House of Commons Hansard Debates for 14 Feb 2000 (pt 44)

Mr. Wilshire: I do not have any great objection to the Minister coming back, but if he intends to do that, why not admit it now?

Mr. Ingram: The date is clearly set out in the Good Friday agreement. It is an objective to which people have

14 Feb 2000 : Column 739

signed up, and that is why we have set it forth. I made the point for argument's sake, and I hope that I will not have to come back. If I do not, it will mean that substantial progress has been made.

The hon. Member for East Londonderry did not rise when I made that point, so I presume that if I have to come back with an amended date, he will be supportive.

We have had a good debate. I commend the order to the House.

Question put and agreed to.

Resolved,

That the draft Northern Ireland Arms Decommissioning Act 1997 (Amnesty Period) Order 2000, which was laid before this House on 1st February, be approved.

EUROPEAN COMMUNITY DOCUMENTS

Mr. Deputy Speaker (Mr. Michael Lord): With permission, I shall put together the motions relating to European Community documents.

Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Standing Committees),

Common Strategy on Ukraine

That this House takes note of European Union Document No. 13523/2/99, the Common Strategy on Ukraine, and the unnumbered Explanatory Memorandum dated 31st January 2000 from the Foreign and Commonwealth Office on the Presidency's work plan on the implementation of the Common Strategy of the European Union on Ukraine; supports the Government's objectives of developing closer, constructive relations with Ukraine; and agrees that the Common Strategy has the potential to make a significant contribution towards strengthening the EU-Ukraine relationship.

State Aid to the Coal Industry 1996-1997

That this House takes note of European Union Document No. 10948/99, Commission report on the application of the Community rules for State Aid to the coal industry in 1996 and 1997; and supports the Government's actions in pressing the European Commission to interpret the Coal State Aid Code strictly.--[Mr. Dowd.]

Question agreed to.

DELEGATED LEGISLATION

Mr. Deputy Speaker: With permission, I shall put together the motions relating to delegated legislation.

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

14 Feb 2000 : Column 740

Education

That the draft Foundation Subject (Amendment) (England) Order 2000, which was laid before this House on 24th January, be approved.

Data Protection

That the draft Data Protection (Subject Access Modification) (Social Work) Order 2000, which was laid before this House on 24th January, be approved.

That the draft Data Protection (Subject Access Modification) (Health) Order 2000, which was laid before this House on 24th January, be approved.

That the draft Data Protection (Subject Access Modification) (Education) Order 2000, which was laid before this House on 24th January, be approved.

That the draft Data Protection (Processing of Sensitive Personal Data) Order 2000, which was laid before this House on 24th January, be approved.

That the draft Data Protection (Miscellaneous Subject Access Exemptions) Order 2000, which was laid before this House on 24th January, be approved.

That the draft Data Protection (Designated Codes of Practice) Order 2000, which was laid before this House on 24th January, be approved.

That the draft Data Protection (Crown Appointments) Order 2000, which was laid before this House on 24th January, be approved.--[Mr. Dowd.]

Question agreed to.

COMMITTEES

Mr. Deputy Speaker: With permission, I shall put together the motions relating to Committees.

Ordered,

12.52 am

Mr. Julian Brazier (Canterbury): I am grateful for the opportunity to hold this debate. I am grateful to my right hon. and learned Friend the Member for Folkestone and Hythe (Mr. Howard), to the hon. Member for Sittingbourne and Sheppey (Mr. Wyatt) and to the Minister for being here to debate this matter well into the witching hour.

It is difficult to exaggerate the scale of concern about the future of acute health services in East Kent, and particularly at Kent and Canterbury hospital. I have received more than 3,000 individually written letters on the subject. It would be out of order for me to refer to the Gallery, but considerable interest is being shown--

Mr. Deputy Speaker (Mr. Michael Lord): Order. The hon. Gentleman is quite correct. It is out of order, and I would be grateful if he did not do it again, on this or any future occasion.

Mr. Brazier: Indeed, Mr. Deputy Speaker.

Since this subject was last debated, the situation has worsened. The hospital is the most heavily used and cost-efficient of all the hospitals in Kent, and the only one in East Kent with a mixture of regional specialist services. I believe that the plans in the "Moving Forward" document will put at risk health care in the whole of East Kent.

In December 1998, the then Secretary of State for Health concluded his considerations of East Kent health authority's so-called "better balance" proposals and sent a letter to Members of Parliament on 22 December, with a further letter following at the end of March to the chairmen of the trusts. The first letter said:

"my decision is to endorse the Health Authority's proposals, subject to a number of conditions."

By any standard, the conditions were major. The letter went on to say that

"the proposals to the Kent and Canterbury A&E . . . are not satisfactory and must be improved."

The letter said that EKHA must

"guarantee that onsite consultant and anaesthetic surgical and medical cover will be provided at the Kent and Canterbury during the day and on-call cover in these specialities . . . out of hours."

That was even reinforced by the condition that

"there will be a designated consultant to develop and lead the Canterbury emergency centre . . . to ensure that a substantial proportion of consultant time is spent at Canterbury",

including

"consultant medical cover for the coronary care unit at the hospital"

and

"and a physician with an interest in coronary care." The Secretary of State also demanded a full review of the provisions for renal medicine.

14 Feb 2000 : Column 742

In his second letter, the Secretary of State gave a further critical guarantee. He said:

"it is clear that many of the respondents to consultation were under the misapprehension that the proposal was to move specialist cancer services, rather than simply the management of those services".

He continues:

"The retention of specialist cancer services at Kent & Canterbury Hospitals was part of that decision. Specialist cancer services at Canterbury, therefore, have a firm future."

He also made a firm commitment to at least 232 beds in Canterbury, as against around 390 at the Kent and Canterbury and the Nunnery Fields hospitals together.

Mr. Michael Howard (Folkestone and Hythe): Has my hon. Friend seen the recent letter written to the chief executive of the East Kent hospitals NHS trust by Mr. Paul Watkins, chairman of the South East Kent community health council, in which Mr. Watkins asks that the implementation of the proposals in "Tomorrow's Health Care" be deferred until the Secretary of State has devised the national strategy that he has promised on the number of beds to be provided in the NHS? Does my hon. Friend think that that suggestion by Mr. Watkins has some merit?

Mr. Brazier: I do indeed. Both my right hon. and learned Friend and Mr. Watkins are right on that point. Last year, in reply to a question that I asked in the House, the previous Secretary of State said in relation to the Kent and Canterbury hospital:

"If it looks as though things are going wrong, I am prepared to step in and ensure that the bed reduction does not proceed as quickly, or as far, as presently agreed".--[Official Report, 11 January 1999; Vol. 323, c. 45-6.]

Even with the commitments that he made, the Secretary of State's decision caused dismay. It will mean the rundown of the full A and E department, which has been in the top third of the major trauma outcome survey for every year since the survey was launched in 1988, and transferring those services to distant units that are still to meet the full standard.

Furthermore, our area is suffering a winter that has seen the most severe pressure on East Kent hospitals. In recent weeks, two out of three acute hospitals in the area have, on several different occasions, been simultaneously closed to all but blue-light work, with bed use running at well over 100 per cent. of nominal capacity, including trollies pushed into offices and corridors. Flu has been part of the cause, but East Kent has some of the largest and busiest road arteries in Europe. Because the mild winter has brought relatively little ice and snow, the road accident work load has been well below average, but still the hospital system has been stretched to near breaking point.

A Government with a large majority can do as they wish. Despite all those considerations, when the Secretary of State made his decision, I decided that the best way that I could defend the services was to engage, rather than simply oppose. He did at least leave us with a single trust responsible for health care, and I have welcomed the meetings with Mr. Conrad Blakey and Mr. David Astley, the new chairman and chief executive.

It was, therefore, with incredulity that I read the "Moving Forward" document, the opening sentence of which reads:

"On 22 December 1998 the Secretary of State endorsed the Health Authority's proposal".

14 Feb 2000 : Column 743

That statement was repeated five times in the text without any mention of his lengthy conditions. On those conditions, I shall leave description of the fiasco over renal services to the hon. Member for Sittingbourne and Sheppey. As for the rest of the items that I have already listed, the Secretary of State's findings on coronary care merit a brief mention on one page, but appear to play no part in the actual plan. Every other pledge has disappeared. The commitment to retain a full cancer centre has been ignored. The commitment to 232 beds has been ignored and no specific bed numbers are mentioned for that site. Consultant cover for emergency work at the Kent and Canterbury hospital has been ignored again.

This imaginative document, "Moving Forward", involves a degree of creative accounting that I can only describe as remarkable. East Kent health authority has carefully kept the capital investment figure just inside the £50 million mark, so that it does not go back to Ministers. Is the Minister content that a health authority can brush aside pledges by the Secretary of State? Is she content to see £50 million of taxpayers' money, along with substantial further sums hidden in revenue flows, go forward without referring the matter back to the Secretary of State to see that the pledges have been maintained?

It is very sad to see EKHA restating the same half truths from the old debate. For example, the document states:

"an economic and social impact study confirmed that the greatest concentration of both the elderly and the socio-economically deprived in East Kent are located in Thanet".

As independent studies show, there are far more elderly people and a slightly greater number of deprived people in the catchment area for the Kent and Canterbury hospital. I raised that point with Mr. Mark Outhwaite, the chief executive, at a public meeting. He pointed out that the people in Thanet live closer together. He is quite right--technically, the largest concentration of elderly and deprived people is in Thanet. Do the people in rural areas, and in small towns such as Whitstable and Faversham, matter less because they live further apart, even though there are more of them? The population figures are flawed throughout the document. Where EKHA got the fatuous growth figure that was fed into the York study team, I cannot imagine. Has it never heard of Serplan, with its projections for huge population growth?

Page 11 of the document says that an implementation plan has been agreed. Yet on page 22, in excusing itself for giving no detail on plans for the Canterbury site, the same document says: