Health Services (Maidstone)

Part of the debate – in the House of Commons at 6:36 pm on 2nd December 2004.

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Photo of Miss Melanie Johnson Miss Melanie Johnson Parliamentary Under-Secretary, Department of Health 6:36 pm, 2nd December 2004

I appreciate the right hon. Lady's view, but both hospitals will continue to provide the bulk of acute surgical, medical, emergency and life-saving care for patients and each will need accident and emergency departments capable of dealing with minor and major illnesses and injuries. I am told that the strategic health authority has categorically stated that Maidstone hospital's accident and emergency department is not closing down or being run down.

I appreciate that issues such as training hospital consultants and doctors, and accreditation by the royal colleges need to be sorted out. That needs to be done locally to ensure that the mix of cases that goes to both hospitals is capable of sustaining the right accreditation by the royal colleges—for example, for accident and emergency accreditation purposes. I understand that the chief executive has met the majority of the consultants individually or collectively.

We do not deny that some concerns have been expressed. They have centred around the misconception that all the surgical services would be transferred to the Kent and Sussex hospital. Some consultants were also worried that there might be pressure on them to express certain views. Notwithstanding that, some have genuine concerns about the future. We accept that concerns have been expressed, but I assure the right hon. Lady that the strategic health authority is committed to two full accident and emergency departments in the two district general hospitals and sustaining the mix of services.

The right hon. Lady mentioned the transfer of the chronic pain clinic. I am not familiar with as much of the detail as I suspect she is. I understand that some £600,000 of additional resources have gone into the clinic at Pembury hospital, to which it is to be transferred. Extra investment has gone into that pain unit, and I am sure that that creates an improved service. We accept that we need two accident and emergency units and two district hospitals. The question is about the division of some of those areas of specialty, which can be provided principally in one or another of the hospitals.

In the past few years, Maidstone hospital has had major investment in its eye, ear and mouth unit. There has been some £11.9 million of investment. The hospital has received £2.8 million for a new breast care centre; £2.2 million for a new emergency care centre; and £1.7 million for the orthopaedic unit. In Tunbridge Wells, the Pembury hospital and the Kent and Sussex hospital have received £3.5 million investment in more doctors; the chronic pain unit that I mentioned; some refurbishment of the maternity unit; and £1.15 million for a new MRI scanner. That shows that there has been a division of resources between the two sites.

The right hon. Lady talked about the pressure on junior doctor hours as a result of the working time directive, but there is a wider rationale. That rationale includes the following considerations: to improve the quality of services for patients; to reduce the number of cancelled operations, as currently one in five elective procedures are cancelled in Maidstone and Tunbridge Wells, which the trust and the strategic health authority are looking to improve on; to reduce the risk of infection by segregating all orthopaedic patients from surgical patients, which is highly important; and the development of on-call rotas that offer consistency of care. Among all the other factors are the fulfilment of the requirement to meet junior doctors' working hours under the European working time directive, and gaining efficiencies of full day-care elective theatre lists to reduce waiting times for patients. The provision of centres of excellence for patients that offer and are able to meet national standards of care and to attract highly skilled staff is also important. Making the best use of the consultant work force, with sub-specialisation, is also a factor.

The benefits for patients that the trust and strategic health authority are looking for are: ensuring that booked operations are not cancelled; reducing waiting time for operations; reducing the risk of infection following surgery; delivering rapid assessment, out-patient, diagnostic and day-case services at both hospitals; and ensuring that professional standards are consistently met. That shows that a rationale exists that makes clear the reasons for this discussion.

Currently, we have only a proposal before us, and I realise that, sadly, the right hon. Lady did not appreciate my right hon. Friend the Secretary of State's letter. I gathered that. He was being very fair in what he wrote to her, however, as he was pointing out that this matter was still up for discussion, and that the details need to be thrashed out. I understand that such discussions raise a lot of local anxieties, and I sympathise with local MPs and local people concerned about them. I have set out a number of powerful and important reasons why it is necessary to examine these issues, including the benefits that can be gained for patients from improvement of patient care.

I want to touch briefly on maternity services, because I want to assure the right hon. Lady that we are committed to good-quality, women-centred maternity care. We have a commitment to improving maternity services by modernising maternity units, increasing the number of midwives and giving women greater choice in childbirth. There have been huge advances. It is now much safer to give birth, and women are now actively involved in making decisions about the maternity care that they want to receive. As I am sure she is aware, we published a national service framework on 15 September, and under the standard, NHS maternity care providers and primary care trusts are required to ensure that the range of antenatal, birth and post-birth care services available constitutes a real local choice for women, including home births and midwife-led care, and midwife-led units in the community or on a hospital site.

Additional funding has been made available for refurbishments, including of hospitals in Kent, to improve the environment. I hope that the right hon. Lady will agree that we all recognise that hospital services need to change if we are to continue to fulfil patients' needs and improve access. Services cannot remain static. They must be responsive to local needs and changing patterns, higher standards and the different services that can be provided as modern medicine advances. That is what we are seeking to achieve through the changes that are being implemented.

The matter in hand is still a discussion on a proposal, and I trust that the right hon. Lady will be able—