On a point of order, Madam Deputy Speaker. I should draw your attention to a statement that has been made by Professor Graham Zellick, who I understand would be the new principal of the Queen Mary and Westfield college, as it has major implications for our proceedings.
I understand, that when Bills are laid before Parliament, they are part of the very process of legislating; that Parliament is supreme and Parliament decides. I should perhaps read you, Madam Deputy Speaker, a statement that undermines the credibility of what we are doing today. I will hand to the Clerks the statement so that you can be suitably advised.
It seems that Professor Zellick has said:
Whether we experience a brief delay of two or three months or even if the Bill is more seriously obstructed and we are unable to secure its passage in this session of Parliament, we shall nevertheless be able to bring about the unified School of Medicine and Dentistry as an integral part of QMW and we shall do that by the beginning of the 1995/96 session whatever the fate of the Bill…
The QMW Council has already made the necessary amendments to its own Statutes and they can be approved by the Privy Council even though the Bill has not been enacted. That will put in place all the necessary structures. We can also do the same with our Ordinances, which do not require any external approval. The HEFC grant for all three institutions will be paid through QMW. We shall therefore be able to function as if the merger had been brought about … We have made enormous progress in the planning for merger and it is now too late to pull back or to delay. I am therefore pleased to report the unanimous view of the Merger Implementation Committee that nothing must now be allowed to impede progress … we shall be able to function as a single institution in accordance with the plans and policies already agreed as from August 1 or any date no later than the start of the new academic year.
That is a significant statement. It means that the managers of the new structure have already foreseen circumstances in which they will implement changes before Parliament decides upon the matter.
The statement is outrageous. You may wish to advise the House how we are to proceed. If these people have powers under prerogative arrangements whereby they can proceed without the approval of Parliament, that changes the nature of the speeches that hon. Members may want to make this evening. Hon. Members would be debating another issue, not whether we should proceed. They would be debating the basis on which those people would be able to proceed without a decision of Parliament.
There is another matter, Madam Deputy Speaker. Some of us have blocked the Bill. I have done so because I want to hear a fair discussion of the issues involved. What happens if people such as me are honoured by being selected to serve on the Standing Committee that considers the Bill? What happens if we sit on the Committee without knowing the precise status of the statement that I have read out? In deciding what action Parliament wants to take tonight, decisions might be taken that undermine the credibility of this place and in particular the credibility of members of the Committee. Perhaps you might be in a position to rule a little later, Madam Deputy Speaker.
Further to that point of order, Madam Deputy Speaker. My hon. Friend the Member for Workington (Mr. Campbell-Savours) showed me a copy of the statement—it appeared in volume 18, issue 4, of Barts Journal for spring 1995, which was published a few weeks ago. It contains a lengthy quote that is attributed to Professor Zellick. I asked members of St. Bartholomew's hospital whether he uttered the words that are attributed to him, and they confirmed that he did. Bart's said that it was astonished and that the words were improper and a direct challenge to the authority of Parliament.
In backing my hon. Friend the Member for Workington I want to ask you this, and it involves deceit. A number of us—especially those of us who have blocked the Bill—have received representations from Professor Zellick and the sponsors of the Bill, telling us that it has to go through as a matter of urgency, otherwise medical education in east London will fall apart. We can debate the truth of that statement; it is a separate issue.
The professor has said that regardless of what Parliament does—even if we vote against the Bill tonight—the merger will go ahead. That suggests that the promoters have been sending opponents of the Bill, including myself, information that is deceitful. That is dishonest and it is part of an attempt to say that one can go behind the back of Parliament to the Privy Council. I am not sure how one can do so, and I have written books on the constitution.
The suggestion is that one can talk to clerks in the Privy Council office, who will talk to clerks on the Higher Education Funding Council for England, and between them the promoters, the Privy Council and the funding council can thwart the wishes of Parliament. There has to be something wrong with that procedure. I have never heard of it and nor, I am sure, has any other hon. Member of this House. I hope that you can give us guidance.
Order. I should intervene at this point. The Chair cannot rule on whether there is an alternative way to deal with matters—that certainly is not within my compass. If hon. Members have grievances and concerns, it would be appropriate to raise them during the debate tonight, which might influence the way in which they vote. I cannot assume the result of such a vote but, for the purposes of argument, let us assume that, if the Bill went to a Standing Committee, such matters could be dealt with in far more detail. At this stage, we should continue the debate. I can deal only with the issue before us, which is the Second Reading of this private Bill.
Further to your ruling, Madam Deputy Speaker. What are we debating? Are we debating a Bill that would lead to the amalgamation of these colleges, and which is the only route to achieve that, or are we debating a Bill that might not lead to that amalgamation, but which permits another route being taken to secure it? We need to know. Surely it is for the Chair to rule on the status of the legislation. If it is not within your area of responsibility, Madam Deputy Speaker, can the Minister clarify the position? What are we debating?
I beg to move that the Bill be now read a Second time.
I shall forgo the pleasure of commenting on the interesting points of order, but I do not think that the legislative matters before the House are unique. At times, the royal prerogative has been used to achieve a legislative purpose. Indeed, one of the great complaints of many Opposition Members is that much European Community legislation is achieved not through this House but through the use of that prerogative. Frankly, that should not deter us from considering the Bill now.
Although the words quoted are of interest and would no doubt repay close study, I am not entirely clear. The quotation might refer to the fact that informal and ad hoc administrative arrangements have undoubtedly existed for some time between the institutions concerned.
Why is it necessary to legislate if we are being threatened with the use of an alternative procedure? If that is the objective, why not simply avoid Parliament and pursue the other route? Why should we be subject to the whims of an external authority?
Such an alternative route would be far less satisfactory. I have not studied the matter closely enough and I am not saying that such a route for achieving the objectives of this Bill exists, but I have no doubt that it is far better for the House to debate the merits of it, as we are about to, than for it to read a pronouncement in the form of an Order in Council.
The purpose of the Bill is to unite three colleges of the University of London. Two are medical colleges—St. Bartholomew's hospital medical college and the London hospital medical college—while the third is the multi-faculty college of Queen Mary and Westfield. The Bill is promoted by those three colleges, with the overwhelming support of their councils.
I am really worried. Before I listened to the introduction to the Bill, I had no knowledge of the facts that were mentioned during the points of order. My right hon. Friend says that it is better for us to debate the merits of this Bill, and I agree, but we are assuming that, if one debates its merits, one can decline to pass it and that that act would have force. I do not understand whether we are going through a sham, or whether we can not only debate the merits of the Bill but take a decision, and that worries me. The fact that my right hon. Friend apparently condoned the notion that the royal prerogative could be used to outwit Parliament shocked me.
My hon. Friend has clearly misunderstood what I said. I said that I did not approve of the alternative way of enacting legislation. I drew attention to the many occasions on which I had protested against it, especially for European Community legislation, so let us be clear about that. I will proceed because I am not here to judge your ruling, Madam Deputy Speaker, or to second-guess what you have said.
The merger will bring together the clinical schools of the London and Bart's to form a single, strong faculty of clinical medicine. That faculty, with the faculty of clinical dentistry at the London and that of basic medical sciences at Queen Mary and Westfield, will constitute the new St. Bartholomew's and the Royal London hospital school of medicine and dentistry, which will be an integral part of the multi-faculty QMW.
The provisions of this short Bill are straightforward. It has a lengthy prologue of some 12 sub-paragraphs that recite a concise history of the formation of the institutions, beginning with the founding of the People's Palace technical schools in 1887, which was the forerunner of the present QMW and takes in the charter of the medical college of St. Bartholomew's, granted in 1921, and the constitution of the London hospital medical school, which was established in 1949.
Clause 3 provides for the dissolution of the existing bodies, while subsequent clauses provide for the transfer to Queen Mary and Westfield of certain properties, obligations, rights and powers to nominate members to education and other governing bodies. The appointed day is 1 August 1995.
There are three main reasons why the Bill should be accepted, and why I should be surprised if it proved to be a controversial measure. First, it is widely accepted that it is right to end the present separation of medical colleges from the rest of university life; secondly, the Bill is strongly supported by all three institutions; and, thirdly, it completes a process of merger between all three colleges, which already embraces their pre-clinical schools. I shall develop those points so that there can be no doubt about their meaning.
It has long been acknowledged that London is different from the rest of the country and much of the world in having medical training carried out by separate institutions rather than as part of multi-faculty colleges. There are cogent academic, administrative and financial advantages to be gained, not least by undergraduates studying medicine, from having medical training carried out within multi-purpose colleges. That point has been acknowledged many times and, dare I say, most recently by Sir Bernard Tomlinson.
The case for the Bill does not, however, rest on Tomlinson. The arguments and principles behind it are anything but new and go back many decades. Of particular relevance is the 1968 recommendation to the Royal Commission on Medical and Dental Education, which proposed that pre-clinical students—those in the first two years of their medical or dental courses—should study in a multi-faculty environment.
The unification of medical colleges with multi-faculty colleges has been going on all over London. Since 1968, a number of medical schools have been united, by private Acts of Parliament, with multi-faculty colleges of the University of London. For example, University College hospital medical school was united with University college in 1979; Kings College hospital medical school and Kings college, as a college of London university, were united in 1983; St. Mary's hospital medical school and Imperial college were brought together in 1988; and the Middlesex hospital medical school was united with University college in the same year.
The Bill basically follows the form of those earlier Acts, as does the King's College London Bill, which is currently before another place and which will combine the united medical and dental schools of Guy's and St. Thomas's with Kings college.
My second reason for claiming that this Bill should be largely uncontroversial is that the merger is an agreed measure. I stress that point. All the governing bodies concerned have made that clear. In particular, Bart's hospital medical college has publicly stated that its decision to pursue an amalgamation with the London hospital medical college and Queen Mary and Westfield is its own decision, which it took because it thought that it was the right thing to do. In no sense is it a takeover bid, either by the London medical college for Bart's medical college or by Queen Mary and Westfield college for the other two.
The Queen Mary and Westfield council will henceforth contain two lay members from each of the present governing bodies of the two medical schools, with three academic members from those two colleges. Moreover, the Queen Mary and Westfield council is forming a committee on medicine and dentistry, on which both the London and the Bart's medical colleges will have still larger representation. As for personnel, the warden of the new school of medicine and dentistry will come from the London, and all those concerned want his deputy and successor to come from Bart's. Other senior appointments, including the chief administrative officer of the new medical school and, hopefully, the head of the new faculty of clinical medicine, will also be Bart's people.
My third reason for believing this to be a largely uncontroversial measure is that the merger which is the subject of the Bill is only the last stage of a move towards unification which was begun several years ago, and has already proved its success. In 1989, in accordance with the royal commission's recommendations, the pre-clinical departments of Bart's hospital medical college and the London hospital medical college, and their students and staff, were established in a purpose-built building on the Mile End campus of Queen Mary and Westfield college. They now constitute the faculty of basic medical sciences there. The three colleges are joined together to form the City and East London Confederation of Medicine and Dentistry. The proposed merger of the clinical departments is the culmination of that process and will build on the success that has already been achieved at the pre-clinical level.
One concern that was, and may still be, in the minds of some of my hon. Friends is the relationship between the Bill and the proposed merger of the two medical schools with Queen Mary and Westfield and the very different matter of the decision by the Secretary of State for Health to close St. Bartholomew's hospital. I deplore and oppose that closure decision in common with my hon. Friends, particularly my hon. Friends the Members for Hackney, South and Shoreditch (Mr. Sedgemore), for Hackney, North and Stoke Newington (Ms Abbott), and for Islington, South and Finsbury (Mr. Smith), whose constituents, like mine, are served so well by Bart's. May I make the point absolutely plain? If I thought that this Bill would advance in any way the intended closure of Bart's, I would not be moving the Second Reading this evening.
The two medical colleges are entirely separate legal, financial and administrative entities from St. Bartholomew's hospital and the Royal London hospital. They are separate institutions. The Bill is not concerned with those hospitals and does not provide for the closure of Bart's. Whatever may or may not happen to Bart's—I very much hope that it will survive—there is a compelling academic case for the merger of those separate medical schools with Queen Mary and Westfield college.
The clinical training of medical students must take place where the patients are. Accordingly, teaching and research will continue at the main site of Bart's hospital at west Smithfield for as long as clinical activity remains at that site.
Obviously, the moment that the hospital is closed, students will not be able to continue their training there. The Secretary of State has already taken that decision, and I presume that it will come into effect over the next two years. I am not quite sure of the timetable. Clearly, if the hospital is closed, students can no longer be taught there. That is what we all wish to oppose. However, the medical colleges are separate institutions and their fate is not linked with that of Bart's. Students will continue to be trained, as some are now, in the Homerton hospital and other hospitals in east London.
Would my right hon. Friend say that his view on the matter is universally held by all people who work in Bart's—the professorship, leading clinicians and consultants, staff members and nurses? Is his view a general view?
I would hesitate to claim a universality of opinion on the matter—I simply do not know. I have received no representations about the medical schools' merger which show that doctors, nurses and other people working in Bart's are worried about it. After all—I make to my hon. Friend the point that I made earlierpre-medical and pre-clinical schools are already joined together and located basically on the Queen Mary site in Mile End road.
The fact that the Bill's proposals have such widespread support is demonstrated by the fact that there are only two petitions against it. They are interesting. One of them, from a Mr. Dawson, appears to allege that the House is unlawfully constituted and that no Act of Parliament is valid unless Royal Assent is given from the throne. Interestingly, it makes no complaint about the principle of the merger.
The other petition is from two former students of Bart's, now residing and practising in Norfolk. They do not approve of the merger of the medical colleges. The weight of opinion is against them there, including that of their own college. However, they also object—this is where some of my hon. Friends may find common cause with those petitioners—to the proposed closure of St. Bartholomew's hospital.
Although a Bill is being introduced to effect the merger of medical schools, no such Bill is required to close the hospital. As the petitioners say:
it is cause for serious public concern that such excellence has been threatened without proper democratic channels of debate in the Commons first being sought in regard to the merger of the two hospitals"—
that is, Bart's and Royal London hospitals. I have sympathy with that view, and the petitioners—the Bonner-Morgans—will be pleased to know that many hon. Members on both sides of the House are pressing for an early debate and opportunity to discuss the proposed closure of hospitals in London, including Bart's.
It would be grotesque for the Bill to be jeopardised as part of some my hon. Friends' efforts to try to keep Bart's hospital open. Let us debate that issue when the time comes; the Bill has nothing to do with it. The creation of the unified St. Bartholomew's and Royal London hospital school of medicine and dentistry within a multi-faculty college of the university offers great scope to establish a medical and dental school of national and international distinction in teaching and research.
East London needs to have a strong medical school to match those being created in the south and west of the capital. Any delay in implementing the merger with, Queen Mary and Westfield will be harmful to students, to staff and to east London, and will not have any effect on the future of St. Bartholomew's hospital.
It is a great pleasure to follow the right hon. Member for Bethnal Green and Stepney (Mr. Shore) and to have listened to his cogent arguments for a measure that, as he has explained, will ensure that London retains its deserved international reputation for excellence in teaching and research.
As the right hon. Gentleman clearly said in his speech, London's research and academic excellence provides support for and gains from our health service. It helps our hospital and other services to respond effectively to medical and technological advances in treatment and to consider new ways of providing the best and most appropriate care. In turn, it benefits from centres of excellence in the health service providing a critical mass of work, a range of skills and expertise in clinical teams and high-quality treatment that enhances not just patient services but teaching and research.
That partnership is of mutual interest. It should be preserved and enhanced so that it continues to benefit academic, research and health interests. It should be strengthened.
On a point of order, Madam Deputy Speaker. Is it not utterly unprecedented for a Minister to come to the Dispatch Box and not to give way on the Second Reading of a Bill? I have been in the House for 15 years and I have never known it before. Why does not he give way and take at least one intervention?
As the hon. Gentleman also well knows, it is the convention during debates on such Bills for the Government broadly to give their position and to go no further than that, which is what I intend to do from the Dispatch Box this evening.
It is important that educational excellence is strengthened. The principle of linking medical schools into multi-faculty colleges, with strong departments of life sciences, is, as the right hon. Member for Bethnal Green and Stepney said, an important step in that direction. As he also said, that is consistent with policies that have been pursued for some years by the University of London. Such mergers offer academic and other benefits for education and research. Both my Department and the Department for Education support that principle, and we look forward to continuing progress.
The Bill's promoters are to be congratulated on their efforts to provide the means by which that aim can be accomplished. As the right hon. Gentleman said, the principles on which the Bill is based stand on their merits alone. Those principles will help to strengthen the fruitful partnership between medical education, research and clinical services. They will do much to help secure London's place at the forefront of research and development in medical science and technology.
It is always a pleasure to listen to my right hon. Friend the Member for Bethnal Green and Stepney (Mr. Shore). He made a fascinating and powerful speech. He has the capacity to be persuasive, even when he is wrong, and we heard a stunning example of that in relation to the European Economic Community. His rhetoric always moves us deeply. I mean no offence, and I hope that no offence is taken, if I say that I thought that his speech lacked substance somewhat and was based on what I would describe as sociological soundbites.
One thing that most of us desist from more than soundbites is sociology. Even if I did not have a temperament that tells me that sociology was not a science, I would have come out against it when I discovered that the Secretary of State for Health has a degree in sociology. No, I lie—she has two degrees in sociology. The mistakes and absurdities of her first degree in sociology led her to announce the closure of Bart's hospital two weeks ago. The mistakes and absurdities of her second degree in sociology have led her tonight to put up a frightened Minister who will not accept interventions to support what is effectively the devastation and closure, in spite of what my right hon. Friend the Member for Bethnal Green and Stepney said, of St. Bartholomew's medical college.
I do not want to be too censorious, because I understand that the Secretary of State obtained her degrees in sociology at Essex university at a time when that was roughly equivalent to obtaining a certificate for attendance at a borstal institution. I do not want to be unkind to people who went to borstal, still less make invidious comparisons with the Secretary of State.
With the Bill has come a statement on behalf of the promoters in support of the Second Reading. I think that we can dismiss the validity of that statement fairly quickly and indeed, although I shall discuss them in more detail later, the validity of each and every argument that my right hon. Friend the Member for Bethnal Green and Stepney made.
In that respect, while it remains fresh in the memories of people in the House, my right hon. Friend said that he had three arguments in favour of the Bill. The first was that, academically, everyone thought that clinical medical colleges should be inside multi-faculty universities and, in effect, clinical medical colleges would become the faculty of medicine in universities, and that St. Bartholomew's medical college would be the faculty of medicine at Queen Mary and Westfield college.
I say to my right hon. Friend that London university, of which St. Bartholomew's medical college and the Royal London hospital are part, has never issued a statement against free-standing medical colleges. I know because first some people from St. Bartholomew's hospital told me and then I had the sense to check so that I did not mislead the House. The university has never condemned the existence of free-standing medical colleges such as that which exists at St. Bartholomew's.
Secondly, my right hon. Friend said that the three institutions—the Queen Mary and Westfield college, St. Bartholomew's hospital and the Royal London hospital—were massively in favour of the Bill. That appears in the statement on behalf of the promoters of the Bill, who say that that policy has been
enthusiastically adopted by Queen Mary and Westfield college and the two medical colleges and is supported by the Higher Education Funding Council for England.
I am afraid that that is not true. That is bunkum.
The House should never have been told that by the promoters. I know that for a fact because I have spoken to scores of senior clinicians at St. Bartholomew's medical college and I have spent, including the Easter recess, the whole of the past fortnight researching the Bill, inquiring into the background and examining the past papers.
St. Bartholomew's medical college has supported the Bill only because of the decision in the Tomlinson report to close St. Bartholomew's hospital. Had that decision not been made, even if there had been an argument for the merger of those two medical colleges—there might have been—we would not be here tonight. I can categorically assure the House that that is the case. I know that from my discussions with many of the people concerned, and I have documents and written evidence, which I will adduce to the House in due course, which show that to be the case.
My right hon. Friend the Member for Bethnal Green and Stepney is a distinguished politician; indeed, a great politician. He served a Labour Government nobly, and if he stands next time, I hope that he serves the next Labour Government nobly. He is a Privy Councillor, whereas I am a small figure in this grand plot, this great canvas. Therefore, he knows better than I do the concept of force majeure. He knows that when someone is so much under siege, so much under attack and so readily being destroyed by forces all around, they sometimes have to accede to that to which they would not otherwise. That, put bluntly, is what has happened in this case.
I repeat, had there been no proposal to close St. Bartholomew's hospital in the Tomlinson report, we would not be here debating the Bill and St. Bartholomew's would have opposed it. I also say in passing—I shall discuss the matter in further detail later—that when one reads the statement of the promoters or listens to my right hon. Friend the Member for Bethnal Green and Stepney, it appears as though there has been some seamless process between the production of the report of the Royal Commission on medical education in 1968 and now.
Incidentally, it is a small matter but the royal commission is referred to by the promoters as the "Royal Commission on medical and dental education". One would suppose that a promoter who drew up such material could get it right. So that there should be no doubt about it, I have the Todd report—the report of the Royal Commission on medical education, as it is described on the cover—in my hand, and it says:
Whereas by Warrant under the Royal Sign Manual bearing date the sixth day of August, 1965, We appointed a Commission, to be called the Royal Commission on Medical Education"—
so let us refer to it as that in future.
Now Know Ye that We, reposing great trust and confidence in your knowledge and ability, do by these Presents appoint you, the said John Norman Romney Barber and Elizabeth Leila Millicent Chilver to be Members of the Royal Commission on Medical Education.
Given at Our Court at Saint James's the eighteenth day of September, 1965; In the Fourteenth Year of Our Reign.
By Her Majesty's Command. Frank Soskice.
From the wrong title of the Royal Commission on medical education, which is not a good start for Professor Zellick, who is not 1,000 miles away, we are given a background note that provides us with that seamless process. It starts from the Todd report of 1968, and then there is a huge jump. It says:
In line with the 1968 Royal Commission, the pre-clinical departments from St. Bartholomew's Hospital Medical College and the London Hospital Medical College, together with their students and staff, were in 1989 established in a purpose-built building on the Mile End campus of Queen Mary and Westfield College as the faculty of basic medical sciences".
You do not need to be a mathematical genius, Madam Deputy Speaker, to realise that there is something of a gap between those two dates—a royal commission in 1968 and a move that took place in 1989.
I am following my hon. Friend's argument with interest, but the movement of opinion—let me put it like that—critical of free-standing medical colleges separate from multi-faculty universities is a growing one. I quoted four examples of previously separate medical colleges in London joining up with multi-faculty universities' departments. All four mergers that I mentioned took place before Tomlinson issued his report. There is evidence of a widespread and strong movement in the direction that I have suggested.
I shall deal in some detail with the Todd royal commission, with the Flowers report of 1980 and with the Tomlinson report in so far as it affects St. Bartholomew's medical college. I shall go into enormous detail and present the counter—arguments, but I cannot do it all in one go. I am fastidious—I studied logic at Oxford and believe that there should be a beginning, middle and end to the story. I shall show that I am not trying to dodge the issue—
Is the hon. Gentleman talking about the Earl of Essex? I should have thought that that would be out of order.
I was talking about what my right hon. Friend the Member for Bethnal Green and Stepney calls the predisposition or the changing nature of people's perceptions of a medical college. I have been able to study the papers in great detail, as St. Bartholomew's has made them available to me. It has also made available to me the responses of the Royal London and St. Bartholomew's medical colleges at each stage.
When one studies the papers, one finds that in 1968 the royal commission, which was a high-powered commission, presumably set up by the Government of which my right hon. Friend was a member, was set up, but then put on the shelf. That was what people did in those days: a royal commission was set up when there was a problem. When it was found that there was no money to do anything, it was put on the shelf. I do not criticise anyone for that.
There was what I call the brutalism of the 1960s, when it was thought that everything could be solved in a simple way, including problems in architecture, medicine and education. It was what those in the 1960s called the rational way—
I shall not take up my hon. Friend's point as I want to keep to the subject and keep in your good books, Madam Deputy Speaker.
In the 1960s, when the report was being drawn up, there was a fantastic blueprint in London for every medical college—there were 12 of them if I remember rightly. The blueprint was to put medical school departments—pre-clinical and subsequently clinical—into multi-faculty branches of universities and make them university faculties. That was typical of all that happened in the 1960s.
I was a civil servant and I saw the same thing happen in architecture. Pluralism and diversity were taken away, as was any suggestion that anything could be successful and work if it did not conform to the pattern. From my time in the civil service, I have a good working knowledge of the way in which royal commissions work.
Some civil servants from the Department of Health obviously advised the high-powered medical figures, who I am sure also had some say. They convinced each other that there was one way of redeveloping medical education—the one way that my right hon. Friend has outlined. I believe that some people have since thought that it was a good way and some that it was a bad way. I shall come to why St. Bartholomew's has queried the method all the way along the line, contrary to what one would think, having heard my right hon. Friend and having read the promoters' note.
It is extraordinary that the promoters' note does not mention the Flowers report—it as though it did not exist. I find that bizarre. I shall quote from the report and produce the responses from St. Bartholomew's hospital medical college and the Royal London medical college. The bulk of the report involves the merger, but that is not mentioned in the promoters' note. I do not know how highly educated people managed to draw up the note and ignore that fact. Lord Flowers was not a fly-by-night; he was a distinguished academic and the vice-chancellor of London university.
The Flowers report into medical education was full of the merger and contained slightly different ideas. The report was carried out at the behest of the deans of the medical colleges in London. Lord Flowers was asked to undertake it because the Todd report had been put on the shelf—for the standard reason that there was no money—and no one had done anything about it. Nothing had happened in medical education.
Shortly after the switch of Government, we entered the 1980s. I was working in television and reporting in Manchester so I can remember the savage attack on university funds. It was inevitable that medical colleges would be included in that savage attack. The deans of the medical colleges said that they would not be able to cope with the way that things were going and wanted the vice-chancellor, Lord Flowers, to see whether he could point some way through and suggest how they could get by. I shall not lay out Lord Flowers' suggestions now, but I shall come to them later. They were roughly similar, but not identical, to those in the Todd report.
There was a fracas, and all the reports refer to the clash that was occurring, to academic arguments, to disputes between St. Bartholomew's medical college and the Royal London medical college. I have read all the annual reports of St. Bartholomew's medical college from the day that Lord Flowers reported up to the most recent report last year. I shall give some quotations from the reports later. I regret that, when one studies the archive reports for six days, with dust falling over one's hair, the picture of rosy consensus is shown not to be true.
My right hon. Friend the Member for Bethnal Green and Stepney did not say a word about the fact that Lord Flowers threatened St. Bartholomew's medical college and said that, if it did not go along with the merger along those lines, he would see that its funds were progressively withdrawn. He went to the General Medical Council to say that in person.
I shall read it out from some annual reports. It is contained in some of the documents that I have. Lord Flowers threatened that the medical college would run out of money and would be unable to function as a medical hospital. The dean at that time was Dr. Kelsey Fry. Not only do I have Dr. Kelsey Fry's annual reports and his statement, but I took the precaution of talking to Dr. Kelsey Fry about six days ago. I know that it is true because at the time, in 1985, Dr. Kelsey Fry asked me, as the Member of Parliament for Hackney, South and Shoreditch—whose constituents benefit most from the work of both the medical college and the hospital—to go to see Lord Flowers to discuss the merger.
I tried to warn Lord Flowers that what he proposed would not be accepted and would not work, but the great Lord Flowers would not listen to a Back-Bench Labour Member of Parliament. I knew him reasonably well because, when I was parliamentary private secretary to my right hon. Friend the Member for Chesterfield (Mr. Benn), Lord Flowers used to be the umpire over difficult nuclear issues. But he did not listen to me, and did not receive the vibes that I gave him. I tried to tell him that there would be trouble and that there might even be trouble in the courts—and there was. There was a judicial review—there was astonishment.
The idea that St. Bartholomew's medical college could take the Royal London and the London university senate to court sent shivers through the academic medical world. There was absolute uproar. Despite his threats, Lord Flower's proposal was never introduced. Instead of a total merger of pre-clinical schools—which was the suggestion advanced at that time—there was a judicial review and the proposal was withdrawn because the university senate could not tolerate St. Bartholemew's proving that it had acted improperly. A confederation of east London hospitals was formed instead and the merger of financial and administrative arrangements which seemed so to fascinate my right hon. Friend the Member for Bethnal Green and Stepney—one would think that he was an ex-Treasury Minister—never occurred.
My right hon. Friend referred to the co-operation between the two colleges. They were not always at each others' throats, as I shall show in a moment. They established a joint curriculum for pre-clinical work and in the clinical sphere—where the merger is now proposed—there were joint activities in seven or eight areas. I will list those in a moment. That arrangement had worked since 1990 and, if it had continued, there would be no need for a Bill to introduce a clinical merger.
I return to my right hon. Friend's intervention-1 have not digressed; I built up my case in order to reply to him. The civil servants who advised the Todd inquiry about the only solution to the problems of medical hospitals also advised Lord Flowers when he drew up his report in 1980, which contained similar suggestions. Those civil servants from the Department of Education and Science and the Department of Health advanced the same ideas.
That is the way bureaucracies work. For example, the Board of Trade supported the policy of free trade for 200 years until it found that it did not work. Civil servants tend to come up with the same sorts of policies. However, on that occasion their views were not taken on board, because a flexible arrangement had evolved which Bart's and the Royal London thought could work, but which did work.
I am not sure why we are under such intense pressure to pass the Bill tonight. The situation is even worse. The Todd report was published in 1969. Another report commissioned in 1979 is not mentioned in the preamble to the Bill. My hon. Friend the Member for Cynon Valley (Mrs. Clwyd) served on the royal commission inquiry into health. I think that she is the only hon. Member in the House to do so and I know that she wishes to speak later in the debate.
I am grateful to my hon. Friend for giving way. He has conducted extensive research, but perhaps he has not read that very lengthy royal commission report, which was allowed to gather dust like so many other reports.
One of its main criticisms of medical colleges at that time was that the curriculum was inappropriate to the needs of the national health service. The system of selection of candidates for the medical college was also criticised because it was found that they came from only one part of society. We also found that the NHS was grossly underfunded. Perhaps we were advised by different civil servants from the ones to whom my hon. Friend has referred.
I am sure that hon. Members will be genuinely interested in those comments, all of which are extremely valid. I shall pick them up, because I do not disagree with them.
The issue of the curriculum is heavily involved in the question of the two mergers—although presumably the pre-clinical curriculum has been dealt with already. At the time of the royal commission inquiry, one could have argued for a variety of reasons that medicine needed to be more scientifically based. I do not dissent from that view, and nor does anyone at St. Bartholemew's. Some hon. Members may not be familiar with the process of training to become a doctor. Students spend three years at a pre-clinical school achieving a degree in medical science, and they then spend the next two years achieving a degree in medicine.
As my hon. Friend the Member for Cynon Valley said, it was valid to claim that the medical curriculum did not place enough emphasis on science. That has been picked up on this occasion. Although it was not in the schema of the Todd or the Flowers reports, a merger—although not an administrative or financial one—of the Royal London and St Bartholomew's medical colleges eventually occurred in 1989, which came into effect in 1990. A new scientific curriculum was drawn up, which is identical to the one for students at Royal London and at St. Bartholemew's. It has worked and it is producing first-class doctors.
My hon. Friend the Member for Cynon Valley raised another point which I also believe is pertinent to the Bill. One of the biggest objections to the medical education curriculum was not touched upon by the promoters, but Professor Lesley Rees, the dean of St. Bartholemew's medical college, certainly discussed it with me. I am afraid that she will take some exception to the comment by my right hon. Friend the Member for Bethnal Green and Stepney that it was intended that she would become the warden after Sir Colin Berry. She has written me a note about that suggestion and she is hopping mad about it. I shall return to that issue in a moment.
She told me that the two medical colleges operate in poor areas of London. The colleges are very good at dealing with specialties and with standard acute medicine. However, many of the problems in the east end of London result from what occurs in the community. They are clearly linked to bad housing, unemployment, low wages and poverty. Doctors must be able to encompass the area of community health; it must not be left as a fag end for social workers to pick up. Doctors must know about the community, and their medical curriculum must take that into account. They must do their training in general practitioners' surgeries and in the community.
Professor Rees is not in the Gallery at present, so I shall spare her blushes. She is the dean of St. Bartholemew's, medical college and she is possibly the best dean in Britain. She has many outstanding qualities, but one of her greatest contributions to medicine has also been picked up by the curriculum of medical colleges all over London. Professor Rees ensures that students spend more time in general practitioners' surgeries as opposed to hospitals and she also ensures that they spend more time in the community. That has become part of the curriculum of the confederation of east London health authorities. That has meant a massive advance for doctors not only in east London but in London as a whole. The policy has spread as the General Medical Council has seen its value and the medical curriculum has been widened.
Secondly, my hon. Friend the Member for Cynon Valley expressed concern about the social intake in hospitals. One could criticise both hospitals—if anything, one could at one time have criticised St. Bartholomew's more than the Royal London hospital—about their intakes. I am not here to give a panegyric about Bart's. I am here to discuss a very important Bill. My hon. Friend the Member for Cynon Valley will find that the social background of the intake of the hospitals has changed.
There has been a massive change in both hospitals in one respect, about which my hon. Friend the Member for Cynon Valley will be pleased—the intake of women. Bizarrely, medical hospitals such as St. Bartholomew's and the London have, down the ages, been as antagonistic to women as some of the worst sectors of male chauvinism in Britain.
The Minister tries to take me off the subject.
Amazingly, the first woman medical student to enter St. Bartholomew's hospital did so in the year 1850, and was called Elizabeth Blackwell. James Padget, who was in charge of the medical school at that time, interviewed her and allowed her to enter Bart's, as she had a medical qualification from Zurich. He wrote some kind comments about her in his diary, and she wrote that she benefited from her experience at Bart's.
Of course, it could not last. When her sister tried to get into the medical college, people started to kick up a stink, and when some other women tried to get in, the matter was taken to the solicitors, and women were debarred from Bart's and the London for a long time. It was not until the NHS came into effect in 1947 that both hospitals were told that they had to admit women. Both agreed and, while I cannot talk about the London, I know that Bart's agreed that women should make up 15 per cent. of its. intake. In Bares—I imagine it is the same in the London—that figure is probably now 50 per cent. of the intake. My. hon. Friend for Cynon Valley made a third point which escapes me. It is not in my notes.
I think that I have dealt with that point. My hon. Friend's third point may have been about the shortage of money.
I have not had time to read the royal commission's report on the NHS, although I have read the royal commission report on London medical teaching, the Flowers report and the Tomlinson report. I did, however, snatch a look at the royal commission's report tonight, as it dawned on me that I was missing something that I ought to see.
One very important paragraph in the 1979 royal commission report on the NHS is pertinent to the debate. It said that we needed to look after our teaching hospitals and to nurture them. I am sure that my hon. Friend the Member for Cynon Valley—who served on that commission—was involved in the agreement on that statement. The Secretary of State for Health is closing teaching hospitals and medical colleges, as well as hospitals. That is hardly nurturing them, as I am sure my hon. Friend will agree. To virtually shut down Guy's and most of its medical college and to close down Bart's and to destroy its medical college through the Bill is not nurturing; it is a destructive, wicked and evil force which civilisation will come to regret deeply, and which hon. Members—should it ever happen—will also come to regret.
I did not finish answering the intervention from my right hon. Friend the Member for Bethnal Green and Stepney. Civil servants were involved in the Todd report, pushed the Flowers report into producing the merger and were then involved in Tomlinson. The same arguments have come out and—as I said to my right hon. Friend—this is the 1960s argument. There is an all-embracing argument for medical colleges which came from civil servants in the 1960s. The Tomlinson civil servants looked back to 1980, and those involved at that time looked back to 1968. We have a departmental policy stretching down two and a half decades, and that is nothing to be proud of.
My right hon. Friend the Member for Bethnal Green and Stepney can say—it can be argued—that there is growing consensus. I say to him that the power of bureaucrats should never be underestimated. People think that they have beaten bureaucrats. Those involved at Bart's thought that they had won after the Todd report, and in fact the report was accepted. They were told that there was no money to introduce the proposed scheme. They were threatened at that time, and also at the time of the Flowers report in the 1970s. Professor Shooter was threatened, just as Kelsey Fry, the dean of Bart's, was threatened more than a decade later.
Professor Shooter was threatened, and was told that, if he did not accept the Todd report, Bart's would suffer financially. Kelsey Fry—15 years later—was told that, if he did not accept the Flowers report, the same thing would happen. Then came Tomlinson, which said that the hospital would be destroyed and those involved would be left with no let out. The only thing that they could do was to hand over the property rights and the property to save some—but not all—of the jobs. That is what the Bill is about, and that is the brief answer to my right hon. Friend.
I would like to get on to my own speech now, as I have been answering the points made by my right hon. Friend the Member for Bethnal Green and Stepney, who introduced the Bill. First, I shall present the broad picture, and then I shall get into detail and talk about world-class medicine and medical science. I shall then give my right hon. Friend an opportunity to answer the my points. I do not believe that we can debate this matter with soundbites, as the future of one of the greatest medical institutions the world has ever known is far too important for that.
We are here tonight to perform the last act in a plan to, wipe the name of St. Bartholomew's off the face of the earth. Two weeks ago, the Secretary of State announced her decision to destroy St. Bartholomew's hospital. Tonight, we are asked to pass a Bill which, in the light of that decision, will destroy Bart's medical college. We are being asked to drink from a poisoned chalice, and then carry out a foul deed in a state of some intoxication.
I was going on to say that we are being pursued by soundbites. We are being asked to complete one of the foulest deeds that any civilised society could contemplate, and it is unnecessary. The decision debases and demeans this House, and it is a deed which, if carried out—I hope that it will not be—will make sinners and barbarians of us all.
My right hon. Friend the Member for Bethnal Green and Stepney says that he has a vision of how medical science should proceed. I must tell him that it is a delusion. He has not properly linked—I hope to persuade him ere the night is out—the way in which the closure of the hospital will destroy the medical college which, I believe, once came close to saving his life. We are being asked to pass a Bill that will create a nuclear winter, to be followed by darkness through eternity and beyond infinity. Why would any rational or sensible person wish to do that?
That is what writers call poetic licence. This is a private Bill and Labour Members are on a free vote. It is sad that Conservative Members are not. That does not seem to be the way to deal with a private Bill. I know that because my pair told me, and Ministers have asked me how long the debate will last. I replied that that was not up to me. They said that the Government would not let them be away. You, Madam Deputy Speaker, know more about this than I do, but that seems an abuse of parliamentary procedure—but I shall not raise that as a point of order or ask anyone to do so.
The principal of the new combined medical college, if it is ever formed, will be Professor Graham Zellick—currently principal of Queen Mary and Westfield college. As you said, Madam Deputy Speaker, we can use that as a point of debate, which would be appropriate.
My hon. Friend the Member for Workington (Mr. Campbell-Savours) produced perhaps one of the strangest documents ever from a private Bill's promoter. When one presents a Bill to the House, presumably one wants to avoid antagonising Members of Parliament by saying, "Stuff you. We don't care what you do. We have no interest in the parliamentary process. I, Professor Zellick, will arrogate to myself the powers of a free Parliament. I, Professor Zellick, will behave in an authoritarian fashion and proceed with this Bill, whether or not you like it. I, Professor Zellick, will take over the rights, duties and authority of the House of Commons. I have worked too hard for my vision and I don't care what Parliament says. My vision must take precedent over Parliament's vision."
These days, there is an extraordinary temptation to slag off Members of Parliament—to say that we are all into sleaze, are over-sexed and waste our time. I have not been wasting my time. I spent a fortnight working hard on this Bill because I believe that it should be defeated. Are we helped when a professor who purports to want the House to pass a private Bill goes public and says that he will take the House on is more powerful than Members of Parliament and is over and above us?
I met Professor Zellick when the blocking motion was tabled. I shall describe the detailed proposals later. When the motion was tabled, the Bill's promoters, including Professor Zellick, Clive Priestley and John Travis Clark from the Royal London—Clive Priestley being the lay member of Bart's and an excellent man, asked me to meet them to discuss the Bill. I did not think that Professor Zellick was a bad man at all.
He is the principal of Queen Mary and Westfield college and will be the principal of the new combined college. I thought that Professor Zellick was well intentioned but uninspiring. I thought that perhaps he was an academic bully, but my experience of academics is that most of them are capable of behaving in a bullying fashion from time to time. Even some hon. Members are capable of that, although of course I exclude myself from that description.
At that discussion—as another hon. Member was present, this can be verified, and Professor Zellick made his own notes of the meeting—I think that the professor lacked judgment a bit. That does not make him a bad man or mean that he could not run the combined college reasonably well. I genuinely thought that, until I stumbled across a particular document. I told the House earlier that one of my hon. Friends showed me a copy, but I admit that I stumbled across it individually. No one will believe that. Everyone will think that somebody from Bart's medical college thrust it into my hands and asked me to come to the House to cause trouble. That simply is not true.
I was browsing through years and years of Barts Journal—not that of the hospital but that of the medical college. Volume 18, issue 4 for spring 1995 contains a letter from Professor David Tomlinson of the department of pharmacology at Queen Mary and Westfield college. It begins "Dear BJ"—B for Bart's and J for journal—and refers to an article in the Evening Standard stating that the Bill might be in jeopardy. According to Professor Tomlinson—I have verified this with people at Bart's, who said that it was true and who were themselves shocked—there is a huge direct quote of around 800 words from Professor Zellick. It says that people reading the Evening Standard might have thought that the Bill was getting into difficulties. He said that the Bill faced two obstacles. There were three petitions against it.
I do not blame my right hon. Friend the Member for Bethnal Green and Stepney for telling the House that now there are only two petitions against it. There was another, slightly longer and much more pertinent petition from the students of St. Bartholomew's medical college and Royal London medical college—
I know that it was withdrawn. Marcus Beadle signed it, and I spoke to him on the telephone when he produced it.
Professor Zellick insists that no pressure was placed on the people concerned to withdraw that petition. In an article in another issue of Barts Journal, Marcus Beadle talks about a hectic two weeks. From the moment the students lodged that petition, people started talking to them. Is that not typical? They did not talk to the students for months on end about their future—and they are only the whole future of medicine in this country. But when a private Bill appears, there is a bit of trouble and Parliament wants a democratic debate, there is a frisson. It is a matter of, "Come in, Marcus. What do you want? I'll do anything."
I do not blame Marcus Beadle for his action—I believe that it is called log-rolling politics in America. Marcus, and presumably students from the Royal London, went to see the great professor—the Dr. Strangelove of science, as we will call him after the House has heard this lot. The professor cleared up lots of points about the students union, lodgings, finance, space and money. But other objections were never cleared up—the more serious, medical objections to the Bill relating to massive uncertainty in east London about the whole health system, caused by the Minister who would not give way earlier to my hon. Friend the Member for Workington.
Much of that uncertainty has been caused by discussion following the publication of the Tomlinson report in 1992, until the Secretary of State's statement two weeks ago that the hospital is to close. Of course that will make a difference to the way that students work. The very existence of Bart's medical college is called into question.
What happens if we close a teaching hospital—I put the argument rather bluntly; my right hon. Friend the Member for Bethnal Green and Stepney might think that it was put too simply, but often simple arguments are important ones—and close the medical college as well? I confess to being rather simple at times. What is the result if a Bill is introduced to merge the college with the Royal London hospital medical college? I shall tell my right hon. Friend what almost anyone at Bart's will tell him, if he cares to talk to them rather than listening to the outward signs of Professor Zellick. The professor says, of course, that there is no connection, but that is absurd. Of course there is a connection. Is it thought that the doctors at the hospital are divorced from those who are providing medical training and undertaking medical research?
I know that there are some pure researchers. Indeed, I shall provide the data. There are many more pure medical researchers at St. Bartholomew's hospital at the Charterhouse square site than there are at the Royal London hospital. It should be said that the researchers do a wonderful job. I shall not demean them. Indeed, I shall name some of them as part of a separate argument. It must be understood that hundreds of doctors and consultants are teaching medical students. They are undertaking their research in departments that are on the hospital site. Their work is not being done in separate buildings. By and large, medical departments are at medical hospitals.
Many of the consultants and practitioners may be on the site because they like working at the hospital. With that in mind, is there not a great danger that many of them will leave London and go elsewhere? As a result, the new school might lose the expertise of these extremely important people.
I assure the House that my hon. Friend has picked up my next point and that there has been no rigging. He has taken up the point that I was about to make to my right hon. Friend the Bethnal Green and Stepney.
The greatest single cause of uncertainty and of people leaving St. Bartholomew's hospital and the medical college was the threat, and then the announcement, of the closure of the hospital. I know that that is true. Professor Lesley Rees, the dean of St. Bartholomew's medical college, gave me a list of people who were leaving. That was before the Bill was introduced. It is quite a long list. Of course, I do not want to encourage anyone else to leave. That is exactly the point that my hon. Friend the Member for Workington made.
We are talking about an extraordinary centre of excellence. My main argument is that it does not need the proposed merger. Powerful medical teams have been built up. They treat patients and lecture to students. I know that that happens. I have talked to people who do both things. There are not two separate entities operating in two different worlds. The people involved are part of an ethos.
There is an academic culture such as we would find at Oxford or Cambridge. There is such a culture to be found at Birmingham, for that matter. There is one at Cardiff, and a very good one, I assure my hon. Friend the Member for Cynon Valley. My hon. Friend the Member for Workington will find an academic culture in the lakes.
Members of powerful medical teams have been attached to an academic culture, sometimes for 50 or 60 years. They have been attached also to a history that is 872 years old. That is the hospital. I shall go through the history of the medical college. There is a massive historical background of people striving monumentally for the same thing. I understand that. I do not say that Corpus Christi, the college to which I went at Oxford, is a piddling little place with 132 people who would benefit from a mega-merger with Christ Church, Balliol or Queen's. Corpus Christi was a centre of academic excellence and a place which one could be proud to go to.
As my hon. Friend the Member for Workington has said, there have been hundreds of years of excellence at St. Bartholomew's hospital. When it is said that the hospital will be closed, the result will be to break up the medical, teaching and research teams. That is the point. Some of the letters that I receive make me so angry. People write, "Don't you know the difference between a hospital and a medical college?" With a degree in logic and having studied linguistic philosophy—the meaning of meaning—I should know the difference between a hospital and a medical college. I know also about the links between a hospital and a medical college. I know too that, when a hospital team is broken up, along with hospital treatment and research, staff will leave.
Professor Rees, the dean of St. Bart's medical college, has fought an heroic battle to save both a hospital and a medical college. The list that she showed me is all to do with the closure of the hospital. She made contact with Professor Frances Heidensohn, the chairman, as she likes to call herself, of the East London and City health authority, and said, "If you close this hospital, I shall lose more and more staff and the former staff will never be rebuilt. My staff will never go to the Royal London."
What about the list? It is a list of people who are not going to the Royal London. They have gone elsewhere. They have gone because a centre of academic excellence has been destroyed. I resent being told to learn the difference between a hospital and a medical college.
My hon. Friend might be interested to know that some years ago I went to see Professor Zellick. He made the case that the medical college at the London hospital, as it was then, was deeply in debt and badly run. He argued that it would be much better run by Queen Mary college. At that time there were no plans—if there were plans, they were hidden and had not been announced—to close St. Bartholomew's hospital. It seemed that there was no linkage. It may be that something needed to be done at the Royal London medical school. Nevertheless, it seems a great pity that that is now linked with the closure of a great hospital such as St. Bartholomew's. What has my hon. Friend to say about that?
These matters are said to be linked and then they are said not to be. It is interesting to look back on what Professor Zellick has said and what is contained in the Todd, Flowers and Tomlinson reports. There is one significant difference. The Todd report never recommended the closure of St. Bartholomew's hospital. Closure was not within a thousand miles of those who sat on the royal commission that considered the national health service. They may have had some doubts about some medical colleges and hospitals, but they did not recommend the closure of the world's most famous hospital. As I have said, closure was never in their minds. The Flowers report on the merger that appeared in 1980 was not drawn up on the basis that the hospital might shut and that we would see a cross-over of patient care, teaching and research and damage to them all.
It was only the Tomlinson report that recommended, first, that the hospital should be shut and, secondly, that a merger should take place. It was then that the entire position changed. It is the crass or wanton inability of people to link those two features of the Tomlinson report that is producing such anger in me and, I imagine, in almost everybody on the Opposition Benches. I should say that most of our colleagues have left it to us to argue the case. That is fine because that is what we said we would do.
I think that my hon. Friend must address his remarks at this point to a letter that I have received. I am one of the signatories to the blocking motion. As a result, during the past two or three days, I have received letters from people like this Dr. Zellick—or Dr. Strangelove, as my hon. Friend calls him—and various other people. The letter is from a fellow called Arnold Wesker. The only person whom I know by that name is a playwright, or was, presumably from the east end. This gentleman is now living at Hay-on-Wye. I suppose that that is where the luvvies are. He wrote:
Dear Dennis Skinner
I've just been made an Honorary Fellow of Queen Mary and Westfield College.
He is now involved in its affairs, naturally. He is probably under the thumb of Dr. Zellick. Mr. Wesker, an honorary fellow of that quango, asked me why I have put my name to the blocking motion—
|Division No. 130]||[8.50 pm|
|Campbell-Savours, D N|
|Tellers for the Ayes:|
|Mr. Dennis Skinner and|
|Mrs. Ann Clwyd.|
|Ainsworth, Peter (East Surrey)||Brandreth, Gyles|
|Aitken, Rt Hon Jonathan||Brazier, Julian|
|Alton, David||Bright, Sir Graham|
|Arbuthnot, James||Brooke, Rt Hon Peter|
|Arnold, Jacques (Gravesham)||Browning, Mrs Angela|
|Ashby, David||Bruce, Malcolm (Gordon)|
|Ashdown, Rt Hon Paddy||Burns, Simon|
|Atkins, Robert||Butler, Peter|
|Baker, Nicholas (North Dorset)||Callaghan, Jim|
|Baldry, Tony||Campbell, Menzies (Fife NE)|
|Barnes, Harry||Carlile, Alexander (Montgomery)|
|Bates, Michael||Carlisle, Sir Kenneth (Lincoln)|
|Beggs, Roy||Chapman, Sydney|
|Beith, Rt Hon A J||Clappison, James|
|Bellingham, Henry||Clarke, Rt Hon Kenneth (Ru'clif)|
|Beresford, Sir Paul||Clifton-Brown, Geoffrey|
|Betts, Clive||Coe, Sebastian|
|Booth, Hartley||Connarty, Michael|
|Boswell, Tim||Conway, Derek|
|Bottomley, Peter (Eltham)||Coombs, Simon (Swindon)|
|Bottomley, Rt Hon Virginia||Cormack, Sir Patrick|
|Bowis, John||Davis, David (Boothferry)|
|Dixon, Don||Maddock, Diana|
|Donohoe, Brian H||Maitland, Lady Olga|
|Douglas-Hamilton, Lord James||Malone, Gerald|
|Dover, Den||Mans, Keith|
|Dykes, Hugh||Marshall, John (Hendon S)|
|Evans, Jonathan (Brecon)||Mayhew, Rt Hon Sir Patrick|
|Evans, Nigel (Ribble Valley)||Merchant, Piers|
|Evennett, David||Mitchell, Andrew (Gedling)|
|Faber, David||Monro, Sir Hector|
|Fabricant, Michael||Nelson, Anthony|
|Field, Barry (Isle of Wight)||Newton, Rt Hon Tony|
|Forsyth, Rt Hon Michael (Stirling)||Nicholson, David (Taunton)|
|Forsythe, Clifford (S Antrim)||Nicholson, Emma (Devon West)|
|Foster, Don (Bath)||Norris, Steve|
|Fox, Sir Marcus (Shipley)||Onslow, Rt Hon Sir Cranley|
|Freeman, Rt Hon Roger||Oppenheim, Phillip|
|French, Douglas||Page, Richard|
|Gallie, Phil||Paice, James|
|Gardiner, Sir George||Redwood, Rt Hon John|
|Garnier, Edward||Rendel, David|
|Gillan, Cheryl||Richards, Rod|
|Goodlad, Rt Hon Alastair||Riddick, Graham|
|Goodson-Wickes, Dr Charles||Robertson, Raymond (Ab'd'n S)|
|Greenway, Harry (Ealing N)||Robinson, Mark (Somerton)|
|Griffiths, Peter (Portsmouth, N)||Rooney, Terry|
|Gummer, Rt Hon John Selwyn||Ross, William (E Londonderry)|
|Hague, William||Rowe, Andrew (Mid Kent)|
|Harvey, Nick||Rumbold, Rt Hon Dame Angela|
|Hayes, Jerry||Ryder, Rt Hon Richard|
|Heald, Oliver||Sackville, Tom|
|Heathcoat-Amory, David||Shaw, David (Dover)|
|Hendry, Charles||Shepherd, Colin (Hereford)|
|Howard, Rt Hon Michael||Skeet, Sir Trevor|
|Howarth, Alan (Strat'rd-on-A)||Spink, Dr Robert|
|Hunt, Rt Hon David (Wirral W)||Spring, Richard|
|Jack, Michael||Sproat, Iain|
|Jackson, Robert (Wantage)||Squire, Robin (Hornchurch)|
|Jenkin, Bernard||Stephen, Michael|
|Jones, Gwilym (Cardiff N)||Stewart, Allan|
|Jones, Lynne (B'ham S O)||Stewart, Allan|
|Jones, Robert B (W Hertfdshr)||Taylor, John M (Solihull)|
|Kirkhope, Timothy||Townend, John (Bridlington)|
|Kirkwood, Archy||Tredinnick, David|
|Knapman, Roger||Trend, Michael|
|Knight, Mrs Angela (Erewash)||Trimble, David|
|Knight, Greg (Derby N)||Trotter, Neville|
|Knight, Dame Jill (Bir'm E'st'n)||Wallace, James|
|Knox, Sir David||Ward, John|
|Kynoch, George (Kincardine)||Wardell, Gareth (Gower)|
|Lait, Mrs Jacqui||Waterson, Nigel|
|Lamont, Rt Hon Norman||Wheeler, Rt Hon Sir John|
|Lang, Rt Hon Ian||Whitney, Ray|
|Lawrence, Sir Ivan||Whittingdale, John|
|Lewis, Terry||Widdecombe, Ann|
|Lidington, David||Willetts, David|
|Lilley, Rt Hon Peter||Wilshire, David|
|Lloyd, Rt Hon Sir Peter (Fareham)||Wolfson, Mark|
|Luff, Peter||Wood, Timothy|
|Lyell, Rt Hon Sir Nicholas||Young, Rt Hon Sir George|
|MacKay, Andrew||Tellers for the Noes:|
|Maclean, David||Mr. Bowen Wells and|
|McMaster, Gordon||Dr. Liam Fox.|
Well, there you are, Mr. Deputy Speaker. If anyone was in any doubt as to whether the Government had taken over this private Bill in a scurrilous fashion, we have just discovered the proof of that. I am sure that it will lead my right hon. Friend the Member for Bethnal Green and Stepney (Mr. Shore), when he replies to the debate, to decide not to support the Bill.
I was quoting from a letter from Professor David Tomlinson—
If my hon. Friend recalls, when "I spy Strangers" was called I was in the process of reminding my hon. Friend that I am one of the signatories to the blocking motion. As a result, I have been inundated with letters from people asking why. I have a good answer. I have listened carefully to what my hon. Friend has said today.
I have had a similar letter today from Arnold Wesker, whom I assume is the playwright, who lives at Hay-on-Wye. He says that he has been made an honorary fellow of Queen Mary and Westfield college. He says:
I write about the … Bill which is to be debated on … Wednesday April 19th. I understand that you and other MPs seek to block the Bill. Permit me to ask why and to briefly argue in its favour.
He goes on to say that there is no connection between the college and the hospital.
That fellow has been made an honorary fellow. I have listened carefully to my hon. Friend and my hon. Friend seems to know that there is a direct link, an umbilical cord, between the hospital and the college. This man—
Order. The hon. Gentleman knows that interventions should be reasonably short. He has been speaking for more than a minute on this intervention, having started it previously. I should be grateful if he would wind up and, if he then wishes to catch my eye, he may do so.
Arnold Wesker says that he cannot understand why we should seek to block a merger that appears to offer high standards in medical education and research.
It seems odd to me that that bloke has been put on this body as an honorary fellow, yet he cannot see the direct connection between the college and the hospital. My hon. Friend the Member for Hackney, South and Shoreditch (Mr. Sedgemore) should use this opportunity to provide an adequate answer to Mr. Arnold Wesker.
I too had one of those letters written in exactly the same terms as that written to my hon. Friend the Member for Bolsover (Mr. Skinner). I replied to the letter because it suggests that we do not have the right to debate the matter on Second Reading. Mr. Wesker does not seem to realise that the only way in which we could secure a debate at this stage was by laying down an objection. Had he realised that, he might have understood that this is a procedural mechanism by which Members of Parliament hold the Executive accountable. It gives us our only opportunity to ask Ministers questions on the implementation of legislation of this nature. Unless we choose to debate these matters, clearly the public will not know what is happening in a particular case.
My hon. Friend has partly answered the point made by my hon. Friend the Member for Bolsover (Mr. Skinner). My hon. Friend the Member for Bolsover is right, however. He saw me becoming angry and upset a moment ago about the claim that none of us knew the difference between a hospital and a medical college. I explained, in fairly strong terms, that it was not possible to close the world's greatest hospital, cutting off patient care, teaching and research—those three services being linked—without having a severely damaging effect on its medical college.
I do not want to attack Mr. Arnold Wesker. He is a playwright; I am an author. The old idea of medical institutions, and even the Labour party, having "luvvies" on their boards does not help the argument. With due respect, it is clear that Mr. Wesker has no idea what he is talking about. He may have had dinner with Professor Zellick and got hold of some rather tatty and tawdry argument—but I do not think that I should repeat what I said earlier. Although you were not present then, Mr. Deputy Speaker, I do not want to try to deceive you about what has been happening.
In his letter to the Barts Journal, Professor David' Tomlinson gives direct quotations from what Professor Zellick has said. Apparently, he does not care whether the Bill is passed tonight—or at some other time—because he will proceed with the merger regardless. He does not care about Parliament. It has all gone on for too long; he is fed up with politicians, and does not respect the democratic processes.
The letter says:
Whether we experience a brief delay of two or three months or even if the Bill is more seriously obstructed and we are unable to secure its passage in this session of Parliament, we shall nevertheless be able to bring about the unified School of Medicine and Dentistry as an integral part of QMW and we shall do that by the beginning of the 1995/96 session whatever the fate of the Bill.
It goes on to say that arrangements have been made between the Privy Council and the Higher Education Funding Council to use the royal prerogative to frustrate the will of Parliament if need be. That takes the biscuit.
The letter continues:
it is now too late to pull back or delay. I am therefore pleased to report the unanimous view of the Merger Implementation Committee that nothing must be allowed to impede progress".
That apparently includes the will of Parliament.
Hon. Members must take into account the good faith of the Bill's promoters. We are entitled to ask what kind of medical college will be created by the merger, and who will lead it. If the person who is to lead it has been selected before the Bill has been given a Second Reading, and shows himself to be wholly hostile to parliamentary democracy, I should have thought that, by definition, he is not fit to run a major academic institution. Surely the House should not merely delay the Bill, but throw it out. It is appalling that a professor should arrogate the rights of Parliament, and say that our work does not matter.
I think that, when people have had a chance to study this astonishing outburst, Parliament will want to set up an inquiry into its proceedings on this and future Bills.
The Secretary of State for Health should make a statement from the Dispatch Box about this approach to private Bills concerning the national health service. It is not Professor Zellick's health service; it is Parliament's and the public's health service. My right hon. Friend the Member for Bethnal Green and Stepney should, in all decency, be prepared to withdraw the motion.
Should the Bill receive a Second Reading, which I hope that it will not, I believe—Madam Deputy Speaker dealt with this point during earlier points of order, Mr. Deputy Speaker, before you took the Chair—that the Committee that eventually considers it will want to see Professor Zellick and the Privy Councillors involved, or members of the Privy Council staff, and members of the Higher Education Funding Council. It will want to find out how it is possible to override the will of Parliament through the exercise of the royal prerogative in regard to a Bill such as this.
I find great difficulty in understanding why the students changed their minds and why they withdrew their petition. Could it be that some sort of educational pressure was exerted on them? Is there any evidence to support that? Or could it be that the students were told that whatever happened in Parliament was irrelevant and that the college, by pursuing the use of the royal prerogative, could secure its objective anyway? Perhaps that is what convinced the students to change their minds. I am sorry to take my hon. Friend back to that point, but it is important.
In truth, I cannot push the matter much further, although I can help my hon. Friend a little. The students would have seen the letter and the speech, because they were published in the Bart's medical college journal—and the leader of the student group at St. Bartholomew's, Marcus Beadle, writes a regular column for the journal. I assume that he reads the rest of it, so that may have subconsciously affected his decision.
As I have said, Professor Zellick told me at a meeting, which my hon. Friend attended, and also in a letter, that he has put no pressure on the students. Perhaps he has not done so, but senior clinicians at Bart's medical college have simply said to me, "Of course pressure was put on; you are a politician so you know the way these things work. The pressure is never direct, it is indirect." I am afraid that our trade is a little dirty—although not in the Chair, Mr. Deputy Speaker—and the academic world can probably be as dirty, backstabbing, malicious and vicious as some politicians—not me—can be. I think that that is the answer to my hon. Friend's question.
Until now, I have been dealing with the preliminary arguments. My central argument is that Bart's medical college is a jewel of medical colleges and a centre of medical excellence unrivalled throughout the world. It can stand on its own. Whatever the sociological arguments produced by civil servants, by the Todd report in 1968, the Flowers report in 1980 and the Tomlinson report in 1992, the truth is that a pre-clinical confederation already exists between Bart's medical college and the Royal London medical college. That confederation works perfectly well. It has not brought together the administrative structures or the finances, but it allows for flexibility and for evolution in the development of medical education.
I want to refer to the Bart's site; the Royal London can speak for itself, as I am not an expert on that matter. There is an extraordinary centre of medical excellence on the Bart's site. There is also an extraordinary centre of patient care, but that is being abolished. However, we are not talking about that today. The preamble to the Bill suggests that one reason for the proposed merger between Queen Mary and Westfield college and the Royal London and Bart's medical colleges is that that would produce an institution that would be nationally and internationally renowned. That was a central feature of the argument put forward by my right hon. Friend the Member for Bethnal Green and Stepney when he introduced the Bill.
I intend to argue that we already have at the medical college of St. Bartholomew's a centre of national and international renown. I defy him in his reply to the debate to argue against that when he has heard my arguments. I intend to go into detail to prove that and challenge my right hon. Friend or anyone else who is in favour of the Bill to say that I am wrong.
I know that my right hon. Friend is going to say that he agrees, but that is not good enough. If we already have the centre, he must say that he can improve it. I do not believe that he can and that is my point. I will give him every opportunity to go into the detail, not the sociological soundbite.
Professor Zellick, one of the promoters, came to a Room in the House of Commons and said to me, "I want to produce a world-class institution." He said it as though, if we said, "Yes, go ahead," we would get a world-class institution. That is the way sociology works. The civil servants who thought about the proposal back in 1968 wanted to produce a world-class institution. They thought that, simply by repeating the words, it would happen. I say that we have a world-class institution and we could destroy it.
How do I prove that St. Bartholomew's hospital is a world-class institution that can stand on its own without the need for the merger?
May I draw my hon. Friend's attention to a letter from the dean of the medical sciences building at the University of Toronto? It is a letter to the Prime Minister dated 7 January 1993. He says:
St. Bartholomew's has a reputation for academic excellence in clinical care, medical education and research which is recognised around the world. My most direct knowledge of St. Bartholomew's concerns Gastroenterology in particular. St. Bartholomew's has been an acknowledged leader in Gastroenterology for more than 100 years. Currently, its clinicians, scholars and scientists in the Academic Department of Paediatric Gastroenterology are recognised world-wide. These facilities represent a resource to London, to Britain and to the international academic medical community.
That was from a Mr. C. A. Ottoway MD PhD FRCP, of the medical sciences building at the University of Toronto. I understand that he is the dean of the department. So my hon. Friend has an example. I have many examples in this book.
My hon. Friend is privileged to have letters which I do not have. I have heard of that particular dean. He is of international renown. When he says that in gastroenterology St. Bartholomew's has a department of world excellence, I am inclined to believe him.
The point that my hon. Friend has to make, and I have to make in order to persuade the House, is as follows. My hon. Friend has dealt with one area. The fact that St. Bartholomew's is recognised internationally as excellent by someone whom we can respect does not mean that it is excellent across the board. How does one prove that an institution is world class? That is the onus on me in this debate. How can I prove to the House that here we have a world-class academic institution which is excellent across the board? Normally, one could not do it.
If we ask people at St. Bartholomew's hospital what they are like, they will tell us that they are brilliant. Of course they will. If we ask people at Corpus Christi college what they are like, they will tell us that they are brilliant. If we are to prove it, we must find external proof across the board.
Perhaps I can give my hon. Friend yet another quotation that is equally valid. It comes from an institution in Amsterdam—the Academisch medisch centrum. I do not speak Dutch so I cannot pronounce it right. It says:
Worldwide and certainly in Europe the significance and the fundamental contributions of St. Bartholomew's Hospital are unanimously recognised. For many decades the hospital has been a leading institute in many areas of gastroenterology. The contributions towards medicine and medical care of many of its distinguished physicians and surgeons in the past and in the present have been of immense importance in many areas of gastroenterology. I would like particularly to refer to all the recent work with respect to diarrhoeal diseases and to various infectious diseases. But there are many other areas in gastroenterology where St. Bartholomew's has excelled.
There are letters from all over the world in this document and they spell out and emphasise the important contribution that that medical college makes in those areas.
I am grateful to my hon. Friend, who is making an important contribution. If he has many such letters, I hope that he will catch your eye later in the debate, Mr. Deputy Speaker. Perhaps he will be able to cover more of the spread than gastroenterology and immunology.
By accident, I can prove that St. Bartholomew's is a global institution, a jewel in the crown and something that any civilisation would be silly to destroy. I shall not prove it in relation to the hospital, as we have had many debates on that, but I think that I can do so as regards the medical college. It is up to right hon. and hon. Members to decide whether they think that I have proved it.
The Tomlinson report contained two recommendations on St. Bartholomew's hospital. One was to close it and the other to merge its medical college with the Royal London medical college, which is what we are discussing. I think that the report referred to that being done in relation to the Queen Mary and Westfield. Those announcements sparked off a frisson throughout the medical world and the globe.
People did not sit back and say that it was something that was happening to some minor hospital somewhere in Britain—well, not somewhere in Britain but in the constituency of my right hon. Friend the Member for Bethnal Green and Stepney and the heart of London, our capital city. They did not say, "It has nothing to do with us." They wrote about it. What is the quality of the people who wrote? What was the scale of the coverage and the depth of their feelings? I shall not quote whole letters, as my hon. Friend the Member for Workington did.
Then it had even more power.
St. Bartholomew's has released to me 344 letters from 48 countries, which were sent to Professor Lesley Rees, the dean of the medical college. To be absolutely fair, some referred to the hospital, but most referred to the medical college and said its resources should not be split up or merged and that it should not disappear as it was one of the world's great institutions. If it works, why muck it around? That is the gravamen that my right hon. Friend the Member for Bethnal Green and Stepney must answer.
I have carried out a fairly unusual analysis of those documents across a wide range of the spectrum. After hon. Members have heard it, if they do not think that it adds up to a global institution that can stand on its own, they should speak and we can carry on the argument.
I spent several days undertaking this new type of summary of the way in which one analyses such things. First, I asked what countries the letters came from, did, they cover a wide spectrum of the globe and were they from important or unimportant people.
My hon. Friend is quite right. Elitism is favouritism. We are talking about academic excellence and in that sense, when it comes to preserving institutions of academic excellence, in one definition of the word I am an old-fashioned conservative. I hope that that will give Conservative Members some comfort. I am trying to behave responsibly in this debate.
The spread of countries from which letters have been sent is extraordinary. It includes Argentina, Australia, Austria, Belgium, Brazil, Canada—17 letters—Cyprus, Czechoslovakia, Denmark, Finland, France, Germany, Ghana, Greece, Hong Kong, Hungary, India, Ireland, Israel, Italy, the West Indies, the United States—97 letters—Switzerland, Sweden, Spain, South Africa, Singapore, Saudi Arabia, Russia, Romania, Portugal, Poland, Oman, Norway, New Zealand, the Netherlands, Malta, Malaysia, Malawi, Kuwait and Japan. Anyone can see that some countries are missing and that some 70 or 80 countries in the world are not represented, but basically that list represents the whole of the advanced medical world, which has sent letters. Is it not worth the House taking notice of them?
I have looked at the number of letters that came from distinguished universities, which I know from my experience and reading have academic experience in the medical world that is worth noting. The following universities sent letters of support and said that this is a global institution and we would be foolish to let its human and property assets dissipate.
That is because my right hon. Friend has not been doing the talking and delving that I have been doing inside St Bartholomew's hospital in the past fortnight. One then gets a different story, but that is a point for later on.
The distinguished universities concerned are, in Australia: Monash university; the University of Adelaide; the University of New South Wales; the University of Queensland; the University of Tasmania; the University of Western Australia; and the Walter and Eliza Hall Institute of Medical Research, Melbourne, which is almost a university. They all said that this is a world-class institution and we should not break it up or let it go.
From Brazil, we received letters of support from the University of San Paulo. From Canada, we had letters of support from McGill university; McMaster university; the Tom Baker cancer centre, Calgary; University hospital, London, Ontario; the University of British Columbia; the University of Toronto; the University of Vancouver; and the University of Western Ontario—all the great universities of Canada. From Finland, we had letters of support from the University of Helsinki and the University of Turku.
In the light of that overwhelming body of opinion worldwide that has written to the Prime Minister, the hospital or whoever in support of retaining the existing college structure, is it not odd that the Minister is unwilling to come to the Dispatch Box to answer a simple question: if it is the will of Parliament that this Bill does not proceed, is it right for the college authorities to proceed on the basis that they can use the royal prerogative? Is it not odd that, given the overwhelming weight of support, Ministers stand aside and not reflect publicly on those matters?
Does my hon. Friend agree that it seems entirely inconsistent with Government policy when, at the same time as they are trying to promote the City of London as a financial centre in the world, we have reactions from all over the world to the dismantling of a great medical institution? Can we imagine our competitors in Frankfurt or Paris doing something similar while trying to attract wealth and jobs to their city?
My hon. Friend makes a point that the City of London realises only too well is perfectly valid. One cannot imagine any other country breaking up a medical institution of this character. The chairman of the policy and resources committee of the City of London corporation, who is obviously a Conservative—Mr. Michael Cassidy—wrote only a week ago about the disaster that is befalling the City of London.
We have had representations from the Aristotolean university at Thessaloniki and Athens university in Greece, the university of Budapest in Hungary, the University of Esfahan in Iran, University college, Cork, Ireland, the Chaim Sheba medical centre at Tel Aviv university in Israel, the University of La Sapienza, Rome, and the universities of Bologna, Florence, Genoa, Milan, Modena, Naples Padova, Pavia, Siena, Trieste and Turin in Italy, Kyoto university in Japan, Kuwait university, the University of Malta medical school, the Academische Ziekenhuis in Groningen, Academische Ziekenhuis in Utrecht, the Catholic university in Nijmegen, Erasmus university in Rotterdam, and the University of Amsterdam. That is virtually the whole of the Netherlands, which has a reputation in medical science.
We have had representations from the universities of Auckland and of Otago in New Zealand, the University of Oslo in Norway, the universities of Lisbon and of Porto in Portugal, the Moscow state university, and the M. V. Lomonosov Moscow university.
Apparently, nobody in the whole world wants to, apart from whipped Conservative Members and my right hon. Friend the Member for Bethnal Green and Stepney.
We have had representations from the University of Ljubljana in Slovenia, the universities of Natal and of Stellenbosch in South Africa, the universities of Barcelona, of Madrid and of Santiago de Compostela in Spain, the universities of Gothenburg, of Lund, of Umea and of Uppsala in Sweden, the Centre Hospitalier Universitaire Vaudois, Lausanne, Hôpital Cantonal Universitaire de Geneve and University hospital, Zurich.
We have had representations from the Albert Einstein college of medicine, New York, the American Cancer Society, Columbia university, Cornell university, Georgetown university, Harvard university, Indiana university, Iowa state university, the Johns Hopkins medical school—one of the greatest medical schools that the world has ever known and ever will known—Loyola university in Chicago, the universities of Stanford in California, Alabama—
I shall come to that.
We have received representations from the universities in Arizona, California, Detroit, Florida, Kentucky, Maryland, Miami, Mississippi, Nebraska, Pennsylvania, South Carolina, South Florida, Southern California, Tennessee, Texas, Vermont, Virginia Washington, North Carolina and St. Louis. [Laughter.]
Hon. Members are laughing, but those are 114 of the world's most prestigious universities with medical schools. One or two of them may have written letters that are over the top. They may have done it out of kindness, but one cannot get 114 of the world's top medical colleges to say, "Keep this medical college as it is, linked to its hospital, and let this global jewel get on with its business." I do not know how my right hon. Friend the Member for Bethnal Green and Stepney will answer that. That is the geographical spread.
My hon. Friend the Member for Workington mentioned gastroenterology. I said that it was all right to mention that but that plenty of other medical sciences existed. How does the spread go in those letters? It goes throughout the medical sciences.
Bart's is being described as a megacentre of academic research and of doctors' teaching and training in the following areas: anatomy, basic science, cardiology, cardiothoracic surgery, clinical biochemistry, clinical pharmacology, dermatology, diabetes, endocrinology, gynaecology, gastroenterology, haematology, human nutrition, AIDS, medical education, medical informatics, medical oncology, metabolism, microbiology, molecular genetics, nephrology, neurology, nuclear medicine, obstetrics, orthopaedic surgery, pathology, paediatrics, paediatric endocrinology, paediatric gastroendocrinology, paediatric oncology, pharmacology, physiology, preventive medicine, psychiatry, radiology, reproductive physiology, surgery, transplant surgery and urology.
That is just about every medical discipline that we know about. Representatives of all those disciplines say that Bart's is magnificent; it is wonderful; it works; keep it; leave it alone. Why have we come here to destroy it?
I shall not read long letters, but I should like to read a few small excerpts. Hon. Members may judge the quality of the people who have written them in relation to the hospital.
Professor Bela Halasz from Hungary wrote:
I was shocked … I was startled … Its scientists are leading members of important international organizations …In my opinion it would be a very great loss, if they
were dispersed. He knows what he is talking about. Perhaps my right hon. Friend the Member for Bethnal Green and Stepney knows him.
On basic science, Professor Guido Pozza from Italy wrote:
It is my strong opinion that such a decision will bring about a great loss for biomedical research in U.K … I do really hope that St. Bart's shall not end its activity.
On cardiology, Professor Sean Blake of Dublin wrote:
It seems to me that this would be a tremendous tragedy.
Dr. Richard Hauer from the Netherlands wrote:
It was with astonishment … deepest support to attempts to avert this highly undesirable development.
Professor Wellens of the Netherlands wrote:
many new developments in the diagnosis and management of cardiac arrhythmias have come from colleagues working in St. Bartholomew's Hospital … St. Bartholomew's Hospital is academically very much alive.
May I just develop this point? I am looking at the clock and I want to give other Members a chance to speak.
On cardiac surgery:
I am astonished … a beacon, a lighthouse and a guide to, not only the Londoner, but also, to the people of the United Kingdom and the world at large … the fate of such a perennial institution, cannot be determined by an ephemeral … body"—
I assume that that is a reference to Parliament—
this national treasure
wrote Professor Gerard Guiraudon of Canada.
On clinical biochemistry, Professor Jarob of Germany said:
This tells a lot about successful and excellent education going on not only in Dr Galton's department but also in the whole institution. So I am sure the closure of this tradition-rich famous institute would be an irreparable error … I feel strongly about my conviction".
On clinical neurophysiology, Anna Maria Seppalainen of Finland wrote:
St. Bartholomew's has often exercised interdisciplinary approach … This type of approach is severely endangered if the facilities and specialists should be dispersed in various locations.
On clinical pharmacology:
several highly respected physicians and surgeons from Bart's have, over the years, contributed to continuing education at the Academy as Distinguished Academicians … There is thus a longstanding academic and professional link between Bart's and the medical community of Singapore … it would be a disastrous mistake to close the Hospital.
That is Professor Vernon M. Oh from the national university of Singapore.
On endocrinology, Professor Luiz Cesar Povoa of Brazil wrote:
As a member of the executive Committee of the International Society of Endocrinology I can testify to the high concept of this institution and its contribution to the Endocrinology not only in England, but in the whole World. So, it seems, I repeat,' incredible … England is respected in the world by its capacity in maintaining tradition, developing new sophisticated techniques and training in a high level
Human Resources. Undoubtedly, St. Bartholomew's Hospital is a symbol of this statement."
On gynaecology, Professor Masterson at the university of Florida in the United States of America, who is one of the great experts in his field, wrote:
surprise and dismay … one of only six training centres approved by the Royal College of Obstetricians and Gynaecologists for clinical and fellowship training in Gynaecological Oncology.
Dr. Holmesley of North Carolina in the United States of America is another respected expert. He said that the
most critical loss would be an active training programme in Gynaecological Oncology".
That is roughly the same statement that I have just read out from the other source.
In the sphere of haematology, Professor Sherrill Slichter from Washington, America, said to Professor Lesley Rees, Dean of St. Bartholomew's medical college:
Your department and institution are well recognised as examples of the best in medical education and scientific excellence … I would consider it both a personal and professional loss to the haematologic community if your department was no longer in existence."
On the subject of immunology and AIDS, the Ruprecht-Karls university in Heidelberg, Germany states that there are
alarming reports … the work of St. Bartholomew's is highly respected in the international transplant community … ranks among the best institutions worldwide.
Professor Jonathan Mann from the Harvard school of public health, another major university, said:
Beyond the clinical and academic excellence associated with St. Bartholomew's, I have had the opportunity to observe the high level of international collaboration which the facility and its senior staff, such as Professor Anthony Pinching, have manifested. Professor
Pinching has been a major figure in AIDS research and in global thinking about HIV/AIDS … a major concern would emerge should St. Bartholomew's cease to exist."
Anthony Pinching came from St Mary's—he is one of the people whose work with the Government stopped the onslaught and spread of AIDS in this country. If his department were to be ripped up, we would all pay a terrible price, but, apparently, that may be on the cards.
In the sphere of medicine, Professor Casanueva of Spain said:
for Endocrinology, your hospital is the most important and leading unit in Europe … prevent this absurd measure.
Mr. Michael Thorner said:
the current policy appears to be precipitous and poorly thought out … Bart's not only serves its patient base, but it is an important centre for teaching of medical students, as a postdoctoral training institution and as a centre for medical research.
The evidence goes on and on. I think that I am beginning to prove my point.
I also looked at one of the major medical institutions of the world—the equivalent of a medical college in Britain. I looked at what 10 people from that one major institution had said to see whether, across the board, I could get a favourable result. I looked for the reaction of the Harvard medical school, one of the greatest medical centres that the world has ever known. Ten professors were asked what they thought.
Professor Goyal from the department of medicine of Harvard medical school said that he felt "great astonishment" and that
the adverse effects of its closing will be felt in the medical community throughout the world.
Professor Walker of the department of paediatrics said that he was "absolutely overwhelmed" and that it was
outrageous … that the government should wish to close such a wonderful example of what British medicine has contributed to the world of medicine, medical research and to the quality of care of patients.
Professor Mannick of the department of surgery at the Harvard medical school said:
I find this shocking in the extreme … St. Bartholomew's is a source of inspiration for academic physicians and surgeons throughout the world.
All the other professors say exactly the same.
Professor Nichols of the department of gynaecology and reproductive oncology said that he felt "astonishment and sadness". He said:
This centre of international communication in medicine has earned the respect of colleagues throughout the world … It is so easy to dismantle that which took professionals generations to develop, but the negative consequences for the women of the world will be those with which we must all live for a very long time.
We can look at the letters in another way. I do not think that anyone has ever done this kind of analysis in support of an institution in this country. Ostensibly, we have a lot of letters which make academic medical points. However, we wish to highlight the strength of the emotions involved. How strong is the emotional tie with St. Bartholomew's? There is a negative emotional response to the idea of closing the hospital and merging the medical college and I have picked out some of the words which show the depth of that feeling.
I have analysed the letters and the principal words used again and again include: "shocked", "dismayed", "astonished", "disbelief", "deepest concern", "saddened", "surprise", "amazement", "appalled", "distressed", "horrified", "stunned", "devastating", "overwhelmed", "disturbing", "inconceivable", "incredible", "unthinkable", "astounded", "apprehension", "speechless", "horrible", "alarmed" and "You must be kidding".
The other side of the coin is how Bart's Smithfield is viewed around the globe. Some of the words used in the letters are: "unequalled", "pre-eminent", "world renowned", "venerable", "irreplaceable institution", "true legend", "wonderful unparalled example", "landmark without peers", "international role model", "pillar", "a beacon", "jewel", "a lighthouse", "shining light", "admiration", "envy", "a guide", "prestigious", "scientific strength", "innovative", "dynamic", "unique", "resource benefit of mankind", "incredible traditions", "highest distinction and renown", "top-flight", "great citadel", "magnificent", "dedication to excellence", "second to none", "superb reputation" and "national treasure". That is how people from abroad view the institution.
If the great medics of this country were to meet the top 25 endocrinologists, cardiologists, physiologists or experts in any field—this exercise is not connected with the letters—would anyone from Bart's be in the room? Would anyone from Bart's stand as an example of that institution's international quality?
If one entered a room containing the world's top 25 endocrinologists, one would find Professor Michael. Besser, professor of medicine at Bart's. Every endocrinologist in the world would recognise him. I do not wish to embarrass him, but Professor Besser is as close as one will ever get to a genius. He is not only a professor of medicine but also a chief executive following the publication of the Tomlinson report. He fought an heroic battle to save St. Bartholomew's hospital.
He would be recognised as the professor of medicine and the chairman of the department of medicine at Bart's. His department of endocrinology received a commendation in the 1992 research assessment exercise. He is a world leader in endocrinology and he has been a visiting professor to universities and medical establishments in Canada, China, Hong Kong, Italy, Malta and the United States of America. He was recently elected senior vice president and senior censor of the Royal College of Physicians.
He is currently chairman of the working party on hormone replacement therapy. He has served on the editorial board of the Journal of Endocrinology and the Journal of Neuroendocrinology and he is currently a member of the editorial board of clinics in endocrinology and metabolism. He could stand among the world's top 25 endocrinologists and people would look up to him. He also performs another function which is not quite as important—he is in charge of the case of my hon. Friend the Member for Workington when my hon. Friend is a patient at St. Bartholomew's hospital. That is the kind of genius and department that I am asking the House to fight to preserve, and not to let slide away into oblivion with the closure of the hospital. Once the department has gone, we will not get it back.
Professor James Malpas would be recognised in that room. He is currently the senior physician at St. Bartholomew's hospital, and he is a world authority on childhood cancer. He is president of the Association of Cancer Physicians. The department that he heads has an international reputation, from both the clinical and academic points of view. It received a commendation in the 1992 research assessment exercise. The professorial heads of several oncology departments in this country and the heads of at least three departments in north America—
|Division No. 131]||[9.55 pm|
|Ainsworth, Peter (East Surrey)||Goodlad, Rt Hon Alastair|
|Aitken, Rt Hon Jonathan||Goodson-Wickes, Dr Charles|
|Alexander, Richard||Greenway, Harry (Ealing N)|
|Alton, David||Greenway, John (Ryedale)|
|Amess, David||Griffiths, Peter (Portsmouth, N)|
|Arbuthnot, James||Gummer, Rt Hon John Selwyn|
|Arnold, Jacques (Gravesham)||Hague, William|
|Ashby, David||Harris, David|
|Ashdown, Rt Hon Paddy||Hayes, Jerry|
|Atkins, Robert||Heathcoat-Amory, David|
|Baker, Nicholas (North Dorset)||Hendry, Charles|
|Baldry, Tony||Hill, James (Southampton Test)|
|Bates, Michael||Hogg, Rt Hon Douglas (G'tham)|
|Beith, Rt Hon A J||Howard, Rt Hon Michael|
|Bendall, Vivian||Howarth, Alan (Strat'rd-on-A)|
|Beresford, Sir Paul||Hunt, Rt Hon David (Wirral W)|
|Booth, Hartley||Jack, Michael|
|Boswell, Tim||Jenkin, Bernard|
|Bottomley, Peter (Eltham)||Jones, Barry (Alyn and D'side)|
|Bottomley, Rt Hon Virginia||Jones, Gwilym (Cardiff N)|
|Bowis, John||Jones, Robert B (W Hertfdshr)|
|Brandreth, Gyles||King, Rt Hon Tom|
|Brazier, Julian||kirkhope, Timothy|
|Bright, Sir Graham||Kirkwood, Archy|
|Browning, Mrs Angela||Knapman, Roger|
|Burns, Simon||Knight, Mrs Angela (Erewash)|
|Butler, Peter||Knight, Greg (Derby N)|
|Campbell, Menzies (Fife NE)||Knox, Sir David|
|Carlile, Alexander (Montgomery)||Kynoch, George (Kincardine)|
|Carlisle, Sir Kenneth (Lincoln)||Lait, Mrs Jacqui|
|Chapman, Sydney||Lamont, Rt Hon Norman|
|Clappison, James||Lang, Rt Hon Ian|
|Clarke, Rt Hon Kenneth (Ru'clif)||Lawrence, Sir Ivan|
|Clifton-Brown, Geoffrey||Lidington, David|
|Coe, Sebastian||Lilley, Rt Hon Peter|
|Connarty, Michael||Lloyd, Rt Hon Sir Peter (Fareham)|
|Conway, Derek||Luff, Peter|
|Coombs, Simon (Swindon)||Lyell, Rt Hon Sir Nicholas|
|Dalyell, Tam||MacKay, Andrew|
|Davis, David (Boothferry)||Maclean, David|
|Dorrell, Rt Hon Stephen||Maddock, Diana|
|Douglas-Hamilton, Lord James||Maitland, Lady Olga|
|Dover, Den||Malone, Gerald|
|Dykes, Hugh||Mans, Keith|
|Evans, Jonathan (Brecon)||Marshall, John (Hendon S)|
|Evans, Nigel (Ribble Valley)||Mayhew, Rt Hon Sir Patrick|
|Evennett, David||Merchant, Piers|
|Faber, David||Mitchell, Andrew (Gedling)|
|Fabricant, Michael||Monro, Sir Hector|
|Field, Barry (Isle of Wight)||Nelson, Anthony|
|Forsyth, Rt Hon Michael (Stirling)||Newton, Rt Hon Tony|
|Forth, Eric||Nicholls, Patrick|
|Fox, Dr Liam (Woodspring)||Nicholson, David (Taunton)|
|Freeman, Rt Hon Roger||Nicholson, Emma (Devon West)|
|French, Douglas||Norris, Steve|
|Gale, Roger||Oppenheim, Phillip|
|Gallie, Phil||Ottaway, Richard|
|Gardiner, Sir George||Page, Richard|
|Garnier, Edward||Paice, James|
|Gillan, Cheryl||Redwood, Rt Hon John|
|Rendel, David||Tredinnick, David|
|Richards, Rod||Trend, Michael|
|Riddick, Graham||Waldegrave, Rt Hon William|
|Robinson, Mark (Somerton)||Wallace, James|
|Rowe, Andrew (Mid Kent)||Waller, Gary|
|Rumbold, Rt Hon Dame Angela||Ward, John|
|Ryder, Rt Hon Richard||Waterson, Nigel|
|Sackville, Tom||Wells, Bowen|
|Shaw, David (Dover)||Wheeler, Rt Hon Sir John|
|Shepherd, Colin (Hereford)||Whitney, Ray|
|Shepherd, Richard (Aldridge)||Whittingdale, John|
|Shore, Rt Hon Peter||Wiggin, Sir Jerry|
|Skeet, Sir Trevor||Willetts, David|
|Soames, Nicholas||Wilshire, David|
|Spink, Dr Robert||Winterton, Mrs Ann (Congleton)|
|Spring, Richard||Winterton, Nicholas (Macc'f'ld)|
|Sproat, Iain||Wolfson, Mark|
|Squire, Robin (Hornchurch)||Wood, Timothy|
|Stephen, Michael||Young, Rt Hon Sir George|
|Streeter, Gary||Tellers for the Ayes:|
|Taylor, John M (Solihull)||Mr. Oliver Heald and|
|Thurnham, Peter||Mr. Raymond Robertson.|
|Ainsworth, Robert (Cov'try NE)||Forsythe, Clifford (S Antrim)|
|Barnes, Harry||Hardy, Peter|
|Beggs, Roy||Illsley, Eric|
|Callaghan, Jim||McFall, John|
|Campbell-Savours, D N||Pike, Peter L|
|Clarke, Eric (Midlothian)||Redmond, Martin|
|Clwyd, Mrs Ann||Ross, William (E Londonderry)|
|Cohen, Harry||Wise, Audrey|
|Cox, Tom||Wray, Jimmy|
|Dixon, Don||Tellers for the Noes:|
|Donohoe, Brian H||Mr. Terry Lewis and|
|Etherington, Bill||Mr. Dennis Skinner.|
|Division No. 132]||[10.10 pm|
|Ainsworth, Peter (East Surrey)||Browning, Mrs Angela|
|Aitken, Rt Hon Jonathan||Burns, Simon|
|Alexander, Richard||Butler, Peter|
|Alton, David||Campbell, Menzies (Fife NE)|
|Amess, David||Carlile, Alexander (Montgomery)|
|Arbuthnot, James||Carlisle, Sir Kenneth (Lincoln)|
|Arnold, Jacques (Gravesham)||Chapman, Sydney|
|Ashdown, Rt Hon Paddy||Clappison, James|
|Atkins, Robert||Clarke, Rt Hon Kenneth (Ru'clif)|
|Baker, Nicholas (North Dorset)||Clifton-Brown, Geoffrey|
|Baldry, Tony||Coe, Sebastian|
|Bates, Michael||Conway, Derek|
|Beggs, Roy||Coombs, Simon (Swindon)|
|Beith, Rt Hon A J||Dalyell, Tam|
|Bellingham, Henry||Davis, David (Boothferry)|
|Bendall, Vivian||Dorrell, Rt Hon Stephen|
|Beresford, Sir Paul||Douglas-Hamilton, Lord James|
|Booth, Hartley||Dover, Den|
|Boswell, Tim||Dykes, Hugh|
|Bottomley, Peter (Eltham)||Evans, Jonathan (Brecon)|
|Bottomley, Rt Hon Virginia||Evans, Nigel (Ribble Valley)|
|Bowis, John||Evennett, David|
|Brandreth, Gyles||Faber, David|
|Brazier, Julian||Fabricant, Michael|
|Bright, Sir Graham||Field, Barry (Isle of Wight)|
|Brooke, Rt Hon Peter||Forsyth, Rt Hon Michael (Stirling)|
|Forsythe, Clifford (S Antrim)||Newton, Rt Hon Tony|
|Forth, Eric||Nicholls, Patrick|
|Fox, Dr Liam (Woodspring)||Nicholson, David (Taunton)|
|Freeman, Rt Hon Roger||Nicholson, Emma (Devon West)|
|French, Douglas||Norris, Steve|
|Gale, Roger||Oppenheim, Phillip|
|Gallie, Phil||Ottaway, Richard|
|Gardiner, Sir George||Page, Richard|
|Garnier, Edward||Paice, James|
|Gillan, Cheryl||Redwood, Rt Hon John|
|Goodlad, Rt Hon Alastair||Rendel, David|
|Goodson-Wickes, Dr Charles||Richards, Rod|
|Greenway, Harry (Ealing N)||Riddick, Graham|
|Greenway, John (Ryedale)||Robinson, Mark (Somerton)|
|Griffiths, Peter (Portsmouth, N)||Ross, William (E Londonderry)|
|Gummer, Rt Hon John Selwyn||Rowe, Andrew (Mid Kent)|
|Hague, William||Rumbold, Rt Hon Dame Angela|
|Hardy, Peter||Ryder, Rt Hon Richard|
|Harris, David||Sackville, Tom|
|Hayes, Jerry||Shaw, David (Dover)|
|Heathcoat-Amory, David||Shepherd, Colin (Hereford)|
|Hendry, Charles||Shepherd, Richard (Aldridge)|
|Hogg, Rt Hon Douglas (G'tham)||Shore, Rt Hon Peter|
|Howard, Rt Hon Michael||Skeet, Sir Trevor|
|Howarth, Alan (Strat'rd-on-A)||Soames, Nicholas|
|Hunt, Rt Hon David (Wirral W)||Spink, Dr Robert|
|Jack, Michael||Spring, Richard|
|Jenkin, Bernard||Sproat, Iain|
|Jones, Barry (Alyn and D'side)||Squire, Robin (Hornchurch)|
|Jones, Gwilym (Cardiff N)||Stephen, Michael|
|Jones, Robert B (W Hertfdshr)||Stewart, Allan|
|King, Rt Hon Tom||Streeter, Gary|
|Kirkhope, Timothy||Taylor, John M (Solihull)|
|Kirkwood, Archy||Thurnham, Peter|
|Knapman, Roger||Tredinnick, David|
|Knight, Mrs Angela (Erewash)||Trend, Michael|
|Knight, Greg (Derby N)||Waldegrave, Rt Hon William|
|Knox, Sir David||Wallace, James|
|Kynoch, George (Kincardine)||Waller, Gary|
|Lait, Mrs Jacqui||Ward, John|
|Lamont, Rt Hon Norman||Wardell, Gareth (Gower)|
|Lang, Rt Hon Ian||Waterson, Nigel|
|Lidington, David||Wells, Bowen|
|Lilley, Rt Hon Peter||Wheeler, Rt Hon Sir John|
|Lloyd, Rt Hon Sir Peter (Fareham)||Whittingdale, John|
|Luff, Peter||Widdecombe, Ann|
|Lyell, Rt Hon Sir Nicholas||Wiggin, Sir Jerry|
|MacKay, Andrew||Willetts, David|
|Maclean, David||Wilshire, David|
|Maitland, Lady Olga||Winterton, Mrs Ann (Congleton)|
|Malone, Gerald||Winterton, Nicholas (Macc'f'ld)|
|Mans, Keith||Wolfson, Mark|
|Marshall, John (Hendon S)||Wood, Timothy|
|Mayhew, Rt Hon Sir Patrick||Young, Rt Hon Sir George|
|Mitchell, Andrew (Gedling)||Tellers for the Ayes:|
|Monro, Sir Hector||Mr. Oliver Heald and|
|Nelson, Anthony||Mr. Raymond Robertson.|
|Ainsworth, Robert (Cov'try NE)||Etherington, Bill|
|Barnes, Harry||Hughes, Kevin (Doncaster N)|
|Callaghan, Jim||Lewis, Terry|
|Campbell-Savours, D N||Pike, Peter L|
|Clarke, Eric (Midlothian)||Skinner, Dennis|
|Cohen, Harry||Wise, Audrey|
|Connarty, Michael||Wray, Jimmy|
|Davidson, Ian||Tellers for the Noes:|
|Donohoe, Brian H||Mr. Brian Sedgemore and|
|Eastham, Ken||Mrs. Ann Clwyd.|