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14 Nov 2002 : Column 224—continued

Dr. Murrison: Does not the hon. Lady agree that her dilemma may be resolved if the Government give us a proper timetable for the rolling out of foundation hospitals? If that timetable were tight, the issues that she is describing would not arise.

Glenda Jackson: I regard the hon. Gentleman's intervention as somewhat flippant. We are talking about major fundamental changes in the provision of health services by the creation of a new tier of hospitals. The Secretary of State pointed out that a much more detailed presentation of what will constitute a foundation hospital will be published, but I have been at some pains to point out that not everyone is as capable—by virtue not of a lack of intelligence but, certainly in my constituency, of not having English as a mother language, for example—of voicing their concerns. If there is going to be genuine consultation on the issue, that consultation must enable everyone who will be affected by the creation of foundation hospitals to voice their opinions. I deeply regret allowing the hon. Gentleman to intervene. [Interruption.] I am entitled to voice my opinion. If Conservative Members do not like it, it is their hard luck.

Centrally and essentially, my concerns stem from my perception that foundation hospitals will not present to users of the health service a more open, more transparent service, where they are genuinely in control and truly the drivers of the quality, type and range of health services that they require. I am open to argument. It would be nice if my mind could be changed by what the Government produce for us to view, but at the moment I am deeply suspicious. It seems that the move will create a two or even three-tier NHS. That is not what the NHS should be about. It is certainly not what a Labour party and a Labour Government should be about.

5.19 pm

Mr. John Horam (Orpington): I am very glad to be called before I succumb to deep vein thrombosis, which might result from sitting on these Benches for a prolonged period. That would be particularly unfortunate during a health debate. However, I am sure other hon. Members have similar complaints.

A fortnight ago, the chief executive of my local hospital trust, the Bromley Hospitals NHS trust, held a meeting in response to the concerns of local residents about hospital treatment in the area. This was occasioned by an incident where a disabled and blind 87-year-old man who had had a series of strokes was kept waiting on a trolley for 32 hours in Bromley hospital. He was neglected to the extent that when his daughter arrived to see him on the day he died, he was lying in a

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pool of his own vomit. It is said that he spent his final hours praying to God for help—he got none from the local hospital. The hospital acknowledged that it had clearly failed in his case.

Although that case is a shocking example of what can happen, in terms of waiting times in accident and emergency it is far from unique. Indeed, at the meeting to which I referred, the chief executive responded sensibly by agreeing to set up a committee of hospital users and relatives to look at cases where hospital care had clearly gone inexcusably wrong. He has also implemented a number of welcome short-term measures to do with accident and emergency. This shows that managers in the health service, of which that chief executive is a fine example, are genuinely very responsive to the problems that they face. The difficulties are certainly no reflection on the staff, who are not only responsive but caring and hard working. The problem is that all too often hospitals are overwhelmed by staff shortages, particularly nurse shortages, and by poor facilities.

Bromley hospital operates on three different sites. Indeed, until a few months ago, Orpington hospital operated in prefabricated buildings that were built during the first world war. However, help is at hand as a new hospital is due to open next April. It is a happy coincidence that I was a Minister in the Department of Health when most of the planning took place, although I give the present Government credit for continuing with the plans and bringing them to fruition. The right hon. Member for Holborn and St. Pancras (Mr. Dobson) was Secretary of State at that time and I give him and the Government due credit for that. As he will be aware, there is one problem, however. The new hospital, which is a PFI hospital, has fewer beds than are now spread over three hospitals. We have already discussed delayed discharges, and as the present hospital has only one star, it is far from being a foundation hospital because of the number of cancelled operations, the readmission rates and the waiting times in accident and emergency to which I have referred. As a consequence, although there might be a shiny new hospital, the circumstances facing local residents may well be worse.

In addition, the plan suggested that the space that patients occupied should be turned into offices for accountants and administrators. As a consequence, I started a campaign, together with a local group, the community care protection group—a dedicated group of women who campaign locally on health issues—to save the beds in the Orpington hospital. Our slogan, not unnaturally, was XBeds not bookkeepers". It was rather obvious, but effective. As a result, we got 11,000 signatures and we were able to go to the primary care trust to present the case for keeping the beds.

Our first suggestion was that the beds be kept for intermediate care because, as health experts will know, there is a severe shortage of care beds and private care facilities. If we are to deal with bed blocking or delayed discharge, some intervening care facility must be available, and here was a hospital with beds in it that could be used for precisely that purpose. To begin with, the PCT was somewhat chary about the suggestion; possibly because it was entirely new and, as a result of the continual reorganisation of the bureaucracy of local

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health, had been in existence for only a few months and had succeeded another organisation that had lasted only a year. Therefore, the trust felt that it had to hang on and be careful before committing itself to something of that kind.

In the end, the PCT agreed that the beds in Orpington hospital should be kept open—for the purposes, possibly, of intermediate care—for 18 months, which will at least see us through the period until April 2003 when the new hospital is up and running. However, the fact was that it was only an 18-month reprieve, but the Bromley Hospitals NHS trust came forward with a better solution when it applied for inclusion in the Government's programme for diagnostic and treatment centres, a programme that the Government have been rolling out for some time.

Bromley was not in the first tranche but has applied to be in the second tranche, on which decisions have to be taken. I should be grateful if the Under-Secretary would convey to her right hon. and hon. Friends my request that a decision be made on the issue. Is Bromley Hospitals NHS trust to be included in the current tranche for diagnostic and treatment centres in south London? I understand that that is a possibility, and that Guy's is another candidate for the programme. I would like an indication this evening as to whether that decision will be made in the near future. We understood that the decision was to be taken in October; it is now November and we need a decision as soon as possible. In that respect, I pay due regard to the Government's decisions on these matters, which have been helpful.

As the Secretary of State said, investment is not the only issue; there are also the issues of recruitment and reform. I, too, welcome the fact that the Government are climbing out of Labour's long-held views about the need for institutions such as the NHS to be run in a monolithic, state-funded way with heavy trade union organisation. I agree that it is a step forward for Labour to move towards Conservative ideas of greater diversity of supply. That is sensible.

What I fear—and what, I think, the Prime Minister fears—in the light of the opposition we have heard today from the right hon. Member for Holborn and St. Pancras, and the hon. Members for Hampstead and Highgate (Glenda Jackson) and for Doncaster, North (Mr. Hughes), as well as in coded phrases from the Chancellor of the Exchequer and from trade unionists, is that that opposition will prevent the Prime Minister from going fast enough and on a broad enough basis to bring about the improvements in public services, and particularly health, that we desperately need.

5.29 pm

Mr. Kerry Pollard (St. Albans): The hon. Member for West Worcestershire (Sir Michael Spicer) was complaining about the Tories' poll position. I have some comfort for him: I do not think that they can go much lower. The right hon. Member for Hitchin and Harpenden (Mr. Lilley) mentioned the downscaling of my hospital in St. Albans and the shutting down of the accident and emergency department some time ago— 10 years ago, in fact, when he was the Member for St. Albans as well as a Secretary of State.

I welcome the modernisation of the health service and the freedom that it may give to local hospitals, with devolution of decision making and local accountability.

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Our primary care trust is ready to take up that responsibility in the fulness of time. In preparation for this debate, I looked up how much money was given to our local health economy in 1996: just over #400 million. This year the figure is just over #800 million—double that amount. Outputs have not doubled, but some improvements have taken place and more will surely follow.

I visited my local hospital yesterday and went to the day surgery unit, which is very ably run by Sister Eileen Kent. She is willing and able to increase throughput so that more operations are done and there are more good outcomes. I also visited the minor accident and emergency unit that remains. The sister in charge, the consultant, Rita Dunkerley, is also pleased to add more facilities to what she already provides. The will is there among the health professionals, and all they want is the freedom to act.

A theatre and two wards were reopened in the hospital two years ago, and a planning application has been lodged for a new theatre to support the four that are already operating. I am sure that that will help with our waiting lists. There is also a plan to provide some much needed key worker accommodation on the site.

About nine months ago, our special care baby unit at Hemel Hempstead hospital was shut because it proved impossible to recruit staff. I am pleased to report that just yesterday, I received a letter from the chairman of our health authority saying that a midwife-led unit would be opened at the hospital to provide facilities for women expecting a low-risk birth.

We are about to undertake a second review of our acute hospital services—we had one three years ago, and I believe that inappropriate decisions were taken then. I hope that this time, the Secretary of State will make a more robust decision, looking to the longer term. There has been discussion about having a big new hospital, a centre of excellence, in the area. Two sites have been identified, one in Frogmore, in my constituency, and the other at the British Aerospace site in Hatfield. Recently, a third site—the old Harperbury mental hospital site—was suggested by Councillor Malcolm Macmillan. It is a huge site very close to the motorway, and should provide all the land needed for a big new hospital. We need extra capacity, and the new hospital should take care of that.

As the right hon. Member for Hitchin and Harpenden said, we want a new teaching unit, a medical school, at the university of Hertfordshire. Next week I will meet the vice-chancellor to further that aim.

I am concerned about outcomes, not about who provides the facilities. My wife suffers from debilitating arthritis and is waiting to see a specialist. I hope that she will be off the waiting list very soon, and will start some treatment. My Auntie Pam, who is very dear to me, is recovering from cancer, and I hope that, having had her sixth chemotherapy treatment yesterday, she will continue to recover.

Close to my constituency there is a BUPA hospital. BUPA stands for British United Provident Association—and provident is the right term to describe providing much needed additions to our national health service provision. It is a not-for-profit organisation that provides good services, and we should use it where we can.

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Finally, I have a serious matter to draw to the attention of the Front-Bench team. A resident of St. Albans has been waiting 50-plus years for an operation to have his tonsils removed.


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