Hon. Nicholas Soames (Shadow Secretary of State for Defence, International Affairs; Mid Sussex, Conservative)

First, let me ask the Minister to pass my sincere sympathy to his hon. Friend the Under-Secretary of State for Health, Dr. Ladyman, and to say how sad my hon. Friends and I were to hear his news.

I am grateful for this opportunity to draw to the House's attention the serious anxieties of many of my constituents about the proposals in the consultation document "Best Care, Best Place". I was grateful to the Secretary of State for seeing an all-party delegation from Mid-Sussex, whose members expressed very clearly their views on the problems involved in the proposals. He gave them a genuine and full hearing. I want the Minister to know that the issue features very strongly throughout my constituency—in Burgess Hill, East Grinstead and Haywards Heath and in the royal areas—and is followed with great interest in the wider Sussex area. I note the support of my right hon. Friend Mr. Maude and my hon. Friends the Members for Arundel and South Downs (Mr. Flight) and for Wealden (Charles Hendry), who I hope may seek to catch your eye, Mr. Deputy Speaker.

Many of these ideas were aired only five years ago when there was another major consultation on a document entitled "Modern Hospital Services for Central Sussex—A challenge for us all". And a challenge they have proved to be, albeit an unresolved challenge. Five years on, here we are again in another period of instability and uncertainty for my constituents and for the patients and staff of the Princess Royal hospital in Haywards Heath.

The Princess Royal is a busy modern purpose-built hospital with 339 beds. During last year 10,700 people were treated as emergency admissions and 3,072 as elective admissions. In its admirable and busy out-patient department, 79,890 people were looked after. The accident and emergency department—a subject of continuing and great local anxiety—cared for 30,734 people.

The Princess Royal has a total staff of 1,331. All those excellent people are dedicated to their work and to those for whom they care, and I pay the warmest tribute to them for the magnificent service that they provide. The Minister will understand that they are extremely anxious about the future, and deeply concerned about the continuing upheaval caused by the endless rearrangements and the lack of stability of service. Many of them know what is right for Mid-Sussex, and think little of what is proposed. I want the Minister to reassure those people tonight, and to give some certainty to what the future holds.

I say that because I want the Minister to appreciate that the Princess Royal is an excellent NHS hospital that is greatly valued in its local community. As I said in a debate five years ago on 29 November 2000 and again on 6 November 2001 in the House, we are truly proud locally of the service that it provides, the skills and excellence of its staff and the solid best efforts of its management. We understand the anxiety of the wider community to have the services that they really need and to which they are entitled.

I should also tell the Minister that there are some fundamental questions relating to joined-up government which must be addressed and which, in my opinion, have not been dealt with well in the document. The Government's new housing proposals require all of us in West Sussex and elsewhere in Sussex—particularly Mid-Sussex—to absorb a substantial number of new houses. The local infrastructure to support those plans simply does not exist—a problem that I have drawn to the attention of the Prime Minister, the Deputy Prime Minister, the Chief Secretary to the Treasury and the Minister for Housing and Planning in parliamentary questions, debates and extensive correspondence.

The provision of an extensive social infrastructure, including health services, is of the first importance. The Government's plans could include about 45,000 extra people in Mid-Sussex. I therefore need an assurance from the Minister that the plans take into account the substantial extra growth being imposed on Mid-Sussex by his Government.

Let me now deal with the consultation document and my constituents' views. My hon. Friend the Member for Arundel and South Downs and my right hon. Friend the Member for Horsham—indeed, I think all of us—understand that the national health service has always evolved, and we accept that that is right.

We accept the movement of some services between the Princess Royal hospital in Haywards Heath and the Royal Sussex County hospital in Brighton if it is based on sound and substantial clinical grounds. But my constituents share strong and determined views concerning the irreducible minimum of services that must be retained at the PRH. There is the deeply held perception locally that a remorseless drift of services away from Haywards Heath towards the Royal Sussex County hospital in Brighton is taking place, and that is what is causing such strong local anxiety.

Mr Francis Maude (Horsham, Conservative)

I congratulate my hon. Friend on securing this debate and I entirely support everything that he says. Does he share my view that the uncertainty that his and my constituents feel about the current arrangements and consultation is amplified by the dithering and procrastination that surrounded the movement of the hospital services on which many of my constituents depended away from Crawley to Redhill? Such procrastination has led to a state of crisis at the East Surrey hospital in Redhill. I now have more complaints about the health service than I have had at any stage in my parliamentary career. Does he share my view that this matter has to be dealt with in the short term with certainty and clarity, and that in the longer term, the answer is to build a new hospital at Pease Pottage—a prospect that was dangled before the public before the last election, and then promptly taken away afterwards?

Hon. Nicholas Soames (Shadow Secretary of State for Defence, International Affairs; Mid Sussex, Conservative)

My right hon. Friend is quite right. The shambles and debacle of the Crawley and Redhill situation is causing the gravest concern to us all because it inspires such little confidence in the NHS decision-making process. As to creating a new hospital at Pease Pottage, that will inevitably have to be considered.

Paediatrics was removed from the PRH a year ago and transferred to Brighton without any proper consultation. We must have today from the Minister some direct assurance that this sort of thing will not happen in future, and that serious thought will be given to preventing services from being stripped from the PRH. Secondly, the accident and emergency department was ludicrously threatened with closure five years ago, but following absolute uproar in Mid-Sussex and a vigorous campaign led by myself, the district council and our excellent local paper the Mid Sussex Times—known as "The Middy"—the decision was overturned and the department, I am grateful to say, has continued.

But because of the ill-handling of this matter and of the very issue raised by my right hon. Friend the Member for Horsham—the current unhappy debacle at the Crawley hospital, which has now been downgraded to a walk-in accident and emergency centre, and the extremely unsatisfactory situation at Redhill—confidence in NHS decision making locally remains very low. We urge Ministers to take a personal interest in the way in which this matter will be handled.

Despite the assurances that have been given, there remains the real concern that our accident and emergency department at the PRH is to be downgraded. We cannot have this and we will not allow it. I am especially anxious about whether a hospital that does not treat acute trauma or provide emergency surgery will be viable in future. Again, we need assurances, particularly given that on our doorstep is Gatwick airport, and the threat of a major incident or terrorist attack.

The third point of great concern is the question of vital maternity services and the possible reduction in neo-natal and maternity services at the PRH. I believe it absolutely essential that these services be retained, and that women should be able to have their babies in Haywards Heath. I understand that the trust is trying to recruit advanced neo-natal nurse practitioners. They are as rare as hen's teeth, and there is understandable scepticism about the idea that they can be recruited. We need assurances on this question and an understanding that it would be wholly unacceptable to the growing Mid-Sussex population—in East Grinstead, Haywards Heath, Burgess Hill and the rural areas—if they were unable to access essential services locally.

There are many serious difficulties that need to be dealt with concerning transport. Access to the Royal Sussex County hospital in Brighton is appalling, as is the traffic congestion that surrounds it. There is very real concern in Mid-Sussex—particularly in East Grinstead, which is to the north of the constituency—that transport times would be unacceptable in an emergency. There are also important questions that must be settled relating to car parking, staff transport and the wholly inadequate public transport infrastructure. We will look to the trust to build on the work that is already being done through the Mid-Sussex transport group.

Mr Charles Hendry (Deputy Chairman, Conservative Party; Wealden, Conservative)

I, too, congratulate my hon. Friend on securing the debate and commend him for the way in which he has led this initiative and campaign. Is he aware that almost 20,000 of my constituents in and around Uckfield are dependent on the Princess Royal hospital? So there is tremendous interest in the accident and emergency unit—for them, it is a 20-minute journey to Tunbridge Wells and a half-hour journey to Brighton or Eastbourne—and the survival of that hospital is fundamental to my constituents as well as to his.

Hon. Nicholas Soames (Shadow Secretary of State for Defence, International Affairs; Mid Sussex, Conservative)

My hon. Friend makes an extremely important point, and I hope that the Minister will deal with it. The kernel of the argument is that what is proposed, if the services were to be downgraded, would be dangerous, unsatisfactory and not acceptable to his constituents or to mine.

There is also the question of the future of Hurstwood Park hospital, which is in the grounds of the PRH. Some detailed work needs to be done on the future location of those services—of course, they must be tied into the medical school part of the trust—but it seems strange that, with £2 million newly invested in that facility, it could be closed and moved.

On a separate, already very important matter, the consultation paper does not adequately deal with the needs of the increasing number of elderly residents in Mid-Sussex. Their needs must be addressed in the detail that they deserve.

In my view, the management of the trust need to be less Brighton-centric and to demonstrate a determination to run a split-site operation more obviously equitably. They need to show a greater tangible commitment to the PRH, not only in the services, but by word and deed. The PRH needs to be reassured of the wholehearted commitment of the medical school. That will require an act of will and leadership, of which we need to see much more.

Finally, may I raise one matter with which my hon. Friends the Members for East Surrey (Mr. Ainsworth) and for Wealden will wish to be associated? The Minister will be aware that in my meeting with the Secretary of State for Health on 28 February, I mentioned to him our concerns about the excellent and unique Queen Victoria hospital in East Grinstead and raised the very important issue of the national burns review. The Secretary of State has since called for further information from officials because I hope and believe that he now realises that the proposals made by the national burns review are not substantial enough to be subjected to public consultation. The robustness of the data used to make recommendations from the review has been criticised independently, and the process appears to have lacked any form of serious transparency and taken little account of patients' needs.

If the Queen Victoria hospital is not a centre able to treat the most seriously burned patients, many will face long transfers to other hospitals and may be exposed to risks for which there is no clinical necessity. If the Queen Victoria hospital has to downgrade in any way, its national emergency responsibility will also be seriously affected. The future development would compromise its world-class research. Staff morale is being gravely undermined by the insensitivity with which the matter is being handled by the Government, and I should be grateful to the Minister if he assured us that any decision will be properly and swiftly taken.

Mr John Hutton (Minister of State, Department of Health; Barrow & Furness, Labour)

First, I express my appreciation to the hon. Members for Mid-Sussex (Mr. Soames) and for Arundel and South Downs (Mr. Flight) for their remarks about the Under-Secretary of State for Health, my hon. Friend Dr. Ladyman. More importantly, my hon. Friend himself will be grateful to both of them for their remarks.

I congratulate the hon. Member for Mid-Sussex on securing this debate and on the way in which he presented the argument. I know that he has been involved actively in the public consultation on these important proposals. He has played an important and significant role.

Before I turn to the specific issues that were raised this evening, I want to take this opportunity to recognise the tremendous work being done by thousands of dedicated NHS staff across the whole of the Brighton and Mid-Sussex area in delivering good quality services. I pay tribute to them—the hon. Member for Mid-Sussex did so himself, very warmly—for their commitment and service to NHS patients and their families. We are very lucky to have them working in the NHS.

It is understandable that all Members of this House attach the greatest importance to developments within their local NHS. Indeed, it is extremely important to all our constituents that they are able to enjoy access to high-quality health care services. That said, I have to tell the hon. Member for Mid-Sussex—as did my right hon. Friend the Secretary of State a few weeks ago—that the best people to make decisions about the NHS in his area are those closest to the front line. That is why we have set up a devolved structure in the NHS and shifted the balance of power to local primary care trusts so that local people can make local decisions.

I want to give the hon. Gentleman, the hon. Member for Arundel and South Downs and Mr. Maude the assurances they are seeking, but I should emphasise that any decisions that are to be taken will be initiated first and foremost by the local PCT.

I would be failing in my duty if I did not put some of these important local issues into a wider national context. For the period 2003–04 to 2007–08, expenditure on the NHS in England will increase significantly: on average by 7.2 per cent a year over and above inflation. For the three years from 2005–06 to 2007–08, NHS spending will increase on average by 7.1 per cent. a year over and above inflation—a total increase of 23 per cent. in real terms over the period. Over this period, the total amount spent on the NHS in England will rise from £69 billion in 2004–05 to £92 billion in 2007–08.

In the constituency of the hon. Member for Mid-Sussex, the Government have provided the Mid Sussex primary care trust with £124.8 million this year compared with £98.1 million when it was established in 2002. By 2007–08, Mid Sussex PCT will receive a total allocation of £165 million.

I do not want to introduce a sour note of party politics into the debate, but I can feel the temptation slightly welling up inside me. Although the hon. Gentleman, like other Conservative Members, voted against the extra resources going into the NHS, I am sure that he would none the less welcome the growth in his local NHS that these extra resources will allow us to sustain.

Mr Francis Maude (Horsham, Conservative)

How does the Minister explain the fact that, through no fault of the staff, who do a fantastic job, the standard of health care for my constituents in Horsham is less good than it has been in all the time that I can remember?

Mr John Hutton (Minister of State, Department of Health; Barrow & Furness, Labour)

The right hon. Gentleman made the point that he was referring to accident and emergency services, not the whole national health service. I would be surprised if he were referring to every aspect of the NHS in his constituency being worse—but perhaps he was. I want to come to the point about accident and emergency services, because he raised an analogy with Crawley and I want to dispel the suggestion that has been made.

The hon. Member for Mid-Sussex raised an important point about population growth in his part of the beautiful county of Sussex. I simply say that allocations to primary care trusts are capitation based, so they take place on a weighted population basis. If there is projected population growth in Sussex, as I am sure there is, we have a proper mechanism by using population projection data from the Office for National Statistics to make sure that the three-year projections for allocations properly reflect the increased likely use of health care and social services by expanded populations. In that regard, I can certainly give him the assurance that he seeks. That is why increases of the magnitude that I have described are going into his county.

The hon. Gentleman raised several specific issues. In order to make the best possible use of the resources that we have made available and to achieve our goal of providing the highest-quality services, the NHS is, in many respects, changing the way in which it delivers its services to the public. We in the House generally recognise that hospital services need to change if we are to continue to fulfil patients' needs and improve access. It is a disservice to the public to try to suggest otherwise. I am glad that the hon. Gentleman has not fallen into that particular trap.

As I said earlier, it is now the responsibility of the local NHS—following "Shifting the Balance of Power", the initiative that we took a few years ago—to manage and improve these services. In the central Sussex area, including Brighton and Mid-Sussex, the NHS has already started to look ahead to plan and develop health services fit for the future. A wide-ranging public consultation, led by the Mid Sussex primary care trust, has taken place across the local health community into how best to improve the quality and range of health care services. Indeed, the hon. Gentleman met my right hon. Friend the Secretary of State to discuss it just last month.

The proposals outlined in the consultation will certainly alter the pattern of health services by seeking to deliver as much care as possible closer to people's homes, but also by ensuring that specialist in-patient care is available to those who need it. This consultation has had the full support of the Surrey and Sussex strategic health authority, and was developed with all the NHS organisations in the area.

The consultation period for the proposals has now ended and the local NHS organisations involved expect to make decisions based on the outcomes of those consultations, taking into full account the views of the joint overview and scrutiny committee over the next few weeks. I have been assured by the Surrey and Sussex SHA that the proposals are about improving the quality of care for patients, making better use of existing skills and resources and providing sustainable, fully staffed services.

As I said, the public consultation has now closed and the local NHS organisations will be making decisions at their next board meetings. I do not want tonight to pre- empt any of those local decisions, but I recognise that the hon. Gentleman needs reassurance that the consultation process was properly organised, and that the plans will ensure that services remain of the highest possible quality. The advice that I have received suggests to me that the joint overview and scrutiny committee of the local authorities expressed broad contentment with the local processes that have been followed.

I understand that the local NHS held a further event last week, at which an invited audience of key local stakeholders reviewed feedback on the consultation, looked at the emerging issues and agreed some action for taking public involvement and engagement forward. By the end of March, a report setting out the feedback and the preferred way forward will be presented to the chief executives of all the health organisations concerned. I understand that the report will be discussed in detail by each individual board before any decisions are made, subject to detailed implementation plans and, where necessary, capital bids.

The hon. Gentleman raised a number of issues to do with the challenges facing his local acute trust, and expressed concerns about his local hospital, the Princess Royal hospital in Hayward's Heath. I am assured by those managing the service locally that the hospital has secured its future following its merger with hospitals in Brighton in 2002. I am also advised that it will benefit from the plans for an elective orthopaedic centre on the site in 2006. This will receive patients from the whole Brighton and Mid-Sussex area, and will provide a highly efficient service, with reduced risk of cancellations. I hope that, in some small way, that deals with his point about a Brighton-centric NHS.

Furthermore, it is my understanding that the consultation proposals offer a positive future for the Princess Royal hospital. Indeed, it has identified the continuation of accident and emergency services there as a fixed point on the campus, which was one of the hon. Gentleman's principal concerns. There is no question of A and E services being downgraded or becoming a minor injuries unit. That is not going to happen.

The Princess Royal hospital has, in fact, benefited from many developments since 2002, and more than £8 million has been invested in improving local services on the site, including an extra operating theatre, increased staffing levels, a new hysteroscopy suite, enlarged teaching facilities to help to accommodate its major role in the new medical school for Sussex and the refurbishment of Hurstwood Park neurosciences centre.I believe that the Princess Royal hospital will go on making a major contribution to the work of the NHS in the hon. Gentleman's constituency.

The hon. Gentleman also asked about the national burn care group and its work on developing proposals. My right hon. Friend the Secretary of State wrote to him only a few days ago saying that the work is being led by the national health service. No final decisions have been made regarding the development of burn care centres. The hon. Gentleman will be aware that any proposals for change will be submitted to a full public consultation process, probably in the summer later this year. It is important to ensure that the NHS has sufficient capacity to deal with those serious injuries, and we recognise that we need to do more work to ensure that it has that capacity.

I have listened carefully to the concerns raised by right hon. and hon. Members. It is our policy that primary care trusts, in partnership with other local NHS trusts and the strategic health authority, should decide the priorities for the NHS locally. That is where specific local knowledge and expertise lies, and it is not appropriate, particularly given Opposition Members' strictures about micro-management by Ministers, for us to decide on the direction of travel and how services should be configured locally. We have made that clear. It is right that the local NHS should do that.

I agree that a number of the problems facing the hon. Gentleman's local area require long-term solutions, and the relevant PCTs and the hospital trust have consulted about the future of all health services, including those at the Princess Royal hospital. I do not wish to prejudge the local consultation process, but as I said, it is my understanding that it offers a positive future for the Princess Royal hospital, but that some changes, to which he alluded, will be necessary. In particular, there will be a greater emphasis on providing care closer to where people live, with more investment in local primary and community services. I hope that he welcomes that.

I will, of course, ensure that local health officials see the Official Report of our proceedings and take note of the hon. Gentleman's concerns, but I hope that he will continue to liaise with his local health economy, which he has done so effectively to date, to bring about more improved services for the residents of his constituency and for central Sussex as a whole.

Question put and agreed to.

Adjourned accordingly at seventeen minutes to Nine o'clock.