The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege): My Lords, the Government continue to believe that the decisions made by East London and the City Health Authority and confirmed by the Secretary of State are right for patients and for the future of health services in East London.
Lord Molloy: My Lords, I thank the noble Baroness for that reply. Is she aware that the threat to St. Bartholomew's Hospital has brought about the most amazing alliances? Is she aware, for example, that the gentlemen of the City are backed by and working together with the people of Stepney to try to save that wonderful hospital; that in the other place yesterday there was a massive revolt about the closing down of Bart's; and that the BMA has said that some of the reports that have been submitted are without fact or foundation? In short, I doubt whether there is anywhere in the country where there has been such opposition to the proposal to demolish that great, well-known British hospital.
Baroness Cumberlege: My Lords, your Lordships are well aware of the reasons for the closure of the hospital. I accept that there have been some very useful alliances formed. The proposal for a community hospital on the St. Bartholomew's site is being actively pursued. It is one to which we give encouragement.
Lord Strabolgi: My Lords, is the noble Baroness aware that Sir Bernard Tomlinson has been reported as admitting that if he had had in his possession the full statistics, he would not have recommended closures to that extent at Bart's or Guy's? In view of that, will she halt the closures, which I understand have numbered nearly 11,000 over the past four years in London alone and which have brought such suffering and distress?
Baroness Masham of Ilton: My Lords, does the Minister agree that the closure of the casualty department at St. Bartholomew's Hospital has put very great pressure on the casualty department of the Homerton Hospital, which has had to close several times because of lack of beds? Is she aware that that has put pressure on the London Hospital, which has had to stop its "cold" surgery so that it can take the casualties?
Baroness Cumberlege: My Lords, there have been pressures on the Homerton Hospital. The noble Baroness is correct. However, she will also know that we are investing £2 million in that hospital and that there will be an extra 28 beds in the emergency department, which are to open quite shortly. We believe that they will reduce the pressure and the problem will not continue.
Lord Dixon-Smith: My Lords, does my noble friend agree that, although the population at large outside London regret the turmoil within London, those patients, doctors and hospitals are glad because of the enhanced services which they are enjoying as a result of what is happening in London?
Baroness Cumberlege: My Lords, my noble friend is absolutely right in what he says. Some of the closures in London represent the success of London in that the very distinguished consultants who worked in those famous teaching hospitals have gone to other parts of the countryto Liverpool, Newcastle, Southampton and all over the countrysetting up departments with enormous expertise. It is those departments which are now treating the people who previously used to come to London. Also, we subsidise London to the tune of £28 million per year. That is money which should be spread to other parts of the country.
Earl Russell: My Lords, is the Minister aware that the future of Bart's has been threatened in other centuries? On those occasions, parliamentary action preserved it. If our representations should prove less successful than those of our predecessors, is that a mark of the declining importance of Parliament in our national life?
Baroness Jay of Paddington: My Lords, the Minister congratulates herself and others on the departure of consultants from London; but is she also pleased with the situation in London in which most hospitals now operate at 95 per cent. bed occupancy, whereas the most appropriate figure is about 85 per cent? Is she aware that in the recent period cancelled admissions in London were 17 per cent. higher than in any other place in England, and that the Thames regions have the highest percentage of patients on waiting lists
Baroness Cumberlege: My Lords, I have heard the noble Baroness on other occasions tell your Lordships that it is time that we improved primary care because a lot of the pressures on London hospitals are due to the poor primary facilities that exist within London. The noble Baroness will know that we have made huge investments into that aspect and, once the services are firmly established, there will not be the problem that exists at the moment in London. In relation to waiting lists, it is interesting to see that over the past year there has been a reduction by 10 per cent. of the patients who have been waiting more than one year. In the country as a whole we have reduced by half the number of people waiting more than one year. That is a tremendous tribute to the National Health Service.
Lord Rea: My Lords, is the noble Baroness aware that Sir Bernard Tomlinson, on whose report the Government's London decisions were based, recently said that had he had the information that is now available, he would not have made the recommendations he did in his report?
The Parliamentary Under Secretary of State, Department of Transport (Viscount Goschen): My Lords, the responses to the consultation exercise on this subject are currently being considered. It is hoped that legislation requiring the fitting of seatbelts in minibuses and coaches used specifically for the transport of children will be introduced in the autumn. A concurrent consultation exercise has been conducted in Northern Ireland and it is intended that regulations will maintain parity with Great Britain on this issue.
Lord McConnell: My Lords, while thanking the noble Viscount for his AnswerI am grateful for the information he has givenmay I ask him whether he will also abolish what is called the "three-into-two" rule? That allows three children to be accommodated on seats designed for two adults. In many cases it results in 101 children being placed into a bus designed to accommodate 53 people.
Lord Clinton-Davis: My Lords, the Minister said that he is considering the use of seatbelts for vehicles specifically designed to carry children. What about those which are mainly, but not exclusively, designed to carry children? Why not seek to apply Article 36, with the agreement of the Commission, to all coaches while the Government are considering this issue?
Viscount Goschen: My Lords, I can correct the noble Lord, Lord Clinton-Davis. Our proposals address the issue of use rather than design. It is not a question of whether coaches are specifically designed for the carriage of children; it is a question of whether they are specifically used for the carriage of children.
Article 36 is not a tool which can be used every time a member state would like to legislate but is effectively prevented from doing so because the EC has the competence. It is not available where there is already full harmonisation of measures designed for the protection of health and life, and that is the case in these circumstances.
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