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The Minister would not expect me to let him get away with that. Think-tanks can cause problems for all parties. The think-tank that he mentioned is independent of my political party, as are all think-tanks. Yes, we are going through a review. It is a full review of all our higher and further education policies, which will be discussed openly at a conference
later this year. My party, unlike the Ministers, will have a full democratic vote on its future policies.
Bill Rammell: I was aware that the Liberal Democrats were undertaking a review. One of the most enjoyable experiences that I have had in a long time was reading the transcript of the interview that his predecessor gave to Andrew Neil at the Liberal Democrat conference, in which an attempt was made to explain the gyrations that were taking place over Liberal Democrat policy on higher education. And, for the record, it was a Liberal Democrat think-tank, supported by Liberal Democrats, that supported the Governments position.
Mr. Hayes: The Minister has not mentioned a point that was raised by a number of hon. Members. On the issue of onward sales, particularly in relation to transfer arrangements, is the Minister absolutely clear that the Secretary of State should be party to those arrangements? Is he determined to put in place changes to the Bill that will allow the Secretary of State to be party to them? Is he also clear that, in respect of onward sales, the loan book will not be soldin part or wholeto any organisation or body that is offshore or that, in the judgment of the House, would not be an appropriate body to handle these matters?
Bill Rammell: I can give the hon. Gentleman a fundamental reassurance on ownership. The contracts will be based on English law and will apply to English law. That ought to give a significant degree of reassurance. He will forgive me if I do not rehearse the arguments that we had on Report about the opportunities for the Secretary of State to be associated with the sales. The amendment that the hon. Gentleman tabled today did not directly address the point that he subsequently went on to make, but if an amendment on that point is tabled in another place, I will give it my active consideration.
Finally, I want to reiterate that the proposals are about the sensible management of the public finances. They are not about impacting on the borrower. The Bill will entail no change whatever to the borrower. Whether the borrowers debt is owned by the public sector or the private sector, they will notice no difference whatever. On that basis, I hope that hon. Members will support the Bill.
That this House takes note of European Union Document No. 15869/07, Commission Communication, The Euro-Mediterranean PartnershipAdvancing Regional Co-operation to Support Peace, Progress and Inter-Cultural Dialogue; and agrees that the Barcelona Process may have potential to help promote UK objectives, provided it focuses not on process but on effective delivery through partnership. [Mr. Khan.]
That the South East Region is seeking to take over planning authority for Aspley Guise, which is part of Mid Bedfordshire.
The Petitioners therefore request that the House of Commons urges the Secretary of State for Communities and Local Government to protect their democratic rights for the future of their village to be planned through the proper process of the East of England Plan and not dictated by a neighbouring Region, the South East; and further urges the Secretary of State to instruct the Government Office for the South East to remove any proposed housing numbers for Aspley Guise in any future revision of the South East Plan and to make arrangements for a future review of the East of England Plan to include consideration of any new housing development in Aspley Guise.
And the Petitioners remain, etc.
Mr. Nigel Waterson (Eastbourne) (Con): I am very pleased to have the opportunity to raise a subject of enormous importance to my constituents in Eastbourne, Willingdon and East Dean. This is far from the first time I have raised this topic in the House, as I have asked parliamentary questions about it, participated in debates and even had a meeting about it with the previous Prime Minister.
On 20 December last year, the local primary care trusts decided to remove consultant-led obstetrics and the special care baby unit from Eastbourne and to establish a single site at Hastings. Only last Wednesday, I raised that issue with the current Prime Minister at Prime Ministers questions. In his reply, he claimed that those changes were recommended by local doctors and were in the interest of patient safety, but I have to tell the House that the Prime Minister was grossly misinformed. Prime Ministers are busy people, so I would not expect him to have all the local details readily at his fingertips, but someone misled him. Every single general practitioner in my areamore than 100and many consultants are firmly against the proposals. Particular credit should go to Dr. Simon Eyre, a member of the local PCT, who broke ranks at the crucial meeting and set out in great detail why he now opposed the decision.
In recent years, two respected consultant gynaecologistsVincent Argent and Kent Ayersleft the local hospital trust, in part because of the proposals; the consultant advisory committee at the Eastbourne district general hospital has come out publicly against the proposals; paediatricians who recently met the PCT were against them; and at least three of the eight current consultant obstetricians were against them, too. Remarkably, a previous high profile and early supporter of those proposals, Mr. Mark Malak, the leading gynaecologist, withdrew his support and asked that his comments in support be withdrawn from the official documents circulated to the public, although that did not happen. The East Sussex LMClocal medical committeerepresenting all GPs in the county opposed the proposals and as recently as 5 December my local PCTs own professional executive committee voted for two sites for maternity services.
Only today, I heard from Mrs. Scarlett McNally, a consultant orthopaedic surgeon at Eastbourne DGH. She produced a letter yesterday objecting to the closure, which has already been signed by 34 consultants from across the range of specialties. Let us therefore put to bed once and for all the absurd spin suggesting that the proposals are somehow backed by, or even originated with, local clinicians. It is simply untrue. It seems to me that NHS bureaucrats, and possibly Ministers, are seeking to use local doctors as a human shield in this situation.
I want to pay tribute to the excellent campaigns running in parallel in my constituency and in Hastingsthe Save the DGH campaign in Eastbourne and the Hands off the Conquest campaign in Hastings. I would particularly like to single out Liz Walke, one of my constituents, who has done a wonderful job in leading the campaign from the front, helping to
organise marches, protests and petitions. Between them, the petitions have attracted some 80,000 to 90,000 signatures across Eastbourne and Hastings. The fundamental principle that has always driven our Hands off the Conquest campaign is not one of beggar my neighbour or competition with each other to be the one to end up with a full maternity unit. Rather, in meeting the health needs of our local populations, we believe that it is broadly right that we continue to have full maternity units in both Eastbourne and Hastings.
I also want to take the opportunity to thank neighbouring colleagues who have worked closely in support of our campaign: my hon. Friends the Members for Wealden (Charles Hendry) and for Bexhill and Battle (Gregory Barker) and the hon. Member for Lewes (Norman Baker). They have all been extremely supportive, while in one or two cases fighting their own border disputes in relation to facilities affecting other parts of their constituencies.
I remind the Minister that the biggest single issue is the 21 miles of poor roads between my local hospital and Conquest hospital in Hastings. National guidelines suggest that in the case of an emergency Caesarean, the ideal time from decision to incisionas the expression goesis less than 30 minutes in the most urgent cases. Lord Darzi, I believe, suggested 10 to 15 minutes in his review Healthcare for London, and I understand that in a recent edition of Womans Hour the president of the Royal College of Obstetricians and Gynaecologists recommended a maximum time for transfer of 20 to 25 minutes. In a recent interview on BBC Radio 2, no less a person than the Secretary of State for Health said
You shouldn't be going 20 miles. Twenty miles is a bit far.
It is precisely because of the dangers posed by a journey that can take an hour or moreas long as an hour and a half, depending on the traffic and the time of daythat we have been so concerned about the proposals from the outset. It emerged at an early stage in the consultation that the projections for journey times issued by the NHS locally were based on off-peak travel, but, having made the journey myself, I can tell the Minister with total conviction that it can take much longer than that.
Last week I raised with the Prime Minister the case of little Hermione Bateman. Hermione was born in my constituency in the early hours of new years day, some 11 weeks prematurely. She was delivered in the family bathroom by her mother, while her father waited outside for the ambulance to arrive. Fortunately she was rushed to our local district general hospital and into the accident and emergency unit, where she received specialist care. She survived, and although she has had a rough time, she is still with us and doing well. I believe that if she had had to be taken all the way to Hastings in the middle of the night, she could not possibly have survivedand that is just an example of the sort of thing that may well be happening 15 months from now.
In March 2006 my daughter suffered an abruption in the 30th week of her pregnancy. She was rushed to the DGH where I was told that it had not been possible to save the baby but that they would do all they could to save her. Thanks to the medical
and nursing teams prompt and skilful actions she survived but it was a close-run thing. Had she had to be taken to Hastings she would not be here today.
Clearly the proposals must involve, if nothing else, a higher risk of deliveries en route to Hastings. Even according to the primary care trusts own projections, there could be as many as 100 a year, which cannot be good news for patient safety. Buried in the decision made last month was a proposal for ambulance crews to receive intensive training in acute obstetrics. Could there be a clearer admission that more babies will be delivered in the back of ambulances?
As part of my routine on Christmas morning I visit the emergency services, and as always this year I visited the local ambulance station. The crews whom I met were less than impressed with the suggestion that they should be trained to deliver babies in the back of ambulances on the way to Hastings. As I see that the hon. Member for Hastings and Rye (Michael Jabez Foster) is present, let me stress that the objection would be exactly the same the other way around. It is not as though there is a problem with existing maternity arrangements in East Sussex, as the Healthcare Commissions findings back in November show. The proportion of local women surveyed who said their care was excellent, very good or good was 90 per cent. during pregnancy, 88 per cent. during labour and birth, and 76 per cent. after birth.
At the recent joint meeting in December, the two PCTs made two crucial decisions: for the single siting of consultant obstetrics and the special care baby unit; and for that site to be in Hastings. I have explained how the first decision flies in the face of the evidence. I can only imagine the relentless pressure that was brought to bear, particularly on the non-executive members, to come to that decision. In fairness, it should be noted that one or two of them did speak up against the proposals. Had one more voted the other way, the proposals would have been sabotaged. The non-executive directors are meant to speak up for local people, but in this instance they failed to do their job.
However, the second decisionto single-site in Hastingsis even more inexplicable. The arguments about distance are, of course, precisely the same; that is why we have always argued to retain two sites. The deciding factor in favour of Hastings appeared to be social deprivation. The latest figures for deprivation in the whole county are depressing, and they are not simply a Hastings phenomenon. Those figures came out only a couple of days ago, and it seems that the national ranking for multiple deprivation has increased for every district in East Sussex; in other words, multiple deprivation has increased in all parts of East Sussex since 2004.
There is often an assumption, particularly by this Government, that East Sussex is a wealthy, well-to-do and fortunate county. No doubt that is why we are so badly funded for older peoples services, even though we have the highest proportion of over 85-year-olds in the country, and it might suggest why this blatant attempt to save money is directed at our facilities. However, I can tell the Minister that there are some significant areas of deprivation in our countyshe is extremely welcome to come to the sunshine coast and see for
herself. Some of them are in my constituency, and there are some in Hailsham, and other Members can talk about their constituencies. Almost 67,000 of the countys residents are income-deprived, and just under 25,000 experience employment deprivation. Eastbourne has dropped in the national ranking by 13 places since the last figures for deprivation were produced, nearly twice as much as Hastings, which has dropped seven places. There are pockets of serious deprivation across the county, including in my constituencyin Devonshire ward, for example.
It is also significant that, despite the unfair image Eastbourne sometimes has in the outside world, there are more births per year in Eastbourne and they are set to rise, not least because of high rates of migration to the town, from Poland and elsewhere. The evidence is that there are more induced births, Caesarean operations and admissions to the SCBU in Eastbourne. I understand that that is largely owing to first-time mothers being on average older. The fact remains that both hospitals have high safety ratings.
The other argument deployed is that larger units are somehow safer, but a single siting at Hastings would not necessarily mean that that unit would benefit from dealing with the existing combined total of births delivered at the two units. It is clear that more women would opt to go to Brighton, Crowborough or Haywards Heath or to have home births, rather than travel to Hastings.
What would be the effect of the large new development at Pembury, which is bound to have a disproportionate effect on Hastings because of the geographical proximity? In another part of last weeks answer to me, the Prime Minister said:
There are six new hospital developments in the whole of the region.[ Official Report, 16 January 2008; Vol. 470, c. 922.]
Well I do not know where they are. The only one I know about that is in any way close to affecting us is Pembury, unless the Prime Minister is suggesting that pregnant women from Eastbourne go to Oxford, Milton Keynes or wherever else in the region is fortunate enough to be getting a new hospital. What we do know is that the Pembury development is going to happen, because that announcement has been made, and that it is likely to take flows of patients away from Hastings.
I do not wish to say much about the process involved in coming to this decision. I have called the consultation a sham before in this House, and nothing has happened in the interim to make me change my mind. It is worth reminding the House that as long ago as November 2006, the medical director of the hospitals trust, Dr. David Scott, was unwise enough to appear on TV to say that a decision to single-site had been taken six months previously. One therefore wonders why we wasted the time, effort and money in the interim having a public consultation that has not made a blind bit of difference to the outcome.
It is also worth making the point that the way in which the consultation has been conducted has been to downplay consistently the overwhelming view of the public and of local doctors, to rubbish to proposals set out in option 5, which had been produced carefully by a combination of local people and clinicians on behalf of our campaign, and in effect to argue that mass opinion as expressed at public meetings and in petitions was somehow less important.
In a masterpiece of drafting, the PCT produced an analysis of the consultation exercise in a document, which contrives to minimise almost entirely the overwhelming public and medical opinion in the area. In the latter stages of the consultation, as it became increasingly apparent which way the wind was blowing, the PCT was at pains to say that this process was not a vote as such and that it was just about asking peoples opinions. Call me old-fashioned, but if one is asking someones opinion on anything, one assumes that there is some purpose to doing so.
It is possible that there will be an application for judicial review. If there is, that will be the time to go into detail about the procedures that have been adopted in this case. I should perhaps tell the House that only last week, Eastbourne borough council voted unanimously, on a cross-party basis, to support the legal costs involved in a possible legal challenge. Incidentally, such a process might also be a good opportunity to investigate precisely how much ministerial interference there has been in the decision for a single siting and, in particular, in the decision for the site to be located in the marginal Labour-held seat of Hastings and Rye.
It is difficult to overstate the callous indifference to local opinion, the cynical manipulation of the consultation process and the ruthless determination to deliver a preset agenda that have all been exhibited by NHS bosses. Let me tell the Minister that it will take a long time to restore a sense of trust and confidence among my constituents in the people who are running our local NHSindeed, there was a unanimous vote of no confidence in the PCT at our last march. I urge Ministers to re-examine this decision, taking into account all the aspects that I have mentioned and perhaps others besides. It may well be appropriate to refer this matter to the independent review panel.
Next Monday, East Sussex health overview and scrutiny committee will meet. I will be amazed if it does not vote to refer the matter back to the Secretary of State. I am a little unsureperhaps the Minister can tell meabout the procedure to refer the matter onwards to the independent review panel, but that sounds like a good idea to me.
To conclude, the changes are not wanted by patients, doctors or local people. They are not based on patient safety or patient choice. They are based, I believe, on money and politics. A shameful decision has been made and, as a result, the lives of some babies and some mothers will be put at risk.
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