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I am grateful to the hon. Gentleman and to the hon. Member for Sutton and Cheam (Mr. Burstow) for letting me get involved in their party, because there are issues in south London that I should like to draw to their attention. There are much the same pressures in Croydon as in Sutton. The hon. Member for Sutton and
Cheam pointed out that health needs and demands mean that much of the hospital care is drawn either south towards Epsom or northwards to serve the needs of people in the borough of Merton. In some ways, the same issue applies in Croydon, in that Mayday is quite northerly
Mr. Pelling: I take that point, Madam Deputy Speaker. In the context of the pressures, we have to take cognisance of the need for relevant services across south London. Close to the constituency of the hon. Member for Sutton and Cheam, and just over the border of Carshalton and Wallington, Purley hospital has not been able to be rebuilt either. As in the example of Mayday, there is a need to move it to the gateway site in central Croydon rather than its being in north Croydon.
Tom Brake: I thank the hon. Gentleman for that intervention. He encourages me to stray slightly beyond the borders of the London borough of Sutton, which I am loth to do. I am sure his constituents have noted his intervention in the debate and the significant points he has made on their behalf.
I have a couple of not such good news stories. A point was raised with both my hon. Friend the Member for Sutton and Cheam and me by one of his constituents about the standard of care received by her elderly relative when she was in St. Helier hospital. Apparently my hon. Friends constituent was asked by nurses whether she lived locally and when she confirmed that she did, she was asked to go home and get some pillows for her relative as there was a shortage in the hospital. Given that the funding the Government have provided the NHS has increased to the extent it has, which we admit, why is it still the case that some of the basicsthe fundamentals of carehave still not been addressed as we would like? The constituent described the care received by her elderly relative in hospital and it is not something that any of us would feel comfortable about if our relatives had experienced it. I cannot refer to the case in more detail because I have not checked whether my hon. Friends constituent would be happy for me to mention anything more specific. None the less, some of the fundamentals have not been addressed.
Again on the negative side, my hon. Friend referred to the de-merger. As he said, it could delay proceedings further, but what is more fundamentally dispiriting is that it is a recognition of the fact that the trust never succeeded in getting the Epsom and St. Helier hospitals and their consultants to work together effectively.
My final point is a Sutton issue, albeit not specifically or solely, so I hope that the Minister will have been briefed about it. It relates to the Henderson hospital, a matter that my hon. Friend and I have discussed with a succession of Ministers for months, if not yearsit is ongoing. The fundamental issue, which has not been picked up by the Minister of State, the hon. Member for Corby (Phil Hope), who has most recently responded to us, is that an assessment of the effectiveness of the therapeutic model at the Henderson has still not been carried out. The Government say that they have looked
at whether there has been replication of the modelthere hasyet the proposal is to cancel or abolish it without anyone having looked at whether it is effective. The Department of Health says that the therapeutic model has not proved itself because there is no evidence and that, because there is no evidence, we have to get rid of it. However, if anyone had been able to obtain some evidence, it might have confirmed that the therapeutic model was perfectly viable and the right approach.
I may have surprised the Minister with that point, but I hope that he can write to my hon. Friend and me to confirm that when the National Institute for Health and Clinical Excellence considers at an international level the appropriateness of models such as the Henderson, it will look at the Henderson and identify hospitals and communities internationally that are doing similar things. That will confirm once and for all whether that type of therapeutic approach for people with personality disorders can work. At the moment the work has not been done, so it would be entirely wrong for the Government to get rid of that therapeutic model. The Minister may say that he is not responsible for that work, but I am sure that he would like in-depth research into the effectiveness of the model. I conclude on that point, but as my hon. Friend said, I hope we shall hear good news about the Better Healthcare Closer to Home project and that the teams proposal will be endorsed by NHS London, the Department of Health and eventually the Treasury so that the development can take place.
The Minister of State, Department of Health (Mr. Ben Bradshaw): I congratulate the hon. Member for Sutton and Cheam (Mr. Burstow) on securing the debate. I appreciate the comments that he and the hon. Member for Carshalton and Wallington (Tom Brake) have made.
I begin by paying tribute to the NHS staff in and around Sutton for their hard work and dedication, as a result of which, with the Governments investment in the health service, the hon. Gentlemens constituents are receiving better health care than ever. Waiting times are at record low levels, life expectancy and other health outcomes are higher than they have ever been and with more than half GP surgeries in the constituency of the Member for Sutton and Cheam now offering extended hours, it is easier to see a GP in Sutton than ever before. The latest annual report into NHS performance by the independent health watchdog the Healthcare Commission said that both the primary care trust responsible for organising services in the hon. Gentlemans constituency and his local hospitals have improved on their performance of last year.
As the hon. Gentleman will appreciate, however, health care can never stand still. With advances in medical technology and treatment, the NHS has constantly to examine how it can best provide services to meet the needs and expectations of the public. There is also, as he understands and acknowledged in his speech, a long history to the debate over the best way to organise services in south-west London.
We are now at the stage where proposals have at last been agreed, as the hon. Gentleman also graciously acknowledged. The proposals are supported not only by all the PCTs and acute trusts in the area that have an interest, but by the local Members of Parliament, with
whom I have had discussions about the issues on a number of occasions in the past, and they have been unanimously supported by the local overview and scrutiny committeesthe local government representatives who scrutinise local health proposals and, if they feel the need, object to them.
The local needs, local health review launched jointly by Epsom and St. Helier University Hospitals NHS Trust and the London strategic health authority will consider whether there are better ways of managing the two hospital sites, as the hon. Gentleman outlined, and better ways for the trust to meet the diverse health needs of his local communities. It will look at how it can ensure that patients access better services locally, and that the trusts continue to improve standards of care and meet their statutory obligations, while recruiting and retaining adequate staff and maintaining their continued professional development.
The review is not exclusive to the trust and the London SHA. It involves three other partner organisations: Sutton and Merton primary care trust, Surrey PCT and the South East Coast strategic health authority. The organisations should be commended for working together in an effort to reach a workable solution that should meet the needs of the populations that they all serve; that is not always easy, when local considerations come into play. The local needs, local health review will be run by a project board, which will be made up of executive and non-executive directors from the five partner organisations and chaired by the London SHA. A project team of senior managers from the partner organisations will support the project board. The team will be led by a project director, who will report directly to the trust.
It is hoped that the project board will meet in December for the first time. One of its first tasks will be to engage staff and volunteers in the review process to ensure that their concerns and views are taken into account. The project board should be in a position to deliver a formal report by the end of spring 2009. That should allow sufficient time for the review to take place, while the uncertainty surrounding the future of the two hospitals is resolved as quickly as possible. Of course, I understand the desire of the hon. Members for Sutton and Cheam and for Carshalton and Wallington to make rapid progress, but I hope that they understand that it is important to get things right, rather than move quickly to make changes that one might later regret.
As the hon. Member for Sutton and Cheam said, the Better Healthcare Closer to Home strategy is linked with the plans for Epsom and St. Helier University Hospitals NHS Trust. The strategy is led by Sutton and Merton PCT, in partnership with Epsom and St. Helier University Hospitals NHS Trust. Its aim is to reshape the whole health service in Sutton and Merton, so that it provides better quality health care, designed around the needs of local people.
The programme proposes to create integrated health care services, based in a number of local care centres that are supported by a local acute hospital that provides core secondary services. The outline business case, referred to by the hon. Members for Sutton and Cheam and for Carshalton and Wallington, was submitted by Sutton and Merton PCT to NHS London on 23 October. It is a complex programme, comprising a number of projects, the largest of which, as the hon. Member for Sutton
and Cheam acknowledged, is the £152 million first phase of redevelopment of St. Helier hospital. Other projects include local care centres in the following locations: Nelson hospital, costing £19 million; St. Helier hospital, costing £15 million; and Wilson hospital, costing £10 million. There will also be an intermediate care centre on the Wilson hospital site, costing £12 million.
In total, the projects for which approval is sought from the SHA have a capital value of £208 million. In addition to the suite of projects that I have just outlined, there are a further twoa local care centre at Wallington and an urgent care centre on the St. Helier sitewith a combined capital value of £18 million. As I am sure that the hon. Member for Sutton and Cheam will appreciate, the assessment of all those projects has to be thorough, and the analysis must be robust. Capital advisory staff at the London SHA will collate responses and questions from the project board, and they will be sent to the PCT and trust in December. Subject to satisfactory responses by the trust and PCT to the questions raised, NHS London will take the case through its approval process in January 2009.
Assuming that all goes to plan, and the proposals are approved by the SHA and my Department, the proposed timetable is as follows: the Wallington local centre should open in 2011, the Nelson and Wilson local care centres and the Wilson intermediate care centre will open in 2013, and the St. Helier local care centre and phase 1 of the site redevelopment will open in 2016. That timetable allows time for the development of detailed plans for final approval, the production and approval of full business cases for each element of the project, including Treasury approval for the St. Helier site, and the construction and commissioning of the buildings.
The hon. Gentleman reminded me of his interest in a possible fifth local care centre, to be sited on the Sutton hospital site. I understand that the PCT is in preliminary discussions with the Royal Marsden NHS Foundation Trust about possible options for the development of a different type of health facility on that site. Again, I hope that the hon. Member will appreciate that all the interested parties want to make sure that the proposals meet the needs of the local community, and that we provide first-class, sustainable services in surroundings that are fit for purpose and represent the modern, high-quality NHS.
The hon. Member for Carshalton and Wallington will have to forgive me; I was not briefed on the issue of the Henderson hospital site. However, I will ensure that he gets a response on the subject from my fellow Minister of State, my hon. Friend the Member for Corby (Phil Hope), who is responsible for mental health matters. On the complaint that he mentioned about services provided at Epsom general hospital
I beg the hon. Gentlemans pardon. I am sure that he will encourage his constituent to make a formal complaint, if they have not already done so. We have an independent, robust complaints system in place, and it is important that Members of Parliament encourage constituents who have such cases to take it up, not least
because hospitals performance is judged not only on the number of complaints that they receive, but on how they respond to them.
The hon. Member for Sutton and Cheam also raised the issue of the provision of mental health services, and mental health beds, in his constituency. The London SHA informs me that the number of mental health beds has gone down in his area, as investment in community services has risen across west London. That pattern is replicated across the country. The four PCTs in the five boroughs served by the South West London and St. Georges Mental Health NHS Trust have recently started work on a joint strategic plan for in-patient services across all care groups. That includes plans for Sutton hospital and mental health in-patient services. Sutton and Merton PCT is leading on that work, which is likely to lead to consultation on a range of options in the spring of 2009, with decisions expected next summer. Those options are likely to include some that retain mental health beds in Sutton and others that transfer them to other boroughs. I encourage him to be closely involved in that consultation process so that he can be reassured that his voice is heard.
Tom Brake: Could the Minister confirm on the record that he would expect accessibility of mental health services to be just as important as accessibility of other health services? The whole proposal, Better Healthcare Closer to Home, is about making general health services more readily accessible to local people, and that must also be the case for mental health services.
Mr. Bradshaw: The hon. Gentleman is right that any organisation of services has to take access into account, and national guidelines will be laid down to ensure that that happens. However, the decision as to how best that is done on the ground is taken by the local health service. If there are fundamental and comprehensive changes to how services are organised in any particular area, it is open to him, or to the local councillors in that area, to raise objections through the overview and scrutiny and independent reconfiguration process, and I encourage them to do so if they are concerned about it. As the hon. Member for Sutton and Cheam knows, the issues to do with the provision of these services are for his local health trust to resolve, and I encourage him and other hon. Members with an interest to engage in that process.
The hon. Gentleman raised a problem in part of his constituency about density of GPs. I will have a word with the primary care trust about that, but I urge him to maintain the pressure on it. It is important that PCTs take GP access seriously to ensure that no members of the public are disadvantaged by a shortage of GPs in a particular area. As I am sure that he will appreciate, overall investment in primary care, as in all health services, is increasing year on year. That is the responsibility of PCTs, which will now be measured and ranked, not least on how they provide these services to deliver them in a proper and fair way.
I hope that this debate has gone some way towards reassuring the hon. Gentleman that the proposals for Epsom and St. Helier, and for local care developments as part of Better Healthcare Closer to Home, are moving forward. NHS London has advised me, in response to another question that he raised, that Better Healthcare
Closer to Home and the local needs, local health review are unrelated. One does not depend on another, the first being about service development and the second being about organisational management arrangements. The local needs, local health review should have no significant impact on any aspect of Better Healthcare Closer to Home. I am meeting the chief executive of NHS London tomorrow, and I will ensure that she is aware that this debate has happened. Matters are still ongoing in relation to the local needs, local health
review. Any decisions taken about the future of Epsom and St. Helier, whether it remains as one trust or becomes two separate trusts, will be subject to consultation, and, as the hon. Gentleman asked, the views of local people will be considered before any final decisions are made.