Royal Marsden Hospital (Hansard, 2 November 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, no decisions have yet been made on any major London hospital. In any case, specific proposals will be subject to public consultation. The Royal Marsden, in common with other London hospitals, is currently out to public consultation in support of its application to become an NHS fourth wave trust from April next year.

§ Lord Molloy
My Lords, I thank the Minister for that reply. Does she accept that the Royal Marsden was the first hospital in the world for the exclusive diagnosis and treatment of cancer? Does she further accept that it is a model for a cancer treatment centre, as recommended by the specialty review into London cancer services? Does she agree that this House ought to make certain that the wonderful work that it has begun will continue? Should not the Government relieve the staff of the hospital, which I visited recently, from the serious anxieties that they are suffering because of the threat of closure of this remarkable, wonderful, world-renowned hospital?

§ Baroness Cumberlege
My Lords, I agree with the noble Lord that the Royal Marsden Hospital has a very fine reputation, which is why it seeks to become a fourth wave trust and become independent.

§ Lord Boyd-Carpenter
My Lords, is my noble friend aware that the Royal Marsden is a hospital of worldwide reputation operating in a highly modern, perfectly equipped building? Does she agree that it is a pity to leave it in a state of uncertainty, as the Government have done for some months now?

§ Baroness Cumberlege
My Lords, that uncertainty is now coming to an end since the consultation period on the trust application will end in January. Yes, the Marsden has a worldwide reputation, but very few of the patients treated there come from abroad; 93 per cent. come from the Home Counties.

The Earl of Halsbury
My Lords, can the noble Baroness confirm that the Question wholly misses the point? It is not what happens to the Royal Marsden Hospital but what happens next door, to the Institute of Cancer Research, which is a postgraduate teaching school of London University. Does she agree that the Royal Marsden Hospital acts as a focus of concentration of clinical material for the work conducted in the research department, which was originally part of the hospital and was converted into an independent charitable trust following the institution of the hospital as a member of the National Health Service?

§ Baroness Cumberlege
My Lords, although the Institute for Cancer Research is independent of the Royal Marsden Hospital and is a separate entity, the two have to work very closely together and in some ways are symbiotic.

§ Lord Mellish
My Lords, does the Minister agree that the decision from the Ministry about the London hospitals has been outstanding for many months? Were we not supposed to get a decision in October? It is now 994 November. When will we know the decision? Let me say, by the way, that Guy's is just as good as the Royal Marsden.

§ Baroness Cumberlege
My Lords, the decision was that the Royal Marsden should consult on whether to become a fourth wave trust. The end of the consultation will be in January when a firm decision will be made.

§ Lord Jenkins of Putney
My Lords, is the noble Baroness aware that on the site there is a collection of skills and associated tasks which are quite unique in the world? Does she agree that to split them up in any way would be highly undesirable? Are the Government bearing that fact in mind?

§ Baroness Cumberlege
My Lords, I am aware of it. I visited the Royal Marsden fairly recently. However, your Lordships will appreciate that there is a difference between clinical teams working together and research and the sites on which they are situated. In the future in some cases it may be necessary to change the sites. We should certainly want to preserve the excellence not only of the Royal Marsden but of other clinical research in other London teaching hospitals.

§ Baroness Robson of Kiddington
My Lords, will the Minister tell me something about the second half of the Question, which does not apply purely to the Royal Marsden but to the facilities funded by private and charitable contributions? Is she aware that, with the enormous changes taking place in the health service and many hospitals at the moment under threat of closure, it will become increasingly difficult, as those changes take place over a period of five years, to obtain charitable contributions? Can she give any guarantee to charities? What happens if they fund something in the interim?

§ Baroness Cumberlege
My Lords, I thank the noble Baroness for that question. She has a distinguished reputation as the president of the League of Friends. I know that she has worked unstintingly in raising charitable moneys for the National Health Service. On the general point of principle on what happens to charitable funds if a hospital closes or indeed changes its use, we are seeking the advice of the Charity Commissioners; and I understand that they are seeking legal advice. If a closure or change of use were proposed, it would be up to the trustees and the trust board—who I am sure would want to discuss it with donors who had recently contributed major amounts—to decide the future use of those past donations.

§ Lord Ennals
My Lords, does the Minister agree that it is absurd that such uncertainty still continues? Will she confirm that in February the Secretary of State ruled out the closure of the Marsden? Did she not say that closure made no economic sense and should not be pursued? Further to the point made by the noble Baroness, Lady Robson, can the Minister give an assurance that that money will not find its way into the pocket of the Treasury?

§ Baroness Cumberlege
My Lords, the decision has been made by the Royal Marsden Hospital that it should 995 seek trust status. We are seeking the views of the Charity Commissioners with regard to charitable funds. A lot will depend on the advice we receive from them.

§ Lord Carter
My Lords, does the Minister agree that the whole saga of the Royal Marsden Hospital, and indeed other London hospitals, indicates that the Government must find a solution either through the internal market or through planning? They cannot have both, and at the moment they seem to have neither.

§ Baroness Cumberlege
My Lords, the Royal Marsden Hospital has applied for trust status. If the decision is taken by the Secretary of State that the trust shall be agreed, it will then be up to the hospital to survive in the internal market. Clearly it is important that health authorities and GP fund holders value the work taking place in the hospital and place contracts with it.

§ Lord Molloy
My Lords, further to the question from the Cross-Benches regarding the new addition at the Royal Marsden, is the Minister aware that it cost £25 million, and the majority of that was raised from the charities? If the Government close that hospital people from all over the country will no longer take a chance and contribute freely to our National Health Service hospitals?

§ Baroness Cumberlege
My Lords, at this moment there is no suggestion that the Royal Marsden Hospital should close. The suggestion is to the contrary. It is seeking trust status so that it can continue.

§ Lord Molloy
My Lords, I thank the Minister for that response.