Previous Section Back to Table of Contents Lords Hansard Home Page

Baroness Jay of Paddington: My Lords, the simple answer to the noble Baroness's last point is no. The decision has now been taken about Bart's. I am amazed that she should describe that decision, on which I have

3 Feb 1998 : Column 529

elaborated in some detail, in such emotive language as "betrayal". This is a sensible use of the available resources. It uses the plant that exists at the Smithfield site and the very considerable medical and scientific expertise which exists at that site to provide a specialist service. As I said in reply to the noble Lord, Lord Annan, and to the noble Earl, we believe that there are very good examples of that kind of service being well provided. The noble Baroness's remarks merely illustrate the difficulties of the decisions that had to be taken in the context of cost-effectiveness, as pointed out by the noble Earl, and the remarks of the noble Lord, Lord Annan, about the potential for different uses of these beds. The right decision has been made, and that right decision is one that we shall stick with.

Lord Shore of Stepney: My Lords, as someone who has represented for more than 30 years the East London area in which the London Hospital is located, I wish to state how much I welcome--as I am sure local people will--the good sense that the Government have applied in their study and the urgent review that they have carried out. I welcome in particular the conclusion reached in the review, which the Government have accepted, that the previous government got it all wrong--the fons et origo of the mistakes of the past 10 years--in saying that London was over-provided with hospital beds.

Baroness Jay of Paddington: My Lords, I am grateful for my noble friend's support for these decisions. His experience is long and authoritative; it has deep roots among that population in East London. I am delighted that he feels that this proposal will be popular in that part of London. We look to the investment and involvement of the people in that community in developing the right sort of services--not simply through the revised hospital proposals but also in the very important primary care services. I am sure that my noble friend will do what he can to encourage that.

Lord McColl of Dulwich: My Lords, I wish to ask a very brief question about the re-evaluation of the proposed shift of other services from Guy's to St. Thomas's. I declare an interest; I work at both institutions.

I realise the problem of building new facilities at St. Thomas's to take the place of the services provided at Guy's. However, in view of the brand new hospital building there and the excellent facilities, particularly in ENT, who exactly will carry out the re-evaluation of the proposed shift? Clearly it will be quite difficult for the management of the Guy's and St. Thomas's Hospital Trust. I congratulate the Government on the choice of Sir Leslie Turnberg. He is an excellent physician and is very much respected by the profession.

Baroness Jay of Paddington: My Lords, I am very happy to accept that endorsement of Sir Leslie Turnberg's great skill in taking these proposals forward. I think the noble Lord will understand that the questions

3 Feb 1998 : Column 530

of management of the change between Guy's and St. Thomas's are, we hope, now that they are in a unified trust, subject to discussion around the table rather than confrontation between rival groups. The noble Lord raises his eyebrows. Perhaps I am more optimistic than the noble Lord, and his local knowledge does not give him that confidence. Sir Leslie's panel highlighted concerns that the extensive building going on at the St. Thomas's site might not represent value for money in the light of the capacity available at Guy's. We accept that view. That means the Department of Health and the NHS executive as well as the local trust, and the South Thames regional office are to review the options, which will probably mean that more services are left on the Guy's site. Precisely which services those are and how they are best configured will clearly be a matter for local discussion.

Lord Winston: My Lords, I declare an interest as a member of the newly-enlarged Imperial College School of Medicine. I believe that the report will be widely welcomed throughout London. The tenor of the Government's response to it is apposite. I particularly like the notion that firm decisions will be taken.

Perhaps I may draw my noble friend's attention to a problem that has dogged London medicine very seriously. As noble Lords will know, London medicine is largely academically led. Many of the hospitals mentioned in the Statement are academic hospitals. One of the problems in London has been a consistent blight on research, and particularly recruitment, because decisions were rather slow in being taken. Will the Minister assure the House that we shall not be kept waiting again and that any decisions needing to be taken will be taken with all speed, so that London medicine and London medical science can get on with the job of improving and maintaining the health of the nation?

Baroness Jay of Paddington: My Lords, I am delighted to reassure my noble friend that decisions will be taken promptly. I cannot give him quite the same assurance about the nature and type of procedures needed to effect some of the changes. For example, some of the capital programmes are subject to the PFI process, in itself a procedure which can take some time. As my right honourable friend said in the Statement which I repeated, this is, like the NHS White Paper, a 10-year programme in which we would expect to see visible improvement year on year but not all delivered within the first year. I hope that my noble friend will have heard the points in the Statement about the need to look at the configuration of London health services in this sectoral way, which enables the connection between the medical schools and the academic medical fraternity to be allied with the service provision in a way which makes sense for both parts of the healthcare system.

Baroness Nicholson of Winterbourne: My Lords, I congratulate the Minister and her colleagues on this remarkable new thinking for London healthcare. I declare an interest in Guy's Hospital as a foster parent of a child who has had many operations in the burns unit. With that experience, perhaps I may ask the

3 Feb 1998 : Column 531

Minister to think carefully about the transfer of burns services for London patients long-term from Queen Mary's Hospital, Roehampton, to Guy's Hospital itself. That would give a new reason and focus for Guy's to use the wonderful new facilities which the previous government appeared to be going to discard. As I understand it, there was no long-term planning at all in the previous thinking for London burns patients but merely short-term and possibly mid-term planning.

Baroness Jay of Paddington: My Lords, I am grateful to the noble Baroness, Lady Nicholson. She was kind enough to write to me and also, I understand, to Sir Leslie Turnberg about the proposal with regard to burns services. My understanding is that the burns and plastic surgery services were looked at in the strategic review which reported last autumn. Consideration was given at that time to the possibility of transferring burns services to Guy's or St. Thomas's but the steering group continued to recommend the transfer of those services to the Chelsea and Westminster Hospital, to remain within the South Thames Regional organisation. The noble Baroness will have heard that, as I said in response to the noble Lord, Lord McColl, the capacity at Guy's to retain certain services which might have been moved to St. Thomas's could perhaps produce another possibility in this area. At the moment I can only refer back to the previous appraisal which suggested moving the services to Chelsea and Westminster.

Lord Aberdare: My Lords, I was interested in the mention of the Elizabeth Garrett Anderson Hospital for Women. I have always had a great admiration for that hospital and had hoped that it would continue to be exclusively for women. It is not clear to me from the Statement whether it is in some way to be subsumed into University College Hospital.

Baroness Jay of Paddington: My Lords, I am sure that the characteristics and quality of the services of the Elizabeth Garrett Anderson Hospital, with which I am sure we are all familiar and about which we feel strongly, will retain their independence, but the buildings will become part of the new University College Hospital, which, as the noble Lord knows, is literally across the street from the old site.

Lord Rea: My Lords, as a practitioner who spent most of his professional life working in north London, perhaps I may say how pleased I am that the decision has finally been arrived at with regard to the UCL hospitals. I welcome also the further strengthening of primary care, particularly in east London where it is much needed. Another thing which greatly pleases me is the decision at last to have a strategic regional office for London. This is something my noble friend will recall arguing for over many years when we were in opposition. Can the Minister say what will happen to the current north and south London regional offices? When there is a strategic London office, will the peripheral health authorities be attached to another

3 Feb 1998 : Column 532

regional office or will they form their own? Will the regional strategic office be coterminous with the new GLA?

Next Section Back to Table of Contents Lords Hansard Home Page