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Grant Shapps (Welwyn Hatfield) (Con): I was elected to the House after defeating a previous Health Minister, Melanie Johnson, on the subject of hospital health care in my constituency of Welwyn Hatfield. That happened despite the fact that the then Secretary of State for Health, now the Home Secretary, had come to my constituency and announced a huge, £550 million project to build a new Hatfield hospital, which was to have been the answer to many of the concerns of my right hon. and hon. Friends in the Hertfordshire area.
We now learn that that project will involve at best investment of only £250 million or £300 million, and that it will not include cancer care. In fact, nine years after the Prime Minister told us that there were 24 hours to save the NHS, we are sceptical about whether it will ever be built.
Mr. James Clappison (Hertsmere) (Con): Does my hon. Friend recollect that when the hospital was originally announced, amid the claims that he has described, the fact that it would include cancer care to reduce the long journey that my and his constituents would otherwise have to make was put forward as one of its principal benefits?
Grant Shapps: AbsolutelyI am grateful to my hon. Friend for raising that point. I have been through cancer; I went through the trauma of chemotherapy and radiotherapy for a year, and can say that the last thing a person in such a situation wants to do is travel. That point comes on to exactly what I was about to say: that we have recently lost our chemotherapy service at the QEII hospital. That means that my constituents and others are having to travel 14 miles to the Lister hospital in Stevenagea journey that no one wants to make when they are feeling sick after chemotherapy.
The issue is not only about the chemotherapy unit, but the maternity unit where my kids were born just two years ago, that is set to be closed, and the ward of elderly care beds that has already gone; another is set to be closed. The issue is about the accident and emergency service, the core of any acute hospital, that is set to be closed.
I defeated the former Health Minister because the paediatric service was to have been closed at night. She said that I was scaremongering, but it is now being closed in the daytime and stripped out entirely. It is difficult to comprehend, but all surgery is to be lost from the hospital. I ask the Minister: if we lose our surgery, our cancer care, our maternity services, our paediatrics and our A and E, what is left of our hospital? The Government have talked recently about their intention to create more community hospitals. Is this the route to creating more community hospitals? The hospital does not offer fundamental core services.
Of course, that would all be okay if there were to be a shiny, new £500 million hospital 2 miles down the road in Hatfield.
Anne Main: As my hon. Friend knows, I defeated the former MP for St. Albans. During the election, we repeatedly sought assurances from Ministers that the hospital would be built. The Minister may be aware that I asked for minutes of the meeting. There have been no assurances from Ministers, and I believe that the public have been sorely misled over the status of the hospital.
Grant Shapps: My hon. Friend is right, and we look today for an assurance about the super-hospital at Hatfield that was promised by the then Secretary of State for Health in a blaze of publicity. There has been no publicity around an announcement to reverse the decision, so we would like to hear that assurance. I invite the Minister to come to Welwyn Hatfield to explain to the people in my locality when and where the hospital will be built, and whether, as was originally planned, it will include the cancer care unit moved from Mount Vernon hospital. Or has that plan been dropped? Will there be a brand-new teaching hospital in Hatfield this decade, the next decade or the one after? All the things that were promised have been quietly dropped now that the attention and focus are off and there is no general electionindeed, now that the seat is no longer in Labours hands.
It is understandable that people are looking to their MPs and asking what is going on. The truth is that, as things stand, we will be left with so little hospital health care in constituencies such as mine and those of my hon. Friends that the Government will be putting lives at risk. It is inconceivable what a constituent who falls over from a heart attack in Hatfield is supposed to do in a busy rush hour to get themselves to the Lister hospital in Stevenage, given that the motorway narrows to two lanes. It is unimaginable how ambulance services, which are being regionalised and cut, will pick up patient or victims of car accidents and get them to the health service that they require.
It is extraordinary to my hon. Friends and to our constituents to hear the Prime Minister and others stand up at the Dispatch Box week in and week out to reel off numbers that bear no relation at all to the situation on the ground. What should be discussed are the 500 job lossessuch figures should be statedthe closure of departments and the broken promises about new hospitals that, when it comes to it, simply will not be built. I ask the Minister to accept my invitation to come and explain in person.
Mr. James Clappison (Hertsmere) (Con):
I congratulate my hon. Friend the Member for South-West Hertfordshire (Mr. Gauke) on obtaining this debate and on setting the scene so well. It is no exaggeration to speak of a crisis in health care in Hertfordshire for all the reasons that he and my colleagues have given. I shall deal with just one outcome of the crisis, but that does not mean that I overlook all the other cutbacks that are taking place in sexual health services, mental health services and
hospital care. There are serious cutbacks in clinical care and in the numbers of doctors and nurses, and there is also the matter of targets for the use of hospitals by patients, including patients who have already been seen by their general practitioner. My right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) was right to raise that subject, about which many questions could be asked.
The one aspect that I wish to deal with in many ways epitomises the crisis in Hertfordshire at present. The Potters Bar community hospital is the responsibility of the Hertsmere primary care trust, which has a serious financial deficit. I have asked Ministers about it, and they say that the PCT must live within its means. However, if that is the case, some serious cutbacks at the Potters Bar community hospital will be required.
The PCT is consulting on a significant reduction in the capacity of Potters Bar community hospital, which is a 45-bed community hospital that is barely 10 years old. It replaced an older hospital that was built in the 1930s and had become dilapidated. The hospital is in a new location. It is a purpose-built community hospital that provides services for all the residents of Hertsmere, including, of course, those of Potters Bar. Although the hospital now serves the whole of Hertsmere as opposed to just Potters Bar, which it used to do in the past, the PCT proposes closing 15 of its 45 beds and using the space that is freed up to relocate services already provided at other premises in Potters Bar. We must be clear about this: there is no question of providing new or additional services at Potters Bar community hospital. It is a case of merging two sites into one to provide both sets of services from the same premises. The premises that are freed up, in the words of the PCT, will be closed and sold, and the proceeds of the sale presumably used to address the financial position of the PCT.
However, Potters Bar community hospital will lose one third of its beds for good under the plans. The PCT has introduced consultation and said what it proposes to do about community health care to make up for the losses, but the proposals are being driven by financial cutbacks in response to a financial crisis. Nobody can say that if the PCT or any other health service provider were planning the best way to provide health care for the residents of Hertsmere they would begin by closing a substantial number of the beds at Potters Bar community hospital.
Some community hospitals are currently under threat of closure, as PCTs consider the best configuration of services in their area. Where these closures are due to facilities that are clinically not viable or which local people do not want to use, then local reconfiguration is right. However, we are clear that community facilities should not be lost in response to short-term budgetary pressures that are not related to the viability of the community facility itself.
That is precisely the situation with the Potters Bar hospital. Local people certainly want to use it. They value it for all the reasons that community hospitals are valued. It is particularly valued by elderly residents of Potters Bar and Hertsmere and those with chronic conditions.
There is no question about the hospitals clinical viability. It is a modern facility. I have to confess that I
attended its opening, which might suggest that I have been here too long. In fact, I have not been here too long. It is a modern facilityit is almost brand-new and the only reason that its position is under threat is because of the financial predicament of Hertsmere PCT.
My right hon. Friend was right to say that there is a question of trust, given what the Government have said about community hospitals. I put it to the Minister directly that if those words mean anything at all, and if the Government are to be trusted, Ministers must step in and do something about the situation at Potters Bar, which corresponds precisely with what they said. My simple plea is that the Minister will step in and assume responsibility for the Potters Bar community hospital to avoid a permanent loss of beds and a permanent loss of a significant part of the health care that is afforded to my constituents, which will come on top of all the other problems that have been outlined. Such a permanent loss to the residents of Potters Bar and Hertsmere will do serious, irreversible damage to the fabric of the health service in my constituency. I ask the Minister to step in and do something about it.
Mr. Oliver Heald (North-East Hertfordshire) (Con): I join the general congratulations to my hon. Friend the Member for South-West Hertfordshire (Mr. Gauke) on obtaining this debate on the crisis in Hertfordshires health service. I wish to pick up on the point about trust that my hon. Friend the Member for Hertsmere (Mr. Clappison) made a moment ago. My right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) also spoke about it.
There are various categories of trust; for example, there is trusting the Governments word in respect of their policies. The Government spend a great deal of time telling people in the mental health field that modern mental health provision is about early intervention, respite for carers, modern therapies and catching problems earlygetting in there to help children and adolescents when they are pre-onset or at the onset of severe mental illness. I have taken a particular interest in that issue. In Hertfordshire, however, the Government are scrapping the early intervention service, the respite care and the in-patient therapies that are so valued, and they are cutting the child and adolescent health services.
The Government say that community hospitals can be valuable centres in which general practitioners can do things such as minor surgery. We have a community hospital in Royston, and there was a plan to develop it in the same way, but it is now on hold and has been for a long time. I have asked the Minister about the future of Royston hospital, but she says, Ask the PCT. However, the PCT is being scrapped and is becoming part of a larger PCT. If one asks the PCT, therefore, it says, We dont know if well even be here. The truth is that we cannot trust what the Government say.
At the local level, we were promised a brand new, spanking great hospital in Hatfield, which was going to cost £550 million, as has been said. We were told that it would have cancer care facilities, which are a crucial
issue in Hertfordshire. Now, however, we are told, Oh no, you cant spend more than £250 million. The whole thing is in limbo.
It is well known that we have had a structural funding problem in Hertfordshire over the past few years. Before the 2001 general election, the then Health Minister, the right hon. Member for Southampton, Itchen (Mr. Denham), put an extra one-off payment into our local health system and said, Its a structural problem, and well have to look at it. However, nothing happened. Of course, he paid the money, but the Labour party won the election again, and no permanent review was done of the funding for our local health system. Every year for the past few years, therefore, a non-recurrent payment of £10 million has been made to our local health system. Now, we are suddenly being told, Oh no, you cant have any more money. Youve got to manage within your budget.
The Government know that there is a structural problem in Hertfordshire and in the East and North Hertfordshire NHS Trustthey made the non-recurrent payments. Now, however, they have the cheek to turn round and say, Oh no, you cant have any more money. Youve got to manage. That means that £66 million has to be taken out of our small East and North Hertfordshire NHS Trust over three years. Five hundred staffor 10 per cent.will go, including 150 doctors and nurses, and we will lose three wards at our two hospitals. Those are major problems, which the Government knew about.
Grant Shapps: My hon. Friend mentions the £66 million, but does he agree that the number seems to go up by £1.5 million a week? The chief executive briefed my hon. Friend on the issue just before me, but when I had my briefing last week, the figure had risen to £69 million. Does my hon. Friend have a projection for the end of the year?
I come to my last point, because I hope that the Minister will be able to reassure us, although I doubt it. We are asking for nothing more than common fairness in Hertfordshire. It is true that the county is better off than some others, but we pay twice as much tax per head as people in the Ministers constituency.
Mr. Heald: Yes we do. In our area, the average is £5,820; in the Ministers constituency, it is £2,710. We are therefore paying a lot of tax in Hertfordshire, but we are not asking for any more than anybody else. We are perfectly willing to accept that we should have a level playing field and a fair allocation of resources. However, while the Ministers constituency gets £1,362 per head, we get £1,057, which is £300, or 30 per cent., less per head. In Hertfordshire, there are many people who are disadvantaged and there are also pockets of deprivation, as my hon. Friends mentioned.
Mr. Heald: Yes, there are also very high figures for learning disabilities and mental health problems. We therefore have real problems, and it is just unacceptable to say that we will be treated in such a mean and unfair way. Will the Minister look at the issue again?
Mr. Mark Prisk (Hertford and Stortford) (Con): May I, too, congratulate my hon. Friend the Member for South-West Hertfordshire (Mr. Gauke). This debate is very timely, and Opposition Members feel very passionately about the issues involved.
As the Minister will recall only too well, the Secretary of State told the Royal College of Nursing in Bournemouth in April that the NHS was enjoying its best year ever. That brought howls of derision from her audience, and rightly so, but it also generated real anger in my constituency. Over the past year in east Hertfordshire, we have had job losses, which my colleagues have described. We also face possible ward closures and longer queues for dentistry and cancer screenings, and there are real concerns about mental health services. To echo the points made by my right hon. and hon. Friends, let me tell the Minister quite genuinely that people in Hertfordshire no longer trust the Government with our health servicethat is the reality.
In the district of east Hertfordshire that I try to represent, we face real problems with preventive services, such as those provided by NHS dentists. The PCTs tell us that they have tried to address the issue, but the combination of new contracts and uncertain funding has seriously undermined confidence among dentists and their ability to do their job. Some of my constituents travel 20, 25 and, in some cases, 30 miles just for a basic dental appointment. As a result, many people are being left behind, and that is particularly true of the elderly, who cannot make such a journey or afford to do so. I could go into that in greater detail, but I am aware that my hon. Friend the Member for Hemel Hempstead (Mike Penning) will want to make a contribution, so I shall be brief.
Mental health services are also under threat. We have heard that the Hertfordshire Partnership NHS Trust faces a £5 million cut, which is 5 per cent. of its budget. When we are told the reason for it, we find that the irony is that it is because of a general overspend. However, the trust has always lived within its budget and has never strayed beyond it in the five years since its inception. The attempt to cut its budget has seen the trust
Mr. Prisk: As my hon. Friend rightly highlights, the trust has been punished. Genuine concern has also been caused among what are probably the most vulnerable parts of our community. Clouds are hanging over good services, such as Signet house, Oxford house and the Seward Lodge day care unit, which are invaluable to our constituents.
As hon. Members have said, the worst news was probably when we were told about the 500 jobs that would be lost from the East and North Hertfordshire NHS Trust. As my hon. Friend the Member for
North-East Hertfordshire (Mr. Heald) said, 150 of those affected will not simply be managers, but doctors and nurses. Up to three wards could well be lost at the two hospitals in Stevenage and Welwyn Garden City. The best way of describing how people feel about that is a quotation that I recently read from a local nurse, who said:
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