§ 2.55 p.m.
§ Lord EnnalsMy Lords, I beg leave to ask the Question standing in my name on the Order Paper.
The Question was as follows:
To ask Her Majesty's Government whether they will make a statement on the futures of the Westminster Hospital and the Westminster Children's Hospital in the light of proposals made by the Riverside Health Authority.
§ Lord SkelmersdaleMy Lords, Riverside Health Authority is consulting formally on a proposal to build a new Westminster and Chelsea Hospital on the site of St. Stephen's Hospital, Fulham. The consultation paper shows that if a new hospital were to be built as is proposed, other hospitals in the district, including the Westminster on its present site and Westminster Children's Hospital, would close. A decision on such a project would be taken only after thorough consideration of the implications for patients, and assessment of the financial and other aspects of the proposal.
§ Lord EnnalsMy Lords, in view of the drastic proposals by the Riverside Health Authority to reshape the hospital provision in the district—which involves, as the Minister said, the closure of four major and well-renowned hospitals, leaving no hospital provision whatever in the Westminster area and the demolition of St. Stephen's Hospital to make room for a new 680-bed hospital—is it not imperative that the Secretary of State should call in that proposal to satisfy himself that if carried through it will provide an effective and adequate service for the people of the whole of Riverside and not just one end of it?
§ Lord SkelmersdaleMy Lords, clearly, as I have said, Ministers have to approve the financial aspects of the scheme as a whole. It would be impossible—in fact, it would not be impossible but improper—to do that without recognising the considerations such as the effect on patients, the cost and benefits, how the scheme would be funded and whether it would give good value for money. Those are the kinds of issues that the noble Lord, Lord Ennals, is interested in.
§ Baroness FaithfullMy Lords, is it right that the review will cover not only costs but the terms of reference for work done by different bands of nurses 9 thereby possibly negating the Salmon Committee report? If the review considers the roles of different types of nurses that will take time. Will it be part of the review? Am I correct in that?
§ Lord SkelmersdaleMy Lords, I am slightly confused, but I believe my noble friend is talking about the clinical grading review of trained or untrained nurses in our hospitals. So far as I know, that is not directly related to the Question on the Order Paper.
§ Lord GrimondMy Lords, will the Minister confirm that the Government are convinced of the necessity for a major hospital to serve Westminster? Will he also confirm that, in the current state of knowledge, there is no better alternative available than the present Westminster Hospital?
§ Lord SkelmersdaleMy Lords, if by "Westminster" the noble Lord means the Houses of Parliament, quite clearly arrangements both for emergency and primary health care treatment of Members of your Lordships' House and those of another place would be a most important factor in reaching any decision in the matter.
§ Lord GrimondMy Lords, I do not mean only Members of this House— important as they are—but also the denizens of Westminster.
§ Lord SkelmersdaleMy Lords, if the noble Lord means more widely, then clearly it is necessary to consider the effect on patients, as I have said. By that I mean all patients in the Riverside Health Authority area.
Lord Wallace of CoslanyMy Lords, is the Minister aware that the Westminster Hospital site is very valuable from the point of view of development? Will he give an assurance that the development value of the site will have nothing whatever to do with the hospital's continuance or closure?
§ Lord SkelmersdaleMy Lords, any of the sites mentioned in the scheme have quite a high potential cash value. It will be necessary to consider the whole scheme and the financial aspects of it all at the same time. I am afraid I cannot give the kind of guarantee for which the noble Lord is asking.
Lord Wallace of CoslanyMy Lords, I find it astonishing that the Minister will not give an assurance on the financial implications of developing the site for other purposes than a hospital. Surely an assurance can be given that the only decision that can be made is for the benefit of the health service.
§ Lord SkelmersdaleMy Lords, I thought that I had already clarified that matter. However, it is equally obvious to me that financial considerations will have to be taken into account.
§ Lord EnnalsMy Lords, is the Minister aware that those involved in the AIDS unit, which is an extremely important unit at St. Stephen's Hospital, 10 are gravely concerned about the effects of this plan on their ability to fulfil their AIDS responsibilities, which are so important at this time?
§ Lord SkelmersdaleMy Lords, yes, of course I am aware of that, but I find this a difficult issue and I must be careful not to pre-judge this particular investigation. I find it difficult to believe that work must be carried out in a particular geographical area.
§ Lord Peyton of YeovilMy Lords, I should like to ask my noble friend whether the forthcoming review will consider the work of boards, councils and committees within the health service and attempt to reach a conclusion as regards their usefulness?
§ Lord SkelmersdaleMy Lords, although that question does not have a great deal to do with the Question on the Order Paper, I think that the official answer to my noble friend is that nothing is sacred.
§ Baroness Masham of IltonMy Lords, is the Minister aware that the Westminster Hospital is a designated rehabilitation centre and that many disabled people attend? Is he also aware that St. Stephen's site presents difficulties as regards transport and, with an ageing population, patients would have extreme difficulty in reaching a large hospital in Fulham?
§ Lord SkelmersdaleMy Lords, I was aware of that matter. Transport is one of the issues at which my right honourable friends look with particular interest when deciding whether to approve or disapprove potential closures.
§ Baroness Macleod of BorveMy Lords, I should like to ask the Minister whether the relevant community health council has so far made representations to him about this matter.
§ Lord SkelmersdaleMy Lords, the district health authority has issued a consultation paper to the community health council which is still deliberating on it.
§ Lord UnderhillMy Lords, in addition to the question asked by the noble Baroness, Lady Masham, about transport for the disabled, is the Minister aware that people travel to Westminster Hospital from various areas of London? It is in a convenient area for them to use their own personal transport, and patients need to attend that hospital in order to see consultants and visit special surgeries.
§ Lord SkelmersdaleMy Lords, having lived and worked in the area for some time, I suggest that if patients are using their personal transport, the car parking facilities, where they now exist, are far from adequate.
§ Lord UnderhillMy Lords, of course I meant public transport, in addition to personal transport, which many people use, as do I, when attending Westminster Hospital.
§ Lord SkelmersdaleMy Lords, I thought that I had already dealt with public transport in answer to the supplementary question asked by the noble Baroness, Lady Masham.