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2.45 pm
The Parliamentary Under-Secretary of State for Health (Mr. Paul Boateng): I congratulate the hon. Member for Solihull (Mr. Taylor) on securing time to debate a subject which I know is of importance to him and his constituents, and to which he brings a depth of knowledge, experience, wisdom and a commitment to the totality of health services in his constituency.
In November, the hon. Gentleman asked me whether Ministers had any plans to visit Solihull to see at first hand the health services provided. I explained at the time that I had a commitment to visit the Birmingham Heartlands and Solihull NHS trust, which I fulfilled last Friday. I was enormously impressed by the professionalism of the staff to whom I was introduced. I had the pleasure of presenting an award to the nurses of ward 19 of Solihull hospital for their introduction of a new, non-invasive ventilation system for patients.
It would seem that the people of Solihull have firm grounds for confidence in the care that is available to them at the Solihull branch of the Heartlands and Solihull NHS trust. I say branch because one of the attractive things about that trust is the way in which two branches, two different sites, make one hospital. That was at the heart of the reorganisation of health services in the area, and the arrangement seems to be working extremely well.
In the past, I know that there was, as there inevitably is when two hospitals come together, a degree of uncertainty and concern on the part of the hon. Gentleman and his constituents about the merger. That merger took place during the previous Conservative Government of which the hon. Gentleman was a distinguished member.
When the brand new hospital opened in 1994, the people of Solihull were almost immediately presented with the threat of its closure due to a combination of financial and emerging clinical difficulties and the possible withdrawal of accreditation by the Royal College of Physicians for some senior house officer training posts. The hon. Gentleman knows all about the Save Solihull hospital campaign which followed.
The solution that was finally implemented after the report of a project group commissioned by the West Midlands regional health authority was a merger with Birmingham Heartlands, in accordance with the philosophy of one hospital on two sites. That provided for the protection of patient services, allowed for staff rotation to allow the culture of excellence to be spread, and ensured cover for smaller specialties. The reduction in management costs and the sharing of support services that resulted helped to eliminate Solihull hospital's financial deficit.
It would be helpful if I spoke about the improvement in services since the merger, because although it was accepted that the outcome of the merger was ultimately a reasonable one, local people had some understandable reservations about the perceived loss of identity to their local services.
The hon. Gentleman put great store on the distinct and unique identity of Solihull hospital. Some were concerned that they would be referred to Birmingham for treatments of any significance. I am glad to say--the hon. Gentleman will acknowledge this--that that did not prove to be the case.
Both the quantity and the quality of hospital health care provision have increased since the merger with Birmingham Heartlands in April 1996. Solihull hospital experienced many improvements after the merger. These include 24,000 more patients treated per year; the development of new patient services at Solihull, such as a £700,000 renal dialysis unit--during my visit to Heartlands and Solihull, I met staff who worked in and were responsible for the unit; a £500,000 ophthalmology unit and a £750,000 dedicated day procedures unit;
the expansion of specialist services with clinics for paediatrics, diabetes, and vascular and thoracic surgery; the integration of planning for obstetrics and gynaecology services at both hospital sites within purpose-built women's units, providing the latest in medical expertise and technology; and the installation of a new £1.2 million MRI scanner, built and funded with the co-operation of the trust and the public.
As the hon. Gentleman knows, the list is longer still, and the improvements in services were very much part of his speech. The point is that Solihull hospital has flourished since the merger. In a written reply to the hon. Gentleman in November, we provided him with an extensive list of the full range of services available at Solihull. It is a quality service. The standard is high, and the reasons for that are clear to see: investment, the dedication of staff, and the confidence of patients.
The performance of the trust has been outstanding. It has increased its number of five-star wards in the NHS league tables from two, three years ago, to 37 in the latest edition. At the same time, waiting times have been kept consistently low, with only 13 people waiting more than 12 months for admission at the end of December.
The hon. Gentleman is concerned about accident and emergency services at Solihull. He knows that the previous Minister of State made it a condition of the merger with Heartlands that a 24-hour A and E service would continue to be provided at Solihull. The hon. Gentleman also knows that, despite the political backing for the continuation of that service, the Royal College of Surgeons took a close look last year at its approval for training accreditation of senior house officers for A and E. I hope that he will agree that the Royal College is, of course, completely independent of Government. It had every right to examine its legitimate concerns for the provision of a safe and effective service, and to ensure that the quality of training for its juniors was adequate.
Despite its concerns, the Royal College reached agreement last autumn with the Birmingham Heartlands and Solihull NHS trust on a way for the full A and E service at Solihull to continue. Training accreditation was confirmed until 31 July 1998, from which time the Royal College agreed in principle a pilot training programme involving A and E at Solihull, which would establish how recognition could be maintained in the merged trust configuration. I understand that negotiations on the training of junior doctors are still in progress with the Royal College. I wish them well.
As for the longer-term future, I am afraid that I cannot in good conscience provide the hon. Gentleman with any guarantees. The NHS is inevitably and rightly a constantly changing environment, and adaptation to that change, though sometimes difficult, is a necessity. In the circumstances, it would be rash for me to speculate about the future for Solihull hospital, or any other unit in the health service. As I have already said, I have confidence in the trust, its chairman and chief executive, with whom I have discussed these issues.
Mr. John M. Taylor:
Will the Minister make it clear that, as he cannot see into the future or give guarantees, Solihull hospital is no different in that respect from any other hospital?
Mr. Boateng:
I am happy to clarify that. I cannot see into the future. The NHS is a constantly changing
I know that the staff are first rate and that the chairman and chief executive have my full confidence and that of the staff and the local community in the service that they seek to provide.
In the remaining minutes, I want to pay tribute to the contribution of the other trust in Solihull, the Solihull Healthcare NHS trust. It, too, has attained a level of excellence that is reflected in the achievement of two five-star awards for short out-patient waiting times. The trust provides learning disability, mental health and community health services to a population of more than 200,000. The trust has a reputation for providing good quality services.
I note the hon. Member's concern about funding for mental health services. That must be a matter for Solihull health authority. Increasing the resources available for one part of the health service inevitably has an impact on another part. Local people will have an opportunity to influence this decision and contribute to the debate and the decision-making processes, as one would expect. There will be renewed debate when the health authority publishes its commissioning intentions each year.
The hon. Gentleman brought up the issue of needs-weighted allocation formulae. We are committed to a fully needs-based approach to resource allocation. Changes to the weighted capitation formula for the 1998-99 health authority allocations were recommended by the national resource allocation group. On the basis of the available evidence, the RAG recommended that we should apply the current psychiatric needs weightings to services for people with learning disabilities. The RAG also recommended that the blocks of expenditure for administration and other hospital services should be weighted for need.
We made those changes as part of our commitment to making the distribution of resources fairer. That is in support of our objectives of reducing both inequities in access to health services and inequalities in health.
The health authority recovery plan has required the working up of a recovery strategy, which has been carefully implemented, but it will obviously have a knock-on effect on the level of health services in the Solihull area that can be afforded. I am satisfied that the health authority is making every effort to ensure that the effects of that financial recovery on service provision are appropriate, and I know that it hopes to appoint a new chief executive soon to assist it in the process.
The health authority has made very significant progress in reducing its management costs and in developing a constructive and energetic GP commissioning council, which will be able to spearhead the developments proposed in our White Paper. I hope that the GP fundholders in Solihull, to whom the hon. Gentleman referred, will work closely with the commissioning council to help ensure the smooth transition for which he wished.
The Secretary of State has made the position clear in terms of the private sector. It is for the local health authority, the trust and other local bodies to decide the most effective pattern of services and how those should be delivered. That will normally be achieved by making the best use of NHS facilities, which is what we have encouraged in our 1998-99 planning guidance. However, it is a matter for them how they apply the resources at their disposal--and I have no doubt that they will take seriously what the hon. Gentleman has said.
I am grateful to the hon. Gentleman for raising those important issues. I hear what he says about private medical insurance premiums, but let us be in no doubt about the fact that we have enormously assisted by diverting the resources from the previous tax reliefs to reducing VAT on fuel. That helps the most vulnerable, including the elderly.
In terms of the resources available to it, the NHS has been massively improved by the additional spending that the Government have provided--an additional £1.2 billion, not to mention the extra money for winter pressures, which has been well used in the hon. Gentleman's constituency.
Question put and agreed to.
Adjourned accordingly at Three o'clock.
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