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16 Jan 2003 : Column 913—continued

6.35 pm

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I congratulate the hon. Member for Boston and Skegness (Mr. Simmonds) on securing the debate. I am aware that he takes a keen interest in health issues that affect his constituency. Indeed, he initiated a similar debate in November 2001 on the future of Skegness district hospital. Having been schooled in Peterborough, I am familiar with the area, so it is good to play a role in the debate.

I recognise the concerns of the hon. Gentleman's constituents to retain access to acute hospital services in their local area. All our constituents would be concerned about that. It is wholly understandable that they should demand modern, reliable and efficient services at a location that is convenient to them. I want to assure them from the outset that they need not fear for the future of their hospital or the future of the NHS under this Labour Government. The hon. Gentleman mentioned the hospital's finances, which I hope to deal with in a moment. However, he is at odds with his Front-Bench spokesmen who said that there would be a 20 per cent. cut in NHS investment.

Mr. Simmonds: I have raised some serious issues. The Minister knows that it is not Conservative party policy to cut NHS spending by 20 per cent. May I suggest that he adheres his remarks to those serious issues?

Mr. Lammy: NHS funding is an extremely serious issue. Labour Members voted overwhelmingly for investment in the NHS and I am concerned that the hon. Gentleman's constituents have the best services available. I am pleased that our allocation to Boston primary care trust will rise by 8.6 per cent. over the next three years. I want them to get that investment and the facilities they need. However, given the hon. Gentleman's manner and tone on finances, it is right for me as a Minister to explain that they would be cut.

Pilgrim district and general hospital has been providing services for the people of Boston and south-east Lincolnshire since the early 1970s. Since April 2000, it has been part of the United Lincolnshire Hospitals NHS trust, when all acute hospital trusts in the Lincolnshire health authority area were merged. In the mid-1990s, the then Lincolnshire health authority reviewed services in the county. Among the recommendations proposed following the review was the transfer of ear, nose and throat services from Boston to Lincoln. I understand that that was not popular locally and the change did not proceed.

The restructuring of health services in 2000 prompted a further wide-ranging review of clinical services in Lincolnshire. A formal review has been commissioned by the local health authority. That is due to be completed in March this year. It would be inappropriate for me to prejudge the outcome but I understand that the trust wishes to see the Pilgrim continue its role as a vibrant hospital that provides a wide range of services. It may be that the outcome of the review sees some enhancement of facilities

That position is borne out by the significant investments that the Government have made at the hospital in recent years. In 1998, a five-year capital programme was agreed to improve the Pilgrim. A total of #12 million has been invested, which facilitated the creation of a new accident and emergency department; the revamping of the outpatients department; two new theatres and two new wards; and essential repairs to the general fabric of the buildings.

As part of the Government's Action On programme, there is United Lincolnshire Hospital NHS trust's bid for the creation of a new ENT and dermatology department at Pilgrim hospital. The Action On programme was developed in 1998 to target efforts to address areas of high waiting times. Four priority areas have been identified—cataracts, orthopaedics, dermatology and ENT—and specific programmes have been created. They are designed to ensure that local services are shaped around patients' needs, streamlining patient pathways and improving patient access. The programmes aim also at facilitating improvements in the quality of care through the dissemination of best practice—maximising efficiency, balancing capacity with demand and providing support to NHS staff.

Under this Government, the ENT and dermatology unit became operational last year and will be formally opened by the hon. Gentleman tomorrow. I am pleased because across the country, people are seeing investment, new hospitals and new services in their communities. Hon. Members in all parts of the House are able to open new facilities in their constituencies. I am delighted and want that to continue—which is why I proudly stand here at a Labour Minister against cuts that would see services disappear.

Those developments are indicative of the large investments that the Government are making in the health service. We are committed to ensuring that everyone, no matter where they live, has access to high-quality, modern and dependable NHS services. The Government recognise that for too long, patients in some parts of the NHS have not had access to the standard of care and treatment they deserve. Last week, we announced a further round of NHS capital allocations for the next three years. They show a growth of 31 per cent. for 2003–04, 14 per cent. for 2004–05 and 20 per cent. for 2005–06—the first time that day-to-day operational capital has been directly allocated to NHS strategic health authorities, trusts and primary care trusts and the first time that capital allocations have been made for three years rather than one. That arrangement will allow local NHS managers to plan for the future and make decisions about the services that they provide.

Right hon. and hon. Members on this side of the House take the view that the NHS cannot be run from Whitehall. We believe in shifting the balance of power, which is why we have localised the NHS, handing it to local communities through their PCTs—performance-managed by our strategic health authorities. I note that the hon. Gentleman disagrees with that position. He would like greater centralisation and me to intervene in some local decision-making processes in his area.

Mr. Simmonds: I did not say that and must correct the record. I certainly believe in devolving power to democratically accountable, decision-making bodies. I was trying to address the point that potential decisions about the future level of service at Pilgrim hospital will not be made by the people at Pilgrim hospital but by people in Trent regional health authority. That does not seem to fit comfortably with the Minister's view and mine that power should be further devolved, not taken away.

Mr. Lammy: The decision will be made by local people, the strategic health authority and the primary care trust working in conjunction, and may well bring enhancements for the local hospital. It is about localisation, which we support, and I am grateful that the hon. Gentleman seems to support that. I urge him to let that process take its course. His constituents can take heart in the fact that the Government are committed to a modern, enhanced 21st-century NHS, which is why we are investing in his hospital, and why he will be able to open those ENT facilities tomorrow.

The total provided for the United Lincolnshire Hospitals NHS trust is almost #34 million over the next three years, allowing it to continue its programme of modernising and improving its facilities. The hospital trust is predicting a deficit this year on its annual revenue budget, but I have been reassured that a recovery plan is in place and is being monitored by the Trent strategic health authority. That plan does not include the reduction of services—the trust is instead considering alternative and more efficient service delivery methods. That deficit needs to be set against Government investment. We have significantly increased funding. For example, East Lincolnshire PCT is to receive an increase of nearly 9 per cent. on its budget for the year 2003–04. We are changing the way in which funding is allocated so that trusts can plan for a three-year period and make provision for the future.

The Government are keen to ensure that that investment is accompanied by reform. The NHS has delivered major improvements in health, but it falls short of the standards patients expect and staff want to provide. The NHS has to be redesigned around the needs of patients. As I have said, local hospitals cannot be run from Whitehall. The purpose and vision of the NHS plan, which was launched in 2000, is to give the people of Britain a health service fit for the 21st century which is designed around the patient. That change will improve the quality of care and affect how and where services are delivered across the NHS.

High-quality care is not just about good outcomes, but about giving people the kind of services that they want. Local people are being placed at the heart of the debate about their local health services. A new legal framework came into force on 1 January 2003 which places new duties on the NHS to consult the public in the ongoing planning and development of services, not just when a major change is required.

There are telemedicine links between Pilgrim hospital, Skegness and District hospital and other services that benefit the area. Those are just some of the ideas we have been exploring over the past few months as part of the work of the configuring hospitals project. I have been greatly encouraged by the fact that there seem to be real opportunities for smaller hospitals in particular to have a new lease of life, with service redesign and networked health systems offering the potential to deliver the kind of local health service that local people want.

We will shortly publish a document for consultation. I repeat that there is definitely a bright future for Pilgrim hospital. Any future developments there will be at the forefront—

The motion having been made after Six o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.

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