HC Deb 14 February 1995 vol 254 cc784-6
6. Mr. Page

To ask the Secretary of State for Health what factors are taken into account in decisions about the relocation of accident and emergency departments.

Mr. Malone

Decisions on local accident and emergency services are made on the basis of the most appropriate service for local needs.

Mr. Page

I thank my hon. Friend for that reply. Although we should all like accident and emergency services at the bottom of our gardens, would it not be better for the health of the nation to have specialised centres run by teams with the facilities and expertise to provide such services, backed up by paramedic teams who can deliver people in a stabilised condition as soon as possible? Small localised services could deal with the walking wounded, as has been suggested in south-west Hertfordshire.

Mr. Malone

My hon. Friend is right in principle. There are a number of facilities that can meet such needs. The introduction of minor injuries clinics has provided a helpful source of immediate treatment; the experimental trauma centre in Stoke-on-Trent, which is being assessed, deals with major trauma; and accident and emergency services now have more paramedics who can stabilise people at the scene. All those developments in accident and emergency care should be evaluated, and should inform long-term decisions.

Mrs. Jane Kennedy

The Minister should be aware that the relocation of the accident and emergency unit at Broadgreen hospital in my constituency has been speeded up because hospitals have been unable to recruit enough senior house officers. What does the Minister propose to do to assist hospitals in such circumstances? Changes in the training of doctors are making available senior house officers scarcer, and the reduction in junior doctors' hours—welcome though it is—has been carried out in a way that has caused a crisis in accident and emergency units throughout the country.

Mr. Malone

The hon. Lady is right to point to stories that have appeared about shortages of junior doctors in accident and emergency units. There are several reasons for that. It partly reflects the normal change in the February turnaround of contracts. That is not unusual or unknown, and can be addressed in a number of ways. For example, management can adopt a more flexible approach to the way in which accident and emergency units are run. It is also important for specialist surgeons in hospital teams to contribute fully. The Government have made an effective contribution by increasing the number of accident and emergency specialists considerably since 1988: accident and emergency is now the largest growing hospital specialty in the country.

Mr. Congdon

I accept the need for and the benefits of large A and E departments, but does my hon. Friend agree that it is vital that A and E departments, especially those in London, should stay open 24 hours a day and should not close their doors temporarily, thereby putting pressure on other A and E departments?

Mr. Malone

My hon. Friend is right. It is important that the widest range of facilities is available, especially across London. I counsel him, however, to consider what is termed a closure. For example, I read in a report this morning that ambulances had temporarily not been going to Homerton hospital. However, I noticed that the A and E department there was still open to treat patients for something as serious as, for example, stabbing. I counsel him, therefore, to consider carefully the definitions in these matters.

Mr. Illsley

Should not the proximity of A and E departments to blood transfusion centres be one of the factors to be taken into account in the relocation of those departments? The Minister will be aware of the petition that was delivered to his Department this morning. It contained 500,000 signatures calling for the reversal of the policy to close five blood transfusion centres. Today, of all days, should not he join the Have a Heart campaign, reverse that policy and consider better and more constructive ways of improving the blood transfusion service?

Mr. Malone

The hon. Gentleman is rather ingenious at getting a bite at a different cherry under this question. Of course, all matters in relation to the provision of the blood transfusion service are extremely important. I know that the Under-Secretary of State for Health, my hon. Friend the Member for Bolton, West (Mr. Sackville), who has responsibility for these matters, takes great care to consider all the arguments.

Dr. Twinn

Is my hon. Friend aware that great concern exists in north London about the future of A and E provision, especially at North Middlesex and Chase Farm hospitals? Will he give those of us in north London an undertaking that no decision will be taken until neighbouring purchasers are made to co-operate over A and E provision, not just in north London but throughout Hertfordshire and Essex? Grave concern exists that we will find ourselves with no A and E provision because of competing authorities.

Mr. Malone

I am pleased to have the opportunity to reiterate to my hon. Friend the undertaking that my predecessor, my right hon. Friend the Member for Peterborough (Dr. Mawhinney), gave to the House. It states that, where there is a reconfiguration of A and E services, similar, if not better, facilities should be and must be in place.