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Northwood and Pinner Community Hospital

1.30 pm

Mr. Gareth R. Thomas (Harrow, West): I am grateful for the opportunity to slip under the wire and raise an issue that is important to my constituents in what, I am told, is the last debate initiated by a Back Bencher in Westminster Hall before the dissolution.

Northwood and Pinner community hospital is in the constituency of the hon. Member for Ruislip-Northwood (Mr. Wilkinson), who is in his place today, but it is of considerable importance to my constituents. It is potentially a key location for new, extra intermediate care provision, which could benefit not only my constituents but people in the north of Hillingdon. From meetings that I have chaired, attended by Hillingdon health authority, local residents' associations from Harrow and Harrow West primary care group, I know that Hillingdon health authority is in sympathy with that idea.

I seek from today's debate and from the Minister recognition of the need for ministerial pressure on the London region of the national health service and on Hillingdon health authority to translate that sympathy into detailed planning and the subsequent modernisation of Northwood and Pinner community hospital.

A key finding of the national beds inquiry, published in February 2000, was that

The Department of Health, in a circular in January this year, said that

Intermediate care is good not only in itself but for the wider modernisation of services in the NHS. It could, for example, help Northwick Park hospital to continue to end problems that it has had with bed blocking. That would help to speed up services for those who most need acute hospital care there as well as providing better care for those who no longer need an acute hospital bed.

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I want to set out some of the context surrounding Northwood and Pinner community hospital. Three key developments in the past six years now impact on some of the issues that affect it. Mount Vernon hospital, some one and a half miles from Northwood and Pinner community hospital--a district general hospital until 1995--lost its accident and emergency unit and its paediatric beds under the previous Government. I and other Harrow Labour councillors vigorously opposed those moves before the 1997 election.

In 1998, perhaps not surprisingly, given the attitude of the royal colleges to specialist services being provided at hospitals that are no longer district general hospitals, Hillingdon health authority proposed to move burns and plastics specialist services from Mount Vernon hospital to Chelsea and Westminster hospital. Following considerable public opposition to the proposal, although the move of burns and plastics services from Mount Vernon has been confirmed, they will instead move to Northwick Park hospital, the main district general hospital serving my constituents. I am pleased that the move will keep excellent clinical teams together.

An almost unnoticed feature of that debate was Hillingdon health authority's offer of new community hospital facilities in north Hillingdon to augment existing provision, which Harrow residents were assured would also be available to them and their GPs.

Another key element of the background picture is that the Government's health reforms were being implemented at about that time. They enabled individual high-quality GP practices to band together to form a primary care group and have much greater input into and say about the structure of local health services.

In addition, following the merger with Central Middlesex hospital, the new management team at Northwick Park is beginning to change the culture of a hospital that has always offered generally excellent care once people are under the surgeon's knife, but has not always been known for the quality of its basic administration, the openness of its management or its customer care. I am referring to the part between the GP saying, "You need an operation", and its taking place. That was coupled with an infrastructure that was starved of resources. For example, the accident and emergency unit, which had needed modernisation for at least the past 10 years, helped to give Northwick Park a reputation that few would envy.

Now, however, there is a sense of things changing. The Minister of State, Department of Health, my hon. Friend the Member for Barrow and Furness (Mr. Hutton), opened a completely refurbished accident and emergency unit several weeks ago. New intensive care beds have been provided, and maternity is next in line. Crucially, the strong new management team is much more willing to engage with the concerns of local GPs and residents and, more relevant to this debate, to contemplate providing specialist clinics closer to patients.

In my constituency, a high-quality primary care group is keen to develop intermediate care facilities and take advantage of the promise of modern expanded community hospital provision. Ideally, it can access high-quality clinician support from a changing and modernising Northwick Park hospital. Where better to

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begin the process of developing intermediate care options than at Northwood and Pinner community hospital, which is no more than 500 yd from my constituency and has considerable local public support?

Northwood and Pinner community hospital was opened on 2 December 1924. It was built on land donated by a local family on the condition that it was used for a community hospital or retirement home. The hospital was built with money given by local people, much of it by weekly subscription. Many of their descendants still live in the area and take an active interest in the development of the hospital, which they rightly regard as partly theirs.

Back in September 1983, Hillingdon health authority decided to close the hospital to compensate for a £1 million overspend. As we can imagine, there was a massive outcry from the local community about a decision that was condemned by the entire hospital staff. They were joined by local business and community groups, local churches, all local residents associations and Brunel university medical group. On 26 October 1983, recognising the considerable support for Northwood and Pinner community hospital, those groups occupied it. They locked the front and back doors and excluded all non-medical management staff. The hospital continued to treat patients but under the management of clinicians and the local community. It was occupied 24 hours a day, seven days a week, with pickets outside protesting at the planned closure and the Conservative Government's running of the national health service.

The occupation had the support of almost the entire community. Local businesses sent food, milk, money and equipment. A carol service, which was led by a local councillor after the hospital's chaplain had refused to take part, attracted 200 people, including the writer and actress Mollie Weir, who had lived in Pinner and knew the community hospital well. I was told that she made a special point of travelling across London to give her support. The protesters eventually took Hillingdon health authority to court after it insisted on the closure, and the High Court found in favour of the protestors. Lord Chief Justice Woolf said that the health authority's actions had been wrong and awarded costs against it.

I pay tribute to the leadership of Councillor Keith Toms, who is now deputy leader of Harrow council, who organised a highly successful campaign. Mike Turner, who now chairs a local health watchdog, Community Voice, described it as one of the few cases in the 1980s when a community forced a health authority to keep a hospital open. I continue, rightly, to be pressed by local residents, general practitioners and councillors--not least Keith Toms, but also Councillor Gillian Travers, who I am delighted is challenging the hon. Member for Ruislip-Northwood at the coming election.

There have been various attempts since 1983 to move forward with other developments at the Northwood and Pinner community hospital. Six years ago, the London region allocated £300,000 to build a new two-storey building on the site, but, in its wisdom, Hillingdon health authority decided to build those new premises in south Ruislip instead. Despite such setbacks, the

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community continues to support Northwood and Pinner community hospital through a friends of the hospital group. It has continued to give many thousands of pounds to purchase special beds and baths, and other important patient facilities. The community hospital, working closely with the health centre next door, provides 10 respite care beds, four of which are used by Harrow GPs, 13 elderly care beds, GP admission beds, physiotherapy, occupational therapy and chiropody.

Those facilities, together with the Northwood health centre, are provided in buildings that are:

The hospital offers an excellent opportunity for my constituents to see their GPs delivering intermediate health services that are neither purely primary care nor best delivered in a district general hospital setting. It is local, accessible and strongly supported by the community. Harrow GPs already have access to beds, but they want to see more short stay beds in order to help more Harrow people move from acute hospital back home. In addition to clinician support from Northwick Park hospital, they see no reason why there should not be outpatient clinics for endoscopy, low-tech dermatology, or ear, nose and throat. Why not expanded physiotherapy and chiropody services too? They also want the opportunity for local GPs with specialist skills to deploy and develop those talents further by providing clinics at Northwood and Pinner community hospital.

The refurbishment plans for Northwood and Pinner seem to have had a lengthy gestation period. That is due in part to a wider review of Hillingdon's health economy and the detailed work that the health authority is doing on the implications of the national beds inquiry for intermediate care in its area. I have excellent individual GPs. They want a refurbished and modernised Northwood and Pinner community hospital to provide the intermediate care options alongside a virtuous circle of a strong primary care group and a slowly improving Northwick Park hospital, the local district general hospital.

That vision is supported in my constituency by most of the health care fraternity and local residents. I look now to my hon. Friend the Minister to provide some much needed push to the London region and to Hillingdon health authority to get on with the detailed planning for the modernisation of this important community asset.

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1.45 pm

The Minister for Public Health (Yvette Cooper ): I congratulate my hon. Friend the Member for Harrow, West (Mr. Thomas) on securing this debate, especially as it is the last Back-Bench initiated debate in Westminster Hall this Parliament. It is also gives us an opportunity to discuss the future of a local community facility that is greatly valued by the people who use it. My hon. Friend made a strong speech in support of the local community hospital, but also gave a powerful description of the views of local people. The views of the GPs in the area will clearly be important in the future direction of local services, particularly when the primary care trust will have such an important role.

Northwood and Pinner community hospital has 34 in-patient beds and is located in the London borough of Hillingdon. Although that is close to the border of my hon. Friend's constituency, it is actually in the constituency of the hon. Member for Ruislip-Northwood (Mr. Wilkinson), who is also present today. Ten beds are provided for respite care and 13 beds are supervised by a local consultant physician for patients who may require rehabilitation and physiotherapy following an acute illness, and may be awaiting residential or nursing home placement. Seven beds are provided for Hillingdon GP access and four for Harrow, West GPs. The average length of stay for patients is 28 days.

The ownership of the Northwood and Pinner community hospital transferred to the Hillingdon Primary Care NHS trust when the PCT was established on 1 April 2000. Hillingdon PCT was a first wave trust, one of only two established at that time in London. It is therefore at the forefront of developing the new models of care for the 21st century NHS. The services at Northwood and Pinner community hospital continue to be managed for the present by Harrow and Hillingdon Healthcare NHS trust, but they are being progressively integrated with those run by the PCT. That is why we feel that the views of local GPs will be so important in determining the future direction of services.

The NHS in Hillingdon, in partnership with social services, is keen to implement an inclusive approach involving local community groups to review all its services, to develop new models of service, along with patient care pathways, which will be utilised to deliver the NHS plan. Proposals are being drawn up jointly between all partners, including an estates strategy for providing suitable premises and infrastructure for the services. The Northwood and Pinner community hospital site is an important part of the NHS facilities in the borough and is already providing some intermediate care services.

The PCT is working closely with health and social care partners in north Hillingdon and the local community to determine the future configuration of local services. I know that my hon. Friend will understand that Ministers cannot pre-empt the outcome of local discussions, but I can reassure hon. Members that any proposals for change will be discussed with the local community and, should changes to services be planned, they will be the subject of full consultation. I shall ensure that the points made so powerfully by my hon. Friend about the need for progress and direction are heard by Hillingdon health authority and by the other partners to the local debate. I reassure my hon.

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Friend that the Government are committed to making appropriate and effective use of community hospitals and see an important role for them in delivering local health care and in the future development of intermediate care. I shall follow discussions in the area with interest; we shall wait for local discussions and consultations to take place on the direction that the local community wants to take.

Mr. John Wilkinson (Ruislip-Northwood): Will the Minister give way?

Mr. Deputy Speaker (Mr. Nicholas Winterton): Before I call the hon. Gentleman, I tell the House that, typically and courteously, the hon. Member for Ruislip-Northwood (Mr. Wilkinson) sought the permission of the initiator of the debate, the hon. Member for Harrow, West (Mr. Thomas), of the Minister and of the Chair for his intervention.

Mr. Wilkinson : I should tell the Minister how much local people on both sides of the borough boundary appreciate any interest in a facility of high quality such as the Northwood, Pinner and district cottage hospital. Will the hon. Lady bear in mind the need for balance between the facility at Northwood and Pinner and existing facilities at Mount Vernon and at Northwick Park and Watford? There is hope that there may be opportunities at Mount Vernon for some community services.

Yvette Cooper : The hon. Gentleman makes a good point about the future of services at Mount Vernon. It is important to take them into account and to ensure that there is proper local community discussion and support for their future direction. I undertake to ensure that the points made by the hon. Gentleman are heard by the local health authority and by partners to the debate locally.

The Government recognise the strength of feeling that people have for their local community hospitals, which include Northwood and Pinner, and the value of those hospitals as part of the community that they serve. In the NHS plan, we pledged that, as well as additional money, by 2004 there would be some 5,000 extra intermediate care beds, some in community hospitals, some in existing facilities, and some in new developments. As my hon. Friend made clear, community hospitals are not just about beds; they could be developed for ambulatory care services and as bases for local access to consultant outpatient advice and treatment. Too often in the past, such hospitals have been sidelined and their potential ignored. Now, with a new emphasis on intermediate care and on delivering care closer to home, there is an opportunity to breathe new life into community hospitals.

As hon. Members know, the national service framework for older people was published in March. That tasked the NHS and its partners to work together to develop modern services to meet the special needs of the older population. I understand that in Hillingdon, and in Brent and Harrow, that approach has been adopted in all service areas, including those for older people.

The Government, and my hon. Friend the Member for Harrow, West, want further developments to proceed as quickly as possible. The modernisation of

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local services is in the interests of my hon. Friend's constituents. Local people expect and deserve a modern health care service in their area. It is important to get the right services agreed in the right place to meet the needs of local people. Thorough assessments are being made of local needs. It is also important to ensure that there is proper public consultation about changes, which should not be driven merely by the NHS in detachment from the local community. Members of the local community should have a proper opportunity to comment on any proposed changes. As hon. Members will know, the NHS plan made available £405 million of additional funds annually by 2003-04 compared to 1999-2000 for the NHS component of new intermediate care services to promote independence and improve the quality of care for older people.

The Government have already invested additional funds in excess of £100 million in the NHS in the past financial year to provide intermediate care services, in part to ease the pressures on acute care over the winter. Between them, Brent and Harrow and Hillingdon health authorities received extra investment of £1.3 million, which helped to ensure that long waits for admission at both Hillingdon and Northwick Park hospitals were kept to a minimum over the winter months. Those sums are part of an overall increase of more than £30 million, almost 9 per cent., for Brent and Harrow health authority and £15.7 million, or 9.35 per cent., for Hillingdon health authority for use in the current financial year. Indeed, in its plans submitted for the

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current financial year, Hillingdon health authority has indicated expenditure of £1.7 million on intermediate care services.

It is clear that there is support for expanding intermediate care services. My hon. Friend made a strong argument for the development of intermediate care services at his local community hospital, and we will follow that debate with interest and ensure that his comments are properly taken on board. We support the determination of hon. Members to obtain patient-centred services in modernised facilities for their constituents and to take advantage of all the opportunities that the NHS plan provides.

I look forward to a successful partnership between the statutory and voluntary agencies in the Hillingdon and Harrow, West areas to develop the future for intermediate care and other facilities, so that we can ensure that every patient--elderly patients and patients across the board--gets access to the modern, high-quality care that they deserve from the NHS.

Mr. Deputy Speaker : Before I move the Adjournment, may I say to the Minister that I wish her well, whenever her happy event takes place.

I believe that Westminster Hall has proved of immense benefit, particularly to Back Benchers. Although I am showing a bias, I hope that the experiment of Westminster Hall will be continued in the new Parliament.

Question put and agreed to.

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