Acute Hospital Services

Part of Opposition Day — [6th Allotted Day] – in the House of Commons at 5:42 pm on 21st February 2007.

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Photo of Roger Berry Roger Berry Labour, Kingswood 5:42 pm, 21st February 2007

It is a pleasure to have the opportunity to speak in the debate. Most of my contribution is critical of the Opposition motion, but I agree with the final clause, which calls for

"a stronger local democratic voice that will contribute to public confidence in the planning of acute NHS services."

I believe in that very strongly, and I have always done so. When the Conservatives were in government, I served on the Frenchay health authority. When a decision was made to remove elected local councillors from health authorities, because we knew too much about local matters, I disagreed. I welcomed the Government's introduction of overview and scrutiny committees, although there is insufficient local democratic accountability, as the Opposition—and I agree with them—suggest in their motion. It is self-evident that that accountability is insufficient to exercise control over financial matters, and local councils would never have been allowed to find themselves in the position in which, sadly, some trusts and PCTs have found themselves. Similarly, it is important that local communities engage in consultation about reconfiguration from the outset, and that proposals are not bounced on to them.

Like my hon. Friend Laura Moffatt, I have experienced reconfiguration and I would like to explain why it improves health care. I agree with Mr. Lansley that we should listen to local professionals. Reconfiguration is the subject of the Bristol health services plan—we are part way through the process—that has been developed precisely because local clinicians, doctors, nurses and other NHS staff have argued for years that it is needed. It is not the product of concern about financial or staffing pressures. That could hardly be the case, given that there are 30 per cent. more staff working in the NHS locally than there were 10 years ago. Nationally, the number of people working in the NHS has risen by 300,000 to 1,300,000. I find it difficult to take too seriously the argument that of all the possible reasons why we might have difficulties, those are due to a shortage of staff. The national health service has never had an increase in staffing like the rate of increase that we have seen in recent years. [Interruption.] I am aware that Opposition Members may be saying from a sedentary position that we should make doctors work longer hours and cut their pay—[Hon. Members: "We did not say that."] When comments are made from a sedentary position, I occasionally mishear them. I apologise. I heard staffing hours mentioned earlier, but that was by the hon. Member for South Cambridgeshire.

My key point is that in the Bristol health services plan, the proposals were put forward by clinicians and have been put forward by them for many years, for three basic reasons. In the greater Bristol area, as in many other parts of the country, 40, 45 or 50 per cent. of people who go to busy accident and emergency departments could be treated in local minor injuries units. They do not need to go to an acute hospital for treatment. Minor injuries such as cuts and sprains could be treated locally in a unit such as the one that I hope we will get at the Cossham memorial hospital in my constituency.

There are in my area, as in others, thousands of people who attend the major hospitals for out-patient clinics and diagnostic tests which could and, in my view, should be provided nearer where they live, in community-based facilities. We all know that, thankfully, we have an ageing population in this country. We should celebrate the fact that people are living longer. More people are therefore living with long-term conditions. They want to go to their local health centre or to a local community hospital nearer home. They do not want to have to traipse to an acute hospital for care and support unless that is absolutely necessary. So the first basis on which clinicians in Bristol have been arguing for reconfiguration is that far too many people are forced to go a fair distance to an acute hospital, when local health centres and community hospitals could provide that support.

The second point made by the clinicians was made earlier this afternoon, so I shall be brief. They argue strongly that acute and specialist services need to be concentrated in centres of excellence, so that patients who are gravely ill will be guaranteed treatment by people who have the expertise and the equipment to do the best job. Again, local clinicians in our area have said that the key obstacle to improving acute services is the legacy of acute hospitals on four sites. In the greater Bristol area, we have Frenchay hospital, Southmead hospital, the Bristol royal infirmary and Weston general hospital.

It is true to say that to some degree the four hospitals provide different services, which can be a disadvantage. I have had constituents who have been sent by ambulance from one hospital to another. It is not self-evident that the more acute hospitals there are in an area, the better. It can mean that people are treated for one condition in one hospital and then, sadly, they are afflicted by another condition for which an acute hospital a few miles away is the specialist provider, so, while chronically ill, they are sent by ambulance from Bristol royal infirmary to Frenchay to Southmead and so on. I do not think that is a clever way to run a health service, but I am not a clinician. It is doctors, nurses and NHS staff in Bristol who have said that we should have not four, but three acute hospitals with accident and emergency departments.

The big debate locally has also been about replacing old buildings. In 1997, we had a hospital service with 18th-century buildings, pre-war buildings, converted second world war huts, portakabins and a hospital built by French prisoners of war. Hospitals were not in a very good material condition. It was clear to everyone working in the health service locally that despite the magnificent efforts of staff, there were some hospital sites that required upgrading in order that patients could be treated properly and in sound and safe conditions.

In essence, the reconfiguration proposals in my area have not been dictated by financial pressures. They have been promoted by clinicians who argue that too many people have to go to acute hospitals for minor injuries, diagnostic tests and so on; that there is a clinical benefit in concentrating on specialist facilities, which everyone in the House accepts; and that existing buildings are unsuitable.

The Bristol health service plan for reconfiguration was first presented in 2003. There had been talk of it for years, but nothing had happened. It was presented not because of financial pressures, but because the Government's substantial increase in investment in the NHS meant that resources were more likely to be forthcoming. Like other reconfiguration proposals, the plan involves transferring services from acute hospital sites to community settings closer to where people live, when appropriate. It also involves massive investment in Bristol royal infirmary, a new heart and lung hospital, new cardiology facilities in north Bristol and south Gloucestershire, and much more.

The controversial question was this: if the number of acute hospitals was to be reduced from four to three, which site should no longer act as an acute hospital? Would the new super-hospital for north Bristol and south Gloucestershire be on the Southmead or the Frenchay site? I make no apology for the fact that I passionately argued the case for the Frenchay site, as did many others. An equal number, including my good and hon. Friend Dr. Naysmith, passionately argued the case for Southmead. The one thing that we all had in common was that we accepted, as we still accept, the clinical case for a single acute hospital, which we believed would put our constituents' health in better hands.

There was extensive public consultation, and there was overriding support for one acute hospital to serve north Bristol and south Gloucestershire. Local councillors of all political parties, through the local joint health scrutiny committee and by other means, supported the Bristol health service plan and its central proposal for one new hospital at Southmead or Frenchay. They also resolved that the choice of site should be left to the local national health service. Southmead was chosen. Obviously I was not happy, but I strongly feel that revisiting that decision would be damaging for my constituents and others who live and work in Bristol.

The decision was made on a clinical basis. It was not about finance or staffing, and it was not made by the Government. At the last election the Tories made a point of saying, "The Government are downgrading your hospital." That is absolute nonsense. The decision was made in precisely the way in which Conservative councillors in my constituency and elsewhere said it should be made. The members of the joint scrutiny committee said unanimously that there should be one hospital and that the decision should be made by the local national health service, and that is exactly what happened.

The one Tory Member of Parliament representing the Bristol area was so exercised that he did not even submit a written response to the consultation exercise, keeping his options open so that he could criticise whatever resulted from it. My Conservative opponent did not bother to do so either. How do I know? Through the freedom of information legislation. It is brilliant: it is possible to find out that people are not doing things, just as it is possible to find out that they are.

I am very sad that in my constituency—I hope it is not happening elsewhere—Tories are playing politics with people's lives. I hope that the Government will be very clear in supporting what local doctors and local national health service staff are saying. I urge—