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Mr. Brazier: How does the Minister reconcile what she has just said--about nothing happening immediately and about working in line with that detailed programme--with EKHA's announcement, out of the blue, that Nunnery Fields hospital, with almost a quarter of Canterbury's beds, is to close this summer?

Ms Stuart: I was going to discuss the Nunnery Fields hospital situation, especially in relation to the care of the elderly. The hospital provides a rehabilitation service for the elderly. It is an old workhouse. It is no longer suitable for the type of care and rehabilitation that we expect to give to elderly people and which they deserve. We expect that, once the reconfiguration has taken place, the hospital care will take place within the Kent and Canterbury.

As I have said, we should focus not only on hospitals but on what is happening in primary care and the support services that allow people--especially elderly people--who do not need to stay in hospital to receive care and support at home or at primary care level. We have spent some £2.5 million to develop primary care and community-based services for the elderly, and there will be an additional £5 million further investment in acute services. More than £500,000 will be directed into the development of transport facilities. I know that the hon. Member for Canterbury feels that that may be insufficient, but I think that we should not sneer at what is a significant amount of money.

I shall now address the issue of the care of the elderly in East Kent, because allegations have often been made that they have been neglected or even marginalised. Nothing could be further from the truth. The health authority is looking after the elderly in East Kent in a very responsive way. For example, community assessment and rehabilitation teams--a joint

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initiative, which is so far being implemented in only one part of the area, although the plan is that there will be four such units--are helping to develop models of care to ensure that elderly patients avoid hospital admissions wherever appropriate, and that patients can be discharged much sooner than they are now.

Modernisation does not only focus on the care of the elderly. We should also take account of such improvements as the booked admissions pilot system. Since it commenced last year, about 40 per cent. of patients who require day surgery have been able to agree their surgery date at their first out-patient appointment.

Two areas were specifically mentioned, one of which was cancer services. The collaborative arrangements whereby we develop a tertiary cancer centre to provide services through an umbrella network managed by the Mid Kent trust are being taken forward. The Kent oncology centre appointed its director in 1999 and there is a policy board to develop the standard of services and support. Radiotherapy services provided at the Kent and Canterbury will continue to be an important part of that service.

I shall deal next with the concerns about renal services that were expressed by my hon. Friend the Member for Sittingbourne and Sheppey (Mr. Wyatt). On the travel argument, he said that his constituents look first to Medway hospital, but as I said before, even within the reconfiguration, 85 per cent. of the people in his area who are expected to go to the Kent and Canterbury will continue to do so. However, the model agreed for the reconfiguration of renal services looks to East Kent and West Kent health authorities providing four satellite dialysis units at Canterbury, Ashford, Maidstone and Medway to support the main renal unit, when it is established in Margate.

Once the new arrangements are in place, they will result in an increase in the number of dialysis stations available, and that relates to the concerns raised about families and travel arrangements. There will be more dialysis stations in the county and the number will increase even further over a 10-year period. At the end of that time, we shall have 26 dialysis stations, which will make life easier for renal patients in the county.

Mr. Brazier: Will the Minister give way?

Ms Stuart: I shall not, in view of the time.

Let me conclude with three assurances for the hon. Gentleman. First, we will ensure that the former Secretary of State's decisions are fully implemented. Secondly, patient safety will not be compromised during the implementation process. The hon. Gentleman was concerned about accident and emergency services and I remind him that, so far, no changes have been made to the services provided in the Kent and Canterbury and none will be made until alternative provisions are in place. Thirdly, robust and adequate services will be put in place in relation not just to accident and emergency, but to all the other services, before there are any changes or any services are transferred.

Question put and agreed to.



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