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Baroness Jay of Paddington: My Lords, I am sorry that I cannot give the noble Lord a full reply to his Question today. As I think he knows, plans for service changes at Queen Mary's Hospital, Roehampton, are currently subject to formal consultation by Merton, Sutton and Wandsworth and Kingston and Richmond Health Authorities. If this consultation does not result in local resolution, the plans will almost certainly be referred to Ministers. Therefore, it is inappropriate to comment before the process is complete. I hope the noble Lord will be pleased to learn that just before Christmas the Government announced the allocation of £6 million of special assistance funding to the South West London Health Authority. This is to ensure that hospital services in the local area can be sustained while the health authorities consult on the longer term future of services at Queen Mary's.
Baroness Jay of Paddington: My Lords, I hope the noble Lord did not walk out because he felt that the accreditation was insufficient. As he will be aware from his involvement with the hospital, there have been longstanding concerns about clinical safety at Queen Mary's. In April 1996 the royal colleges of general surgery and orthopaedics indicated that they no longer considered services at Queen Mary's to be clinically sustainable. The hospital also lost doctor training accreditation for surgery, paediatrics, emergency services and children's services in April 1997 and accreditation for A&E in August 1997. I hope the noble Lord will be reassured, however, that, with regard to any decision which Ministers finally take about the future of the hospital, we will want to be fully satisfied that it is in the interests of local people.
Baroness Hamwee: My Lords, when may we expect to see the results of the team which is reviewing hospitals in the London area? That, after all, is the context in which decisions about Queen Mary's should be based. The noble Baroness will be aware that the various problems around Queen Mary's are leading to what has been described to me as a haemorrhaging of staff, which is a very unhappy situation. Secondly, and quite separately, can she give assurances as to the capital funding for the scheme which the health authorities are proposing? Their own consultation document indicates a shortfall of almost £30 million.
Baroness Jay of Paddington: My Lords, I am grateful to the noble Baroness. As I said in an earlier reply, I hope she will understand that because of the present statutory situation I cannot comment in any detail on potential future plans for the hospital. I can assure her that, as I said, we are making every effort to ensure that services are maintained in this very difficult period, which I recognise has led to the loss of some staff in this particular area. That is a problem. As I said in my initial reply, we are very concerned about the issue of clinical quality and the problem that may result in the long term.
Baroness Jay of Paddington: My Lords, I am so sorry, but I genuinely forgot. The report is imminent. But there is a separate report on services at Queen Mary's. That is out to consultation until the end of January. That must be considered separately. I believe that the final date for consultation is 26th January.
Baroness Jay of Paddington: My Lords, my noble friend will be aware that one of the problems at Queen Mary's has been what is technically called the "case mix". That refers to people who have come in for acute care and where all the concerns that I have previously illustrated are very high. There is a very large input of elderly patients looking for more basic community care. That is the highest proportion. I believe that under any suggested plans that will continue to be the greatest number of patients to be looked after by this hospital.
Lord Gillmore of Thamesfield: My Lords, perhaps I may declare a personal interest in asking this question. For the past few years a close member of my family has been receiving the most expert and dedicated treatment at Queen Mary's Hospital. Can the Minister explain why the decisions that led to the withdrawal from that hospital of the in-patient beds, the maternity unit, the paediatric beds and the accident and emergency unit were taken before the results of the so-called South Western Review were known? Can the Minister say whether those responsible for the review--or the royal colleges whose withdrawal of accreditation led, I believe, directly to the removal of the accident and emergency unit--undertook any examination of the health needs of the people now being served by Queen Mary's Hospital or indeed carried out any proper consultation with them?
Baroness Jay of Paddington: My Lords, I am delighted that the noble Lord's relative has been so well looked after. Perhaps I may make it clear that the royal colleges are not deciding the future of the hospital. The Specialist Training Authority--the so-called STA--is legally responsible for approving hospital posts for training purposes and for safeguarding standards of postgraduate medical training. The royal colleges advise the STA and do work on its behalf, but the decisions rest with the STA. We believe that this is an important guarantee of consistency and excellence across a large number of medical specialties. We do not wish to see doctors trained in environments where they cannot benefit from the full range of experience or supervision. We view the decision of the royal colleges to remove these accreditations that I outlined in my original answer, as a key indicator of the clinical quality which, as noble Lords will know from our White Paper, is something that we want to stress in the organisation and the management of the NHS.
Baroness Jay of Paddington: My Lords, I certainly agree with the noble Baroness that the panel was extremely distinguished and did its work very thoroughly. The detail of when it completed its work is something that we do not need to discuss. Some of it was conducted privately and some publicly. I believe that the discussion this afternoon about the details of the alteration of services at one hospital trust alone illustrates the complexities of the issues that are being looked at in the London review. It explains why Ministers and the regional organisations have wanted to look very carefully at the proposals which have been made.
Earl Howe: My Lords, is the Minister aware that there is a real fear locally that Queen Mary's Hospital is being allowed to wither away to nothing before that process can be halted? Will she convey to her right honourable friend the concerns that have been expressed on this matter and ask him to make it clear that the hospital will not be allowed to close without the Government fulfilling their pledge before the election that where closure of a hospital is suggested, a public local hearing should be held to give the local community the opportunity to cross-examine those putting forward such a proposal?
Baroness Jay of Paddington: My Lords, I shall certainly convey to my right honourable friend a sense of urgency about this decision. As I said in reply to the noble Baroness, Lady Hamwee, we expect the consultation period on this decision to be completed by the end of January. By then we will have had a very full and fair discussion of these issues at local level. From the interest which a number of noble Lords have taken in this matter, including my noble friend Lord Jenkins of Putney, who has kept me well up to speed on this, I am aware of the degree of local concern, local involvement and discussion. As I said in answer to a previous question, we shall not make any decisions which are not in the interests of local people.
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