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14 Jan 2003 : Column 658—continued

Mr. Andrew Tyrie (Chichester): I should like to say a few words that follow on directly from what my hon. Friend the Member for Isle of Wight (Mr. Turner) was saying about King Edward VII hospital. The closure of that hospital, if it takes place, will indeed be dire for the citizens of the Isle of Wight and will make life difficult for many patients throughout the region.

I just want to put a few points to the Minister, so that they will be clear in his mind. First, the King Edward VII is not a private hospital. It is an independent charitable hospital that has taken roughly 50 per cent. of its patients from the NHS sector for the past 50 years. In many respects, it is a prototype of exactly what a foundation hospital should look like—that is, a genuine public-private partnership. As my hon. Friend said, many capital costs are borne by the private sector. The NHS reaps all kinds of benefits—some tangible, some less tangible—from having such a superb hospital available for its use.That is reflected in the fact that it generates enormous local charitable giving. People are keen to give to it; they want to support it. It has achieved exactly what the Secretary of State for Health has said he wants foundation hospitals to achieve: a genuine partnership with the local community.

The main reason the hospital is in trouble is that there has been a sharp drop in the NHS work being referred to it. The figures for patient discharges over the past 18 months show a drop from 270 per month to 112 per month. NHS funding has gone down 40 per cent. in the past six months. One of the reasons given for that is that the hospital is more expensive to run than others—that it costs more per unit of treatment. I notice that a press release from the strategic health authority today suggested that a coronary bypass costs 38 per cent. more at King Edward's than in Southampton. I have discussed that figure with experts, who tell me that it may look all right, but that NHS figure excludes all costs relating to consultants. There is no consultancy fee in the NHS comparator, so the figures are not comparable. I know from my time in the Treasury—I am sure that the Minister is becoming aware of this—that who really bears the costs in the NHS is a hugely complicated question. Most of the comparator figures that he is being given are questionable, to say the least. The more he delves into them and scratches them, the more he will discover that.

What will happen if the King Edward VII hospital closes? Patients from the Isle of Wight will find themselves on very long waiting lists at other hospitals—in Southampton, Portsmouth and Guildford, in particular. What will happen to waiting time targets for radiotherapy, for example? Those targets are already not being met. There is no way that the 2004 targets that have been published will be met by those hospitals, even without the closure of King Edward's. King Edward's has superb radiotherapy facilities, which would no longer be available. While all this is going on, patients are being sent abroad—for orthopaedic care, for example—at a much greater cost than that of the treatment they could get just up the road. That includes patients from the Isle of Wight. There really must be an absurdity in the NHS funding system if that is what is going on.

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There is more to the closure of some hospitals than patients going through them like pieces of meat through a sausage factory. Here, we are talking about a centre of excellence. King Edward's has not just been a private hospital doing some routine surgery. It has been at the cutting edge of research, treatment and innovation, particularly in orthopaedics, in some aspects of cardiac care and now, with the equipment that it has, in radiotherapy. I implore the Minister to look at how these extraordinary decisions to cut NHS funding at such short notice have been taken. The constituents of my hon. Friend the Member for Isle of Wight will be gravely affected by this, as will mine in Chichester.

7.39 pm

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I congratulate the hon. Member for Isle of Wight (Mr. Turner) on securing a debate on a subject that is important to the NHS and, especially, to his constituents. National health service and social services provision on the island is rightly of particular concern to him and he eloquently expressed the reasons for that. I assure him from the outset that the Government are committed to providing high-quality health services for everyone, wherever they live.

I am pleased to respond to the debate because it enables me to put on record the developments and improvements on the Isle of Wight in the past few years. Not only has health care provision been reorganised but the Government have invested considerably in NHS infrastructure and service delivery.

Health services are never stagnant: they adapt to new opportunities and challenges as they appear. That applied especially when the Government introduced the NHS plan and the XShifting the Balance of Power" initiative. In accordance with those policies, it is up to strategic health authorities and primary care trusts, with their specific local knowledge and expertise, to plan and develop health services in line with the needs of their local communities.

It might help if I dealt with the hon. Gentleman's point on special status for the island immediately. As he knows, the advisory committee on resource allocation—ACRA—considered any additional cost that is associated with being an island in September 2001. The announcement was made in the following December.

The committee concluded that the arguments in a local consultancy report on behalf of Isle of Wight health bodies did not constitute a convincing case. It recommended no adjustment to the Isle of Wight's target under the resource allocation formula. My right hon. Friend the Secretary of State accepted ACRA's recommendations.

Since 1997, there has been continuous investment in the Isle of Wight's health economy. It may help to remind the hon. Gentleman and the hon. Member for Chichester (Mr. Tyrie) of some of that investment, which includes: #28 million to refurbish mental health accommodation; #640,000 for personal dental services; #631,000 to implement the free nursing care policy; #400,000 to improve intermediate care; #100,000 to help reduce waiting lists; #100,000 for local capital modernisation funding; #38,000 for smoking cessation programmes; #29,000 for palliative care; #17,000 to help

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reform the emergency care that the hon. Member for Isle of Wight mentioned, and a further #10,000 for the booked admissions programme.

However, we are considering not simply investment but improving health care for those who live on the Isle of Wight. I shall give one example of service improvement. The Government set ambulance services a target of reaching 75 per cent. of category A—life-threatening—calls in eight minutes. In 1997, the Isle of Wight ambulance service reached only 55 per cent. of such calls in the target time. The trust informs me that, as of January this year, the figure is 81 per cent. I congratulate the men and women who operate the Isle of Wight's ambulance service on fulfilling and exceeding the target.

The trust also anticipates reaching the 12-month in-patient waiting time, the 21-week out-patient targets and the accident and emergency access target times this year. I am sure that the hon. Member for Isle of Wight wishes to join me in congratulating all members of his local NHS team on their industry and hard work.

Let me consider the increases in financial resources. In 1997–98, the island received an allocation of #68 million—a 3.48 per cent. increase over the previous year. That has risen considerably to #108 million in 2001–02—a cash increase of 9.6 per cent. By any standards, those are considerable increases in financial allocation.

In fact, next year the Isle of Wight's primary care trust will receive a further increase of 9.7 per cent.—some #11.6 million. That is one of the highest increases in funding across the strategic health authority, and higher than the national average increase of 9.24 per cent. Even the hon. Gentleman must acknowledge that, far from the cash available for improvements to health care on the island being reduced, resources have increased dramatically during the period of office of this Government.

I hope that the hon. Gentleman will also accept that that proves that the principles set out in the NHS plan were not just empty gestures. We have put the necessary money into the system to carry the reforms through and to support service delivery. Of course, we are not stopping there. In December, my right hon. Friend the Secretary of State announced the budget allocations that PCTs will receive in the next three years. For the first time since the inception of the NHS, local organisations can plan service provision years in advance, and according to local priorities and needs, many of which were articulated by the hon. Gentleman. As I said, the Isle of Wight PCT, which is the hon. Gentleman's local organisation, will receive a 9.7 per cent. cash-terms increase—a cash allocation of some #131.7 million. That is a significant amount of money.

The hon. Gentleman also raised the issue of HealthFit. HealthFit is a process that is taking place across Hampshire and the Isle of Wight to ensure that safe and sustainable health services are available for local people. We have a responsibility not just to provide health services today, but to ensure that they are fit for the future. The NHS in Hampshire and the Isle of Wight takes these responsibilities very seriously, and it is at the early stages of a process that will go on throughout this year and beyond, and which will include open discussion

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and debate with patients, the public and partner organisations. It will ensure that local people are fully involved in that process.

Both the hon. Gentleman and the hon. Member for Chichester mentioned the King Edward VII hospital in Midhurst. I do not want to make the point too strongly, but there is something of a paradox here. Both hon. Members are keen to ensure central intervention and investment in that local hospital, but in some senses that is in conflict with the policy position of their party. We are putting in the money, and ensuring that such local decisions are taken by local people.


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