HL Deb 20 April 1999 vol 599 cc1015-7

2.43 p.m.

Lord Peyton of Yeovil asked Her Majesty's Government:

When the expert advisory group is expected to report to the Hillingdon Health Authority concerning the future of the plastic surgery and burns unit at Mount Vernon Hospital; and whether the Government expect to be consulted about the decision.

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

My Lords, the expert advisory group will provide its interim report to the Hillingdon Health Authority on 22nd April 1999, prior to making its final recommendations in May. Depending on the health authority's proposal arising from the recommendations of the expert group, further public consultation may be required. If the local community health council contests the health authority's proposal, the matter will be referred to health Ministers to determine.

Lord Peyton of Yeovil

My Lords, I am grateful to the Minister for that Answer. I should like to say how much I appreciate the courtesy and sympathy with which she received representations on this matter. I am most grateful to her.

However, is the noble Baroness aware of the continuing anxiety caused by the very long time it has taken to reach a decision? I hope that she will bear in mind that this charity's income from charitable sources has been very much damaged in this period.

Baroness Hayman

Yes, my Lords, I certainly shall. I recognise the contribution that the Restoration of Appearance and Function Trust (RAFT) has made to services on the Mount Vernon site. I know that there is impatience to have some certainty here, but there is also impatience to achieve the right answer and to keep the team which has done such sterling work together. I hope that we shall have some clarity after the final report in May.

Lord Clement-Jones

My Lords, is the Minister aware of the considerable local concern about the lack of independence of the expert advisory group and the fact that it did not necessarily consider all the options in a proper fashion? Is the noble Baroness also aware that some 80,000 signatures have been raised in a petition to save Mount Vernon and its burns unit? Would she or her ministerial colleagues be prepared to meet representatives of the local community and to have their concerns expressed directly to her?

Baroness Hayman

My Lords, I am very aware of the concerns, as are my ministerial colleagues. They have been raised in another place and on other occasions by the noble Lord, Lord Peyton, in your Lordships' House.

The expert advisory group consists of 25 members including local clinicians, service users and lay representatives. Expert advice is provided externally by representatives from professional and research bodies including the Royal College of Paediatrics and Child Health, and the Royal Colleges of Surgeons, of Anaesthetists, and of Nursing, as well as the British Burn Association. The breadth of membership should give some confidence locally that all the issues are being properly addressed. It is because we need to review carefully and make the right decision that it has taken a long period of time.

As I said earlier, if the CHC challenges the final proposal by the health authority, health Ministers will have to determine on that issue.

Lord Tebbit

My Lords, is the Minister aware that there are two aspects to this problem? The first is the anxiety about the possibly excessive concentration of the burns service over such a large area of the south of England which will cause problems were, for any reason such as accident or infection, the one remaining unit which will serve this huge area to go out of service.

Secondly, is the noble Baroness aware of the progressive increase of concern among the team of specialists and researchers about where they will live, and where their children will go to school, if the service is broken up and if it is not possible for them to continue their work at Mount Vernon? That is resulting already in a progressive disintegration of the ability of the charity to provide funds for the work which has been done at Mount Vernon which is of such importance.

Baroness Hayman

Yes, my Lords, I recognise the issues that the noble Lord, Lord Tebbit, raises. There is a range of options as to the eventual location of the services, including Mount Vernon itself. Other options involve not necessarily concentrating services at an existing site. The review of national burns care, which is being undertaken by the British Burn Association, will help us to determine the right catchment area and access to those specialised services.

However, I recognise what the noble Lord says about the importance of keeping that team together wherever it is located. The further the distance that any potential move involves, the more difficult that may be. Together with issues about the right support services, the specialist imaging and the paediatric services, those factors are being taken into account by the advisory group.

Earl Howe

My Lords, is the Minister aware that alongside the review to which my noble friend has rightly drawn attention there are three other reviews into specialist services in north-west London? They relate respectively to cancer, cardiothoracic care and orthopaedics. Can the noble Baroness confirm that despite the close connection between all four of those clinical disciplines, the reviews are being conducted in complete isolation from one another? Does she agree that if that is true it is a ridiculous state of affairs?

Baroness Hayman

My Lords, one must balance having the right kind of specialist expertise in reviews of specialist services against taking an overall strategic view of major centres. One cannot look at, for example, cancer services without looking at Calman-Hine and the implications of its national implementation. It is the responsibility of the regional office to ensure that when exercises are run in parallel, there is proper integration of thinking so that the consequences of recommendations for other services are taken into account. It is difficult, but it is right provided that the co-ordination is correct. That must be the job of the regional office.