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8.38 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): I congratulate myhon. Friend the Member for Harrow, East (Mr. Dykes) on his success in the ballot, and I am pleased to have the opportunity to debate what is undoubtedly an important matter. As always, my hon. Friend spoke forcefully and with eloquence in advocating the best possible health care for his constituents. He has, if I may say so, conducted a long and skilful campaign on the matter.
I should mention in passing that my hon. Friend the Member for Hendon, South (Mr. Marshall), who has also been assiduous in this matter, unfortunately cannot be here this evening. I know that he has also played a part in the long-running campaign.
I acknowledge the point that my hon. Friend the Member for Harrow, East made forcibly about the strength of local feeling on the matter, which is probably running as high as it has been at any stage during the whole lengthy business. I can assure him that the Government are concerned about the matter. Ministerial colleagues and I have devoted a great deal of time and attention to the subject in recent months, and we want to ensure the best possible balance for the future provision in the area. I hope that my hon. Friend will take those commitments and assurances in the spirit in which they are given.
My right hon. Friend the Secretary of State has recently met deputations about the future of Edgware hospital--including one led by my hon. Friend--and the matter has been the subject of debate in this House and in another place on a number of occasions. I also assure my hon. Friend that the Government's first priority, and that of the Secretary of State, is to put the interests of the patient first. As decisions are implemented and new decisions are taken, our guiding principle will be that the quality of service should be at the very least maintained, and wherever possible improved.
The changes already agreed at Edgware are designed to provide the people of Barnet and Edgware with a high-quality, improved clinical service for patients. The present split-site arrangements at the Wellhouse
NHS trust, with the inevitable duplication of facilities between the Barnet and Edgware sites, are not only inefficient, but significantly detrimental to good patient care. That is despite the dedication and hard work of the excellent medical and nursing staff at the Wellhouse trust. To ensure that the best health services possible are provided, patients need modern facilities in hospitals large enough to ensure appropriate levels of staffing and expertise. That is precisely what the development at Barnet general hospital is about.
The changes due to take place at Edgware and Barnet hospitals are part of a long-term programme of improvements to health services provided at the Wellhouse trust. They have been finalised only after an extensive and thorough process of consultation. Barnet health authority has been exemplary in involving the public in its deliberations through a series of public meetings, the distribution of leaflets and articles in the local press. It has gone to great lengths to explain how patients will benefit from the planned changes, and why change is necessary.
Inevitably, when change comes to much-loved local hospitals such as Edgware, there is great public concern. It is also unavoidable that, when changes to any local health services are determined, there will be some who find the new arrangements less convenient. I fully understand that. I say again, however, that we believe that the changes at Edgware and Barnet will lead to an improvement in patient care.
I now wish to refer to the implications for Edgware hospital, which are of such concern to my hon. Friend. Despite any change to its status that may ensue, Edgware hospital will continue to be a significant provider of health care in the area. I note the point that my hon. Friend made about a letter from my right hon. Friend thePrime Minister, which stated that the hospital would be a significant provider of health care. He rightly asked what exactly was meant by the word "significant" in that context.
The Government mean that there will be an extensive provision of out-patient clinics, day-care services, a breast-screening centre and mental health services. These will ensure that the hospital continues to provide an extremely wide range of services. In addition, an accident service will continue at Edgware. My hon. Friend knows that the MATS centre--to use the jargon--was opened by the chief nursing officer in November 1995, and the majority of patients who currently look to Edgware for their health care needs will continue to find them there.
Decisions remain to be taken on the final pattern of services at Edgware. Consultation is under way on various proposals, including the treatment of the elderly and children on the Edgware site. The decisions that have already been taken--never mind those that may be taken following consultation--mean that around four out of every five patients currently attending Edgware will continue to be treated there.
I must also emphasise--quite apart from what I have said about existing and potential services--that the changes at Edgware hospital will not happen immediately. They will only take place once any redevelopment of Barnet general hospital and the expansion of services at Northwick Park and the Royal Free hospital have been completed, and improvements in the ambulance service have started to be delivered. All this is part of a coherent
plan, and we must ensure that nothing happens until we are perfectly certain that all the other elements are in place.
The House will be aware that the redeveloped Barnet general hospital will provide the full range of acute services. I can assure the House that the facilities being developed there will be of the highest quality. The£29 million first phase of redevelopment work started in November last year. The second and final phase, costing £33 million, can now go ahead. Once this work has been completed, we will in effect have built an entirely new hospital, which will allow local people access to the highest quality specialist acute facilities. The new accident and emergency department at Barnet will be one of the most up-to-date in the country, capable of treating 70,000 patients a year to the highest clinical standards.
As Edgware hospital changes its role and becomes more of a local hospital, so local primary services will need to adapt to the different circumstances. It is an essential element of the plans that primary care services will be developed. Local GPs will need time to develop human and financial resources to manage the shift from secondary to primary care, and will need to be closely involved in the development of services on the Edgware site.
My hon. Friend did not mention the fact that, in order to facilitate these changes, the local primary health care development fund plans to invest £17 million over a five-year period to improve local primary care services. My hon. Friend knows that the Government believe that the health service should be primary care-led, so we attach great importance to bringing together hospital and primary care.
Projects at present under way include the extension of nursing in the home for the terminally ill, improvements in GP surgeries and an outreach ophthalmology clinic. Projects planned for the future include increases in community nursing staff, further training of GPs to carry out minor surgery, and the introduction of community physiotherapy to improve the care of diabetics. I believe that these developments provide an excellent framework in which to ensure the success of the new Edgware hospital.
My hon. Friend also referred to the problems of transport in the area. I am aware that specific concerns have been expressed about the problem. I do, of course, acknowledge that some patients from the Edgware area will have great difficulty in travelling to Barnet. For this reason, a free NHS bus service will operate between the sites for those patients who require services that are being concentrated at the Barnet site. Special arrangements will be made for elderly and infirm patients who are less mobile. It must be recognised, however, that the majority of the services currently provided at Edgware will remain.
Particular concern has been expressed about the problems of transport in relation to accident and emergency provision. To address these concerns, the health authority intends to provide additional investment over and above the significant increase already agreed this year. Two additional ambulances and crews will be funded at an extra cost of £320,000.
As a former Transport Minister, I have considerable sympathy for my hon. Friend's point about traffic congestion in the area. He said that that was a serious matter that had not been fully addressed. We take that
point seriously, and understand local concern that problems could be caused at the congested bottom end of the M1. I will look at that point.
Mr. Dykes:
We are concerned about the specific length of the journey from Edgware general to Northwick Park. The actual time would be a minimum of 45 to 50 minutes in normal traffic conditions, and that is far too long.
Mr. Horam:
I hear what my hon. Friend says, and that adds to my concerns about traffic congestion. I will look at that point.
We believe that the proposals approved for the development of hospital services for Edgware and Barnet will lead to improved health care for the local community.
They are being brought forward after lengthy consideration and consultation--which has not yet been completed--and will allow Barnet health authority to meet its statutory duty to ensure that residents of the area are provided with a comprehensive health service meeting the full range of their needs.
Some of the current facilities are below the standards that we believe patients should be able to expect. We are engaged in an effort to improve conditions for the people of the Harrow and Barnet area. We believe, therefore, that, if the plans are properly and fully implemented, taking into account the additional consultation, which is in train, that part of London will have facilities that will match the very best in the national health service.
Question put and agreed to.
Adjourned accordingly at eleven minutes to Nine o'clock.
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