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3.33 pm

Mr. John Cryer (Hornchurch): I was pleased to hear my right hon. Friend the Secretary of State refer to the new Oldchurch hospital with an air of imminence, which gave me the impression that it cannot be too far away.

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I pay tribute to my hon. Friend the Member for Romford (Mrs. Gordon), who has campaigned for more than a decade to keep the hospital open. Without a shadow of a doubt, if the Tories had won the last election, Oldchurch hospital would have been closed and the accident and emergency department would have been shifted to Harold Wood hospital. That would have disadvantaged my constituents and those of my hon. Friend enormously.

I have quite a long constituency, which extends down to the River Thames. People from Rainham, which is next to the Thames, would have had enormous difficulty travelling to Harold Wood hospital by public transport. Oldchurch hospital is situated in the centre of the conurbation and it is much easier to reach, particularly for older people who travel by public transport. Its proposed closure was little more than an asset realisation: the previous Government planned to sell the land for the maximum price and to concentrate hospital services on those parts of the trust property that were worth considerably less.

We can thank the Labour Government for keeping the hospital open. However, I have some doubts, not about Oldchurch, but about some of the new hospital schemes. I have read in the past few months about the bed levels proposed under those schemes. I realise that the greatest bed reduction since the founding of the national health service in 1948 occurred during the 1980s, when there was a 33 per cent. reduction in the number of beds across all specialties in the national health service. The biggest single reduction was in the number of mental health beds, which were cut by 50 or 55 per cent. That is why, in the past few years, deeply vulnerable and sometimes dangerous people have been left to wander the streets without proper care and medication. The most notorious case was that of Christopher Clunis.

Some of the new schemes propose a reduction in the number of beds to eight or nine per thousand people. The traditional national health service standard is 13, 14 or 15 beds per thousand people. I am more than willing to recognise that technical advances have changed the situation considerably. However, what will happen if there is a winter crisis when many elderly people fall and break hips, legs and arms? If the number of beds is reduced--notwithstanding the huge technical advances--what will happen in those circumstances? I hope that the Minister for Public Health will answer that question when she replies to the debate.

I would like to touch on one or two local problems, the principle one being the shortage of speech therapists. I suspect that that is a national problem, but it seems to be particularly acute in Havering. The health trust covering Barking, Havering and Brentwood, which is responsible for primary care services and therefore for speech therapists, is starting to address the problem.

Dr. Jenny Tonge (Richmond Park): Does the hon. Gentleman agree that shortages are a problem common to all paramedical services in the NHS? There is a shortage of all the people who help doctors and nurses in their work. That is due primarily to the very low rates of pay, which the Government have failed to address this year.

Mr. Cryer: I agree that there is a shortage of people working in the NHS in all sorts of specialties. However, the shortage of speech therapists--which, as the hon.

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Lady pointed out, is a national problem--seems to be particularly acute in Havering. I am not sure why that is so. The local trust is beginning to address the shortage but, apart from pay, the root of the problem nationally is that we are not training enough speech therapists. We are probably not training enough physiotherapists and other specialists in those sorts of fields either.

Most of those who go to speech therapists in my area--and probably across Havering, Barking and Dagenham--are children who suffer from learning difficulties, attention deficit hyperactivity disorder, autism and other conditions. They are extremely vulnerable. After they have had speech therapy for a few weeks, their therapist disappears and they have to wait for another block of therapy. Those patients are placed in an increasingly vulnerable position. Parents of such children have told me that their children are enormously disturbed and distressed when the therapist whom they are used to is replaced after a few months. I hope that my right hon. Friend will turn her attention to that issue at the end of the debate.

I receive many complaints from older people about an apparent inconsistency in NHS treatment. I draw my right hon. Friend's attention to a survey conducted by Age Concern which was released on 9 April. According to the survey, one in 20 people aged over 65 has been refused treatment by the national health service. A further Age Concern report, by Professor Peter Millard, which was recently released, claims that hospitals could make 72,000 more admissions a year if health and social services worked together to provide comprehensive rehabilitation packages. I know that partnership is an important part of the present programme, but it does not seem to be as effective as I had hoped.

That point brings me to issues that are not directly associated with the national health service, but affect the way in which it works. I refer to living and working conditions. If we started to tackle those in a big way, we would begin to modernise the health service on an enormous scale. We can build all the hospitals and clinics that we like and set up primary care groups, but if we do not tackle conditions that allow, for instance, employers to take advantage of employees and disregard health and safety at work legislation, which in many cases is too loose, we will not achieve very much.

This year, for example, about 4,000 people are expected to die of diseases related to working with asbestos. That figure will go up, not down. An easy way to start to tackle the problem, at least for future generations, would be immediately to ban the importation of asbestos, tighten up on health and safety at work legislation and allow the criminal prosecution of employers whom the court views as criminally negligent; that is difficult to do at present. If we started to make such differences, we would make an enormous impact on people's lives, and relieve some of the burdens and pressures on the national health service.

Those who originally argued for the creation of a national health service and eventually achieved it--I refer to people such as Jimmy Maxton and Nye Bevan--certainly did not foresee a health service run by an enormous army of managers and bureaucrats appointed by the Tory Government. They foresaw a democratically run organisation controlled not only by those who used it, but by those who worked in it, and in the longer term, we should move towards that position.

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3.42 pm

Mr. John Wilkinson (Ruislip-Northwood): I am glad that the hon. Member for Hornchurch (Mr. Cryer) referred to the need for a democratically run health service. A theme that I have come across throughout my political experience as a Member of Parliament in London is the gap between my constituents' aspirations and what the NHS is able to provide. The NHS bureaucracy is unwilling to accede to local people's wishes. The hon. Member for Romford (Mrs. Gordon) emphasised this when she spoke from her committed experience of 10 years of fighting for her local hospital, and made it absolutely plain how difficult it was to get the message across.

My hon. Friend the Member for Uxbridge (Mr. Randall), in a speech of great eloquence and force, again brought home our problems in the Hillingdon borough in ensuring that a strongly articulated and well-organised campaign is translated into effective action on behalf of local people by the NHS bureaucracy. To a large extent, it remains to be seen whether we have succeeded.

I shall touch on one or two themes to which the Secretary of State referred. First, London should be the centre for medical research. At Mount Vernon hospital and Harefield hospital in my constituency, pioneering research goes hand in hand with the most advanced clinical treatments--in cancer, burns and plastics at Mount Vernon, and in cardiothoracic treatments at Harefield. The Secretary of State said that it is important to combine research facilities and clinical services. I hope that his policies will bring this about at Mount Vernon and Harefield. He said also that local people want to have access to the highest-quality care. In west London, they have it at Mount Vernon and Harefield. The question is whether they will continue to enjoy it.

I am delighted that the Secretary of State announced again the £2 million of new resources for the second stage of the heart science centre at Harefield hospital. The centre is a monument to Sir Magdi Yacoub's pioneering work in heart and lung transplantation and cardiac treatments generally, and its work is recognised the world over, as is that of Harefield hospital, as my hon. Friend the Member for Uxbridge explained. The hospital is as excellent as it is because of the quality of Sir Magdi and his team.

My hon. Friend the Member for Rutland and Melton (Mr. Duncan) said that there was no asset more important to the national health service than the people who work in it, but he said also that the health service is more effective if there is a genuine partnership between the public and private sectors. We have this in the research work done at Harefield and Mount Vernon; Mount Vernon has important private medical facilities in the Bishopswood hospital, as well as the privately funded research which is conducted at the site.

I shall concentrate on the health service as it is perceived locally because that is how it is judged throughout the capital. It is only by the quality of service delivered to our individual constituents that we can make an informed judgment. In an intervention on the hon. Member for Romford, the hon. Member for Ilford, North (Ms Perham) said that, in the process of modernisation, we should not forget the potential for improving good hospitals. In essence, we should not put all our eggs in new baskets.

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There is a drive in the NHS to create more and more brand new hospitals, funded by the public or by the private finance initiative. They have their role, and we welcome them where they are created, but they should not be built at the expense of centres of excellence that have been built up, in some instances, over generations, which still do pioneering work and could do even more such work for a relatively modest input of additional funding. I hope that the cautionary tale I shall tell today will have genuine relevance, particularly for building on success.

Mount Vernon hospital is the biggest cancer centre on a single site in the south of England. The Secretary of State has referred again and again to the importance of cancer treatment; it is at the heart of his strategy for the NHS. One wonders how he or anybody in the NHS bureaucracy could contemplate undermining a cancer centre of such strategic importance and excellence.

Undoubtedly, cancer treatment is enhanced if there are plastic surgery facilities on site, as there are at Mount Vernon. This is not a run-of-the-mill facility, but, with its burns unit and the research done at the site, a comprehensive one. It brings in a great deal of private capital and exciting research, particularly through the Restoration of Appearance and Function Trust charity.

This charity is recognised and appreciated in the House. Many questions have been asked in the other place about its future, and the all-party fire safety group appreciates its work. I must remind the House of RAFT's origins. They lie in the generosity of the consultant plastic surgeons at Mount Vernon who, from their own salaries, put money aside to fund research into plastic surgery and burns treatment. From that small acorn a mighty oak of research has grown, which is internationally recognised and greatly appreciated in the House.

So important is the burns facility that, when its future was called into question, I challenged the chairman of the then North Thames executive, Mr. Ian Mills, to a bet. Mount Vernon is ideally located for burns and plastics work by virtue of not only its complementarity with the cancer unit, but its location. It is in the same borough as Heathrow airport, quite near RAF Northolt and at a modal point of the M4-M1-M40-M25 network. Helicopters may also land there, which is important.

I hypothesised to the chairman of North Thames on the dire eventuality of a major air accident at Heathrow involving many burns casualties. I said, "We will go to Heathrow, you and I, in my car, pretend that an air crash has occurred, and time the journey to Mount Vernon as against that to Chelsea and Westminster hospital," to which Hillingdon health authority was at that time suggesting the burns and plastics unit should be transferred. I said that, if we could get to Chelsea and Westminster in a lesser time, I would give Mr. Mills a crate of champagne. Understandably, he did not take the bet because he knew full well that he had not a hope in hell of winning.

The health authority's incomprehensible proposal aroused huge hostility in the community. There was a series of so-called consultation meetings, which were a charade; the general public asked questions, but the bureaucrats refused to answer them. It was only by dint of massive effort that, in October, we persuaded the regional health authority at least to look again at the future of the burns and plastics unit. An expert committee was established under Professor Lessof. The committee is still

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sitting and I believe that it is due to come to its conclusions today. We know that its favoured conclusions--my hon. Friend the Member for Uxbridge described them--are a move either to Hemel Hempstead or to Northwick Park.

I think that I have explained the importance of keeping the burns and plastics facility next to the cancer unit at Mount Vernon, but I should like to mention also the consequences for RAFT, which is a privately funded charity. Why should the donors, who have been so generous over the years, bear the cost of their unit being translated to Northwick Park? I know that a number of Mount Vernon's consultants have said that they are not against the move to Northwick Park and are quite sympathetic to the idea--but only as a second best, because they believe that NHS bureaucrats have prejudged the issue and are determined, whatever the arguments in favour of Mount Vernon, to ignore them and to see that the facility moves elsewhere.

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