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Mr. Peter Viggers (Gosport): May I thank Mr. Speaker, through you, Madam Deputy Speaker, for allowing me the opportunity to raise this evening on the Floor of the House the issue of health care on the Gosport peninsula? The subject has been forced to the centre of our concerns in Gosport because of the Ministry of Defence's decision in December 1998 to close the Royal hospital Haslar, which is the only military hospital left in the United Kingdom. The local population greeted this decision with dismay and I proposed a rally and a march to the hospital—it involved 22,000 people—to express their view that the hospital should be retained.
The cause of the problem is that the MOD is seeking to disengage from hospital management, which is in stark contrast with the approach of Governments in other countries, who are building up—or at least maintaining—their defence medical services. Faced with a tremendous shortfall in key faculties in general surgery, anaesthetics, orthopaedic surgery and general medicine, the Government have taken the most peculiar decision to close the one remaining military hospital, at Haslar, and to develop a centre of military excellence elsewhere.
I maintain that in this area, more than any other, what we need is joined-up Government and the maintenance of links between the MOD and the national health service, but I am afraid that this Government have resolutely refused to provide that. In fact, although the Under-Secretary of State for Defence kindly invited me to his office, the purpose of the invitation was to tell me in clear terms that the MOD is absolutely determined to withdraw from Haslar not later than 31 March 2007. So, it is clear that the Government are determined to press ahead.
However, there is no doubt that Haslar hospital will be needed after March 2007, because the proposed development of Queen Alexandra hospital, Cosham, which is the subject of a private finance initiative bid, will not be completed by that date. Secondly, military medicine is still strong at Haslar and has much to offer in the context of the new hospital arrangements in south Hampshire, even after the development of Queen Alexandra hospital. Haslar still has 33 Field hospital. It has advanced telemedicine, a clinical measurement department, echocardiograms, cardiac systems and neurophysiological systems; such provision is not available at the proposed new location in Birmingham. If satisfactory arrangements can be made for the conjunction and joint use of Haslar with Queen Alexandra hospital, defence medicine would have a lot to gain and a lot to offer.
Military medicine is currently in a very sad state and there is a shortage in every specialty. The proposal was to move from Haslar to a new centre of defence medicine. At one point, the idea was jointly to involve Guy's and St. Thomas' hospitals in London. Then, the John Radcliffe hospital in Oxford was considered; indeed, Newcastle was also considered. Eventually, Birmingham was chosen and the decision was taken
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to spend £200 million on a new centre of defence medicine at Selly Oak hospital. Doing so would also allow military personnel to use the very good facilities at Birmingham university. Unfortunately, the Government ran out of money. The £200 million development was cancelled and, among other things, the admiral in charge of the project resigned from the Navy, rather than put through a project that he thought unworkable. Currently, armed forces personnel are left billeted out in twos and threes in small groups all around Birmingham. Some live in a YWCA hospital, some in a former hostel for the homeless. There is no real centre for defence medicine. The plans have collapsed, and so has the ethos of defence medical services.
The Ministry of Defence defiantly says that recruitment is satisfactory, but retention of trained doctors is at an abysmal level to the extent that the shortage of trained medical staff is a factor in troop deployment. We have to rely on other nations, particularly the Americans who, unlike us, give medical back-up a priority. If hospital and secondary care can be sorted out in Portsmouth and the Gosport peninsula, defence medicine could have a future in the south Hampshire area even now.
The civilian aspects, which are the main subject of my Adjournment debate this evening, are dominated by the construction of the new Queen Alexandra hospital at Corsham and the MOD's intention to close the Haslar hospital. The local population has consistently showed over the past six years complete determination in wanting Haslar to continue as a hospital providing local services. As a result of that determination, a consultation was undertaken by the Portsmouth and South East Hampshire health authority, which resulted in changes being announced in January 2000.
The announcement was as follows:
"The new Haslar Accident Treatment Centre will replace the RH Haslar accident and emergency department. This will treat . . . an estimated 17,500 per year . . . It will open 24 hours a day, seven days a week, and will be staffed by emergency nurse practitioners."
"Day surgery will be provided on the Haslar site for many patients in good general health—an estimated 1,100 cases a year. The day surgery will include general surgery, orthopaedics, gynaecology and urology. Diagnostic services, including x-ray facilities, and investigations will be provided at Haslar. Outpatient clinics on the Gosport peninsula will be increased so that around 5,000 more patients a year than at present will be seen at either Haslar or Gosport War Memorial Hospital. It is expected that there will be more than 100 clinics a week in over 20 specialties."
That is an outline of the proposals advanced by the health authority in 2000. The Haslar taskforce, which I formed and have chaired from the beginning, reluctantly went along with those proposals, believing that it was the best that could reasonably be expected. We were somewhat reluctant to lose in-patients but felt that Haslar could at least survive as a major hospital and perhaps even expand in due course.
We formerly had a primary care trust both for Gosport and for Fareham, then a Fareham and Gosport PCT, and now a Fareham and Gosport PCT that shares its executive with an another PCT—not a happy scene. That PCT has now put forward two revised proposals,
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both of which involve having a community hospital at Fareham. The main difference between the two is that the first proposal has one key idea—the retention of the Haslar cross-link to provide various facilities, including an accident treatment centre, out-patients, physiotherapy and occupational therapy. The alternative proposal would have similar facilities, but provided at the Gosport War Memorial hospital. It would expand the Gosport health centre to provide an accident treatment centre, out-patients, minor surgery and more diagnostics. Both alternatives include the Fareham community hospital, but only one would retain Haslar with the other developing the Gosport War Memorial hospital.
Haslar is a major hospital. It is a former district general hospital equivalent and it deals with out-patients, has an accident treatment centre, a breast unit, 5,000 gastroenterology cases a year, a first-class X-ray department, including an magnetic resonance imaging scanner and ultra-sound. Its diagnostic and treatment centre is very successful, having succeeded in reducing waiting lists for operations in the area. It is a busy and successful hospital. Support for Haslar in the community has not wavered. People respect its superb facilities and its staff and they admire the way that nurses march at Haslar. It is a military hospital and it retains the ethos and spirit of the area, which has very much a military flavour in south Hampshire. Haslar is an outstandingly good hospital and people want it to be retained.
Gosport War Memorial hospital, on the other hand, is a former cottage hospital. When it was a cottage hospital, it was proposed that it should close, and we all campaigned to keep it open. While we did that—this shows how fashions change in medicine—it suddenly became fashionable to have a community hospital, so it was expanded to become one, and it is also much loved. However, it is a small hospital on a site that is already quite congested. Car parking is really quite difficult and it would not take further expansion.
The one thing that is not mentioned in the latest consultation document by the primary care trust—in the shorter version, certainly—is money. What I most fear is that the comparison between the two proposals will not be dealt with like for like, but handled entirely on the matter of money. The primary care trust, on advice, has concluded that for the Haslar alternative, economic assessment capital over 30 years would cost £93.038 million, risk adjusted, net present value—that is the way these things are assessed. The War Memorial hospital option would cost £75.318 million on the same basis. In capital terms, it is maintained that Haslar would cost £13 million, which would need to be paid to the Ministry of Defence, and £14.9 million in capital cost. The War Memorial hospital would cost £3.594 million, plus £2.6 million for replacing the health centre, where there might be some capital offset through a lift project. There would also be some £23.6 million for the community hospital at Fareham under both plans.
Where do we go from here? Hampshire county council's scrutiny committee, which is charged by statute to look at local plans, will meet on 26 November, and I look forward to being there to discuss the issue. The Fareham and Gosport primary care trust plans to make its final decision on 15 December.
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I do not believe that those making the judgments are comparing like with like. Gosport War Memorial was a cottage hospital; it has been expanded and is a busy site, and it will not take further expansion. Car parking is a problem. Haslar is a large, airy, superb location. It is a former district general hospital. There is room for change and expansion. Excellent equipment is in place and it has the suites of operating facilities that will be needed. Portsmouth and South East Hampshire hospitals trust concluded in 2000, and again in 2002, that Haslar would be needed. We simply cannot believe that it will be possible to manage in future with fewer operating theatres and fewer beds. There is an absolute and widespread conviction that Haslar is needed, and my plea from Gosport is that consultation should be genuine. Our wish is to retain Haslar hospital, and I ask the Minister to support that proposal.
7.13 pm
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