I congratulate the hon. Member for Canterbury (Mr. Brazier) on securing a debate on a matter of great concern to his constituents. He has keenly supported his local hospitals for many years, particularly Kent and Canterbury and Nunnery Fields. His interest bears testimony to his commitment to the needs of local people, who are keen to see a high-quality health service for themselves and their families. I assure the hon. Gentleman that we share their vision.
The debate on hospital services in the East Kent health authority area has gone on for some time. I should like to spend a few moments outlining the reasons for the change in acute services, but I will address the hon. Gentleman's specific points later. First, I convey my thanks and those of the House to all the people in the national health service who worked over winter to cope with extraordinary pressures arising from the combination of an extended Christmas holiday, the millennium celebrations and the flu.
I shall outline the context of the changes to acute services in East Kent. They are not primarily driven by money, as has been suggested. I should record the fact that the health authority is receiving an additional cash increase of more than £23 million, which represents real growth of 3.7 per cent. No matter what the funding stream, changes would still be necessary to services in Kent.
In East Kent, the major issues are not only money, but the supply and training of doctors and the changes in medical technology. NHS services cannot stand still—locally or nationally. Changes in the NHS are complex and, as we all know, contentious. People want to fight for their local services. That is only right.
However, in East Kent, the process of modernisation has been a long one. As the hon. Gentleman pointed out, it started back in 1997, after detailed examination and the most exhaustive local consultation ever carried out for the NHS. As he said, the matter was referred to Ministers.
The then Secretary of State for Health, my right hon. Friend the Member for Holborn and St. Pancras (Mr. Dobson), gave careful consideration to the issues that had been raised and to the representations that had been received. He made his decision at the end of 1998. I fully accept that his decision was not universally popular, especially in the constituency of the hon. Member for Canterbury. However, I assure the hon. Gentleman that such decisions are never taken lightly.
Ministers need to combine the needs of the local population for access to local services with the requirement to provide top-quality treatment in a safe environment, in facilities that are fit for the 21st century. The decision taken will ensure that high-quality care will be provided on three sites—the Kent and Canterbury, the William Harvey and the Queen Elizabeth the Queen Mother hospitals. It will provide the opportunity to develop the scope and capacity of local primary care services. We must not forget what happens in primary care. The decision lays the foundation for acute and specialist care that will be of long-term and sustainable benefit to local people.
I make it clear again—although it has been made clear on previous occasions—that the decision announced by my right hon. Friend is not negotiable. I reiterate that: we shall not revisit the overall decision. However, it is important to point out that we shall ensure that the framework for that decision is properly implemented on the ground; that the plans are robust; and that the needs of the local population are met. I have, therefore, asked officials from the south-east regional office of the NHS Executive to monitor the progress of implementation to ensure that it takes place in a proper, sensitive and well-managed way.
The three trusts are merging to become the East Kent Hospitals NHS trust. That is right, because the new trust structure supports the implementation of the changes to hospital services. A single trust is much better placed to achieve that goal. The new trust combines the benefits of strategic oversight of hospital services in East Kent with a commitment to be responsive to local communities and their primary care groups.
The new trust has moved swiftly with its NHS partners to draw up an implementation plan for the service changes. The hon. Member for Canterbury referred to the document "Moving Forward". That document sets out the strategic development plan for acute services in the area. It builds on the work of clinical specialty groups. It sets out proposals to build new services and estates configurations.
However, it is important to be clear as to the purpose of the document. Although it addresses a variety of audiences, it has a specific purpose. It is not a consultation document, nor, as the hon. Gentleman implied, is it intended to set out in detail the clinical models for each specialty. Its key purpose is to obtain approval to move through the private finance initiative process to the outline business case stage. It has been referred to the regional office of the NHS Executive—not for the executive to provide the funding, but to ensure that due process is followed.
The implementation plan has been agreed locally between the trust, health authority, community health council, primary care groups and the regional office. The hon. Gentleman referred to capital spending of £50 million of taxpayers' money. That is not what the plan is about. It is intended that the sources of capital will come from the private sector. If the PFI developments are approved, the plan will be developed over five years. Only when the future models of care have been agreed will there be any redevelopment of the Kent and Canterbury site. Even when the changes are fully implemented, about 85 per cent. of patients who would currently expect to attend the Kent and Canterbury hospital will continue to be treated there.