HC Deb 15 May 1997 vol 294 cc266-74

>Motion made, and Question proposed, That this House do now adjourn.—[Ms Bridget Prentice.]]

9.44 pm
Mr. Michael Wills (North Swindon)

I am grateful to Madam Speaker for allowing me the opportunity to introduce this Adjournment debate. I am particularly grateful that I have been able to combine it with making my maiden speech. I understand that most Members of Parliament do not adopt this method of introducing themselves to the House, but the subject is one of deep and immediate concern to my constituents, and I am grateful to have been given the opportunity to raise it without delay.

My constituents, like so many others, have suffered from the operation of a two-tier system in the health service. They will have been delighted to hear my right hon. Friend the Secretary of State's plans to replace that system with a fairer and better one. There is a particular crisis with hospital care in the Swindon area and an urgent need for Government action to solve it. It is because of the importance of the issue to the people of Swindon that, with permission, I should like to give up half the time allocated to me in this debate to my hon. Friend the Member for South Swindon (Ms Drown), whose constituents share my constituents' concern and who has worked so tirelessly on their behalf.

Two weeks ago the voters of North Swindon granted me the privilege of representing them in the House. The new constituency takes in under one parliamentary roof many different communities. It takes in most of the northern area of the town of Swindon itself; it encompasses the historic market towns of Highworth and Cricklade; and it embraces the Wiltshire villages of Castle Eaton, Marston Meysey, Stanton Fitzwarren, Latton, Hannington and Blunsdon.

In the previous Parliament, the area covered by the constituency was represented by three Members of Parliament, two of whom are no longer in the House. I should like to take this opportunity to thank them for all their work over the years on behalf of the people of North Swindon. Those people know well the extent of the debt that they owe to Simon Coombs, Richard Needham and the right hon. Member for Devizes (Mr. Ancram).

The Swindon area is known nationally as one of the economic successes of the past two decades, but there has been nothing inevitable about that. It was built on its great railway works; when they declined and were eventually shut down in the 1980s, Swindon could have become a ghost town, but it did not. It reinvented itself. The talents, adaptability and hard work of its people, supported by an active partnership between business and the local Labour authority, have made Swindon one of the fastest growing economies in the country.

Today, Swindon business represents a cross-section of excellence in our economy. My constituents work in state-of-the-art manufacturing companies such as Rover, Honda and GEC-Plessey. They work in companies at the cutting edge of technology such as Motorola and Intel; they work in prominent financial services firms such as Allied Dunbar and the Nationwide building society; they work in distribution services for high street names such as Woolworths and W. H. Smith; and they work in many other firms that lead their fields.

Those firms need a continuing supply of highly skilled and motivated people to build on their successes. They are the firms that will recognise the importance of this Government's commitment to upgrading skills and enabling everyone to continue to upgrade their skills throughout their working lives. My constituents recognise the opportunities that will be offered to them.

Swindon sets a vibrant and inspiring standard for what working people can achieve for themselves, when given the right support by the community. For all its successes, the Swindon area has been dominated by a problem over the past few months. It is that problem which is the subject of this debate. In other circumstances, I should like to say much more to the House about the remarkable constituency that I am privileged to represent, but I hope that the House will understand if I focus on the subject of the debate: the crisis in hospital care in the Swindon area.

Economic growth and population growth are often close companions, and Swindon is no exception. Its population is growing three times faster than the national average, and the numbers of the very young and the old are growing at a particularly fast rate. It is those groups which have special recourse to hospital services. Yet as need has grown in the Swindon area, provision has shrunk.

Last year, the RAF hospital at Wroughton, the much loved Princess Alexandra hospital, where one in 10 of the Swindon population were born, was closed as part of the Conservative Government's defence review. That was a bad decision, taken in haste and repented ever since by the armed services and by Swindon alike. On its own, that would have caused problems enough. Overnight, a valve that relieved the pressure on the national health service at times of peak demand was removed. The closure of that hospital added 6 per cent. to the work load of the NHS Princess Margaret hospital.

That is not all. Princess Margaret hospital itself desperately needs renewal. There is a £28 million maintenance backlog, which increases with every month that goes by. A full business case for the renewal of the hospital was submitted to the Treasury two years ago, but the Conservative Government's insistence that it should be tested under the private finance initiative has meant that still no decision has been reached. We are told that plans are well advanced and that the trust is close to signing a new deal for a new hospital under the private finance initiative; but what we are not told is when exactly that deal will be closed. No matter how often we ask, we are not told and neither have we been told the details of that imminent deal. Those things are precisely what the people of North Swindon need to be told.

Delay in providing new hospital facilities has left the area relying on old and increasingly inadequate ones. Since 1994, wards at Princess Margaret hospital have been closed three times because of infections—a problem that could have been avoided had appropriate isolation facilities been available. On one occasion, an operating theatre had to be closed because air conditioning backfired, spraying a sterile theatre with droplets of dirty water. Old and inflexible structures have helped to push up waiting lists for in-patients by up to 40 per cent. in the past two years. Patients have had to be bussed to hospitals as far away as Birmingham and Southampton. Delay increases anxiety among patients and their relatives and in the community at large. Delay demoralises staff; delay is one big problem.

Lack of adequate information about the proposed deal under the private finance initiative is another big problem, and we definitely need information in order to feel reassured about the deal in North Swindon. The feeling is spreading that the plans for the new hospital have been driven, not primarily by clinical need, but by the need to meet the commercial objectives of the private sector partners in the private finance initiative. It is feared that, to meet commercially driven targets, patient throughput will be speeded up by up to 10 per cent., even if that is not always clinically appropriate and leaves other health care providers to pick up the pieces.

There is now growing local concern among professionals and lay people alike that, even if they can be implemented quickly, current plans will not solve the present crisis, but will merely institutionalise it. It is feared that an integrated approach to health provision in the area has been precluded by the priority that has been given under the private finance initiative to commercial, rather than clinical, objectives. To avoid fragmentation of provision, any replacement of Princess Margaret hospital must clearly involve appropriate co-operation between the trust, the health authority, the GPs, the community health council representing the users of the health service and the local authority.

In January, Princess Margaret hospital had to cancel all non-life-threatening operations. Forty beds have been closed for much of this spring because of the difficulty in recruiting and keeping staff to work in the deteriorating physical environment at Princess Margaret hospital, which the hospital itself acknowledges. All the staff at the hospital have been working to the highest standard of their profession and beyond to cope with the mounting pressures on them. Everyone is grateful to them, but they cannot continue in that fashion indefinitely. They and everyone else in North Swindon need to see some glimmer of hope for the future.

Of course, the closure of Princess Alexandra RAF hospital, the delays in renewing Princess Margaret hospital and the continuing question mark over the plans for the new hospital are not the only reasons for Swindon's hospital problems. No one in Swindon expects a guarantee that there will never again be any problems with their hospital care, but the people of Swindon do expect some recognition of the seriousness of the problems that they face. They do expect some real and effective action to be taken to tackle the problems. That is precisely what they never got from the previous Government.

Swindon deserves better, so I ask my hon. Friend the Minister to reassure the people of North Swindon on three points: first, that if Princess Margaret hospital is renewed under a private-public partnership, the clinical needs of patients will be paramount; secondly, that the decision on any new hospital facilities will be taken in the context of co-operation between primary, secondary and community care providers in the area to ensure the best possible care for patients; and thirdly, that any obstacles to an immediate decision on the renewal of Princess Margaret hospital will be removed.

During my time in the House, I intend to work to ensure that my constituency continues to prosper and thrive and that there will be fulfilling jobs for all who want them. I shall work to ensure that all my constituents are given an equal opportunity to succeed, to reach for their dreams without being held back by the accident of who they are or where they were born. I shall work to ensure that they all have equal access to the best possible health care and education, because such equality is the hallmark of a decent and civilised society. I want all my constituents to be able to grow old with dignity and all that that entails. However, as vital as those tasks will be during my years in the House, nothing is more immediately pressing for my constituents than the plight of their hospital.

Since 1 May—Labour day—there has been a new mood in the country, a palpable sense of a fresh start. I hope that my hon. Friend the Minister can tonight assure us that there will be a fresh start for Swindon's hospital care.

9.55 pm
Ms Julia Drown (South Swindon)

I thank my hon. Friend the Member for North Swindon (Mr. Wills) for allowing me to contribute to the debate on Swindon's hospital care. I congratulate him on securing this debate so early in the Session.

This is my first speech in the House and I should like to say that it is an honour to be the first Member of Parliament to represent the people of South Swindon. The old Swindon constituency has been split in two—my constituency takes part of the former Swindon seat and a small part of the old Devizes constituency.

I pay tribute to the work of my predecessors. Mr. Simon Coombs greatly enjoyed his 14 years in the House. He answered thousands of letters from his constituents and helped hundreds of people. He was a keen supporter of some of the town's important activities, such as our football team and the local choral society.

I follow in the footsteps of David Stoddart, who was the Member of Parliament for Swindon from 1970 to 1983 and who is now in the other place. It is an interesting coincidence that he also made his maiden speech within a day of the new Parliament beginning. I am proud to follow him in that respect.

I am delighted to be the first woman to represent Swindon in Parliament. This election saw a sea-change in the number of women in Parliament, and I am pleased to be part of that change. We will make Parliament a better place. I was a health service professional for 11 years and now bring my skills to the House. I should like to use my experience of health service finance for the good of Swindon's health and for the good of the health service across the nation.

Swindon is a great town. We have some of the best leisure facilities in the country; we have one of the best local authority collections of modern art; and we have access to wonderful green areas, within the town and in the rural parts of my constituency. We have an active voluntary sector and an active chamber of commerce. Our environmental centre would make most towns green—but only with envy. I am also proud to have the national dance studio in my constituency.

In Swindon, we are aware of our history as a railway and industrial town, now diversified to include many financial services and communication businesses. In our rural areas, farming remains vital to the economy. We know that the ability to change and diversify is the key to business success and prosperity. We have a higher level of employment than many other areas, but there is still a need for skills training and job opportunities for many. We welcome the firms that have made their home in Swindon, attracted by our facilities, our work force and our excellent communications with the rest of the country.

Swindon's borough council has done much for the town. It has this year become a unitary authority and looks forward optimistically to the revival of local government.

The town of Swindon has grown quickly, and facilities such as the health service have been under huge pressure to keep up with demand. My hon. Friend the Member for North Swindon raised a number of concerns that my constituents share. I should like to pay special tribute to the many staff of all trades and professions in Swindon's health services who have worked tirelessly for patients in what have been, over the past 18 years, increasingly difficult circumstances.

Princess Margaret hospital has experienced large increases in patient work loads, partly because of the increasing population of the town, but partly also because of the closure of Princess Alexandra hospital in Wroughton, which is also in my constituency. It was a services hospital, but it treated thousands of NHS patients. It was highly valued by local people and is much missed. Millions of pounds were spent on new theatres and a scanner for the hospital only a few years before its closure—

It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.

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

Ms Drown

South Swindon finds it difficult to understand why a much valued hospital with all that recent investment was closed. Princess Margaret hospital was built using state-of-the-art designs and building materials of the 1960s and 1970s. The buildings are now out of date; the Health and Safety Executive and the fire service are concerned about our buildings. We must meet those concerns and ensure that the facilities are updated to modern standards.

Not only did we face a number of weeks last winter when the hospital could accept only patients with life-threatening conditions, but the number of patients waiting more than 12 months is now significantly higher than it was last year. Because the urology waiting list is already 18 months long, GPs are not putting any more patients on the list. That means patients waiting until they become emergency cases to get treatment.

There are genuine problems with recruiting nurses. Many people feel that the training courses are too academic and may put off recruits who would do the profession proud. Mental health facilities also need upgrading, and plans for that are progressing well. Support for our community facilities is also vital.

In all parts of the NHS, more managers are in place and there is increased bureaucracy. Our health region spends £320,000 on bureaucrats every day: that cannot be right. Swindon wants money spent on patients, not paperwork. Yesterday's Gracious Speech outlined how the Government will do just that.

The most pressing need, however, is for a decision on the future of Princess Margaret hospital. The business case was approved some years ago in principle. It then had to be tested under the Government of the day's private finance initiative. That process caused delays.

In April of last year, Swindon was told that it would have a completely new hospital; we were told to expect work to commence soon after September 1996—yet not even a planning application has been lodged. The new hospital proposal is with the Treasury as we speak. It is regrettable that many details of the scheme have not been available to patient groups or the general public. Less has been available in Swindon than has been provided to groups concerned with projects elsewhere in the country. The people of South Swindon have a right to know what is planned for their health care provision. I hope that the Minister will ensure that more information is made available to the people of Swindon.

We have lived with the uncertainty over our hospital for long enough. Swindon needs to know that its hospital will be modernised. It needs to know that the proposed privately financed scheme will provide value for money for generations to come. It is no good having a more expensive big shiny hospital if we find in future that we do not have the money to send patients to it.

Swindon needs to know that a modernised hospital will be run by the NHS in the interests of Swindon patients. That is of particular concern to the hospital's hard-working staff. Many of them have put in years of dedicated service to the NHS because they wanted to work for the NHS. They are now threatened with forcible transfer to private companies. I urge the Minister to find ways to allow those who wish to remain part of NHS teams to continue their valued service as part of the NHS.

Having pointed out the difficulties, I want to record my optimism about the future of the NHS in Swindon. Morale has been low, but health service workers are enthusiastic about the new Labour Government. If we can harness the enthusiasm and initiative of health workers and learn from their experience, I am confident that the NHS will once again be the envy of the rest of the world.

The NHS is a great institution. The society in which we and our fellow citizens will be looked after when we are ill, however rich or poor we are, is a civilised and great society. I ask the Minister to work with Members of this House to ensure that we deliver what the people of Swindon need—a modernised hospital service giving quality health care to those who need it.

10.4 pm

The Minister of State, Department of Health (Mr. Alan Milburn)

It is a special honour to be able to respond to this Adjournment debate—first to welcome you to the Chair, Mr. Deputy Speaker; secondly to congratulate my hon. Friend the Member for North Swindon (Mr. Wills) on securing this debate so early in his parliamentary career; and thirdly to congratulate him and my hon. Friend the Member for South Swindon (Ms Drown) on making such impressive maiden speeches. They have argued their case forcefully, sincerely and, if I may say so, with some expertise.

I have had the opportunity to speak to both my hon. Friends since their election and I can confirm that they are health service experts. I value that greatly as an incoming Health Minister. I shall be relying on some of the expertise that they have to offer, not just on issues relating to Swindon, but on more general issues.

I am, of course, sympathetic to the concerns that my hon. Friends have expressed about the state of the national health service in the town. I pay tribute in particular to all those who in recent years have worked so hard in difficult circumstances to cope with the pressures that the local health service has had to face, particularly during the winter months.

There are obviously no quick and easy solutions to the problems in the NHS that the outgoing Government have bequeathed to this Government, but I can assure my hon. Friends that we are already taking action to tackle bureaucracy in the national health service and we are taking the first steps towards replacing the absurd internal market, which is the cause of so much of that excessive bureaucracy. Our ambition for the national health service is no less than to modernise it and equip it properly for the challenges of not just the next few years but the next century.

The Swindon and Marlborough trust faces particular pressures, as my hon. Friends said, because of anticipated high population growth in the area and the recent closure of the hospital at RAF Wroughton. As my hon. Friends have made clear, there is pressing local concern about the facilities from which care is currently delivered and about the delays that there have been in replacing those facilities under the private finance initiative.

Proposals for a new Princess Margaret hospital were first put forward for approval in 1994. Since then, they have been subject to delay after delay. It has become clear that the initial proposal fell short of the demanding standards required to secure clear approval.

I understand that the trust has now submitted the final details of its revised proposal for consideration. Whatever the outcome of that deliberation, I assure my hon. Friends that clinical considerations and service needs will in no way be overlooked. They will be central to an assessment of the proposal. I am pleased that a Swindon forum has been established, meeting regularly and chaired jointly by the trust and the health authority. I hope that it will ensure that local decisions are taken not in isolation but with proper regard to the views of all interested parties.

It is clearly important that such a major proposal secures the confidence of the local people. As far as possible, open details should be made available to people in the area about the nature of the proposal. It is not the consortium's national health service; it is not even the trust's national health service; and it is not mine. It is the people's national health service, and we should never ever forget that.

Schemes such as the one in Swindon have been in the PFI procurement process for too long and I believe that that cannot continue. In such cases, a decision needs to be made, which confirms either that the project is suitable for agreement with the private sector partner, or that it is not. Both public and private sector participants must not be left indefinitely wrestling with schemes, trying to satisfy ill-defined rules, only to find that there is a finishing line that moves forward continually.

Unlike our predecessors, this Government are committed to developing public-private partnerships in the national health service which actually work and do the business of getting new hospitals off the ground. They should lay the bricks and the mortar. The time for talking on these issues has come to an end. This Government want to be remembered as a Government who built hospitals rather than as a Government who promised the building of hospitals. We are determined to rejuvenate the private finance initiative and to get it working.

It is precisely to deal with problems such as those faced by Swindon that my hon. Friend the Paymaster General announced on 8 May a major review of the PFI across government. His aim is to remove the obstacles in the way of bringing projects to fruition and to find ways in which to streamline the whole process. At the same time, I can announce this evening that I have asked my officials to carry out an urgent review of the PFI process in the national health service. I will listen to the views of those closely involved with the PFI from both the public and private sectors. The objective will be to identify how the current gridlock can be eliminated and to ensure that much needed schemes are completed quickly, making best use of the skills and expertise of both the public and private sectors to achieve best value for money.

I know that all talk of a review inevitably leads to some concern about the potential for delay, so I shall try to pre-empt my hon. Friends' concerns on that point. Perhaps I can best point to the progress that we seek to make on the PFI by reference to the proceedings today in another place. The Government introduced a new Bill in the other place to speed progress on the PFI. The Bill will clarify the powers of NHS trusts to enter into PFI-type agreements and it will remove one roadblock that has caused considerable frustration and delay for some of the most advanced schemes. It signals the Government's absolute determination to speed up the process of attracting private capital into the national health service and our commitment to make sure that public-private partnerships actually deliver the goods.

I very much hope that a PFI solution can be found for the redevelopment in Swindon. I share the desire of people in the town to see their NHS facilities improved. I am extremely grateful to my hon. Friends for making their case so eloquently. I can tell them that today, I have instructed the NHS executive to agree with the trust a clear way forward for the project and for other schemes that have already been approved, but which have not made the progress expected of them. I shall also ask the trust's chief executive to make himself available to meet my hon. Friends to explain the PFI proposal in more detail, so that they and their constituents are clear about it.

I offer my hon. Friends an open invitation. I am happy at whatever point to meet them to give them the opportunity further to press their case on this very important proposal. The way in which they have rationally and cogently argued their case this evening is important and it speaks volumes for the Swindon team that we can expect in this House for many years to come.

Question put and agreed to.

Adjourned accordingly at fourteen minutes past Ten o'clock.