§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Heppell.]
7.28 pm§ Mr. Peter Viggers (Gosport)Some of my parliamentary friends and colleagues have expressed mock surprise at my raising this issue in the House as the subject of an Adjournment debate, as I have raised it so many times before. However, I would certainly claim not to be a one-club golfer. I spoke in the House last Thursday about defence and I spoke and answered questions yesterday on behalf of the Speaker's Committee on the Electoral Commission. Nevertheless, it is true that, according to the ever-efficient Library, I have raised the issue of Haslar 63 times, and I shall continue to do so until the Government see sense and act to ensure that these facilities are used properly.
The Royal hospital Haslar was originally a naval hospital that opened on 23 October 1753, so its 250th anniversary will occur shortly. However, I put the case for the hospital not because of its history but because of its superb facilities. Some £35 million has been spent on it in the past 10 years and it has outstanding operating suites and facilities.
The problem arises because the Royal hospital Haslar is the only services hospital that the Ministry of Defence owns and controls. In 1988, a Ministry of Defence committee, which was chaired by Commodore Lawrence and comprised no medical personnel, decided that the best future for service medicine was to proceed with dramatic reconstruction. The committee was facing a significant shortfall of 50 per cent. to 90 per cent. in the key specialties. Recruitment to the armed forces medical services has traditionally been good, but recently retention has been bad. In the important faculties, such as general surgery, orthopaedic surgery, anaesthetics and general medicine, there is approximately a 75 per cent. shortfall. The Ministry of Defence has therefore only a quarter of the personnel that it needs.
The Lawrence committee recommended that there should be a new centre of defence medicine. The Government accepted the recommendation, but after it was touted around various places where they would have liked it to be located, it ended up at Birmingham, which is not a popular centre.
Recruitment to the Defence Medical Services is currently good, but retention remains bad. That is why it has been necessary in Iraq to use reservists, some of whom are charging approximately £1,000 a day in compensation for their loss of earnings. I have read press reports of some doctors being paid £180,000 or £250,000 a year in compensation for loss of civilian earnings to make up for the lack of service personnel. There was a serious problem and the solution that the Ministry of Defence proposed was the closure of the Royal hospital Haslar. The original statement made it clear that it would not close before 2002. There was local uproar and a march of 22,000 people who expressed their deep concern at the loss of the local facility.
There are several concerns, not only in services medicine, but I shall give one more example of the latter. The Ministry of Defence has decided to cut the umbilical 831 cord between medical staff and service patients at the same time as the closure programme. Until fairly recently, service doctors gave preference to service personnel, but that is no longer the case. There is no fast-tracking and 18,338 service personnel are currently medically downgraded. That means that, for example, a paratrooper with a back problem has to queue for treatment with an elderly lady who needs a hip replacement. That is a serious disadvantage from a services point of view. Defence Medical Services has not prospered by the decision.
Let me deal with the sphere of activity for which the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton) is responsible. I am pleased and grateful that he is responding to the debate. Although we have a Ministry of Defence health problem. it is also a specific problem for the civilian population of the Gosport-south Hampshire area.
The facilities at Haslar are outstanding. It has 280 beds, nine exceptional operating theatres and a range of other facilities, including radiological equipment and magnetic resonance imaging equipment. Its telemedical equipment is as good as that anywhere in the world. Indeed, it is a world leader in telemedicine. The local community needs the facility. The next piece of the jigsaw puzzle is that the national health service has decided that the Queen Alexandra hospital at Cosham, which is eight to 12 miles away from my constituency, needs to be renewed. A private finance initiative has been proposed for it. The plan is to complete the PFI in 2007, though no one is putting money on that happening. Like most programmes, it might creep to the right and be delayed. Anyway, let us take 2007 as the relevant date.
The original plan was to close the outstandingly good facilities at Royal hospital Haslar in 2002. The subsequent plan was that they would close in 2007. There has, however, been a development since then. I raised the issue on the Floor of the House in the Christmas Adjournment debate, and subsequently received a letter, dated 29 January 2003, from the hon. Member for Salford (Ms Blears), who was then the Under-Secretary of State for Public Health. She pointed out that, following a consultation by the local authority
a commitment was made to the people of Gosport to develop a substantial facility at RH Haslar (subject to Ministry of Defence agreement on the use of the site), with day case surgery, diagnostic services, outpatient clinics and the Haslar Accident Treatment Centre. The local NHS remains committed to this vision, and are working closely with the Ministry of Defence to take it forward.The problem is that the caveatsubject to Ministry of Defence agreement on the use of the siteis proving quite significant because some people in the Ministry appear to be dragging their heels in regard to the concept of effecting the necessary transfer of premises from the Ministry to the NHS and the local hospitals trust. I have heard it said that the commitment is not the one that I have just read to the House, but one to develop facilities on the Gosport peninsula. That is not what the Minister said, however. She said that the facilities would be retained at Haslar, and that is what we want to hear. If it is indeed the case that they will be 832 retained at Haslar, it is important that all those involved should come together to discuss the manner in which the transfer will be carried out.I am grateful to the Under-Secretary of State for Defence, the hon. Member for Hove (Mr. Caplin), who wrote to me about the transfer of authority and responsibility, and about the proposed MOD attitude after 2007. He kindly invited me to go and see him, which I look forward to doing on the morning of Wednesday 15 October. What we need now is an absolute commitment from the NHS that it understands the need for the Haslar facilities, and that it is committed to an orderly transfer of the premises there from the Ministry of Defence to the national health service.
A few months ago, before the summer recess, there was a fear—indeed, it was a stated intention—that the King Edward VII hospital at Midhurst would need to close. It is a charitable structure. That caused concern locally, because it was widely accepted that the facilities in Hampshire were not sufficient for us to manage without that hospital. Haslar hospital is quite different, however. It is much more substantial, much more important, and much more geared to the Minister's and the Government's initiatives.
The Government have recently introduced significant initiatives, one of which involves diagnostic and treatment centres. In these centres, there is virtually a production line of operations, which can take place in specially allocated premises. Such a production line of hip replacements, cataracts and the like—procedures known as cold surgery—can take place in a dedicated hospital, without the disruptions that can be caused by major accidents and emergencies. Treating the victims of major road accidents would normally take priority over cold surgery. Cold surgery therefore needs facilities that can be used on a regular, structured basis so that it can be carried out in a well-organised way. That is exactly the kind of facility that Haslar can offer.
There is also an accident treatment centre at Haslar, which is ideally suitable for treating the victims of minor accidents who do not need to go to the accident and emergency unit at Queen Alexandra hospital in Cosham. I believe that the number of accident treatment centre cases is about 8,000 a year, and a study has shown that some 6,000 additional cases could be taken away from the accident and emergency unit in Cosham by treating them in Haslar. Clearly, that initiative would take some pressure off the district general hospital at Cosham.
I am pleading for an understanding by Government at the highest level that we cannot do without Haslar hospital. The primary care trust has taken an initiative, and has asked the strategic health authority to consider the future of the Haslar site. We need to bring all the major actors into this dialogue: the Ministry of Defence, which is the current owner of the site, the national health service, which is the holder of the purse strings through the PCT, the ambulance trust, which has a heavy burden because of the extra carriage of patients between Gosport and the Queen Alexandra hospital, Gosport borough council, which is the planning authority, the hospitals trust and all the other participants—stakeholders, as the Government like to call them—in the health scene in south Hampshire. That is urgently 833 needed, because we cannot manage without the facilities at Haslar hospital. I urge the Minister to respond to this debate, and to agree that he will participate in this initiative and ensure that those facilities are not lost.
The Ministry of Defence has said that it wishes to get out of the business of hospital management. I hold my own view on that. The Defence Medical Services has not only surgical and medical skills, but administrative skills. I maintain that it would be helpful to the Defence Medical Services to have a facility at which defence medical personnel could train in administration as well as in medical matters. Haslar, which has superb facilities and is highly regarded, could be a centre for an esprit de corps in the Portsmouth and south Hampshire area. The Defence Medical Services would appreciate that.
Once the premises are transferred to the hospitals trust, the Ministry of Defence, having achieved its primary objective of getting out of hospital management, may well reconsider the facilities and realise that a combination of Queen Alexandra hospital and Haslar hospital would provide an excellent training ground for its own personnel. The Ministry of Defence may come back on side and realise that it has that opportunity.
My plea is for the Minister to recognise the problems, and to undertake to involve himself in the transfer of premises at Haslar hospital to the national health service.
§ The Minister of State, Department of Health (Mr. John Hutton)I congratulate the hon. Member for Gosport (Mr. Viggers) on securing this debate. I assure him that I will draw his comments on the Defence Medical Services to the attention of my right hon. Friend the Secretary of State. I am here to answer the hon. Gentleman's questions about the national health service. I am sure that he will appreciate that I must confine my remarks to that subject.
All right hon. and hon. Members naturally and rightly attach the highest importance to developments in the NHS in their constituencies, because access to good quality, convenient health care services is an essential ingredient in the life of any community. That is true in Gosport, and it is certainly true in Barrow and Furness. I fully understand the concerns that have been raised in Gosport by the hon. Gentleman's constituents over the provision of local NHS services, especially the future of the Royal hospital Haslar.
As the hon. Gentleman said, for many years the Royal hospital has played a central role in the provision of NHS services in his constituency. I pay tribute, as I am sure he would, to the professionalism and dedication of all the staff at the hospital. Any fundamental change along the lines that he has talked about is bound to raise concerns and anxieties locally. It is clear to him—it is clear to me, too—that decisions concerning the configuration of local services need to be made. We need to get on and make them in order to allay legitimate concerns and lay the foundations for the growth and expansion in services that he and I want to see.
It was clear from the hon. Gentleman's remarks that he appreciates the fact that these decisions are first and foremost the responsibility of the local primary care trust, the NHS trusts and the strategic health authority. 834 Any decision should be made after the fullest possible local consultation and involvement. People's concerns should always be responded to fully and fairly. They should have the full facts before them, and they need to be aware of all the available options.
I know that the NHS in the hon. Gentleman's constituency is committed to those principles as it takes forward work on the best pattern of local services. If he has any concerns to the contrary, he should raise them with me and I will pursue them vigorously on his behalf.
I also agree that there is a challenging agenda for local NHS organisations, but I believe that the Portsmouth Hospitals NHS trust is responding vigorously. As one of the largest trusts in England, providing acute health care services for nearly 1 million people covering Portsmouth, the Isle of Wight and the surrounding region, it is already planning for the future. As the hon. Gentleman said, central to its plans is the new private finance initiative scheme for the redevelopment of hospital services in Portsmouth, focusing on the current Queen Alexandra site in Cosham. As he knows, the plan is to develop a high quality centre for acute services, which will serve as the hub of a network of services for outpatients, rehabilitation, preoperative assessment and much more, available in local communities for local communities throughout south-east Hampshire. I understand that the plans are strongly supported by local clinicians.
In summer 2002, a review of the proposals was conducted to ensure that the objectives still met the needs of the local health system. Clinical staff from both the NHS trust and the primary care trust confirmed their original view that the integration of acute care on a single site was the most clinically sustainable and effective model, complemented by a variety of local services. Plans for the new hospital are well under way. The Portsmouth NHS trust has recently announced the name of its preferred bidder, the Hospital Company, and is now developing a full business case for approval. It is envisaged that work will start on the site in February next year, and that the new hospital will open in 2007. Once the work is completed, in-patient services currently at Haslar will move to the new site. In the meantime, they will remain at Haslar.
To address short-term capacity problems, the Portsmouth trust is working in partnership with the independent sector on a separate project to shorten the time for which local patients wait for orthopaedic surgery. The idea is to commission an overseas clinical team of surgeons, nurses and allied health professionals who specialise in the delivery of orthopaedic services. A team from the Portsmouth trust and the Plymouth NHS trust is currently in South Africa to assess and select clinical staff and finalise the appropriate contract negotiations. The project will then begin next month, continuing until 2004. I should make clear that the focus for providing the long-term capacity needed in the local NHS to reduce waiting times for patients in south-east Hampshire will be based on the redeveloped Queen Alexandra hospital site in Cosham.
Both projects are major new developments for the local health community which form part of a wider strategic vision for the future of local health services throughout Hampshire and the Isle of Wight. The strategic health authority is currently steering a process known as Healthfit, the aim being to develop a strategic 835 framework for local health services that will be safe, sustainable, affordable—which is important—and fit for the future. A key priority now is to identify the pattern of local health services, and Fareham and Gosport primary care trust is leading a project to consider that. The PCT will ensure that the process fully involves health professionals, local patients and communities, as well as elected representatives. As the right pattern of services becomes clearer, the local NHS will be able to match those services with the most appropriate premises.
The hon. Gentleman rightly said much about the future of the Haslar hospital. It has been a subject of local discussion for many years, particularly since 1998 when the Ministry of Defence first announced its intention of withdrawing from the site in 2007. The commitments made in 2000—confirmed by the Minister for Crime Reduction, Policing, and Community Safety, my hon. Friend the Member for Salford (Ms Blears), when she wrote to the hon. Gentleman in January—still stand. The NHS in Hampshire and the Isle of Wight remain committed to the pattern of services for the population on the Gosport peninsula that were agreed following the consultation in 2000.
As I have said, however, the future of the Haslar hospital cannot be seen in isolation. The NHS has a responsibility to examine a range of options to ensure that primary and secondary services are meeting the needs of local patients, and conform to wider plans for modernisation. The precise configuration of the services is being discussed locally, as the hon. Gentleman will know. Following confirmation they can be matched with the right premises, at the right price, to ensure that resources are used effectively and efficiently to provide the range of services needed by the local population. As part of that process, the NHS continues to engage in discussions with the MOD so that the Haslar hospital can be considered a possible option for the location of future services. However, as I am sure the hon. Gentleman would be the first to acknowledge, the NHS has a duty to use public money wisely, and must therefore consider other options.
The hon. Gentleman again referred to the need for joint working between the NHS and the Ministry of Defence on this issue, and he said that there are no clear arrangements for the transfer of services. I am particularly concerned about this issue and the suggestions that he has made this evening, but I am advised that what he said is not the case. In fact, both sectors continue to work closely not only on the future of the Royal hospital Haslar site, but to confirm the provision of NHS and defence medical services in the local area.
The MOD has confirmed its intention to withdraw from the site in 2007, and that confirmation provides a firm foundation through which the NHS and especially the MOD can ensure continuity of NHS services for local people. It is clear that services will need to be provided from the Royal hospital site until such time as the new hospital is ready to receive admissions.
Work is being taken forward through a local partnership board, which meets quarterly, and through a high level strategic partnership that provides an overview of all aspects of partnership work between the 836 NHS and the MOD. The priority is to ensure a robust and practical way forward that is sustainable for the NHS, and which will meet the needs of local people. However, any decision taken by the NHS on the future use of the Royal hospital Haslar site will clearly need to take into account the MOD's own plans for the rest of the Haslar site. The MOD and the Defence Medical Education and Training Agency take the lead on this issue, and I understand that, as the hon. Gentleman said, the MOD will meet him next month to discuss arrangements for withdrawing from the management of the hospital. Any decisions on the use of the site will clearly be subject to the necessary local planning approval processes.
The future of the Royal hospital Haslar is obviously of great concern to the hon. Gentleman and I genuinely understand the worries that he expressed this evening. It is our policy that primary care trusts, in partnership with local trusts and the strategic health authority, and in the light of their specific local knowledge and expertise, should decide the priorities for the NHS locally, including the location of any eventual services. This is an opportunity to plan for growth and expansion in NHS services locally; we are not talking about contracting the range of services available to the hon. Gentleman's constituents. That is the context in which, I hope, he and his constituents will see these developments.
I conclude by reassuring the hon. Gentleman that every effort is being made by the local NHS to plan ahead for the future. It will continue to work with the MOD, and with him, to ensure a model of care that best meets the needs of the people whom he represents.
§ Question put and agreed to.
§ Adjourned accordingly at eight minutes to Eight o'clock.