Adjournment (Summer Recess)

Part of Orders of the Day – in the House of Commons at 4:23 pm on 25th July 2006.

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Photo of John Stanley John Stanley Conservative, Tonbridge and Malling 4:23 pm, 25th July 2006

I, too, wish to refer to the community hospitals in my constituency: Tonbridge hospital and Edenbridge hospital. The two hospitals have a similar past and, sadly, a similar present. Both were founded after the first world war as a result of private benefactions and donations and taken into the national health service under the National Health Service Act 1946. Since then, they have both attracted huge amounts of additional financial support from the private sector, running to hundreds of thousands of pounds from private donations and the wonderful activities of their leagues of friends. Both hospitals provide outstanding nursing care and levels of treatment. And yet both hospitals, under the orders of the South West Kent primary care trust, have half their beds taken out of use. The future of both hospitals is at present clouded in uncertainty.

That situation arises not because of any local failure by the South West Kent primary care trust, but because of a disastrous decision taken by the Secretary of State. We face not a local, individual, constituency crisis for community hospitals, but a national one. If ever there were a clear demonstration of that, it was in this House on 28 March, when, I understand, there was the largest ever simultaneous presentation of petitions by 21 right hon. and hon. Members, involving 45 separate community hospitals the length and breadth of the country, from the constituency of my right hon. Friend David Maclean down to Kent and the east and west. It is a national crisis, which has been occasioned by the Secretary of State.

The Secretary of State took, in my view, a reckless decision to give absolute priority to one single political target—achieving the 18-week waiting time for acute hospitals, regardless of the consequences elsewhere. To achieve that, she introduced Payment by Results, the new acute hospitals tariff, on 1 April 2005. The desirable consequence of that was a great deal of additional activity in acute hospitals, with waiting times coming down. Regrettably, however, the Secretary of State failed to accompany an improved tariff for acute hospitals with proper revenue arrangements for community hospitals. As a consequence, a significant switch of resources away from community hospitals to the acute sector has taken place.

In my constituency, the South West Kent primary care trust estimates that the consequence of the Secretary of State's introduction of Payment by Results for the Maidstone and Tunbridge Wells NHS Acute Hospitals Trust is a transfer of approximately £2 billion a year from the community sector to the acute sector. Predictably, primary care trusts across the country have gone from the black into the red. By virtue of being in deficit, their community hospitals are under threat. The Secretary of State's announcement of the £750 million of capital will not improve the situation at all. It is capital that will be hard-contested by all Members with community hospitals in their constituencies. The first bids, for the first tranche of £150 million, go in by 30 September, and I suspect that the total bids will be way in excess of that figure. That does not deal with the revenue crisis facing community hospitals.

There are only two routes to solving that crisis. Either the Secretary of State must introduce a proper tariff for community hospitals, or she must extend Payment by Results to cover the community hospital sector. Sadly, it seems that she is setting her face against both of those obvious solutions. The written answer that I received from the Minister of State, Andy Burnham, on 17 July, stated:

"We will set out shortly plans for the national tariff in 2007-08 but we have never said there will be a community hospital tariff."—[ Hansard, 17 July 2006; Vol. 449, c. 245W.]

Therefore, the community hospital tariff seems to be off the Government's agenda.

As for extending Payment by Results to the community hospital sector, the Secretary of State said in her letter to me last week, dated 18 July:

"For services outside the scope of PbR (such as community services) funding should be negotiated locally."

What an answer that is! Why should the community hospitals and PCTs be the Oliver Twists of the national health service, reduced to going out begging local providers for income so that they can return their beds to use? The situation is grossly unfair and unreasonable.

I put it to the Minister, and through him to the Secretary of State, that the position of community hospitals throughout the country is unacceptable. My two hospitals in Tonbridge and Edenbridge ask reasonably and justifiably, with my full support, why 80 years of private donation, effort, fundraising and excellent community care should risk being swept away by the bulldozer as a result of the Secretary of State's mismanagement of NHS finances. That is the central question.

I say to the Minister that the Secretary of State must address the revenue issues. She must provide an assured source of revenue for the community sector, as for the acute hospital sector. Until that happens, there will not be the assured future for community hospitals in this country that, in Edenbridge and Tonbridge and up and down the country, they deserve and need.