§ Mr. Eggarasked the Secretary of State for Social Services if he has yet decided the future administrative structure for health services in London; and if he will make a statement.
§ Dr VaughanI have carefully considered the recommendations of the four Thames regional health authorities, the advice of the London Advisory Group and the many representations made to Ministers. I have now decided that, subject to the necessary orders being made in due course, the district health authorities listed will be established to come into being on 1 April 1982. In most 191W cases these districts are those recommended by the regional health authorities and endorsed by the London Advisory Group.
The London Advisory Group, however, proposed that there should be a single Riverside district based on the existing South Hammersmith and Kensington and Chelsea and Westminster south districts and that the existing North Hammersmith district should be included in an Ealing and Hammersmith district. I am convinced that the proposed Riverside district would create insuperable problems for liaison with the three London boroughs concerned. I have already announced my decision to establish a special health authority for the Hammersmith hospital. I have now decided that there should be a separate Ealing district health authority, coterminous with Ealing borough; a Hammersmith and Fulham district health authority; and a Victoria district health authority based on the existing Kensington and Chelsea and Westminster south district. The new special health authority will, however, continue to manage all the services at present managed by the existing North Hammersmith district until the new authorities, the regional health authority and the boroughs have had time to consider together what new arrangements would be appropriate.
The North East and North West Thames regional health authorities and the London Advisory Group were influenced by my previous guidance that there should be no major change in regional boundaries and recommended that the existing South Camden and Kensington and Chelsea and Westminster north east districts should be retained. Both these districts would have very small resident populations. University College hospital and the Middlesex hospital are contiguous and have begun to co-ordinate closely their clinical activities. I believe that new administrative arrangements should build on this co-operation and that both these hospitals should be in the same district. Accordingly I have decided that the regional boundary should be changed to bring the existing Kensington and Chelsea and Westminster north east district within the North East Thames region and that this district should be merged with the existing South Camden district to form a new Bloomsbury district health authority. I would, however, expect the Middlesex hospital to continue to provide regional services—as recommended by the London Health Planning Consortium and the London Advisory Group—for the North West Thames region. I also wish planning for the eventual closure of Horton and Banstead hospitals to continue and have asked the North West Thames regional health authority to consider urgently which district health authority should now manage these hospitals. Both regional health authorities will need to consider jointly new arrangements for nurse training
Another area where it seems sensible to change the regional boundary relates to the proposals for North and North West Surrey. I have decided that it would be wrong to break up the existing North Surrey district and include the Spelthorne part in North West Surrey because it is a separate community on the other side of the Thames. I also consider that Spelthorne would not be a viable district health authority on its own. I believe its links are much stronger with Hounslow than with North West Surrey and have decided therefore to include this district in a Hounslow and Spelthorne district health authority, in the North West Thames region.
192WSimilarly, I have decided that it would be wrong to break up the existing Roehampton district. Furthermore, I believe that the proposed Kingston and Richmond district health authority would be too large and complex a district to be managed effectively. I acknowledge the dedication and effort of all those who have striven to resolve the difficulties of managing the existing single district area, with its complex overlap problems, but I am sure it is right to split this area into a Kingston and Esher district and a Richmond, Twickenham and Roehampton district. Teddington Memorial and St. John's hospitals, which have very close links with the West Middlesex hospital, will however be extra-territorially managed by the Hounslow district health authority.
The South East Thames regional health authority recommended retaining the names of St. Thomas's, King's and Guy's in the new district health authorities. I do not consider it appropriate for districts to be named after hospitals, particularly in view of the need to give higher priority to community care. I have therefore proposed that these districts be named West Lambeth; Camberwell; and Lewisham and North Southwark; but I will be willing to consider suggestions for other names for these, for the Bloomsbury and Victoria districts and for any other districts with cumbersome names.
Finally, I must again express my appreciation for the thorough and constructive manner in which the Thames regional health authorities and the London Advisory Group developed their proposals and for the responsible approach adopted by all those who subsequently put forward their views to myself and my Ministerial colleagues.
Subject to parliamentary approval, the new district health authorities will be:
Resident population North West Thames Region Hounslow and Spelthorne 295,000 Ealing 292,000 Hammersmith and Fulham 167,000 Paddington 131,000 Victoria 157,000 North East Thames Region Newham 229,000 Tower Hamlets 146,000 City and Hackney 205,000 Islington 170,000 North Camden 107,000 Bloomsbury 157,000 South East Thames Region West Lambeth 179,000 Camberwell 228,000 Lewisham and North Southwark 326,000 South West Thames Region North West Surrey 203,000 Mid-Surrey 167,000 Kingston and Esher 182,000 Richmond, Twickenham and Roehampton 236,000 Merton and Sutton 329,000 Wandsworth 199,000