St. Bartholomew's Hospital (Hansard, 26 February 1996)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, my right honourable friend the Secretary of State for Health has met a number of individuals and groups in recent months and has listened carefully to their views and concerns about the future of St. Bartholomew's Hospital. He has made clear that he will not be re-opening decisions, announced in April 1995, on the provision of hospital services in east London.

§ Lord Molloy
My Lords, I thank the Minister for that Answer. Has a response been submitted to the report of the King's Fund Institute, which stated, "Keep Bart's open"? It also stated that, in addition, two smaller specialist units should be created near that great hospital which would be for the benefit not merely of Londoners but all the citizens of our country.

§ Baroness Cumberlege
My Lords, the Secretary of State has met a number of groups recently. All have drawn his attention to the recommendations of the King's Fund Report on the future of the Bart's site. We have serious reservations about the report. It does not look at the wider context of population needs in east London. It starts from the premise, "Here we have a site. What can we put on it'?". It does not take into account the other services which are provided at University College Hospital, London, the Royal London and the Guy's and St. Thomas's sites. It does not even take into account the fact that medical schools have merged. The report itself states that it has not fully costed all the options. Indeed, it endorses many of the conclusions of the Royal Hospitals Trust's own business case for change.

§ Lord Boyd-Carpenter
My Lords, is my noble friend aware that many of us would regard it as tragic if this famous ancient and historic hospital were to be closed and can see no justification whatever for doing so? Will the Government reconsider the matter?

§ Baroness Cumberlege
My Lords, it is people, rather than buildings, who contribute towards the special ethos mentioned by my noble friend. For years and years—indeed for centuries—people have looked at the health needs of Londoners. We know that they are not being met by the present state of the hospitals; by the way that they were planned haphazardly—indeed, hardly planned at all. Therefore, there is no question of revisiting these decisions. I am absolutely convinced that by bringing together the two great hospitals—the Royal London and St. Bartholomew's—we shall have a much stronger 1222 health service for east Londoners. Already, as a result of the merger, the cardiac unit is being enormously strengthened.

§ Baroness Gardner of Parkes
My Lords, will my noble friend comment on the plan to open an 8 a.m. to 8 p.m. service at the hospital, which will cover the period when most commuters might require medical attention in the City of London'?

§ Baroness Cumberlege
My Lords, a minor injuries unit has already been established at St. Bartholomew's Hospital. I visited it on Friday and saw that it was being very well used. It is meeting the need that we thought it would. Of course, there are accident and emergency departments within a two-mile radius of the previous catchment area.

§ Baroness Jeger
My Lords, why does the Minister refer to local needs as regards Bart's, as though it were a village cottage hospital? Is she not aware that when one visits Bart's one finds patients not only from all over this country but from other countries too and that it has a representation far beyond Shoreditch and Mile End? Has that been taken into sufficient account?

§ Baroness Cumberlege
My Lords, yes, it has. No capital in the world can sustain I I teaching hospitals within a six-mile radius. We have been most anxious that the United Kingdom should retain its reputation as a centre of excellence in medical education, treatment and services. We know that if one fractures the services and has specialties in so many different places—13 cancer units, 14 cardiac units and so forth—one cannot retain the essential excellence that is required and is achieved by bringing the various specialties together. It is because we care about the leading position that this country has in the world, and because we care about the people of London, that we have had to take some very hard decisions.

§ Lord Kennet
My Lords, I believe that the Minister took the King's Fund Report to task for not having asked the question, "Here is a site. What shall we put on it?". Would not the more apposite question have been, "Here is a site with something on it, which is well known to be useful and splendid. Why should we move it?"?

§ Baroness Cumberlege
My Lords, we are convinced that, in order to strengthen services in London, we must bring them together. We must concentrate the expertise that exists. Bart's is a splendid building. We all recognise that and that is why my right honourable friend has set up a task force, chaired by Sir Ronald Grierson, to look at the site and to consider what can be made of the buildings. However, we are absolutely convinced that we should not start with buildings but with the expertise of the people who provide a service and then see how we can build upon that.

§ Lord Elton
My Lords, does my noble friend realise that she is widely supported in her premise that, with a fall in population in the capital, there must be a reorganisation of resources? The prime concern must be 1223 the service given to the citizens of this metropolis and that can best be done by manoeuvring the human and technological resources and not being pinned within ancient buildings?

§ Baroness Cumberlege
My Lords, I am grateful to my noble friend for that comment. He is absolutely right. It is not only the fall in population that affects London but the fact that superb services are now provided in all parts of the country. That is London's success. It is a result of the fact that people who were trained and set up departments in the famous London teaching hospitals have moved to other parts of the country. All over the country—for instance, in Sheffield, Liverpool, Leeds, and Exeter—better services are being provided locally, with shorter stays in hospital and better primary care. We must concentrate our services in London on better primary care.

§ Baroness Jay of Paddington
My Lords, is the Minister aware that, in spite of the excellent performance of the emergency services, there is concern about the absence of a local accident and emergency department at Bart's in the City of London following the recent bomb outrages? Is it possible that the Government could look again at that matter? The Government were warned about the consequences of closing the casualty department at Bart's at a time of high security risk in the City.

§ Baroness Cumberlege
My Lords, we have put an incredible amount of investment into accident and emergency departments of local hospitals; for example, Mayday, Lewisham, King's College, Queen Mary's Hospital, Sidcup, and Greenwich Healthcare. That is proving to be successful. Nobody could criticise the way in which the recent Docklands bombing was dealt with. Indeed, when I visited the Royal London I was told that it could have dealt with three times the number of emergencies without any trouble at all. I believe that we have overcome the greatest difficulties in relation to accident and emergency departments and, indeed, the situation in London is now improving.

§ Lord Stallard
My Lords, in her first reply, the Minister mentioned the services being supplied by University College Hospital. Is it not a fact that the main building of that hospital has been lying idle and empty for months and months now and that no services are provided there?

§ Baroness Cumberlege
My Lords, we are strengthening certain parts of that hospital. We are linking it much more to the university. It is a centre of academic excellence. But we shall see empty buildings in London and, indeed, we are also seeing new buildings in London. That is all part of the major change that is so necessary.

§ Lord Molloy
My Lords, I am grateful to the noble Baroness for the magnificent and well deserved tributes that she has paid to St. Bartholomew's Hospital. It is difficult therefore to understand why she wishes to abolish it. Will the Minister consider holding a meeting with the senior staff, who would love to have an hour 1224 with her to explain the situation at Bart's; the possible creation of two new hospitals; and the fact that that would boost the morale of health service staff not only in London but throughout our beloved country?

§ Baroness Cumberlege
My Lords, we are not abolishing Bart's. We are merging it with the Royal London Hospital. Its expertise will be strengthened. As regards senior staff at Bart's, it is interesting that we are now able to recruit staff to the new merged trust. Cardiac anaesthetists are as rare as hens' teeth but we have been able to fill three vacancies in the last year. The senior staff almost live at the Secretary of State's door.