HC Deb 24 October 1996 vol 284 cc227-34

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

10 pm

Mr. David Rendel (Newbury)

I am delighted to have the opportunity today to raise the issue of hospital services in Newbury, and I am grateful to Madam Speaker for giving me the opportunity. Before I start, however, I feel that I should make my position clear—to avoid any possible accusation of sleaze—by saying that my wife is a general practitioner who works in the health service in Newbury. Therefore, I have a personal, if somewhat indirect, interest in the matter, which I hope that the House will accept puts me in an even better position to speak up for the interests of all those who are concerned about the future of hospital services in Newbury—whether as patients, staff or in some other capacity.

I shall begin by setting the scene. Newbury currently has two small hospitals. The first—Newbury district hospital—was originally built in the 19th century. I should repeat that fact, because it is hardly credible: Newbury district hospital was built in the last century, more than 100 years ago. It has, of course, been developed in fits and starts since then, and not all the buildings are quite that old. The original buildings, however—the heart of the hospital—are more than 100 years old.

Within that heart, the hospital has two wards: one for men and one for women. The wards are used to treat some 2,000 in-patients and day case surgery patients each year. Perhaps more important, however, the hospital also treats 24,000 out-patients each year. It also provides X-ray and pathology services, and a minor injuries unit.

The other hospital in Newbury—Sandleford hospital—is even older. It was originally built as long ago as the 1840s, and one can get some idea of what the hospital is like when I say that it was built as a workhouse. Sadly, it used to provide many more services than it does now, but gradually it has been run down in the constant expectation that the new Newbury hospital was about to be built.

Sandleford hospital is now used primarily to care for elderly patients, for rehabilitation or to provide for those who, sadly, have enduring mental health problems. The hospital also contains a more modern block—the Charles Clore Macmillan day unit, which is the most modern block of any of the hospital services in Newbury—which serves cancer patients and those who have life-threatening illnesses.

After hearing about the current situation, it will not surprise the House to learn that hospital services in Newbury have long been an issue of great concern to everyone living in west Berkshire. As a result, in election after election, the Conservatives have promised the people of west Berkshire that a new hospital would be built. They promised it in 1979. They promised it in 1983, and they promised it in 1987. They promised it in 1992, and they promised it again during the Newbury by-election, in 1993. By that time, of course, not many people still believed the Conservatives' promises—as the people of Newbury showed in that by-election.

Our concern for west Berkshire's health services was greatly increased in the mid-1980s when the town, loyally supported by the local paper, the Newbury Weekly News, had to fight off plans to close the existing Newbury district hospital without any replacement. We were delighted to win that battle. Localised hospital services are a crucial part of any health service built round the needs of people, rather than the convenience of bureaucracy. However, that win was by no means the end of the long-standing struggle to secure modern hospital facilities to serve west Berkshire.

On a recent visit to the current hospital, I spoke to a senior nurse. She began her training at the hospital in 1960, and is now nearing retirement. She told me that she hoped that she could still look forward to working in the new hospital before she finally retired. Amazingly, she also told me that she remembered that when she started training in Newbury 36 years ago, the trainee nurses were even then being assured that a new Newbury hospital was due to be built shortly.

In case anyone should think that that nurse was exaggerating, let me quote from today's edition of the Newbury Weekly News.One article in the section called "Old Memories Revived"—often the most interesting and revealing part of the newspaper, where articles taken from previous editions are reprinted—refers to a joint meeting of the Newbury town and district councils that took place exactly 30 years ago today, on 24 October 1966.

The article, headed "No New Hospital for 10 Years", says: Newbury must make do with its much-criticised district hospital for at least another 10 years,"— I remind hon. Members that the article was written in 1966— members of the Newbury Town and District Councils were told at their first joint meeting on Monday. A letter from the secretary of the Regional Hospital Board informed them that there were long-term plans for a new 400-bed hospital at Newbury,"— would that the hospital currently planned had anything like 400 beds— but it was not expected to be built until 1975–76. The news was given to the meeting by the Town Clerk who had asked the board what proposals there were for improving hospital facilities. Dr. R. Warwick-Brown of Thatcham, added that a new hospital in Newbury was so far down the priority list that it might not be built before the 1980s. I only wish that the very worst predictions of the 1960s had come true—that is, the construction of the new hospital in the 1980s.

People in Newbury are patient; we are used to waiting. The one thing that everyone now knows about Newbury is that we have had to wait for more than 30 years for relief from chronic traffic congestion—we are still waiting—but 36 years, a whole generation and more, is far too long to wait for a new hospital. Even now, there is no end in sight.

The excellent health service staff work wonders to provide the level of service that they do and they are greatly appreciated by the people of Newbury, but our doctors and nurses have their hands tied behind their backs. Day in, day out they strive to overcome the problems of working in 19th-century buildings. Inevitably, it is impossible for them to work as efficiently and as effectively in their patients' interests as they could in more modern buildings.

The fact that patients and visitors have to cross a busy main road to get from the car park to the hospital is not good enough; the fact that hospital services are split between two sites is not good enough; and the fact that 18,000 trips a year have to be made to the Reading hospitals because of insufficient facilities in Newbury is not good enough. That is a huge number of unnecessary journeys, often made by people in considerable pain, and even those figures ignore the visits that may be made by patients' relatives. When one adds to that the fact that Battle hospital in Reading is due for closure, one can see that the pressure on the other main hospital in Reading—Royal Berkshire hospital—will become acute. That is also an excellent reason why the new Newbury hospital is needed so soon; it would relieve much of that pressure.

The number of both in-patients and out-patients due to be served by the new facilities is roughly double the number who can be treated in the present Newbury district hospital. What is more—I should have thought that even the Government would accept this point—the cost of treating Newbury people in Newbury hospital is far less than the cost of treating them in Reading.

In case there is any doubt about the effect on service standards of the ancient facilities that I have described, I shall report briefly what happened when I took up a complaint from a constituent with the Nuffield orthopaedic centre. In its response to my letter, it put the point simply: The facilities available to us at the Newbury District Hospital are of a poor standard, which does not allow the Orthotist to provide the standard of service that he/she would like to. But of course the Government accept that the facilities offered by the aging hospitals in Newbury are not good enough. The case has been made and it is clear for all to see. Indeed, before the Government introduced their health service reforms and transferred the hospitals to the new Priority Care trust, it had long been agreed in principle that a new hospital should be built.

But the agreement in principle was not enough for this Government. Although in every other part of the country it is accepted that it is the job of the national health service to provide facilities for the health care of local people, the Government decided that in Newbury's case, a large chunk of the necessary finance would have to be provided by the people of Newbury themselves.

The Newbury Hospital Helpers League, of which I am proud to be a member, was persuaded to pledge the proceeds of a very generous bequest from a Miss Rook towards the cost of the new building. Not only that, but the Government then insisted that the value of the land was not sufficient and that it should, therefore, be given planning permission for development to enhance its value. A green-field site which, in all likelihood, would never otherwise have been developed, was sacrificed by the local population, desperate as we were to make sure that the Government had no further excuse for putting off the hospital any longer. That very precious green-field site makes up part of the strategic green gap between the towns of Newbury and Thatcham. That site would never have been given development permission were it not for the very special community need that the new hospital represents.

I suggest to the House that the people of Newbury have already more than played their part in making it easy for the Government to go ahead. In fact, had the health service reforms to which I referred a moment ago not put the whole question of what to do and when to do it back into the melting pot, there is little doubt that the new hospital would have been built by now.

Even under the new regime, the proposals for a new hospital were accepted by Berkshire health authority in December 1995. They were then accepted by Anglia and Oxford regional health authority in June this year. That is not exactly great progress in 36 years, but at least it is something. We are getting closer. But the frustration felt by the people of Newbury is now met by another brick wall—the private finance initiative. It has already become abundantly clear that the PFI has been a failed attempt to privatise by stealth. However, it has also been a smokescreen for cuts in capital investment.

There may well be some areas where the PFI has a role to play, but when public health needs have been established, the PFI must not be allowed to introduce additional delays, as has happened in this case. Public health is just too important for that. So the health service is not the best place for the Government to experiment with private funding.

What the people of west Berkshire want from the Government is a cast-iron assurance that funds to build the new hospital will be forthcoming now. What the staff and patients of Newbury district hospital want are decent, modern facilities that afford the best available standard of care.

The country is crying out for investment in its infrastructure. When will the Government put aside their ideological insistence on private finance and provide that infrastructure? The whole point of the public purse is to fund public benefits. There can be few greater public benefits than first-class hospital services.

I look forward to the Minister's assurance that the people of Newbury will have their hospital by the end of the century and, I hope, in good time before that long-suffering nurse, whom I referred to at the start of my speech, retires.

Newbury has more than fulfilled its side of the bargain. It has provided a very special site and granted a special planning permission to raise the £2 million of charity funding that the Government have demanded. Newbury has permitted the health authority to redevelop the current hospital sites. It has been patient beyond all reasonable expectation.

It is now time for the Government to fulfil their half of the bargain, and I call upon the Minister to do so tonight.

10.15 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Horam)

I was grateful to the hon. Member for Newbury (Mr. Rendel) for choosing as his subject for tonight's Adjournment debate "Hospital Services in Newbury". The debate has brought to my attention yet another local picture of an NHS that not only is providing high-quality care but has real ambitions for the future.

The West Berkshire Priority Care Service NHS trust runs two small hospitals in Newbury. In both hospitals, a range of quality community services is provided, albeit from ancient buildings.

Newbury district hospital has a core of late Victorian buildings, with a typical hotchpotch of development throughout the century. Sandleford hospital occupies a building with a familiar history in terms of NHS building—a former workhouse now transformed to provide around 50 beds. It houses the much-valued Charles Clore Macmillan day unit for patients with cancer or other life-threatening illness, and has a broad range of clinics.

Between the two hospitals, sterling work is done for the people of Newbury, as I am sure the hon. Gentleman would agree. Consultants from the Royal Berkshire and Battle hospitals in Reading provide services in Newbury, giving local access to first-rate acute care. Out of hours, the hospitals are in the safe and familiar hands of the local general practitioners.

It is a credit to all the staff who work in the area that patients charter and waiting list standards are consistently achieved. The current NHS performance guide shows the trust obtaining a clutch of five-star awards for the services that it provides.

I was particularly pleased to learn of the improvements which the trust has recently been able to make in the provision of a nurse-led minor injuries clinic in Newbury, which has also brought some relief to the GPs in the area, including the hon. Gentleman's wife. Meanwhile, patients requiring full-scale accident and emergency services are well cared for in Reading at the Royal Berkshire and Battle hospitals. Next year, the introduction by the Royal Berkshire Ambulance NHS trust of a priority dispatch system—one of only four in the country, as Berkshire was chosen as a pilot area—should also mean more rapid transfer for those whose need is paramount.

Newbury GPs are in the vanguard of the development of GP fundholding, with the latest wave of applications from GPs who wish to become fundholders. The benefits of the scheme, which puts GPs in direct control of the care that their patients receive, will be extended to some 70 per cent. of people in Berkshire.

That is the current position—what about the future? Berkshire health authority's purchasing plan for 1997–98 holds much that is of great interest to the people of Newbury and I hope that the hon. Member for Newbury will read it carefully, and offer his comments to the authority.

Among the plans of particular interest to the hon. Gentleman's constituents is the agreement which has just been reached on the re-provision of services for those severely mentally ill adults who are currently living at Fair Mile hospital. As part of the agreement, discussions will be taking place about the model for local community services.

GP fundholding has, for the first time, given general practice a central and powerful role in shaping local services. To extend the benefits of this fundamental change, health authorities are required to involve GPs in their own planning processes. Since 1 April, Berkshire health authority has worked in conjunction with local GPs to establish six localities—including one for Newbury—to consider how all GPs can become fully involved in the commissioning of local services for local people. In Newbury, the locality group has settled on its priorities for change, and they are reflected in the health authority's purchasing plan.

Newbury stands on the verge of its biggest leap forward in hospital services since the creation of the NHS. The plan to build a brand new £16 million community hospital to replace both Newbury and Sandleford hospitals would give local people the facilities that they certainly deserve for the 1990s and beyond. A new hospital between Newbury and Thatcham would improve access to services for many people. It would provide the full range of current services. Through the use of the latest medical advances, it would allow the number of patients enjoying the considerable benefits of day case surgery to rise to around 4,000 each year. In all, the amount of care provided locally would almost double. For a great many people—the hon. Gentleman referred to the number of journeys—journeys to Reading and back for examination and treatment would become a thing of the past.

Not only will local services improve with the building of the new hospital but the overall running costs to the health authority will fall, as the hon. Gentleman implied, since services in Newbury can obviously be provided at less cost than those in Reading.

As with any building project, of course, planning issues have had to be resolved before the business of building the new facility could begin in earnest. The sale of the Wash Water site will provide some £2 million towards the cost of the new hospital. The project has been thoroughly discussed at the appropriate planning forum and I certainly do not propose to dwell on such planning matters now. Suffice it to say that the trust has been willing to scale down development plans for the site in accordance with local concerns, and there certainly will be no development at Wash Water unless and until the new hospital becomes a reality. That is a commitment.

As the hon. Gentleman has made clear, the proposed new hospital for the people of Newbury is to be financed through the private finance initiative. The Newbury scheme benefits, however, from the experience of those who have already trodden the PFI path. As we now know, the scheme is precisely the type for which the benefits of the PFI will be most readily available. It is relatively small, on a green-field site, and benefits from a high level of contributions from land sales and the support of the health authority and local GPs. It is also based on sound activity assumptions and is unencumbered by further major land or planning issues.

The hon. Gentleman said that the private finance initiative was delaying the building of a new hospital for the people of Newbury. Nothing could be further from the truth. Indeed, under the old system of "public funding or nothing", the new hospital, which, as he said, has been an aspiration for many years, received precisely nothing. Now he suggests that the hospital should return to its place in the queue for public money. As he says, it was low on the list of priorities—so it would be low in the queue. Such an approach would simply set things back.

Under the PFI on the other hand, the plans have achieved approval in the outline stage from the health authority and the NHS executive. A steering committee including local GPs has been established to drive the project forward. It will work closely with everyone else who has an interest to ensure that the hospital is built on target. With those advantages, there is no reason why the scheme should not progress smoothly and swiftly through the PFI process and present the people of Newbury with a new hospital fit for the new millennium. The present estimate is that the building will begin in 1998 and be completed in 2000.

The Government's commitment to modernising the NHS is second to none. The NHS building programme is the largest of its kind in the world. Even excluding the £500 million-worth of PFI schemes that have already received final business case approval, the programme includes more than 275 projects, each valued at more than £1 million. I remind the House that every £1 saved, whether by use of the PFI or by any other means, is £1 more available for patient care.

The hon. Gentleman commented on the PFI in adverse terms, but when the National Health Service (Residual Liabilities) Bill was before the House earlier this year, it was his hon. Friend the Member for Southwark and Bermondsey (Mr. Hughes) who said that the real issue was ensuring that there is an accountable way of getting value for money irrespective of whether projects are in the public or private sectors."—[Official Report, 12 March 1996; Vol. 273, c. 841.] I agree. That is exactly what the PFI process is all about.

I remind the hon. Gentleman that the only time NHS spending was cut was when the Liberals last had a say in government. Health spending has increased in each of the past 17 years, and will continue to do so under this Conservative Government and future Conservative Governments. This year, that has meant an extra £13.5 million for the NHS in Berkshire—a rise well ahead of inflation. Indeed, it is the 10th biggest rise in the country. That strong record of investment means that the hon. Gentleman's constituents can look to the future of local hospital services with confidence.

Question put and agreed to.

Adjourned accordingly at twenty-five minutes past Ten o'clock.