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7 Apr 2003 : Column 102—continued
8.31 pm
Hugh Robertson (Faversham and Mid-Kent): I rise to speak in support of my hon. Friend the Member for Canterbury (Mr. Brazier). In doing so, I should like briefly to pay tribute to the work that he has done on behalf of the Kent and Canterbury hospital over very many years. He has done an enormous service to his constituents in Canterbury and to many from throughout the wider east Kent population. I should also like briefly to pay tribute to all the members of the Campaign for Health in East Kent—I do so not least because they are present—who have done marvellously well in keeping up their enthusiasm and keeping the campaign going. They have been a tremendous tonic to those of us who have been fighting the political battle.
I wish to represent the interests of my constituents in Faversham and the surrounding villages, who will be severely affected by any changes to the Kent and
Canterbury, perhaps more than anybody else in east Kent in many ways, for six reasons. I shall confine my remarks to concerns that are specific to my constituency, rather than to the much wider issues to which my hon. Friend referred. Of course, he made some very specific points, and I should like in particular to draw the Minister's attention to his comments about cancer, which is a huge problem area.My particular concerns are as follows. The first is transport. Transport links in east Kent are known to be extremely poor. It is sometimes difficult enough to make a journey from Faversham to Canterbury, but it is always difficult to travel from Faversham to Margate. To make a journey from Faversham to Ashford, as many of my constituents will have to do, is almost impossible on many days. As my hon. Friend said, the road is small and winding and is used by farm traffic. Lorries regularly jam the road and a protest group is currently forming to express concern about its current traffic level. If we were to add all the traffic that would travel along it carrying people to hospital, the situation would become intolerable. Public transport provision in that part of Kent is also hugely inadequate.
Secondly, on the question of location, as my hon. Friend said, Canterbury is at the hub of east Kent. It has a cathedral and a huge student population. By any judgment, it is the correct location for a hospital in that part of the world, regardless of where the others are situated. Neither Margate nor Ashford has any of those advantages.
Thirdly, there is the question of capacity. The Government have announced huge house-building plans for much of the south-east. Many of the houses will be built just to the south of my constituency border. That will clearly bring an enormous number of extra people into the county, and they will have health needs. With that capacity increase in the wind, surely it is not time to be shutting, downgrading or closing hospitals.
Fourthly, there is a lack of alternative facilities for my constituents. Faversham cottage hospital is an excellent small local hospital to which I pay tribute. However, it is not and was never intended to be the Kent and Canterbury. I should have thought that it was eminently sensible to build up local facilities before downgrading the Kent and Canterbury. Clearly, that has not happened.
Fifthly, there is a problem of deprivation. Although some areas of east Kent are extremely wealthy, others are extremely poor. My market town of Faversham has a relatively prosperous mediaeval core and a Victorian part, which was built with the arrival of the railways. A third generation of people came from the east end of London to pick fruit in the summer. It has a huge area of social housing. Downgrading the local hospital will lead to many people feeling excluded from the health service. They will feel that their local hospital has gone and they will suffer from that loss because they are often heavy users of the health service.
Sixthly, delay is a problem, to which my hon. Friend the Member for Canterbury has already alluded. The saga has gone on for a long time and has undoubtedly affected the confidence of many of the excellent people who work in our hospital. It has certainly affected the
confidence of many constituents. I hope that the Under-Secretary and the Department can soon bring it to an end.Given the bigger political picture in the national health service and in population growth throughout Kent, I am surprised, if not amazed, that the Government should even consider downgrading the Kent and Canterbury hospital. In my view, it is simply the wrong option at the wrong time. Perhaps I would say that as I was born there 40 years ago. I urge the Under-Secretary, in the strongest possible terms, to reconsider the decision.
8.36 pm
The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): I congratulate the hon. Member for Canterbury (Mr. Brazier) on securing the debate on a matter of concern to him and his constituents. I also acknowledge the passion with which the hon. Member for Faversham and Mid-Kent (Hugh Robertson) made the case on behalf of his constituents. Health service issues always cause concern. That is right because our constituents greatly value the health service.
The people of Kent deserve a fully modernised health service, which provides them with the highest quality services. Everybody acknowledges that reconfiguring acute services is an integral part of the agenda. I stress to all hon. Members who have contributed to debates on the subject that the decision will be made in the interests of all the residents of east Kent. It is right and proper to say that.
For that reason among others, the Secretary of State has decided to refer the case to the independent reconfiguration panel for consideration. The new advisory body was announced in the NHS plan to help ensure that decisions on the outcome of major health service reconfigurations are fair and objective. The panel's remit is to consider three main items: whether the proposed service configurations are sustainable, whether they fully support modernisation and whether they result in improved service for patients. The panel will provide advice to the Secretary of State, who will then make an informed decision, taking the panel findings into account.
The NHS plan sets out a challenging 10-year programme for NHS reform. Far-reaching changes are inevitable to try to provide the best possible services for patients. We all acknowledge the pressures on the service, not only in east Kent but throughout the country, of trying to increase capacity so that patients can get ready, quick and responsive access to services. We want not only to increase capacity but to raise clinical standards generally.
There are major inequalities in the health service throughout the country and we are committed to tackling them. We must also ensure that services are accessible and flexible. We want to design services around the needs of patients. The NHS must no longer be configured around the needs of institutions. We must follow the patient pathway and wrap services around the patient's journey.
As part of the modernisation programme, many NHS trusts are considering changes to the way in which they organise their services. I believe that we all recognise that hospital services need to change if we are to
continue to fulfil patients' needs and improve access. Things cannot remain in aspic. There are a number of different pressures on the service, including the working time directive and certain clinical governance issues. All those issues need to be taken into account as the health service changes.We want to try to help trusts that are developing their plans for service expansion and redesign to have a direction of travel in their minds when they were considering the changes. That is why we have published the new guidance, "Keeping the NHS Local: a New Direction of Travel", to which the hon. Member for Canterbury has referred. This is a significant piece of guidance for the health service, in which we try to say that the drive towards "big is best" is not always the direction in which we want to travel, and that we will try to make services responsive to local people.
In providing advice to the Secretary of State, the independent reconfiguration panel will be asked to take into account the contents of the guidance and, in particular, the three core principles that the NHS should consider when planning reconfigurations. The hon. Member for Canterbury has referred to these. They are first, the need to involve the public and staff in developing options for change. This is a big change for us. It is about saying that the public and staff should be involved in the design of services right from the outset—not just when preferred options are developed—because we believe that, in that way, the partners will sign up to change and that change will be sustainable in the longer term.
The second principle is the need to redesign existing services rather than simply going for relocation, with primary care trusts increasingly taking the driving seat with the budgets. They are doing some incredibly innovative work on providing services closer to people's homes out in the community, and making them more accessible to people. The third principle involves trying to take a whole systems view of the whole health economy. This involves looking not simply at the role of the acute trusts, but at how they integrate with intermediate care in community hospitals and how they relate to services at primary care level. So we are looking at the whole health economy when designing services and trying at every step to work in partnership with other health providers in the area.
The document sets out the importance of public involvement, and says that any change must have support and engagement from staff and patients. The hon. Member for Canterbury highlighted one of the most important phrases in it, which states that the NHS needed to develop options for change "with patients" and local people, rather than for them. Again, it is a real culture change for the NHS to be working together with local people. We also now have the section 11 duty under the Health and Social Care Act 2001, which provides that every part of the NHS is under a statutory duty to involve patients and the public. We have issued guidance as a result of that statutory provision, and are now beginning to develop a proper framework against which trusts can measure their proposals.
The involvement of the public has always been a key factor in the proposals for east Kent. I know that the hon. Member for Canterbury feels that the proposals have not taken account of the views of local people, but it was a pretty comprehensive process. It aimed to
ensure that the proposals were widely disseminated to staff, patients and other key stakeholders. The chief executive wrote to every member of the trust's 8,000 staff, inviting their views, and all staff received a summary consultation leaflet. Three rounds of staff seminars were held at each of the trust's five hospitals, with evening seminars for night staff, and 12,000 summary leaflets were distributed to members of the public. These were available at GPs' surgeries, hospitals and pharmacies, and a range of other public outlets. The leaflet was also included in a local newspaper delivered to 227,000 households in east Kent. More than 100 voluntary groups were invited to take part in seminars, and around 2,000 people attended a series of public meetings. As the hon. Gentleman mentioned, I was delighted to visit Canterbury last July. I spoke personally to health professionals, patients and representatives of the local authorities about the proposals. It is certainly fair to say that, during the consultation, the issue was well ventilated in the community, even if the process did not deliver a result that either of the hon. Gentlemen would support.
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