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Viscount Goschen: My Lords, indeed, Morocco is not bound by Council regulations. The important point on the airport agreement side is that the ball is in Gibraltar's court. The Gibraltarian administration refuses to implement the agreement because it believes that it cedes important concessions on the issue of sovereignty to the Spanish. This is not the position of Her Majesty's Government. We continue to press the Government of Gibraltar to act in this area. The emphasis is on the Gibraltarians; we will continue to press them to make progress on this important issue.
Lord Clinton-Davis: My Lords, while thanking the Minister for that reply with which I wholly concurmaybe uncharacteristicallycan he confirm that this specific Question has absolutely nothing to do with the issue of the sensitive Gibraltarian/Spanish relationship? Is he further aware that the Opposition support the view that he has taken? There was of course a deal struck in 1986-87, in which I had some part to play, which concluded a not wholly satisfactory arrangement between Britain and Spain on the issue. It is a sensitive matter and it does not help if rather irrelevant questions are imposed on it.
Viscount Goschen: My Lords, it is difficult to separate out the issues. We believe that coming to an agreement on the airport is important for a number of reasons. I wholly agree with the noble Lord that this is a sensitive point. We continue to press for progress.
The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege:): My Lords, we believe that the National Hospital will benefit from trust status but, after careful consideration, my
Lord Walton of Detchant: My Lords, in thanking the Minister for that reply, I first declare an interest as the current president of the World Federation of Neurologya federation of some 75 neurological associations across the world. Does the Minister agree that this hospital has an exceptionally proud record of patient care and service to the community; that it is at the moment financially viable; and that its associated institute of neurology has obtained one of the highest ratings in the HEFC national assessment exercise for the quality of its research? Can we be assured that if it were to merge with another hospital to form a trust its identity would be confirmed?
Baroness Cumberlege: My Lords, I am very pleased to be able to agree with the president of the world federation of neurological associations and I congratulate him on that very distinguished position. This particular hospital and its institute have a very proud record. The hospital is, we believe, of world standing but we do not believe that its future is necessarily viable. That is why we are looking ahead. If it joins a trustas we are recommending it shouldwith another hospital, we would want to keep the excellence and the worldwide reputation and expertise embodied in Queens Square.
Baroness Jay of Paddington: My Lords, the noble Lord, Lord Walton, rightly refers to the concern in the international neurological community about a possible merger. Is the Minister also aware of the great concern felt in the National Health Service because of the potential threat to the number of intensive care beds in this specialty which may be threatened by the merger? Have the Government taken into consideration the cases of, for example, the patient who had to be flown from the south of England to Leeds for intensive care, and of the surgeona matter raised in your Lordships' House by the noble Lord, Lord Smithwho unfortunately died as a result of a lack of beds? Have the Government considered these service concerns when considering the merger?
Baroness Cumberlege: My Lords, we have considered all these aspects; indeed, we commissioned an independent inquiry, a review of neuro-sciences within the London area. The review was undertaken by some very distinguished consultants and professors in neuro-sciences. Their verdict was unequivocal. They said that the historical pattern of service provision is not fully geared to meet current population needs. Changes in demography mean that service sitings are no longer relevant as we move into the 21st century. As to the expertise in tertiary neuro-sciences centres such as that at Queens Square, the review recommended that such centres should be sited within a multi-specialty general teaching hospital and should have formal research and training links with medical schools and higher education institutes. We have accepted those recommendations,
Lord Peyton of Yeovil: My Lords, is my noble friend aware that her answer is reassuring in referring specifically to the excellence of this hospital? I hope that I can ask her now to redouble the assurance. Is she quite confident that the excellence of this institution will not be diluted by being spread?
Baroness Cumberlege: My Lords, it is our intention not only to protect and maintain the expertise within this hospital and within the institute, but also to promote its excellence. We believe it is a remarkable institution and we want to see it strengthened.
Baroness Cumberlege: My Lords, it really is up to the National to choose its partner. Clearly, it is considering a number of options. As the institute is already looking at University College London, perhaps that may influence its final decision. But the choice is the National's.
Baroness Masham of Ilton: My Lords, will the decision be made quickly? As the Minister knows, committee meetings and consultations take doctors away from patients. Is she aware that some patients are suffering from long waiting times in that hospital?
Lord Dean of Beswick: My Lords, the noble Lord, Lord Walton, says that the hospital is financially viable. The Minister in her reply says that the decision is based on the fact that it may not necessarily be viable in the future. What evidence has the Minister to substantiate that course of action? What proof is there that the hospital will not be viable? It may well be viable if the case is not proved. Have the Government taken any soundings of the highly qualified professional staff who man the hospital as to whether the service may deteriorate if there is a merger with another hospital?
Baroness Cumberlege: My Lords, we always consult with staff whenever there is a proposal. The evidence is that 13 district health authorities who commissioned services have indicated that next year they will reduce work to be done by this hospital. Indeed, the hospital itself is planning to handle up to 15 per cent. less work over the next three years.
Baroness Cumberlege: My Lords, I cannot give that undertaking. It depends what happens in terms not only of the number of contracts that are placed with this hospital but also movements in clinical activity in the way that medical science is changing. Your Lordships
Lord Walton of Detchant: My Lords, will the Minister accept that there is a major multi-million pound development of a new building going on at the Queens Square site at the moment? If, as she very properly suggests, a merger with another major hospital does take place, may we be assured that the existing site will nevertheless be retained?
Lord Inglewood: My Lords, the matter is likely to be discussed within the OSCE later this week. We would expect Turkey to act in accordance with all the commitments of the Budapest Declaration, including those relating to the code of conduct and the human dimension.
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