§ 2.43 p.m.
§ Lord Molloy asked Her Majesty's Government:
§ Whether they have received representations from the staff of Guy's hospital concerning the contribution the hospital can make to the National Health Service as a whole; and whether they will reconsider their decision on the hospital's future.
§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)My Lords, we have received a number of letters from staff at the Guy's and St. Thomas's Trust about the future of those two hospitals. The proposals recently announced by my right honourable friend the Secretary of State are subject to more detailed work and in due course to statutory public consultation.
§ Lord MolloyMy Lords, I thank the Minister for that slightly encouraging reply. I am sure that she is aware that the staff, patients and relatives of patients at Guy's hospital are deeply perturbed. It is a world renowned hospital. Surely the Government understand that it has great service to give to London and to our nation.
§ Baroness CumberlegeMy Lords, there is no need at present for patients or their relatives to be concerned. It will take a long time for the proposals to come about. Therefore, we can guarantee that those patients now being treated will have the best possible treatment available.
§ Lord Boyd-CarpenterMy Lords, does not taking a long time for a decision have an adverse effect on the staff of the hospital? They are left in a state of uncertainty.
§ Baroness CumberlegeMy Lords, I agree. Uncertainty is most damaging for any organisation or institution. We have taken a decision in terms of the proposals that we want to put forward. But it is important that the trust works those out in detail. After that we are bound to go out to public consultation.
§ Lord MellishMy Lords, outpatients' clinics at Guy's are famous for their variety and for the large number of patients using them. I wish to ask the Minister two questions. First, when do the Government propose to shut the clinics down? I assume that they are to be shut down. If not, what is all the fuss and ado about? Secondly, can we have an indication of the time span?
§ Baroness CumberlegeMy Lords, there is no question at the moment that the outpatient department 1334 should be closed. The proposals are for continuing care in Guy's hospital, but it will be different care in future. We see it being much more based on community services, and on day services and high-tech day surgery. I have forgotten the second part of the question.
§ Lord MellishWhen will the transfer to St. Thomas's take place?
§ Baroness CumberlegeThat will depend on the business case that is being drawn up by the trust. We have asked the trust to be expedient so that we can receive its proposals as soon as possible.
§ Lord HayhoeMy Lords, perhaps I may declare an interest as chairman of the Guy's and St. Thomas's Trust. While recognising the great strength of feeling among those on the site of Guy's about the Secretary of State's decision, does the Minister agree that the right way forward now is for all concerned on both sites to work constructively together so that these two great institutions have a great future? That is certainly possible provided that the funding comes forward for the capital expenditure necessary for both medical and educational work on both sites. Those combined hospitals will continue to provide patient care of the highest quality as well as being an institution of excellence so far as concerns medical teaching and research.
§ Baroness CumberlegeMy Lords, my noble friend is absolutely right. I am grateful to him for the work that he does chairing the trust board. I know that the Secretary of State and her Ministers have great confidence in the trust. My noble friend is right that those two very noble institutions will continue, albeit in a slightly different form.
§ Lord EnnalsMy Lords, perhaps I may—
§ Lord MarshMy Lords—
§ Lord MarshMy Lords, I thank noble Lords for the vote of confidence. Given the very high passions which exist in both hospitals on the issue, does the Minister agree that it is inconceivable that any government will achieve agreement? It is therefore absolutely crucial that the Government declare a clear policy, stick to it and get on with it.
§ Baroness CumberlegeMy Lords, yes. The noble Lord is quite correct. We see the new Guy's hospital as a place that offers a unique opportunity to build on considerable academic and research strengths. By bringing together the King's College London and the United Medical and Dental Schools on a single campus we will create a powerful centre for medical education and academic excellence.
§ Lord EnnalsMy Lords, the recently published research by Professor Brian Jarman—until now he has always been regarded as an authority—states that far from being over-bedded, London is under-bedded. Therefore, has not the main argument of the Secretary of 1335 State and the Minister from the Front Bench now been totally undermined? Is it not absolutely vital that the whole issue should be carefully reconsidered?
§ Baroness CumberlegeMy Lords, no. We have to go forward. It is important that these longstanding issues are grasped. Indeed, we know that for over 30 or 40 years there have been problems in London. We cannot see London simply squeezed of money. We need to build up the plan.
I turn to the Jarman research that has been carried out. Professer Jarman agrees that hospital provision needs to shift from inner to outer London and the shire counties and that care needs to shift from hospital to the community. Professor Jarman's research was based on all beds in the whole of London. The research that we carried out was on acute services in inner London. So there was a different basis for the two parts of the research. Professor Jarman gave evidence to the Tomlinson inquiry. We respect the work that he has done and understand that he feels that there should be more provision for the mentally ill and for those needing long term care. So do we. But those beds are not suitable in high-tech hospitals. We need to see them in a different kind of provision altogether. That is what we are aiming for.
§ Lord Cledwyn of PenrhosMy Lords, does the noble Baroness accept the figures produced by Professor Jannan and published in a number of newspapers recently? They show that there are fewer beds pro rata in London than in the rest of the country.
§ Baroness CumberlegeNo, my Lords, we do not accept all those f gures. Professor Jarman says that in some instances—and it depends which beds we are looking at, whether they are acute or long-stay beds—that is not the situation.
§ The Countess of MarMy Lords, can the noble Baroness say what are the proposals for the National Poisons Unit which is at present based at Guy's hospital? If it is to be moved to the St. Thomas's site, will she ensure that the unit has its own laboratories in which to work, rather than a joint laboratory? It does specialised work which is extremely valuable in different kinds of poisonings.
§ Baroness CumberlegeMy Lords, that will be a matter for the trust board when it builds up its business plan.
§ Baroness Jay of PaddingtonMy Lords, my noble friend Lord Molloy rightly drew attention to the anxieties of patients and staff. Is the Minister aware that as well as Professor Jarman's comments on the situation, the South East Thames Health Authority, which covers both Guy's and St. Thomas's hospitals, recently said in its current five-year strategy that,
the current level of hospital activity [in our area] should not change significantly over the next five years"?Are the Government not prepared to accept that local advice?
§ Baroness CumberlegeMy Lords, the future of London has to take into account the changes in 1336 population needs, medical practice and also rising costs. There is an extremely good letter from my noble friend Lord Jenkin of Roding in The Times today to which I wish to draw noble Lords' attention. It sets out extremely succinctly the case for change.
§ Lord ColwynMy Lords, my noble friend briefly mentioned the dental school. Will she give an assurance that in view of the excellent undergraduate and postgraduate training for dental students at Guy's, its future will be assured?
§ Baroness CumberlegeMy Lords, I can give that assurance.
§ Lord MolloyMy Lords, does the Minister agree that there is unity on almost all sides of the House that this great hospital should in no way be done away with? Would it therefore be possible for the noble Baroness to meet representatives of all staff and also of patients and then report to the House? Then, when the decision is made, it will be a truly British democratic decision.
§ Baroness CumberlegeMy Lords, there is no question of either of the hospitals being closed. As my noble friend Lord Hayhoe, the chairman of the trust board, said, those institutions will continue but in a different form. It is appropriate that staff should meet the board and I believe that much discussion has taken place. They also have an opportunity to meet with the chairman of the London Implementation Group, Sir Tim Chessells. I believe he is going out of his way to meet some of them.
§ Lord MonkswellMy Lords, I wish to ask how the Government can justify statements of their policy being written in the newspaper by someone who is not even a member of the Government rather than it coming from the Government's Front Bench?
§ Baroness CumberlegeMy Lords, I would go through the letter in detail but I do not think it appropriate to do so at this time and in this place. It is just information which I thought your Lordships might value.