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1 Apr 2003 : Column 875continued
The petition of 701 residents of Brandon, Suffolk, and others
Declares that the government should reject proposals from the Office of Fair Trading that would remove restrictions on entry to the community pharmacy market in order to preserve the local pharmacies and safeguard their continued service to local communities.
The petitioners therefore request that the House of Commons urge the Secretary of State for Trade and Industry to reject the Office of Fair Trading proposals.
And the Petitioners remain, etc.
Sir Michael Spicer (West Worcestershire): I am delighted that the Under-Secretary of State for Health, the hon. Member for Tottenham (Mr. Lammy), will respond to the debate. I confess that I would have been even more delighted if the Minister of State, Department of Health, the hon. Member for Redditch (Jacqui Smith), who has just left the Chamber, were responding because she knows Malvern very well. I first met the hon. Lady when she was a student at the Chase school in Malvern and I was addressing the sixth form. So great was my eloquence that she immediately rushed off and joined the Labour party.
Coming straight to the point, I have some questions for the Under-Secretary. First, do the Government still support the policy of developing community hospitals? Secondly, following on from that, do the Government support the community hospitals of Malvern and Pershore? It is hard to exaggerate the importance that my constituents attach to both hospitals. Each hospital has served the surrounding area for around 100 years; each is an essential feature of the community; and each has provided a highly cost-effective service for the elderly and the dying, and above all, in recent years, those recuperating from treatment in the high-cost acute hospitals, particularly, this year, the new Worcestershire Royal hospital.
The great benefit that both community hospitals provide is that patients can recover close to their home and family at a cost that is far lower than that of the large acute hospitals. For that reason, residents of Malvern and Pershore and the surrounding villages have for many years cherished the hospitals and subscribed generously to their respective associations of friends. Each hospital, in different ways, is suddenly under threat. Malvern hospital has reached the point where it needs massive renovation and refurbishment. That has been anticipated for many years, which is why, for most of the period during which I have represented Malvern in Parliament, the hospital authorities have had a firm intention to rebuild the hospital. The previous hospital authority secured a site for precisely that purpose several years ago at Seaford court. In recent years, the plan for a new hospital has been analysed from every viewpoint, including the prospect that it might be subject to a private finance initiative.
Year after year has passed without a final decision being made. The current position is that South Worcestershire primary care trust has further postponed a decision until, it says, the summer. It is now essential that a decision to go ahead is made within the next month or so, otherwise the present hospital will fall into disrepair beyond redemption. My third question to the Minister is, therefore, what is to happen to Malvern hospital? What is its future? I hope that the Minister can provide some positive news.
Pressing as is the case for a new hospital in Malvern, a crisis point has been reached in Pershore, caused by the sudden announcement in the past few weeks by South Worcestershire primary care trust that it intends to close Pershore hospital in its present form and transfer
Even if the necessary money could be found for the conversion, questions arise about the propriety of running a residential home above a hospital. For elderly people, the prospect of having to share an entrance with the hospital is likely to be distressing. The proposal flies in the face of the accepted need for more residential places for the elderly in the county to avoid bed blocking, particularly in the expensive acute hospital in Worcestershire. It is ironic that we should be discussing that immediately after the passage through Parliament of the Community Care (Delayed Discharges etc.) Bill. The proposal would mean losing 25 badly needed beds for elderly residents. Indeed, I understand that those rooms have already been assigned to specific people, who have even chosen the colour of their wallpaper. Their future is now in limbo, as is that of people suffering from dementia, who will have no place in Heathlands if the proposals go ahead.
It is all quite unsatisfactory. The idea of exchanging a purpose-built hospital with facilities for minor injury operations, day rooms and proper wards for a makeshift facility with inadequate parking, limited access for ambulances and no minor injury theatre makes no apparent sense at all. At best, the proposal is likely to be unstable. It is made in the context of the failure of South Worcestershire primary care trust, despite repeated assurances to me to the contrary, to honour its commitment to reopen the minor injuries unit at Pershore hospital, as it promised to do when it was temporarily closed because of staff shortages.
In Worcestershire, the word of the primary care trust is not considered to be its bond: put bluntly, my constituents do not trust the SWPCT. That is particularly so because of the reasons that the trust has given for making the move. It claims that that will help to address a deficit, which it says it inherited from the Worcester area health authority. There is a good deal of muddle about the size and nature of that deficit. For instance, was it inherited debt or is it recurring debt? That has not been fully established. What is the size of it? Is it 1 or 2 per cent. of the PCT's annual budget? That has not been properly established, either. My fourth question to the Minister is, what are the facts about the deficit and, if it exists at all, how can the Pershore hospital proposal solve it?
If the primary care trust carries out its proclaimed intent to sign a long-term contract with the Heart of England housing association, the owners of the residential home, it is difficult to foresee how any recurring savings would be made from exchanging a purpose-built hospital for one that is not purpose built. The servicing of 25 individual rooms, for example, must
Mr. Peter Luff (Mid-Worcestershire): Can my hon. Friend confirm that if a capital revenue were to accrue to the South Worcestershire primary care trust arising from the sale of the current site of the Pershore hospital, it could not be used to pay off the deficit because it would be capital money, not revenue money? It would be in a separate pot, so it would not contribute to solving a deficit problem.
Sir Michael Spicer: That is an interesting question, and it is one of the reasons why it is important to sort out the deficit issue and establish whether it is a recurring current account deficit or whether it can properly be attributed on the balance sheet to the past and be treated as a capital amount. Those are important questions, and my hon. Friend pinpoints a significant aspect.
Part of the growing anger in Pershore stems from the nature of the consultation exercise now under way on behalf of the South Worcestershire primary care trust. The consultation exercise has been truncated to eight weeks. There have been no costings or time scales. It has failed to anticipate the obvious objections and problems. Surrounding villages whose residents look to Pershore hospital have not been consulted. I imagine that my hon. Friend has such villages in his constituency. Above all, the consultation has made no effort to consider the alternatives.
Untested assertions have been made at public meetings, and invariably no supportive evidence has been provided. For example, it has been argued that to rebuild the existing hospital using private finance would be unviable because planning permission would not be forthcoming to provide the land and scope for adequate parking and ancillary services. There is no evidence to suggest that the planning authority, Wychavon district council, would take such an outright negative position with respect to the height of the building or to the change of use of the land behind the present hospital.
It is clear that car parking could be provided adjacent to the present site, which would allow the hospital to be rebuilt to an adequate size on the existing site. It is unacceptable that this alternative has not been considered as part of the proposals put forward by the PCT in the consultation process. For all those reasons, the suspicion remains that the current proposal is a smokescreen for closing the Pershore community hospital outright.
So my fifth question to the Minister is this: will he require the South Worcestershire primary care trust at least to consider alternative proposals to rebuild or refurbish Pershore hospital on its present site, or on any other appropriate local site, and in so doing, supply the public with proper costings, which it has not done to date? He at least owes it to the taxpayer, who is about to inject an additional £18 million next year into the bank account of the South Worcestershire primary care trust, to ask why that extra money is to coincide with a threat to the future of two hospitals for which it has direct responsibility.
The Government have a responsibility to the nation to ensure that the money raised from income tax is not siphoned out into a morass of administration and wasted expenditure. That is precisely what seems to be happening in West Worcestershire, where the Minister must intervene at least to the extent of being able fully to answer the questions that I have put to him. Let me very briefly summarise those questions. First, does he support community hospitals in general, and in Malvern and Pershore in particular? Secondly, does he reject the notion that South Worcestershire PCT inherited a debt that justifies the proposed closure of the existing Pershore hospital? Thirdly, does he agree that the PCT should at least come up with options involving the continued existence of the hospital in Pershore, either on its present site or on another appropriate local site? Finally, is he satisfied with a situation in which closure of a community hospital is proposed when, at the same time, taxpayers are pouring millions of extra pounds into the area?