The Royal Marsden Hospital (Hansard, 14 June 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, Ministers are currently considering independent advice from the team reviewing specialist cancer services in London. They will also shortly receive independent advice about research at the Royal Marsden Hospital. These reviews will help to inform decisions about the future pattern of cancer services in London.

§ Lord Boyd-Carpenter
My Lords, I thank my noble friend for that somewhat imprecise reply. Is she aware that the proposal—first put forward a short time ago and dropped, and now apparently revived—to demolish this world famous hospital, with its wonderful premises and high standards, would be regarded as an outrage by a great many people, who would never forgive a Secretary of State who destroyed it?

§ Baroness Cumberlege
My Lords, I regret being imprecise; but I fear that I shall have to continue to be so. Until the reviews have reported, it is impossible for the Government to reach a decision.

§ Lord Donaldson of Kingsbridge
My Lords, as the only Peer in the House today (as I hope) whose wife is at the moment in this splendid hospital, is the Minister aware that, for once—and it is unusual for me—I fully support what the noble Lord, Lord Boyd-Carpenter, said?

§ Baroness Cumberlege
My Lords, I am aware of the superb work that is carried out at this hospital in terms of the service that it provides; and I know that its research too has in the past been outstanding.

Viscount Tonypandy
My Lords, is the Minister aware that the Royal Marsden, where I myself was treated (and I therefore declare a very grateful interest) has a collection of accumulated experience and wisdom in dealing with cancer such as is the envy of the world? Is she also aware that people are sent there from the four corners of the world? Ought she not to hurry up and be precise?

§ Baroness Cumberlege
My Lords, I accept that advice from the noble Viscount.

§ Lord Mellish
My Lords, will the noble Baroness clearly understand that some of these hospitals, 1212 including the Royal Marsden, are held back because of lack of decision? Does she agree that that is a very worrying thing? Is she aware that, for example, I have £1.5 million to give away, but to Guy's only, which cannot take it because of the Government's threat of the merger of Guy's with St. Thomas's? For goodness sake, can we have a decision soon one way or the other about the Royal Marsden, Guy's and the rest (I do not quarrel with all that has been said) so that I can give this money back?

§ Baroness Cumberlege
My Lords, I am very aware of the planning blight that exists while these reviews take place. But the situation in London is extremely complex. It would be dilatory of the Government not to study this matter with due care. We have been anxious to employ people from outside London in order to give an unbiased view, both of the research that is carried out in London and also of its services. The intention is that the specialty reviews should report towards the end of this month and the research reviews at the beginning of next month. The final proposals will be presented to Ministers in the autumn.

§ Lord Peyton of Yeovil
My Lords, will the Minister bear in mind that the revival of an ill-starred proposal such as this, once it has been rejected, or seems to have been rejected, by Ministers causes very widespread dismay indeed? Will she remind herself of what she said previously on this subject?

§ Baroness Cumberlege
My Lords, I agree with my noble friend that uncertainty is very damaging, and so is indecision. Unfortunately I cannot, however, prevent speculators from speculating. In this case the Government have reached no decision and they will not do so until they have the result of the two reviews.

§ Baroness Jeger
My Lords, does the Minister agree (almost alone in the whole world) with Tomlinson's description of the Royal Marsden in paragraph 136 as an "isolated and vulnerable" institution? To what is it vulnerable? In my view, it is vulnerable only to the predations of this Government. Are the Government unaware of the pioneering work at the Royal Marsden, which cannot in any way be described as isolated? Has the Minister taken sufficient notice not only of the high level of research and treatment, but of the very important training, which many people in this Chamber must have experienced, of specialist cancer nurses, including the Macmillan nurses, who do so much work at home for the terminally ill? As for isolation, is the noble Baroness aware that it was in the Royal Marsden that the European Oncology Nursing Society was set up and that it is flourishing? If that is isolation and vulnerability, have I misunderstood those terms?

§ Baroness Cumberlege
My Lords, I am not sure what was in Sir Bernard Tomlinson's mind when he wrote that particular sentence. There are 13 cancer units in London. They are isolated in terms of being fragmented. It is important when one is a world leader, and indeed an international leader in terms of research, that units are big enough to sustain the 1213 quality of the research that is required in competition. With regard to the skills and expertise that are incorporated not only in the Royal Marsden Hospital but in other London teaching hospitals, the Government certainly want to maintain, enhance and preserve that expertise regardless of the building in which it is housed.

§ Lord Strabolgi
My Lords, are the Government aware that £25 million has been raised in charitable donations for the Royal Marsden and that has been used to build a new clinical block with four new operating theatres and four new wards, including a radiotherapy unit? Are they further aware that the wards for the radiotherapy unit must have concrete walls which are three feet thick? How can that unit possibly be moved to a flimsily built tower block such as the Charing Cross Hospital?

§ Baroness Cumberlege
My Lords, the noble Lord is reaching conclusions that have not yet been made. As I said before, we have to wait for the results of the specialty and the research reviews. I am very much aware of the generosity of the people of London and far beyond in giving money to the National Health Service and in particular to the Royal Marsden Hospital.

§ Lord McGregor of Durris
My Lords, is the Minister aware that the blight to which she referred is not merely a planning blight but one which afflicts the lives and work of the staff in such institutions, whose work and attitudes are wholly disoriented by uncertainty? Will she accept that I know such matters directly, not from the Royal Marsden but from the situation at Bart's?

§ Baroness Cumberlege
My Lords, that is absolutely true. That is why the Government are anxious to come to a conclusion as soon as possible. But I should like to stress to the House that this issue has been outstanding for many decades; indeed, some would say for centuries. It is important that the Government get things right and that they reach their decisions on the best information that they can glean. That is what we seek to do at the moment: to get that information.

The Earl of Halsbury
My Lords, in the event of the Royal Marsden being liquidated, what plans are there for the future of the Institute of Cancer Research? That is an entirely independent organisation which is nevertheless sited alongside the Marsden and which can act as a focus of concentration for clinical material of relevance to its current research.

§ Baroness Cumberlege
My Lords, it is those and other issues that the research reviews will take into account.

§ Lord Carter
My Lords, is the Minister aware that Professor Tomlinson made it clear that costing was not part of his brief and that he had to rely on the health authority figures? Does she agree that it is now known that Ernst and Young have produced figures showing that the cost of closure of the Royal Marsden will be much greater than the figures given in 1214 Tomlinson? Whose figures do the Government intend to rely on when they make their decision regarding the future of that great hospital?

§ Baroness Cumberlege
My Lords, the London Implementation Group, the management executive and indeed the Royal Marsden Hospital itself will all be party to the proposals that will be put forward to the Government. At that time the figures, the working and the thinking informing those figures will be revealed to your Lordships.

The Earl of Selkirk
My Lords, is my noble friend aware of the very great local support for that hospital, which admirably reflects the regard in which it is held and the quality of service that it supplies to the general public, certainly in that part of London and elsewhere?

§ Baroness Cumberlege
My Lords, I am aware of that and also of the support that the Royal Marsden receives for its bigger branch, which is in Sutton, Surrey.

Lord Bruce of Donington
My Lords, when the noble Baroness reflects on this matter, as she must do, will she bear in mind when considering the whole question of value for money, which appears to be a dominant consideration, that it is highly probable that the value to the nation of the Royal Marsden is much greater than that of her own headquarters at Richmond House, 79 Whitehall?

§ Baroness Cumberlege
My Lords, at Richmond House we make no pretence of treating patients.

§ Lord Sharp of Grimsdyke
My Lords, is my noble friend the Minister aware that there is not a single consultant with long-term personal knowledge and experience of London's cancer needs either on or advising the specialty committee which is reviewing cancer needs in London? Is she further aware that such deliberate omission causes Londoners to view any recommendations with alarm and suspicion?

§ Baroness Cumberlege
My Lords, as I have already stated, there are 13 cancer units in London. When an independent inquiry takes place, I think it correct that the Government should put on that inquiry people who are independent of London, who have no axe to grind, who are experts in their own field and who will come to an unbiased decision.