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1 Apr 2003 : Column 890—continued
Sir Michael Spicer: Does the Minister really accept that a few beds in a purpose-built residential home that is pretty well completed is an acceptable definition of a hospital? If he does—I hope that he does not—what are the implications for the future of the residential home and, indeed, for the beds that will be lost?
Mr. Lammy: I have said that I do not want to prejudice the final outcome of the consultations, but I am advised that the staff are working in inadequate conditions and that patients deserve a more modern in-patient facility. The PCT wants the service to continue in the town, but the existing site is too small. The people of Pershore should have modern health care facilities, and these proposals mean that each patient would have a single en-suite room instead of the existing Nightingale multi-bedded ward.
Sir Michael Spicer: The Minister is being very good about giving way.
Mr. Luff: We have plenty of time.
Sir Michael Spicer: Yes, we have another half an hour.
When the Minister says that the existing site would not be big enough to rebuild a hospital on it, that is surely a prejudicial statement in itself. The fact is that there is plenty of room, subject to planning permission. The supposition is that planning permission would not be given, but that supposition is not accurate. He is trying not to prejudice the consultation process, but that does not tally with some of his comments—for example, defining a hospital as something inside a residential home, saying that we are going to keep a hospital, and saying that there is no room on the existing site. Of course, it has all been given to him by the PCT or by whoever wrote his speech—I do not blame him personally—but he must understand that he is prejudicing his own position by making those very assertive remarks. That is precisely what the PCT is doing, and precisely why I introduced this debate on the Floor of the House.
Mr. Lammy: I am reminded of Sherlock Holmes at this point. On the contrary: I said that I am advised that this is the situation and that the site, as currently framed, is too small. However, it is of course the subject of consultation.
Sir Michael Spicer: That is exactly the point that I am trying to raise. As my hon. Friend the Member for Mid-
Worcestershire (Mr. Luff) and I have said, the problem is that the way in which the proposition has been couched allows for no alternatives. It has been asserted during the consultation process that the size of the existing site is insufficient. They have gone from one particular—It being Seven o'clock, the motion for the Adjournment of the House lapsed, without Question put.
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Caplin.]
Sir Michael Spicer: We have raised this issue precisely because of what has been said and because the consultation is flawed—possibly legally flawed. The problem with this debate is that one suspects that the Minister's speech has been written by the people who have already put the matter out to consultation. Those are the people against whom we are making various comments, hoping to hear some objective advice from the Minister.
I do not expect the Minister to answer without having thought the matter through with his advisers, but the least I expect of him is that he take on board the central point that the consultation process is flawed, perhaps legally. I hope that he will look into that and come back to us on why no options have been offered and why the money is going up but the quality of service at the hospital is going down.
Mr. Lammy: I am advised that there is genuine commitment to a community hospital in Pershore. That is the subject of consultation. It cannot be right that we should conduct that consultation among ourselves in the Chamber. That consultation should take place in the local community. The Government are committed to that consultation, and in January we introduced the section 11 powers, under the Health and Social Care Act 2001, to bring into being the overview and scrutiny committee. That was opposed by the Opposition, but the consultation is taking place.
Mr. Michael Foster: Earlier this year, I attended a meeting at which the chairman and chief executive of the South Worcestershire primary care trust gave a briefing on the proposals. I left the room believing that there was a genuine intention to keep the services at Pershore, and a genuine commitment to Pershore community hospital. I entered the room immediately after the hon. Member for West Worcestershire (Sir Michael Spicer) left. He had had a similar briefing from the same people.
Mr. Lammy: That sets out the position as I suspected that it was.
Mr. Lammy: I ought to make some progress. As I was saying, we cannot conduct the consultation in this Chamber; it should be conducted locally. The Government gave overview and scrutiny powers to the community that the hon. Member for West Worcestershire represents so that people could take ownership of decisions. I ask the hon. Gentleman
whether he has met his strategic health authority to convey his views. I have heard Opposition Members talk about the challenges of centralisation and localisation. The Government are localising the health service through the establishment of primary care trusts and overview and scrutiny committees, and are delegating downwards and shifting the balance of power, yet not even two months into a consultation, I am being asked to intervene on what is clearly a local issue.
Mr. Luff: The Minister has been generous in giving way and as there are 26 minutes remaining, there will be a few more opportunities. I think he does not understand that the consultations are being held because of directions from the Government about the rate at which deficit should be repaid. It is not a localising issue but a centralising one: the Government are telling the primary care trust what to do through the strategic health authority. I realise that this is a legal matter and that the Minister may want to think about it, but will he at least promise to write to me about the legality of the consultation? The Pershore document asks:
- "The existing Pershore cottage hospital is loved by local people why must it relocate?"
Mr. Lammy: This is not the right Chamber in which to raise issues of legality. There are chambers of a different nature where they can be taken up. My understanding is that consultation is taking place and that we should at least allow it to finish before prejudging the outcome or the manner in which it was conducted.
Without prejudicing the final outcome of the consultations, it is worth stating some of the public commitments made by the PCT and their context. The PCT wants to retain a local hospital, and has made it clear publicly that it hopes that a consultation process relating to a new Malvern community hospital will be developed during the summer. The PCT recognises that the local community is becoming frustrated by the length of time that the process has taken. I accept the point that the hon. Member for West Worcestershire made about that.
The PCT is committed to the future of the two hospitals and will develop plans in accordance with the outcome of the public consultation. Several other local public consultations are currently under way on the provision of community services in south Worcestershire.
As I said, I am unable to comment in detail on the proposals while the consultation is going on.
Sir Michael Spicer: The hon. Member for Worcester (Mr. Foster) said that he had attended a meeting after which he and I had been assured that hospital services would be maintained in Pershore, although I must confess that that was not exactly what was said to me.
In that context, does the Minister think that, in general terms, it is suitable for residential homes to be partially converted to so-called hospitals? That is being proposed elsewhere, so it must have turned up on his desk as a general issue. Is it a good way forward?
Mr. Lammy: That depends on several things, including community-based provision in primary care and the needs of older people. As the hon. Gentleman knows, many older people do not want to be in residential homes; they want to stay in the community. In different health economies, depending on the demography of the area, there may be a move in that direction. It will also depend on consultation and on the other services that are needed to support older people or people who require residential care.
There is no one-size-fits-all answer to the hon. Gentleman's question. Our national health service employs 1.2 million people. Every year, 13 million people receive emergency care alone. There can be no one-size-fits-all solution in such a complex health economy in one of the western world's major democracies. The question is complicated and the answer is determined by local variations. Clinicians and managers in local communities throughout the country are trying to do their best for local people to deliver the kind of health service that we want.
As I have stated, I cannot comment on the proposals in detail, but, clearly, the first stage is to get involved with the public consultation itself. As the hon. Member for Mid-Worcestershire said, section 11 of the Health and Social Care Act 2001 puts a new duty on the NHS to make arrangements to involve and consult the public in planning the services for which it is responsible. The Department has just published "Strengthening Accountability"—policy and practice guidance to support the NHS in meeting the requirements of that duty.
South Worcestershire PCT will be aware of its duties in that regard, and it will have been further advised on its consultation processes by the West Midlands South strategic health authority. The PCT is holding a number of consultation meetings. My hon. Friend the Member for Worcester has suggested that some of those meetings have taken place, and hon. Members have had a chance to go to them. If hon. Members feel strongly, I would encourage them, the public or stakeholders to attend those meetings and get their views across. I encourage them to raise such issues with the local authority, which now has a nexus in the overview and scrutiny committees, and with the strategic health authority, which clearly has an interest.
There is also the opportunity to submit written views to the PCT during the consultation period. I repeat that this Adjournment debate is being held during the consultation period, which has only been running for a few weeks.
The Health and Social Care Act 2001 has also given new powers to local authority overview and scrutiny committees to review and scrutinise the planning, operation and development of health services, thus ensuring that the democratically elected representatives of local people with responsibility for their well-being have proper influence over the NHS. Those powers came into force on 1 January.
The hon. Member for Mid-Worcestershire mentioned my words in the preface to "Strengthening Accountability". Even though I have a self-interest, I am very proud of that preface—proud of its substance and proud of the fact that the Labour Government have given local people the powers and accountability that they did not have before. I encourage hon. Members, even though they voted against that legislation, to use those powers to raise such issues as they see fit, and to do so locally, with their local stakeholders at local meetings with local people. That arena, not Whitehall, must be the right one in which to do that.
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