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10.16 pm

The Parliamentary Under-Secretary of State for Health (Ms Hazel Blears): First, I congratulate the hon. Member for Ruislip-Northwood (Mr. Wilkinson) on securing this debate about the future of specialist hospital services in north-west London. It gives me a chance to set out the work under way in relation to Harefield hospital and the Paddington basin complex.

The scheme will cost £360 million, and will bring together the NHS and the Imperial college school of medicine in a development that will be a centre for clinical excellence, innovation, teaching and research. It also represents a unique opportunity to establish hospital design at the forefront of a massive urban development.

Tonight's debate also gives us a chance to discuss the provision of some specialist services in north-west London, as well as the options for change being developed for Mount Vernon hospital cancer services. Although it is inevitable that I shall have to rehearse some of the arguments behind the options being developed in relation to services such as cancer services at Mount Vernon hospital, it is important that I do not prejudge the future consultation. I hope that the hon. Member for Ruislip-Northwood will understand that, given that the proposals are still very much under development and that public consultation has yet to commence, I am not in a position tonight to engage in a detailed debate about some of the matters that will arise out of that consultation process.

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The hon. Gentleman has raised in this House the future of Harefield hospital on many occasions on behalf of his constituents. I think that we all know that, under the inspirational clinical leadership of Professor Sir Magdi Yacoub, Harefield hospital has been remarkably successful in its development of heart and lung services. It has also become a centre where research and development is an integral part of the work to improve life expectancy and the quality of life for those with serious cardiothoracic conditions. I would like to take this opportunity to acknowledge that specialist care of the type that has been pioneered at Harefield will continue to form a crucial part of the overall network of services provided for people with coronary heart disease.

The Department of Health confirmed last October that it intended to move ahead with plans to develop a new hospital complex at Paddington. That development will bring together three world-class hospitals and include cutting-edge research facilities. The £360 million Paddington basin scheme will offer specialist services for children, with heart and lung patients being concentrated on one site in Paddington. That will bring together the strength of the Royal Brompton, St Mary's and Harefield hospitals. Specialist kidney services, including transplants, will be developed at Hammersmith.

The Paddington health complex will be a centre for clinical excellence, innovation, teaching and research, and it will form part of a major urban regeneration scheme. We should not underestimate the strength of the project being developed.

The hon. Gentleman referred to the objections of the community health councils to the proposals. Those have been considered by Ministers, and a full response was given by my right hon. Friend the Minister of State, Department of Health. He was satisfied at that stage that the conditions associated with the decision and the undertakings about further work to be done will address many of the issues raised during the consultation process.

The hon. Gentleman has expressed concern in the past that the option of investing at Harefield was not given sufficient attention during the consultation process. In fact, I can confirm that the option of a centre at Harefield hospital was included in the consultation. It considered the option of developing an independent specialist centre at Harefield hospital. It acknowledged Harefield hospital's national reputation as well as the strong doubts about the ability of a single specialty hospital to continue in relative isolation. I acknowledge that proposals and decisions of that nature are difficult for local communities. There are tensions involved in bringing together services so that they can provide excellence within a setting of other specialties rather than continuing to develop in a fairly isolated situation. Sometimes those issues are finely balanced and raise tremendous concerns in local communities.

The argument presented was that Harefield, being several miles from local general hospitals with accident and emergency departments, would not be in a position to draw on support from the wider range of specialties that are found at such hospitals and that the only way to achieve these benefits would be to build a completely new major general hospital on the Harefield site. Such a proposal would seriously threaten the viability of two

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existing hospitals—Hillingdon and Northwick Park. The options that were shortlisted were considered more robust because, if implemented, they would make use of existing major teaching hospitals rather than requiring the creation of a new one at the expense and probable demise of two other local general hospitals.

The hon. Gentleman referred to the staff concerns about whether they will be able to transfer to the new complex at the Paddington basin. Staff recruitment and retention, particularly in this part of the country, are challenging matters for the national health service. Every NHS trust has to carry out a survey of all its staff to see how it can improve recruitment and retention, provide flexible working hours and child care facilities and ensure that when we attract the best staff into the NHS, we keep them there.

I confirm that the trust is developing plans to ensure that all staff will see a career path and options for their future that will mean that they want to continue to play a part in the provision of health services in the area. The new Royal Brompton and Harefield NHS trust will open on the Paddington basin complex in 2007, so we have a lengthy period in which to prepare and ensure that staff receive proper reassurance about their future.

Staff have raised issues such as help with transport, financial incentives, accommodation, career opportunities and working environment. An action plan for all those issues is being developed by the trust to make sure that measures are in place to address the concerns about accommodation, transport and travel in the area.

In his response to the community health councils, my right hon. Friend the Minister of State emphasised the importance of drawing a line under any uncertainty or confusion that patients or staff might feel. There is investment in the Harefield site while we are waiting for the development of the Paddington basin. More than £4 million is being put into a patient services centre and £1 million into pathology services on the site.

We have also made available £2.5 million to the Harefield Research Foundation for the further development of the heart sciences centre on that site. The centre will remain on the hospital site beyond the transfer of clinical services to Paddington. The second phase of the centre is under construction. That presents an opportunity for the development of a science park built on the success of the heart sciences centre. A feasibility study was commissioned last year and a draft report is being assessed. It appears that there is a market for a science park in the area, but further work is required in collaboration with the Imperial College of Science, Technology and Medicine. The two trusts are developing a full business case for the Paddington basin scheme which, as I said, should be completed by 2007. That will safeguard all the excellent research and clinical work that is going on and will provide services that are fit for the 21st century.

Mr. Gareth R. Thomas (Harrow, West): On uncertainty, does my hon. Friend realise that there has been considerable concern about the future of specialist services in north-west London ever since the accident and emergency unit at Mount Vernon hospital was shut in 1996? Does she realise that the profound concern expressed by the hon. Member for Ruislip-Northwood (Mr. Wilkinson) about the future of cancer services at

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Mount Vernon is shared by my constituents? Will she ensure that the consultation process currently under way and the considerations by her Department take into account the concerns of my constituents in Harrow as well as those of the hon. Gentleman?

Ms Blears: My hon. Friend and the hon. Member for Ruislip-Northwood have referred to the uncertainty of local people. Any period of change and uncertainty in the NHS causes great distress to local people. That is partly because they value their services enormously—that great attachment to the NHS makes us realise how central its services are to local communities. It is vital that patients and the public be fully involved in all the consultation processes. The hon. Gentleman said that the voice of patients and of the public is not heard so we must consult the public creatively and innovatively rather than simply going through a formal process.

It is important to get to the heart of the concerns of local people. We want to provide modern, 21st-century services of a much higher standard than those that existed previously. It is essential to take the public with us on that journey. My hon. Friend the Member for Harrow, West (Mr. Thomas) made the point extremely well.

A large number of reviews of Mount Vernon hospital have failed to deliver a long-term solution. It is essential to clarify the long-term future of the whole cancer network so that decisions about medium and long-term investment can be made sensibly.

The Mount Vernon cancer review started in February 2001 and an interim report was published in September. Feedback has been received on the three options for developing the cancer centre: at Mount Vernon; at a greenfield site; or at an upgraded district general hospital in Hertfordshire. A detailed site survey was conducted at Mount Vernon and the other district general hospitals under consideration to identify their condition and capacity for further development. A further survey of public and car transport has been undertaken. Access to those services is a key issue for local people.

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