Previous SectionIndexHome Page

5.15 pm

Dr. Jenny Tonge (Richmond Park): Once upon a time, the people of Richmond had good GPs, a little hospital called the Royal hospital and social services delivered by their local council. It all seemed relatively simple and easy. If they needed secondary or tertiary care, they went to any of the many London teaching hospitals because in those days GPs could refer them anywhere.

Then the Royal hospital closed and we were told that we had to use Queen Mary's hospital in Roehampton. Several hon. Members have spoken about it. It was formed into the Richmond, Twickenham and Roehampton Healthcare NHS trust, which was rather difficult because it meant that social workers in my borough were dealing with three different district health authorities and two area health authorities. That made for great confusion and obfuscation between hospital, community and GPs about where patient care was coming from.

After a long fight--I empathise with the hon. Member for Romford (Mrs. Gordon) about candlelit vigils, mock patients on trolleys and petitions to Downing street--the death sentence on Queen Mary's hospital was passed by the Conservative Government. The Labour Government, in their defence, had no option but to carry on with those plans when they came to power, unless they could have dug up a huge amount of cash from somewhere, which they were unable to do.

My constituents are now left with a hospital service which consists of an out-patient service for one part of the constituency at Queen Mary's hospital, Roehampton, which is not in the constituency and is run by consultants who are based at Kingston hospital, which is on the borders of my constituency and relates rather more to that of my hon. Friend the Member for Kingston and Surbiton (Mr. Davey)--I hope that we will hear from him later, Mr. Deputy Speaker, if you call him. As a result, there is great confusion and I should like the Minister to take that on board.

The health service has never solved the problem of medical records. Patients are seen in out-patients departments and somehow notes get lost when they then have to be in-patients, or vice versa. I have never understood why we have this problem. I worked in the NHS for 32 years before I became a Member of Parliament and notes were always getting lost. It seems to me that we have two options: either we can go in for technology in a big way and call up patients' records on screen or patients can be responsible for their own records. Why on earth can that not happen? It happens in other countries and I fail to see why we cannot have our own records with us when we go to see a consultant or our GP. They can keep records too, if they want to, but at least some notes would exist.

The other big problem is that because of the shortage of nurses in the London area, many beds at Kingston hospital remain closed, despite valiant efforts by the chief executive to recruit nurses. Hon. Members may have read in the newspapers about nurses being recruited from the Philippines, and very good nurses they are too. Despite all those efforts, beds remain closed. Because of the demography of the constituency and that of Kingston, many beds contain elderly medical patients. We now have an added problem. At Kingston hospital, surgical consultants do not have enough surgical beds because such beds are blocked by medical cases. The consultants

6 May 1999 : Column 1161

are becoming extremely worried that, sooner or later, the royal colleges will decide that there is not enough surgery taking place at Kingston hospital and they will no longer accredit the hospital, which means that there will be no junior staff. That is how Queen Mary's hospital started to die about 10 years ago. I am extremely worried that Kingston hospital will suffer the same fate, if we do not do something urgently about funding and the nursing complement. We must ensure that the area has a comprehensive service.

In my constituency at present, patients go to Queen Mary's or Kingston for out-patient treatment and they go to Kingston, St. George's or Chelsea and Westminster hospital for in-patient treatment. The mental health services have been transferred to Kingston and the district community trust. The trust has already stated that 20 beds for the elderly mentally ill will be closed--that is exercising me a great deal. The Twickenham community health service has been hived off to the primary care group in Twickenham, which is excellent news. As the community health services in Richmond were part of Queen Mary's, Roehampton, they have been merged with the Merton, Sutton and Wandsworth community trusts. If hon. Members are a little confused, they should imagine what it is like to be a district nurse, social worker or GP in my area, who is trying to work out exactly where the services have gone and where they can be accessed for patients.

That leads me to a general point: people in the health service are entirely sick of being reorganised. I hope that the Minister takes that fact on board--indeed, I know that she will do so. We have been reorganising the health service since 1974--major and minor reorganisations. Each chief executive who takes up his post undertakes a whole reorganisation of the staff under him. The staff of the health service expend all their energy, innovation and intelligence trying to cope with management changes, when they should be dealing with patient care. I make a plea for an end to further reorganisations.

In my area, luckily we have extremely good GPs. I very much welcome the formation of primary care groups; I think that they could be the answer. They could certainly be the answer to achieving that magic quality of coterminosity, which my area has failed to achieve in 25 years of health service reorganisation. Good primary care groups, running their own community health services and liaising even more closely with social and mental health services, could be the answer. Such groups are a brilliant idea; I hope that they are very successful and I congratulate the Government on introducing them.

However, I have some worries. Although NHS Direct and walk-in health shops are a good idea, I think that some GPs consider that those services might undermine GP services. I hope that, in time, the Government will try to merge NHS Direct and the walk-in health shops with the primary care groups. Perhaps the Minister could address that point in her closing remarks. GPs need and deserve to know what is happening to their patients, and who is responsible for their care. Is it the GP, the doctor in the walk-in health shop or the NHS Direct nurse at the end of the phone line? That matter must be addressed, because we need co-ordination. At this stage, money for the formation of those groups could have been much better spent on GP services.

I promised to be brief and I want to deal with two other aspects. The document setting out the goals for the modernisation of the health service in London states that

6 May 1999 : Column 1162

London leads the way nationally in specialisms and expert care. Of course it does. However, there is a problem that I hope that the Government will address. The hon. Member for Ruislip-Northwood (Mr. Wilkinson), who is no longer in the Chamber, raised the issue of a hospital that is brilliant at one service, but depends on another service for its brilliance. He asked how far one could actually separate them. I do not think that the hon. Gentleman's example was a good one, but I know a better one, involving a hospital very close to this place.

The hospital has a major trauma centre, but no longer has a neurosurgery unit. As the House knows, trauma centres usually take large numbers of head injuries, which often require neurosurgery, but the neurosurgery unit has been moved to another hospital several miles away. Because of that, neuroradiology--the specialty that attempts to find out what is happening inside the head and spine before the surgeons go in--has become unpopular in the hospital and the consultants have moved elsewhere. The result is a major trauma unit that cannot provide a good head injury service, and that worries me.

There are countless other examples of interrelated services, one of which is that maternity services have to be close to paediatric services--they must be in the same hospital. It is a source of concern that, as hospitals become centres of excellence and concentrate on one specific service or another, which is good in its way, we shall lose the combination of services that is essential to patient care. I hope that the Government will address that issue.

I heard yesterday from a group of senior managers that, despite the apparently magnificent extra funding that the Government are giving to the health service--I think the figure is £21 billion over three years, but I cannot be sure; it is like my own income, which is spent in several different directions at once, and I never know where it has all gone--most health authorities expect to be in a standstill position this year. That is because of pay awards and the extra money that they have been given being ring-fenced for specific projects, such as breast cancer services. Those projects are all worthy of our support, but they might not have been each health authority's priority this year. Because the health authorities will be at a standstill, we shall not see huge improvements or people rushing out into the streets saying how wonderful everything is and how they do not have to wait long for treatment any more.

We must take a serious look at what we set up in 1947, because the problems of the health service will never be solved by reorganisation or small amounts of funding. We need huge hikes in funding and we have to decide whether that will come from general taxation or some other source. The health service needs far more than what the Government are providing at the moment. The health service was created to cater for us from the cradle to the grave. Then, it had to cater for us from the womb to the tomb. It subsequently had to stretch its resources from the sperm to the worm. Now--I am glad that the Secretary of State is no longer here, because I have already told him this joke, which is far better than his--the health service has to cater for us from erection to resurrection. That cannot be done--we have to find another way.

Next Section

IndexHome Page