| Previous Section | Index | Home Page |
Miss Julie Kirkbride (Bromsgrove): My hon. Friend makes a relevant point: what is wrong with the people of Worcestershire; why have the Government broken their promises to them? When discussing the electoral consequences of those broken promises, will he bear in mind the fantastic results that we achieved in the local elections in Bromsgrove, which were the result partly of the closure of Kidderminster hospital, which serves a third of my constituency, and partly of the closure of the accident and emergency department at the Alexandra hospital in Redditch, which is also to be downgraded to a local emergency centre? The people of Worcestershire, and of Bromsgrove in particular, are most concerned about that.
Mr. Gill: My hon. Friend is a doughty fighter for her constituents and has been a staunch ally in the fight to preserve Kidderminster hospital. That must be an object lesson to the hon. Member for Wyre Forest, who should have fought harder for his constituents; his party might then have done much better in the local elections.
Mr. Lock: Will the hon. Gentleman give way?
Mr. Gill: No. The hon. Gentleman has heard what I have to say on the subject. Had he been generous in giving way to me in earlier debates, of course I would have given way, because I like debate; I like to be able to answer his arguments, but he has had time enough in previous debates.
The pressure to keep Kidderminster hospital going on the present basis comes not only from me and my constituents or my hon. Friend the Member for Bromsgrove and her constituents but from right inside the constituency of the hon. Member for Wyre Forest. The Kidderminster and district community health council continues to be totally opposed to the plans, but it is getting nowhere with the Government, who appear impervious to local opinion.
It might interest the Minister to know that a formidable action group fighting for the retention of Kidderminster district general hospital is to go to the High Court at the
end of this month to seek permission for judicial review. That is how strongly my constituents and others feel about the issue. One does not seek judicial review lightly. That is the action of an enormous number of people in desperation at the Government's insouciance in the face of their representations.
I invite the Minister to comment on the fact that, whereas Worcestershire health authority says that the downgrading of Kidderminster hospital will save £4 million a year, the finance director of Kidderminster hospital trust, who should know something about it because he is employed at the hospital, says that the savings will be at best only £300,000 a year.
Which of the figures is correct? My constituents want to know, because one of the figures must, obviously, be wrong. Major decisions are being made on the strength of the figures provided, and it behoves the Minister to tell the House exactly what figures are being used in the considerations.
Worcestershire health authority has a preponderance of representatives from the south and east of Worcestershire, who have clearly voted against the minority of representatives from the north-west of the county, where the Kidderminster hospital is. My constituents feel very sore about the fact that the future of our area is being decided by people from an entirely different part of the country, who have a vested interest in the new hospital that is proposed for Worcester.
The Parliamentary Under-Secretary of State for Health (Mr. John Hutton):
I congratulate the hon. Member for Ludlow (Mr. Gill) on securing time to debate a subject that I know is important both to him and some of his constituents and to the people of Kidderminster and all who value the services provided by Kidderminster district general hospital. It is customary on these occasions to congratulate both Opposition and Government Members on their thoughtful and positive remarks; sadly, on this occasion I will not be able to do that.
I would like to state clearly from the outset that the Government see a very clear and positive future for Kidderminster hospital in the context of our decision on Worcestershire health authority's strategic review of services. That view has been echoed by the health authority.
In the months since the ministerial decision last December, we have made strenuous efforts, with the assistance of my hon. Friend the Member for Wyre Forest (Mr. Lock), to explain that the solution that we have arrived at for Kidderminster is not a closure but a positive change reflecting the needs of a modern health service. I am sad to say that both the hon. Members who have
spoken in this debate have given the false impression that we are closing the hospital. The hon. Member for Bromsgrove (Miss Kirkbride) made that allegation, which is untrue. Such misleading statements do nothing whatever--[Interruption.]
Mr. Deputy Speaker (Mr. Michael Lord):
Order. I would like to think that we could continue this debate without sedentary interventions from any part of the House.
Mr. Hutton:
Thank you very much, Mr. Deputy Speaker.
Both hon. Members have misled their constituents about the Government's intentions. We have no plans whatever to close Kidderminster hospital.
Mr. Lock:
I am very grateful to my hon. Friend for giving way, in stark contrast to the behaviour of the hon. Member for Ludlow (Mr. Gill). I welcome the cast iron, on the record assurance that Kidderminster hospital will not close. May I also have an assurance that 24-hour emergency services, led by a consultant, will remain at Kidderminster, and that the driving force behind the changes, as recognised by the "Save Kidderminster Hospital" campaign's own experts, is strictly medical, and not party political? Will my hon. Friend come to Kidderminster to repeat those assurances and to discuss issues surrounding the implementation of these difficult decisions?
Mr. Hutton:
I can give my hon. Friend all the assurances that he seeks, and I will be happy to go to Kidderminster to explain the situation to his constituents.
The change is not a ruling from on high, but is based on expert clinical advice, sound financial judgment and a spirit of compromise and listening to local views. Let me explain briefly the background to the strategic review in Worcestershire and what it set out to achieve. The Government's White Paper on the future of the national health service emphasised the need for health services to be able to respond effectively to change. The NHS is moving towards modernisation of services provided by hospitals that may serve relatively small local populations.
Current and future medical developments require a complex, modern and comprehensive model of health care. The health service is responding to demands from doctors and other health professionals for the skills and experience that come from greater specialisation. This approach, known as centres of excellence, is aimed at providing patients with the very best that medical science and technology can offer, delivered in well-equipped hospitals with appropriate staffing levels. That was very much the backdrop for Worcestershire's strategic review--the need to secure clinical services that are safe for patients, of high quality, and sustainable in the long term.
Some have suggested, wrongly, that the review was driven by the need for financial cuts in the face of increasing deficits. It is the responsibility of every public organisation to balance its books, and Worcestershire health authority is no exception. On its formation in April 1996, under the previous Administration, the health
authority inherited from North Worcestershire health authority an accumulated deficit of £3.8 million. The health authority has worked hard to contain that position, but overspends by GP fundholders and local costs pressures, especially at Kidderminster health care trust, have worsened the situation. The duplication of services at each of the acute trusts in Worcester has made the delivery of efficiency savings a difficult task in the county, and one certainly cannot sustain a pattern of services that will bankrupt a health authority. However, money was merely one factor in the decision, not a driver.
In reaching the decision, our primary consideration has always been the need to ensure access to clinicallysafe and viable services for the whole county of Worcestershire and its catchment area beyond the county, including the 12,000 south Shropshire people in the constituency of the hon. Member for Ludlow, who are currently served by Kidderminster general hospital. I am conscious of his concerns about increased travel times and I will, therefore, ask Worcestershire health authority to investigate the possibility of providing regular services to take visitors from Kidderminster to the Worcester royal infirmary during visiting hours.
The decision on Worcestershire was based on a very complex process of option evaluation and consultation. Locally, the health authority has been discussing the future of its health services with stakeholders since 1995. That culminated in early 1998 in the consultation document "Investing ln Excellence", which evaluated seven options for change. During the extended consultation exercise, the health authority held 13 public meetings and received more than 1,500 written responses. Those were carefully evaluated by the health authority, and, following the formal objection of the local community health council, were fully and properly reviewed by Ministers.
In arriving at our decision, Ministers took the advice of clinical professionals, both nationally and locally, and we took seriously the issue of local access to services, which I know is very important in rural areas such as north Worcestershire. In short, everything was done to consult properly and fully with the public and local health professionals. We were satisfied that it was not possible to sustain three centres for emergency medicine and surgery in Worcestershire and that the accident and emergency service should be countywide. Some saw that, erroneously, as the end of all A and E services at Kidderminster. Nothing could be further from the truth.
Even now, the health authority is actively involving the local community in implementing the decision. Through the newly formed primary care groups, it has established local reference groups--including users and carers, patient groups and local authorities--to act as a proper sounding board as implementation proceeds. The fact is that, after three years of uncertainty, the service in Worcestershire can now move forward, with a critical, continuing and important role for Kidderminster.
So that we can be clear, let me remind the hon. Member for Ludlow of exactly what was decided by the Government last December. Kidderminster will continue to have a consultant-led emergency service. Major trauma cases will no longer go to Kidderminster and the emphasis there will be on care provided by nurses, backed up by an effective telemedicine link to the countywide A and E service. However, the designated consultant, the post that my hon. Friend the Member for Wyre Forest did so much
to secure, will be responsible for training and clinical standards at the new emergency centre at Kidderminster, and will spend a substantial proportion of his or her time at the hospital.
Our current best estimate is that nearly half the patients who currently use Kidderminster's A and E department will continue to use Kidderminster's emergency centre, but that figure does not take into account the expected advances in telemedicine before the changes at Kidderminster are implemented. Furthermore, all out-patient appointments will continue to be provided at Kidderminster hospital. That represents a much improved out-patient service because specialties currently only available at Worcester royal infirmary will now be available in Kidderminster.
We expect Kidderminster hospital to be a leading light nationally in the development of telemedicine. We have doubled investment in equipment to reflect that desire, enabling local clinicians working at the hospital to treat as many patients there as possible. Further announcements about additional investment will be made in the near future.
There are already some exciting local models of closer working between acute hospitals and primary care, for example, in east Worcestershire and south Shropshire, which includes the constituency of the hon. Member for Ludlow. With the continuing development of primary care groups, I expect the number of those initiatives to increase. I hope that the extra 35 GP-designated beds at Kidderminster hospital--another improvement that my hon. Friend the Member for Wyre Forest did much to secure--will be taken up by local GPs.
We also expect around 70 per cent. of elective cases to continue to be treated at Kidderminster hospital, along with most out-patient services. Furthermore, we expect Kidderminster to keep its one-stop clinics, specialist follow-up clinics, diagnostic testing and out-patient based treatments. Its rehabilitation facilities and cancer resource centre will continue to be developed and improved over the next few years. Indeed, the rehabilitation facilities will be used by patients returning from major surgery in Worcester. In all those areas, services will continue to be provided at Kidderminster hospital.
I pay a special tribute to my hon. Friend the Member for Wyre Forest. As a direct result of his strong and effective representations, the health authority's plans for Kidderminster hospital were amended to ensure the provision of safe local services, including, for example, a consultant-led emergency centre at the hospital; the doubling of the amount being spent on refurbishing and improving the hospital, including an extra £750,000 which the hon. Member for Ludlow conveniently forgot to mention; and making provision for 35 GP-designated beds at the hospital. Unlike the hon. Member for Ludlow, my hon. Friend the Member for Wyre Forest has done an excellent job on behalf of local people.
That is the framework that we have laid down for the health authority. Although the changes will by no means be introduced overnight, it has already begun work on the detailed implementation. Since the announcement on
Worcestershire, the Government have signed up to the brand new £116 million private finance initiative hospital at Worcester, which was promised by the previous Administration but not delivered. If the hon. Member for Ludlow believes that his party's record of expenditure on the NHS was so magnificent, he might wish to offer an explanation of why the Conservatives suffered their worst ever election defeat in 1997. The truth is that people do not trust the Conservatives on the NHS.
My right hon. Friend the Secretary of State began the commissioning work for the new hospital on 19 March. The new facilities at Worcester have been planned to take account of the changes at Kidderminster hospital. There will be sufficient capacity in 2002, when the hospital is opened, to accommodate the anticipated number of emergency and elective patients. The new hospital will enable services to be configured in a way that is clinically and financially acceptable. In the interim, there will be moves towards implementation of some of the service changes agreed on--for example, the development of the ambulatory care centre in Kidderminster.
As part of the consultation, the issue of trust reconfiguration was raised and those consultations are proceeding. I assure the hon. Member for Ludlow that Ministers will be vigilant in ensuring that the health authority is mindful of its responsibilities to consider the implications of its proposals for out-of-county patients and will work with neighbouring health authorities, including Shropshire, to ensure continuity and equity of access to services.
| Next Section
| Index | Home Page |