§ Mr. John Randall (Uxbridge) (Con)I am grateful to have the opportunity to raise issues that are important not only to my constituents but to people in the wider area of west London—perhaps I should say Middlesex.
When London's specialist health services are mentioned, people tend to think of the famous names—for instance, the Great Ormond Street children's hospital, Moorfields eye hospital and the Royal Marsden hospital. However, the area of which I speak, although designated as west London by the national health service management, is outside that central, inner core.
I am delighted to see my hon. Friend the Member for Ruislip-Northwood (Mr. Wilkinson) here today and, in our part of west London, Harefield and Mount Vernon hospitals and the Royal National Orthopaedic hospital at Stanmore come to mind as beacons of excellence. All are situated in beautiful and peaceful rural surroundings—the antithesis of city life—and all are efficient, respected and valued. Having spoken to many patients, I would say that they are loved and cherished.
None of those hospitals is more famous than Harefield; under the leadership of Sir Magdi Yacoub and his team, it has pioneered advances in heart care, and has carried out more heart transplants than any other hospital. The result is that the name of the English village in which it is situated, from which it takes its name, is known all over the world. Sir Magdi Yacoub's heart science centre is also on that site, ensuring that bed and bench—patient and research—are near each other, to the benefit of all.
Last August, Harefield's clinicians again demonstrated that they remain in the forefront by performing the first heart bypass in this country with a local rather than a general anaesthetic. We should congratulate them on such a wonderful advance. Risks will be fewer for such patients, and recovery times will be shorter, which will ease pressure on hospital beds.
Despite such advances in patient care outside London, two of the specialist hospitals that serve my constituents and so many others are under threat. They are Mount Vernon and Harefield. The public reaction to that threat was anger tempered with disbelief, made more so by the fact that the views of patients and the public have been ignored. The way that they have been treated, and continue to be treated, makes a joke of the Government's policy of patient and public involvement in health care.
356WH Those who are fighting for Harefield's survival have tried to gain the ear of the Secretary of State for Health. However, the request by my hon. Friend—the hospital is in his constituency—that the Secretary of State meet the hospital's representatives has been refused.
§ Mr. Andrew Lansley (South Cambridgeshire) (Con)My hon. Friend refers to patient and public involvement in health. Last week, I sought the names of the members of the patients forum at Addenbrooke's hospital in my constituency, only to be informed by the Commission for Patient and Public Involvement in Health that such names were not yet available. Indeed, the commission said that it proposes this week to write to members of the forum to ask whether their names can be made public. As the forum has existed for some time, and as its role is meant to be representative, that seems rather remiss. Has my hon. Friend had any greater success?
§ Mr. RandallI am hardly surprised by that lack of success. My hon. Friend may be interested to know that, as a result of a recent parliamentary question, I found that the turnover of members of such forums has been surprisingly high, with a large number of resignations. Perhaps the commission cannot give the names because members do not stay long enough.
As I was saying, the request made by my hon. Friend the Member for Ruislip-Northwood to meet the Secretary of State for Health with the representatives of Harefield hospital was unfortunately unsuccessful. A similar request, made by the chief executive and chairman of the hospital, was ignored by his predecessor. However, my hon. Friend has previously given us much of the history, so I shall move on to the issue that interests me: the business side of the Paddington health campus scheme.
By taking its work, the Paddington health campus would close Harefield hospital. My interest in the issue grew after I learned that the project costs had escalated from £360 million in 2000 to £800 million in 2003. By then, the press were beginning to compare the campus to the millennium dome and estimated the eventual cost at £1 billion. The doubling of the costs in that short period is equivalent to a financial fire alarm going off—it means that the original business case is bound to have been flawed.
When it also became clear that the Paddington scheme did not have planning permission, despite having applied for it in 2000, I asked a question in the House. NHS management does not have expertise in schemes such as the Paddington health campus, so they must make use of external advisers. Given that so little visible progress had been made, I wanted to know how much had been spent on advisers. The Minister's response in November 2003 was that £3.177 million had been spent on external advisers up to the end of March 2003. My hon. Friend the Member for South Cambridgeshire (Mr. Lansley) later asked a question on the same subject and found that more than £5.5 million had been spent by the end of December 2003. That is well over what was spent on the new patient centre at Harefield hospital.
On 23 March 2004, I asked the Minister for a progress report on the Paddington health campus. I noted that 357WH the word "progress" was rather a contradiction in terms when applied to the scheme because there had, quite blatantly, been none. I said:
"seldom has so little been done by so many at such great cost to the public purse"—[Official Report, 23 March 2004; Vol. 419, c. 695.]I respect the Minister, who takes these matters seriously, but I am afraid that on that occasion—perhaps because he was in the bear pit of Question Time—he rejected my concern on the grounds that I was against the project. I am not, however, against the project per se—I am against wasting public money on a project that has lacked viability since September 2002.I was surprised that the Minister rather brushed aside such legitimate concerns, given that the doubling of the costs has led to an independent inquiry. The Department is one of the participants, and the others are the Treasury and the National Audit Office. The inquiry is reviewing not only the rise in costs but how the situation arose. Given that it is supposedly independent, I thought that the Minister might have given a slightly different answer—that he was aware of the concerns but would reserve judgment, pending the independent inquiry's report. However, I have never reached the dizzy heights of being a Minister so I do not understand quite how such answers are produced.
The Minister did not inspire great confidence when he did not appear to know that the Treasury and the NAO were involved in the independent inquiry into the project, which he said his Department was reviewing in conjunction with local health bodies. I would not describe the Treasury or the NAO as local health bodies. Furthermore, the statement that the Minister expected to make before the end of March about the future of the Paddington health campus has not yet materialised.
Sadly, no amount of spin can disguise the fact that the project is in crisis. We cannot ignore the fact that if the Government had listened to the solid arguments that well-informed bodies raised against the scheme, it would not have gone ahead. By informed bodies, I mean the community health councils of Harrow, Brent, Hillingdon and South West Hertfordshire, all of which objected to the scheme, but all of whose objections were dismissed. Barrie Taylor, then the chief officer of South West Hertfordshire CHC, which covers Watford, pointed out that should the project go ahead, it would lead to a diminution in patient care.
§ Mr. John Wilkinson (Ruislip-Northwood) (Con)My hon. Friend makes some exceedingly important points. Does he remember the extraordinary fact that the health council that promoted the Paddington basin project was the one that was charged with analysing the results of the consultation? That is an amazing state of affairs. Everything was geared up from the start to produce the result that the Government desired, namely that the Paddington health campus project should go ahead regardless of public opinion, fairness or objectivity.
§ Mr. RandallMy hon. Friend is absolutely right. However, I am never surprised these days. I came to this place free from conspiracy theories, but the longer I go on, the more cynical I become, and the more inclined I am to believe such things. Perhaps one day I shall have my innocence restored to me.
358WH Perhaps hon. Members representing the area should concentrate on ensuring that Paddington's local hospital, St. Mary's which desperately needs attention, is improved. For a fraction of the cost of the project, both Harefield and Mount Vernon hospitals could be expanded and improved, and so retain invaluable staff. That would also solve the problem of space on the Paddington site. That is what Sir Magdi Yacoub counselled in May 2000, when he welcomed progress in London, but not at the expense of Harefield. Over the last four years the need has grown to retain specialist hospitals outside the capital. They are far less likely to be disrupted by threats of terrorism and transport problems.
Any building development, NHS or not, is governed by whether it is practical, affordable and good value for money. Paddington health campus does not meet any of those criteria. By September 2002, those managing the project knew that they were nearly one fifth short of space on the designated site and that it was impossible, within existing planning regulations, to accommodate such a shortfall on an inner-London-constrained site. There was also the knock-on effect of the £360 million estimated cost having been shattered by the need for more space.
Correspondence shows that, instead of stopping and reassessing the viability of the project, the management attempted to keep knowledge of the shortfall out of the public arena: it depicted the 17.5 per cent. shortfall as a 17.5 per cent. rise in the elderly population in the Paddington area. That is not borne out by census statistics. The term that is often heard in such circumstances is cover-up. However, why should one occur if there was no mismanagement? How could a project team put in its third amendment to a planning application, get a "minded to grant" in August 2002, and then realise the following month that that was useless, due to there being nearly 20 per cent. too little space? The only rational explanation is that the project team did not take into account the need for greater space in hospital planning, due to the higher consumer standards introduced by the Department of Health. Whatever the reason, by September 2002, the project had more problems than it had had at the outset.
Further losses could have been prevented by a reassessment of viability. Instead, the project management team ploughed on, seeking extra space off-site in the Paddington area, which would only add further cost to the project. It is self-evident that those who spend public money have a duty to ensure that it is spent wisely. Inability to get planning permission for a project on a designated site equates to the end of that project when the development is tied to that site. I do not think that I am painting too harsh a picture of the failure of the management of the project. A recent edition of Building magazine described it as problematic and the "PFI from hell". When those with knowledge of the construction industry make such severe criticisms, they cannot be brushed aside as being against the project.
An equally critical article inConstruction News in March commented:
"Faced with burning millions bidding for a scheme that has not got planning permission, many firms will turn and run."The conclusion must be that such an ill-fated scheme has brought the NHS and Government policy on PFI builds somewhat into disrepute. However, such remarks are 359WH perhaps rather unfair to PFI in this case, because no PFI partner was involved, neither has a PFI partner been advertised for. Whatever blame there is falls, I am afraid, on the management team.Since 2000, the proposed Paddington health campus has been hard sold as an everything under one roof development for specialist services in west London. Harefield hospital is one of the most successful hospitals in the world, but the fact that it would close if the development were built has been ignored. Relocating Harefield is impossible, because its staff will not work in London, but that has also been ignored.
In response to a staff survey conducted as early as 2000, only 10 per cent. of Harefield's nurses said that they would be willing to work in the capital. In the latest independent staff survey the figure fell to 8 per cent., while the figure for all Harefield's staff was 7.1 per cent. In 2003, the Institute of Employment Studies reported that 19 per cent. of respondents intended to move, 46 per cent. had said no, and 35 per cent. were unsure. However, those percentages hide big differences between the Royal Brompton hospital and Harefield hospital. At Brompton, 24 per cent. of respondents said yes, 35 per cent. said no, and 44 per cent. were unsure. At Harefield, 8 per cent. of respondents said yes, 64 per cent. said no, and 28 per cent. were unsure.
When senior NHS management of the trust concerned has so obviously failed to persuade its staff that the project is worth while, there is a lesson to be learned. It is bad management to consider moving an organisation that employs skilled staff if they will not relocate and there is little or no possibility of replacing them in the proposed new area. The lack of management skills is compounded when the area chosen to relocate to is extremely expensive, making reasonably priced accommodation, whether rented or bought, an impossibility. Firms are relocating out of London, not into it, for that very reason. The shortage of NHS staff in London is well known. It results in huge agency costs, which strain NHS finances. Adding to that problem is irresponsible. Retention of staff is as important in the NHS as recruitment.
When permission was given to plan the project, certain undertakings accompanied it, including one to continue surveying staff attitudes to the proposed move. Rather than carrying that out and discussing the results sensibly, however, in 2002 the survey was evaded. In the latest staff survey, trust management refused to include the one question that was suggested on behalf of Harefield's staff by Heart of Harefield, which is an organisation fighting for the hospital's survival. The question was on retention of staff and simply asked what Harefield staff would say if the project did not go ahead. The probable answer to such a key question in assessing staff attitudes to the Paddington health campus made it unacceptable to those promoting the project. TheHealth Service Journal described it as a hair-raising question. NHS staff are its most important asset and we should treat their opinions with respect.
It is also unacceptable for those hard-selling the project to promote their scheme by denigrating the facilities at Harefield hospital. Harefield has a new patient centre, with the most up-to-date technology, two new operating theatres and new pathology labs, and ongoing plans to remove its older, disused buildings.
360WH There is still room for improvement, but Harefield is at a stage when patients ask whether the intention to close it down is due to the money being spent on it.
A Paddington health campus briefing note of 19 December 2003 gave the opposite impression of Harefield, however. Those reading it would be misled into believing that the hospital was almost contravening health and safety regulations and was so short-staffed that it would soon be closed. Such allegations are untrue. The briefing said that should Harefield hospital remained open for a longer period, it would
"require significant investment to remain safe and viable. This will exacerbate the already acute staffing and clinical governance problems that this site prevents".It is disgraceful that a deliberate smear tactic against Harefield hospital should appear in a briefing document from the Paddington health campus project. It would have remained hidden, giving Harefield no chance to refute it, had the briefing note not been leaked to Mrs. Jean Brett, who leads the campaign to save this great hospital.When such distasteful tactics are used, the Paddington health campus loses all credibility. Desperation and misinformation have now become its hallmarks. Misinformation also reared its head when the project team sought to make up the shortfall in space by leasing the Point building, a prestigious office block on the other side of the canal to St. Mary's hospital. The cost of leasing it would be enormous, and it was absolutely ludicrous for the project team to describe it as an investment, because money would be going out with no prospect of a return.
Leasing the Point building would incur costs in addition to the £800 million already on the table, yet in two presentations in 2003 the Point was talked up as the ideal solution for the decant of St. Mary's hospital and to the space problem. The most important fact was not mentioned, which is that the Point is the least suitable building for decanting a hospital.
The terms of the lease forbade any in-patient treatment, meaning that no patient could stay in the Point overnight. As unclear was the fact that the only access to the main Paddington health campus site from the Point was by a public footbridge over the Grand Union canal. In addition, only 25 per cent. of the Point could be used for medical purposes, and within that was a restriction on any substance abuse clinic. It needs to be remembered that we are talking about the Paddington area of London. Just as oddly, the use of the ground floor, which is the most accessible, for patient care was denied for clinical purposes. There are different ways of being economical with the truth—misleading by the omission of relevant facts is among the worst.
Such details mean that we have a fatally flawed project, where saving face has become more important than openness, accountability and a willingness to admit that serious mistakes have been made. Since February 2003, the project team has been made aware by Westminster city council that it has to put in a new planning application in order to make any progress. Fifteen months later, that new planning application is still not in. If there had been a viable solution to the space problem, it would have been found.
361WH [Mr. Randall] Can the Minister confirm whether his answer of October 2003 about the number of beds in the Paddington health campus scheme still holds? The House was assured that the project would have 1,088 in-patient beds—80 more than those provided by St. Mary's, the Royal Brompton and Harefield hospitals. Will he also confirm whether the assurance still stands that the Paddington health campus now planned
"is 20 per cent. larger in size and will treat a higher number of acutely ill patients"?—[Official Report, 20 November 2003; Vol. 413, c. 1407W.]The bottom line is that there has been an arrogant determination to force through this project, despite the lack of viability. The same arrogance of attitude was displayed in dealings with patients, members of the public and the objections of the community health council. The public consultation process was a farce. Before it had even started, a planning application for the project had been put in to Westminster city council. Planning applications for complex schemes take time, trouble and expense. Clearly, the public consultation process was to be cosmetic.The lack of respect for the public consultation process was underlined when the post of project director was advertised before the consultation had ended. That is shocking and inexcusable. Events have now overtaken those planning the destruction of Harefield hospital. Two years away from its original completion date of early 2006, the Paddington health campus has not only made nil progress, but it is in a worse position than when it started. The completion date now varies between 2012 and after 2014, depending on which statement of the project is referred to. Its capital costs are unaffordable, its space problems insoluble and a supposedly independent review into how its £360 million outline business case was so flawed is still ongoing.
It is time to draw this tale of inefficiency to a close by abandoning the scheme. It was always described as a vision. I have no problem congratulating people on having a vision and wanting to achieve it, but I am afraid that that vision has turned into a bit of a mirage.
The clinical argument that every specialty needs to be under one roof, adjacent to accident and emergency departments, is as flawed as the management skills of those running the Paddington health campus project. Accident and emergency departments feed into Harefield—not the other way around. Due to advances in the skills of paramedic ambulance crews and the equipment that they carry, cardiac patients who need specialist care will be taken straight to Harefield. That has already happened, and it increases patients' survival chances.
Also flawed is the argument that because differing health problems sometimes appear in the same patient, other specialties should be on tap. It is well within modern technology for clinicians to confer on a patient visually without being in adjacent buildings.
The gross mismanagement of the Paddington health campus demands that there should be an independent inquiry, alongside which there should be an inquiry into why the public consultation process was such a mockery. I would welcome an explanation as to why, in 362WH December 2003, the Minister assured a London MP in writing that the Secretary of State had written to the Chief Secretary to the Treasury expressing confidence in the project and making it clear that he expected it to go ahead. There could not be greater interference during an independent review than for one of the involved parties to pressurise another.
I make no apologies for concentrating on Harefield hospital because of its link to the flawed Paddington health campus scheme, and because it illustrates how plans for major private finance initiative schemes can implode. The if it's not broken, don't mend it argument applies equally to Mount Vernon and to Stanmore orthopaedic hospital.
It is ironic that the chief executive of the excellent hospital at Stanmore was, for years, one of the main drivers for the Paddington health campus. Stanmore does not have an accident and emergency department and, like Harefield, is a specialist stand-alone hospital. However, instead of promoting its closure, its chief executive, Andrew Woodhead, is promoting a PFI plan to improve it. Those who support Harefield's retention agree with London clinicians that the bed and bench should be together for the benefit of all, as at the Harefield site. The research could not be led by a more eminent clinician than Professor Sir Magdi Yacoub. The Government's contribution to the heart science centre at Harefield contradicts any decision that could result in the loss of the adjoining hospital.
When the right hon. Member for Darlington (Mr. Milburn) was the Secretary of State, he officially opened the second phase of the Harefield research centre. That was greeted by applause from the assembled Heart of Harefield campaigners, but a far bigger cheer will go up when Harefield hospital is saved. The relocation of Harefield hospital is a euphemism for its destruction. The core problem is that its success has made it vulnerable to what might be termed clinical takeover bids from London.
In my seven years in this place, I have tried to take the middle line on most things, but with my business experience, and having looked at all the options, I am quite angry about this project. The Government would show great courage by putting an end to this project, and would save the public a lot of wasted money that is desperately needed in the NHS. It would be apt for the Government to remember that when the Home Secretary was the shadow Secretary of State for Health, he described a threat to Harefield hospital as vandalism. Vandalism does not cease to be vandalism just because there has been a change of Government.
Mr. Deputy SpeakerOrder. Hon. Members wishing to participate in the debate should bear it in mind that the Front-Bench speeches must commence not later than 10.30 am.
§ Mr. John Wilkinson (Ruislip-Northwood) (Con)We owe a deep debt of gratitude to my hon. Friend the Member for Uxbridge (Mr. Randall), who has taken a sustained interest in NHS services in west London as a whole. His presence, his exposition and the attendance 363WH of the hon. Member for Harrow, West (Mr. Thomas) demonstrate that concern about the future specialist services in the NHS in west London extends far beyond my constituency, in which Mount Vernon and Harefield hospitals are located.
Since 1997, no health subjects have consumed more parliamentary time than the future of Mount Vernon and Harefield hospitals. We have had countless debates on each hospital, and a few years ago in this very Chamber, we had a similar debate on the future of hospital services in west London. To day's debate shows that instead of getting a grip on the situation and rectifying several of the problems, the Government are still floundering about and cannot provide the sort of specialist hospital services in west London in which the public can have confidence.
To be candid, that is an unutterable disgrace. If the general public knew how much time Parliament, Ministers, NHS officials, consultants, the Department of Health and others had devoted to these questions, and still so little progress made, they would be even more critical of the NHS and of Her Majesty's Government. I suggest a slogan for the hustings in the London elections: "Remember Harefield and Mount Vernon, and look at what is happening in the Paddington basin." That says it all. If we want a monument to the inefficiency of centralised, socialist control in providing the sort of specialist hospital services that people want and need, we have only to consider the stillborn Paddington basin project and, of course, the uncertainty about the future of those two admirable hospitals—Mount vernon and Harefield—which my hon. Friend rightly calls beacons of excellence.
Let us consider the hospitals one by one and in alphabetical order. Objective, fair-minded observers would find it utterly incomprehensible that Harefield hospital should be under threat of closure when it is regarded worldwide as probably the most pioneering, innovative and imaginative hospital in the cardiothoracic field in the United Kingdom, particularly with regard to transplantation. Those observers would point to the amount of support that Harefield hospital has always enjoyed from a variety of organisations such as the ReBeat club, whose members have had surgery but who have improved, continued in good health, and maintained their interest in the hospital, and the Heart of Harefield organisation, a marvellous organisation led by Mrs. Jean Brett, which, in the many years since the project to move to Paddington basin was announced, has produced a formidable range of well researched memorandums, papers and presentations, has admirably conducted meetings with high officials, the public and others, and has sustained great interest.
Members of the Hamsters—a club formed by people who have had transplants—do not speak against Harefield hospital or say that it must move to Paddington basin. On the contrary, their experience has been that there is no better environment than Harefield hospital for recuperation and the sustained treatment that they require after transplantation. Its quiet, rural location is ideal for the purpose. I invite hon. Members to imagine going out into the Paddington basin area near Praed street after surgery, if not on one's Zimmer 364WH frame, then hardly able to move. One is more likely to be mugged than to make a good recovery.
I wish that the NHS would listen to the counsel of good, sound common sense. We are not talking about any advice that I may have given, but about the advice given by the tens of thousands of members of the general public who have written to the consultation in support of Harefield hospital. It is remarkable that a Government who are, as my hon. Friend said, supposedly so amenable to public opinion, should fly in the face of all the advice of all interested parties and the general public and press ahead with the move of Harefield to Paddington basin.
My hon. Friend has said most of what there is to say about Paddington basin; however, I, who have never, in my 28 and a half years in the House, had cause to initiate a National Audit Office inquiry, asked the National Audit Office to look into the Paddington basin project. I did so because the consultation was a fraud. It was a fraud, because, first, as I said in my intervention, the Kensington and Chelsea and Westminster health authority, which is promoting the project, was the body that analysed the responses and reached conclusions based on them. That is improper and wrong.
Secondly, the Government, under the leadership of the right hon. Member for Darlington (Mr. Milburn) when he was Secretary of State, had initiated an NHS plan, which was to put most attention and most resources into the care of heart problems and cancer. In both instances they were hellbent on closing the most fantastic facilities in London and moving them at vast expense to places where people did not want to go, although the money could have been used to improve the facilities even further and to build on their success. As the military men say, one should build on success, not reinforce failure. That is one of the first things that one learns at staff college, and the same applies to politics and management; it is common sense.
After I initiated the National Audit Office inquiry I was promised that the outcome would be made known in April. Of course, it was not. The fact that it has been so delayed is proof in itself that the project is hardly going well. All the leaks from the specialist journals to which my hon. Friend referred show that even the construction industry has no faith in the project.
I call the consultation a fraud because in that consultation the project was predicated on cost figures that have been exceeded to what most people would consider an incomprehensible degree. We were told that the cost of moving Harefield to Paddington basin would be something of the order of £360 million gross, and after the land sales, presumably of the Harefield and Royal Brompton sites, about £135 million net.
We are now talking about £837 million, if the latest article is to be believed. The Secretary of State gave a figure of £800 million. That is utterly grotesque. It damages the economy of the country, making the Chancellor borrow more and making everyone poorer, but above all it has delayed the full improvement of the cardiothoracic facilities at Harefield, and again the public have suffered.
Similar points can be made about Mount Vernon. One would have thought that after all the trauma of the Harefield episode the NHS, under the present Government, would have learned a lesson, but no. 365WH Again the approach was to ignore all the consultation and to take not a blind bit of notice of community health councils, Community Voice, or the thousands of people who wanted the cancer centre to remain because the facilities on the Mount Vernon site are second to none.
There is a complementarity of facilities at Mount Vernon. Expertise is to be found there, particularly in radiotherapy, and there is cancer research at the Gray Cancer Institute. Macmillan Cancer Relief is there; Michael Sobell house is a facility for cancer patients; cancer patients can go to the Bishopswood private hospital and enjoy the services of consultants in the NHS but support Mount Vernon; there is a centre for reconstructive, plastic and burns surgery, while the Restoration of Appearance and Function Trust supports research in the field of reconstructive surgery; and, of course, there is a scanner centre.
Only a fortnight ago I was at the scanner centre—the Paul Strickland centre—for the opening of a £1.5 million combined PET-CT scanner. I think that it is only the second in the United Kingdom. Like all the other scanners there, it was installed through the support, sacrifice and dedication of people who charitably provided the money—it was not NHS money. By golly, what a comparison. Some £837 million has been spent at Paddington basin, but there is still nothing there, while £1.5 million from people's pockets has provided yet another scanner at Mount Vernon's Paul Strickland centre.
The mind boggles, but it boggles further when one considers that we do not even know where the proposed cancer centre is to go. All that we have been told is that it will be in Hatfield, but one could not have anywhere further removed from my constituents in north-west London. Hatfield is difficult to get to, and accessibility is important for not only patients but the many people who want to visit them. Yet, the centre will be on the old British Aerospace airfield or somewhere else, although we do not know where. Honestly! What a way to run things. It is deeply sad.
People at the opening of the scanner centre told me that the proposed scheme was wrong-headed. It is far from certain that specialist centres alongside or incorporated into general hospitals are the right way to provide the best patient care. A strong body of clinical opinion believes that specialist centres such as Mount Vernon and Harefield are the optimum locations for work at the frontiers of medical science.
I hope that the debate will at least cause Her Majesty's Government to think again. There is no point in putting vast amounts of public money into projects that the public do not support and that are in the wrong locations. The opportunity cost to the NHS is enormous. Harefield and Mount Vernon do a superb job as it is, but if just a little of that money had gone into them since the start of the Government's term in office in 1997, how wonderful they would be now. When the Heart of Harefield team asked specialist consultants to look into how much it would cost to modernise Harefield, the answer was just £18 million to £20 million.
To conclude, I shall support Harefield, Mount Vernon and other specialist centres of excellence until my last day in the House of Commons. We are grateful 366WH to my hon. Friend for introducing the debate and for his interest in the issue. We are also grateful for the interest shown by my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), whose constituency includes the Papworth heart hospital, and who only recently took the time and trouble to go to Harefield. That gives us great hope for the future because we trust that, before very long, he, and not the Minister, will be in government. Time is passing, politics in the United Kingdom is changing and we are looking for a new start under a new Government and for the revivification of Harefield and Mount Vernon hospitals.
§ Mr. Paul Burstow (Sutton and Cheam) (LD)congratulate the hon. Member for Uxbridge (Mr. Randall) on securing the debate and the hon. Member for Ruislip-Northwood (Mr. Wilkinson) on his contribution.
I come relatively fresh to the issues of Middlesex health care and reconfiguration, although, over the past few days, I have carefully studied some of the issues that the hon. Member for Uxbridge has brought to the Chamber. What has struck me—it is self-evident from the passion that has been expressed in the debate—is the fierce loyalty and pride that people feel for their local health care systems and hospitals. As a result of the health care that they receive, people form an emotional attachment to their health care facilities and may, as the hon. Gentleman said, even come to love them.
In considering reconfiguration, it is important that we are satisfied that the processes on which we have embarked—their conclusions are unfolding and being implemented in part of London and in Hertfordshire and Bedfordshire—are objective and robust and have properly taken into account all the economic, social and health-related factors. Therefore, I shall simply ask a few questions by way of a contribution.
Both hon. Gentlemen referred to the reconfiguration proposals that will affect Harefield and the Paddington health campus, and Mount Vernon hospital. I want to talk primarily about Harefield, but I shall touch on the other programme. The hon. Gentlemen told us of their experience and knowledge of Harefield, saying that it is a centre of excellence and at the leading edge of developments; they also told us of their own and their constituents' concerns.
The hon. Member for Uxbridge mentioned that a meeting with Ministers had been sought. I know that, a little while ago, a petition was presented to the House about the need for dialogue with Ministers in respect of Mount Vernon. In connection with that and with progress on the Paddington health campus, I hope that Ministers will take the opportunity to meet local Members of Parliament. I hope that the Minister of State will say today that it will be possible.
Concern has been expressed about access to patients forums, a subject that came up only last week when the Minister of State appeared before the Health Committee. Problems are said to be the result of data protection difficulties I say difficulties, but I am not convinced that that is the real reason for denying access to information about who is representing the public. The forums are meant to enable a genuine public involvement in the making of health care decisions; it is 367WH unsatisfactory that people cannot yet find out who are their representatives. I hope that the Minister can say a little more about that than was said in exchanges at last week's Select Committee meeting.
The costs of the Paddington health campus have been rehearsed today, especially the fact that they increased from £360 million in 2000 to £800 million in 2003. The Minister said in a written answer in September that that was due to an increase in the size of the campus. It is not clear from the written answers that I have read on the subject what level of scaling up we are talking about. There seem to be an extra 80 beds compared with the original plan; and, as we heard, there will be a 20 per cent. increase in capacity or activity. Will the Minister elaborate in his response on how a 20 per cent. increase or an extra 80 beds can account for the more than doubling of the cost of the project? It would be useful to know.
Will the Minister also say a little about the exercise being undertaken by the National Audit Office and the Treasury? Back in March, it was said that that exercise would inform the next stage of the project. What are the findings? As the hon. Member for Ruislip-Northwood said, it would be useful to know when they will be published. If we are to be confident that taxpayers are getting value for the money that they are putting into the project, that work needs to be in the public domain.
Reference has been made to PFI Today's debate is not so much about every last dot and comma of PFI, or even about the principle. However, when reading an article in last week'sHealth Service Journal, I was struck by some of the consequences of PFI projects. The journal gave the example of Norwich university hospital PFI, which was completed in 2001, Under that scheme, the isolation wards were supposed to be plumbed into the ventilation system, but when the system did not work and the ceiling tiles were removed, it was found that the ventilation pipes were still unconnected. Such problems could arise with conventional building methods, but in that case it was laid at the door of PFI.
Consultation with staff at Harefield covered the issue of staff retention and recruitment, which has been touched on already. I was struck by the fact that the survey mentioned by the hon. Member for Uxbridge said that 33 per cent. of Harefield staff and 27 per cent. of Royal Brompton staff cited transport as one of the issues that would be either a barrier or an inducement to moving, and that free transport might be a deciding factor. Will the Minister say what weighting was given to the question of transport and access by staff to the new campus? Are moves afoot further to ease the concerns of staff on that matter?
Costs have been referred to, and we have heard that the use of agency staff is a big factor. About half the total cost of agency nursing in the country is borne by London. The current cost, according to answers supplied by the Minister, is about £1.4 billion a year—a huge sum. Although a specialist centre might find it easy to attract staff to work at it more readily than others, we must ask whether any facility in central London will always be able to get the full range of staff, from the porter up to the consultant surgeon, to work there. I hope that the Minister will say how those concerns were weighted in the assessments to date.
368WH The situation that the hon. Gentleman described at Harefield hospital is obviously of great concern to him and his constituents. I conclude with a question about time scales. It has been said that the original completion date was 2006, but most of the material that appears on the websites associated with the project seems to talk about an opening date of 2010. Will the Minister say when the campus will open, if that nirvana of a Conservative Government, which the hon. Member for Ruislip-Northwood described, does not come to pass at the next general election?
Mount Vernon is of great concern and generates fierce loyalty among residents in that part of the world. The Bedfordshire and Hertfordshire strategic health authority has led the project. In reading the documentation from its consultation exercise, I was struck that comments that London Members had made were not even listed, although I can understand why. The material came solely from those outside London.
§ Mr. WilkinsonWill the hon. Gentleman give way?
§ Mr. BurstowI am not making a criticism.
§ Mr. WilkinsonThe hon. Gentleman makes an important point. To an objective observer, it is amazing that a health authority from outside London should dictate the future of cancer services inside London. It is par for the course, is it not, that London MPs should be ignored, because the objective was, quite clearly, to build a hospital in Hertfordshire and to ignore the opinions and needs of Londoners? We know that, but I am grateful that the hon. Gentleman has highlighted it.
§ Mr. BurstowI am grateful for the hon. Gentleman's intervention. When the Minister reviews the consultation exercises that have led to the decisions to change the character and content of services provided at Mount Vernon hospital, will he satisfy himself that the process is robust enough to ensure that the health needs and aspirations of the population in north-west London, in Middlesex, have been properly taken on board? There seems to have been a parallel exercise in north-west London, which was solely about Mount Vernon, but the changes to the hospital have been entirely driven by decisions made outside the strategic health authority. That other exercise almost seems to have been lost.
The hon. Member for Uxbridge has used this Adjournment debate in a powerful fashion to raise some important concerns, which have already been rehearsed through written answers, oral questions and debates. I look forward to the Minister's response.
§ Mr. Andrew Lansley (South Cambridgeshire) (Con)I join others in congratulating my hon. Friend the Member for Uxbridge (Mr. Randall) on initiating this debate and on the way in which he opened it. He rightly pointed out that during his seven years in the House he has sought to strike the right balance and adopt what one might characters as moderate views on issues. He spoke with great concern and commitment to his constituents. He will recall that I played a small part in his victory back in 1997—actually, I played no part, 369WH because as I went round Uxbridge everybody knew who he was. They knew perfectly well that, with his integrity and commitment to Uxbridge, he was exactly the person to represent them. He was a shoo-in.
My hon. Friend has always represented his constituents in the most exemplary fashion, as indeed has my hon. Friend the Member for Ruislip-Northwood (Mr. Wilkinson), who has shown passion and commitment to his constituents and to Harefield hospital. I know that my hon. Friend's record is recognised, not least because when I visited Harefield on 15 April I was told so. I am glad that I had that opportunity. I did not know that we might have a Westminster Hall debate on the subject then, but I knew that it was right to visit, because these problems are increasingly coming to a head. Even then, it was clear that the strategic health authority could not be too far away from making an announcement.
If I recall correctly, the Minister told us during oral questions in March that an announcement would be made by the end of the month. It was not; nor was it made in April. So far, none has been made in May, and I suppose that none can be made before the elections on 10 June. If, indeed, the strategic health authority is to say anything, it will say it much later than was anticipated. However, as my hon. Friend made perfectly clear, such is the nature of this project that, so far, nothing has happened according to the anticipated timetable.
I shall make a few observations about the issues that my hon. Friends have raised. I will not, however, confine myself to Harefield hospital, but will discuss other specialist hospitals—in effect, tertiary services—to which they referred. There are important issues relating to the future of tertiary services. Interestingly, I first became familiar with the benefits of tertiary centres of excellence at the Royal National Orthopaedic hospital in Stanmore, which I visited while I was private secretary to Norman Tebbit. Margaret Tebbit was receiving treatment at the hospital at the time.
I got to know some of the clinicians at the RNOH very well through Aspire, the Association for Spinal Injury Research, Rehabilitation and Reintegration. The Minister will be familiar with Aspire and its work. I engaged in fundraising to provide Aspire with facilities to treat spinal injury patients at Stanmore in the mid-1980s, and have been privileged to remain a patron of Aspire ever since.
The clinicians told me how they could improve outcomes significantly, and attributed much of that to their ability to operate as an independent centre of excellence. Patients at the RNOH were receiving their second hip replacement when patients in many other hospitals throughout the country would have been having their third hip replacement, such was the quality of its artificial hips and the work done there. I have never needed to be persuaded that centres of excellence can deliver the best clinical outcomes. The question that we need to answer is how best to protect and maintain those centres of excellence—a question that is especially relevant to Harefield hospital.
Several questions should be asked about the Paddington health campus and Harefield. First, why is the cost of the project escalating, and why is the project 370WH being managed in a way that fails to deliver what was originally intended? What is going wrong? Such questions demonstrate precisely why my hon. Friend the Member for Ruislip-Northwood was right to call for a review, and why the National Audit Office is party to it. The NAO is not there to decide whether this is the right project for the future, but to discover why a project that was supposed to cost £360 million will cost in excess of £800 million. As the hon. Member for Sutton and Cheam (Mr. Burstow) rightly said, only a 20 per cent. increase in capacity is required—although that is still a significant increase—so why has this happened? If we knew the answer, we would not need the NAO, the Treasury and others to conduct a review.
I am still uncertain and sceptical as to whether the announcement that is due from the strategic health authority will be accompanied by a transparent publication of the results of that review, so that we know what has happened in the past and not simply whether the strategic health authority is asserting the business case for the Paddington health campus in the future on its changed costings.
The question of the management of the project goes beyond the escalating costs, and prompts the question whether the project will meet the original business case. The business case was essentially constructed around the co-location of a range of services, including those of St. Mary's, Royal Brompton, Harefield and the medical faculty of Imperial college. If the nature of the site and the compromises that have to be struck are such that the benefits of co-location are not being realised and split-site or dispersed activity is being engaged in around the Paddington site, serious questions are raised.
The third point, which I found most compelling and had not fully appreciated before visiting Harefield, is that although it is asserted that the business case for the Paddington health campus remains strong, from the standpoint of either of the two main trusts—particularly that of the Royal Brompton and Harefield NHS trust—the environment that the health service lives in has significantly changed from the environment in which the original business case was constructed. To look at it from Harefield's point of view, that is true in a number of respects, including in terms of clinical practice and outcomes in relation to heart disease.
Only a few weeks ago, I was present when the British Heart Foundation launched the results of its minutes save lives campaign in the Jubilee Room. Dr. Roger Boyle, the national director for heart disease, made presentations, and others spoke about the dramatic changes in the treatment of heart disease resulting from not only the prophylactic benefits of stains, but the improved call to needle times for thrombolysis for heart patients. These developments are changing the volume of activity, certainly at Harefield. The idea that one can simply assume, as one did three years ago, the levels of demand for cardiothoracic work in the future is far from obvious. The business case needs to be revisited on that basis.
If Dr. Boyle is right, and 20 years hence—or perhaps it was 10 years—if we do the right things and lead the right lifestyles, there will be no need for anyone under the age of 65 to experience a heart attack, the nature of commissioning of specialised cardiothoracic surgery across the UK will look very different from now. However, that is not the only matter that impacts on the 371WH business case. The Minister knows that, as we talked about it throughout the proceedings on the Health and Social Care (Community Health and Standards) Bill last year and since. Other matters include the structure of payment by results, the structure of the national tariff and its implications, and the possibility of hospitals becoming foundation trusts and being able to manage and determine their futures to a greater extent.
All such matters have an impact on the business plan. The ideals of the days when PFI projects were essentially negotiated on the basis of guarantees by primary care trusts for future income now seem to be misplaced. As the hon. Member for Sutton and Cheam said, this is not really the place to discuss the whole future of PFI, but one particular point is apposite. Unless I am mistaken, it is necessary to go back to the original business case for the Paddington health campus and to re-establish it, not on the basis of guarantees from PCTs but on expectations of the levels of work, the nature of tariffs and the volumes of activity that will support the future of the trust.
I hope that the spirit of greater freedom for NHS hospitals, which we subscribe to, will be embraced in the decision. This decision is not for the strategic health authority to make. It is for the boards of the Royal Brompton and Harefield and the St. Mary's NHS trusts to decide whether to go ahead. They are accountable to their local communities. In due course, if they become foundation trusts, they will be genuinely accountable to their local communities?much more so than patients forums appear to be; it is difficult to understand how they work.
My hon. Friend the Member for Ruislip-Northwood referred to Papworth, which, as a cardiothoracic institute, shares many of Harefield's characteristics. I believe that last year more heart transplants took place at Papworth than at Harefield, but I do not want to argue about the pre-eminence of one cardiothoracic institute over another. They are very similar, as the Minister knows, and the debate continues as to whether Papworth should move from its Papworth Everard site to the Addenbrooke's campus, creating a further extension of the south Cambridge medical campus.
There are strong arguments for such a move, and many clinicians at Papworth are in favour of it. Not the most important argument, but one with which people identify, is that a person involved in a road traffic accident, who suffers major trauma and has both chest and head injuries, might have to be transferred from Papworth to Addenbrooke's in order to have neurosurgery, or the other way for chest surgery. That may not happen often, but it does happen.
Clinicians want to be at Addenbrooke's because they want to be where the research is taking place, and near the large biomedical campus that is likely to be created alongside them there. Ever since the move was mooted some four years ago, I have been clear—as has the Papworth board—that two things are necessary. The first is that the staff should be carried with it. There are substantial differences in the willingness or otherwise of staff who are vital to the provision of services at Harefield to migrate to Paddington and that of staff at Papworth to move—in many cases, to return—to Addenbrooke's.
372WH The second is that Papworth and Harefield should retain their independence as separate institutes. We are not talking, nor should we do so in future, of merging tertiary centres of excellence, which have very successful, positive outcomes, into large hospitals where their services become part of what is offered by a much larger organisation. It is clear from the clinicians at Harefield that they have to maintain their focus on using their expertise to deliver the best outcomes for their patients, to the exclusion of other considerations. If that focus can be maintained only on separate sites, that is a compelling argument, notwithstanding the other considerations.
My hon. Friend the Member for Ruislip-Northwood said that he hoped that we would, in due course, be in a position in which these issues would come before us as Ministers, rather than before the present Government. With that in mind, I cannot now say how Conservative Ministers would judge the issues, not least because of the desirability of decisions, including project finance decisions, being made by the boards of NHS trusts on behalf of their patients and the communities that they serve. However, I shall put four key issues to the Minister, because I hope that he will share the view that they must be thoroughly guaranteed before the Paddington health campus proceeds or the future of Harefield is decided.
The first is that the financial sustainability of any such project can be brought into question not only by cost escalation but by changing commissioning and cardiothoracic care requirements. No project should go ahead if it is not financially sustainable in the long term. Looking 20 years ahead, I see some big changes to the health service in prospect.
Secondly, there must be opportunities for service development. We know only too well the difficulties that can ensue from putting hospitals in urban, city-centre locations on sites that are too constrained, with the need to manage service development and possible consequent changes in service.
Thirdly, we must be able to realise the benefits of synergies between clinicians and scientists, such as those at Imperial college's faculty of medicine and Sir Magdi Yacoub's heart science centre, which I have visited. There will be competing considerations with regard to synergies in research in relation to Harefield, and the best interests of Harefield's patients, in terms of location, will need to be carefully considered.
The last and absolute requirement is that the independence of the Royal Brompton and Harefield NHS trust and its sense of focus on its task must be retained, as must its ability to deliver positive outcomes for its patients, regardless of location.
I have not mentioned Mount Vernon hospital and I will not go on about it, but it, too, can be used to illustrate by analogy. The Royal Marsden hospital has a site in the constituency of the hon. Member for Sutton and Cheam, and if one were to say to it, "Well you've just got to put everything from Sutton into Chelsea, because the benefits of co-location and the synergies of research with clinical practice are so compelling," notwithstanding that there is a substantial research facility on the Sutton site, I think that the Royal Marsden would reply, "Don't be foolish; we cope now, 373WH and we have the benefit of two sites. We are preeminent." That hospital is the leading cancer specialist tertiary referral service in the country.
The reconfiguration of services sometimes seems to be driven more by bureaucratic objectives than a desire to meet the needs of patients and clinicians. It is not an obvious decision. For example, it will be difficult to decide whether Papworth hospital should be transferred to the Addenbrooke's site, and if there is a good reason for Harefield to transfer, it has not been compellingly made. In fact, the reverse is true for the clinicians, staff and patients of Harefield.
§ The Minister of State, Department of Health (Mr. John Hutton)I warmly congratulate the hon. Member for Uxbridge (Mr. Randall) on securing the debate. This matter is, quite rightly, of concern to him and his constituents and to millions of NHS patients in west London. The same applies to the hon. Member for Ruislip-Northwood (Mr. Wilkinson).
It comes down to this: the challenge that we all have to face—whether we are in or out of government—is how best we can maintain the clinical excellence of those important services in a rapidly changing scientific and medical environment in a way that maximises as their convenience and patients' access to them. It is not easy to do that, especially in a way with which everyone, including patients, the public and staff, can always agree. The NHS has set out proposals to achieve that for specialist services in west London, but it is obvious from this debate, and from the previous occasions on which this issue has been raised in the House, that those plans have generated considerable controversy.
I have listened carefully to hon. Members, but I am not at all clear about what alternatives the hon. Member for Uxbridge has to those plans, or about the level of medical or clinical support that any such alternative would have. Neither he, nor the hon. Member for Sutton and Cheam (Mr. Burstow), nor the hon. Member for South Cambridgeshire (Mr. Lansley) set out any such alternatives today with any clarity.
The hon. Member for South Cambridgeshire made a thoughtful contribution, which was devoid of some of the passion that the hon. Members for Uxbridge and for Ruislip-Northwood, who have constituency interests, brought to bear. His speech may have served as cold comfort to his two hon. Friends. The hon. Member for Ruislip-Northwood shakes his head, but I saw the look on his face.
One thing is clear. We have not heard from the official Opposition today any promise to keep Harefield open or to keep Mount Vernon in its current state. They put the best face they can on the matter, but that is the uncomfortable truth for those two hon. Gentlemen.
The hon. Member for Uxbridge has often raised the question of the future of Harefield hospital on behalf of his constituents—rightly. Under the inspirational clinical leadership of Professor Sir Magdi Yacoub, the hospital has been remarkably successful in its development of heart and lung services and has rightfully earned a reputation as a centre of excellence for that specialist work. Research and development 374WH have become an integral part of its work to improve life expectancy and the quality of life for those with serious cardiothoracic conditions. Like all hon. Members who have spoken in the debate, I pay tribute to the staff at Harefield who have contributed over many years to the hospital's excellent work.
Specialist care of the type that has been pioneered at Harefield will continue to form a crucial part of the overall network of services that are provided for people with coronary heart disease. As the hon. Gentleman is aware, in October 2001 the Department of Health confirmed that it intended to move ahead with plans to develop a new health campus at Paddington—a development that could bring together three world-class hospitals alongside cutting-edge research facilities. The decision was reached after full local public consultation and after the proposal had been referred to my right hon. Friend the Secretary of State for a final decision.
It is obvious from the remarks of the hon. Member for Ruislip-Northwood that he views the consultation exercise as a fraud. That was the word that he used. That is a pretty serious accusation and it is noteworthy that the outcome of the consultation was not challenged. Certainly no challenge was made to the decision of my right hon. Friend.
§ Mr. WilkinsonI am grateful to be able to give an explanation of my remark. Is the Minister aware that there was virtual unanimity in the responses? People were unanimous in not wanting the transfer of Harefield to Paddington basin. Notwithstanding that fact, the Government pressed on, and that is an insult and a fraud. If consultation means anything, there has to be an active response to try to modify proposals in the light of what people want. Otherwise, why engage in consultation in the first place?
§ Mr. HuttonI shall come to that point, but the hon. Gentleman has been around the block many times. He will remember the outcry in his constituency when a Conservative Government closed the accident and emergency unit at Mount Vernon, despite widespread local opposition. He said today that decisions that had been taken about Harefield represented centralised socialist control of the NHS. What a load of nonsense that allegation is. I do not remember him making that allegation about the right hon. Member for Charnwood (Mr. Dorrell) when he made that decision to close accident and emergency services at Mount Vernon.
I do not want to embarrass the hon. Member for South Cambridgeshire any further than I may already inadvertently have done, but his speech showed balance and a recognition that in such matters it is not always possible to make decisions about services that guarantee unanimity among the public. Sadly, that is the responsibility of Government. He recognises that and his hon. Friends do not. That is a difficulty for him, not for me.
Despite the wish of the hon. Member for Ruislip-Northwood to brush over the matter, doubts have been expressed by clinicians about the ability of a single specialty hospital to continue in relative isolation. That 375WH is because it is becoming crucial for the success of single specialty hospitals to have access to a wider range of related sub-specialties. The hon. Member for South Cambridgeshire sensibly drew attention to the strong arguments for such relocations in relation to Papworth and Addenbrooke's. Fortunately, he could not see his two hon. Friends' reaction.
Harefield, being several miles from local general hospitals with accident and emergency departments, is not in a position to draw on support from the wider range of specialties that are found at such hospitals, or to benefit from the closer relocation of tertiary services. I am sure that the hon. Member for Uxbridge will agree with me—to be fair to him, I think that this was his starting position—that we should all be prepared to accept that hospital and community services will, from time to time, need to change if they are to continue to fulfil patients' needs and improve services.
Services should not remain state forever, frozen in time, but should reflect advances in technology and clinical practice. The only way to achieve those benefits in the case of Harefield's specialist heart and lung services would, I am advised, have been to build a completely new general hospital on the Harefield site. Such a proposal would seriously have threatened the viability of three other existing hospitals—Hillingdon hospital, Northwick Park hospital and Watford general hospital. With the benefit of not only hindsight but a bit of common sense, I do not think that that it would have been sensible or wise to take such a course of action.
That is why a different way forward has been chosen. It will incorporate St. Mary's hospital, the Royal Brompton and Harefield hospitals and Imperial College's faculty of medicine on a new, purpose-built health campus in Paddington.
§ Mr. LansleyLest we proceed under a misapprehension, let me ask whether the Minister is really suggesting that Harefield has literally no alternative but to go to the Paddington health campus? If so, I disagree. I am not signing up to the alternative of re-provisioning the tertiary cardiothoracic institute on the existing site, but Harefield clearly has that option, and the same is true of Papworth.
§ Mr. HuttonI am grateful to the hon. Gentleman for reconfirming that he is not promising to keep Harefield open. Of course there are other options, but the question is which is the optimum one. Which will guarantee the highest standards and the benefits of new technology and closer collaboration between specialties? That is the choice that we face, and it does not serve the purpose of this debate or the wider debate to suggest otherwise. I am certainly not suggesting that there are no alternatives: there have always been alternatives, which have been considered, but, crucially, they have not been supported by the clinicians involved, and I shall come to the reasons why in a second.
The purpose of the health campus will be to create a new centre of clinical excellence, innovation and teaching research in one of the capital's major urban regeneration schemes. The hon. Member for Uxbridge said that the vision was originally exciting, and I think that it remains exciting.
The hon. Gentleman accused me of wrongly saying that he opposed the Paddington health campus project, but given his contribution today, I would prefer to stand 376WH by my remarks. I do not know whether he originally supported the Paddington health care campus, but he certainly has reconfirmed his opposition to it today.
§ Mr. RandallThe Minister seems to think that it is wrong to oppose it. I am concerned that the costs and everything else in the business case are escalating out of control. We have discussed the other options before, but my point today is that I am deeply concerned about the project itself.
§ Mr. HuttonI understand the hon. Gentleman's concerns. I, too, have concerns, to which I shall come in a minute. However, his view might have had more credibility if he had supported the Paddington health campus in the beginning. I understand, however, that he always opposed the campus because he wanted to appease local campaigners over Harefield's future.
§ Mr. RandallThe Minister is being unfair. He says that hon. Members oppose something only when they want to appease someone, and it is unfair to suggest that we cannot make up our own minds. My own business experience tells me that some of these things, which have been dreamed up by people with wonderful vision, simply cannot be afforded.
§ Mr. HuttonHon. Members will come to their own view on all these matters when they read the debate and the hon. Gentleman's remarks. However, it might be helpful if he could confirm whether he supported the Paddington health care campus on the basis of the original costings.
§ Mr. RandallI have not been a supporter of the Paddington health campus because I thought from the outset that it was a fraud.
§ Mr. HuttonWell, there we are. I said that the hon. Gentleman had always opposed the campus, and he said that that was not true, but now we know the full story.
§ Mr. Randallrose—
§ Mr. HuttonI shall not give way to the hon. Gentleman again. We have had several exchanges on the issue, and this one is pedantic and is not taking us much further forward.
Given the steep rise in the costs of the new campus development, a review of the outline business case and the management of the project to date was begun late last year, and rightly so. The team was led by officials from my Department and included officials from the Treasury and the National Audit Office. The review has now been completed, and the North West London strategic health authority will, I think, make a statement on the outcome in the next fortnight. It will cover the timetable for the new campus, as well as its affordability. It was right to conduct that review: costs have risen steeply, and delays in the project have become obvious. That cannot be allowed to continue without adversely affecting the proper organisation of those crucial NHS services.
The recent review has brought a new and necessary focus to the project. The NHS and patients in west London need to know soon that the project can be taken 377WH forward quickly and expeditiously. I shall ensure that those hon. Members who raised concerns today will be fully advised of the outcome of the review; we can share the results of the report.
The hon. Gentleman raised a number of questions on staff, specifically whether staff will consider transferring to the Paddington health campus. It is true that only a small percentage of Harefield staff have said that they will definitely relocate, and that a large number have not yet decided. That is hardly surprising, as the move will not take place for several years; it will not be until 2010 at the earliest. However, it is important to recognise that the project continues to enjoy broad clinical support. Leading clinicians at Harefield continue to give their support for the Paddington health campus and the model of care that it proposes, and they recognise the part that the campus will play in preserving the heritage of Harefield.
Dr. Rosemary Radley-Smith, associate director of the Royal Brompton and Harefield NHS trust, has made clear her firm support for the move to Paddington. She has worked at Harefield for more than 30 years, treating many thousands of patients, but she recognises that without the support of other disciplines Harefield may not be a viable choice for transplant surgery in the longer term, an issue rightly raised by the hon. Member for South Cambridgeshire. Other centres could provide a better and safer service for patients; as a consequence, they will be sent there. That is not in the long-term interests of Harefield, nor of what it stands for.
Dr. Charles llsley, chair of the Harefield medical committee, confirms the wider support of hospital consultants at Harefield hospital, saying that they are fully behind the relocation of services to Paddington. Those are serious voices; we should pay them serious attention.
Not all of Harefield's work will transfer to the new campus project. Only a third of Harefield's cardiology patients will need to travel to Paddington; 65 per cent. of all cardiology patients will be treated in local services at their nearest acute hospital. For cardiology outpatient and day-case patients, the figure is even higher at 82 per cent. Up to 25 per cent. of surgical patients already travel to St. Mary's or the Royal Brompton hospitals for care. Because the treatment is highly specialist and complex, it depends on proximity to the specialist care provided by St. Mary's.
With much of the clinical work load staying locally, staff will have the opportunity to do the same; they will be able to transfer to a local district general hospital— 378WH for example, to Hillingdon or Watford—if they do not want to remain with Harefield in Paddington. As I said, staff at Harefield have enormous skill and expertise, and I am confident that they will not be lost to the NHS family.
In the couple of minutes left to me, I want to deal with Mount Vernon hospital. The hon. Gentleman was right to speak about the future of the hospital and its cancer services. For the past two years, the NHS in Bedfordshire arid Hertfordshire has worked extremely hard with its local communities in the North West London strategic health authority to develop an agreed strategy for health care, including specialist cancer care. Between June and September 2003, Bedfordshire and Hertfordshire SHA held a formal consultation on the future configuration of health services in the two counties.
It took more than two years to come to a conclusion—rightly so, because it is a complicated and important issue. The chosen option will see Bedfordshire and Hertfordshire retaining and developing the five existing hospitals, and building a new hospital in Hatfield to replace the QEII hospital at Welwyn Garden City. The plans for the new hospital will include the provision of a new cancer centre.
In light of the Bedfordshire and Hertfordshire proposal and the subsequent decision to establish a cancer centre in Hertfordshire, two further consultations were held in 2003 to determine and guarantee a future for Mount Vernon hospital. It is important to ensure that that future is made available. I know that that is what local people want to see. My hon. Friend the Member for Harrow, West (Mr. Thomas) led a delegation from his constituency to press home the point to me only last month. He has fought tirelessly for Mount Vernon, and I want to record my appreciation for the way he has put the argument to me.
The consultation has resulted in a clear commitment to maintain cancer services, including radiotherapy and chemotherapy, at Mount Vernon. Its future as a cancer centre is not in dispute. I accept that more work needs to be done on the details of the services that will be provided on the site. That will be determined through the development of a new strategy for cancer services across the whole of north-west London.
Bedfordshire and Hertfordshire strategic health authority is continuing to work closely with colleagues in North West London SHA on the development of its cancer strategy, which includes future cancer services on the Mount Vernon site.