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Mr. Crispin Blunt (Reigate) (Con): I am delighted to catch your eye, Mr. Deputy Speaker, and to follow the hon. Member for Kingston upon Hull, North (Ms Johnson), but I hope that she will understand that it is the speech of the hon. Member for Mitcham and Morden (Siobhain McDonagh) that I want to focus on in particular. I think that her contribution to the debate was sparked by the fact that I told her a couple of days ago that I wished to address the issue of Sutton and St. Helier in my remarks, and I shall try to keep them brief.
There is a substantial health and technical case against the Secretary of State's decision to overturn the recommendation of the local health community in Surrey and south-west London to site the new critical care hospital at Sutton rather than at St. Helier. The merits of that recommendation are substantial and it is the product of well over a year's work, with an enormous consultation process and the rest.
Mr. Blunt: That does not entirely surprise me because, if one examines the scale of the hon. Lady's House postage budget, one sees that she is one of the most efficient Members at using the allowance to contact constituents. I wonder how much of the effort to get individuals to reply to the consultation was hers.
I want to address the substance of the issue: the merits of the case. I hope that the merits of the case for Sutton against St. Helier will now be addressed judicially. There is only one way to overturn the decision of a Secretary of State in these circumstanceswhen the decision is perverse, unfair and, in my judgment, has been taken for reasons of party political advantage rather than because it best serves the health needs of the 500,000 people who will be served by the critical care hospital. That is to invite a judge to review the decision, and I hope that that judicial review process is now in hand to put right this manifest unfairness.
It is not that case that I particularly wanted to deal with but the use of the term "health inequalities" by the hon. Lady in her lengthy campaign to secure St. Helier as the site of the hospital. She simply could not answer the central point that I made to her in two interventions, a point that has been made repeatedly in different ways during this debate. Primary care services and community care hospital services are far more effective at tackling the issues arising from health inequalities, particularly those arising for social and economic reasons. That is especially true under the new model proposed for hospital services in the area served by the Epsom and St. Helier trust, which serves 50 per cent. of the hon. Lady's constituents and 50 per cent. of mine.
When I intervened on the Minister, she did not challenge that basic proposition. The hon. Member for West Lancashire (Rosie Cooper) made clear the importance, in providing such care, of getting to working men's clubs and other such institutions, if one is genuine about drilling down through the community, as the hon. Member for Stroud (Mr. Drew) put it, to address health inequalities.
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It is unforgivable to put politics ahead of the genuine interests of our constituents. The reason I am so severe towards the hon. Member for Mitcham and Morden is that this is not the first time that this has happened to me and my constituents. I am afraid that we had a very similar case in 2001 when a Labour Secretary of State for Health decided to intervene in the provision of secondary care in the south of my constituency, imposing a moratorium on the reorganisation of services between Crawley hospital and East Surrey hospital. That cost the trust £10 million a year, delayed for three years the implementation of important advances in services for my constituents and has left the trust burdened with the largest deficit of any secondary health care trust in the United Kingdom. That is a direct result of the intervention of the Labour Secretary of State for Health for party political reasons. I have produced a full memorandum on the issue and I regret to say that I will have to repeat it for what has happened in the north of my constituency for my constituents there.
During all the hon. Lady's efforts to secure the siting of the new critical care hospital at St. Helier, the fact that a community care hospital would be a more effective way of addressing health inequalities was repeatedly explained to her.
Siobhain McDonagh: I apologise to Members on both sides of the House for intervening again, but this is the last time I will do so. Who needs access to maternity care led by consultants? It is young women who smoke and have babies at an early age. Who needs access to an A and E department? It is people who do not have a GP. Those are the people in my constituency, so I certainly reject the idea that local care hospitals can meet the needs of my constituents and others surrounding the St. Helier site.
Mr. Blunt: Three miles away from the St. Helier site is St. George's hospital in Tooting, 4 miles away is the Kingston general hospital and 5 miles away is the Mayday hospital. A rather greater distance away is the East Surrey hospital, whose trust has the largest deficit in the country. As a result of the Secretary of State's intervention, 7,000 more people will present themselves at the A and E at that hospital and there will be 800 more in-patients, which will require an additional 25 permanent beds. That hospital cannot cope at the moment. The situation is bizarre. A simple examination of the map would suggest where the new hospital should be sited. The consequences for the 500,000 people who are to be served by the critical care hospital and for those whose services will be deflected to other hospitals should be taken into consideration.
The party political interest in having the big institution with the flag on it close to home is being disguised. Everyone when asked says that they want the critical care hospital close to them; it was the only common factor throughout the consultation process. That we all want it as close as possible comes as no surprise, but the hon. Lady should know, because she was told so repeatedly, that addressing health inequalities in her constituency and anywhere else is about the effectiveness of primary care and community
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care. Critical care hospitals serving 500,000 people are not as important in addressing health inequalities. She knows that, I know that and, far more importantly, all the health care professionals involved in putting together the proposal know that. Yet the Secretary of State has intervened to overturn the recommendation of all the health care professionals, contrary to the view of the consultants, doctors and everyone else who will be involved.
The really dispiriting thing is that if the hon. Lady succeedsI sincerely hope that the last throw of the dice on behalf of my constituents in taking the issue to a judge will overturn the decisionthe opportunity for a world-class hospital in association with the Royal Marsden in Sutton will have been passed up. That site would have attracted the very best doctors and consultants to serve the people whom both the hon. Lady and I represent. If the decision is allowed to stand, it will be a tragedy for 500,000 people.
It is a great shame that the hon. Lady has put the party political interests as she sees them in her constituency ahead of all the evidence about what is needed to address health inequalities. She has campaigned for an outcome that might suit her own political interests, but I regret to say that the health interests of her constituents, my constituents and everyone else who could have been served by a world-class institution on the Sutton site in association with the Royal Marsden will be so much the worse off.
Andrew Gwynne (Denton and Reddish) (Lab): I welcome the debate and am pleased to contribute to it. My constituency is in eastern Greater Manchester and covers two local authority areas. The first, Tameside, like much of east Manchester, contains a number of deprived areas, which consequently have serious public health problems. The second, Stockport, is considered one of the most affluent areas in north-west England, but, despite that, it must be recognised that there are areas of serious deprivation in Stockport, including parts of the borough that form my constituency. In socio-economic terms, they have much more in common with Tameside and east Manchester than with the prosperous areas of Bramhall and Cheadle in the south of the borough.
More than 100 years ago, at the height of the industrial revolution, the city fathers of Manchester sought to make a radical improvement in the health of the growing population by ensuring a supply of clean drinking water from the Lake district. Almost overnight, the rates of cholera and other preventable diseases plummeted. That, along with other sanitation services and the provision of public parksI believe that one of the first municipal parks in the country was in Greater Manchesterwas the first major step towards greatly improving public health in our major cities. With the introduction of the NHS in the late 1940s, there was a remarkable improvement in public health. I am proud of the fact that the former Denton urban district council was among the first councils to adopt the Clean Air Act 1956.
As a result of all those decisions, life expectancy has increased dramatically and our quality of life has been transformed from the standard that my grandparents'
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parents were used to. That said, health inequalities have continued, despite the steps forward over the past century. It is sad but true that to this day there remains a direct correlation between one's background, housing, environment and income, and one's health.
Mr. Deputy Speaker, with your indulgence, I wish to focus on the work undertaken by agencies throughout Denton and Reddish to tackle issues of concern. First, as a result of the single regeneration budget round 5 funds, there has been tremendous investment in the regeneration of the most deprived parts of the constituency. In Haughton Green, SRB funding has enabled the provision of innovative community-based health services in a new joint community and health centre. The services are provided by numerous agencies, but come together under one roof to provide local people with access to housing and homeless services, local health services, benefit advice, access to the credit union, child care help and advice for young people, including advice related to tackling sexual health issues and teenage pregnancies. That superb facility has provided the local community with a new resource.
Adjacent to the Haughton Green community and health centre are the Haughton Green playing fields. Again, spearheaded by SRB 5 and the commitment of the neighbourhood forum and local councillors, major funding was secured to refurbish completely the rather derelict, overgrown waste of space. Through community consultation, a bid for doorstep green funding was secured and that public open space in an urban area that lacks good-quality open space has been transformed into a community asset to be proud of. Not only were the football pitches drained, new play areas for toddlers, children and teens, and a new floodlit multi-purpose games area were provided. Even the old bowling green was restored after being out of action for at least two decades. Now, the area is used by all the community. A bowling club has been established and the sports development unit at Tameside metropolitan borough council ensures that the state-of-the-art sports facilities are well used by local youths in particular. That is crucial, not least to ensure that the ticking obesity time bomb is diffused in communities such as Haughton Green.
I also want to highlight the impact that Sure Start is having in my constituency, offering access to a variety of services such as child care and health advice, providing new parents with the skills necessary to be a parent, and developing simple skills such as cooking. These are crucial in areas such as Haughton Green and other parts of Denton and Reddish. Sure Start is beginning to address long-standing problems and I am proud that my constituency will eventually benefit from six Sure Start centres. I point especially to the good work being done by Reddish Vale early years centre in the Stockport part of my seat, which provides all the services that I mentioned. It has undoubtedly been a resounding success.
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I draw to the attention of the House the work of Tameside youth service and the Tameside and Glossop primary care trust in providing services to young people throughout the borough. Whether we like it or not, many teenagers find themselves in situations where they have access to alcohol and sometimes to drugs. Usually as a consequence of being under the influence of those substances, they may be more inclined to have, or be at risk of having, unprotected sex.
In connection with the borough's health targets and the crime and disorder partnership, the joint service offered by the PCT and the youth service provides local young people with an all-in-one support service on drug abuse, alcohol abuse and sexual health issues. As a result of the latter, teenage pregnancy levels in the borough are starting to show an improvement. I commend to the Minister the recent report of Tameside's health and education services scrutiny panels on teenage pregnancies, which describes in much more detail the progress being made in the borough.
Finally, I highlight the proposals of Tameside and Glossop primary care trust to devolve primary care services to local communities. Three primary care centres are being developed which will provide services far more locally than ever before. A range of services previously available at only the district hospital or outside the borough will be available in the state of the art new centres. Importantly in the context of the present debate, the centres will be located in some of the most deprived wards in the borough. One of the wards, St. Peters, which is partly in my constituency and partly in the constituency of Ashton-under-Lyne, is in the top 5 per cent. of deprived wards in the whole country.
The availability of services locally is important because too many people from areas like St. Peters do not have access to good services if those are not available in the communities. Whether because of low car ownership or poor bus services, if facilities are too far away, people will not access them, so I commend Tameside and Glossop primary care trust for taking the services directly to those communities.
Leading and responding to the debate is a Health Minister, and a very good one at that, but I could fill up the Front Bench for this, because tackling health inequalities is a responsibility not just of the Department of Health. I have spoken of the single regeneration budget, community regeneration, the crime and disorder strategy and sports development, but I could also mention the hundreds of millions of pounds being invested by New Charter Housing and Irwell Valley Housing through stock transfer, and by Stockport Homes through an arm's length management organisation, which will bring the area's housing stock up to the decent homes standards.
I could talk about the new schools being built and the innovative joint services being developed with the NHS and social services, or the new jobs coming into the area through redevelopment and regeneration schemes. Put simply, tackling health inequalities involves cross-cutting responsibilities. When that is looked at as a whole, the Government have much to be proud of.
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