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1 Apr 2003 : Column 887—continued

6.42 pm

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I congratulate the hon. Member for West Worcestershire (Sir Michael Spicer) on securing the debate. I know of his interest in health matters in his constituency, and of his long association with Malvern hospital. I also congratulate my hon. Friend the Member for Worcester (Mr. Foster) and the hon. Member for Mid-Worcestershire (Mr. Luff) on their speeches, and on their commitment to the hospitals in their area. I shall try to answer the questions asked by, in particular, the hon. Member for West Worcestershire and my hon. Friend the Member for Worcester, but if I cannot manage that this evening I shall write to them both in due course.

The proposals for community health services in West Worcestershire are complex. Three public consultations are being undertaken by South Worcestershire primary care trust. As all the proposals are out to public consultation, I hope that the hon. Gentleman will understand that I cannot comment on the details. However, I am willing to outline the context. Let me answer two of the hon. Gentleman's questions immediately. The Government are committed to community hospitals, and that includes those in Pershore and Malvern.

South Worcestershire primary care trust came into being on 1 April 2002. It has a population of approximately 280,000 across the south of Worcestershire. The geographical area stretches from Broadway in the east to Tenbury Wells in the west and from Worcester city and Droitwich in the north to Upton-on-Severn in the south. It manages community hospitals with a total of 132 beds—Evesham, Malvern, Tenbury Wells and Pershore hospitals.

The NHS plan outlines a series of challenges designed to deliver a 21st-century health service that puts the needs of each patient as the focal point of the system. South Worcestershire PCT, like all other NHS organisations, will benefit from the massive investment being made by the Government over the next three years. The resources available to the PCT will have increased by £59 million from the level in 2002-03, an overall increase of nearly 30 per cent. The hon. Member for Mid-Worcestershire raised the issue of the deficit, but that increase of £59 million, or nearly 30 per cent., will be a tremendous contribution from the Government to dealing with that problem. That is an indication of the Government's commitment to the area's health economy.

Mr. Luff: I am glad that more money will come in, but where will it go?

Mr. Lammy: It will go into the health economy and an overall package of services, and that will be clear to the hon. Gentleman's constituents. I will come to some of the proposals for the area later in my speech. He should tread lightly in that area, as it is Conservative Front Benchers who propose a 20 per cent. cut.

Mr. Luff: The Minister must understand that that is simply untrue. There is no parliamentary turn of phrase

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that I can find to describe what he has just said, but there is an unattractive word with three letters that I cannot use in the Chamber. What he has just said is not true and I challenge him to produce a single quotation that justifies that preposterous and outrageous claim, because it has no basis in truth. I hope that I have made myself clear.

Mr. Lammy: That is a matter for the hon. Gentleman and his Front Benchers. The Opposition's policy is well known, in the House and in the country. I am not attempting to be partisan on what is an important issue to his constituents and to the Government. The investment is going in, but there is a historic deficit and cuts would make the situation worse. It is right that I, as the Minister responsible, make the Government's position clear and that the hon. Gentleman's constituents understand the dividing line on the issue.

The set of challenges in the NHS plan, combined with unprecedented growth in investment over three years, gives South Worcestershire PCT the opportunity to plan for change and to deliver the principles of public sector reform—devolved, responsive, flexible services with choice for the people who use the NHS. In South Worcestershire, that planning has just been completed via the PCT's local delivery plan. The LDP matches investment over the three years to the challenges set out in the NHS plan to meet service demand needs overall, in particular for emergency and planned care. Overall, South Worcestershire has had a significant share of the resources and has planned sufficient capacity to deliver all targets.

Sir Michael Spicer: That is all rhetoric and political stuff that is not answering the questions that we asked. We accept that taxpayers' money will be spent in the area, but we want to know how it will be spent and how it can be that we now have worse services and two hospitals in my constituency under threat of closure. The Minister must address those precise questions, instead of giving us all that rhetoric that has been written for him by someone else.

Mr. Lammy: I hope that the hon. Gentleman will forgive me, but this is not rhetoric. I am setting out the position in his trust area. I am only three minutes into my contribution, and I hope that I will be able to move on and deal with some of the issues raised in the debate. However, people waiting for surgery and in-patient and out-patient appointments have seen the targets met, as have those waiting for emergency services. Now, 90 per cent. of people wait no longer than four hours, and tremendous progress has been made, in his constituency and elsewhere. It is unacceptable to suggest that services have somehow not improved. They are improving. They are getting better, and the money is going in. I need to repeat that.

If the hon. Gentleman is not happy with what I have said, he can take the matter up in the usual way. Indeed, the hon. Member for Mid-Worcestershire mentioned section 11 and the duty of overview and scrutiny, and the normal way in which hon. Members and local people can take such matters up. Those are the normal mechanisms, and the hon. Member for West Worcestershire is free to use them if he is not satisfied with what is happening in his local health economy.

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As I said, in South Worcestershire this planning has just been completed via the PCT's local delivery plan. That matches investment over these years to the challenges set out in the NHS plan to meet service demand needs overall and, in particular, for emergency and planned care. Overall, South Worcestershire has had a significant share of the resources and has planned sufficient capacity to deliver all targets. The strategic issue is to achieve the right balance between primary, community, secondary and social care.

That is particularly important in relation to maximising the benefits of having a new, private finance initiative, state-of-the-art acute hospital, and developing appropriate community-based services to enable people to be treated and cared for in the community, as far as possible.

Gradual change is being taken forward locally through a series of modernisation compacts between primary and secondary care, the implementation of first-class clinical governance systems, and the identification and delivery of improvements to clinical and service quality.

The PCT instigated a series of service reviews in November. The reviews lasted several months, and involved consultation meetings. Every general practitioner in Worcestershire was invited to those meetings, so that they could gain a degree of ownership of the reviews and the evolving proposals arising from them.

The PCT board met in February 2003 to receive a report on the service reviews and a consultation was proposed entitled, "Improving GP and Community Services in Malvern". In March, the board met and agreed to further consultations. One is entitled "Modernising Health Services in Pershore", and the other is called "Proposed Changes to Health Care Provision in South Worcestershire".

Agreement was also given to a series of public meetings to support the consultation process, with the community health council agreeing to host the meetings and feed back their conclusions. The meetings have started and are ongoing.

The consultation for South Worcestershire as a whole outlines proposals covering occupational therapy, GP-attached social workers, GP practice-based counselling services, sexual health, and the day rehabilitation services of community hospitals. The consultation on Pershore covers the options for the redevelopment of Pershore health centre and the expansion of Abbotswood medical centre. It also considers the provision of minor injury services, the community dental service, and a new community hospital of up to 25 NHS beds at the Heathlands development as a re-provision of Pershore hospital. The consultation covers substantive matters and it is hoped the investment that has gone into the local area will be spent wisely on those substantive matters to meet the point raised by the hon. Member for Mid-Worcestershire. The final consultation on better GP services and community healthcare for Malvern plans to bring the existing services of Malvern health centre and Court road surgery together, on one site and under one roof.

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Without prejudice to the final outcome of those consultations, it is worth stating some of the public commitments made by the PCT in the context of the reconfigurations. That is particularly pertinent given some of what has been said, which, at least on my advice, is not the basis on which the consultations are being conducted. For Pershore hospital, the PCT gave in its public consultation a clear indication that it is seeking to retain a local hospital. The PCT also confirms that any new hospital would continue to provide the majority of services, with the possible exception that some of those services would be provided in a primary care setting. In addition, the latest proposals signify that overall bed numbers would in fact increase.


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