§ 7. Sir Michael Neubert
To ask the Secretary of State for Health what are the main criteria for her policy for the location of accident and emergency, neurosciences and oncology services in the Greater London region.
§ Mrs. Virginia Bottomley
No accident and emergency department will be closed in London, or anywhere else, unless and until it can be shown that proper alternative facilities exist which will secure patient safety and provide quality patient care. As for the specialist services to which my hon. Friend refers, the Government are seeking to reduce the current duplication and fragmentation in London and create a number of world-class centres for treatment, teaching and research.
§ Sir Michael Neubert
Is my right hon. Friend aware that Oldchurch hospital in my constituency, which is easily accessible to an area with an above-average incidence of illness and deprivation, has served the health needs of the people of Romford and around it to their satisfaction for generations? Is she further aware that there is massive public demand for that hospital to continue as a fully functional district general hospital, and that repeated attempts to remove vital services—the latest being accident and emergency services in respect of which four alarming cases within a month have revealed that patients can expect to wait up to four to six hours in casualty before treatment—are greatly resented and are being actively resisted?
§ Mrs. Bottomley
I am well aware that my hon. Friend is a great champion not only of his local health service but of Oldchurch hospital in particular. Throughout the country, we must face change in the delivery of health care if we are to have cost-effective improvements that take forward the pioneering medicine that is so important to the citizens of the United Kingdom.
I have looked at the figures for my hon. Friend's area. An extra 1,100 patients were treated last year. A £6.1 million building programme is in place, involving a new theatre, maternity and paediatric block at the local Harold Wood hospital. The area is also doing extremely well under the patients charter—a written constitution of what local people can expect from their health service. My hon. Friend's health authority will be bringing forward further plans. Above all, it must take forward quality improvements for local people.
§ Ms Abbott
On the question of oncology services, the Secretary of State suggests that there is duplication and 133 excess provision. My constituent, Dr. Spitzer, wrote to me a few days ago about a patient of his whom he sent to the oncology department at Bart's. The consultant recommended that that patient be admitted immediately because his cancer was so far advanced. He was sent home because of a shortage of beds and he died that evening. When will the Secretary of State concede that people are dying because of her policies in London and that more people will die if those policies are pushed through?
§ Mrs. Bottomley
Only yesterday, the chief executive of the NHS produced his annual report which showed that an extra 1.3 million patients had been treated since the introduction of the reforms. Clearly, when anything goes wrong, it is essential to investigate and learn any lessons. But the average cancer service in London, as the independent review of services in London showed, sees about half the number of patients seen elsewhere. The health service has to be cost effective in the delivery of care. I have explained to the House how we have produced an extra £1.6 billion, and there is an extra £70 million for the hon. Lady's region next year. At the same time, however, we have to find the most efficient way of delivering that care.
§ Mr. Carrington
Has my right hon. Friend considered the need for a major trauma centre in west London? Does she agree that the ideal location for such a centre would be the Charing Cross hospital, which has magnificent specialty services and is ideally located, with easy access from Heathrow and central London?
§ Mrs. Bottomley
I well understand my hon. Friend's commitment to his own hospital, which serves his constituents so well. It is the case—independent experts and those in the medical profession are agreed—that the duplication and institutional costs in London are excessive. If we are to take forward the 100 projects in primary care and to have more balanced health provision in London, we must face change. I hope that we shall be able to bring the uncertainty to an end before long and I will certainly note the points that my hon. Friend makes.
§ Mr. Blunkett
Will the Secretary of State comment on the front page of the London Evening Standard, which has a headline about 5,000 fewer nurses and triple the number of men in grey suits? Will she bear in mind the Tomlinson report and the work of the London implementation group; the separate and contradictory proposals for closure and rationalisation under the specialty reviews; and the fact that the internal market is threatening a completely separate set of hospitals such as University College hospital? Given all that, is it not time that the Secretary of State came clean on her proposals for the future of London's health service and made a statement to the House to end the demoralisation and despair among staff and patients in our capital city?
§ Mrs. Bottomley
I am sure that the hon. Gentleman must be aware that a great number of former nurses have been redesignated as managers because they held senior positions of responsibility. The same applies to Project 2000 nurses. We have now been able to extend Project 2000 throughout the country so that all nurses training are designated as students rather than nurses. Only six weeks ago, I was announcing the abolition of the regions and the 134 substantial slimming down of the layers of authority, and what did the hon. Gentleman say? He complained about redundancies.
The hon. Gentleman simply cannot have it both ways. We want a slim, lean, effective service that has the maximum number of people providing hands-on care. That is our whole commitment in London, where change is necessary. I believe that that should unite us and we shall bring the uncertainty to an end before long.
§ Mr. Harry Greenway
Is my right hon. Friend aware of the increasing pressure on the casualty department at Ealing hospital with much larger numbers coming in for treatment in recent weeks? Will she consider whether extra funding can be provided to meet the enormous pressure on Ealing compared with other hospitals in London?
§ Mrs. Bottomley
In London in particular, the use of accident and emergency services and its relationship with primary care and GP services is a central factor. My hon. Friend will be aware that 100 primary care projects are under way within the London area in the year ahead. I shall look at the particular factors my hon. Friend describes, and I have some good news for him. The allocations to his region that I am announcing today will include an extra £61 million for next year. That will mean that his region has a total spending of £1.3 billion.