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14 Jan 2003 : Column 651—continued

Bob Russell: It is the Government we are worried about.

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.

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I have no doubt however that the comments of Opposition Members this evening were genuine. If we decide to make a bid, we accept that they will support it.

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 City—my 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 sector—will 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—

It being three hours after commencement of proceedings, the motion for the Adjournment of the House lapsed, without Question put, pursuant to Order [7 January].

Mr. Bernard Jenkin (North Essex): On a point of order, Mr. Speaker. I am seriously concerned that Parliament is not being kept properly informed of very significant changes in Government policy.

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.

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Arms Controls

7.18 pm

Rachel Squire (Dunfermline, West): I am honoured to present a petition signed by 178 pupils of St. Columba's high school, Dunfermline, and organised by the school's Amnesty International youth group.

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.

To lie upon the Table.

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Public Services (Isle of Wight)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kemp.]

7.20 pm

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 island—and 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 issues—dentists, financial allocations, HealthFit, as it is called, and the King Edward VII hospital at Midhurst—but 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 ACRA—the advisory committee on resources action—on 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 authority—or PCT—as 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 adjust—coastlines 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.

The manifestations of our needs are that we have more consultant posts per head of population because they are needed to provide 24-hour cover. We have an

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increased cost of specialist residential care. For example, when patients go to the mainland for cancer treatment, they need to stay at the Abbey unit in Southampton. In their condition, they are unable to take two sea journeys a day, five days a week for up to six weeks. That is an additional cost, and there are additional costs in running the ambulance service. Of course, there is also unused capacity. It was estimated in 2000 that those additional costs, which are unique to the island, amounted to between #2.4 million and #2.8 million.

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.

I recognise, of course, the continuing need to obtain greater efficiency and improved patient care, but the health authority itself states:

It proposes two primary care diagnostic and treatment centres with a range of functions, and it looks as though it is proposed that St. Mary's hospital in Newport should be one of those centres. Two sites would lose under those proposals—Winchester, which, of course, can speak for itself, and the Isle of Wight.

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It is curious that the document states elsewhere:

I certainly recognise that—

Let us examine what the closure of accident and emergency services means. It means that 2,000 people in February and 3,000 in August would have to travel to the mainland accident and emergency services. Air ambulances at present are used about once a month. Emergency transfer by ambulance and ferry can be undertaken within 35 minutes, but what would the walking wounded do? What would those who do not need an ambulance do? What would happen when the ferry was fully booked? Would private cars be able to jump the queue if it were claimed that somebody needed accident and emergency treatment? What would happen at night, when ferries do not run for two hours and the high-speed service does not run at all? What about the occasions—only two or three days a year, perhaps—when the high-speed ferries are cancelled, and those occasions—fewer, but there are still some—when all ferries are suspended? That has to happen when there is a force seven gale or worse. As the Isle of Wight Healthcare NHS trust has said,

Indeed, it is not an option of choice at all, as my constituents know to their cost.

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

The strategic health authority obviously thinks that it is Moses and can make the seas part. I fear that it is more like Canute, because the islanders are not the children of Israel and accident and emergency services in Portsmouth are certainly not the promised land. If the Department of Health is really putting as much new money into the NHS as it says, the proposals should be unnecessary. Whether or not that is the case, they are unacceptable to my constituents and to me. I very much hope that they are unacceptable to the Minister, too.

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),

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I suspect, will seek to catch your eye in a moment, Mr. Speaker, to add to my comments. It was an appalling and terrible shock to hear that that fine hospital was in receivership on 30 December. The immediate reason is clear—the failure of NHS purchasers to offer dependable contracts. Patients and supporters on the Isle of Wight have been harrying me, quite rightly, since my election to prevent the cardiology contract being moved to Brighton. The primary care trusts reckoned that eight patients could be treated at King Edward VII for the same sum that could be used to treat 10 at Brighton, which has greater capacity. However, waiting times at King Edward VII were three months, but are six months or more at Brighton. Brighton only counts waiting times—this is idiosyncratic in the extreme, with one doctor describing it as scandalous—from the point of the first appointment with a consultant. Patients are now being sent to Oxford, Tooting and further afield. The PCT has to pay the trust from patients' choice funding to send the patients elsewhere, despite the fact that Brighton cannot fulfil its contract. Last Wednesday, the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton), said:

I asked him about King Edward VII—words came aplenty, but answer was there none. I shied away from expressing my view on the PCT's decision when it was made—after all, I have to live with its members and have no reason to distrust them. Now, however, I know of other business taken from King Edward VII by hospitals across the south of England, and can report the view of a doctor in my constituency, who told me on Monday that

I cannot begin to understand why a hospital that was built and upgraded at no cost to the NHS is good enough for the NHS when the NHS fails to meet its waiting list targets, but not at other times. I cannot begin to understand why it is wrong for a PCT to make a contract with a hospital, but it is right for a trust to sub-contract to the same hospital. I cannot begin to understand why 400 opportunities for cardiac intervention a year are lost while my constituents are waiting—and one or two of them regrettably die on the waiting list.

Dr. Mark Connaughton, the heart doctor at St. Mary's hospital, Newport, told me:

He said that King Edward VII is of

Most people who need cardiac intervention are old. They have paid into the NHS since its inception, yet in their hour of need they are told to wait, despite capacity being available. That is quite simply something that neither they nor I can understand. I hope that if the Under-Secretary can understand it, he can explain it.

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7.34 pm

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