Isle of Wight: Emergency Surgery Facilities (Hansard, 19 February 2003)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the future of services on the Isle of Wight is currently under discussion in the local process called "Healthfit", which embraces the development and shape of services in the whole of Hampshire. No firm decisions have yet been taken.

§ Earl Howe
My Lords, I thank the Minister for that reply. Is he aware of the enormous anxiety on the Isle of Wight that accident and emergency services at St Mary's Hospital may be withdrawn? The strategic health authority has not felt able to give any kind of guarantee about the future of emergency surgery facilities there. Is the Minister aware that, without emergency surgery, a full A&E service could not be delivered and that that would have serious implications for the population of the island, which numbered some 300,000 people during the summer?

§ Lord Hunt of Kings Heath
My Lords, I am aware of the anxieties being expressed. However, I hasten to add that this is the first stage of a process which will take some time. Consultation will take place over the next few weeks and months, and these matters will have to be considered by the people who make the decisions at the local level. However, on 28th January the chairman of the strategic health authority wrote to the local media saying: I cannot envisage the closure of accident and emergency services at St Mary's. The bulk of accident and emergency services will always need to be provided from local facilities, because of the need for urgent access". He went on to say: It is worth clarifying that the section of the document"— that is, the "Healthfit" document— referring to emergency care relates specifically to services for the most serious accidents and the most complex emergency surgery".

§ Lord Burnham
My Lords, I declare an interest as one who, in the middle of the night, was taken by ambulance to St Mary's Hospital in Newport. Is the Minister aware of the excellence of that hospital? Is he also aware that there is an awful lot of wet stuff between Newport and Southampton if it should prove necessary to take a patient from the Isle of Wight to Hampshire?

§ Lord Hunt of Kings Heath
My Lords, I was aware of the sea; I was not aware that the noble Lord had taken advantage of the excellent services provided by St Mary's Hospital. Of course, I take the point that the noble Lord makes. At present, in many serious cases where patients need to be moved to highly specialist services—probably in Hampshire—many would be seen and stabilised first within the local hospital. All those factors will need to be taken into account when the strategic health authority comes to make decisions. However, the time for decision-making is some way off.

§ Lord Oakeshott of Seagrove Bay
My Lords, does the Minister accept that we are not talking about specialised cases being moved on later? Does he accept, and will he tell the chairman of the strategic health authority, that the mainland is simply not an option if a person has an accident or a heart attack on the Isle of Wight?
As my noble friend pointed out, if an ambulance is called to Freshwater or Ventnor, it takes half an hour to reach the ferry. Storms in the Solent often mean that helicopters cannot fly. Only the car ferry is available, and that takes 45 minutes. There is an hour between sailings in the winter and two hours between sailings during the night in the summer. Therefore, it can easily take more than three hours to reach a hospital in Portsmouth or Southampton.
Can the Minister give an assurance not that the bulk of cover will be maintained—a matter causing great concern on the Isle of Wight—but that accident and 1134 emergency cover will never be cut to the standards which are more appropriate for a remote desert island than for 130,000 people living in southern England?

§ Lord Hunt of Kings Heath
My Lords, I am learning more than ever about the Isle of Wight and its geography. I understand the point that the noble Lord makes. But, ultimately, such decisions need to be made at the local level. The process being followed by the strategic health authority is, first, to gather together a group of professionals in order to map out an outline philosophy which will guide the process and, then, to consult informally many organisations and people within the whole of Hampshire and the Isle of Wight. All those factors will need to be considered. Of course, I understand the geographical constraints. That is why the chair of the strategic health authority wrote in the terms that he did. As I said, under current practice, many patients will go first to St Mary's Hospital for stabilisation and care and will then be transferred to more specialist centres on the mainland where appropriate. I believe that that will always be a factor in terms of the services provided within the Isle of Wight.

§ Baroness Blatch
My Lords, I declare an interest in that my husband comes from the Isle of Wight and many members of our family still live there. Therefore, we know the hospital in question very well. Is the noble Lord at least sympathetic to the notion that these considerations should not even form part of the review? For example, if it is not possible to perform an emergency caesarean section, a mother will have to leave the Isle of Wight about a fortnight before the baby is due because such complicated surgery cannot be carried out for the reasons that have already been given. But it is not unknown for helicopter flights to be cancelled and the frequency of sailings is such that sometimes even the boats are cancelled. Therefore, this issue should not even be part of the review process.

§ Lord Hunt of Kings Heath
My Lords, the local health service is engaged in the very early stages of the process. I believe that, instead of trying to micro-manage the local health service, it is better to allow it to take forward those discussions. The driver of change in the whole of Hampshire and the Isle of Wight is to ensure that the services are as effective as possible. I would not discourage strategic health authorities from taking on that responsibility.
I have said that I understand the geographical factors that make it important that the local services available on the island can deal with the cases that noble Lords have mentioned. I have also clearly stated that those factors will need to be taken fully into account by the strategic health authority, which has yet to make any decisions on this matter.

§ Baroness Gardner of Parkes
My Lords, following the comment by my noble friend Lady Blatch, and in view of the Minister's own statement that he fully understands the need for an emergency service, is he not able to confirm that it was unnecessary for this 1135 item to have been included in the consultation document? It should have been outside the consultation document, in which case the chairman of the strategic health authority would have had no cause to write to the newspaper to clarify the matter.

§ Lord Hunt of Kings Heath
My Lords, I could not disagree more. For the strategic health authority to say, "We will have a fundamental review of the way services will be delivered in Hampshire and the lisle of Wight except that as far as the Isle of Wight is concerned what is provided now will be set in stone for ever", would be irresponsible. Of course it has to consider the services provided across the whole of the county.
It is worth making the point that while referring to how to deal with highly specialist services, the outline document, which has already been published, also refers to how to expand primary care services and how to give greater access to local people. Surely, we should have confidence in the process. We should allow the discussions to take place, the strategic health authority to come to a view, and the formal consultation process to take place. We must hear in mind the statement made by the chairman of the strategic health authority, which I read to the House, which makes clear that A&E services will continue to be provided at St Mary's.