London's Health Services: BMA Resolution (Hansard, 16 July 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, the issues raised in the British Medical Association's resolution are currently being addressed by the London implementation group through existing agencies.

§ Lord Molloy
My Lords, I thank the Minister for that Answer. I also acknowledge the fact that the resolution of the BMA is quite comprehensive. However, can the Minister confirm that if and when any corrective difficulties are embarked upon, they will not be at the expense of secondary care in other parts of London? Can the Minister also confirm that if the proposed reductions in staff take place, there will be no fall in the quality of medical undergraduates or in post-graduate education? Further, can she say whether careful arrangement will be made for the redeployment of academic staff should that prove to be necessary?

§ Baroness Cumberlege
My Lords, those are all issues that were raised in the resolution at the annual general meeting of the British Medical Association. As I said, every single one of them is being addressed.

§ Lord Rea
My Lords, can the Minister give us a progress report on the implementation of one of the recommendations in the original report of Professor Tomlinson; namely, that primary healthcare services—and, I would add, social service support services—should be in place before any hospital beds are closed? Can the noble Baroness say how far that recommendation has been implemented and whether there has been any progress towards it?

§ Baroness Cumberlege
My Lords, it is very early days yet. However, as noble Lords will he aware, £43.5 million has been set aside to invest in primary care in London in the current year. A number of schemes are being developed. I should be delighted to give the noble Lord a list of them in due course.

§ Lord Glenarthur
My Lords, I declare an interest as the chairman of one of the London NHS hospital trusts. Does not my noble friend agree that at least some of the statements which have emerged from the BMA in recent days have not really accurately reflected at all the position on the ground and the readiness, the willingness and the enthusiasm with which many doctors are embracing the changes which the Government have brought forward? Many of us who are closely involved with this matter see that progressive attitude displayed day by day.

§ Baroness Cumberlege
My Lords, I agree entirely with my noble friend. The enthusiasm for these proposals is growing day by day not only within London but especially outside London. However, the BMA is of course a registered trade union.

§ Lord Jenkins of Putney:
My Lords, is it not the case that the BMA is a representative body and that the majority of doctors take the contrary view to the one expressed just now by the Minister's noble friend?

§ Baroness Cumberlege
My Lords, we have no evidence that they are taking a contrary view.

§ Lord Annan
My Lords, is not the Government to be congratulated on taking this difficult problem of London medicine step by step: first, as regards the broad brush of Tomlinson and now as regards the finer brush of many committees which are now sitting to investigate much of the academic side and the 427 research side in London medicine? The special health authorities' research review is an example of this. It shows that highly distinguished doctors and medical practitioners are represented on the panels. The great decisions are not being decided purely by bureaucrats. It is the profession itself which is involved in this problem of the revision of London medical care. Out of this the Government may well hope that there will be agreement not merely from the public as a whole but also from the medical profession.

§ Baroness Cumberlege
My Lords, the noble Lord, Lord Annan, is right. The issues in London are extremely complex. It is important that those who reach these decisions—in the final analysis, the Secretary of State and her Ministers—are fully informed; and that is why the specialty reviews, the research reviews and other information are being sought and will be taken into account before any decisions are reached.

§ Lord McColl of Dulwich
My Lords, does not my noble friend agree that to be fair to the British Medical Association, that body agrees with the reduction in the number of hospitals in London, which is hardly surprising because the rest of the country has been asking for this for only 105 years?

§ Baroness Cumberlege
My Lords, I am sure that my noble friend's patience will be rewarded in due course.

§ Lord Molloy
My Lords, does not the noble Baroness agree that the BMA is always willing to work with the department to try to get the best facilities for the vast area of London? Is she prepared to say that there will be no hasty closures of London hospitals? Will the Government also take into consideration homeless people who are in a hospital which might be closed? I am talking about human matters, and I believe the BMA would wish the department to consider these matters in a civilised manner.

§ Baroness Cumberlege
My Lords, although the Government welcome the BMA's stance with regard to London and its future, the BMA did not take a positive stance when it came to consider the reforms. The BMA consistently has opposed the reforms. It was interesting that at its last annual general meeting it supported fund holding for the first time. I believe that in due course the BMA will see the error of its ways and understand that the new measures we are taking will improve healthcare for Londoners.