HL Deb 27 March 1995 vol 562 cc1402-5

2.51 p.m.

Lord Walton of Detchant asked Her Majesty's Government:

Why the application for trust status submitted by the National Hospital for Neurology and Neurosurgery has been rejected and whether, in the light of the concern that this decision has caused in the national and international neurological community, they will reconsider the question.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege:)

My Lords, we believe that the National Hospital will benefit from trust status but, after careful consideration, my right honourable friend the Secretary of State has decided that the hospital's interests will be best served by joining with another hospital that is equally committed to research and teaching, rather than operating independently.

Lord Walton of Detchant

My Lords, in thanking the Minister for that reply, I first declare an interest as the current president of the World Federation of Neurology—a federation of some 75 neurological associations across the world. Does the Minister agree that this hospital has an exceptionally proud record of patient care and service to the community; that it is at the moment financially viable; and that its associated institute of neurology has obtained one of the highest ratings in the HEFC national assessment exercise for the quality of its research? Can we be assured that if it were to merge with another hospital to form a trust its identity would be confirmed?

Baroness Cumberlege

My Lords, I am very pleased to be able to agree with the president of the world federation of neurological associations and I congratulate him on that very distinguished position. This particular hospital and its institute have a very proud record. The hospital is, we believe, of world standing but we do not believe that its future is necessarily viable. That is why we are looking ahead. If it joins a trust—as we are recommending it should—with another hospital, we would want to keep the excellence and the worldwide reputation and expertise embodied in Queens Square.

Baroness Jay of Paddington

My Lords, the noble Lord, Lord Walton, rightly refers to the concern in the international neurological community about a possible merger. Is the Minister also aware of the great concern felt in the National Health Service because of the potential threat to the number of intensive care beds in this specialty which may be threatened by the merger? Have the Government taken into consideration the cases of, for example, the patient who had to be flown from the south of England to Leeds for intensive care, and of the surgeon—a matter raised in your Lordships' House by the noble Lord, Lord Smith—who unfortunately died as a result of a lack of beds? Have the Government considered these service concerns when considering the merger?

Baroness Cumberlege

My Lords, we have considered all these aspects; indeed, we commissioned an independent inquiry, a review of neuro-sciences within the London area. The review was undertaken by some very distinguished consultants and professors in neuro-sciences. Their verdict was unequivocal. They said that the historical pattern of service provision is not fully geared to meet current population needs. Changes in demography mean that service sitings are no longer relevant as we move into the 21st century. As to the expertise in tertiary neuro-sciences centres such as that at Queens Square, the review recommended that such centres should be sited within a multi-specialty general teaching hospital and should have formal research and training links with medical schools and higher education institutes. We have accepted those recommendations, but we have suggested to the National Hospital that it should choose its partner rather than be pushed into a gunshot wedding.

Lord Peyton of Yeovil

My Lords, is my noble friend aware that her answer is reassuring in referring specifically to the excellence of this hospital? I hope that I can ask her now to redouble the assurance. Is she quite confident that the excellence of this institution will not be diluted by being spread?

Baroness Cumberlege

My Lords, it is our intention not only to protect and maintain the expertise within this hospital and within the institute, but also to promote its excellence. We believe it is a remarkable institution and we want to see it strengthened.

Lord Stallard

My Lords, can the noble Baroness say which other hospital she has in mind for the merger?

Baroness Cumberlege

My Lords, it really is up to the National to choose its partner. Clearly, it is considering a number of options. As the institute is already looking at University College London, perhaps that may influence its final decision. But the choice is the National's.

Baroness Masham of Ilton

My Lords, will the decision be made quickly? As the Minister knows, committee meetings and consultations take doctors away from patients. Is she aware that some patients are suffering from long waiting times in that hospital?

Baroness Cumberlege

My Lords, we have the support of both the chairman and the medical director of the National Hospital. They are preparing to bring forward a recommendation next month.

Lord Dean of Beswick

My Lords, the noble Lord, Lord Walton, says that the hospital is financially viable. The Minister in her reply says that the decision is based on the fact that it may not necessarily be viable in the future. What evidence has the Minister to substantiate that course of action? What proof is there that the hospital will not be viable? It may well be viable if the case is not proved. Have the Government taken any soundings of the highly qualified professional staff who man the hospital as to whether the service may deteriorate if there is a merger with another hospital?

Baroness Cumberlege

My Lords, we always consult with staff whenever there is a proposal. The evidence is that 13 district health authorities who commissioned services have indicated that next year they will reduce work to be done by this hospital. Indeed, the hospital itself is planning to handle up to 15 per cent. less work over the next three years.

Lord Stoddart of Swindon

My Lords, do the Minister's previous answers imply that there will be no reduction in the number of beds for this particular speciality?

Baroness Cumberlege

My Lords, I cannot give that undertaking. It depends what happens in terms not only of the number of contracts that are placed with this hospital but also movements in clinical activity in the way that medical science is changing. Your Lordships will be aware that, because things are done very differently today, over the years we have seen a remarkable decrease in the number of beds as more and more activity takes place on a day case basis.

Lord Walton of Detchant

My Lords, will the Minister accept that there is a major multi-million pound development of a new building going on at the Queens Square site at the moment? If, as she very properly suggests, a merger with another major hospital does take place, may we be assured that the existing site will nevertheless be retained?

Baroness Cumberlege

My Lords, that is really for the trust to decide once it is formed. I am aware that in the National Health Service it is a very dangerous thing to say, "Never, never, ever".