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14 Jan 2003 : Column 651continued
Mr. Caborn: The hon. Gentleman should not worry about the Government; he should worry about the Liberal Democrats. I hope that they will pass on the sense of partnership and unity in the House to their minions in local authorities who will, like their colleagues in Manchester, bash the hell out of the bid.
I assure hon. Members that we are working with the Mayor's office. In the event of our making a bid, it would be a red herring and a dangerous sign to send from the House that there were differences between us on the project. The partnerships that we have forged with the Greater London Authority, the Mayor's office and the Citymy right hon. Friend the Secretary of State has been working hard with City leaders and the Bank of England to make sure that we know the attitude of the private sectorwill stand us in good stead. A message should not go out from the House that there are major differences of opinion. There are not. We are working together with those other bodies to make sure that if we do make a bid, there will be unanimity.
May I tell my hon. Friend the Member for Feltham and Heston (Alan Keen) that, in my opinion, his command of the French language is brilliant? What he said was true: one can know the price of everything and the value of nothing
Over the past few hours, it has become evident that the Government are planning to make a statement tomorrow on Government policy on missile defence. It is being reported already on the Press Association wires, and the written press is preparing to report in detail, that the Government are minded to accept the American request for the use of the Fylingdales base in Yorkshire, in the constituency of my hon. Friend the Member for Ryedale (Mr. Greenway). I hope that you will share my concern that the announcement appears to be being made outside this place, instead of in this place as a courtesy to Members and to allow proper scrutiny.
If that were not enough, earlier today a written statement was issued on further contingency preparations being made for possible military action in the Gulf. Little was made explicit in that written statement, but it is being taken by the informed defence press to mean that that constitutes the final decision to deploy 7 Brigade and elements of 4th Armoured Brigade, possibly comprising as many as 20,000 men. Although the Government may have made no final decision about that deployment, it again seems that they are trying to smuggle announcements out to avoid embarrassment and proper scrutiny, instead of being honest with the British people, Parliament and the armed forces. Will you express this concern to the Government and ensure that we have proper statements tomorrow on both subjects?
Mr. Speaker: This is the first that I have heard of the matter and the complaints that the hon. Gentleman makes. The best thing that I can do for him is to investigate the matter. I will reply to him as soon as I can.
The petition declares that the current arrangements for arms controls are in need of improvement, and that the United Kingdom Government need to display a more robust style of leadership on the issue. The petitioners therefore request that the House of Commons urge the Government to strengthen UK arms controls, make the export control system more open and accountable, and demonstrate robust international leadership in pushing for the adoption of tough regional and international controls on arms transfers.
Mr. Andrew Turner (Isle of Wight): I am grateful to you, Mr. Speaker, for offering me the opportunity to raise this subject in an Adjournment debate. Although the debate is about public services on the Isle of Wight, for reasons that will become apparent, I shall devote my speech almost entirely to health, and I thank the Minister for taking up the challenge.
I should like to acknowledge the hard work done by all those involved in the provision of health services on the islandand not only those at the front line, as the managers sometimes come in for undue criticism. I acknowledge with thanks the help that David Crawley and Graham Elderfield, respectively the managers of the primary care trust and of St. Mary's and the Isle of Wight Healthcare NHS trust, have given to me in preparing for this debate.
I wanted to raise four issuesdentists, financial allocations, HealthFit, as it is called, and the King Edward VII hospital at Midhurstbut the Minister and I had a little outing over dentists earlier today and I do not propose to repeat it. I shall therefore start with island health funding. The question that concerns many people on the island is whether we are to live a hand-to-mouth existence in health funding or whether the funding formula will explicitly recognise the island's needs. In autumn 2000, the case was made for recognition of the island's particular needs and it was referred to ACRAthe advisory committee on resources actionon 23 August 2001. ACRA made recommendations that led to Ministers turning down our case for the island's specific needs, and we were notified of that decision on 19 December 2001.
I recognise that the Government are putting an extra #37 million into the Isle of Wight primary care trust over three years, as was announced on 11 December last year. However, is that a recognition of the island's explicit needs or merely part of a funding uplift that the Government are imposing generally? The basis of the argument that has been advanced, which is set out in more detail in the document XThe Isle of Wight Health Economy: The Island Factor", dated September 2000, is that the Isle of Wight is an atypical health authority or PCT. Indeed, it is a unique health authorityor PCTas it is, first, an island. Things cost more on the island because of the cost of transport. There are diseconomies of scale on the island that cannot be met by merger with an adjoining health authority. Secondly, we have a population of 125,000 most of the year round, which is swollen to 350,000 by tourism in the middle of the year. Thirdly, we are one of only two non-ambulance trusts with responsibility for ambulances. Fourthly, our boundaries are defined not by arbitrary and easily adjustable lines on maps, but by something that is rather more difficult to adjustcoastlines and cliffs. Travel to the mainland takes about one hour and 45 minutes from St. Mary's hospital in Newport to the Southampton hospitals, or one hour 15 minutes to St. Mary's in Portsmouth.
I recognise that the Government may argue that those costs have been met in 2003 to 2006, but I ask the Minister to confirm whether those needs are explicitly met in the funding allocation formula for PCTs or whether it is merely a matter of luck. If they are explicitly met, how has the formula been changed to take that into account?
The assumption underlying our argument is not like those for Scottish islands or remote rural parts of England, where there is a population of fewer than 30,000 or where there are road links to other hospitals. It is that 350,000 people in the summer and 125,000 in the winter must have an accident and emergency service, and therefore must have the 24-hour cover that supports that accident and emergency service, which has been described by the joint consultants committee of the BMA as acute medicine, acute surgery, trauma and orthopaedics, obstetrics and gynaecology, paediatrics, a full anaesthetic service, ITU, CCU and HDU, pathology and radiology, 24 hours a day, seven days a week, 52 weeks a year. That is a basic minimum without which A and E cannot function effectively or, indeed, safely. The excess cost of having that was #1.4 million in 2000.
The island also runs its own ambulance service and has made great efforts to improve the quality and efficiency of that service. The cost of patient transport is not covered by other activities as it is in other areas. I am asking the Government to recognise the continuing need for the accident and emergency service, for patients on the island to be treated within that golden hour within which they need to be treated if they are to have a good chance of survival.
That brings me on to a proposal that emerged only last week from the strategic health authority. It is bringing forward proposals which, if implemented, would undermine the argument that there is a minimum Xmust have" provision for the population as I have described. Last week it published Healthfit, a set of proposals with the effect of reducing from five to three the number of district general hospitals in Hampshire and the Isle of Wight.
What about maternity provision? I had the privilege of visiting the maternity unit at St. Mary's on the Friday before Christmas. The report says that a relatively small number of units offering the most high-tech care to women were required. In terms of Hampshire and the Isle of Wight, it was suggested that two units at Southampton and Portsmouth would be sufficient. The group recognised the particular needs of the island, which it says will need careful thought. My reading of that proposal accords with that of the overwhelming majority of islanders. The Isle of Wight County Press described the report as Xexplosive". A packed meeting of the community health council last night rejected the proposals. The trust says that islanders
Finally, I come to the receivership and possible closure of King Edward VII hospital, Midhurst. One hundred of my constituents were brought together at 24 hours' notice on Friday, and were joined by many more people today from across the south of England. My hon. Friend the Member for Chichester (Mr. Tyrie),