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The hon. Member also mentioned one or two other issues, and I shall not make the political points thatI might have done [Interruption.] Can I get away with saying that, in relation to cardiology services, 2.5 million patients are now receiving specialist drug treatments compared with 300,000 in 1997? I do not know how much of that is related to extra funding, how much is related to technology and so on. Without making a political point, I am glad, as he will be glad, that 2.5 million people are receiving that treatment. Of course, since 1997, heart disease is down by 38 per cent.
Mrs. May: If cardiology services have improved so much, why did more than 100 patients have their operations cancelled at the John Radcliffe hospital, which is part of the Oxford Radcliffe Hospitals NHS Trust, at the turn of the year? They were not put on a longer waiting list; they were just told that the hospital did not provide that operation any longer.
Nigel Griffiths: I am sure that staff at that hospital did not sit down and say that they were going to consign 100 patients to some terrible condition from which they are going to die. I do not believe that modern clinicians, surgeons and cardiologists do that. The right hon. Member is using that case selectively, without appreciating the full facts. No doctor or consultant would deprive any of her constituents of an operation or treatment that they thought necessary. They are getting more funding to carry out such treatment now than ever.
My hon. Friend the Member for North Swindon (Mr. Wills) raised a number of issues relating to regeneration. I know that he will make further representations, and I was pleased that he raised the issue of a new library, as the staff of Edinburghs Sighthill library, which is near my constituency, have just been given a UK-wide award for best public service delivery of the year.
As the hon. Member for Bexleyheath and Crayford (Mr. Evennett) warmed to his subject, he became less heated and more persuasive, having started at a pretty fierce pace. It is unusual for me to praise a Member for that. Of course, we share his concern about gangs of youths, which was also raised by other Members. We have put through legislation that is helping to control that problem, and that was acknowledged. Some criticism was made relating to whether the police could provide better enforcement, and I am sure that we all have that dialogue with our police forces when we get complaints from local residents. I know that chief constables such as mine listen and respond in relation to their policing technique. There are many more police to deal with the problem now. I will not give the figure. It should also be recognised that there have been 4 million fewer victims of reported crime over the past nine years, along with a substantial drop in the number of burglaries and cases of violent crime. We want to ensure that that trend continues. I have listened carefully to what has been said by the hon. Member and others, and I will ensure that, notwithstanding his other duties at the moment, the Home Secretary is aware of the concerns that are being voiced.
My hon. Friend the Member for West Ham (Lyn Brown) raised a case involving a constituent that I am sure is not unique. I should also be surprised if the
chief executive did not respond fairly promptly. I know that she would not hesitate to refer the matter to Ofwat if she did not receive a satisfactory response. My right hon. Friend the Secretary of State for Environment, Food and Rural Affairs will happily respond to any issues that she may wish to raise with him.
The hon. Member for Argyll and Bute (Mr. Reid) advocates road pricing. I am sorry that I could not enlist his support for the conversion of the Liberal Democrats in Edinburgh, who campaigned against it with environmental groups. I may refer them to him for a bit of education. I will certainly check whether the Scottish Liberal Democrat Minister responsible for transport, Tavish Scott, can intervene with a subsidy to help the ferry service about which the hon. Gentleman is concerned. He may not have budgeted for it, but the hon. Gentleman issued a heartfelt plea.
There are a number of serious issues relating to the Post Office. For me, the most serious is the poor treatment that it receives from Liberal Democrat councils such as Aberdeen. Unlike my colleagues in Edinburgh, who have ensured that people can pay rent, service charges and trade waste charges in their local post offices, I am afraid that the Liberal Democrats in Aberdeen refuse to take up that service. After I raised the matter when responding to an Adjournment debate some time ago, they said that they would think about it. That was before the election, so it was at least a year and a bit ago. I am sorry that there has been no movement on that. We have shown in Edinburgh how it can be done, and that it is the best way of supporting a local service.
The best way to support the card service is to do what the Government have been doing: spending, I understand, almost £1 billion on the service over its duration, until towards the end of the decade. The service has been strongly endorsed by the Government and funded by them to the tune of the colossal sum of about £100 million a year. I understand that it is only one of 23 or 24 card and payment services that are available to post office customers, and I urge them to explore those other services as well.
The hon. Member referred to the search and rescue helicopter service. I will certainly draw that to the attention of my right hon. Friend the Secretary of State for Defence. The hon. Member mentioned digital changeover, and called for taxpayers money to help. I do not know whether that is an uncosted Liberal Democrat budget promise. He raised another tax issue with his plea for a reduction in the tax on petrol in rural areas. Again, I am keen to see the costings. I am not sure whether the matter was raised in the recent Budget debate, but I will check the minutes. I am sorry that my Labour colleagues in the Scottish Parliament in Edinburgh seem to have been misled, seduced almost, by the Liberal Democrat practices down in Hull that my hon. Friend the Member for Kingston upon Hull, North (Ms Johnson) highlighted. She made an excellent speech about the need to tackle obesity. That sounds like a pilot project well worth extending throughout the country, and I hope that my colleagues in the Department of Health will note what she said.
Mr. Mark Harper (Forest of Dean) (Con): I first want to place on the record my thanks to Mr. Speaker for selecting as the subject for this Adjournment debate health services in the Forest of Dean and Gloucestershire. The background to the debate is that on 10 May, which was rightly named black Wednesday by my hon. Friend the Member for Cotswold (Mr. Clifton-Brown), 12 hospitals or similar facilities and hundreds of beds and jobs were threatened with closure by the local health trust.
As those closures will affect all the Gloucestershire constituencies, we tried to start an all-party campaign against them. Four of the six Gloucestershire MPsmy hon. Friends the Member for Cotswold and for Tewkesbury (Mr. Robertson), the hon. Member for Cheltenham (Martin Horwood) and myselfare opposing the closures. I see that the hon. Member for Stroud (Mr. Drew) is in the Chamber, and I know that he, too, has many concerns about the closures. We are stronger when we are united; it is just unfortunate that we have been unable to get all six Gloucestershire Members on board for a united campaign.
In my constituency, both the community hospitalsthe Dilke Memorial hospital and the Lydney and district hospitalface closure, and the closure of Colliers Court, which deals with mental health, is also proposed. I am very grateful to our local press, which has run strong campaigns on this issue. The Forester and its editor, Viv Hargreaves, ran a Save our Services campaign, and The Citizen and its editor, Ian Mean, ran a Save our Hospitals campaign.
So that the Minister completely understands why people in Gloucestershire are so concerned about these closures, it is worth considering briefly one or two of the recent headlines in the local papers. The Citizen ran A Black Day for Health Care in the County, The Forester ran Meltdown in the NHS, and the Forest of Dean and Wye Valley Review ran The Bitter Pill. As recently as yesterday, one paper ran the headline, Take Your Medicinethe only way to beat off the threat to the Dilke and Lydney hospitals is to bring down the Government. That is perhaps going a little too far for the moment, but that headline certainly represents the strength of feeling in my constituency. In the light of the tremendous public concern, the broadcast media have also been excellent. ITV, the BBC and our local radio stations have covered the issue very well. I want also to pay tribute to local campaigners who have rallied to defend our services; there are too many to thank individually.
On 11 May, my hon. Friends the Members for Cotswold and for Tewkesbury and I wrote to the Secretary of State for Health a letter that we, with a delegation of nurses from Gloucestershire, hand-delivered to the Department of Health. We are still waiting for even a holding reply. People in the office of my hon. Friend the Member for Cotswold spoke to the Department last week and at the beginning of this week, but we cannot expect even the reply to a request for a meeting until next weekduring the recess.
The Secretary of State has already had a meeting with the hon. Member for Gloucester (Mr. Dhanda), and I had thought that the Department was perhaps playing party politics. Then I discovered during yesterdays Westminster Hall debate on community hospitals that the hon. Member for Stroud, too, has written to the Secretary of State and has not had an answer. We expect a reply soon, and with no disrespect to the Minister present, we also expect to have a meeting with the Secretary of State. I would be grateful if the Minister gave some indication of when we will get a reply, and a meeting.
Mr. David Drew (Stroud) (Lab/Co-op): I am happy to make common cause with the hon. Gentleman. I have not said that I will not see the Secretary of State; in fact, I have been lobbying her very carefully in the past few days. The hon. Gentleman might be surprised to hear that I have had a reply from the chief executive of the strategic health authority. On tracking down the figures, it has emerged that in the past four years, Avon and Wiltshire received £175 million in additional funding, of which Gloucestershire has, of course, had none. We might want to raise that point with the Secretary of State, and the hon. Gentleman will doubtless be willing to join me on that particular bandwagon.
Mr. Harper: I am very grateful to the hon. Gentleman for raising that point; we would welcome his joining us in our meeting with the Secretary of State. That interesting information perhaps highlights the concerns that constituents have when they see that the various areas within a strategic health authority are not being treated fairly and equally, which is all that they are asking for.
The White Paper on community hospitals makes it clear that community hospitals that are under threat of closure should not be lost in response to short-term budgetary pressures. Both the Dilke and Lydney community hospitals in my constituency are threatened with closure for exactly that reason, and I want to know what the Government intend to do about that contradiction.
I raised that issue with the Prime Minister yesterday, and instead of answering my question he changed the subject. I hope that the Minister will do better. The Prime Minister is quick to claim credit for any good news in the NHS, as he attempted to do in his response to me yesterday, but if he is personally responsible for all that goes well, it follows that he must take responsibility for what goes badly. If he is responsible for new hospitals opening, he is also responsible when community hospitals are closed.
It is not only hospitals that we must be concerned about, but the services available in the community. I received an e-mail yesterday from a GP in my constituency, who pointed out that there is a complete embargo by the PCT on replacing staff who leave and on employing new staff. In the West Gloucestershire PCT, which covers my constituency, six health visitor posts and two community nursing posts are being held unfilled. That does not fill us with confidence that services that are being cut in hospitals will be replaced by services in the community.
The Minister will know that I continue to raise, through parliamentary questions, the issue of the policy of the Department of Health on deficits in the NHS. The cuts proposed in Gloucestershire have been prompted by deficits, but there is a contradiction at the heart of Government policy, and I hope that the Minister can clear it up. The January 2006 operating framework for 2006-07 said:
All NHS organisations should plan to recover deficits for previous years and balance their books for 2006-07.
all organisations that are overspending to show improvements during 2006-07, and by the end of the year everyone should have monthly income covering monthly expenditure.
Those two statements outline different policies and both cannot be true. My hon. Friend tried to get an answer to that conundrum at Health questions on 16 May. The Secretary of State was absent, for a good reason, and the Minister of State, Department of Health, the hon. Member for Leigh (Andy Burnham) skirted around the issue and did not answer the question.
My hon. Friend the Member for Westbury (Dr. Murrison), in winding up for the Opposition in the debate on community hospitals in Westminster Hall yesterday, pressed the matter again. The Minister of State intended, I am sure, to answer the question yesterday, but unfortunately ran out of time. I plan to give the Minister adequate time to deal with the question in this debate, and it is critical to my constituents and others in Gloucestershire that she does.
The strategic health authority for Avon, Gloucestershire and Wiltshire is operating under the impression that financial balance must be achieved across the year and all historic deficits must be cleared. That message is being driven down to the primary care trusts. Moreover, Gloucestershireto reinforce the point made by the hon. Member for Stroudis losing £6 million this year, which is being taken away to bail out other areas, and we are expected to cut services to fund that. If the Minister does not confirm the position set out by the Secretary of State in her letter to my hon. Friend the Member for South Cambridgeshire, the cuts bandwagon will continue rolling and will pick up speed.
PCTs taking current decisions about the future of community hospitals will be required to demonstrate to their SHA that they have consulted locally and have considered options such as developing new pathways, new partnerships and new ownership possibilities. SHAs will then test PCT community hospital proposals against the principles of this White Paper.
I have to say that many people in my constituency have a very cynical view of consultations. They believe, with some justice, that decisions are already taken, that lip service will be paid to their views and then the PCTs will plough on regardless. Just yesterday, I heard that an official from the PCT turned up at the Dilke hospital, and when asked what he was doing, said that he was there to oversee the closure. That is before the consultation process has even started.
there is a statutory duty for NHS bodies to consult the local overview and scrutiny committee on a substantial change...committees should also note the duty to consult and involve patients and the public conferred on NHS organisations.
The NHS has also issued guidance on service changes. It says that proposals for reconfiguration of services should involve the development of options with people, rather than for them. They should also focus on the redesign of services, and not their relocation, and take a whole-systems view that explores the contribution of all health and social care providers, working together to build sustainable solutions for the whole community. None of that has happened. The proposals for cuts came out of the blue and at short notice. They took everybody by surprise.
The Departments guidance also states that the local NHS body must also make it clear when the consultation period will end. Full consultation should last for a minimum of 12 weeks. In their headlong rush to cut services, the PCTs are determined that consultation should last only five weeks, but I can see no justification for that. Moreover, the PCTs are also threatening us. The chief executive of the West Gloucestershire PCT told The Citizen newspaper on23 May:
We have no option but to speed up our plans to change services...Every month that goes by without savings being made increases the level of savings required later in the year.
That is blackmail, pure and simple. It is not acceptable to me or to my constituents to say that more services will be cut if we demand a proper consultation period. I hope that the Minister will spell out the Governments view of the matter, as I am sure that the PCT will take note of it. Does she agree that the people of the Forest of Dean and Gloucestershire are entitled to a consultation process of at least 12 weeks, or does she support the blackmail strategy adopted by the PCTs?
I wanted to talk about whether the changes are substantiala description used but not defined in the relevant regulations. I do not have time to go into detail, but some of the proposal headings deal with changes in service accessibility, the impact on the wider community and especially on transport, the number of patients affected and the method of service delivery. I therefore contend that the proposed changes are indeed substantial.
In addition, I want to put it on record that if the overview and scrutiny committee considers that the proposal is not in the interests of the health service in its area, it may refer the decision to the Secretary of State. If the consultation process lasts only a meagre five weeks, I strongly urge the committee to do just that.
The NHS guidance also says that, when the overview and scrutiny committee considers whether a proposal is in the interest of the local health service, it should also consider the extent to which patients, the public and stakeholders more widely have been involved in planning and development. Only by securing full involvement activity will an NHS body be able to take a considered view of whether its plans are in the interests of the health service for which it is responsible. I contend that so far, none of that activity has taken place.
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