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Norman Lamb (North Norfolk) (LD): First, I   congratulate the hon. Member for North-West Norfolk (Mr. Bellingham) on securing this debate and thank him for inviting other Norfolk hon. Members to
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contribute to it. The debate has more force if the message comes from across the parties and I welcome the approach that he has taken.

I endorse all that the hon. Gentleman said about the importance of tackling this problem head on. He has done a lot of work in representing the interests of users of the hospital and I pay tribute to him for that. He spoke about staff morale and it is worth making the point that in an organisation faced with large deficits and change at the top—with the chairman and chief executive leaving in June this year—it is difficult for staff to keep their morale up and to maintain standards of professionalism. Clearly, they have done that and they need to be applauded.

Despite the difficult circumstances, they have managed to achieve their out-patient waiting time target three months ahead of schedule and they are either at or close to hitting accident and emergency waiting time targets and should be congratulated.

The hon. Gentleman talked about the loss of 57 beds, which is bound to have an impact on patient care. One can look in cold terms at the average stay at the hospital and compare it with others around the country. But if, on an emergency basis, we attempt to cut the number of beds as quickly as the hospital has to do, there is bound to be an impact. The Minister would be wise to acknowledge that that adverse impact is likely to occur. If we lose beds at the current rate, the inevitable consequence, described by the hon. Gentleman, is the cancellation of operations, resulting in a lot of personal anguish for the patient and their family.

There is also a wider impact. The hon. Gentleman and I have campaigned on behalf of Wells hospital, which is in the west of my constituency, close to the border with the hon. Gentleman's constituency. This small cottage hospital closed temporarily in December last year. It is still closed, at least in part because both the local primary care trusts, which both contributed financially to the operation of the hospital, are financially strapped. Inevitably, in trying to get their recovery plans delivered, they face an impossible task when the demand of the local community, rightly, is that that hospital be reopened.

The loss of those intermediate beds has an impact in my area and that of the hon. Gentleman. When combined with the loss of 57 beds, including beds for the elderly at the Queen Elizabeth hospital, the overall impact is severe. Wells hospital covers a rural area that is not well served by public transport. It primarily serves an elderly population and patients and relatives will now have to travel much longer distances without the benefit of good public transport. The local community is working towards establishing a charitable trust to reopen and run the hospital. I have spoken to Lord Warner about this proposal.

I urge the Minister to do whatever he can to facilitate the much-needed reopening of Wells hospital. Over the years, it has benefited enormously from a very strong local commitment. Inevitably, local people are prepared to raise funds for a small local hospital, and as a result of such efforts, extra money goes into the local health service. When such a hospital is closed down, that local contribution to health services comes to an end. We do not always think about such consequences of the loss of local hospitals, and the Government should take them
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seriously into account. Wells is a much-loved hospital and we need it back again. Anything that the Minister can do to facilitate that would be enormously appreciated by the local community.

I want to say a word or two about the reorganisation of PCTs, to which the hon. Gentleman referred. The Minister himself is not to blame because he was not in post at the time, but anyone looking in from the outside and watching a Government establish PCTs, only to abolish them two years later and set up a new structure, would think that the whole system had gone completely crazy. One can only imagine the amount of money involved in two successive reorganisations. It is acknowledged that the Government have pumped a lot of extra money into the health service, but when people ask, "Where has all the money gone?", it should be pointed out that reorganisations take their share. Effectively, that is money down the drain. The sooner that we can achieve a stable and permanent structure without further reorganisations, the better.

I turn to the usage charge, to which the hon. Gentleman also referred. I entirely understand the importance of financial discipline. A system has to be put in place to ensure that those running local hospital trusts understand that spending beyond their means has consequences. We have new management in place and a recovery plan that has been agreed with the Government, but the Government have imposed an extra fine. On top of what is already a desperate situation, it is ludicrous to have to cope with an extra £1.6 million in loss of funds. I urge the Minister genuinely to look again at the usage charge.

The hon. Gentleman is absolutely right: the deficit faced is bad enough. He and I know from representing our communities that our part of the country, which has a low-wage economy and is very rural, has received less than its fair share of health service funding. Insufficient account has been taken of the ageing population in our county. My constituency has one of the oldest age profiles in the country, and providing health services to such a population is expensive. One cannot simply point the finger of blame at local management and say, "It's your fault." We need to look at why the deficit has grown to the extent that it has. Once an historical deficit has been acquired, it is impossible to clear it without impacting on patient services. It is incumbent on the Government to look again at this issue genuinely and sincerely, because the impact on the people whom we collectively serve could be very serious.

I again congratulate the hon. Gentleman on securing what is a very important debate. I hope that the Minister will listen and respond constructively, so that we can get through this very difficult situation and give our constituents quality health services with stable funding.

8.39 pm

Mr. Christopher Fraser (South-West Norfolk) (Con): May I too, compliment my hon. Friend and neighbour the Member for North-West Norfolk (Mr. Bellingham) on securing this debate? It comes at a time when health care provision in Norfolk is in crisis. We cannot forget that when constituents contact us about such issues, they are doing so in their hour of need. On those
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occasions when we need to go to hospital or to the doctor, we need to know that the service will be adequate, well provided for and funded correctly, so that we can receive the treatment that we deserve.

May I draw the Minister's attention to my recent correspondence with the well-respected Swaffham and district pensioners association, which is concerned about the inevitable pressure on beds at the Queen Elizabeth hospital, which serves my constituency? As the hon. Member for North Norfolk (Norman Lamb) said, we should not view such problems in isolation, because hospitals and health services in the area serve a large rural community. People are not well off and they suffer in many ways. How do they travel to the hospital or the doctors, and how do they secure the service that they want? We have drawn that issue to the Government's attention in the past. When people arrive at hospital, they should be confident that it is well funded and well maintained. As my hon. Friend the Member for North-West Norfolk said, people who work in the health service in Norfolk are unsung heroes who work jolly hard in difficult circumstances. It is our duty as their parliamentary representatives to make that point, because when times are hard the tough get going, even though that is not always acknowledged by the   press and the media. I therefore hope that the Government will take my hon. Friend's observations into account.

The Swaffham and district pensioners association would like an assurance that plans are in place to deal with

I hope that the Minister can alleviate their concerns. May I also draw his attention to the problem of cutbacks in hospitals in my constituency? At Thetford cottage hospital some clinical services have been withdrawn, and five wards are currently closed. Local people and staff are concerned about the prospect of further cuts, so I hope that the Minister can provide an assurance that they will not be made. There is a great deal of concern about the availability of beds for the long-term elderly sick at Swaffham community hospital. It was full in July, which does not bode well for availability in the winter months when demand could reach a peak. The weather is not as bad as it could be at this time year, but a harsh winter is predicted. Many elderly and vulnerable people in my constituency are worried about the provision of health care, and it is in their hour of need that we ask for an assurance so that everyone in Norfolk who is entitled to use the services that my colleagues and I have raised can go to bed comforted in the knowledge that the Government will ensure that there is proper provision and financing of health care in Norfolk now and in future.

8.43 pm

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