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7 Apr 2003 : Column 106—continued
Mr. Brazier: I am grateful to the hon. Lady for giving way, and I am particularly grateful for the announcement that she made at the beginning of her speech. That was excellent news. However, I put it to her that, however many people went to the meetings—most of which were actively hostile—the central weakness of the whole process was that it did not involve the community hospitals and health care provision in the area as a whole. That was the explicit reason that every branch of the Royal College of Nursing in east Kent rejected it. It is now central to the Minister's own White Paper.
Ms Blears: I am sure that that is one of the matters that the independent reconfiguration panel will want to take into account. It is part of the guidance on keeping the NHS local, and the integration of the service will clearly be a key factor for the panel.
I want to say a little bit about the proposals, and what they mean in terms of service delivery for patients. The four shortlisted options included in the consultation document set out an important role for Kent and Canterbury. Three propose the retention of an acute hospital role, while a fourth proposes the provision of community-based services at the Canterbury site. A 24-hour nurse-led minor injuries unit would still be provided at Kent and Canterbury under all the options. I want to give local people the reassurance that the role for the Kent and Canterbury would still be substantial.
Under all options, a number of core services would be provided at Kent and Canterbury. As well as those for minor injuries, they include day surgery, out-patient paediatrics, services for older people, community assessment, intermediate care, a day care hospital, out-patient clinics, midwifery-led services and cancer services, which are hugely important to people in that community. I want to say a word or two about those.
First, I commend the good work done by hospital. There is a major programme of investment in cancer care, involving both equipment and staff. Recent developments include a new £1 million breast screening unit and a new £1 million linear accelerator for radiotherapy treatment, which will make an important
contribution to improving detection and treatment of cancer. I reassure Members that cancer services will remain a central part of the services that Kent and Canterbury will offer.Key points need to be made. First, Kent and Canterbury hospital is part of the Kent cancer network. It will remain so under the recommended option. The network, which is very successful, serves a population of nearly 1.8 million people, including residents of Kent, Medway and Hastings and Rother. East Kent's service for radiotherapy and chemotherapy day attendees will continue at Kent and Canterbury, supported by high-quality diagnostic and treatment services.
Under the recommended option, Kent and Canterbury will develop an ambulatory and out-patient model of care, which will allow the vast majority of patients to continue to receive their cancer care locally. In fact, it is the model that most patients undertake now in terms of their diagnostic, screening and initial treatment options for cancer. Therefore, it is right to say that the cancer option that has been set out means that Kent and Canterbury will still be part of the Kent cancer network and will be providing high-quality services to people in the area.
Mr. Brazier: I am most grateful to the Minister for giving way once more. Does she accept that, during the consultation process, two of the three consultants responsible for delivering those cancer services spoke out most vehemently against the weaknesses in the proposals? At the end of the process, when Professor James, who has overall responsibility from Maidstone, alleged that medical staff were in favour, the third was so angry that she too spoke out vehemently against them. No consultant at Canterbury believes that the proposal on the table would deliver long-term, viable joint cancer centre services.
Ms Blears: I am aware that the proposals are controversial, as are the rest of the proposals for Kent and Canterbury, but I am also aware that the national cancer director, Professor Mike Richards, went down to the hospital and his information is that the consensus was perhaps larger than the hon. Gentleman suggests in terms of the reassurance given to local consultants on the quality and safety of the services that would be available. Inevitably, when there is change—I understand this—local clinicians are extremely concerned, because they have the real interest of patients at heart in trying to provide those high-quality services. In terms of the cancer network, reassurances have been given on ensuring that Kent and Canterbury remains a key part and that it can provide good-quality services to local people.
I want to say a word or two about transport, which is another key issue. The hon. Member for Faversham and Mid-Kent has emphasised that. On my visit, I had the opportunity to travel some of the area's winding roads, so I appreciate the transport difficulties there. The matter has been reviewed by the Kent county council scrutiny committee, which has done an extremely thorough job in considering the proposals. The trust has now accepted that further work is needed on the feasibility of expanding NHS transport in the area, and
it will continue to work with public transport providers to try to maximise travel opportunities to the hospital sites.The Kent county council review found that services should be tailored to the needs of local people in terms of transport arrangements for patients and visitors. It is crucial for visitors to be able to attend hospital, as access to them is often a key factor in a patient's recovery. Such arrangements should be developed and implemented within the wider plans for reconfigurations. This is not an isolated issue in respect of east Kent, as a recent social exclusion unit report shows that people in many communities up and down the country often do not attend hospital appointments because they cannot get there using existing public transport options. We need to be much more imaginative in trying to find ways to facilitate easy access. The problems in rural areas are clearly sometimes exacerbated due to sparse rural transport.
The response from the trust has highlighted the positive steps that have already been taken. It is working on two projects to try to improve patient and visitor access, and is examining other rural transport schemes. It has plans to implement a green transport plan to address problems on-site, and intends to carry out further work to examine whether transport links can be improved across the region. Under the options, on which, clearly, Ministers have not decided, and which are subject to advice from the independent panel, I understand that 85 per cent. of patients would still be treated at Kent and Canterbury who could normally expect to be treated there. I am not seeking to minimise the transport problem: although not everyone will have transport problems, clearly it is a significant issue in this area.
The interim delivery strategy, to which the hon. Gentleman referred, has not been the subject of consultation and is certainly not the subject of decisions by Ministers. I am pleased, however, that he welcomes aspects of that strategy. It is being developed by a working group from the trust and the primary care trust, involving clinicians and public representatives. A draft strategy was presented to the East Kent hospitals trust board on 14 March, and three options were set out. I understand that the hon. Gentleman takes exception to the third option that has been set out, but welcomes some of the other proposals. It is an important strand of the overall programme to modernise and update services, and it demonstrates the commitment of the trust and the primary care trust, which, ultimately, will have to find the resources to sustain the changes—to make sure that services in east Kent are safe and sustainable—and, given the pressures within the system, attempt to have a best-value approach to ensure financial efficiency.
The hon. Gentleman mentioned the financial difficulties that the area faces. Services there will benefit from an increase in investment of around 30 per cent. over the next three years, which is similar to other areas in the country—the biggest ever investment in the NHS—but I recognise the pressures that the whole health service is under. We have a long way to go in terms of increasing capacity, dare I say, after many years of under-investment and a lack of capacity in the system.
All three options outlined in the interim strategy will mean that Kent and Canterbury will retain a number of core services. There are proposals to enhance emergency services with the introduction of an emergency centre, under which vascular surgery, urology and clinical haematology would be provided together at Kent and Canterbury. A clear, important and sustainable role for the hospital is therefore envisaged in some of the proposals.
In relation to the interim delivery strategy, the local health community has been engaged fully in the process to try to meet the third core principle of our new guidance: that there should be a whole systems approach to these decisions. The plans have also been shared with senior clinical staff and presented to the Canterbury and Thanet community health council.
In conclusion, I want to say a few words about the next steps in the process, as those will be of great concern to local people. I am very conscious of the length of time that it has taken to resolve these matters. For clinicians, the public, the patients and everyone who works in the trust, certainty is very important. Although, as I have said, the matter will be referred to the independent reconfiguration panel, which is the right thing to do, we will make it clear, as a matter of urgency, that we want
the independent reconfiguration panel to report to us with their advice. We will be writing as a matter of urgency to the panel. We will set out the terms of referral. We will also write to the community health council chairmen who referred the case originally to inform them of the action that is being taken. We will certainly try to let local people know far as we possibly can that this matter is drawing to a conclusion. I expect the independent reconfiguration panel to look at the case quickly and to provide its advice to Ministers as a matter of urgency because, as I say, I am hugely conscious of the need to get some certainty into the process.Regardless of the final decision that is taken, new facilities and models of care in this area are needed. They will enable the trust to provide health care to Canterbury residents. What is important for all of us involved is that those services be sustainable in the long term. They must provide an improved and better service for patients and the local community. That is what we are all aiming to achieve for the residents of the whole of east Kent. That is our overriding duty.
- Adjourned accordingly at six minutes to Nine o'clock.
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