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Motion made, and Question put forthwith, pursuant to Standing Order No. 25 (Periodic Adjournments),

Question agreed to.

4 Dec 2003 : Column 751

Hemel Hempstead Hospital

Motion made, and Question proposed, That this House do now adjourn.—[Paul Clark.]

6.37 pm

Mr. Tony McWalter (Hemel Hempstead) (Lab/Co-op): I have only one theme under the debate title of "Hemel Hempstead Hospital". I want the Minister to require some sums to be done by the Bedfordshire and Hertfordshire strategic health authority. It has refused to do any sums and in my view it threatens health services in its area with a huge debt for the next four decades.

I thank the Dacorum hospital action group, which is in no less than its 29th year of campaigning on the matter. During my seven years as an MP, I have delivered 88,000 signatures to Health Ministers, to Downing street and to others in defence of Hemel Hempstead hospital, yet there is still a strong sense that a desperately bad, wasteful and what I call nugatory decision is about to be taken. By that I mean that the decision will not benefit Hertfordshire and will not lead to the dispersion of services.

The context of the debate is the desperately bad state of the Hertfordshire acute health system. I have called it a black hole because it is the only population of 1 million that I have been able to find that has no tertiary acute services to support it. There are four acute hospitals, of which three are in a state of acute decay. It is estimated that it will cost £90 million to repair Princess Alexandra tower at Watford, and £90 million to repair the main tower at the Queen Elizabeth II hospital in Welwyn Garden City. There has been a quotation of £50 million for the Lister hospital in Stevenage. Only Hemel Hempstead hospital is in a passable condition and that follows the closure of St. Albans acute services in the early 1990s.

The desperate condition of the service is reflected in the desperate condition of mental health services, with four large mental health hospitals closed during the Thatcher era. Our system has operated at a chronic loss for decades, so every time we need anything done, people say, "Sorry, we cannot do it. There's no money." The system has been divisive; those in Hertfordshire who are wealthy can go to London, but the poorer get treated in second-rate hospitals that cannot give the full range of services in Hertfordshire.

That could change. The Government have offered a way forward, with funding that will make the system free of debt and with some tertiary acute services provided locally. The Varley report on cancer said that there should be a location of such services in Hertfordshire and the Government have indicated that they are prepared to finance that move. That is fantastically good news for Hertfordshire and I thank the Minister and his Department for the response that they have made to the recommendations in that report.

For three decades, there has been a desire for two things from the administrators of health in Hertfordshire. First, there is a desire for what is called a super-hospital—a single hospital with acute services, governing the whole population of Hertfordshire. That is a stupid suggestion because Hertfordshire is a series of relatively small market towns with relatively poor

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transport links between the various bits of the county. We need a distributed hospital system, not a concentrated one. With those suggestions, there has always been a suggestion of marginalising Hemel Hempstead hospital, despite the fact that it is in the most populated part of the county and, indeed, the eastern region.

We had a review recently. Those involved called it a consultation; we called it an absolute stitch-up. There were two options in the consultation but both involved significant service closures at two of our four hospitals. The first option was to prefer Hemel Hempstead hospital and Stevenage but to shut trauma facilities at Welwyn Garden City and Watford; there was a tick for Hemel and Stevenage under that option. The other option was to close trauma facilities at Hemel and Stevenage and improve them at Watford, while inaugurating a new hospital in Hatfield after shutting down the mouldering Welwyn Garden City hospital. There is a strong demand in most communities for new hospitals and mine is no exception, so option two—the new hospital in Hatfield—was favoured.

The costs were never properly examined, despite a claim by my hon. Friend the Member for St. Albans (Mr. Pollard) at a recent meeting that all the sums had been done. I speak as a mathematics graduate and say that none of the sums has been done. Throughout the consultation, there was a strong feeling that an agreement for a £500 million private finance initiative could be gained from the Government, so a new hospital at Hatfield and the demolition of the present hospital at Welwyn Garden City were given active consideration. While we are about it, it was thought, why not bung the new cancer centre in Hatfield, even though it is not even in the current Mount Vernon cancer network area? Why not, by the way, also develop a new medical school—but that was not factored in. That was the strong feeling in the community.

The deadline for the end of the consultation was early September, but it became clear at the beginning of August—when I made a 20-page submission to the strategic health authority—that although we heard that trauma facilities at Hatfield and Watford were to be developed, only £27 million had been allocated to Watford for improvements. That would not even repair the plumbing. Watford is in as dreadful a state as the Queen Elizabeth II hospital in Welwyn, which the strategic health authority proposed to demolish.

On 28 August, a mere five days before the consultation was due to end, it was realised that if that part of the plan was kept to, Watford would pull out, recognising that it, too, was going to lose its facilities in a major way. On that day, a document—a "clarification"—was issued, which I have before me. It strengthened option 2 by what I can only describe as fairy godmother economics: let money pour out of the sky, and as a result not only build a £500 million hospital in Hatfield but, it seemed to suggest, provide a similarly scaled scheme at Watford. Incidentally, the Hatfield initiative would be the largest health private finance initiative ever, overtaking the University College hospital, which cost £422 million. But the Watford scheme was never costed or admitted to; mutterings were simply made to the effect that "whatever it took" would be provided.

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I have since found out in a recent meeting with the chair of the West Herts Hospitals NHS trust that every single building at Watford may well have to be demolished and replaced. Thus we have not just a massive, £500 million project, which is what the consultation was said to be about, but a project twice that scale, involving demolishing and replacing two hospitals. We have not a £500 million project for two new trauma centres, but a £1 billion project for two new hospitals in Hertfordshire. That is the current suggestion of the strategic health authority.

I am afraid to say that in my view, the strategic health authority has severely misled the public. It released the figures on Watford only after I made my submission, in which I pointed out that its plans were incompetent. All that it did was simply to adopt the fairy godmother option: spend, spend, spend, regardless of the constraints that any responsible Government body should have. That is why I ask that the sums be done.

I do not actually believe that the result of those activities will be a series of new super-hospitals. The strategic health authority's plans are so absurd, costly and damaging that the laudable plan of addressing the problems of the Hertfordshire NHS by developing new tertiary services, along the lines of the Varley report, will be lost as well.

Everyone is in favour of fairy godmother economics—if they are to receive benefits. At a recent vote, the strategic health authority approved this wonderful plan by 10 votes to one. Personally, I would not have voted for either of its rotten options. Option 1, which people said would benefit Hemel hospital, was based on a wonderful premise that most did not spot. The strategic health authority arrived at the idea that the options would not be that different in cost. How could it have done so, given that the only hospital in Hertfordshire with a decent estate is Hemel? Everyone admits that it is in much better condition than the other three hospitals. The strategic health authority said, "Actually, putting the cancer centre at Hemel hospital, which everyone agrees is decidedly possible, will cost £95 million." That is not exactly chicken-feed, bearing in mind that Dartford hospital cost £94 million. We were pleased that that was possible, but the strategic health authority said, "If we're going to put the centre there, you've got to knock down the rest of the hospital, leaving only the Verulam wing standing."

What a pernicious, even vicious, premise on which to base a consultation! We repudiate and reject the idea that a hospital that has recently been given £4.2 million of investment—including a superb new facility that allows excellent communication between accident and emergency and the fracture clinic, and a new magnetic resonance imaging scanner—should be knocked down, just so that the strategic health authority can make it seem as though it is faced with two options of similar cost.

Hemel Hempstead happens to be at the geographical centre of the Mount Vernon cancer network area. The new cancer centre could be developed on the so-called Paradise site, which is in public ownership—it is owned by English Partnerships—and can be offered to the NHS as a massive development site, at agricultural prices, in a town centre in Hertfordshire. What a phenomenal boon that would be to the NHS budget. I

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have arranged that deal myself, so I know that it is binding on English Partnerships, which has development land elsewhere in exchange.

Dacorum council also wants hospital consolidation, and has offered an additional site for accommodation for nurses and other hospital staff. Hemel Hempstead hospital has the capacity to quadruple its present size and still have adequate facilities for a whole range of developments. It also has wonderful access to the M1, the M25 and the A41, and, because it is in a town centre, fantastically good bus links with a wide variety of locations, many of which are a long way from Hertfordshire.

For £200 million, the whole Hertfordshire hospital system could be revivified, and most of the remaining £105 million could be spent not at Hemel Hempstead hospital, which does not need that much, but in the rest of the system, which is crumbling, derelict in places and desperately neglected. We might then be able to negate the accurate perception that Hertfordshire is not in the forefront of NHS acute services development.

I do not expect the Minister to announce now that he is in favour of one way of improving the health service in Hertfordshire rather than another. I have known him too well and for too long to think that such an answer would be forthcoming. All I want him to do is to ensure that the sums are done, because we are talking about the difference between £1 billion and £200 million. It will be a scandal if people get away with knocking down new productive NHS plant and putting the same facilities up elsewhere, at massive cost to the taxpayer and the NHS.

I ask the Minister to direct that any business plan for the development of acute services in Hertfordshire carefully considers the prospect of improving services by developing the cancer centre at Hemel Hempstead, which is in the middle of the cancer network area. The taxpayers of Hertfordshire support the Government's plans to improve the NHS in the county, but they do not want their system saddled with chronic debt for the next 40 years, and they want some resources left for primary care and mental health. Any numerate person must know how absurd are the ill-considered, late breaking, support-brokering plans of the Bedfordshire and Hertfordshire strategic health authority.

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