Since 1 May 1997, I have received a number of representations about proposals by health authorities for the closure of hospitals in Wales, including an Adjournment debate last Thursday initiated by the hon. Member for Brecon and Radnorshire (Mr. Livsey). Such proposals are the responsibility of health authorities and are referred to me for decision only if they cannot be agreed with the local community health council. To date, I have received no such referrals.
The Minister will be aware of the strength of the opposition from both health care professionals and patients in Powys to the proposed merger of the Powys Health Care NHS trust and the Ceredigion and Mid Wales NHS trust, because of fears that the merger would inevitably lead to the closure of community hospitals. He will also be aware of the level of expectations raised throughout the country by the Chancellor's much hyped announcement last week of additional resources for the national health service.
If Labour's manifesto commitment to save the NHS in Wales is to mean anything to the people of Powys, will the Minister give the House an assurance that the saving of the community hospital-based system in Powys will an absolute priority in the spending of the additional NHS funds allocated to Wales? Will he confirm that, as a result of that extra money, none of the community hospitals in Powys will close?
The reconfiguration of the trusts in Wales will make more money available for patient care in Powys and Ceredigion, and everywhere else, so the two issues of community hospitals and of trust reconfiguration have nothing to do with one another. I confirm that the extra money provided for the health service in Wales by the Chancellor will be spent on ensuring that we have a better health service throughout Wales.
As for community hospitals, I will await proposals to see whether there are disagreements. I can tell the hon. Gentleman that in Tenby an agreement has already been made whereby the community hospital is to close, but other provision has been agreed by all concerned.
I am confident about what will happen in Powys and Ceredigion—and, by the way, there is widespread support in Ceredigion for the trust reconfiguration proposal. I certainly hope that there will be a proposal for Powys and Ceredigion that will provide better care for everybody.
May I remind my hon. Friend of two excellent local hospitals, Meadowslea and Dobshill, in my constituency, which he has not yet visited, and about which there are rumours of closure? Does he agree that those hospitals have a wonderful record? Will he please visit them? Is it not the case that, now that the Chancellor has made money available, there should be no need for rumours of closure?
I assure my hon. Friend that I certainly shall make an effort to visit those two hospitals in the near future. I have heard nothing about rumours of closure and I reassure him that the extra money provided by the Chancellor will ensure that there will be a better health service in Wales in the coming years and, as long as there is a Labour Government, that will continue.
Does the Minister agree that the hon. Member for Runnymede and Weybridge (Mr. Hammond) was preaching a lot of humbug, because it was his party that first put the skids under the idea of closing community hospitals?
When the Minister receives an objective report from Dr. Robert Maxwell of the King's Fund which recommends that community hospitals in Powys remain open and that there is no amalgamation of the Ceredigion trust, will he take note of those recommendations and act positively on them?
I certainly agree with the hon. Gentleman's first question—I have no problem with that. I underscore the fact that the trust reconfiguration exercise has absolutely nothing to do with the future of community hospitals. The additional money that the exercise will produce will make it more, rather than less, likely that community hospitals will survive. I look forward to reading the Maxwell report commissioned by Powys Action for Patients, but we must await the outcome of the consultation before any final decisions are made.
In view of the substantial extra resources now to be devoted to the health service—5 per cent. extra in real terms for the next three years—is there not an overwhelming case for all health authorities to reconsider any closure plans and the Government's policy of halting the steep decline in the number of hospital beds? We need the beds, we need the hospitals, and we now have a Government who are providing the resources to sustain them.
I assure my hon. Friend that the Chancellor's decision to provide additional money for three years ahead will give health authorities and everyone in the health service the chance properly to plan for the provision of health care. I am confident that health authorities, trusts and all those involved in providing health care will be grateful for that extra money, and will use it wisely to promote and enhance patient care.
Does the Minister recall that the Madog community hospital in Porthmadog was closed on the basis that there would be a new community hospital in that town and that, when a delegation met him to discuss that point, he made it clear that it was a matter for the North Wales health authority and the Gwynedd Community Health NHS trust? Now that the health authority and the community trust have supported the idea of a new hospital and the Minister has an abundance of new money available, will he give the go-ahead for that hospital?
I thank the right hon. Gentleman for acknowledging that there is an abundance of new money available, thanks to the Chancellor. We shall consider the proposal for the right hon. Gentleman's constituency when it is put before us. I am pleased that there is at last agreement. We must now consider the best way of making sure that the hospital is provided.
Is my hon. Friend aware of the tremendous support and affection for the Mardy hospital in Merthyr? Will he reassure the House that, if the proposal to close the hospital is pushed through, the new community hospital that has been proposed will be built?
My hon. Friend will know that I visited the Mardy hospital, and I well appreciate the difficulties for staff operating from there in providing high-quality care for patients. I do not want to comment specifically on a possible closure or replacement, but I would want to be absolutely sure that, in the event of any closures, there would be proper provision in Merthyr Tydfil and the North Glamorgan NHS trust area.
All parties in the House understand the need to obtain value for money in health care; but, having worked as a doctor in community hospitals, I know that the value of community hospitals has to be measured in more than simply economic terms. Would it not be money well spent to keep local people in a local environment, within easy access of families, transport and support? What assessment has the Minister made of the average cost per day per bed in community hospitals compared with that in acute units in Wales?
First, I assure the hon. Gentleman that, as someone who, as a child, spent some time in the Brecon war memorial hospital, I am well aware of the good service provided by community hospitals. It would not take a genius to know that care in a community hospital costs far less per bed than in an acute general or district hospital. Community hospitals have a valuable role to play and I want to be sure that, throughout Wales, facilities in general and district hospitals and in community hospitals are properly interlinked.
I congratulate my hon. Friend on his announcement of no less than £1 billion extra for health spending in Wales. Does he agree that tackling the chronic levels of ill health in Wales requires a strategic approach, and that the pledge of extra money will go a long way towards committing money for that strategy?
I thank my hon. Friend for that observation and question. In addition to the extra money, we have also developed a strategy to raise health standards in our "Better Health—Better Wales" Green Paper. We want to tackle the causes of bad health as well as treating it. The money will surely help us to raise health standards in Wales.