St. Bartholomew's Hospital: Future (Hansard, 13 February 1995)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, Ministers have received a number of representations from professional staff at St. Bartholomew's Hospital. My honourable friend the Minister for Health has visited the hospital and met staff there recently.
434 The Royal Hospitals Trust—of which St. Bartholomew's is a part—has drawn up plans for the future organisation of services across its sites. East London and the City Health Authority is currently conducting public consultation on those proposals.

§ Lord Molloy
My Lords, I am grateful to the Minister for that comprehensive reply. Is she aware of Professor Jarman's report which states that the number of people now waiting for treatment in hospitals is increasing, and that, in particular, the accident rates are increasing? On its first visit, the King's Fund Commission recommended that St. Bartholomew's should be closed. It was then called back to make a second more thorough investigation and it said that its first decision was wrong and that St. Bartholomew's should in no way be removed.

§ Baroness Cumberlege
My Lords, with regard to Professor Jarman's proposals, although the number of people waiting in London has increased, the time it takes to treat them is decreasing and progress has been considerable.
As regards the King's Fund Commission, I am interested that it should have reviewed its findings, but some members of the original commission still feel that the original findings were correct.

§ Baroness Gardner of Parkes
My Lords, will my noble friend inform me of the position regarding the Homerton Hospital? Is it a fact that the population has largely moved away from the St. Bartholomew's area towards Homerton? I understand that the two hospitals have always worked together. Is the Homerton Hospital now taking a great load of the work which would previously have been done at Bart's?

§ Baroness Cumberlege
Yes, my Lords, the Homerton is certainly taking some of the accident and emergency cases. However, the Royal London Hospital, which is twinned with St. Bartholomew's, will take most of the specialist services in the future.

§ Baroness Jay of Paddington
My Lords, what is the Minister's response to the report published last week by the inner London health authority chief executives, called Hospital services for Londoners? The report states that people in inner London are using NHS beds at a 17 per cent. higher rate than was previously expected. Does the Minister agree with the report's conclusions that: London's … hospitals are operating under very considerable pressure"?

§ Baroness Cumberlege
My Lords, in the report the chief executives of inner London reinforced the direction the Government are taking. They said that we should invest in primary care; that we should strengthen specialist services by concentrating expertise and patient numbers in fewer, larger centres; that we should bolster medical research in education by bringing undergraduate and postgraduate teaching together; that we should find better ways of providing care and treatment for elderly people in their own homes and neighbourhoods; and that we should provide the general 435 hospital services which we need for routine medical and surgical treatment as close as possible to where people live.

§ Lord Strabolgi
My Lords, what is the noble Baroness doing about the shortage of emergency beds which is now reaching a dangerous level?

§ Baroness Cumberlege
My Lords, we are expanding considerably the number of emergency beds at the Royal London Hospital. In fact, we are investing £3 million in that in the current year; at the Homerton an extra £2 million; and at UCL £800,000.

§ Baroness Jay of Paddington
My Lords, I thank the Minister for her original reply to my question. But can she please respond to the point that I made about chief executives saying that it seemed that Londoners were using NHS beds at a 17 per cent. higher rate than had been expected? Does that not suggest that bed closures have been premature?

§ Baroness Cumberlege
No, my Lords. The chief executives were quite firm in saying that with the proposals that I have just outlined to the noble Baroness, there would be less need for inappropriate use of hospital beds in London.

§ Lord Molloy
My Lords, does the Minister agree that St. Bart's is famous throughout this country and the Commonwealth, not because of the building but because of the remarkable staff who work there? It appears that they will now lose their jobs and that is a great shame. Would the Minister be prepared to consider meeting a small delegation from the remarkable staff of a remarkable hospital to listen to their case?

§ Baroness Cumberlege
My Lords, I appreciate the very strong emotional feelings as regards this hospital, and I am grateful for the noble Lord's comments about buildings. With regard to the expertise of the people who work there, the London Implementation Group has already set up an agency to help staff find new posts. But I am very confident that with the skills and expertise of the people who are involved, the vast majority will continue to work in the National Health Service, and many of them in London.

§ Lord Dean of Beswick
My Lords, can the Minister give an assurance that, whatever the final outcome of the changes in this area, they will result in a better service for the people who live there?

§ Baroness Cumberlege
Yes, my Lords.

§ Lord Annan
My Lords, is the Minister aware that in 1968 the noble Lord, Lord Todd, reported that there should be an amalgamation of the medical schools of St. Bartholomew's and the London? Is she further aware that in 1980 a similar report by the noble Lord, Lord Flowers, recommended exactly the same thing? Since then there have been a multitude of reports, some initiated by members of the medical profession and some by the Minister's department; all of them pointed inescapably to the fact that St. Bartholomew's must recognise that some change in its status is bound to take place. Is it not a fact that when the forcible 436 amalgamation took place of regiments in the. Army, after the initial dismay the amalgamations were conducted with great expertise and with a good effect on morale?

§ Baroness Cumberlege
My Lords, the noble Lord, Lord Annan, is correct in every word that he says. Countless reports have said that there should be changes in London. With the changing needs of populations; with different aspirations; with clinical practice changing; with developments in science, technology and medical education; and with rising costs, we simply cannot freeze all the London services into a time warp. That would be totally wrong. We have to produce a better service for London. These changes will ensure that that happens.