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Mr. Denzil Davies (Llanelli): Is my right hon. Friend aware that there will be considerable anger in Llanelli at the decision to abolish the Llanelli Dinefwr hospital trust and that the anger will be compounded by the fact that the decision was taken by a Labour Secretary of State? Is he further aware that there will be widespread cynicism about the consultation process, because all groups in my constituency--health professionals and others--were totally opposed to the Welsh Office plans? Is he finally aware that all his fine words about not downgrading hospitals will carry little credibility because there is real concern, as a result of the decision that he has taken, that Prince Philip hospital in Llanelli will be downgraded and we will lose our medical services?
Mr. Michael: I know and understand my right hon. Friend's passion for the health services in his area. I hope that he will help to ensure that nobody pursues the approach of either cynicism or promoting the belief that there is any threat to Prince Philip hospital. I have made it clear that that is not the basis on which the reconfiguration is proceeding. I have been absolutely explicit--I hope that he will pass my words on to those of his constituents who have expressed concerns--about the requirement on the trust, the board and officials at the Welsh Office to ensure that none of the dangers that he fears will come about.
I understand the fears and cynicism that have arisen from the way in which health service decisions have been taken over the past 20 years. Many of us have had worries about our local services. The whole point of making my statement in a clear and considered way, measuring each word, is to ensure that the changes that I have to accept as necessary to concentrate on health care are implemented in such a way that high-quality care is provided, but with a proper regard for factors such as the affection of people in Llanelli for their own hospital. I hope that that offers the reassurance that my right hon. Friend seeks.
Mr. Rhodri Morgan (Cardiff, West):
I agree with 80 per cent. of the statement, but I want to ask my right hon. Friend about the two-stage reorganisation of the
How long does my right hon. Friend expect the period to be between the completion of stage one reform, with the two mergers that he has announced today, and the ultimate merger of the two newly merged trusts into one mega-trust covering the whole of Cardiff and the Vale of Glamorgan? How high will morale be among the top management, the clinicians and everybody working in the health service in the Cardiff and Vale of Glamorgan area when they work for two organisations with such a limited shelf life?
Mr. Michael:
I accept that a two-stage reform is not ideal, but nothing else was on the cards from the beginning of the consultation, as my hon. Friend knows. I hope that not only will we have no grouse moors, but no grouses at the end of the process. I have made our direction clear, following much uncertainty in the health service in Cardiff and the Vale of Glamorgan. People suspected that we would have stage one and that stage two would never happen. I am determined that we shall have a short first phase, leading to the completion of the job as soon as possible. I will consult further on how quickly that can be done, so that a time scale can be produced that gives some certainty to clinicians and staff in the area.
It is only fair to point out that the complexities in the area, of which my hon. Friend is aware, include the moving of the accident and emergency unit from Cardiff Royal infirmary to the University hospital of Wales and a variety of other movements in the acute services in the area. We do not intend to dismember the Llandough hospital from community services, thus producing a mish-mash and pretending that that is a second stage towards a single trust. Instead, we will merge existing arrangements in a manageable first stage, which will quickly lead to a sensible second stage and the degree of certainty that my hon. Friend rightly suggests should be achieved.
Mr. Don Touhig (Islwyn):
I welcome my right hon. Friend's statement as far as Gwent is concerned, because I believe that the single trust is the proper solution. However, I know that my hon. Friends have some concerns about that and I am sure that they will express them to him. Will he confirm that his decision will provide us with an opportunity in Gwent to shift resources from bureaucracy to patient care and how does he intend to ensure that that happens?
Mr. Michael:
My hon. Friend is right: the purpose is to shift resources from bureaucracy into patient care by having only one level of bureaucracy and ensuring that services are available to people in appropriate and convenient locations. We wish to strengthen services in the northern half of Gwent, about which there has been some concern, and we want to ensure the safety and long-term security of Nevill Hall hospital. I am certain that the reconfiguration can achieve the improvement in patient care in Gwent for which my hon. Friend hopes.
Mr. Paul Flynn (Newport, West):
I thank my right hon. Friend for his statement and I agree that the best
Mr. Michael:
I am grateful to my hon. Friend for those remarks. He is right to suggest that we should focus on seeking to improve health care where it is worst, including wards in his constituency and areas in north Gwent. The purpose of the reforms is to ensure that everyone, wherever they live, has access to high-quality health care from acute and community services and from the complementary services of local authorities.
Mr. Alan W. Williams (East Carmarthen and Dinefwr):
I wish to express my disappointment with the statement as it affects my constituency. The policy of forced mergers of trusts that my right hon. Friend has inherited from his predecessor and my hon. Friend the Member for Bridgend (Mr. Griffiths) is mistaken, because mergers should be voluntary. What reassurance can my right hon. Friend provide for my constituents and people in Llanelli that services will be available in both areas and will not be affected by rationalisation?
Mr. Michael:
I can understand my hon. Friend's disappointment, but I am not sure about the concept of voluntary mergers because that might mean leaving the management of trusts that may have been established on an unsatisfactory basis to choose whether to merge. The overriding consideration must be the need to provide the best quality of patient care, as I know my hon. Friend agrees. I am happy to give the reassurance he seeks that the quality and choice of care in his part of the new county area will not be downgraded, and I shall remind those who will run the trusts of the need to ensure that there is no asset stripping of one hospital for another. That applies equally to both sides of the combined trust.
Mr. Llew Smith (Blaenau Gwent):
While I welcome my right hon. Friend's commitment to Nevill Hall hospital, people in Blaenau Gwent will still be angry about the statement. My right hon. Friend quoted the Royal College of Surgeons, but if he had quoted the local authorities, such as Blaenau Gwent, Monmouthshire and, even, Newport he would have found opposition to a single trust for the county of Gwent. The vast majority of general
Mr. Michael:
I understand the concerns that my hon. Friend presents on behalf of his constituents. I accept that different voices have different views, but I mentioned the Royal College of Surgeons because it has argued for larger concentrations of acute services, which can cause problems for more localised services, unless they are a part of a combination. I have proceeded with the interests of his constituents and the services at Nevill Hall hospital in mind. I accept my hon. Friend's concerns for his local area, but I believe that the creation of the local health groups and a stronger voice for community health councils will be a way in which to achieve our intentions. I am happy to discuss with my hon. Friend and his colleagues the changes to community health councils, because they will be important to our scheme.
Mr. Huw Edwards (Monmouth):
I remind my right hon. Friend that, when the previous Government introduced the trust system, they included no consultation whatever. The Government should take some credit for having a consultation process on this occasion. My right hon. Friend will know that I campaigned with my hon. Friend the Member for Blaenau Gwent (Mr. Smith) for a separate trust for north Gwent and I must express the disappointment of campaigners that my right hon. Friend has decided not to implement that. Will he give us an assurance that Nevill Hall hospital will be maintained as a district general hospital, that there will be no drift of resources to south Gwent and that the Government's commitment to combat social inequalities in health will work specifically in the interests of the people of north Gwent?
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