HC Deb 04 July 2000 vol 353 cc146-8
5. Mr. Phil Sawford (Kettering)

What advice his Department gives to health authorities regarding mergers of NHS trusts. [127512]

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart)

We have said that mergers should proceed only where they bring clear benefits for health and health care. Every merger must save at least £500,000 in management costs in the first two years. The savings released are retained locally for investment in front-line NHS services.

Mr. Sawford

I thank my hon. Friend for that answer. Does she recognise that in trust mergers, services do not always dovetail perfectly? Where they do not, will she give guidance and ensure that services are levelled up, rather than down, that there is no fragmentation of services and that services to patients are the principal factor guiding the process?

Ms Stuart

Of course, I agree with my hon. Friend, and the proposals for Northamptonshire make it clear that we want to create a new organisation that delivers community-based services throughout the county. It is intended that the new organisation will capitalise on best practice, and the main outcome will be that local people and staff will have access to high-quality, modern community services. My hon. Friend will be aware that consultation on the proposals is well under way, and the outcome will be accepted by Ministers only when it is clear that the proposals represent the best possible options for patients locally.

Sir Sydney Chapman (Chipping Barnet)

Can the Minister give a categorical assurance that when two NHS trusts merge, each with its own hospital with an accident and emergency department, it will not lead to one of those departments closing? I am thinking in particular of the merger between Chase Farm and Barnet.

Ms Stuart

It may be helpful if I remind the hon. Gentleman that mergers of trusts should not be confused with hospital services reconfigurations. Merger proposals concern the merging of organisations and management, and the services that are to be provided form part of the reorganisation structure. Trust mergers do not always lead to the closure of associated hospitals—that is always a matter for local consultation.

Mr. Bill O'Brien (Normanton)

When considering trust mergers, will my hon. Friend have regard to the fact that we now have community health trusts, whose functions are changing? Are there are any proposals to make trust mergers more efficient by merging community health trusts with hospital trusts, or is there a general policy in the Department to review the workings of community health trusts?

Ms Stuart

As it stands, it is unlikely that community and acute trusts will he merging. It is important to stress that mergers and reconfigurations are being considered because we have ended the competition of the internal market in which one hospital competed with another, and our policy has a wider scope and focuses on the provision of decent services for local areas. I take on board what my hon. Friend said about the provision of community services, but any mergers have to be in the interests of the patients and must provide significant savings for the local community.

Mr. John Wilkinson (Ruislip-Northwood)

When contemplating trust mergers, will the hon. Lady always bear it in mind that a clear line of responsibility and chain of command are crucial for the effective provision of services within the hospitals that are grouped together? Is it not the case that, all too often, the loyalty and morale of individuals are undermined and, as a consequence, the standard of patient care diminishes?

Ms Stuart

I agree with the hon. Gentleman that the whole purpose of the process must be to improve patient care, and that sometimes requires sensitive handling of discussions and negotiations, because some of us fear change more than others. That is why we are always sensitive about the need to consult locally with all key stakeholders and to come up with service configurations that serve local communities. Sometimes that is difficult: when we inherit health economies that have run up huge deficits, hard choices have to be made. However, I reassure the hon. Gentleman that the bottom line for any decision is patient care.