I do indeed. Both my right hon. and learned Friend and Mr. Watkins are right on that point. Last year, in reply to a question that I asked in the House, the previous Secretary of State said in relation to the Kent and Canterbury hospital:
If it looks as though things are going wrong, I am prepared to step in and ensure that the bed reduction does not proceed as quickly, or as far, as presently agreed".—[Official Report, 11 January 1999; Vol. 323, c. 45–6.]
Even with the commitments that he made, the Secretary of State's decision caused dismay. It will mean the rundown of the full A and E department, which has been in the top third of the major trauma outcome survey for every year since the survey was launched in 1988, and transferring those services to distant units that are still to meet the full standard.
Furthermore, our area is suffering a winter that has seen the most severe pressure on East Kent hospitals. In recent weeks, two out of three acute hospitals in the area have, on several different occasions, been simultaneously closed to all but blue-light work, with bed use running at well over 100 per cent. of nominal capacity, including trollies pushed into offices and corridors. Flu has been part of the cause, but East Kent has some of the largest and busiest road arteries in Europe. Because the mild winter has brought relatively little ice and snow, the road accident work load has been well below average, but still the hospital system has been stretched to near breaking point.
A Government with a large majority can do as they wish. Despite all those considerations, when the Secretary of State made his decision, I decided that the best way that I could defend the services was to engage, rather than simply oppose. He did at least leave us with a single trust responsible for health care, and I have welcomed the meetings with Mr. Conrad Blakey and Mr. David Astley, the new chairman and chief executive.
It was, therefore, with incredulity that I read the "Moving Forward" document, the opening sentence of which reads:
On 22 December 1998 the Secretary of State endorsed the Health Authority's proposal".
That statement was repeated five times in the text without any mention of his lengthy conditions. On those conditions, I shall leave description of the fiasco over renal services to the hon. Member for Sittingbourne and Sheppey. As for the rest of the items that 1 have already listed, the Secretary of State's findings on coronary care merit a brief mention on one page, but appear to play no part in the actual plan. Every other pledge has disappeared. The commitment to retain a full cancer centre has been ignored. The commitment to 232 beds has been ignored and no specific bed numbers are mentioned for that site. Consultant cover for emergency work at the Kent and Canterbury hospital has been ignored again.
This imaginative document, "Moving Forward", involves a degree of creative accounting that I can only describe as remarkable. East Kent health authority has carefully kept the capital investment figure just inside the £50 million mark, so that it does not go back to Ministers. Is the Minister content that a health authority can brush aside pledges by the Secretary of State? Is she content to see £50 million of taxpayers' money, along with substantial further sums hidden in revenue flows, go forward without referring the matter back to the Secretary of State to see that the pledges have been maintained?
It is very sad to see EKHA restating the same half truths from the old debate. For example, the document states:
an economic and social impact study confirmed that the greatest concentration of both the elderly and the socio-economically deprived in East Kent are located in Thanet".
As independent studies show, there are far more elderly people and a slightly greater number of deprived people in the catchment area for the Kent and Canterbury hospital. I raised that point with Mr. Mark Outhwaite, the chief executive, at a public meeting. He pointed out that the people in Thanet live closer together. He is quite right—technically, the largest concentration of elderly and deprived people is in Thanet. Do the people in rural areas, and in small towns such as Whitstable and Faversham, matter less because they live further apart, even though there are more of them? The population figures are flawed throughout the document. Where EKHA got the fatuous growth figure that was fed into the York study team, I cannot imagine. Has it never heard of Serplan, with its projections for huge population growth?
Page 11 of the document says that an implementation plan has been agreed. Yet on page 22, in excusing itself for giving no detail on plans for the Canterbury site, the same document says:
the detailed site plan will be drafted when a robust medical services model has been developed.
What sort of medical organisation embarks on £50 million worth of capital spending without a robust medical plan?
EKHA' s overstretched financial plans—and they are overstretched, because of the sheer scale of the capital spending, which is disguised in revenue—include £600,000 for investment in transport services. There is no mention of continuing spending. Most of East Kent's scattered rural communities, and some small towns, have no public transport access to the other two hospitals. Even if that allocation survives, does anyone really believe that an all-embracing taxi service can be delivered by East Kent's undermanned and overstretched ambulance service?
One sinister sentence explains how the financial circle is to be squared. It says:
the largest single savings will come from bed reductions
and from "improved efficiency". Presumably, no one from EKHA saw the trolleys in the corridors and the offices this winter. Yet the whole document hinges on 15 per cent. fewer beds. Vast capital expenditure and a shift from Kent's lowest cost hospital to less efficient sites is to be financed by removing beds. Is that what the Government want for the future of health care in East Kent? Will the Secretary of State require EKHA to resubmit its plans to see that at least those minimum pledges are met, and to take account of the new national findings on bed numbers?
I should like to end by asking the Minister a few specific questions. Will Canterbury retain the full range of services of a joint cancer centre, as defined under the Calman-Hine guidelines? Will a new linear accelerator be purchased, as promised, or just a second-hand one, which can be readily abandoned? Do the pledges on emergency cover and coronary care at Canterbury stand? Does the pledge of at least 332 beds stand, and does the hon. Lady think that that is adequate for our burgeoning population?
People all over East Kent, relying on our overstretched service, are waiting for answers—the old, the vulnerable, children, accident victims, doctors, nurses and health care workers. I urge the Secretary of State to call in the plans to see whether the earlier pledges are being maintained and whether they go far enough for the future of acute health care in East Kent.