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Dr. Richard Taylor: I want to emphasise the urgency of those changes. Forgive the clinical detail, but some of my constituents with prostate problems have to get up 15 times at night and cannot go to work because they are so desperate, and they require simple prostate operations as soon as possible. I fear that that will not be possible for many months because the trust wants to make major structural changes. It must be made possible, and the facilities already exist. In my constituency, the men of my age—luckily, I am not quite troubled in that way yet—must be able to get their prostates seen to within the next very few months, please.
Ms Blears: The hon. Gentleman makes a very important point. Not just for people in Kidderminster, but for people throughout the country, trying to reduce waiting times is clearly a key priority for us, so that they are seen as soon as possible.
Mr. Luff: Will the Minister confirm that the new surgical facilities that she mentions at Kidderminster are
intended to serve not just Wyre Forest, but the whole county? Will she take on board the fact that none of the county's other MPs has been informed of the outcome of the report to which she has alluded? We have relied on press reports. Will she encourage her colleagues in the Department of Health and, indeed, in the health authority to make greater efforts to explain that those new facilities will serve the whole county? It is very important to ensure that that is understood.
Ms Blears: Yes, the new facilities will serve the whole county, but they are primarily directed in the first instance at serving local people, because they are the people who will have access to them. As the services develop, they will improve for the whole county. I certainly will undertake to try to ensure that the information is made available to as many people as possible. After all, this is extremely good news, and it is certainly in everyone's interest that that information is broadly available.
Matthew Green: The Minister keeps referring to the county of Worcestershire. Is she aware that about 15,000 people in my constituency used Kidderminster hospital? That number is now declining because they have to travel further afield. She talks about the services being available for Worcestershire, but will she also include the many residents in the South Shropshire and Bridgnorth districts?
Ms Blears: I am aware that the hon. Gentleman's constituents have used the facilities at Kidderminster for a long time, and the intention is to provide facilities for as many people, who want to use them, as we can in the area. As the facilities develop and begin to come on stream, local people will be the first priority and then those across the county. Under the new organisation of the health service, it will be a matter for primary care trusts to commission appropriate services for their populations, but clearly they will want to consider the range of facilities available, irrespective of county and administrative boundaries.
We must consider where it is appropriate for patients to go and where it is best for them to get their local services, so I do not view administrative boundaries as an artificial cut-off. The patient flows and clinical networks are important, and putting the power with the primary care trust will enable local communities to commission appropriate services for local people, which will be a significant improvement.
More beds and operating theatres will be provided at Kidderminster, and a wider range of surgical procedures will be available. That is extremely good news for local people. I am also pleased to inform the hon. Member for Wyre Forest that, as part of national commitments to reduce maximum waiting times for operations to six months by 2004, 6,000 more operations will be carried out in Worcestershire. Thanks to Professor Darzi's recommendations, it is envisaged that Kidderminster hospital will carry out about 2,500 of those extra operations. That should result in more local people being treated more quickly and more conveniently at Kidderminster.
The hon. Gentleman will also appreciate, given his background, that local clinicians and health care managers need to ensure that the Kidderminster diagnostic treatment centre is well planned, successfully introduced and provides high-quality services. Of course, we are anxious
to avoid any delay in implementing Professor Darzi's recommendations, but the Health Act 1999 places a statutory duty of quality on the health service. We must ensure that we put in place arrangements to monitor the standards of the services provided.As hon. Members have noted, the local primary care trusts will play a pivotal role in leading the development to ensure that the all health organisations in the area take part in developing the service and that they have a commitment to supporting it in the future. It will therefore be necessary to develop protocols for referrals, training and new ways in which new clinical services are to be introduced.
The local health community anticipates that the trust will be in a position to implement many of the report's recommendations before the planned opening of the diagnostic and treatment centre. We intend to get on with that as quickly as we possibly can. At the same time, we shall maintain the high-quality standards that local people are entitled to expect.
Miss Kirkbride: That news will be extremely welcome to my constituents. I enter a caveat, however. Is the Minister aware that the accident and emergency department that was at Kidderminster is now a minor injuries unit and that accident and emergency services are now provided at the Alexandra hospital and the Worcester hospital? Clearly, if in-patient surgery for people having fairly serious operations takes place at Kidderminster hospital, the present arrangements for accident and emergency will have to be beefed up so that more than the current service for minor injuries is provided.
Ms Blears: I commend the hon. Lady's ingenuity in raising the issue of accident and emergency services. I shall come to that shortly. However, I assure her that issues of clinical safety and those relating to high-quality services will be paramount. Therefore, the developments will take place in the context of the whole service. They will not take place piecemeal without any recognition of the knock-on effects that they may have. I am not convinced that that means there will be a full-scale accident and emergency centre at Kidderminster, but I will come to that point shortly.
In February this year, the Secretary of State announced that 26 new diagnostic and treatment centres will be opened to try to increase the number of routine scheduled operations that can be carried out. By separating them from emergency work and by protecting both streams of work, we can have a real impact on waiting times.
The new centre at Kidderminster will allow for virtually all the non-emergency, hospital-based health care to be provided for the Wyre Forest population locally. It will also attract those patients from elsewhere in the country—and, no doubt, from Shropshire—who wish to take advantage of the state-of-art facilities proposed.
It is important to stress again that Kidderminster hospital is not closing. In addition to day-case provision and a comprehensive range of out-patient services, Kidderminster hospital currently provides a purpose-built chemotherapy suite that supports cancer services, paediatric day assessment and home-based support, a midwifery-led unit, a minor injuries unit and a specialised medical rehabilitation ward providing services for patients recovering from medical conditions such as a stroke,
together with a range of back-up diagnostic facilities. It is important to reassure local people that it will be a centre of excellent health care for themselves and their families.Approval has already been given for the development of a new satellite renal dialysis unit to be housed in the Kidderminster diagnostic treatment centre. The centre will also have up to 20 short-stay surgical beds in single rooms with en-suite facilities.
Worcestershire health authority gave a commitment to keep all services running at Kidderminster hospital during the building of the diagnostic and treatment centre. The hon. Member for Wyre Forest will appreciate therefore that the decanting of services needs to be planned with extreme care to ensure that it proceeds as smoothly as possible.
The immediate development of short-stay in-patient facilities would almost certainly result in other services being moved around the site. That might make it difficult to keep all the existing services operating, so we need to make sure that the plans go forward in balance and that we recognise the effects on each of the constituent parts of the service. That requires extremely careful planning.
It is planned to open short-stay surgical beds on a Monday- to-Friday basis for patients with an average length stay of between 24 to 48 hours once suitably qualified staff have been recruited. That is an immediate step that can be taken as soon as staff are in place, and it will ensure that an overnight facility is provided. Additional operating lists have been identified that could take place in Kidderminster to increase the range of services available and these should be in place within the next three to six months. They will come on stream very quickly.
The full business case for the new centre is due to be completed by the end of this month. The current plan is for construction on the refurbishment of some buildings on the Kidderminster hospital site to commence in June or July 2002 with a view to full opening in the autumn of 2003. On completion, all Professor Darzi's recommendations will be implemented in full.
As for accident and emergency services, the decision to remove blue light services from Kidderminster was a clinical one, based on real concerns about maintaining high standards of clinical safety where three accident and emergency departments were fairly closely situated. Our overriding duty has to be to put the safety of patients first. I am not aware that any compelling evidence has been produced to convince the health community or Ministers that it would be both safe and viable to provide blue light emergency care from Kidderminster.
The hon. Member for Bromsgrove (Miss Kirkbride) mentioned the minor injuries unit, which is one of the most successful of its type. It has an overall throughput of 20,000 patients and is seeing 75 per cent. of the number of people who used to go to accident and emergency. It is a major part of the service and functioning extremely well. It has well developed protocols with the ambulance trust. The extra investment of £1.3 million has enabled the trust to provide additional crews with high-dependency facilities and additional front-line paramedics to support the ambulance service, which is also functioning extremely well, to ensure that patients are taken to the right place immediately. From April next year the constituents of the hon. Member for Wyre Forest will benefit from access to the new £87 million
hospital in Worcester which will combine state of the art accident and emergency facilities with appropriate clinical expertise.
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