| Previous Section | Index | Home Page |
Madam Deputy Speaker: I think the Ayes have it.
Division deferred till Wednesday 24 March, pursuant to Orders [28 June 2001 and 6 November 2003].
ADJOURNMENT (EASTER)
- That this House, at its rising on Thursday 1st April, do adjourn till Monday 19th April 2004.—[Mr. Heppell.]
PARLIAMENTARY CONTRIBUTORY PENSION FUND
- That Mr Eric Martlew, Ms Gisela Stuart and Dr Nick Palmer be discharged as Managing Trustees of the Parliamentary Contributory Pension Fund and Mr David Borrow, Mr Terry
- Rooney and Mr Andrew Love be appointed as Managing Trustees in pursuance of section 1 of the Parliamentary and other Pensions Act 1987.—[Mr. Heppell.]
PETITION
Council Tax
9.15 pm
Mr. Paul Goodman (Wycombe) (Con): I wish to present a petition on behalf of 1,000 readers of The Star newspaper in my constituency about the council tax. It reads as follows:
- To the honourable the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled,
The humble petition of the readers of The Star newspaper sheweth
That levels of council tax are too high and should be reduced.
Wherefore your Petitioners pray that your Honourable House will urge the Deputy Prime Minister to reduce the levels of council tax in Buckinghamshire.
- And your Petitioners, as in duty bound, will ever pray, etc.
Health Services (Northavon)
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Heppell.]
9.16 pm
Mr. Steve Webb (Northavon): After two and a quarter hours of voting, it is good to have the opportunity to raise the future of hospital and community health services in my constituency. I particularly welcome the Under-Secretary of State for Health, the hon. Member for Welwyn Hatfield (Miss Johnson), to her place, because I understand that she grew up in Northavon, or at least spent 10 very happy years there. She will therefore appreciate some of the issues that I seek to raise about the need for health care not merely for those living in inner-urban areas, but for those who live in market towns and rural villages.
The future of hospitals and community health services in my constituency is in a state of flux, and it feels as though it has been like that for as long as I have been a Member of this House, and probably for a very long time before that. The local strategic health authority is preparing something called the Bristol health services plan, and it is indicative of the approach being taken that it is seen as a Bristol-driven process to look at the needs of the urban community. The fact that it also serves the more rural communities of south Gloucestershire and north Somerset does not seem to feature quite as strongly on the agenda of the strategic health authority as I would wish.
At present, the local health trusts are involved in what they call "engagement" with the local communities, rather than consultation, as they do not yet know what they want to do. Public meetings are being held, some of which are well attended, some of which are sparsely attended. I could have saved the trusts a good deal of trouble in that regard. As the Minister knows, I undertook my own "engagement" with my constituents, in which I issued a detailed and careful health survey to every household in the constituency. I received more than 8,000 replies, and I have supplied the Minister with a copy of the report of the survey.
Sometimes such surveys can be a bit dodgy, involving questions such as "Do you want your local hospital to be closed: yes or no?" We all know the value of the response to surveys such as those. I like to think that the exercise that I undertook was a bit more serious. It put to local residents some of the hard choices that have to be made and asked them whether, if local health professionals advocated a particular reconfiguration, they would endorse it, whether or not it was driven by clinical guidance.
I should like to report some of the survey results to the House. The most striking was that 81 per cent. of the constituents who responded felt that the residents of south Gloucestershire—as distinct from the residents of Bristol—were not being fully taken into the process. To give an example of that, the local national health service trust, North Bristol NHS trust, recently reported a massive financial deficit and invited local MPs to a meeting to tell them about it. I discovered on the day of the meeting that I had not been invited. The meeting was being held at Frenchay hospital, in my constituency. When I rang the hospital to ask why I had not been invited, I was told that the Bristol MPs had been invited,
and that I was not in Bristol but in south Gloucestershire. This may sound like parochial nit-picking, but it goes to the heart of my concerns. Health care decisions are often driven by an urban agenda, and by the needs of the big city and the big conurbation. Areas such as south Gloucestershire can sometimes be marginalised in the decision-making process. When I turned up to the meeting, I asked whether local councillors had been invited, and I was told, "Yes, the Bristol city councillors are here," so I said, "Have any south Gloucestershire councillors been invited?" The reply was, "Oh, no, we didn't think about that." It is indicative that the Bristol health services plan has not paid attention to the needs of south Gloucestershire residents, and that is why I am pleased to raise the issue.Not only did 81 per cent. of my constituents feel that south Gloucestershire's residents were not being listened to properly in this process, but there was substantial opposition to one of the key ideas coming forward. That idea was that of the two principal sites currently run by North Bristol NHS trust—Frenchay and Southmead— the current drift of thinking is that Frenchay should be at best downgraded, perhaps lose its A and E department, perhaps be no more than a community hospital, or even have nothing at all on the site. Some 81 per cent. of my constituents said that they would not accept that outcome, even if the trust said that that was on medical grounds. The public are very sceptical. They have heard about the financial position of the trust, and they are sceptical about the proposals being driven by health considerations rather than financial ones. One of the difficulties that the trust faces is that at the same time as trying to make long-term plans, it is trying to deal with a massive deficit. Short-term cuts are therefore going on at the same time as it tries to set out a long-term vision. That sends confusing messages to the local public about cuts.
Dr. Doug Naysmith (Bristol, North-West) (Lab/Co-op): Will the hon. Gentleman give way?
Mr. Webb: I will not at the moment. If I have time, I will do so later.
I put to my constituents the idea of some community-based facilities. One idea that I put to them was that of a walk-in minor injuries centre, perhaps at Yate, one of the principal population centres in my constituency. That idea was quite well received, but it was clear that people did not regard that as an adequate substitute for a properly resourced 24-hour accident and emergency unit at a proper hospital. My constituents will not be satisfied if they end up with somewhere to deal with bumps and bruises locally but lose access to a high-quality casualty unit 24 hours a day at a local major hospital, which they currently have at Frenchay.
I put some options to my constituents as to community facilities that they would like to see. The three that came out top were: first, a minor injuries unit, particularly in the Yate and Sodbury area, but there was also support in the Thornbury area; secondly, being able to have out-patient appointments nearer home, which obviously would be popular and, given the lamentable state of public transport in the area, very sensible; and thirdly, intermediate care beds. Certainly, the existing provision in my constituency at Thornbury hospital, which people are able to use nearer to home, rather than a big, slightly impersonal hospital, is very much valued.
Under the current process, local trusts are preparing what are known as strategic outline cases. Those are nearly finalised and will be submitted to the strategic health authority in the next few weeks. They will be sent on, assuming that they are approved by the strategic health authority, and will reach the Government by the end of April. I understand from talking to North Bristol NHS trust today that it is anticipated that the Department of Health will receive 11 of those strategic outline cases and is likely to approve five. The broad time scale to which it is working is by the summer. If that is not right, I hope that the Minister will correct me.
I want to ask the Minister what criteria the Department of Health will use in assessing those bids, which, I presume, will be from health authorities all around Britain. I want to suggest three criteria that I would like to see used. First, I do not want cuts in capacity. The current plan envisages cuts. At present, once minor adjustments have been made, North Bristol NHS trust has 1,563 beds. The draft strategic outline case that I have seen envisages cutting that by nearly 200 beds. That is at a time when demand, as a result of a rise in the population, would imply an increase of 281 beds. If we add those two numbers together, there is an implied shortfall, compared with present provision, of nearly 500 beds. In south Gloucestershire, the number of people over 65 will rise by half in the next decade or so, and the number of people over 75 will rise by a similar proportion. Given the huge growth in demand for hospital services, the idea that any strategic outline case would contain fewer beds than at present seems totally unacceptable.
We have seen what happens when hospitals do not have enough beds. Now we are confronted with the idea that we should plan on the basis of fewer beds. The theory is that the hospital will become more efficient, will drive people through more quickly, and will progress from being one of the worst to one of the best performers, freeing bed space and allowing the provision of care. Let us see the evidence. Let us see the hospital deliver improved throughput. Then we might look at how many beds are needed. The idea that we should plan on the basis of cutting hundreds of beds when population pressures imply that we should be adding hundreds of beds is totally unacceptable.
The Bristol Evening Post recently ran a front-page story about cancelled operations at North Bristol, another big problem for my local trust. The main reason given was lack of beds. If that is the situation now, what will it be like when 200 beds are taken away, given population pressures that should add a further 300? I simply do not accept that a strategic outline case based on bed cuts will be acceptable to my constituents.
The second thing that my constituents want is access to world-class facilities, including accident and emergency. Access is a key issue. The Minister knows, having been to school in a village in my constituency, that reaching Frenchay hospital works for many of my constituents, particularly in the main area of Yate and Sodbury. If casualty services were taken out of Frenchay hospital, which is mooted in the medium term, I think it unlikely that people would be able to travel from my constituency up towards the Cotswolds, from villages such as Charfield, where the Minister grew up, Wickwar or Hawkesbury to Southmead hospital in a decent period. It may be possible at some times of day,
but at others, when the north of Bristol and the south of south Gloucestershire are clogged and the ring road is clogged, people could get stuck. I am not convinced that any strategic outline plan that removes 24-hour access to A and E from my constituents will be acceptable to them. I hope that the Government will take that into account when responding to the strategic outline case.
| Next Section
| Index | Home Page |