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It is fair to say that the process has gone on for a long time. The better health care closer-to-home project dates back to 2003, with proposals for local care hospitals to be supported by one new critical care hospital sited at either Sutton or St. Helier. There was a comprehensive consultation exercise over a three-month period which finished in November 2004. In January 2005, the then three trust boards—Epsom and St. Helier University Hospitals NHS Trust, East Elmbridge and Mid Surrey primary care trust and Sutton and Merton PCT—met separately but agreed to proceed with the proposed model of a network of local care hospitals supported by a single critical care hospital. At that time, their preferred view was that that should be on the Sutton hospital site. However, in March 2005, in line with the procedures created by the Government, Merton overview and scrutiny committee referred the decision to the Secretary of State. At the end of 2005, she responded to the referral, concluding
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that the arguments at the time over the siting of the critical care hospital were finely balanced.

The Secretary of State decided that it was appropriate to give significant priority to the needs of communities suffering social and economic disadvantage and to ensure that major redevelopments should contribute to the case for the broader regeneration of disadvantaged areas. My right hon. Friend was right to take that view. She therefore asked the NHS locally to take forward plans for the new critical care hospital to be developed on land opposite St. Helier hospital.

It became clear—hon. Members on both sides of the House will be more aware and understanding of the local sensitivities and the reasons for this than I am—that for planning reasons it was not possible to develop the site and there were no viable options to develop the existing site either at that time.

Siobhain McDonagh: All local MPs are united in our belief that the decision on planning grounds was a red herring thrown into the debate to prevent the hospital from being built on the St. Helier site. We have also received, as far as it has been possible, much support from the Mayor of London, who recognises that there is a great economic, social and health reason for developing the new hospital on the St. Helier site.

Mr. Lewis: I have to respect my hon. Friend’s view of the situation. She has been a tireless campaigner on behalf of her constituents not just in the context of the NHS, but in terms of the need for social and economic regeneration in every aspect of Government policy. It is consistent for her to articulate that view about the decision.

Tom Brake: It is not just the view adopted by the hon. Member for Mitcham and Morden (Siobhain McDonagh); indeed, it was the view adopted by the Secretary of State. However, the planning reasons as deployed were a red herring.

Mr. Lewis: I have to accept the view of hon. Members who know that community and the decision-making process. Planning considerations were one issue that the Secretary of State took into consideration. The primary issue, though—she was clear about this—was that the socio-economic nature of the communities concerned had to be regarded as a priority when the decisions were being looked at.

The next thing that happened in this long process was that the London strategic health authority wrote to the Secretary of State to ask that she refer the matter back to it so that it could review the whole situation. On 16 August, the Secretary of State responded to NHS London, noting the developments and supporting the SHA’s requests to carry out a review. Again—this is consistent with her views—she asked that the review should pay particular attention to the needs of disadvantaged communities in the context of the Government’s determination to tackle inequalities in health. That review is being carried out and it is being led by Sutton and Merton PCT. It is scheduled for completion by the end of next month. I hope that hon. Members on both sides of the House respect the fact that it would be inappropriate for me, in the midst
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of that process, to make any pronouncements or judgments from the Dispatch Box. The only point I would make is that a constant part of the brief that has been given to people and organisations that have been asked to consider the matter is the socio-economic conditions and the health inequalities that exist within the relevant health economies.

Let me deal with the local financial situation raised by the hon. Members for Sutton and Cheam and for Carshalton and Wallington. The trust has a recovery plan that identifies an estimated £24 million in savings to be achieved by March 2008. It has sought to create a plan involving minimum disruption to staff and patients. While the trust cannot rule out staff redundancies entirely, there is a public commitment to keep them to an absolute minimum, and an assurance that in most circumstances staff will be redeployed.

The requirement for NHS organisations to bring their budgets into balance is one that we should all support. It seems wrong to me that over the years overspending organisations have been bailed out by those that have not overspent.

I agree with the hon. Member for Sutton and Cheam about the dreadful report on learning disability services in the community, which we all received with shock. That applies particularly to Orchard Hill. In the aftermath of the scandal in Cornwall, we must take practical and decisive action not only to close Orchard Hill as soon as reasonably possible—it provides outdated, inappropriate care for people with learning disabilities in a modern world—but to learn the lessons from Cornwall and Orchard Hill in the development of future national policies and the way in which we treat adults with learning disabilities. We must respect their views and the rights of their families.

The hon. Members for Sutton and Cheam and for Carshalton and Wallington spoke of their personal histories in relation to the hospital. I began my working life working with children and adults with learning disabilities. If there is one thing I am passionate about achieving in this job, it is ensuring that we never see another Orchard Hill. My job is to minimise the possibility of people with learning disabilities ever experiencing such problems again, although I can never promise to eliminate it.


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Tom Brake: I hope that, in the couple of minutes that are left, the Minister will be able to guarantee that transitional funds will be available.

Mr. Lewis: The hon. Gentleman would not be a Liberal Democrat if he did not ask for yet more resources. Neither he nor his hon. Friend the Member for Sutton and Cheam has drawn attention to the fact that by next year the Government will have nearly tripled investment in the national health service. I have no doubt that that has benefited the hon. Gentleman’s constituents significantly, but I doubt that it has ever appeared in a “Focus” leaflet in these particular communities.

I will answer the question, however. It is imperative for the closure to take place quickly and also properly, in terms of alternative arrangements made for adults with learning disabilities to the satisfaction of their families. I assure the hon. Gentleman that if resources are necessary to make that happen, it will not be undermined or impeded as a consequence of lack of resources. As he knows, I do not write blank cheques from the Dispatch Box—it is a matter for the strategic health authority—but I assure both hon. Gentlemen that this is a priority not just for them and the primary care trust, but for central Government. If it is proved that resources are necessary to make the closure work for the people affected, who have already undergone unacceptable experiences, we shall not be found wanting in ensuring that they are made available. As with everything else, however, a proper case must be made.

The hon. Members for Sutton and Cheam and for Carshalton and Wallington have made a powerful case for their constituents, and in particular for the future of St Helier hospital. It is not appropriate for Ministers sitting in Westminster and Whitehall to make decisions that are best made at local level, but the Secretary of State has given a clear steer that the health inequalities and social and economic deprivation affecting these communities must be one of the primary considerations when final recommendations and decisions are made on St Helier and other health trusts.

Question put and agreed to.

Adjourned accordingly at nine minutes past Eleven o’clock.


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