§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Mike Hall.]
2.11 am§ Mr. David Prior (North Norfolk)It is a great pleasure to have the chance to debate the redevelopment of Cromer hospital—a pleasure that might be slightly diminished by the fact that it is 2.15 am, but a great pleasure none the less.
The first Cromer cottage hospital was established in Louden road in 1886. It was funded by local people, as were all subsequent additions and improvements. In 1932, it moved to its current site, and it was taken over by the national health service in 1948. However, the tradition of local involvement, personal donations and local fundraising activities has remained a hallmark of Cromer hospital to this day. The friends of the hospital are a dedicated and hard-working organisation, raising thousands of pounds a year and ensuring that the local community enjoys a close involvement with the hospital.
The atmosphere in the hospital reflects that close involvement. It is happy, friendly, relaxed, welcoming and caring. This is a genuine community hospital, and it is essential that, whatever its future development, its character is preserved. I have spoken to a great many people over the last few years—patients, and people who have known the hospital for years—who have praised it and its staff for the care and love that they devote to it. The hospital can be proud that it stands for all that is best in the great vocational tradition of the health service, but it stands for something else as well: it is a 1930s building, which has been added to piecemeal ever since.
A report prepared by Norfolk and Norwich Health Care NHS trust, of which Cromer hospital is a part, stated in 1998:
Facilities within the Hospital are not efficiently organized.Accessibility to critical areas is hindered by the current configuration.Parking is increasingly a problem.Entrance to the hospital grounds is narrow and makes access difficult.
The current facilities at Cromer are old, ill maintained and not best suited to modern medicine. The building requires substantial investment to meet the minimal requirements of relevant statutory regulations and it is likely that increasingly large amounts of investment will be required in the future as the buildings age and deteriorate further. Current estimates of the potential cost of carrying out the backlog of maintenance required at Cromer put the cost as high as £2.2 million over the next three years in order for the hospital to meet its statutory obligations for health and safety.
The report continues:
The two wards currently cater for patients of varying ages and recovering from various ailments. This situation is by no means ideal as providing care on this basis greatly increases the risk of cross infection. At present strict procedures are in place for disease management in order to minimize this risk requiring extra resources for disease management.In many ways, therefore, Cromer hospital is a symbol of the NHS: it has outstanding and caring staff supported by the community, but working with substandard 795 facilities. For those reasons, since 1994 Norfolk and Norwich Health Care NHS trust has generally accepted that Cromer hospital should be substantially redeveloped. The recent dedicated cataract surgery and gastroenterology services are examples of the trust's commitment to that.In July 2000, a resident of Cromer, Mrs. Sagle Bernstein, died, leaving Cromer hospital a fantastically generous legacy of £10 million. The trustees of the legacy are the board of Norfolk and Norwich Health Care NHS trust. To avoid any misunderstandings, I wish to state unambiguously, first, that no NHS funding will be lost as a result of that legacy. The legacy must be additional to NHS funds.
Secondly, the legacy and all the accumulated interest are for the benefit of Cromer hospital; that will not be siphoned off for use elsewhere in the health service. That has been confirmed to me by the chief executive of the acute trust. I hope that the Minister will confirm those two vital points in her reply, as I know that that would go a long way to putting at rest the minds of many of those who live in Cromer.
That incredibly generous bequest allows the trust to create a world-class hospital in Cromer. It means that we can now look forward for the next 100 years, not only the next two or three. It also allows the nursing, clinical, caring and community traditions of Cromer hospital to be allied to world-class facilities, operations and resources. It is an opportunity that I as the Member of Parliament for North Norfolk am determined to see grasped.
The acute trust and the primary care group in north Norfolk have promised that they will deliver a business plan by the end of March 2001, setting out their joint agreed proposals for the future. It will bring together primary care, intermediate care, elderly rehabilitation and acute care. It will also need to take into account the location of the general practitioner's surgery in Cromer and the rehabilitation facilities currently located at Benjamin court, in Cromer, as well as the acute services.
It is generally agreed that all the existing services in the hospital will be retained and enhanced with major expansion in ophthamology, dermatology, endoscopy, cardiology, diagnostics, maternity services, diabetics, eurology—including a service for stroke victims—renal dialysis, minor surgery and post-operative cancer treatment. That is not a comprehensive list; nor would it be appropriate for me to submit one as I am not a clinician. By the end of March, however, there will be agreement between the primary care group and the acute trust on what should be included.
There must also be proper consultation with the community. It is essential that the deadline, at the end of March, is adhered to, so that local people feel that, after so many years of uncertainty, progress is at last being made.
Some 35,000 to 40,000 people in North Norfolk are over 65. By 2011, the number is predicted to increase by 20 per cent. That will lead to increased demand for intermediate care services, day care, rehabilitation and out-patient services. It is essential, therefore, that the plans for the hospital take those requirements into account. Cromer should become a centre of excellence for the treatment of older people, with intensive physio and 796 occupational therapy services such as hydrotherapy. I support also the provision of general practitioner community beds in the new hospital.
A few years ago, when the acute trust drew up its plans, it was looking at Cromer primarily as a satellite of the Norfolk and Norwich. That has changed. Rightly, the future of Cromer hospital requires an integrated approach from primary care through to rehabilitation. That may mean that the current site is not large enough or adequate and that alternative sites in Cromer will have to be investigated. If so, I am that sure that the district council will be supportive. A new state-of-the-art hospital could play a major part in the regeneration of Cromer, to which all of us in north Norfolk are committed.
I am anxious, however, that the involvement of different parts of the health service—the Norfolk and Norwich health authority, the acute trust, the community health trust and the primary care group—does not lead to unnecessary, bureaucratic delay. When the plan has been put together, it needs one organisation to be in charge to drive it through. The Minister needs to address that issue urgently.
I remember well when, in the early 1980s, Sir Roy Griffiths produced a report on the national health service and said that if Florence Nightingale was walking through an NHS ward, she would ask who was in charge. The issue of who is in charge at the new Cromer hospital is a very important one for the Minister to grasp. As I said, it is essential that there is open, transparent and genuine consultation with local people.
Cromer hospital is very much north Norfolk's hospital. It belongs to the people of north Norfolk, not to Whitehall or even to Norwich. We want a world-class hospital in Cromer, but we also want it to retain the character that it has developed over the past 100 years. It needs to reflect the great voluntary tradition of all those who have supported it for so many generations.
I hope that when the plan to redevelop the hospital emerges at the end of March, as has been promised, the Minister will lend her support to it. I also hope that she will lend her weight and authority to ensuring that the lines of responsibility are clear and that action is taken.
We have a chance that comes once in a generation to create something really special in Cromer. Let us make sure that we do the right thing and let us get on with it.
§ The Parliamentary Under-Secretary of State for Health (Yvette Cooper)I congratulate the hon. Member for North Norfolk (Mr. Prior) on securing this debate on the redevelopment of Cromer hospital. However, I commiserate with him about the late hour at which the debate has been called.
I am aware that there has been considerable local interest in the redevelopment of Cromer hospital and the proposals for it. It is clear from the hon. Gentleman's remarks that the local support for Cromer hospital is something of which the local community can be proud.
The hospital's services provide a vital local resource which is clearly valued by local people and the town's many visitors alike. It currently provides a wide range of out-patient and day-case services, including neurology, orthopaedics and ophthalmology, as well as a minor injuries unit. The services provided by the hospital and 797 the dedication of its staff have rightly been given the recognition they deserve by the remarkable legacy of Mrs. Bernstein.
Cromer faces a number of challenges in terms of its health and its regeneration, particularly in relation to the decline of traditional industries such as fishing. There is widespread determination by the local NHS to ensure that all stakeholders, especially the public, will be involved in decisions on the future of the town and its services.
As the hon. Gentleman explained, there have been various and lengthy discussions about the future redevelopment of Cromer hospital to provide more efficiently organised, expanded and modern services. He is right to say that many challenges are faced by the hospital facilities. It is important that the discussions about the modernisation and development of Cromer hospital reach fruition and can make progress to benefit those living locally.
The hospital was built in 1932 and is run by the Norfolk and Norwich University Hospital NHS trust, which provides the majority of services currently on the site. I understand that in 1995, and again in 1998, discussions began with local commissioners about what services should be included in a redeveloped Cromer hospital site. However, on neither occasion was it possible for commissioners to determine the scope of services required. That was due partly to the anticipated intermediate services strategy which was being developed by the then East Norfolk health authority, but also to uncertainties about future commissioning arrangements. As a result, no business case was produced at that time, and there was no tangible progress for Cromer hospital and its patients. These previous efforts to determine how Cromer hospital should be redeveloped have clearly contributed to an understandable local feeling that more needs to be done to progress Cromer hospital and that the investment needs to be secured and made without further delay.
This is a matter for the local health authority, the trust, the community health council and local people to determine, through formal consultation, if required. If there is still local disagreement, the community health council can, of course, refer the matter to Ministers. However, this is first and foremost a local matter, and it should be resolved locally.
I understand that progress is being made on the redevelopment of Cromer hospital. The proposals being considered include diagnostic and treatment services, pathology and primary care, such as general practitioner services, as well as the future configuration of community care in Cromer. No decisions have been made to date, and it is anticipated that the proposals will be completed in the near future, when there will be an opportunity for the public to have their say. The proposals will then be developed into a strategic outline case by the local NHS, led by the Norfolk and Norwich University Hospital NHS trust. The strategic outline case will be submitted to the regional office later this year. The production of the proposals is, of course, not the end of the process, and it is important that this is understood by all; even after the proposals have been made public, discussions will need to continue on development, the cost of the proposed services and how they will be provided, and other details. I look forward to the conclusion of that work and the publication of the proposals as soon as possible.
798 One of the most fundamental issues that will have to be thought through as part of that process will be the running costs of the redeveloped Cromer hospital. That matter must be resolved before any work can begin on the ground. Agreement will need to be reached on the revenue implications of the developments. All local parties, including the public, must satisfy themselves that the benefits of the improvements to Cromer hospital and health services in Cromer are sustainable, adaptable and robust for the long-term future.
Public involvement and support will be key aspects of the proposals for Cromer hospital. There is a great deal of local interest in the future of the hospital, so it is crucial that patients and local people support the future developments.
The NHS plan demonstrates the Government's commitment to patient-focused services, and it is essential that services meet that aspiration; after all, that is what patients and the local community expect. Those proposals must have local support, so the involvement of the local community health council in the working group is also a key part of the process.
The working group that has been established to consider the redevelopment includes Norfolk and Norwich University Hospital NHS trust, the North Norfolk primary care group, local GPs, the Norwich Community Health Partnership NHS trust, local authorities, including North Norfolk district council, and the local community health council.
It is extremely important that we take a partnership approach to the development of Cromer hospital. I take on board the point that the hon. Gentleman makes about the need for clarity in developing the proposals and his argument that a partnership approach should not entail too many discussions that do not lead to a conclusion. I do not think that is the consequence of a partnership approach; it is clear that Norfolk and Norwich University Hospital NHS trust would take the lead in developing the strategic outline case. However, I shall bear the hon. Gentleman's points in mind as the plans progress. It is important that the partnership is conducted so as to deliver the results that local people expect.
Fresh impetus has been brought to discussion of the proposals by the substantial and completely unexpected bequest of Mrs. Bernstein in summer 2000. Mrs. Bernstein's regard for the excellent care and services provided to her sister by the staff of Cromer hospital led her to bequeath the remarkable sum of approximately £10 million to the hospital for the improvement of its general facilities. Understandably, that has invigorated discussions about the hospital's future.
Of course, the size of the bequest and its significant implications for the hospital mean that decisions about the future redevelopment have to be the right ones. An opportunity on that scale is unlikely to he repeated, so there is an obligation on the people drawing up the plans locally to ensure that the money is used to benefit local people for the long term. The public will have to be satisfied that the plans are right for the local area and will deliver the maximum possible benefits.
In response to some of the points made by the hon. Gentleman, I can reassure him that no money from Mrs. Bernstein's legacy is being spent on any other project; it is not being used to support the new Norfolk and Norwich hospital or any other health project in the area. It will be used specifically for Cromer, as stipulated 799 in Mrs. Bernstein's will. It will make a significant contribution to the capital expenditure on the redevelopment of Cromer hospital. I agree with the hon. Gentleman that it would be completely unacceptable if the area's fair share of NHS funding for a wide range of projects were affected by Mrs. Bernstein's bequest—it was clearly intended to improve facilities and to make a real difference for the people of Cromer.
The bequest represents a huge opportunity for those in Cromer, for the local community and for those in the NHS. It coincides with a big increase in funding to the NHS in Norfolk. As I am sure the hon. Gentleman is aware, the Chancellor announced in his Budget statement the biggest ever increase in funding for the NHS in England. I am sure that he is also aware that, in his Budget speech on 7 March, the Chancellor announced extra resources for the NHS in England in each of the next three years, with an extra £300 million in 2001–02. That involves additional revenue and capital resources; provides a chance to improve NHS facilities across the board in Norfolk and the Norwich area; and comes at a useful time in the debate about Cromer hospital's future.
800 I am sure that all parties in the process are working towards a common aim—providing the best possible health services for the people of Cromer. I look forward to the speedy development of the proposals for the future of Cromer hospital and to those proposals being made public in the near future, as well as to partnership work involving not only all those in the NHS but local authorities, voluntary groups and the local community. Things are not standing still in Cromer while those discussions are taking place. Developments continue at the hospital—for example, improvements to the dermatology department are currently being implemented.
The redevelopment of Cromer hospital will be a very significant milestone for health services in Cromer, so all parties must ensure that the best possible solution is found. The health authority, the trust and those involved in the local discussions will take note of the points that the hon. Gentleman has made in this debate. All local stakeholders owe it to the people of Cromer, the hospital's staff and Mrs. Bernstein, who had regard for them all, not to waste this opportunity.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-nine minutes to Three o'clock.