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12.46 pm
The Minister for the Armed Forces (Mr. John Spellar): The hon. Member for Gosport (Mr. Viggers) has raised important issues. I am fully aware of his longstanding interest in the Royal Hospital Haslar and in the defence medical services generally, which he demonstrated in his speech. I am also pleased that other hon. Members with an interest in the hospital are here, notably my hon. Friend the Member for Portsmouth, North (Mr. Rapson) and the hon. Member for Eastleigh (Mr. Chidgey).
I recognise the concerns of people in the Gosport area about our plans for the Royal Hospital Haslar and about the recent changes in the hospital's paediatric and intensive care services. It is appropriate to remind hon. Members of the problems faced by Haslar and the reason we decided that it should close. The intention to close it is part of the future strategy for the defence medical services announced by noble Friend the former Secretary of State for Defence in December 1998. I assure hon. Members that that decision was taken only after very careful consideration and that closure will happen only when suitable alternative arrangements are in place.
As hon. Members know, Haslar was originally selected by the previous Administration to be the tri-service core hospital following the notorious defence costs study 15 in 1994, to which the hon. Member for Gosport alluded. It was expected to provide the number and variety of cases to enable our medical personnel to develop and maintain their skills and professional accreditation so that they could support operational deployments and provide a high standard of health care. In the event, there has been a considerable shift since then in conventional wisdom in the national health service towards much larger acute hospitals that can sustain a high degree of sub-specialisation. That does not apply only in this case; it is a much broader national debate.
Unfortunately, Haslar does not have a sufficient population fully to support modern specialised services or to maintain training accreditation for our medical personnel. In addition, it is fair to say that our working experiences of closer co-operation with the NHS at the three Ministry of Defence hospitals units in NHS district hospitals at Plymouth, Frimley Park and Peterborough have shown that there are many benefits to be had from such arrangements in this sort of organisation. At the same time, it has become clear that Haslar's running costs are significantly higher than possible alternatives. That matter has been carefully examined.
Our plans for defence secondary care in the Portsmouth area are, therefore, now based on the establishment of a new Ministry of Defence hospital unit in a local NHS trust hospital--the Queen Alexandra hospital at Cosham--which is represented by my hon. Friend the Member for Portsmouth, North. The Portsmouth Hospitals NHS trust plans to redevelop that hospital under a private finance initiative. Hon. Members may be aware that the trust's proposals were approved earlier this year. The Portsmouth and South East Hampshire health authority is leading the process in planning the shape of new services in the Gosport area, and our Defence Secondary Care Agency is a full partner in that process, together with local NHS provider units and primary care groups.
I should like to take the opportunity to make it clear once again that we are committed to retaining Haslar until our new MOD hospital unit is in place at the Queen Alexandra hospital. Any rumours that we have plans to close the hospital before that time are unfounded. I very much welcome the opportunity to reaffirm that. However, that is not to say that there will be no changes in the way services are delivered, as Haslar and the Portsmouth Hospitals trust work increasingly closely together. We have not said that exactly the same services would be provided on the Haslar site right through until its final closure. Hon. Members will, therefore, understand that the timing of Haslar's eventual closure will depend on the establishment of that new hospital unit. That, in turn, will obviously depend on progress on the redevelopment of the Queen Alexandra hospital by the Portsmouth Hospitals trust. As the hon. Member for Gosport will understand, we cannot say categorically how long Haslar will remain open. However, through discussions, we are aware that the redevelopment of the Queen Alexandra hospital is expected to take several years, and, once again, I can confirm that Haslar will remain open during that time.
The former Secretary of State for Health, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), said that the people of Gosport are entitled to top-quality health care. That is why we are working closely with the Department of Health to ensure that the standard of health care is maintained throughout the transition to new arrangements. As hon. Members will be aware, a partnership board has been established to ensure effective management of local health care during that period. As hon. Members would expect, that board includes representatives from our Defence Secondary Care Agency, from the Portsmouth and South East Hampshire health authority and the Portsmouth Hospitals trust--as the main providers in that area.
We had realised that the partnership board might identify services that could sensibly be re-configured before Haslar's closure. That has proved to be the case in respect of paediatrics and intensive care services. The decision to close in-patient paediatric services was made as a result of low activity levels and child patient occupancy, and--an important point that carries weight in all these matters--the impact of those factors on the accreditation of paediatric staff by their professional organisations. On average, only two of the 12 paediatric beds were occupied. Children's acute in-patient and day-case services were thus transferred to the Queen Alexandra and Queen Mary's hospitals on 31 July this year.
I realise that that change caused understandable concern among local people. However, we are assured that the alternative care arrangements put in place will ensure that a high standard of care is maintained locally. Furthermore, out-patient clinics continue to be held at Haslar. The accident and emergency department there continues to treat children who are not seriously unwell, nor suffering from major trauma.
The transfer of intensive care services also became necessary as a result of low patient throughput, which additionally caused problems with the new requirements
for training accreditation in intensive care. That is a subject over which we have little control, because the matter is decided by the professional associations which provide accreditation. Furthermore, there were problems as to the availability of service personnel. The transfer of services to the Queen Alexandra hospital took place on 31 August this year. However, Haslar retains a high dependency unit, and there has been no reduction in the overall volume of intensive care services in the Portsmouth area.
Further re-configuration of services may be necessary. The hon. Member for Gosport has rightly drawn attention to local speculation and concerns about the future of the accident and emergency department at Haslar. He will be aware that the MOD, the Portsmouth and South East Hampshire health authority, Gosport borough council and the save Haslar task force are participating in a workshop on 22 October to review models of accident and emergency care. The workshop will explore alternative ways of providing services with the help of experts in accident and emergency care and emergency medical transport. When a decision is made on future arrangements, it will then be the subject of statutory public consultation.
The priority in any such changes is to ensure that high quality services continue to be available to residents of the Gosport area. The Defence Secondary Care Agency is working with the Portsmouth and South East Hampshire health authority and the Portsmouth Hospitals NHS trust to achieve that. I can assure the House that my Department will continue to work closely with the Department of Health on future health care in the Portsmouth area. The importance of joint management during the transition programme leading up to the closure of Haslar is fully appreciated by all concerned.
Under the local partnership board, a joint implementation management team and a clinical integration board have been set up to plan and manage the transition--including the move of services between sites where that is necessary in order to sustain training and patient care. There is also close co-operation at senior level between my Department and the Department of Health. That co-operation will be not only at official level. Shortly, I shall be meeting my noble Friend, Lord Hunt, the Under-Secretary of State for Health to discuss health care arrangements in the Portsmouth area and other related matters. As the hon. Member for Gosport kindly mentioned, I also look forward to visiting the Royal Hospital at Haslar on 2 November and discussing those issues with task force representatives.
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