HC Deb 13 December 1985 vol 88 cc1253-60

Motion made, and Question proposed, That this House do now adjourn. —[Mr. Lennox-Boyd.]

2.30 pm
Mr. K. Harvey Proctor ( Billericay)

This is the first occasion upon which I have sought to raise a matter on the Adjournment of the House. I do so now because of its importance and significance to my constituents. My right hon. Friend the Minister for Health replied on 3 December to the Adjournment debate of my hon. Friend the Member for Basildon (Mr. Amess). Both debates have their origin in the decision of the Basildon and Thurrock health authority to reorganise health services in its district. As my right hon. Friend indicated in his reply on 3 December, the health authority's proposed changes form a wide-ranging package of proposals and are largely interdependent, one upon the other.

The proposals are contained in a document from the health authority that is entitled Consultative document for the reorganisation of hospital services, particularly involving the maternity, gynaecology, paediatric, regional plastic surgery/burns and some geriatric services and thereby the closure of in-patient facilities at St. Andrew's hospital Billericay and changes to Orsett and Basildon hospitals. The previous Adjournment debate revolved around the proposal that, for clinical reasons, inpatient maternity services should be centralised on one site, namely Orsett hospital in my constituency. That decision has met with the approval of my constituents in the Thurrock part of my constituency, but understandably it has met with the disapproval of my constituents who live further away from Orsett hospital —in Laindon, Wickford and Billericay.

However, I wish to concentrate today on the proposal of the health authority, contained in its option 5, to close St. Andrew's hospital in Billericay and transfer the regional specialty units of plastic surgery and burns to Basildon hospital. It is this proposal that has met with universal condemnation not only from my constituents in Billericay but from across Essex and the country.

Several of my colleagues have generously given their support to opposing these proposals. My right hon. Friend will have seen the terms of early-day motion 99. It has been signed by eight other right hon. and hon. Members, including the right hon. Member for Castle Point (Sir B. Braine), who I am glad to see has joined our debate and who, with the agreement of the Minister and you, Mr. Deputy Speaker, will say a few words in support.

I have received over 600 personal, individual letters opposing the proposals. That is an enormous mailbag on any one subject. I have received nine petitions, including one from the Federation of Essex Women's Institutes that is signed by 4,200 people. More than 20 separate organisations have registered their opposition with me. The consultants' staff committee for the district is also opposed to the recommendations. On Monday I shall help to deliver a petition to the health authority that contains over 80,000 signatures. In total, that represents locally the strongest, unified body of opinion placed before me since first becoming a Member of Parliament in 1979. To that body of opinion I wish to add my support and hence this Adjournment debate.

I have had three separate meetings with county councillor Mrs. Joan Martin and Mr. Richard Taylor, the chairman and the administrator of the health authority. I thank them for their courtesy and frankness. I plan to meet them again after the consultation ends on 21 December —on 13 January. I urge all my constituents who have not already done so to let the health authority know their feelings before the 21 December deadline.

Let me try to explain briefly to my right hon. Friend the Minister for Health why we all feel so strongly, although I appreciate that he will not be able to comment in any detail. St. Andrew's hospital is old. The oldest part of the site dates back to 1840 and some accommodation is contained in temporary huts erected during the second world war. But it is a well loved local hospital with a deservedly high reputation and, with the plastic surgery and burns unit, a reputation far beyond the bounds of my constituency. However, most of the buildings on the site are in good condition, with the exception of the emergency medical services wards, and a considerable amount of money has been spent on the site and the hospital in recent years.

The hospital is well sited geographically. It is convenient. A recent survey shows that if the services are transferred to Basildon, 57 per cent. of current patients would experience an increase in return travelling time of an extra one hour and 26 minutes every time they visited the hospital. Basildon would be only marginally faster for only 23 per cent. of current patients.

Inevitably, a move will risk the break up of the team of specialists in various disciplines so important to the super specialties which operate at St. Andrew's. The team includes not just the consultants and surgeons but the physiotherapists, speech therapists, occupational therapists and nurses, all of whom have pooled their expertise. A move will inevitably loosen up that team for no good purpose.

On 3 December my right hon. Friend said that we have to achieve a proper balanced judgment which will ensure efficient use of resources to the benefit of everyone concerned. However, a central plank of the current proposals is the move of a purpose-built burns unit which was opened only three years ago. It is the ideal burns unit format, separate and isolated from other services. I am afraid that my right hon. Friend was wrong on 3 December when he inferred that burns patients would be rehoused in modern buildings more suitable for the practice of modem medicine." —[Official Report, 3 December 1985; Vol. 81, c. 279–-80.] Option 5 of the health authority report clearly envisages that the burns unit will be placed in existing ward accommodation vacated by the maternity unit. That is completely unacceptable. Cross-infection would be much more difficult to prevent and it would be a wholly backward step.

My right hon. Friend knows well the problems of recruitment for the NHS. Yet the Billericay site, I am pleased and not at all surprised to say, is the easiest site in the district for which to recruit. I am told that Basildon is not good and that the difficulties at Orsett are appalling. That is a fact which must weigh heavily with my right hon. Friend.

Remarkably, option 5 did not take into account another hospital in Billericay, the Mayflower. The 75 long-stay geriatric beds there in an old building must sensibly be considered as must the question of whether the 35 acute geriatric beds at St. Andrew's hospital should not be placed at an acute hospital as best medical experience advises.

All the consultants at St. Andrew's hospital have supported an alternative proposal involving the closure of the Mayflower hospital for long-stay geriatric patients, as envisaged in the district strategic plan for 1983–93, the transfer of those beds to a redeveloped St. Andrew's and the switch of the acute geriatric beds to Basildon hospital, where there is no geriatric provision. The alternative has been submitted to the district health authority for consideration and I believe it to be a well-argued document.

If the proposals go through unamended, there will be a threat to voluntary endeavour. Building the burns unit cost £1.2 million, of which £400,000 was raised by the spectacularly successful burns unit appeal. I pay tribute to my right hon. Friend the Member for Castle Point for all that he did to get the burns unit established and for his help with that spectacular appeal.

Is that endeavour to be wasted? Not only will those who gave their time, effort and money feel hurt, offended and angry, but the goodwill that was generated will disappear. People in Billericay and Essex generally will never again respond to help the NHS and I, for one, would not blame them.

I have said outside the House, and I should repeat for the record, that we are not talking about cuts, although our political opponents will muddy the waters by suggesting that we are. In fact, we are talking about how sensibly to spend increased sums of money on the Health Service locally. We must remember that there is no limit to the amount of money that could be spent. The level is an arbitrary one and a matter of political judgment. Locally, we must get the best deal in the best interests of the patients. They must come first.

As a Government, nationally we have done well. We have 58,000 more nurses and midwives, over 5,000 more hospital doctors and dentists, 3,000 more family doctors and over 13,000 more radiologists, laboratory technicians and other professional staff than were in place in 1978. They are all caring for patients. Government spending on health services has increased by 23 per cent. in real terms. This year, the NHS will receive over double the amount provided by the Labour Government in 1978–79.

We must ensure that the money spent locally by our health authority is well spent. I know that my right hon. Friend the Minister will realise that I mean no disrespect when I say that I hope that these local matters do not come to him for his decision. I hope that cold logic and rational argument will win the day with the health authority. However, the Minister now knows the strength of feeling on the issue; that feeling will not abate until St. Andrew's hospital and the burns unit are saved.

2.43 pm
Sir Bernard Braine (Castle Point)

I am grateful to my hon. Friend the Member for Billericay (Mr. Proctor) for raising this matter. I think that I speak for many Essex Members when I say that it is high time that the subject was ventilated in the House.

My hon. Friend kindly said that I had an interest in the matter. When I was elected as the first hon. Member for Billericay 35 years ago, St. Andrew's hospital was dear to the heart of all the town's citizens, and I believe that it still is.

I intervene to support my hon. Friend, who deployed the case superbly, and to say something on my own account. I was involved from the beginning in the campaign to provide a regional burns unit. There was a powerful reason for my interest. As the House knows, I represent a constituency where 30,000 or 40,000 people are exposed to the largest concentration of gas, chemical and oil storage in this country, where there have been four public inquiries and where the Health and Safety Executive carried out its first environmental survey into those hazards and concluded that they were considerable. Canvey island is safer than it was, but the possibility of burns resulting from an industrial accident is high.

I lent all the enthusiasm that I could to a public appeal. The National Health Service was not concerned with providing a regional burns unit. Our region was the only one in the country at that time without a regional burns unit. If children were seriously burned at home or a man was burned at work they had to go either to a hospital on the west side of Middlesex or to East Grinstead. As anyone with any knowledge knows, in the treatment of burns it is essential to take the patient quickly to the right place with the right skills.

My task was to try to persuade the public to demonstrate an interest. By golly, they did demonstrate that interest. They raised substantial sums. I conducted the first negotiations, helped by Mr. Moonman, then the Labour —Member for Billericay, to persuade the regional health authority and the Department of Health and Social Security to match pound for pound the money that we raised. So it was that after many years of struggle, led by the public, a magnificent regional burns unit was established at St. Andrew's hospital.

The reorganisation of other hospital matters in my hon. Friend's constituency is a matter for him. My interest is that this first-class, purpose-built unit should not be moved in defiance of the wishes of its medical staff, of the local authorities and of many people. I too have received many letters from former patients and people whose relatives have been patients there. They are deeply grateful for the magnificent treatment that they have received and for the lives saved. No risks should be taken with it. It should not be moved to Basildon.

Our purpose is to ensure that the Minister understands the deep sense of anxiety and anguish in our part of Essex that such a plan should be contemplated. I hope that the Minister will persuade the regional and district health authorities to scrap the plan, to clear it out and to start thinking again. Whatever is done about hospital reorganisation generally, they must leave the burns unit alone. It admirably serves the whole region, not just the people of Basildon. Staff morale and public confidence are high. Leave it alone!

2.48 pm
The Minister for Health (Mr. Barney Hayhoe)

I congratulate my hon. Friend the Member for Billericay (Mr. Proctor) on his "maiden" Adjournment debate. He has chosen a subject of considerable local and regional importance. He has had the spoken support of my right hon. Friend the Member for Castle Point (Sir B. Braine), who intervened with his usual passion. My hon. Friend also has the unspoken support of my right hon. Friend the Chief Whip who, unusually, is present during an Adjournment debate. That is a sign of my right hon. Friend's close interest in an issue which goes wider than my right hon. Friend's constituency.

I am left in no doubt about the strength of local feeling that the proposal arouses. As my hon. Friend kindly and courteously made clear, the proposal to relocate the regional plastic surgery and burns unit at St. Andrew's hospital, Billericay, at Basildon hospital and to close St. Andrew's hospital is part of a package of measures which may ultimately —if the community health council, which formally represents the views of the community, objects —come to me for a final decision. The only way in which that happens is if the district health authority wishes to go ahead with the proposal and the community health council objects to it. If the regional health authority endorses the proposal; it will be submitted to Ministers for a final decision.

As my hon. Friend acknowledged —he has been following these matters with care —it would not be appropriate for me to comment now in detail on the arguments one way or the other. My hon. Friend has concentrated on the transfer of the burns unit from St. Andrew's hospital, as he did in his recent early-day motion, which he said was signed by my right hon. Friend the Member for Castle Point and a number of other local Members who have a particular interest.

It must be borne in mind —this was reflected in the speeches of my hon. Friend my and right hon. Friend —that we are dealing wth one facet of a wider proposed reorganisation involving the maternity, gynaecological, paediatric and geriatric services in the area. A number of hospitals are involved and the proposed reorganisation involves the closure of St. Andrew's hospital in Billericay.

As my hon. Friend acknowledged, this is the second debate on these matters that we have had during the past few days. On 3 December my hon. Friend the Member for Basildon (Mr. Amess) spoke powerfully and eloquently on another part of the proposals. He directed his remarks to the proposed centralisation of the district's maternity services at Orsett hospital. Much of what I said in reply to my hon. Friend the Member for Basildon is relevant today to the subject of my hon. Friend and right hon. Friend's concern, which is the effect of the proposals on the burns unit at Billericay and the future of St. Andrew's hospital.

The proposals are wide-ranging and they intermesh. I am advised that they are largely interdependent. In considering the proposals, the overall interests of the many types of patient needs must be kept in mind. As the debate has shown the proposal to relocate the plastic surgery and burns unit is clearly a matter of considerable local interest and concern. St. Andrew's hospital is, I gather, a well-loved local hospital that offers a high standard of care. As my hon. Friend the Member for Billericay recognises, there is provision for consultation and comments must be submitted by 21 December. I have little doubt that the two debates that have taken place in the House, one on 3 December and one today, will encourage local people to make their views known. It is an important part of our democratic process that individual matters of this sort can be raised in the House. They attract attention, and proper account will have to be taken of the views which have been expressed.

I said on 3 December that I understood that the district health authority believes that the move to Basildon would improve facilities for burns and plastic surgery cases by rehousing them in a modern building more suitable for the practice of modern medicine. My hon. Friend the Member for Billericay has commented upon that and my right hon. Friend the Member for Castle Point referred to the purpose-built character of the unit and the special consideration that should apply to it. I would not wish to go further than merely to note their comments and to reiterate that I am sure that they, along with the many other relevant factors, must be taken into account when decisions on this matter are made, whether at district, region or, if the matter reaches Ministers, national level.

I am told that the general condition of St. Andrew's hospital is not good and that considerable capital investment would be necessary to get it into a proper state of repair. I recognise the points made by my hon. Friend the Member for Billericay, which I am sure are well known to the health authority, about the travelling that some patients will have to undertake if the unit is moved. My hon. Friend commented with considerable precision on the extra time needed for travel. The health authority recognises that local people who have recently contributed to improvements in facilities —£400,000 was raised by local efforts, in which my right hon. Friend the Member for Castle Point played an important role —should be taken into account.

Sir Bernard Braine

I think that my hon. Friend made a slip of the tongue. In talking about contributions from local people, he used the word "recently". The point that we are trying to establish is that, from the beginning contributions came from local people —from all over the regions, but principally from Essex —and it was not until they had made a substantial showing that there was the slightest interest in NHS money being found. Our interests is not recent —we have been demanding this facility for a long time. We have only just got it, and now it is to be moved away. That is unacceptable to us.

Mr. Hayhoe

I am grateful to my right hon. Friend for that clarification. In trying to scramble through in the limited time available, I may have over simplified the point which my right hon. Friend made tellingly earlier. It is not appropriate for me to comment, as my right hon. Friend the Member for Castle Point recognises as well as any other hon. Member because he has served here for so long with such distinction. I face the difficulty of having to respond by saying that I have no substantive comment to make because of the procedures that have been set up to allow the committees in the Health Service at district and regional level to bring their consideration to bear on the problems and to provide opportunities for the expression of local views.

I want to emphasise what my hon. Friend the Member for Billericay said about the purposes of the review. There is a considerable difference of opinion between what we have heard today and the views of some of those who have brought these proposals forward as to what is right in terms of patient care. I am glad that my hon. Friend made it absolutely clear that the purpose of the proposals is not to save money but to meet clinical service needs. If any financial benefit arises, those resources will be used to improve patient care. This is not a cost-cutting exercise, although I recognise that local people, motivated by party political considerations, may seek to misrepresent the position. I hope that the debate has gone a long way towards discrediting such comments.

Resistance to change in Health Service matters is often deep seated. When the proposed change is for the worse, one has total sympathy with that resistance. Over the years I have found that sometimes —I make no comment on this specific proposal —resistance to change is expressed even when the change is for the better and in the long-term interests of all concerned. I hope that we all want a more effective deployment of resources to provide better patient care and that proper account is taken of local wishes and desires in arriving at those judgments. I insist that the test —I hope that I carry my colleagues with me —is that of better patient care. That is what we are about.

Question put and agreed to.

Adjourned accordingly at one minute to Three o'clock.