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My hon. Friend pointed out that I had been unable to produce a broad estimate of what the proposal might cost. I could not do so because the cost would depend on the behaviour of the Government and the discretion that they would give themselves under the provisions of clause 2. My hon. Friend the Member for Gainsborough (Mr. Leigh) said that any additional costs would pale into insignificance compared with the torrential waste that occurs in so many Government Departments at the moment. For example, only a few weeks ago, somebody called Wanless, who had
previously proposed that we should spend vast extra sums on the health service, said that most of that money had been wasted. We are talking about the waste of a huge proportion of public expenditure.
My hon. Friend the Member for Tunbridge Wells also spoke about judicial review, and seemed to think that that option was available and that that was no big deal. I would simply say to him that to expect people to apply for judicial review in order to obtain justice in relation to job applications is asking the impossible. Judicial review is a long, and very expensive, process. In planning cases, for example, even after they have gone to judicial review and the process has been found to be faulty, the arrangements do not deal with the substance of the matter, which is what people are normally concerned about. Judicial review would not deal with the substance of the complaints of people who felt aggrieved about the operation of the provisions.
My hon. Friend said that people need a genuine right of redress but that giving the Government the discretion to decide whether to accept the provisions would result in something less than such a genuine right. I accept that, but national security matters could be raised in this context, and it is better to leave some discretion to the Government. At that point, Mr. Deputy Speaker intervened to prevent us from getting into a discussion about Equitable Life.
Let us conclude with what the Minister had to say. She referred to bureaucracy and felt that the proposals were unjustifiable and unnecessary. She said that the Government supported selection on meritdont we all! The message that should come out of todays proceedings
Paul Farrelly (Newcastle-under-Lyme) (Lab): On a point of order, Mr. Deputy Speaker. A number of important Bills appear on the Order Paper today, including my own Bill to try to stop discrimination against agency workers. There is a Bill on trade union rights and one on age-related macular degeneration, which causes blindness in 40 per cent. of the population. There is also an important Bill that deals with free prescription charges for cystic fibrosis sufferers. Will you therefore advise me, Mr. Deputy Speaker, on behalf of the millions of vulnerable people affected by those Bills and also on behalf of the people in the Gallery, including the schoolchildren there, how I can put on record my dissatisfaction with the antics of a small Conservative wrecking crew that has stopped us from considering those Bills?
Mr. Deputy Speaker:
First, I should say that references to people or persons outside this Chamber are not in order. Secondly, the hon. Gentleman knows perfectly well what the rules of engagement are in respect of the availability of private Members time. Clearly, far more private Members Bills are proposed during a Session of Parliament than the amount of time available for their expeditious disposal. Inevitably, we reach a point where, because of consideration of the Bills that have priority according to the ballot conducted at the beginning of a Session, many other
Bills will not make progress. However, matters that are thought to be of general interest often have a habit of coming back againand some eventually succeed.
John McDonnell (Hayes and Harlington) (Lab): Further to that point of order, Mr. Deputy Speaker. May I ask Mr. Speaker to examine the case for granting a private Members Bill that has reached this stage and been accorded such priority by the House some sort of carry-over process similar to the process applied to Government Bills?
Mr. Deputy Speaker: I would say that many changes in procedure take place over the years. The hon. Gentleman might wish to write about that to the Chairman of the Modernisation Committee, or, indeed, to the Procedure Committee.
Derek Conway (Old Bexley and Sidcup) (Con): May I thank Mr. Speaker for allowing me this brief debate on the future of services at Queen Marys hospital in my constituency in Sidcup? I thank the Under-Secretary of State for Health, the hon. Member for Brentford and Isleworth (Ann Keen), for being in her place to reply today. I am also delighted to see my hon. Friend the Member for Bexleyheath and Crayford (Mr. Evennett), who has been at the forefront of the campaign to protect our services, the hon. Member for Erith and Thamesmead (John Austin), who shares with us representation of the borough of Bexley, and our parliamentary neighbour the hon. Member for Eltham (Clive Efford). I hope that they will catch your eye later, Mr. Deputy Speaker. I will not make my remarks overlong so that, with your consent, they can contribute to the debate.
This matter is of enormous concern in Old Bexley and Sidcup, the borough of Bexley and the neighbouring areas that use the facilities at Queen Marys hospital in Sidcup. Like many hospitals across the country, it has had severe financial problems. The four acute hospitals in south-east London, three of which have private finance initiative status and were new builds, have had special difficulties. Queen Marys hospital is much older, but in 2005 it still had a £20 million deficit. That has been reduced this year to just under £2 million£1.8 million. That required an enormous effort by the clinical staff at the hospital in how they go about their business, and by the administrative and management staff. The turnaround has been remarkable, and they should be congratulated on and praised for that.
As the Minister will no doubt tell the House, the cost of operating at hospitals is based on a cost average set at 100 points on the scale. In 2005-06, Queen Marys was just over that at 104 points, but that is because it was frequently paid under tariff by our local care trust. This year, it is below that 100-point tariff. The institution is now financially efficient in the health care that it provides. There were more than 23,000 emergency and 3,000 elective in-patients over the past year. There were 16,500 day cases, and 52,000 new out-patient appointments. There were 132,000 follow-up out-patient appointments. The number of patients treated is of a high order at this very effective local acute hospital.
The accident and emergency department is under threat of closure, which is obviously of major concern. Over the past year, 74,682 people attended the department, of whom 10,803 had to be admitted. There is clearly great demand, and people are given very efficient treatment: 98 per cent. of those patients were seen and treated, discharged or admitted in under four hours. Not only is Queen Mary's financially viable, but it has one of the most efficient accident and emergency units in the country. That is why we are concerned about the clinical proposal to cut provision from four hospitals to two. There would not be enough beds, doctors or space. Super-trauma centres may be
the way of the future, but people are worried about whether they will be able to cope with the volume.
Of particular concern to those of us who represent London areas, particularly in south-east London, is travelling time. It is not so much the distance that is the problem. The journey from the gates of the House of Commons to the boundary of my constituency can take 40 minuteslegallybut it can also take as long as two and a half hours, with great deal of bad language and bad traffic.
The maternity unit at Queen Mary's is under threat of complete closure. Some say that a midwifery unit may remain, but at the moment nothing is intended to remain. Yet the maternity unit is superb. It has been clinically assessed as being at level 2, which is the highest rating in the London area. Last year it dealt with 3,021 births. People keep telling me that the number of births is falling, but that is not borne out by the figures. This year, the number has risen to 3,360.
As the Minister will know, the Royal College of Midwives has set 3,000 births a year as the benchmark for an acceptable and viable unit for training midwives. Although those of us with children will pay tribute to the services and expertise of midwives, a midwifery unit alone is clearly not enough. My elder son was born in distress and required surgical intervention to arrive safely with us. More than 20 per cent. of births in this country require surgical intervention, which a midwife cannot provide. A midwifery unit alone will not give our constituents enough reassurance. I am sure the Minister will be concerned to learn that the United Kingdom is now 19th in the world survey of birth safety. We hoped that the situation would get better, not worse.
Although Queen Mary's is one of our older hospitals, its infection rate is much lower than those of many of its neighbours, especially those in London. There were no cases of MRSAI hope the House will forgive me if I do not give the name in full; that would be too much of a challengein June, July or August. Two years ago there were 41 cases; the number was down to 12 this year. The number of cases of clostridium difficile fell by 30 per cent., against a national rising trend, and the board has allocated an extra £500,000 for cleaning.
This is a hospital that is serving the community wellit is both cost-effective and clinically effectiveand has a lower rate of infection than is found elsewhere. Despite all that, however, it is subject to perpetual rumour and speculation, which undermines public confidence and is understandably of great concern to the excellent men and women who work at the hospital and provide us with such cover. The panic locally was started by Lord Warner, a former Health Minister in the present Government who has been appointed chairman of the NHS provider agency.
When the four acute boards were instructed to merge their chief executive posts, no account seemed to be taken of the £3 million or £4 million redundancy costs that that would involve for senior staff. At a number of meetings, Lord Warner has said that he would like to see the Queen Mary's site cleared for housing, which
gives us no reassurance at all. Although the site near the A20 is no doubt valuable, we would prefer it to be kept for a hospital.
There are clinical proposal groups which will report by the end of the month. They will go to Professor Alberti for scrutiny. We all wonder what the Darzi plan overlay will be for that, because everything seems to be very confusing. There is a tremendous race to get all this done by mid-December before Christmas, so a valued local hospital and dedicated staff are being pressured into accepting something they do not wish to happen.
There have been problems at the hospital, but they have been met, despite the hospital not having a financial level playing field for a number of years. We accept that there must be some changes. Nobody is sticking their head in the sand. What is confusing, however, is the number of fingers in the pie. NHS London seems to be wobbling all over the place. Who will count, Darzi or Alberti? Will the clinical boards take into account travel times? I am told that that is not part of their remit. The A Picture of Health consultation is being steamrollered through, so the number of hospitals will fall from four to two with no one sure what is intended. The care trust has got its finger in the pie, and the acute trusts are all over the shop. Meanwhile, behind the scenes, Lord Warner pushes on through the swirling, confusing mess.
I have a warning for the Minister. We are glad that she is present, and we look forward to hearing what she says, but those who stand behind her who are creating this swirling mess need to know that closure of the hospital will be bitterly opposed.
John Austin (Erith and Thamesmead) (Lab): The hon. Member for Old Bexley and Sidcup (Derek Conway) has highlighted the anxiety felt by his constituents and those of other Members present. People are attached to their local hospitals for very good reasons, and he has identified some of the reasons why so many people are attached to Queen Marys, Sidcup.
We need an assurance from the Minister that there will continue to be four hospitals serving the boroughs of Bromley, Bexley, Greenwich and Lewisham, whatever the outcome of the consultations. Queen Marys has been financially challenged, but there has been a turnaround both financially and in quality of care.
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