recognising that it should not have been built up in the first place, will he consider writing it off?
Mr. Michael:
There are proposals to deal with the problem to some extent. A recovery programme is being set up, and my right hon. Friend makes a reasonable point when he says that the debt should not have been built up in the first place. The reconfiguration will help the process, but I recognise that the problem to which he alludes is extremely difficult. We will be conscious of it when we consider how the new trust is to develop its work.
Mr. Cynog Dafis (Ceredigion):
There is widespread cynicism in Wales about the reconfiguration exercise. People think that it has more to do with a pre-election undertaking than with actual need and the provision of a more efficient health care system. There will be widespread dismay at the failure to take the opportunities for improvements in health care delivery in mid-Wales--especially in relation to the integration of services--that were carefully described in the consultation process.
Will the Secretary of State guarantee that the development of services and of clinical excellence that has taken place in Ceredigion, and particularly in Bronglais general hospital, will be able to continue? Does he accept that accessibility is also vital, and that the royal colleges need to--and are in fact beginning to--understand that? May I warn him that any diminution in the status of Bronglais hospital in Aberystwyth or reduction in its range of services and specialties would evoke a furious public reaction in the area, compared with which what we have witnessed in Powys would pale into insignificance?
Mr. Michael:
I agree that there is widespread cynicism in Wales. That is precisely why, when I took up my post, I delayed the announcement of the reconfiguration in order to examine the proposals and ensure that I would not be announcing something that I could not put my hand on my heart and say would improve patient care. That is my objective in today's announcement. That is precisely why the announcement is about not only lines on the map, but the way in which the new arrangements will be put into practice.
I would have hoped that the way in which I made the announcement would have set some of the hon. Gentleman's doubts to rest. He asks whether I can
guarantee that the development of clinical excellence in Bronglais will continue. The whole point of the way in which I referred to Bronglais and services in Ceredigion is that I recognise that there is a specific problem there. That problem would not have been helped at all by simply merging it with another set of problems at Powys Health Care trust: that would have been running away from the problem.
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