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Lords amendments Nos. 172 to 215 agreed to


Madam Deputy Speaker (Sylvia Heal): I propose to put together motions 4 and 5.

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) ( Delegated Legislation Committees ),

Criminal Law

Constitutional Law

Question agreed to.



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Further Education (Wirral)

7.58 pm

Ben Chapman (Wirral, South) (Lab): Although the residents of Eastham are much concerned about the effect on their lives and environment of the proposed development of a Biossence waste recovery plant and an Agri Energy biofuel plant, they are also concerned about keeping the good things that they have. Some 110 of those residents have petitioned against the closure of Carlett Park campus during the brief period of opportunity for them so to do. Their petition states:


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Health Care (Sutton)

Motion made, and Question proposed, That this House do now adjourn. —[Ian Lucas.]

7.59 pm

Mr. Paul Burstow (Sutton and Cheam) (LD): A little earlier, when I walked into the Chamber, I was overwhelmed by the pleasure that Members displayed on seeing me. I think that it had something to do with the earliness of the hour and the opportunity they would have to get on with other business on behalf of constituents.

I am grateful for the opportunity to raise the issue of health care in my constituency and in the wider borough of Sutton, and my hon. Friend the Member for Carshalton and Wallington (Tom Brake) hopes to contribute to the debate if he can. I shall start with some geography. Although my constituency is called Sutton and Cheam, the area known as Worcester Park makes up a large part of it. Many of my constituents feel that because it is not included in the name of the constituency, it is often overlooked. I wish to ensure that that is not the case in this debate.

There are real concerns about the quality and accessibility of primary, acute and mental health care in the London borough of Sutton and in particular in my constituency. I wish to raise five issues with the Minister in this debate. The first is the need for an early decision on the funding for “Better Healthcare Closer to Home” in general, and the new patient block at St. Helier in particular. The Minister will know from meetings that we have had that this issue is close to my heart and of considerable concern and interest to my constituents.

Secondly, I want to talk about the future governance arrangements for the Epsom and St. Helier trust and the constituent parts of that trust. Thirdly, I want to draw attention to the shortage of GP cover in the Worcester Park part of my constituency. This has been an issue for some time, which is why I am mentioning it tonight. Fourthly, I want to register some concerns about mental health services and their development—or lack of it. Finally, I want to raise the future of the Sutton hospital site.

“Better Healthcare Closer to Home” is a programme that has been worked up by the local acute trust, Epsom and St. Helier, the Sutton and Merton PCT, Surrey PCT and others over the last five or six years. A great deal of time and taxpayers’ money has been spent on endless rounds of stakeholder engagement, citizen juries, consultation, strategies, plans, designs, the redrawing of those designs and—of course—consultants, to little apparent effect over the last 10 years. Although “Better Healthcare Closer to Home” is the current programme, there have been previous exercises with various titles, including “Investing in Excellence”. All those programmes have attempted to grapple with problems such as providing more health care outside general hospital settings and in the community, to bring more health care, diagnostics and other treatments closer to where people live.

Many of us welcome such ideas, but it is also recognised that long-overdue investment is needed in the general hospital at St. Helier. I say that many of us recognised that, but not all of us did, and part of the reason why the process has taken so long is that that view was not generally held for some considerable time. As a result, we have had much to-ing and fro-ing over where a new
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general hospital might be built. I am pleased to say that we now have a conclusion, which is that it should remain where it is, at St. Helier, and that that is where the investment is needed.

For the period 2004-08 more than £4 million has been spent on the “Better Healthcare Closer to Home” programme. That money has not built anything, but it has produced reams and reams of paper. So far, it has not delivered anything. We will never know how much was spent on the abortive work on “Investing in Excellence”, because as the trust said in reply to a freedom of information request,

We will therefore never know precisely what costs were incurred, but we do know that—since 2000 when the St. Helier and Epsom hospitals merged into a single trust—£7.7 million has been spent on consultants. We do not know whether all that consultancy related to these programmes.

As a result of all these delays, while Kingston, St. George’s in Tooting and even the Mayday hospital in Croydon have seen investment, St. Helier has sat perched on the hill overlooking south London, with paint peeling, marking time, waiting for a future.

Tom Brake (Carshalton and Wallington) (LD): My hon. Friend may remember that some new investment went into St. Helier hospital—for a new fountain at the entrance.

Mr. Burstow: My hon. Friend is correct: we have seen investment in a much needed fountain at the front of the hospital. I am sure that it has been uplifting to the spirits of many of our constituents who have passed through its doors, although they would probably have preferred to see investment in the buildings.

Mr. Andrew Pelling (Croydon, Central) (Ind): Residents in Croydon obviously have a real interest in health care in the constituencies of the hon. Members for Sutton and Cheam (Mr. Burstow) and for Carshalton and Wallington (Tom Brake), who have been conscientious about raising these issues in the House. Is not the problem that we have seen uncertainty about health provision in that part of south London? Now is the time to invest, but the only investment in St. Helier hospital will be in Ferguson house. In many ways, perhaps because of the university and training hospitals elsewhere in London, our area suffers from a lack of investment. Our residents in Croydon and Sutton therefore end up being short-changed.

Mr. Burstow: The hon. Gentleman makes some fair points about the limbo that the health service in the London borough of Sutton has experienced for some time. At long last, however, the local NHS has come up with a plan that has secured the support of the joint overview and scrutiny committee, which comprises elected members from Merton, Sutton and Surrey, and local residents and local MPs, including the hon. Member for Mitcham and Morden (Siobhain McDonagh). That plan has been submitted as an outline business case to NHS London. The plan includes a brand new, state-of-the-art building that will replace Ferguson house and will house the majority of the hospital’s wards and clinics. It also sees the establishment of a network of local care centres—formerly known as care hospitals—throughout Sutton and Merton.

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The investment at St. Helier in the new patient block is the keystone of the plan. Without it, the plans collapse, because they do not support the weight of the logic that drives them. Without that plan, my constituents will not get the 21st century health care to which they are entitled. What is urgently required now is a green light from the Government—in the first instance, from NHS London and then from the Department for Health and the Treasury—to fund the £140 million cost of the new building. I fear that further delay could be fatal to the future of our general hospital.

My second point concerns the future governance arrangements for Epsom and St. Helier hospitals. The trust is consulting on a range of options, including maintaining the status quo of the current arrangements for Epsom and St. Helier, and the possibility of an amicable divorce between the two hospitals. Having seen a succession of chief executives struggle to make the trust function as a single effective entity, I am convinced that a de-merger is the right way forward. Straddling the Greater London boundary, the trust finds itself pulled in at least two directions: south to meet the needs of north Surrey and north to meet the needs of Sutton and Merton. It is constantly being pulled by two strategic health authorities with different agendas, trying to meet the different aspirations and needs of different populations. It will always find it difficult to meet those aspirations as one corporate entity.

Epsom and St. Helier was created by something of a shotgun marriage in 1999. At the time, the Department of Health saw the need to try to stabilise the financial situation in both trusts—particularly, as I understand it, in the Epsom Health Care NHS Trust, as it was at the time—and drove the change to a speedy conclusion. It certainly did not benefit from as much external scrutiny as local overview and scrutiny committees would give such changes today. The legacy of that shotgun marriage has been a decade of paralysis.

De-merger would allow a St. Helier NHS trust, as it would become, to focus on meeting the needs of residents in Sutton and Merton, delivering long overdue investment in services and infrastructure. My only concern, however, is that a possible de-merger could derail investment at St. Helier and the implementation of “Better Healthcare Closer to Home”. My hon. Friend the Member for Carshalton and Wallington and I have sought reassurances from the Epsom and St. Helier trust that that would not be the case, and we have heard warm words of encouragement. The trust believes that it would not undermine anything within the outline business case that has been submitted. I hope the Minister will be able to reassure me on that point. If we can secure the future of St. Helier and see the roll-out of “Better Healthcare Closer to Home”, that should create the necessary space to concentrate on other deficits in local primary care and mental health services in the Sutton area.

That brings me to my third point. I have for some years now been dealing with constituents in Worcester Park who have experienced serious difficulties in obtaining access to a local GP’s list. Indeed, I understand that constituents moving from the Sutton part of my constituency to Worcester Park often beg their GP to let them remain on their books for that very reason.

Worcester Park could be described as a GP desert. When one crosses the Kingston and Sutton boundary, one will find no GP practice until one hits the London
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road. I believe that it is time that Sutton and Merton, as a primary care trust, took up its responsibilities to ensure a fair distribution of GP provision across the area and actively engaged with local residents in Worcester Park to gauge the true level of local need and to meet it appropriately. The trust has continued to argue for too long now that there is no problem, despite all the anecdotal evidence, the evidence from my mailbag and the views of some GPs in the area who have identified the problem. I hope that the Minister will encourage the primary care trust to take on that challenge and to engage with the local population on the issue.

My fourth point relates to mental health. Again, reorganisation of mental health services in south-west London and sometimes weak health care leadership—particularly in the past—have left mental health services in the London borough of Sutton suffering from under-investment. There has been a lack of investment in developing supported living and supported employment and in building capacity in the private and voluntary sectors to provide a more diverse and appropriate community-based set of services for people with mental health problems and learning disabilities.

A consortium of south-west London primary care trusts is on the verge of consulting on plans for acute provision that might lead to the loss of beds at the Chiltern wing on the Sutton hospital site in my constituency and their possible transfer to remote locations at either Tolworth or Springfield in Tooting. I do not support the loss of acute beds in the borough. I think that that would be bad for patients and for their carers and families. I strongly believe that the opportunity should be taken to break down the stigma around mental health by co-locating mental and physical health services on the same sites.

Community mental health services could be co-located with local care centres. Indeed, that is suggested in the outline business case that has been submitted. The opportunity should similarly be taken to consider the possibility of locating acute mental health beds separately but on the St. Helier site. That should not be lost sight of in the necessary drive to get an outline business case signed off for the new patient block at St. Helier.

Finally, question marks remain over the future of the Sutton hospital site. If “Better Healthcare Closer to Home” moves from theory to practice, and we start to see its implementation, that will leave a question mark hanging over the future of the Sutton site after 2016. That seems some way away, but my constituents feel that they need to know with some certainty that there are clear undertakings and processes surrounding how that site’s future will be determined. They regard NHS land as precious, as I do. Once it has been built on—particularly once houses are built on it—it is lost, which means that the huge opportunities are lost. Before it is lightly disposed of, the site’s potential for future use by both the NHS and social care in my area should be actively explored. I hope that the Minister agrees that my constituents should have a chance to have their say in the future use of the site, to ensure that it meets local health care needs and addresses the running sore of spill-over parking on residential roads around the site.

Sutton hospital has some prestigious neighbours: the Royal Marsden and the Institute of Cancer Research. They deliver world-class research and world-class treatment and care. The opportunity to expand science and to
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develop cancer services should not be missed. Already, the possibility of collaboration between the Marsden and local GPs is under discussion. The idea is to develop a new GP clinic on part of the site.

Let me end where I began. Too much time, energy and money has been absorbed getting to this point, but we are here at last. Much now hangs on an early green light for the outline business case for St. Helier and for “Better Healthcare Closer to Home”. Those proposals unlock the opportunity to deal with mental health and primary care, and I hope that the decision can be taken soon.

8.16 pm

Tom Brake (Carshalton and Wallington) (LD): First, I apologise to my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) for arriving two minutes into his speech. I had anticipated that we would reach this point at 10 o’clock, so I had to hot-foot it in from my constituency to be here in time for the debate. I thank my hon. Friend for giving me a couple of minutes, and I shall not detain the Minister for longer than that.

It is incumbent on my hon. Friend and me to confirm that there is some good news in Sutton. I am pleased that in Wallington, at the Shotfield health centre, we can see major works under way with lots of scaffolding. Significant progress is clearly being made and, in the next 18 months or so, we will see a large, new, purpose-built, fit-for-purpose health centre. It will replace the health centre that my family have used, which is completely inadequate at present. That will be a fantastic, positive and modern development and I want to praise the GPs for the way in which they have worked with local residents, local residents’ groups and local councillors to come forward with a scheme that is acceptable to everyone locally.

I also want to take this opportunity to praise Carshalton Fields surgery, which organised a vocal campaign on the issue of polyclinics, expressing support for continuing to operate as a local family practice. I welcome confirmation from the PCT that the surgery can continue to do that if it so chooses.

I also welcome the “Clean Your Hands” campaign, which has been organised by the primary care trust. It is clearly beginning to have an impact both in the primary care trust and the acute trust. I do not know whether my hon. Friend has been to St. Helier hospital recently, but wherever one walks there are machines that dispense hand creams and that talk to people as they walk past, encouraging them to make use of them. That is a positive development.

The final positive development is the substance of my hon. Friend’s debate, and that is the proposed business case. My hon. Friend and I both await a positive outcome and the confirmation that the £140 million that will be required to enable that case to proceed will be forthcoming.

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