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VIGGERS
AGAIN PRESSES CASE FOR HASLAR
MP FOR THE Gosport constituency, Peter Viggers again took
the opportunity of speaking in an Adjournment Debate in the
House of Commons in support of the retention of the Royal
Hospital Haslar.
His
comments were answered by the Minister of State for Health,
John Hutton MP.
Royal
Hospital Haslar
7.28 pm
Mr. Peter Viggers (Gosport): Some of my parliamentary
friends and colleagues have expressed mock surprise at my
raising this issue in the House as the subject of an Adjournment
debate, as I have raised it so many times before. However,
I would certainly claim not to be a one-club golfer. I spoke
in the House last Thursday about defence and I spoke and answered
questions yesterday on behalf of the Speaker's Committee on
the Electoral Commission. Nevertheless, it is true that, according
to the ever-efficient Library, I have raised the issue of
Haslar 63 times, and I shall continue to do so until the Government
see sense and act to ensure that these facilities are used
properly.
The Royal hospital Haslar was originally a naval hospital
that opened on 23 October 1753, so its 250th anniversary will
occur shortly. However, I put the case for the hospital not
because of its history but its superb facilities. Some £35
million has been spent on it in the past 10 years and it has
outstanding operating suites and facilities.
The problem arises because the Royal hospital Haslar is the
only services hospital that the Ministry of Defence owns and
controls. In 1988, a Ministry of Defence committee, which
was chaired by Commodore Lawrence and comprised no medical
personnel, decided that the best future for service medicine
was to proceed with dramatic reconstruction. The committee
was facing a significant shortfall of 50 per cent. to 90 per
cent. in the key specialties. Recruitment to the armed forces
medical services has traditionally been good but recently,
retention has been bad. In the important faculties, such as
general surgery, orthopaedic surgery, anaesthetics and general
medicine, there is approximately a 75 per cent. shortfall.
The Ministry of Defence has therefore only a quarter of the
personnel that it needs.
The Lawrence committee recommended that there should be a
new centre of defence medicine. The Government accepted the
recommendation, but after it was touted around various places
where they would have liked it to be located, it ended up
at Birmingham, which is not a popular centre.
Recruitment to the Defence Medical Services is currently good,
but retention remains bad. That is why it has been necessary
in Iraq to use reservists, some of whom are charging approximately
£1,000 a day in compensation for their loss of earnings.
I have read press reports of some doctors being paid £180,000
or £250,000 a year in compensation for loss of civilian
earnings to make up for the lack of service personnel. There
was a serious problem and the solution that the Ministry of
Defence proposed was the closure of the Royal hospital Haslar.
The original statement made it clear that it would not close
before 2002. There was local uproar and a march of 22,000
people who expressed their deep concern at the loss of the
local facility.
There are several concerns, not only in services medicine,
but I shall give one more example of the latter. The Ministry
of Defence has decided to cut the umbilical cord between medical
staff and service patients at the same time as the closure
programme. Until fairly recently, service doctors gave preference
to service personnel, but that is no longer the case. There
is no fast-tracking and 18,338 service personnel are currently
medically downgraded. That means that, for example, a paratrooper
with a back problem has to queue for treatment with an elderly
lady who needs a hip replacement. That is a serious disadvantage
from a services point of view. Defence Medical Services has
not prospered by the decision.
Let me deal with the sphere of activity for which the Minister
of State, Department of Health, the right hon. Member for
Barrow and Furness (Mr. Hutton) is responsible. I am pleased
and grateful that he is responding to the debate. Although
we have a Ministry of Defence health problem, it is also a
specific problem for the civilian population of the Gosport-south
Hampshire area.
The facilities at Haslar are outstanding. It has 280 beds,
nine exceptional operating theatres and a range of other facilities,
including radiological equipment and magnetic resonance imaging
equipment. Its telemedical equipment is as good as that anywhere
in the world. Indeed, it is a world leader in telemedicine.
The local community needs the facility. The next piece of
the jigsaw puzzle is that the national health service has
decided that the Queen Alexandra hospital at Cosham, which
is eight to 12 miles away from my constituency, needs to be
renewed. A private finance initiative has been proposed for
it. The plan is to complete the PFI in 2007, though no one
is putting money on that happening. Like most programmes,
it might creep to the right and be delayed. Anyway, let us
take 2007 as the relevant date.
The original plan was to close the outstandingly good facilities
at Royal hospital Haslar in 2002. The subsequent plan was
that they would close in 2007. There has, however, been a
development since then. I raised the issue on the Floor of
the House in the Christmas Adjournment debate, and subsequently
received a letter, dated 29 January 2003, from the hon. Member
for Salford (Ms Blears), who was then the Under-Secretary
of State for Public Health. She pointed out that, following
a consultation by the local authority
"a
commitment was made to the people of Gosport to develop a
substantial facility at RH Haslar (subject to Ministry of
Defence agreement on the use of the site), with day case surgery,
diagnostic services, outpatient clinics and the Haslar Accident
Treatment Centre. The local NHS remains committed to this
vision, and are working closely with the Ministry of Defence
to take it forward."
The problem is that the caveat
"subject
to Ministry of Defence agreement on the use of the site"
is proving quite significant because some people in the Ministry
appear to be dragging their heels in regard to the concept
of affecting the necessary transfer of premises from the Ministry
to the NHS and the local hospitals trust. I have heard it
said that the commitment is not the one that I have just read
to the House, but one to develop facilities on the Gosport
peninsula. That is not what the Minister said, however. She
said that the facilities would be retained at Haslar, and
that is what we want to hear. If it is indeed the case that
they will be retained at Haslar, it is important that all
those involved should come together to discuss the manner
in which the transfer will be carried out.
I am grateful to the Under-Secretary of State for Defence,
the hon. Member for Hove (Mr. Caplin), who wrote to me about
the transfer of authority and responsibility, and about the
proposed MOD attitude after 2007. He kindly invited me to
go and see him, which I look forward to doing on the morning
of Wednesday 15 October. What we need now is an absolute commitment
from the NHS that it understands the need for the Haslar facilities,
and that it is committed to an orderly transfer of the premises
there from the Ministry of Defence to the national health
service.
A few months ago, before the summer recess, there was a fear-indeed,
it was a stated intention-that the King Edward VII hospital
at Midhurst would need to close. It is a charitable structure.
That caused concern locally, because it was widely accepted
that the facilities in Hampshire were not sufficient for us
to manage without that hospital. Haslar hospital is quite
different, however. It is much more substantial, much more
important, and much more geared to the Minister's and the
Government's initiatives.
The Government have recently introduced significant initiatives,
one of which involves diagnostic and treatment centres. In
these centres, there is virtually a production line of operations,
which can take place in specially allocated premises. Such
a production line of hip replacements, cataracts and the like-procedures
known as cold surgery-can take place in a dedicated hospital,
without the disruptions that can be caused by major accidents
and emergencies. Treating the victims of major road accidents
would normally take priority over cold surgery. Cold surgery
therefore needs facilities that can be used on a regular,
structured basis so that it can be carried out in a well-organised
way. That is exactly the kind of facility that Haslar can
offer.
There is also an accident treatment centre at Haslar, which
is ideally suitable for treating the victims of minor accidents
who do not need to go to the accident and emergency unit at
Queen Alexandra hospital in Cosham. I believe that the number
of accident treatment centre cases is about 8,000 a year,
and a study has shown that some 6,000 additional cases could
be taken away from the accident and emergency unit in Cosham
by treating them in Haslar. Clearly, that initiative would
take some pressure off the district general hospital at Cosham.
I am pleading for an understanding by Government at the highest
level that we cannot do without Haslar hospital. The primary
care trust has taken an initiative, and has asked the strategic
health authority to consider the future of the Haslar site.
We need to bring all the major actors into this dialogue:
the Ministry of Defence, which is the current owner of the
site, the national health service, which is the holder of
the purse strings through the PCT, the ambulance trust, which
has a heavy burden because of the extra carriage of patients
between Gosport and the Queen Alexandra hospital, Gosport
borough council, which is the planning authority, the hospitals
trust and all the other participants-stakeholders, as the
Government like to call them-in the health scene in south
Hampshire. That is urgently needed, because we cannot manage
without the facilities at Haslar hospital. I urge the Minister
to respond to this debate, and to agree that he will participate
in this initiative and ensure that those facilities are not
lost.
The Ministry of Defence has said that it wishes to get out
of the business of hospital management. I hold my own view
on that. The Defence Medical Services has not only surgical
and medical skills, but administrative skills. I maintain
that it would be helpful to the Defence Medical Services to
have a facility at which defence medical personnel could train
in administration as well as in medical matters. Haslar, which
has superb facilities and is highly regarded, could be a centre
for an esprit de corps in the Portsmouth and south Hampshire
area. The Defence Medical Services would appreciate that.
Once the premises are transferred to the hospitals trust,
the Ministry of Defence, having achieved its primary objective
of getting out of hospital management, may well reconsider
the facilities and realise that a combination of Queen Alexandra
hospital and Haslar hospital would provide an excellent training
ground for its own personnel. The Ministry of Defence may
come back on side and realise that it has that opportunity.
My plea is for the Minister to recognise the problems, and
to undertake to involve himself in the transfer of premises
at Haslar hospital to the national health service.
7.42
pm
The Minister of State, Department of Health (Mr. John Hutton):
I congratulate the hon. Member for Gosport (Mr. Viggers) on
securing this debate. I assure him that I will draw his comments
on the Defence Medical Services to the attention of my right
hon. Friend the Secretary of State. I am here to answer the
hon. Gentleman's questions about the national health service.
I am sure that he will appreciate that I must confine my remarks
to that subject.
All right hon. and hon. Members naturally and rightly attach
the highest importance to developments in the NHS in their
constituencies, because access to good quality, convenient
health care services is an essential ingredient in the life
of any community. That is true in Gosport, and it is certainly
true in Barrow and Furness. I fully understand the concerns
that have been raised in Gosport by the hon. Gentleman's constituents
over the provision of local NHS services, especially the future
of the Royal hospital Haslar.
As the hon. Gentleman said, for many years the Royal hospital
has played a central role in the provision of NHS services
in his constituency. I pay tribute, as I am sure he would,
to the professionalism and dedication of all the staff at
the hospital. Any fundamental change along the lines that
he has talked about is bound to raise concerns and anxieties
locally. It is clear to him-it is clear to me, too-that decisions
concerning the configuration of local services need to be
made. We need to get on and make them in order to allay legitimate
concerns and lay the foundations for the growth and expansion
in services that he and I want to see.
It was clear from the hon. Gentleman's remarks that he appreciates
the fact that these decisions are first and foremost the responsibility
of the local primary care trust, the NHS trusts and the strategic
health authority. Any decision should be made after the fullest
possible local consultation and involvement. People's concerns
should always be responded to fully and fairly. They should
have the full facts before them, and they need to be aware
of all the available options.
I know that the NHS in the hon. Gentleman's constituency is
committed to those principles as it takes forward work on
the best pattern of local services. If he has any concerns
to the contrary, he should raise them with me and I will pursue
them vigorously on his behalf.
I also agree that there is a challenging agenda for local
NHS organisations, but I believe that the Portsmouth Hospitals
NHS trust is responding vigorously. As one of the largest
trusts in England, providing acute health care services for
nearly 1 million people covering Portsmouth, the Isle of Wight
and the surrounding region, it is already planning for the
future. As the hon. Gentleman said, central to its plans is
the new private finance initiative scheme for the redevelopment
of hospital services in Portsmouth, focusing on the current
Queen Alexandra site in Cosham. As he knows, the plan is to
develop a high quality centre for acute services, which will
serve as the hub of a network of services for outpatients,
rehabilitation, preoperative assessment and much more, available
in local communities for local communities throughout south-east
Hampshire. I understand that the plans are strongly supported
by local clinicians.
In summer 2002, a review of the proposals was conducted to
ensure that the objectives still met the needs of the local
health system. Clinical staff from both the NHS trust and
the primary care trust confirmed their original view that
the integration of acute care on a single site was the most
clinically sustainable and effective model, complemented by
a variety of local services. Plans for the new hospital are
well under way. The Portsmouth NHS trust has recently announced
the name of its preferred bidder, the Hospital Company, and
is now developing a full business case for approval. It is
envisaged that work will start on the site in February next
year, and that the new hospital will open in 2007. Once the
work is completed, in-patient services currently at Haslar
will move to the new site. In the meantime, they will remain
at Haslar.
To address short-term capacity problems, the Portsmouth trust
is working in partnership with the independent sector on a
separate project to shorten the time for which local patients
wait for orthopaedic surgery. The idea is to commission an
overseas clinical team of surgeons, nurses and allied health
professionals who specialise in the delivery of orthopaedic
services. A team from the Portsmouth trust and the Plymouth
NHS trust is currently in South Africa to assess and select
clinical staff and finalise the appropriate contract negotiations.
The project will then begin next month, continuing until 2004.
I should make clear that the focus for providing the long-term
capacity needed in the local NHS to reduce waiting times for
patients in south-east Hampshire will be based on the redeveloped
Queen Alexandra hospital site in Cosham.
Both projects are major new developments for the local health
community which form part of a wider strategic vision for
the future of local health services throughout Hampshire and
the Isle of Wight. The strategic health authority is currently
steering a process known as Healthfit, the aim being to develop
a strategic framework for local health services that will
be safe, sustainable, affordable-which is important-and fit
for the future. A key priority now is to identify the pattern
of local health services, and Fareham and Gosport primary
care trust is leading a project to consider that. The PCT
will ensure that the process fully involves health professionals,
local patients and communities, as well as elected representatives.
As the right pattern of services becomes clearer, the local
NHS will be able to match those services with the most appropriate
premises.
The hon. Gentleman rightly said much about the future of the
Haslar hospital. It has been a subject of local discussion
for many years, particularly since 1998 when the Ministry
of Defence first announced its intention of withdrawing from
the site in 2007. The commitments made in 2000-confirmed by
the Minister for Crime Reduction, Policing, and Community
Safety, my hon. Friend the Member for Salford (Ms Blears),
when she wrote to the hon. Gentleman in January-still stand.
The NHS in Hampshire and the Isle of Wight remain committed
to the pattern of services for the population on the Gosport
peninsula that were agreed following the consultation in 2000.
As I have said, however, the future of the Haslar hospital
cannot be seen in isolation. The NHS has a responsibility
to examine a range of options to ensure that primary and secondary
services are meeting the needs of local patients, and conform
to wider plans for modernisation. The precise configuration
of the services is being discussed locally, as the hon. Gentleman
will know. Following confirmation they can be matched with
the right premises, at the right price, to ensure that resources
are used effectively and efficiently to provide the range
of services needed by the local population. As part of that
process, the NHS continues to engage in discussions with the
MOD so that the Haslar hospital can be considered a possible
option for the location of future services. However, as I
am sure the hon. Gentleman would be the first to acknowledge,
the NHS has a duty to use public money wisely, and must therefore
consider other options.
The hon. Gentleman again referred to the need for joint working
between the NHS and the Ministry of Defence on this issue,
and he said that there are no clear arrangements for the transfer
of services. I am particularly concerned about this issue
and the suggestions that he has made this evening, but I am
advised that what he said is not the case. In fact, both sectors
continue to work closely not only on the future of the Royal
hospital Haslar site, but to confirm the provision of NHS
and defence medical services in the local area.
The MOD has confirmed its intention to withdraw from the site
in 2007, and that confirmation provides a firm foundation
through which the NHS and especially the MOD can ensure continuity
of NHS services for local people. It is clear that services
will need to be provided from the Royal hospital site until
such time as the new hospital is ready to receive admissions.
Work is being taken forward through a local partnership board,
which meets quarterly, and through a high level strategic
partnership that provides an overview of all aspects of partnership
work between the NHS and the MOD. The priority is to ensure
a robust and practical way forward that is sustainable for
the NHS, and which will meet the needs of local people. However,
any decision taken by the NHS on the future use of the Royal
hospital Haslar site will clearly need to take into account
the MOD's own plans for the rest of the Haslar site. The MOD
and the Defence Medical Education and Training Agency take
the lead on this issue, and I understand that, as the hon.
Gentleman said, the MOD will meet him next month to discuss
arrangements for withdrawing from the management of the hospital.
Any decisions on the use of the site will clearly be subject
to the necessary local planning approval processes.
The future of the Royal hospital Haslar is obviously of great
concern to the hon. Gentleman and I genuinely understand the
worries that he expressed this evening. It is our policy that
primary care trusts, in partnership with local trusts and
the strategic health authority, and in the light of their
specific local knowledge and expertise, should decide the
priorities for the NHS locally, including the location of
any eventual services. This is an opportunity to plan for
growth and expansion in NHS services locally; we are not talking
about contracting the range of services available to the hon.
Gentleman's constituents. That is the context in which, I
hope, he and his constituents will see these developments.
I conclude by reassuring the hon. Gentleman that every effort
is being made by the local NHS to plan ahead for the future.
It will continue to work with the MOD, and with him, to ensure
a model of care that best meets the needs of the people whom
he represents.
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