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Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),


That the draft Extradition Act 2003 (Amendment to Designations) Order 2005, which was laid before this House on 13th January, be approved.—[Mr. McAvoy.]

Question agreed to.


Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

Question agreed to.


Motion made, and Question put forthwith, pursuant to Standing Order No. 119(9) (European Standing Committees),

10 Feb 2005 : Column 1753

European Defence Market Equipment

That this House takes note of European Union Document No. 13177/04, on the European Commission Green Paper on Defence Procurement; endorses the Government's support for the Green Paper's aim to open up a debate on the competitiveness of the European defence industry; and supports the Government's wider objective to create an effective and competitive European defence equipment market.—[Mr. McAvoy.]

Question agreed to.





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Hospital Services (Paddington)

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Mc.Avoy.]

6.13 pm

Ms Karen Buck (Regent's Park and Kensington, North) (Lab): I apologise to my hon. Friend the Minister for his drawing the short straw of replying to the Thursday Adjournment debate.

Before I begin, I want to declare the ultimate non-pecuniary interest. My feelings about St. Mary's hospital are motivated in no small part by the fact that over the past 25 years it has seen me through serious illness, major surgery, a cancer scare and the birth of my child. I am committed totally to the hospital and its place in what, if we get it right, will be one of the most exciting hospital developments that has ever been attempted in this country.

The time is drawing near for a decision on the future of St. Mary's hospital in the context of the Paddington health campus. The fact that this has been a difficult decision to take—it has been seven years in planning and development—is not surprising, given the fast-changing backdrop of the development of health policy and the complexity of the specific scheme in the very heart of London. It is understandable—indeed, it is right and proper—that such a project should be rigorously scrutinised and meet the demands of the future, as defined in 2005, as much as it would have done when it was first conceived not far off a decade ago.

I have no argument about the fact that the scheme has been subject to rigorous scrutiny in the Department of Health and elsewhere, but my worry and the reason why I requested this debate is that some of the negative publicity that has accrued to the scheme over the years, and even the old ennui factor that is inevitably attendant on a scheme that has been so long in gestation, may have obscured some very important central facts and prevented us from the viewing the scheme and the new offers that are being made to facilitate it at this late stage clearly on their merits.

I do not intend to dwell on some of that negative publicity, although it is important that its existence is not denied because it provides a proper context for the debate. I merely wish to point out that the whole concept of the Paddington campus has had its opponents from the beginning, and they have been largely motivated by opposition to the closure of Harefield hospital. That is in many ways understandable from their perspective, but I very much regret that the local concern that has been expressed has muddied the waters a great deal around the campus itself.

The key fact is that the Paddington health campus continues to offer us an extraordinary, once-in-a-generation opportunity to renew and improve health care in north-west London. The most recent business case presented to the Department just before Christmas has the backing of all three local primary care trusts, the strategic health authority, clinicians from all three of the participant hospitals and the medical school, patients and the patients organisations, Conservative-controlled Westminster city council, the Mayor of London and the    Commission for Architecture and the Built Environment. Indeed, in response to a question that I
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asked a few weeks ago, the Prime Minister described it as "extraordinary", "imaginative" and "state of the art". I could describe a political—with a small "p"—coalition of that kind as implausible. In fact, I have never known that breadth and depth of support across agencies in 25 years in public life.

It is worth recapping for a moment the importance of the scheme and what it has to offer. Combining heart and lung services with acute general specialist services will dramatically improve patient care for the seriously ill, children and those with complex health problems. All the renowned expertise of the Royal Brompton and Harefield hospitals, Imperial college postgraduate research and teaching centres and St. Mary's hospital will be available to patients on a single site. The two hospital trusts and Imperial college have a tradition of research into improving health care, linking science to medicine. Harefield has the largest European heart and lung transplantation programme. The national heart and lung institute at the Brompton hospital is an internationally recognised five-star research centre, and St. Mary's is a leading research centre into infection in its own right. Bringing together all that research with Imperial college's world-renowned expertise will enable a major centre for research to be created, which will strengthen London's standing internationally, as well as directly benefiting patient care. However, a few myths need to be demolished for the record.

Myth No. 1 is that this is some kind of bloated super-hospital, a dinosaur from a bygone age and a over-ambitious amalgamation that is in danger of looking old-fashioned before it has even started. In fact, it is two hospitals on one site, with parallel academic development. It is not a single hospital, but a way to reduce costs by relocating three existing hospitals on to one site that is strategically located, with superb communications available to it that are not available anywhere else in north-west London. It is adjacent to Paddington station and, I hope, to a new Crossrail site, with easy access to Heathrow—a location advantage that cannot be replicated on any other site in inner, north or west London.

Myth No. 2 is that the campus will lock London into a surplus capacity of NHS beds. In fact, the Paddington health campus assumes that the requirement for 15 per cent. of routine surgery will be supplied by the private sector, and most routine elective surgery will be carried out in other hospitals in north-west London in any event. The campus has been designed to deal with complex tertiary work at St. Mary's and the new Brompton and Harefield, with St. Mary's also providing emergency services with appropriate backup for the local population, as at present.

Myth No. 3 is perhaps the most important of the myths doing the rounds: there is a quicker, cheaper and easier alternative. Relocating the Brompton and Harefield and rebuilding St. Mary's on this inner London site is complex and challenging, but the value-for-money case is strong. The other options—there must be other options because doing nothing is neither clinically nor financially viable—remain tentative in financial and planning terms. Significant cost benefits could be enjoyed by pooling central services, such as administration, payroll, catering and a range of others.
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It is estimated that revenue savings of £20 million a year could be made, but they would not materialise under other options that involved upgrading the hospitals separately or using any other configuration.

If we did not proceed with the campus, it would not reduce the need to move specialist heart and lung services away from Harefield hospital, or modernise the Brompton and St. Mary's facilities. If detailed capital and revenue cost plans for alternative options exist to demonstrate that they would represent better value for money, and all their details on the cost of such things as land assembly and planning permission have been scrutinised to the extent of those for the Paddington health campus, I am not aware of it.

All the arguments in favour of the Paddington health campus have been strengthened even more in recent days by the latest offer from Westminster city council to reduce the cost to the NHS of the land deal required for the campus. The council has offered to broker land deals in a manner that would cut both the cost and complexity of the scheme. That would represent better value than all previous options and would save the NHS in excess of £60 million more than the existing scheme. The capital surplus would be increased, the steady state operating position would be substantially improved and contingent liabilities would be greatly reduced.

Westminster city council can explain its own motives for the latest offer. However, it would be true to say not only that it is committed to maintaining a local hospital with international teaching excellence, but that it sees the scheme as a further step in the wider regeneration of the Paddington area. The retention and improvement of hospital facilities is thought of as not only being of direct benefit to people, but allowing further redevelopment throughout the Paddington basin. The campus is one piece of a jigsaw that has already included the introduction of the Heathrow Express, the refurbishment of Paddington station, the £62 million Paddington bridge project, the establishment of 97,000 sq ft of office space and 922 residential units, and substantial changes to education provision. There is more to come, including Crossrail—the hybrid Bill will hopefully be introduced in the near future—a potential business improvement district, the re-provisioning of the City of Westminster college, and a major new affordable housing development.

Additional benefits have already included 7,000 permanent jobs, thousands of construction jobs and huge investment in the local economy. That was much needed when we remember that despite the mythology of Westminster's uniform prosperity and the fact that it includes some of the most prosperous parts of the country, the four wards immediately surrounding Paddington are among the 10 per cent. most deprived wards in the country. Other wards in the surrounding district are among the 30 per cent. most deprived in the country.

When critics say, as they sometimes do, that the campus development has been seven years in the making and has yet to reach fruition, it would be true to say, "So has Paddington." The Paddington that we knew seven years ago when the health campus began to evolve is not the Paddington that we see now, because at that stage there were no academy schools or plans for the redevelopment of the secondary sector, no business improvement districts, and no immediate prospect of
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the blight on the Crossrail development being lifted. The project has been fluid and constantly changing, so inevitably land assembly deals have had to be done. Additionally, the hospital has been subject to constant re-evaluation because as health needs change, capacity needs change. It would be unfair to make harsh judgments about the Paddington campus without appreciating the momentum of the whole regeneration scheme.

If the final decision is taken to rebuild St. Mary's hospital alone, I am confident that a fine teaching hospital will continue to be available for my constituents. St. Mary's is not a hospital that is any longer fit for purpose because many of its buildings are inappropriate for a 21st century hospital. It is absolutely essential to redevelop the hospital, ideally within the campus site. If it is not situated on the campus site, however, it will continue to provide first-class services. The quality of services within St. Mary's was recognised when it won the Dr. Foster's hospital of the year award three years ago, when it received its star ratings and when, only a few weeks ago, it was included in the latest wave of possible foundation status hospitals.

I am more worried about the long-term viability of institutions that will not benefit from the scale and concentration of resources. Without the campus, health facilities in north-west London will continue to suffer from fragmentation and dispersal, with services for children in particular increasingly at risk. The failure to consolidate heart, lung and paediatric specialties would deny patients the opportunity to improve the quality of care for complex medical conditions in particular.

The case for the campus clinically, in terms of overall value of money and regeneration, is compelling. The chance, once lost, will not come again. Given the new financial impetus that has been afforded by Westminster city council's latest offer on land assembly, I urge the Minister to take back the message that the scheme must proceed. I look forward to hearing his comments and hope that we get the clearest possible indication that, after all these years, those who looked forward to having the most prestigious hospital teaching and research developments in Europe will, at last, be satisfied.

6.25 pm

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