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10.12 pm
Mr. Paul Marsden (Shrewsbury and Atcham): I will keep my remarks very brief.
I am dismayed and disappointed by the remarks of the hon. Member for The Wrekin (Peter Bradley). He talked in the language of great misgivings, bitter experience and rivalry. Those terms were very appropriate under the Conservatives before 1997, when there was bitter rivalry between the Royal Shrewsbury and Princess Royal hospitals. That is certainly no longer the case. I am afraid that he most certainly speaks as one of the minority—the tiny minority.
Having checked with the PRH and the RSH tonight, I can say that it is clear that there is overwhelming support for the merger in Shropshire and Telford and the Wrekin. Seventeen out of 18 stakeholders, including community health councils, local authorities, the trusts, primary care trusts and the hospitals themselves, are in favour of merger. The 18th stakeholder has passed no motion in favour or against merger and expressed no opinion. There have been 35 meetings with the public and staff to explain what is happening, and there has been overwhelming support.
I genuinely wish that the hon. Member for The Wrekin had not been quite so strident in expressing his views. If the merger is delayed, it will be at a grave cost to the hospitals. A population of about 500,000 is needed to make a hospital viable in this day and age.
The joint population of Shropshire, Telford and the Wrekin is about 436,000. However, if he expects that the Princess Royal hospital can survive alone as one of the
two smallest district general hospitals in the country, he is sadly mistaken. All the clinicians, GPs, consultants and other health care professionals are on board. The public are on board—more than 95 per cent. are supportive. It is incredible to think that the hon. Member for The Wrekin, and possibly the hon. Member for Telford (David Wright), too, are against the proposed merger. I urge the Minister to think carefully and to take everybody's views on board. We want a thriving, sustainable future for Shropshire health care services, and if we delay on this proposal we jeopardise the futures of the Royal Shrewsbury hospital and the Princess Royal hospital.10.15 pm
David Wright (Telford): I want to respond briefly to the hon. Member for Shrewsbury and Atcham (Mr. Marsden). In general terms, neither I nor my hon. Friend the Member for The Wrekin (Peter Bradley) is, as he suggests, opposed in principle to the merger of the two hospitals: we are interested in ensuring that a medium to long-term development plan is in place to ensure the future success of the two hospitals. The problem that communities in Telford have had over many years is that we have not had any reassurance from numerous Ministers—I have to say that my hon. Friend the Minister is excellent at liaising with Back Benchers—about a long-term commitment to ensuring that we have a sustainable hospital in Telford. That is what we are seeking in this Adjournment debate and have tried to seek throughout the consultation process.
I am extremely concerned by the final point made by my hon. Friend the Member for The Wrekin about the possible budget deficit for the two hospitals, which may mean that resources have to be found from the wider health authority and strategic health authority economy in Shropshire and Staffordshire. I hope that the Minister will reassure me that we can look to some central provision to support the strategic health authority in progressing the merger and ensuring that, if it goes ahead, it is successful, so that the needs of both communities—in Shrewsbury and Atcham and in Telford—are met, and we have the highest-quality health services that we can possibly have for our people.
10.17 pm
The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I begin by congratulating my hon. Friend the Member for The Wrekin (Peter Bradley) on securing the debate on an issue that is important to him and to his constituents. I commend him for the assiduous way in which he has continued to lobby on behalf of the people of The Wrekin and Telford. He, like the people of Telford and Shrewsbury and the surrounding area, is eager to secure the very best-quality health services that those communities expect. In that sense, I hope that I share common ground with him and, indeed, with my hon. Friend the Member for Telford (David Wright).
The proposed merger of the Princess Royal hospital and NHS trust and the Royal Shrewsbury hospital and NHS trust was subject to public consultation following a decision to merge on 26 June 2002. The consultation ran between December 2002 and March 2003. As my hon. Friend will know, following that consultation the
chairs of the two trusts decided to merge the two hospitals. The matter was then automatically referred to the Secretary of State for Health for a final decision. I am currently considering my decision on the merger, so my hon. Friend's debate is timely. I welcome this further opportunity to hear his views and assure him that I will take them fully into account as I consider every last detail of the merger plan over the next few weeks.It will be useful if I remind hon. Members of the background to the consultation and give an indication of the issues that I will consider before making any decision.
As my hon. Friend said, much local history surrounds the proposed merger of the two trusts. Although they have separate boards, for several years they have shared an executive management structure and they collaborate closely on clinical networks and services.
Before approval to go to formal consultation, the two trusts prepared an expression-of-interest document. It set out a range of reasons for an acute hospitals merger based on factors such as the effective use of resources and building on the existing shared arrangements at chief executive level. As my hon. Friend the Member for The Wrekin said, I met him and my hon. Friend the Member for Telford before the start of the public consultation to discuss his request that it should be delayed. I am grateful for the credit that he gave me for delaying the consultation for a period of weeks. I stated that it must be as
- "open a consultation as possible."
I also stressed that no service change is being proposed in the merger discussions. I listened to my hon. Friend's comments about that. As he knows, the consultation specifically covers structural merger and is not about the services provided by the hospitals. However, I am fully aware that some stakeholders are anxious about the future provision of services. I have looked for them to be addressed in the merger proposal.
Let me summarise the key consultation issues. The consultation was on the proposal that the two existing NHS trusts should be dissolved and a new NHS trust established from 1 October 2003. It focused solely on organisational benefits, both managerial and clinical. It states:
- "The proposal does not discuss nor propose any changes to the services provided by the hospitals. There are no plans to change clinical services as a consequence of this proposed merger."
The consultation document set out three options: reverting to separate management arrangements; doing nothing and having continued collaboration; and merging the Princess Royal and the Royal Shrewsbury NHS trusts. The third option was the preferred option. The form of the consultation had two elements. The
Secretary of State has conducted a formal consultation with the community health councils of Shropshire and Montgomery and with the staff of the two hospitals. A public consultation has also taken place so that Ministers—in this case, me—could decide whether there is local support for the proposals.It is important to remember that the consultation specifically provides that no part of the proposals related to a plan to change any services. Indeed, the consultation is explicit about the commitment to retain accident and emergency, critical care and paediatrics at both hospitals. An independent chairman, Mrs. Cessa Moore, who has no direct connection with the two trusts, was appointed to lead the consultation. She established a consultation project board to oversee the process.
The project was led by a project director, Mr. Neil Lockwood, again with no direct interest in the result of the consultation.
Membership of the consultation project board included the chief officers of the two community health councils. The chief executive of the two trusts was also a member to ensure a link between the consultation process and the ongoing activities of the hospitals.
My hon. Friend will be aware that 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 services. The Department has recently published a document entitled "Strengthening Accountability" providing policy and practice guidance to support the NHS in meeting the requirements of this duty.
That Act also gave new powers to the overview and scrutiny committees of local authorities to review and scrutinise the planning, operation and development of health services. That ensures that the democratically elected representatives of local people, with responsibility for their well-being, have proper influence over the NHS. Those powers also came into effect on 1 January.
Overview and scrutiny committees have a particularly important role to play when a substantial change or variation to services is proposed. The NHS must consult the overview and scrutiny committee on any such proposal. The committee has a specific right to refer the proposals to the Secretary of State if it considers that public involvement has been inadequate or that the proposal itself is flawed.
Any consultation documentation needs to demonstrate that it was clear, simple, concise and could be readily understood. It also has to be readily available in both its full and summary forms, and all groups must have had sufficient time to consider their responses. I shall be looking to ensure that those statutory obligations have been met as I consider my decision.
I shall also be concerned to ensure that the analysis of responses was both accurate and comprehensive, covering both positive and negative aspects raised as part of the consultation. I will pay particular interest to the responses given by the local authority scrutiny boards, clinicians, nurses and other hospital staff, as well as the views of hon. Members.
My hon. Friend has many times made his misgivings on the merger clear, in particular the omission of Shropshire's third hospital, the Robert Jones and Agnes Hunt orthopaedic hospital. I am also aware of my hon. Friend's view that in any merger the west of the county might tend to dominate in decision making about access to services and facilities, potentially adversely affecting services at the Princess Royal hospital.
I recognise those concerns and in making my decision I shall be mindful of what is said in our recently published document, "Keeping the NHS Local". That states that hospital services need to change—
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