HL Deb 06 July 1998 vol 591 cc957-8

3 p.m.

Baroness Castle of Blackburn asked Her Majesty's Government:

What steps are being taken to protect the role of community hospitals in the National Health Service.

The Minister of State, Department of Health (Baroness Jay of Paddington)

My Lords, in our White Paper The New NHS we set out the important role community hospitals can play in providing locally based services. As I am sure my noble friend is aware, within this broad framework, individual health authorities are responsible for determining the appropriate balance of care for their populations. But any local decision to change community hospitals—those which might be referred to the Secretary of State—will be upheld by my right honourable friend only if he is convinced that resources could be used differently to improve services for patients.

Baroness Castle of Blackburn

I appreciate that reassurance. But is the Minister aware of the growing national concern at the increasing tendency of local health authorities to consider, in their desperate search for economies, that community hospitals are expendable? Is she aware, for example, that Watlington Hospital in the rural area in which I live is now threatened with closure as part of an attempt to raise £1.5 million worth of cuts? Would it not be a tragedy if this Government, who believe so strongly in making community care more worth while and more humane, were to allow this vital element of local community care, which is so helpful, particularly to the elderly, just to be swept aside in the overall rush for competing claims?

Baroness Jay of Paddington

My Lords, I very much appreciate what my noble friend said about the Government's intention to improve community services. That is indeed the case. However, I would challenge her view that this is a widespread change which is happening throughout the health service. In fact, at the moment, only four possible community hospital closures have been referred to my right honourable friend the Secretary of State—all four of those are in Cornwall—and he is now in very detailed discussion with the regional health authority responsible to try to achieve a solution which does not involve closing all those hospitals. As far as concerns the Oxfordshire situation, I would suggest to my noble friend that that health authority has recently received a great deal of money which should help it to address the problems to which she referred. For example, it received £3.4 million more than any other authority in that region to combat so-called winter pressures, and £554,000 has recently gone to community rehabilitation services and £2.1 million in general to community schemes.

Baroness Gardner of Parkes

My Lords, does the Minister agree that many community hospitals and cottage hospitals can provide a useful local service and also respite care? Is she aware that in some areas of the country, such as Essex, these hospitals have been taken over by groups of general practitioners? They are used for local people and take pressure off the major hospitals.

Baroness Jay of Paddington

Yes, my Lords. I very much agree with the noble Baroness that there have been several imaginative schemes to keep open these services in different localities. The point is that there can be no national blueprint for this kind of service because in some places a traditional community cottage hospital may be the most appropriate way of spending local resources but in others community-based nursing services may offer the same services in a more appropriate way.

Lord Jenkins of Putney

My Lords, can my noble friend say whether her right honourable friend has consented to the closure of Putney Hospital? Does that not rate as a community hospital?

Baroness Jay of Paddington

My Lords, I believe that decision is still under consideration. It is difficult to define community hospitals; but within the terms of the discussion this afternoon, that would not come within that category.

Baroness Masham of Ilton

My Lords, does the Minister agree with the new emphasis on primary health care? But is it not difficult for general practitioners to look after their patients if they do not have facilities to do that? Does she further agree that there is tremendous support from local people for community hospitals?

Baroness Jay of Paddington

My Lords, there is always support for services which people feel are those which serve the local community well. However, I would suggest to the noble Baroness that there are new ways of offering that kind of direct care which may be attractive to people in different parts of the country. For example, my right honourable friend the Secretary of State yesterday announced that we were extending the NHS Direct service, which is the 24-hour nurse-led helpline, so that it now covers 10 million people in the country. That may be one of the ways in which, imaginatively, we can improve these services in the future.

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