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Mr. Gray: Of course more households had less than half the average wage in 1994-95 than in 1979. That is because the average wage became so much higher. More people had more money then than they have ever had under Labour.

Ms Keeble: All the agencies that deal with child poverty and similar issues recognise that by the end of 18 years of Conservative government the proportion of children growing up in poverty was an absolute scandal. That has been well recognised by this Government, and we are determined to end it.

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Virtually all the policies proposed by the hon. Member for Cotswold are already in place: fiscal incentives for regeneration; use of the planning system to prioritise redevelopment of brownfield sites; involving the business community; and creating partnerships. We are very much committed to those policies. Our argument with the docklands and UDC model is not that it locked businesses in—which of course it did—but that it locked the communities out.

The hon. Member for Carshalton and Wallington (Tom Brake) talked about rural crime and disadvantage, which indeed we recognise. Throughout my opening speech, I stressed the fact that we do not say that disadvantage is the exclusive preserve of the towns and cities. It can have a terrible impact on the lives of people in rural communities, too. Our policies are designed, through the role of local partnerships and the assessment of local needs, to ensure that the needs of all disadvantaged communities are properly met.

The hon. Gentleman also outlined the impact of low demand. He was right to bring up the appalling scale of low demand and the tragedy of all those empty properties. All sectors of housing are affected in similar ways by low demand, be they housing association, council or private sector. We are currently considering proposals for a market renewal fund to deal with those issues. We are also considering targeting. We have national minimum floor standards but we are also trying to ensure that communities assess and meet their own needs.

The hon. Member for North Wiltshire (Mr. Gray) talked about the need to get the built environment right. He is absolutely right about that, although we may disagree on the details. We are actively pursuing the urban renaissance. The Rogers report recommendations have been accepted and are being implemented.

The hon. Member for Hexham (Mr. Atkinson) also spoke about rural poverty. I remind him that we have provided extra funding for rural housing and transport and dealt carefully with issues of rural planning.

The hon. Member for Westbury (Dr. Murrison) highlighted the problems of homelessness. We have set up a homelessness directorate.

I am sorry that I missed the speech of the hon. Member for Poole, who spoke about the plethora of schemes. We are working to simplify the current range of schemes and to ensure that they are better known and that the communities can get involved.

To the hon. Member for Fareham (Mr. Hoban) I would say that we have also recognised the importance of education in regeneration and made it one of our key targets.

It is by results on the ground that our strategy to transform our poorest neighbourhoods must be judged. We know that there is still a lot to do. We believe that our strategy and our goals are right and that, working in partnership with our poorest communities, we can defeat poverty and regenerate the most disadvantaged areas of this country.

It being half-past Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.

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Stoke Mandeville Hospital

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Kemp.]

2.30 pm

Mr. David Lidington (Aylesbury): I am grateful for the opportunity to raise the future of Stoke Mandeville hospital in my constituency. The Under–Secretary of State for Health, the hon. Member for Salford (Ms Blears)—who I am delighted to see in her place—will know that Stoke Mandeville has a national and international reputation, the latter deriving in particular from the record of its famous spinal injuries unit.

But to my constituents, it is, above all, their local hospital; the district general hospital on which they rely for their treatment and that of their families. I should declare a personal, as well as a constituency interest, as my family use Stoke Mandeville, although I have now reached that stage of family life when my visits are no longer to the maternity unit but more to the accident and emergency and paediatric units.

The hospital employs more than 2,000 staff, making it one of the biggest employers in my constituency and in Buckinghamshire as a whole. I want to spend most of my speech talking about the proposals for the future redevelopment of Stoke Mandeville hospital, but first I want to refer briefly to some serious allegations made in The Observer on 27 January.

Much of that article dealt with matters that were to do with the employment of individual doctors or with the removal of previous executives and directors of the trust. Those matters either still are, or have recently been, the subject of disciplinary proceedings or an industrial tribunal. I do not think that it would be right for me to comment on those in any detail now. The point is that, as the Under-Secretary will know, the article made public and serious allegations that patient safety within the accident and emergency unit was at risk.

The Under-Secretary will know that I have received assurances from the trust management that those allegations have been thoroughly investigated and that no evidence has been found to suggest that patients are at risk. I should be grateful for her assurance this afternoon that the Department is also satisfied that everything possible has been done to give patients confidence that they will continue to be well treated in the accident and emergency unit.

I wish to refer to the rebuilding project for Stoke Mandeville, something with which I feel I have been living ever since I was first elected to the House a decade ago. Stoke Mandeville is renowned, but it still relies, in part, on isolation units that were built in the 1940s. The hospital as a whole occupies a ramshackle complex of buildings spread out over a vast site. Patients and staff often have to walk—or, in the case of some patients, be transported—long distances between one unit and another. Inevitably, this means that the quality of treatment is not what one would expect in a modern 21st century hospital, despite all the professionalism and efforts of the staff, to whom I am most willing to pay tribute.

The site also creates economic inefficiency because the costs of heating, cleaning and maintaining such a ramshackle spread of buildings add to the unit costs of

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the treatments provided by the hospital. That inevitably has an impact on the health care that the hospital can offer to local people within the money allocated to it. The present plan, which is slowly moving forward, is for a £25 million redevelopment to include new medical and paediatric wards, a day procedures unit, an admissions ward and assessment unit and the refurbishment of other trust buildings. The rebuilding is long overdue.

There has been some new building on the Stoke Mandeville site, under this Government and their predecessor, but the current plan for major redevelopment has been subject, over the last decade, to repeated delays, causing increasing frustration to staff and the wider local community. It might be helpful for me to sketch in brief the chronology of the story during my time as Member of Parliament for Aylesbury.

As far back as 27 June 1994, the Department of Health said that the business case for a Treasury-funded scheme for Stoke Mandeville's redevelopment had Government approval. A written answer in 6 June 1995 informed me that the scheme


Yet in the late summer of 1995, the trust was informed that the Treasury scheme had to be tested against a PFI alternative. By October of that year, the trust was informed that no Treasury money could be forthcoming, and that it must look to a PFI scheme or to nothing.

In 1996, the first PFI consortium collapsed and the project was re-advertised. By the summer of 1997, the trust had reconstituted its bid and was ready to proceed to preferred bidder status with the second consortium. At that stage, of course, a new Government were elected, who decided to put all PFI schemes on hold, at least temporarily, pending a reassessment. After a period of reassessment, 12 were allowed to proceed as a first tranche, but Stoke Mandeville's scheme was not included.

In 1998, when I last secured an Adjournment debate on this topic, Stoke Mandeville was allowed to advertise for the third time for a PFI partner. By March 2001, the trust's annual report was able to say:


Last autumn, however, the Government picked Stoke Mandeville as one of three pilot projects for the new policy of contracting out the management of ancillary staff at acute hospitals. That has led to yet another delay.

The trust hopes to move to the next stage in March, but the Minister needs to understand that, in the light of events under Governments of both major political parties—I am being non-partisan—there is considerable cynicism among the general public, and among staff and the wider medical community in Buckinghamshire in particular, as to whether this much-needed and much-wanted redevelopment will ever take place. A great deal of money has been spent, but to little conspicuous purpose. About £3.5 million was spent on new internal roads and utilities, and on a brand-new roundabout outside the hospital that is ready to serve the new buildings, for which we are still waiting. In the past eight to 10 years, a considerable sum must also have been spent on consultancy fees, let alone on trust management time, as four different schemes were worked through.

Inevitably, those events have demoralised the hospital's doctors and nurses. General practitioners have told me that, in their view, there is a hidden agenda to run down

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Stoke Mandeville and make it little more than a cottage hospital—an outpost of either Wycombe general hospital or one of the Oxford hospitals. Despite repeated assurances from the health authority and the NHS regional executive that that is not their agenda, I must tell the Minister that such assurances are received with scepticism because of what has happened in the past 10 years.

To raise morale locally, the bulldozers need to be on-site as soon as possible, so that reconstruction can get under way. I hope that the Minister can assure me that that will happen soon and that the Government do indeed treat the redevelopment of Stoke Mandeville as a priority. I hope, too, that she can offer a time scale, so that my constituents will know when work on the site will begin and when the new services will be completed and in operation, providing modern health care for the people of Buckinghamshire.

Local concern has also been aroused by the way in which the goalposts for the redevelopment scheme have been shifted from time to time to take account of real changes in the administration and organisation of health care, or in the development of clinical practice. I hope that the Minister will take account in her response of some of the issues that continue to cause worry.

One is the future nature of the relationship between the Stoke Mandeville hospital and Wycombe general hospital, which is part of the South Buckinghamshire NHS trust. A review of acute services in mid-Buckinghamshire is being carried out at the moment, and I understand the clinical reasons for that, including the arguments being put forward by the royal colleges, and the new deal on junior doctors' hours. It is right to examine how services are provided and what the correct configuration should be over the next 20 or 30 years. We must not be hidebound by the pattern of provision that was best in the past.

I hope, however, that the Minister will be able to assure me that the review and the pending decision about a possible merger between the trusts will not cause any further delay to the redevelopment at Stoke. I also hope that she will be able completely to deny the suggestion that these reviews and discussions conceal a secret agenda to move acute services away from Stoke and to concentrate them in High Wycombe because, locally, some people believe that that is what is going to happen.

I hope that the Minister will also tell me where the Government stand on a possible merger between the two trusts. My understanding is that a decision has been on the Secretary of State's desk for two or three months now as to whether to go out to public consultation over a trust merger, and I would be interested to know the Government's view on that proposal.

The second cause for concern relates to the creation of the new strategic health authorities and the consequent abolition of Buckinghamshire health authority. I am worried that the new SHA might wish to go back to square one, to re-examine anew the case for Stoke Mandeville's redevelopment, and to review acute services provision on a sub-regional Thames Valley basis, rather than accepting the agenda as it has developed over the last decade. I hope the Minister will say that that is not the case, and that the SHA, when it comes into being, will remain committed to a good district general hospital in Aylesbury, and give its full backing to the Stoke Mandeville redevelopment plan.

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I want to say something about the financial resources available for health services at Stoke Mandeville and in Buckinghamshire generally. I also want to question the Minister about the number of beds provided for in the current redevelopment plan for Stoke Mandeville. A recent written answer that I received from the Minister, confirmed that Buckinghamshire will still get some £12.2 million less in the forthcoming financial year than the Government's formula—the so-called weighted capitation formula—suggests that the county ought to receive from the NHS pot. That is a continuing source of concern and frustration locally. I understand that the Government are now considering replacing the weighted capitation system altogether. I would like to hope that that means that our deficit will not simply be brushed aside and forgotten, and that the problem of Buckinghamshire getting less than the Government's formula suggests it should receive will be addressed by the funding reforms.

On bed provision, Buckinghamshire health authority's consultation document published in 1998 envisaged that redevelopment would mean a fall in the number of acute beds from 378 to 320, and a fall in the number of spinal beds from 115 to 108. Again, I acknowledge that there are clinical reasons for different judgments about bed numbers being appropriate now, compared with 20 or 30 years ago. Advances in day surgery and improvements in anaesthetics are two obvious reasons.

Against that, we must balance the increased demand that will be placed on Stoke Mandeville by the major increase in the local population, particularly in the town of Aylesbury, envisaged in the local plan. We are looking at the prospect of the population of Aylesbury increasing by about one third over the next 10 years or so. Will the new-look Stoke Mandeville have adequate bed capacity under present plans to deal with those numbers of people, or will the Government review the situation?

The need for a review is made even more marked by the conspicuous pressure on beds. I know from a constituency case that on one day at least this week, Stoke Mandeville hospital was on divert. Patients were being sent to Wycombe general, which was itself on red alert and finding it difficult to accommodate all the patients whom general practitioners wished to refer there. I have been told of at least one weekend last month when Oxford was diverting to Milton Keynes, Milton Keynes was diverting in part to Stoke Mandeville, which was in part diverting to Wycombe general, which again had to close its doors to some additional patients whom doctors wished to refer there. There is great strain on accident and emergency provision, and I hope that the Government will examine the issue, particularly in the context of Stoke Mandeville, but also in the sub-regional context.

I hope that the Minister will be able to give my constituents cause for hope and optimism. For example, a large chunk of the Stoke Mandeville site is in the ownership of the Secretary of State and designated for housing development. I hope that at least some of the capital receipts that the Department will gain might be used for the provision of services to my constituents.

Above all, I go back to the previous debate on this subject on 29 January 1998. It may be some consolation to the Minister to know that the junior Minister who had the dubious privilege of replying to me at the time is now Secretary of State for Health. The right hon. Member for Darlington (Mr. Milburn) said then:

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The hospital still has the very strong support of the local population in and around Aylesbury. I hope that the Minister will be able to reassure me that it still has her support and that of the Government.


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