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Mr. Dobson: If I said sight tests, I said it inadvertently. I am perfectly aware that it is dental checks that pregnant women and nursing mothers are entitled to. If the two got stuck together in one sentence, I duly apologise.

Mr. Forth: A rare event.

Mr. Duncan: I thank the Secretary of State for that apology, which is indeed a rare event. We have to be

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persistent in opposition and try, by degrees, to bring him and his ministerial team down to a level where they will engage in serious debate and be accountable for what they say in the House, rather than continuing to distort so much of their stance on the health service.

Mr. McNulty: The hon. Gentleman said at the start of his speech that he wanted us to have a grown-up and mature debate on the health service in London. When is he going to start it?

Mr. Duncan: I will be happy to send the hon. Gentleman a copy of my lecture, and I look forward to a sensible critique.

Mr. Gapes: Will the hon. Gentleman give way?

Mr. Duncan: To do so seems like a hopeless way to raise the tone of the debate, but I will.

Mr. Gapes: While the hon. Gentleman is sending out copies of his lecture, will he send out extracts of his book containing the chapter that was in the original version but left out of the reprinted edition?

Mr. Duncan: That rather proves my point.

There are clearly problems in the London ambulance service, and I hope that the Minister will address them in detail when she winds up. We all recognise that national health service staff work very hard but, as I try to argue day in, day out, they are hard pressed and overstretched and are being asked to deliver far more than should be expected of any normal human being, especially on straitened resources. That is certainly the case in the London ambulance service.

The Evening Standard last week carried a large article on the state of the ambulance service, claiming that morale is plunging, that there is a growing staff shortage--not an inherited one--and that sickness and absenteeism are on the increase. It appears that there has been a sharp increase in response times and new figures show that the service is struggling. What steps are being taken to remedy that? It is important to keep response times to a minimum and we need to know what the Government intend to do.

I always try to give credit where credit is due. There was also a survey in the Evening Standard on people's views on GPs in London. By and large, the views were highly favourable, and we should congratulate the GPs--the family doctors--on that. That will change, however, if the Government continue to impose on family doctors structures in the primary care groups with which they are not happy.

What flexibility will be introduced in the way in which primary care groups can be changed? At the moment, doctors are forced into groups, often against their will. The survey shows that most people are happy with their GP, but that people especially like it when their GP is a single practitioner and do not necessarily want to go to a group. How do the Government intend to ensure that satisfaction ratings continue to be high? Moreover, how does the Minister respond to the accusation by the British

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Dental Association this week that it is increasingly difficult to find a national health service dentist in London?

Mr. Gareth R. Thomas (Harrow, West): How does the hon. Gentleman think that Londoners will gain a health benefit from his plan to introduce charges for visiting GPs?

Mr. Duncan: As neither I nor any other Conservative Member has said anything about that, I suggest that the hon. Gentleman goes away and does a bit of research.

The health service in London is a massive endeavour. Like the health service everywhere else in the country, it is doing its best on limited resources--and, as elsewhere in the country, it requires a vision for future health care, which it is not getting from the Government. The Opposition congratulate all those who work in the health service in London, but we look forward to a debate that will go beyond mere political battling and look to health provision for the benefit of future patients both inside and outside the public sector.

2.21 pm

Mr. Tony Colman (Putney): Thank you for calling me early in the debate, Mr. Deputy Speaker, so that I can correct some of the extraordinary statements made by the hon. Member for Rutland and Melton (Mr. Duncan). He started his speech saying that we, as politicians, should not use political licence when we talk about the national health service, but hon. Members on both sides of the House should condemn what he said, especially in the later stages of his speech, because that is exactly what he did.

First, I need to put the record straight about Queen Mary's hospital, Roehampton, so I remind the House what happened before I was elected to represent Putney in May 1997. The decision on the transfer of services was taken in December 1996, and supported by Tory Wandsworth council, by the previous Tory Member for Putney, David Mellor, and by the Tory Government.

The changes, which took place in April 1997, a month before I was elected, involved the transfer out of acute surgery, orthopaedics and paediatric and maternity services, and the downgrading of the accident and emergency department to a minor injuries unit. The services were largely transferred to Kingston, but the previous Government had made no plans for their reception there. There were no additional wards or beds, and no additional help for the A and E department, so there was chaos. That was what I found when I became the Member of Parliament for Putney.

The Turnberg report mentioned the piecemeal erosion of services at Queen Mary's hospital, which had been going on for many years before the decision was made in December 1996, and utterly condemned it. It offered a vision of a new community hospital with a rapid diagnostic unit on the Queen Mary's hospital site, and I was pleased to hear the Secretary of State confirm his commitment to that hospital in his opening speech. I look forward to the business case for it going to the region, and then to Ministers this autumn.

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I note that, in the report on what happened in the year since the Turnberg report was published, there is a commitment of £25 million for the development of that new community hospital. I remind hon. Members that the existing hospital dates from the early 1920s, and many of its buildings are converted Nissen huts. That is a good example of the way in which the health service had to patch and mend for so many years, especially under the Conservative Government. An appalling situation has been allowed to continue for too long, and my constituents and I look forward to the building of a new community hospital under a Labour Government.

Mr. Edward Davey (Kingston and Surbiton): The hon. Gentleman said that services had been transferred from Queen Mary's to Kingston hospital in recent years. I know that he was recently a patient at Kingston hospital, so can he confirm that the transfer of services put great pressure on that hospital, and that it needs backing in the form of new capital and extra resources to meet the transferred demand?

Mr. Colman: I entirely support everything that the hon. Gentleman has said, and I shall deal with that subject later.

Secondly, I shall remind the House of what is happening in the interim, while we are waiting for the new community hospital to be built. A newly refurbished out-patients unit was opened on 27 April by Chris Patten, the former chairman of the Conservative party, who is now a resident of Barnes. The choice of Chris Patten was a cross-party move which I strongly supported.

One hundred consultants continue to work in the out-patients clinics at Queen Mary's, and the rapid diagnostic packages of care are developing. Streamlined procedures for breast care, cardiology, dyspepsia and thyroid care are already in place. Furthermore, at a cost of £924,000, services for out-patients and the elderly that were previously provided at Putney hospital and Barnes day hospital, in outmoded wards, will be transferred to the Queen Mary's hospital site this summer.

I make a particular plea for the continuing use of the Putney hospital site when it becomes vacant. It should remain available for health care purposes, and I especially endorse the bid being made by Abbeyfield nursing homes for housing for elderly people on the site.

As part of the funding package for the new community hospital at Queen Mary's, there is a proposal that land not needed and therefore released--the hospital now sprawls over a large area, so the new hospital will not need the whole site--should be used for the relocation of Whitelands college, which is part of Roehampton institute and the university of Surrey at Roehampton. That will ensure that all the constituent colleges can be on the same site.

One of the services on the new Queen Mary's site will be a healthy living centre, for which a bid will be made in the next round. I also endorse the services provided at the cancer support centre in Wandsworth, which now operates in not totally suitable premises at the Battersea Methodist church mission hall, but has none the less been supported by the local community health trust and the health authority as a centre of excellence for the support of cancer sufferers.

I welcome the introduction of NHS Direct, which is now available for my constituents, and others in south-west London. As the hon. Member for Kingston and

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Surbiton (Mr. Davey) said, although some went to St. George's, the vast majority of the acute services for my constituents were transferred to Kingston hospital in April 1997.

The present Government are having to pick up the pieces of the Tory Government's failed policies, and they built additional wards and provided extra beds in the Roehampton wing of Kingston hospital, which were opened in September 1998--just in time for me to occupy one of the beds the following November, and see for myself the great difficulties that the hospital is having in the A and E department, where I waited for eight hours to be treated. I strongly urge the Minister to take forward the current bid for a £2 million renovation and extension of the existing A and E at Kingston.

I understand that, in the past few days, the local trust has withdrawn the bid, because it foresees some major rebuilding that could cost up to £10 million. However, I am keen to ensure that, from this autumn, my constituents--including me, if I suffer again--do not have to wait as long as I, and they, have had to wait in the past.

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