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To be read a Second time on Friday 16 July.
GENETICALLY MODIFIED ORGANISMS BILL
Order for Second Reading read.
To be read a Second time on Friday 15 October.
TELECOMMUNICATIONS MASTS (NEED AND SAFETY TESTS) BILL
Order for Second Reading read.
To be read a Second time on Friday 16 July.
CRIMINAL JUSTICE (JUSTIFIABLE CONDUCT) BILL
Order read for resuming adjourned debate on Second Reading [14 May], That the Bill be now read a Second time.
Debate to be resumed on Friday 16 July.
TOWN AND COUNTRY PLANNING (TELECOMMUNICATIONS MASTS) BILL
Order for Second Reading read.
To be read a Second time on Friday 16 July.
18 Jun 2004 : Column 1049
Clinical Services Review (South West London Health Authority)
Motion made, and Question proposed, That this House do now adjourn.—[Margaret Moran.]
2.32 pm
Tom Brake (Carshalton and Wallington) (LD): I am pleased to have secured the debate in the pre-consultation period of the "Better Healthcare Closer to Home" project, which is otherwise known as the clinical services review or strategy. My hon. Friend the Member for Sutton and Cheam (Mr. Burstow) hopes to catch your eye, Mr. Deputy Speaker, and I shall leave him some of my time to raise other points with the Minister.
I had friendly discussions with the Minister's spy at yesterday's seminar and I understand that the spy has been in touch with him and that he has been fully briefed. I therefore hope that he can respond to the points that I shall make.
First, I support the concept of the strategy, which is that there should be a critical care hospital and several local care hospitals. Yesterday's meeting was well attended by representatives from many health organisations, patient groups and so on. There was support for the initiative at the meeting. People asked for more information but they also wanted to make progress. A problem with such projects is that the time scales are inevitably long because of the need for consultation, reforms, the building process and so on. If steps are not taken, there is a risk that the project will die an unceremonious death when some new initiative supplants or replaces the current one. People want progress to be made.
St. Helier hospital and Sutton hospital clearly need to be rebuilt. Anyone who has visited those hospitals will know from the state of the structures that they require urgent attention. I understand that parts of St. Helier hospital are off-limits to patients because of health and safety concerns. Measures such as the working time directive make the need for the development of such concepts even stronger, and the proposed changes would probably happen in any case.
Whatever configuration is arrived at for the local care hospitals and critical care hospital, the highest priority must be to ensure the best quality of patient care. It is also important that the critical care hospital should be as close to the centre of the area that the trust serves as possible, with that centre adjusted to take into account the health profile of the catchment area. St. Helier is an area of my constituency, and of the London boroughs of Sutton and Merton, that has significant health needs to be addressed.
Accessibility and employment considerations will also be factors in determining where the critical care and local care hospitals will be located. St. Helier, which crosses the London boroughs of Sutton and Merton, is one of the areas with the highest level of deprivation in those two boroughs, so the employment impacts will be significant. Accessibility for a
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population many of whom do not have access to their own transport will also be important. One measure that could significantly improve the accessibility of St. Helier hospital, which is already good, would be the extension of the Croydon tram to Sutton. If the Minister is a good friend of Ken Livingstone, perhaps he will have a word with him about bringing that tram to Sutton. We would certainly welcome that. The location of the hospital will of course be dependent on other factors such as the availability of land and planning considerations, but taking all those criteria into account, the St. Helier site is likely to be the most appropriate for the development of a critical care hospital.
I should point out that although I think that the development of such a hospital would be welcome in the area, some residents who live on the proposed new hospital site would be affected quite significantly by it and might have some objections. I intend during the next few days to write to the residents who would be most closely affected to ask them for their views and to bring to their attention the fact that although there is nothing concrete about the plans yet, there are proposals of which they should be aware.
If the St. Helier site is developed, because the proposed land is metropolitan open land the Office of the Deputy Prime Minister will have to approve the change, although I understand that there is likely to be compensation in terms of metropolitan open land being provided at another location close by, which might address that issue.
Another site, the Sutton site, is also being considered, as is the Epsom site. There is an issue specifically in respect of the Sutton site on which I hope the Minister will respond. The site is close to the Royal Marsden hospital, which has, as the Minister will know, recently secured foundation status. If the Sutton site were to be developed, I have no reason to believe that the Royal Marsden, were it approached and asked to contribute some of its land, would refuse such an approach. In fact, I understand that some positive discussions are under way. However, I pose a hypothetical question to the Minister. If such a trust or foundation hospital anywhere in the country were approached and asked to participate in a project that the community felt was in the best interests of the local health community, and that foundation hospital decided that it did not want to take part, would the Minister have the power to direct that foundation hospital, and would he use that power if he had it? I hope that he will be able to respond on that point.
Another point on which I hope the Minister will respond is the proposal that some have mooted that if the St. Helier site, for example, were developed, the Epsom site would declare UDI and go its own way. Has the Minister had a chance to consider that suggestion? What does he think of its viability?
I have a couple of points on the consultation process. The formal consultation will run from 1 September to 30 November, and my hon. Friend the Member for Sutton and Cheam and I intend to hold a large public meeting in September to hear people's views on the proposals. For the consultation process to be meaningful, options setting out the probable or likeliest location of both the local and critical care hospitals will have to be provided. It must be seen as
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a package. Given that the range of possible locations for the critical care hospital is limited, it should be possible to identify the probable locations of local care hospitals at the same time. We will need to know what the range of services provided by those hospitals will be, too.
Consultation with patients and future patients will have to be extensive, because the existing forums, which were put in place after the abolition of community health councils, are in their infancy. Consultation will have to encompass not just the people who were present at yesterday's meeting but those who have traditionally been excluded such as black and ethnic minorities, the unemployed, single parents and so on—it must go beyond the usual suspects. Does the Minister believe that the effectiveness of the forums would be enhanced by allowing them to sit as observers on the programme board for the clinical services strategy? I understand that they currently do not have observer status.
The battle over community health councils was lost, but their replacement is in many ways much more complex and underfunded. Does the Minister agree that the original indication was that patient forums would have about 15 volunteer representatives, but that the number has been reduced to 10? Will he explain why? I have been told that that is to save on their expenses, which, incidentally, are lower than those of staff, which I do not quite understand. Will he assure us that the Secretary of State's recently announced cull of quangos will boost the funds that will go to local forums?
Is the Minister aware of a letter that was sent from the collective forums of the south-west London strategic health authority to the chief executive of the Commission for Patient and Public Involvement in Health, in which Barbara Price expresses concern that owing to a lack of information that the forums and forum support organisations receive from the commission, they are struggling with some of the essential administrative and financial aspects of this role? They are concerned that no timetable has been set in which their concerns will be addressed. I hope that he will pick up on that point.
To return to the specifics of the "Better Healthcare Closer to Home" initiative, and to conclude to allow my hon. Friend the Member for Sutton and Cheam an opportunity to speak, it is important that residents who remember the breach of trust that occurred when a previous NHS trust failed to provide a separate children's hospital on the St. Helier site are reassured that the total package will be delivered. They will also need assurances that the reorganisation will not affect existing services and will not exacerbate problems that still exist between the Epsom and St. Helier hospitals, which have not been addressed since their merger a number of years ago.
Mental health issues must be brought to centre stage because they are currently on the periphery, and I welcome the fact that the programme board has agreed that it will present a paper covering the subject. The
18 Jun 2004 : Column 1052
impact on other trusts needs to be properly quantified and assumptions about how many patients will choose to travel to an alternative hospital will need to be verified against actual changes experienced elsewhere in the country. Nothing will progress without funding, and I hope that the Minister can provide some reassurances on that.
"Better Healthcare Closer to Home" should be good news for patients. It should improve outcomes and make health care more accessible. I hope that the Minister's response will make it clear that the Government will give their backing to these plans. Without the Government's financial support, "Better Healthcare Closer to Home" will be nothing more than a pipedream.
2.44 pm
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