Hospitals (North-west Kent) (Hansard, 11 January 1996)

§ Mr. Bob Dunn (Dartford)
I am delighted to have secured the Adjournment debate this evening on the subject of hospital provision in north-west Kent as it gives me the opportunity to reaffirm my determination to help to bring about the construction of a new, all-purpose, state-of-the-art general hospital in Dartford by the end of the decade. The new hospital will serve the interests and health needs of the people of north-west Kent well into the next century.
The Minister will know that the journey to this point has been troubled in the past, but it now appears that the hospital will become a reality, with the consent of all levels of Government and all levels of the national health service. For the benefit of the House, I must explain that the changes that are taking place in north-west Kent in the context of development within the Thames gateway strengthen the case for the new district general hospital as we debate health care in and for the next century.
Conservative Members who take a strong interest in health matters in north-west Kent are fully aware of the firm but sure steps that have been, and are being, taken along the path towards new build. Not for us the manipulation and incorrect usage of the A and B lists as issued by the private finance initiative sector and not for us the shroud waving of the Labour party: we are determined to get things done. It is interesting to note that, despite Labour's huffing and puffing, not a single Labour Member is present in the Chamber tonight to listen to and participate in this important debate.
As a matter of public record, I seek an assurance from the Minister, whom I welcome most heartily to the Dispatch Box, that his Department will ensure that the timetable for the construction of the new hospital is not allowed to slip. Will the Minister assure me that the involvement and interrelationship of the private sector through the private finance initiative is working satisfactorily and that the objectives that the private sector need to see fulfilled are, in themselves, sufficient reward to retain that sector's interest now and in the future? There may well be a need for the involvement of public funds alongside private funding and that would be a sufficient lever for the project in Dartford to come to fruition. I also hope that my hon. Friend the Minister will assure me that the evaluation of the project will be carried out speedily and effectively by Whitehall Departments so that there is no delay whatever to the timetable. I hope that he will be able to mention the timetable in his reply.
It is essential that my constituents in Dartford have an understanding of the progress made so far, and the progress that needs to be made in the future, if the project is to happen by the end of the century. It is worth placing on record the fact that we will have in Dartford, in north-west Kent, a huge range of diverse developments that will make the construction of the new district general hospital more essential.
Perhaps at this point I may pay tribute, not only to the work of my local authority and the leader of the Conservative group, Councillor Kenneth Leadbeater, but to the work of my hon. Friend the Member for Gravesham 386 (Mr. Arnold). He has worked with me in the trenches to secure our objective. I must also pay tribute to the work of my hon. Friend the Member for Sevenoaks (Mr. Wolfson) who has battled with us shoulder to shoulder on this issue.
During the next three years, the new station and its associated infrastructure will be developed at Ebbsfleet for the channel tunnel rail link. Bluewater park, which is a little closer to the centre of north Dartford, will generate many thousands of work opportunities for the people of south London and Kent. We have a huge programme of house building over the next 10 to 20 years, with a range of houses to suit all needs. I know that I sound like an estate agent.
Those changes will bring new residents and new workers, and people will come into north Kent for leisure purposes. The burden on the health service will be immense. We cannot expect a health structure that was developed largely in the last century, for purposes which were relevant and germane then, to be available to support the needs for health care of my constituents in the 21st century.
I hope that there will be no doubt after this debate of my commitment and my hon. Friend's commitment to the construction of the new district hospital. The determination of the Department of Health to support us means that the different interests will come together to ensure that we have new district general hospital in Dartford very soon. I am most grateful to the Minister for coming here tonight and I look forward with interest to hearing his remarks.

§ Mr. Jacques Arnold (Gravesham)
In the nine years that I have served as Member for Gravesham, one of the highest priorities for my constituents has been the replacement of our hospital facilities. My hon. Friend the Member for Dartford (Mr. Dunn) has served Dartford for much longer and the replacement of our hospital provision has also been a high priority for him.
As my hon. Friend said, we depend now on three old hospitals that have served the area well since the last century. The need for a new hospital has always been clear, but the problem has been the cost of some £100 million, and it has been a daunting job for Ministers in the Department of Health to ask the Chancellor of the Exchequer for a cheque for that amount. That is why, year after year, we have not got our hospital.
I am now absolutely delighted with the Government's new private finance initiative, which will bring private capital and expertise to ensure that we can enjoy the hospital that our constituents in north-west Kent have always deserved. I take great encouragement from the fact that there are four consortia composed of great household names bidding for the opportunity to build the hospital for local people.
I remind the Minister that there are two parts to the project. By far the greatest is the provision of the new district general hospital at Darenth park, but the provision of a community hospital is also of great concern to the people of Gravesend. At the moment, approximately one third of our general hospital provision is provided at the Gravesend and North Kent hospital in Gravesend, which is very close to the hearts of my constituents.
387 The conurbation of Gravesend and Northfleet and the surrounding villages like Meopham and Istead Rise, and Longfield in the constituency of my hon. Friend the Member for Dartford, contain some 100,000 people. Clearly, basic hospital provision is necessary. Therefore, I am very encouraged by the intention of the Dartford and Gravesham NHS trust and the other trusts, especially the Thameslink Healthcare Services NHS trust, to use the Gravesend and North Kent site to provide a community hospital at a cost of about £8.5 million.
I hope that the Minister will be able to assure us that he has in his sights the need to provide finance, through the private finance initiative, for the follow-through. We will need a community hospital in Gravesend, when the general hospital provision—mostly maternity—departs from Gravesend and North Kent hospital to our brand new hospital in Darenth park.

§ The Parliamentary Under-Secretary of State for Health (Mr. John Horam)
May I congratulate my hon. Friend the Member for Dartford (Mr. Dunn) on his success and his luck in securing this debate? I gather it was because another hon. Member had to withdraw his subject and therefore my hon. Friend could bring forward his subject. We are having this debate at a rather more timely hour than could perhaps have been foreseen.
My hon. Friend the Member for Dartford has always been a stalwart supporter of local health services, and I am very pleased to be able to respond to his comments about hospital provision in the Dartford and Gravesham area. He has spoken eloquently about the need for improved hospital services in the area, and makes very good points which I have listened to carefully.
My hon. Friend the Member for Gravesham (Mr. Arnold) also spoke and I also know of his commitment and enthusiasm over the years to his hospital services. I note also his support, not only for the new hospital proposed at Dartford, but for the follow-through, as he put it, that is so important to Gravesham—the new community hospital—which we hope will follow on from the main hospital.
Acute services in the area, as we know, are provided by Dartford and Gravesham NHS trust and are spread across three hospitals—Joyce Green, West Hill, and Gravesend and North Kent hospital. The latter, I believe, is known colloquially as the GNK. The main acute hospital is Joyce Green which dates from Victorian times. While those hospitals have served the local population extremely well over the years, they are clearly no longer well suited to the delivery of modern health care. They would need significant investment to remain in use in the longer term.
At present, accident and emergency services are located at West Hill hospital in central Dartford, along with trauma and orthopaedics. General medical, elderly and surgical services are provided from Joyce Green, while maternity and gynaecology are based at Gravesend and North Kent hospital. The difficulties of that three-way split are readily apparent. My hon. Friend the Member for Dartford has often made that point. Not only do patients frequently need to be transferred between sites, but the arrangement also creates practical staffing difficulties.
388 Despite operating from relatively poor buildings, the trust provides a full range of excellent health services, to the considerable credit of its 2,000 doctors, nurses and other staff who work for the trust. I am sure that my hon. Friends appreciate the work that the staff have done despite the inadequacy of the buildings in which they work.
The trust treated about 164,000 patients in 1994–95, and it expects to treat a remarkable 10 per cent. more during this year. That is excellent news for my hon. Friends' constituents, who will also be heartened to know that waiting times have been substantially reduced. The trust expects to have no over-12-month waiters by the end of March; the number of over-12-month waiters fell from more than 400 in February to no more than 69 in September of this year. That is a remarkable improvement and a great credit to all concerned.
More evidence of improving performance is to be found in the NHS performance tables. The trust achieved an impressive five 5-star rankings in 1994–95, including assessment of A and E services—four more than the previous year. Well over half of all the trust's elective surgery is now carried out on a day case basis.
As my hon. Friends pointed out, various proposals for a new hospital were made during the 1980s, but it was not until 1994 that a scheme appearing to be really viable emerged. It would not be helpful this evening to rehearse the discussions that took place in the intervening years; but people's expectations of a new hospital were raised, only to be disappointed. I can therefore understand the frustration felt by all concerned—local residents, hospital staff, my hon. Friends who have campaigned tirelessly and other hon. Members.
Although I can give no guarantees, there is now much more than a chink of light at the end of the tunnel. Dartford is clearly closer than ever before to getting its new hospital. For good reasons to which I shall come in a minute it is necessary for the trust to explore private finance for the scheme. In that respect it is making excellent progress. In June 1995 the trust was granted approval to test the scheme to provide a new general hospital under the private finance initiative. It advertised the scheme in the Official Journal of the European Communities on 5 September; following a pre-qualification exercise, four consortia, representing a good selection of the major players, were selected—as my hon. Friend the Member for Gravesham pointed out.
The short-listed consortia have been issued with a draft contract, service level agreements and other documentation, and have been invited to submit their detailed proposals by the end of January. Following evaluation, the trust will select two candidates with which to renegotiate detailed contracts. Further negotiations will follow and the trust will select a preferred partner, probably this summer. It will then submit a full business case for approval to the NHS executive. On present plans I expect it to be forthcoming this autumn.
The overall process is as short and efficient as it can be, consistent with ensuring that value for money and the requirements of public accountability are achieved. If all goes to plan, building work should begin during the first half of 1997—that is the present supposition.
I can assure my hon. Friend the Member for Dartford that the project has the full support of all concerned—at authority level, regional level, NHS executive level and 389 Government level. I can assure him also that the evaluation will be carried out as speedily as possible in Whitehall, so there will be no delays at our end. The speed will of course depend on the detailed progress of negotiations between the selected consortia and the local hospital trust. I cannot guarantee how quickly or slowly they will proceed, but I know of no reason why they should not maintain their present rate of progress.
The scheme would create a new acute general hospital with up to 400 beds, an accident and emergency department and a full range of services on the proposed Darenth Park site. The new hospital would replace the hospitals at West Hill and Joyce Green and the Gravesend and North Kent hospital.
The GNK hospital will be transferred to Thameslink Healthcare NHS trust and be converted to a community hospital. I emphasise that it will be a large community hospital—the plans for it are quite ambitious. I can well understand the enthusiasm of my hon. Friend the Member for Gravesham for the project, and I can assure him that the plans to take it forward will be finalised as quickly as possible, consistent with progress on the scheme for the main hospital. I hope that the follow-through will be quick, but it will depend on progress at the main hospital.
390 West Kent health authority is responsible for identifying the health needs of all its residents, including the people of Dartford and Gravesham, and for ensuring that those needs are met. The health authority supports the proposed new hospital. As the main purchaser of Dartford and Gravesham trust's services, it is in its interests to see that the trust provides services of the highest quality as cost-effectively as possible.
The planned allocation for West Kent for 1996–97 is £369 million, an increase of no less than £9.4 million, or 2.7 per cent., on this year after taking account of inflation. I refer here to the running costs of the health services in the area. That considerable improvement should be of immediate benefit to my hon. Friends' constituents.
The people of Dartford and Gravesham are now closer than ever to getting a new acute hospital, with the trust at an advanced stage of the PFI process. As my hon. Friend the Member for Gravesham pointed out, the plans include not just a new acute general hospital but a community hospital too. All this is excellent news for my hon. Friends and their constituents.