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10.50 am
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): It seems a long time, Mr. Deputy Speaker, since you and I were in the House debating health matters earlier this morning. It is as if you and I were nailed to our seats--the Opposition will undoubtedly say that that is a penance.
I congratulate the hon. Member for Leeds, East (Mr. Mudie) on securing a debate on such an important subject. I appreciate the bipartisan, or non-political, spirit with which he approached the subject, and I should like to respond in a similar fashion. I think it was the hon. Member for Southwark and Bermondsey (Mr. Hughes) who said that it was the duty of us all to make the national health service work, and I assure him and the House that that is certainly the wish of Ministers.
I hope that the hon. Members for Lewisham, East (Mrs. Prentice), for Southwark and Bermondsey and for Warrington, North (Mr. Hoyle) as well as my old sparring partner the hon. Member for Rother Valley (Mr. Barron) will not mind if I concentrate, at least in the first instance, on the specific points made by the hon. Member for Leeds, East, to whom we are grateful for initiating the debate.
The Gentleman spoke graphically of the circumstances surrounding Mrs. Harrison's sudden illness. Those events are of course a matter of great sorrow, and I should like
to express my sympathy and condolences to her family. The hon. Gentleman asked specifically what action was being taken by the health authority in the aftermath of those events although, as his remarks made clear, he will be aware of some of what is happening.
The hon. Gentleman will be aware that the authority plans further work on intensive care, and that work can be classified under three main headings. First, it aims to complete a thorough review--which, as the hon. Gentleman knows, is already under way--into the facts surrounding Mrs. Harrison's transfer from St. James's hospital to the Hull Royal infirmary. Secondly, it aims to ensure that arrangements are in place to guarantee that every possibility of a bed in Leeds has been fully explored before a transfer to an intensive care unit outside the city is considered. Thirdly, the health authority will convene a meeting with intensive care clinicians to consider with them the protocols and procedures within which intensive care services in Leeds operate.
The hon. Member for Leeds, East raised another important point about which we have corresponded--the situation at Killingbeck. We are in fact discussing a separate matter in relation to that hospital, but I shall say a little about intensive care beds there as he raised the matter today. As he knows, there are seven cardiac intensive care beds at Killingbeck hospital, which are dedicated for the use of cardiac patients and support the highly complex specialist services which Killingbeck and the Leeds general hospital provide. It is because of the specialist nature of these beds and the specialised training of the staff involved that they are not made available for general intensive care use. Their availability is therefore not reported.
It is not correct to say that those beds are ring-fenced financially; because of their specialist nature, they are not generally available. I hope that the hon. Gentleman will accept that. In view of the circumstances, however, the health authority has agreed to review, with the local trust, whether, in certain situations, those and other cardiac intensive care unit beds should be made available to provide general intensive care for local people. I must stress that the use of those cardiac beds for general intensive care would require very careful selection of cases--for example, infectious medical cases such as patients suffering meningitis would not be suitable for treatment in a unit containing cardiac surgery patients. The idea is being considered, but I hope that the hon. Gentleman understands that the matter must be handled with great care.
The hon. Gentleman also mentioned the general expansion plans for ICU beds in the Leeds area, a matter that we have discussed before. He knows of, and acknowledged, the investment of an extra £1 million in Leeds this year to fund one extra bed at Leeds general hospital and one at St. James's. That has been followed by the commitment of an additional £127,000 and a West Yorkshire-wide bid for a further £325,000 for intensive care. That significant investment builds on a general increase in intensive care beds in Leeds in recent years. For example, the number of paediatric ICU beds at the University of Leeds teaching hospital trebled between 1992 and 1996, and beds for adults increased from seven
to 10 between 1993 and 1996. An average occupancy rate of 85 per cent. at St. James's ICU suggests that there are sufficient beds for most eventualities.
Mr. Hinchliffe:
I have listened carefully to what the Minister said, but I think that he will accept from what he has heard this morning that there is a particular problem in the northern and Yorkshire region of the NHS. We have lost more beds in the past five years than any other region--27 per cent. of our beds have disappeared. That loss has a knock-on effect on intensive care provision in a wider area.
Mr. Horam:
There is clearly a connection between the number of beds in absolute terms and the use of intensive care beds. Indeed, the hon. Member for Rother Valley commented on that. Nevertheless, in this particular instance I am talking about the provision of intensive care beds in the Leeds area and more generally. As the hon. Member for Wakefield (Mr. Hinchliffe) knows, there is a major new development at the Leeds general infirmary. The cost is £72 million, and phase 1 will come into operation this year. That offers the opportunity to look again at the balance of intensive care and high-dependency beds in the hospital to ensure that there is more flexibility to provide intensive care at peak periods.
Mr. Bayley:
A number of the paediatric intensive care beds in Leeds are specialist beds related to heart surgery, burns or other clinical disciplines and are not available, or appropriate, for general use. Will the Minister separate the figures for those specialist beds as it would be wrong to count them with general paediatric intensive care beds?
Mr. Horam:
I take the point. Paediatric intensive care beds should be considered separately from general
I also take the point raised by the hon. Member for Wakefield. It is important to consider the matter not on a Leeds basis, or indeed a York basis, but on a regional basis.
Mr. Hoyle:
The debate has been initiated by my hon. Friend the Member for Leeds, East so it is important that the Minister deals with the points that he raised, but I hope that he will leave himself time to say why the report was not given to my hon. Friend the Member for Warrington, South which, as I said earlier, prevented him from having all the information that he needed for yesterday's debate.
Mr. Horam:
I should like to look into that. I shall write to the hon. Member for Normanton (Mr. O'Brien), who raised the point today and in yesterday's debate, and to the hon. Member for Warrington, North.
As a result of the additional regional funding that we have provided for adult intensive care and high dependency care this year--the £4 million that we were talking about--an extra five intensive care beds and six high dependency beds are being opened in the Northern and Yorkshire region. More will be opened in the region in the next financial year as a result of the extra £5 million that we have earmarked for adult intensive care and high dependency beds, to be matched by £15 million from the growth money provided by local authorities. A stream of new provision is under way.
In the little time that we have left, I should like to point out to the hon. Member for Lewisham, East, who commented adversely on the plans made for this winter by my hon. Friend--
Mr. Mark Wolfson (Sevenoaks):
Its isolation, its history and its position--a tiny dot in the south Atlantic--make St. Helena a romantic and beguiling place. It does not disappoint. From the island's first appearance as a misty bump on the horizon until the Royal Mail ship St. Helena drops anchor under the towering cliffs flanking Jamestown harbour, and when visitors leap ashore up the same steps as Napoleon used, the sense of history is everywhere.
Fascinating as that is, I requested this debate to address the present-day issues of St. Helena and the Saints who live there. My colleagues and I are grateful for the speed with which the debate was granted by Madam Speaker.
The hon. Member for Monklands, West (Mr. Clarke), who is in his place, Lord Beaumont and I visited St. Helena with the Commonwealth Parliamentary Association. Those who know St. Helena will not be surprised to hear that we were given a warm and friendly welcome. Arrangements for the visit were well structured--we had an opportunity to meet many islanders at a large reception at Government house, and we had well-organised briefing papers and discussions. We all felt that the way in which the visit was put together was a credit to the island's Government, staff and elected councillors, and made best use of our time, which was short because of the shipping schedule.
Despite being on the island for only two and a half days before the ship left for Cape Town, we were able to get a clear picture of the problems facing St. Helena. I regret not having been able to lean over gateposts for a chat and meet people in the street. I should also have liked the opportunity to see more of that beautiful and interesting island, but that would have required a longer visit, which would not have been easy for the CPA to fund or organise.
The four key issues that came up over and again were: citizenship; communications--or lack of them--with the island; the commitment of the United Kingdom Government and Parliament to St. Helena; and the constitution. I shall deal with those four Cs in turn.
The first issue is citizenship. Many hon. Members--but by no means all, as I have found from talking to some--will be aware that full British citizenship and the right to live and work in the United Kingdom were removed from the Saints in 1981, and they regard that as a serious and continuing injustice. Citizenship is the key and burning issue for them.
The restoration of the right for Saints to live and work in the UK, quite apart from citizenship, would have many beneficial effects on the island: it would benefit the island economy, because money would be remitted to families still there; the opportunity to work in the wider world in the UK would motivate the islanders further to make progress at school and afterwards; and--this is a key factor in moving forward the development plan for the island--it would bring back outside experience and expertise to St. Helena, particularly from those who might have had entrepreneurial experience in the United Kingdom. Unless the island benefits from such experience, the strategic plan, on which the Government's policy hinges, is unlikely to be effective.
Those two issues of citizenship and development are linked. All those from the House who visited St. Helena believed that, after the handover of Hong Kong later this
year, Parliament should again address the issue of citizenship in the interests of justice and practical economics. I am not having withdrawal symptoms about my decision not to stand for Parliament again, but I shall regret no longer being here to advance these arguments--particularly that on citizenship--in the interests of St. Helena.
11 am
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