Mount Vernon Hospital Burns and Plastic Surgery Unit (Hansard, 11 January 1999)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hayman)
My Lords, the future of burns and plastics services at Mount Vernon Hospital is to be considered by an expert advisory group commissioned by Hillingdon Health Authority. The establishment of this group follows the public consultations on the future of both specialist and local services at Mount Vernon and Watford Hospitals NHS Trust, undertaken last summer.

§ Lord Peyton of Yeovil
My Lords, I am grateful to the noble Baroness for that Answer. Does she agree that any proposal to relocate a large team of specialist experts who have an excellent regime under their control is almost certainly doomed to failure; that the proposal to cut it in half and put half in that place which should never have been built—the Chelsea and Westminster Hospital—would be sheer vandalism; and that such a proposal and the process of inquiry is extremely discouraging for staff, all grades of which have rejected it, and for possible donors? I speak as a chairman of a charitable trust.

§ Baroness Hayman
My Lords, I certainly acknowledge that the concerns voiced by the noble 2 Lord, Lord Peyton of Yeovil, were expressed also in the public consultations about the proposals put forward in relation to the future of those specialist services. I acknowledge the work carried out in research and education supported by charitable trusts at the Mount Vernon burns unit.
We must recognise also the importance of highly specialised units being located in environments where they can obtain support from all the necessary services. I am thinking in particular of paediatrics. More than half the patients in the burns unit at Mount Vernon are children but there are no paediatric services on site. Therefore, balances must be struck. But the expert advisory group is looking at those issues and is looking in particular at how the expertise which has been built up can be safeguarded.

§ Lord Archer of Sandwell
My Lords, does my noble friend accept that such a unit, as the noble Lord, Lord Peyton, pointed out, depends on a whole range of people doing a number of jobs? Many of them depend upon working close to their homes. If an attempt is made simply to relocate a unit, that will inevitably mean the loss of some of the experience of working together gained over a long period of years.

§ Baroness Hayman
My Lords, I recognise the points that my noble and learned friend makes. However, they must be balanced with the recognition that we need a proper geographical spread of high quality services which are supported by the necessary infrastructure. The expert advisory group has been called in to achieve that balance and it will be wrestling with that problem.

§ Lord Goodhart
My Lords, I echo what has been said already from both sides of the House. Is it not the case that the Chelsea and Westminster is wholly unsuitable for the relocation of that unit? If it must be relocated, it should be relocated no further away than Northwick Park, which is sufficiently close to enable the staff of the unit to be retained as a whole.

§ Baroness Hayman
My Lords, that was a point put forward extremely clearly in the consultation process. 3 There was debate on two issues: first, the necessity of relocation in the first place; and, secondly, as regards the relocation site were it to go forward. It was clear that the preferred option of the health authority for Chelsea and Westminster was challenged within the consultation process. As I understand it, that is one of the reasons the expert advisory group has been formed—specifically to look at that issue.

§ Baroness Gardner of Parkes
My Lords, is it correct that the other plastic surgery and burns unit set up after the King's Cross fire is to be moved northwards? If so, is there not perhaps a gap in the south? Now that there is one health authority covering the whole of London, does the Minister not agree that it is extremely important to have those facilities distributed evenly throughout the London area? In the past, other relocations have worked extremely satisfactorily; for example, the paediatric gastroenterology unit to the Royal Free Hospital.

§ Baroness Hayman
My Lords, the noble Baroness makes an important point. We must not look at such proposed moves in isolation but in relation to providing the right spread of specialist services to serve a region or an area as a whole. That is one of the reasons we are supporting the British Burn Association's national burn care review which is looking to produce guidelines for the NHS that can give advice on commissioning burns services and ensure that there is access to a high level of specialist care on an even geographical basis.

§ Lord Walton of Detchant
My Lords, does the Minister agree that, irrespective of any decision that may be made on strategic grounds to locate these services, as a point of principle when one is dealing with a unit with a major international and national reputation and a proud record of research, it would be a profound error to divide that unit into two? That would inevitably have a detrimental effect upon the quality of the service and the research carried out.

§ Baroness Hayman
My Lords, I take seriously the contribution made by the noble Lord, Lord Walton of Detchant, on this issue. There is always concern that one may lose by movement, particularly when splitting up services. As I say, these are not easy balances to be struck, as the noble Lord is well aware. It is because they are not easy balances to be struck that the expert advisory group, which will draw in a range of expertise on these issues, is being consulted.

§ Lord Stallard
My Lords, given the uncertainties that have arisen since the consultation programme started, can my noble friend tell me how much longer the consultation process will take? Also, does she have a rough idea when we will reach the end of it and how we will ensure that we obtain a decent result?

§ Baroness Hayman
My Lords, I understand that the advisory group will report its interim findings to the health authority in April of this year advising on the provision of services and having taken specific account 4 of those issues arising from the public consultation exercise. I know it is difficult when these issues drag on. On the other hand, it is important to take into account all the issues that are raised.

§ Lord Pilkington of Oxenford
My Lords, has the Minister borne in mind that when previous units of excellence were broken up, the staff dispersed? Will the inquiry bear in mind that centres of excellence have been lost as a result of staff dispersing and not awaiting the results of an inquiry?

§ Baroness Hayman
My Lords, that is borne in mind. As the noble Lord, Lord Peyton, pointed out, there is mixed experience in these areas. Sometimes moves can be destructive and at other times, if they are handled with sensitivity, whole teams can be taken across and moved for the benefit of the service.