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Before addressing the specifics of the changes to the hon. Gentlemans local hospitals, I shall set out the context for those changes. During 60 years of the NHS, society, technology and medicine have changed beyond all recognition. It is important that our health service also changes and evolves to meet those challenges. Today, more and more conditions can be treated and cared for at home or closer to where patients live, in
their local community. More services are therefore being provided outside the traditional hospital setting. Hospital care itself is also changing. If we go back 20 years, most surgery almost always required days or even weeks in hospital. Today, the majority of surgery is done on an out-patient basis and patients can be at home and in their own bed on the same day.
As medical science has advanced, our doctors and surgeons have become ever more capable of extraordinary feats of clinical care. There is a growing need for that expertise to be located in centres of excellence that bring together specialists from a number of different areas to work together as a single team. Given those wider trendsmore community-based care and the need for greater specialismthe old way of doing things, which involved a local general hospital providing most of the care for a population, is not necessarily the safest or most medically effective way to treat patients. That is the context against which the reorganisation of health care in outer south-east London is taking place.
The other important thing that I need to make clear is that decisions on how local services are organised are no longer made by Ministers in Whitehall, and rightly so, but by autonomous NHS professionals on the groundat least, that is the case in England. I should like to take this opportunity to commend the collaborative approach that has been taken by the primary care trusts and acute hospital trusts involved in the outer south-east London reorganisation. Given the local concerns and in some cases rivalries, it is no mean feat that they have managed to come up with a set of proposals that they believe will not only ensure safe and high quality services for the people of their boroughs, but put the NHS in outer south-east London at long last on a stable financial footing.
The process of drawing up the proposals, which are called A picture of health, has been led by doctors and other health care professionals and, as the hon. Gentleman is well aware, has involved extensive public consultation. The clear view of the clinicians involved is that, although many services can be devolved further out into local communities, the speciality or complexity of other services means that they need to be concentrated on three sitesrather than the current four sitesto make the most of available expertise. Under the respected surgeon Professor Sir George Alberti, an independent national medical advisory team reviewed the proposed changes in south-east London and said:
It is obvious that no change is not an option. This has been stressed particularly by hospital clinicians... We support the view of concentrating acute services on fewer sites as soon as possible.
As I am sure the hon. Gentleman is also aware, in July, the joint committee of the four PCTs involved agreed to recommend a variation of one of the four options that had been considered during the public consultation. The Queen Elizabeth hospital Woolwich and the Princess Royal hospital Bromleyhis own hospitalwill both become major admitting hospitals. University hospital Lewisham will become a medically admitting hospital and Queen Marys hospital Sidcup will become a borough hospital. That will lead to an enhanced role for his Princess Royal hospital as the major acute hospital that serves the people of Bromley and, more widely, Bexley.
The enhanced services will include improved maternity services, with more options for mothers, such as a midwifery-led maternity unit and the extension of consultant cover for the traditional maternity wards. There will also be an expanded critical care facility, improved specialist rotas for medically ill patients, who will be admitted under a specialist in their condition, and an increase in accident and emergency capacity, including increased numbers of senior medical staff to serve that speciality. The local NHS said that it believed that that solution would deliver the most clinical and non-clinical benefits to local people.
As the hon. Gentleman has said, and rightly so, the NHS in south-east London has faced serious challenges for a number of years. As he also noted, when we announced last week the early achievement of the historic milestone that, on aggregate across England, 90 per cent. of admitted and 95 per cent. of non-admitted patients receive treatment within 18 weeks, Bromley primary care trust was one of only five PCTs in England performing below 80 per cent.; in fact, it was the worst performing PCT in the country. That trust is receiving a high level of assistance from both the London strategic health authority and my Departments intensive support team to resolve those issues. Urgent recovery action is under way with the trust and the local health community. It will be extremely challenging for the trust to improve performance sufficiently to meet the December targets, and for that reason, the plan to repatriate surgical work from the Orpington site to the Princess Royal university hospital in Farnborough has been deferred to 31 March.
I also note, as I am sure the hon. Gentleman did himself, that the Healthcare Commission annual health check, which was published two weeks ago for Bromley Hospitals NHS Trust, rated the trust as only fair for the quality of services and weak for the use of resources. That is a deterioration in its performance from 2006-07, when it was rated good for services and weak for the use of resources.
The annual health check is an important independent tool for measuring performance across the NHS and identifying areas for improvement. The Department is working with the Healthcare Commission to take action against trusts that have performed badly, such as Bromley. Any trust that scores weak in either quality or finance must prepare an action plan that details the steps taken and further plans to address weaknesses. All of those plans will be monitored and trusts will be revisited in the new year.
I am afraid that I cannot give the hon. Gentleman confirmation of the exact figure; that is a matter both for the acute trust and Bromley primary care trust, which, as commissioner, has the responsibility for achieving the 18-week target. What is important for his constituents is that they get the same quality and speed of service as everyone else in the country now expects. If treating patients within 18 weeks means that Bromley PCT has to refer more patients or give them the choice of being referred to an independent or private
sector provider that is not something that should be sniffed at. That is about delivering high quality care and the 18-week target to his constituentssomething that people in the rest of the country already take for granted.
Mr. Horam: On that point, I recognise that giving people an option of where to go for their treatment is not to be sniffed at, as the Minister has said. However, there is concern about whether alternative sources have the right kind of equipment to deal with the complicated hip and knee operations that the Orpington treatment centre hasfor example, the laminar flow equipment at Orpington is not available in some of the private hospitals. I do not wish to exaggerate that matterI am sure that people do their best to give excellent treatment wherever they arebut, none the less, there is a real local concern that the alternative treatment might not be as good as the treatment that they would have received at the Orpington centre.
Mr. Bradshaw: It is not for me to second-guess the decisions that are made correctly by commissioners locally. They will be cognisant of the need to ensure that his constituents get their treatment within 18 weeks, which is something that they should be able to expect and is something that people in most parts of the country already enjoy. However, as the hon. Gentleman rightly says, we must ensure that that treatment is of the highest quality. Many patients already choose alternative providersfor example, independent treatment sectors, voluntary sector organisations and charitable institutionsthat give high-quality treatment, including some providers in his area. Indeed, sometimes that treatment is of a higher quality than that of local providers. I do not want to be dogmatic about that matter, because it is right that that decision should be left to his local commissioners in the PCT.
The hon. Gentleman also mentioned the critical report into financial management and governance at Bromley
hospital that was published on 25 September. As he will be aware, the chairman of the board has publicly apologised for the corporate failings outlined in the Taylor report. There is now a new board and none of the executive or non-executive members of the board who were identified in that period of corporate failure remain on the new board. The hon. Gentleman will know that, for some time, his trust has been one of the most financially challenged in the organisation and that south-east London as a whole contains the most financially challenged health economies in the country.
The financial position of all trusts across London, including those in south-east London, continues to be monitored closely by the provider agency in NHS London. That monitoring process includes monthly reporting for each trust and escalation meetings between NHS London and the trust if forecasts change. Bromley Hospitals NHS Trust forecast out-turn position as presented in the 2007-08 final accounts was a deficit of more than £17 million, but the forecast out-turn position as presented in the 2008-09 plans is for a £203,000 surplus. As the hon. Gentleman recognised, that will be a challenge, but NHS London continues to work with the trust to look at further ways to save costs and to ensure that plans can be put in place.
There are many more points to which I need to respond, but in the minute that I have left, the most important thing to say is that the trusts new chief executive has a high reputation across the NHS. I urge the hon. Gentleman to take part in the meeting of chief executives on Thursdayall MPs in the area have been invitedand to engage in the discussions taking place about the future organisation of management, which will have a vital impact
Mr. Don Touhig (Islwyn) (Lab/Co-op): I sought the debate to draw attention to the restoration of the Newbridge Memo, in my constituency. That extraordinary building, which includes a 1920s art deco cinema, is not a museum as so many other miners institutes have become. It is the living, pumping heart of the town of Newbridge and the surrounding area. It is open seven days a week, and 28 local organisations use it for everything from tea dances to meetings of the Royal British Legion.
The Memos dance floor is said to be the best in Wales. Over the past eight decades, great names ranging from the Joe Loss orchestra to James Dean Bradfield and Nicky Wire of the Manic Street Preachers have played thereJames Dean Bradfield used to serve behind the bar. Tom Jones had a pretty rough time when he sang there at the start of his career. One of the Memos bouncers went on to become head of news at ITV. Ricky Valance, the first British singer ever to have a number one in the United States, with Tell Laura I Love Her, is a local lad and performed at the Memo only last year.
The Prince of Wales visited. He asked that his visit be extended to more than two hours and said that he would come back to reopen the Memo when the restoration was complete. The Memo was runner-up in the final of the BBCs Restoration programme. Hundreds of Newbridge folk marched behind members of the local colliery band and others to Hampton Court palace for the final. The Memo is no royal palace, but it is the palace of the valleys. Ruth Madoc, the actress, named it that when asked where her palace would be if she were Queen of Wales. She said, The Newbridge Memo. The Memo was used as a key location for the shooting of the film Very Annie Mary. Flick, starring Faye Dunaway, was partly filmed there, and last year it played host for the filming of a full-length episode of Doctor Who.
The Memo or, to give it its full name, the Celynen collieries institute and memorial hall was built and paid for by the pennies of miners and their families. It was built in memory of the boys from Newbridge who went to the great war of 1914 to 1918 and never returned. The name of every serviceman from the town who answered the call to serve our country is listed on the walls of the Memonot just those who gave their lives, but everybody who was ever called to the colours from that town. I think that that is probably unique.
After such a build-up, one might ask, Why this debate? Well, the answer is simple. The Friends of Newbridge Memo need money to carry on the restoration. They need £4.9 million to start and they have been turned down by the Heritage Lottery Fund. Let me say at this stage that I am very disappointed that no Minister from the Department for Culture, Media and Sport, which after all is the Department responsible for the HLF, could be bothered to reply to this debate. However, I am hugely encouraged by the presence of my constituency next-door neighbourhe represents Caerphillyand good friend the Under-Secretary of State for Wales. Although the Wales Office has no direct responsibility
for this matter, I know that, with him and the Secretary of State for Wales, my pleading will not fall on deaf ears.
Hywel Williams (Caernarfon) (PC): I am very glad to be able to pledge my support for the cause. People throughout Wales took an interest when the Memo was on television. It was an interesting programme and it was very disappointing that the Memo came second. Does the right hon. Gentleman share my disappointment that so much lottery funding is being diverted from Wales? The sums required in this case could easily be met from the £107 million that I understand has been diverted from Wales to the Olympics.
Both Ministers in the Wales Office come from true working-class stock and know only too well the debt that we owe the mining communities of Wales. Just as the whole community came together to build the Memo in the first place, they now rally behind the Friends of the Memo and their chairman, Howard Stone. The Friends of the Memo are all volunteers. All give endless hours of their time and all make a contribution to the quality of life of the people of Newbridge that is beyond measure. Their last application was turned down by the Heritage Lottery Fund, but they have not been deterred. They have already embarked on a second bid with determination and grit. My worry is whether the pot will be empty when their bid goes in. So much money for good causes has been diverted to the 2012 Olympicsas I well know as a member of the Public Accounts Committeethat I fear the cupboard will soon be bare.
The permanent secretary at the DCSF and David Higgins, chief executive of the Olympic Delivery Authority, appeared before the PAC on 14 November 2007. The PAC was told that the national lottery fund would have to contribute £2.17 billion to the Olympicsan increase of £675 million. Surely that cannot be good news for projects such as the Newbridge Memo, which need lottery funding so badly. We heard in the PAC that a £5 billion error had been made in estimating the true cost of the Olympic games, and the national lotteryor should I say worthwhile projects such as ourswill pay the price for that error. I am concerned that the Heritage Lottery Fund will be squeezed, that people who work hard to restore amazing buildings such as the Memo will become discouraged and that those worthwhile projects that celebrate working-class history will be lost for ever.
The 2012 Olympics will, I am convinced, be a time of great celebration and success for this country, and I want the Olympics to succeed, but I hope that those celebrations will not leave a bitter aftertaste for the Memo if our further bid is to fail. The truth is that funding for causes such as the Memo has been pillaged to help the Olympics and that has to stop now. Today, I am seeking a cast-iron assurance from the Government that no more lottery money will be siphoned off, thus putting projects such as the Memo restoration at risk.
I said earlier that the Memo was the palace of the valleys, and so it is, which makes me wonder: if it were a royal palace or a great familys stately home, would it be treated better by the Heritage Lottery Fund when bidding for money? This palace celebrates the history not of
royalty or great families, but of the working class of Britainthe people who put the word Great into Great Britain. Sadly, many people no longer have an idea of how important coal mining was to the communities that we grew up in. It is important that the restoration of the Memo goes ahead, because for some of us it is our last link to the historic past of the valleys in which we were born.
It is important to support the social and historical heritage of working people embodied in such places as miners institutes. They are fast disappearing from our towns and villages. If we want to prevent that, we must ensure that when restoration projects are proposed, the funding bodies give a fair share to those projects as they do to stately homes, palaces and castles. Many of those institutes have either gone to rack and ruin or become one of the many faceless Wetherspoons pubs that we see throughout the country.
I am determined, as are the Friends of the Memo, that we will not let that happen to the Newbridge Memo. Even though the Memo lost out on the £3 million prize from the Restoration programme, they made an application for £4.9 million to the Heritage Lottery Fund. Following advice from the officers of the HLF to turn the restoration into a two-phase project, they made an application for £3.2 million, which was turned down by the HLF trustee board.
I met Jennifer Stewart, head of the Heritage Lottery Fund in Wales, following the failure of the last bid, and I was told that there was nothing wrong with the bid but the Memo lost out because there was just £6.5 million left in the pot because of funding having to go elsewhere. I thank Jennifer Stewart and her team, because they have been very encouraging and supportive to the Friends of the Memo, who, as I said, are all volunteers. I spoke to her only this morning, and she told me how impressed she had been that the Friends of the Memo, having been turned down by the HLF just recently, have come back determined to fight back and make a further bid. They have a very positive approach. Jennifer Stewart is encouraged by that, and so am I. What concerns me, however, is the criteria used by the Heritage Lottery Fund when judging bids. Indeed, when I asked that very question of the Secretary of State for Culture, Media and Sport, I was told:
The Heritage Lottery Fund assesses all applications against its strategic aims. In addition, the Heritage Lottery Fund considers project planning and delivery, projects costs and partnership funding, long-term viability and value for money.[Official Report, 15 September 2008; Vol. 479, c. 2024W.]
I am sorry, but I still do not understand how the Heritage Lottery Fund can decide that one project should be judged more worthy than another. Perhaps it should apply common sensealthough I remember my mother saying to me as a lad, Son, in life youll find that sense isnt that common. A little common sense should be applied, so that if two projects of equal merit are being considered, preference or added weight ought to be given to projects in county boroughs such as CaerphillyI share the borough with my hon. Friend the Ministerthat have not had their fair share of lottery funding.
The Memo has probably had one of the highest profiles of any heritage project restoration in Wales. I am sure that the hon. Member for Caernarfon (Hywel Williams) will confirm that. It is seen in headlines almost every week. However, the popular vote seems to count for nothing for the trustee board of the Heritage Lottery Fund. The borough of Caerphilly has had just 38 Lottery awards, totalling £566,000. It is the second lowest supported area of Wales. We have been let down. All we want is a fair share so that that wonderful project can go ahead.
In a couple of weeks, we will be marking the 90th anniversary of the end of first world war. The historical importance of the Memo needs to be recognised, of course it does; but more important is the fact that the Memo is no museum. It is the very heart of a very special town. The people of Newbridge and the Memo deserve better treatment with the new bid. I hope my that my hon. Friend will have something encouraging to say. I invite him and the Wales Office to stand shoulder to shoulder with me and the community of Newbridge as we make a renewed bid for funding to restore the Memo. It is a palace for the valleysa palace for working people to enjoy and celebrate. It deserves a great future.
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