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Clause 5
Lords amendment: No. 1, in page 2, line 18, leave out ("an emblem" and insert ("up to three emblems").
12.15 am
The Parliamentary Under-Secretary of State for the Home Department (Mr. George Howarth): I beg to move, That this House agrees with the Lords in the said amendment.
Mr. Deputy Speaker: With this it will be convenient to discuss Lords amendments Nos. 2 to 7.
Mr. Howarth: The principal purpose of the registration scheme for political parties is to facilitate the running of the new systems for election to the Scottish Parliament, the National Assembly for Wales and, we hope, the European Parliament.
The Bill also addresses the problem of misleading candidates' descriptions. That is in part achieved by the introduction of party emblems on the ballot paper. When introduced, the Bill provided that a party could register one emblem, reflecting what we believed to be the position at that time: that all the main political parties used only one emblem. During consideration of the Bill in the other place, the Conservative Party realised, first, that the party in Scotland had a separate emblem and, a few days later, that the party in Wales also had its own emblem.
The amendments address that problem by providing that a party may register up to three emblems. It will be up to each party to determine whether it wants to register an emblem and, if so, whether it registers one, two or three. A candidate from a party that has more than one emblem registered may, however, use only one of them against his or her name on a ballot paper. This modest change will afford some welcome flexibility not only to the Conservative party but to all registered parties. I therefore commend the amendments to the House.
Mr. John Greenway (Ryedale):
After a five-hour interlude, we are back to electoral matters. This is likely to be the final debate in this long Session, but the nature and subject of the amendments is typical of so much that has gone before. We are being asked to examine and approve details of the Government's constitutional reforms that were clearly overlooked in the original
The Minister knows that I am charitable, and I do not hold him personally responsible--we have enjoyed working together over the past 18 months on many pieces of legislation, and Conservative Members are grateful for the amendments, which we support--but he will also know that we did not approve of having emblems on ballot papers. Why include emblems when we have managed so long without them? It is becoming increasingly clear that, under the Labour Government, voting for a party is more important than voting for a candidate.
It is clear, as it should have been clear to the Government, that the need for a Bill to register political parties has been prompted by the fact that people will vote for parties in elections for the Scottish Parliament and the Welsh Assembly; therefore it ought to have been obvious that there would be a requirement for more than three emblems. We objected to emblems and would prefer that no emblems were used, but if the Government want emblems, there ought to be more than three. I am surprised that it was not thought of earlier.
We agree with the amendment and are grateful to the Minister and to Lord Williams of Mostyn for the courtesy that they have shown. We feel that sufficient damage has been done to the Government's credibility as regards electoral reform proposals for one day to enable us to accept the amendment, even at this late hour.
Mr. Richard Allan (Sheffield, Hallam):
I shall not delay the House by entering into a debate about who should or should not determine the electoral systems that face the people of this country, but it is important that I register the Liberal Democrats' support for the amendment, which is one that we proposed at various stages during the Bill's passage. It is welcome, because it will allow parties in the constituent parts of Great Britain to register their own emblems in their own right, as Scottish, Welsh or English parties. On that basis, we fully support the Government, who have listened to the representations that were made. Having offered our support and registered it in the Official Report, I shall not detain the House any longer.
Lords amendment agreed to.
Lords amendments Nos. 2 to 8 agreed to.
Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),
Mr. Deputy Speaker (Mr. Michael Lord):
With permission, I shall put together the remaining motions relating to delegated legislation.
Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Betts.]
Mr. David Prior (North Norfolk):
I am pleased to have secured this vital debate on the future of intermediate care in north Norfolk. The issues raised will resonate in many other rural areas. I shall focus especially on the services provided by our community and cottage hospitals, which include rehabilitation. The debate builds on my Rural and Community Hospitals Bill, which I presented to the House last May, but which fell because of lack of parliamentary time.
In July 1998, the East Norfolk health authority produced for consultation a draft strategy document on intermediate services. The consultation period finished in October and the final decisions are promised next week, on 25 November. I want to use the debate to highlight my great concern about the effects of the health authority's proposed strategy on my constituency. The strategy implies the closure of several hospitals and I hope to elicit the Government's support in preventing any such closures. I think that the views I express are cross-party views in Norfolk, and I am delighted to see the hon. Member for Norwich, North (Dr. Gibson) present in the Chamber at such a late hour, although I sadly note the absence of any Liberal Democrat Members.
There are four community hospitals in North Norfolk, covered by the shadow primary care group North Norfolk Health. They are Benjamin Court in Cromer, Cranmer House in Fakenham, Kelling hospital outside Holt andthe Wells cottage hospital. In total, they provide 95 community beds, but the health authority proposes a staggering reduction in that number, to between 16 and 21 beds--a reduction of 80 per cent. Most incredibly, Benjamin Court is to be reduced from 36 beds to none. Benjamin Court, I should add, is almost brand new. That reduction, if implemented, would undermine the viability of Wells, Cranmer House and Benjamin Court. The most likely survivor is Kelling, for which the health authority suggest a much reduced requirement for 12 to 15 beds. That is ironic, because only two years ago Kelling was the hospital that the health authority was most determined to close. So much for consistency.
Are the health authority's forecasts for bed requirements right? Let us consider in contrast the views of North Norfolk Health, the primary care group. North Norfolk Health comprises 34 general practitioners in eight practices, covering 62,000 patients. Its assessment is that it needs not 16 to 21 beds, as the health authority suggests, but 65 to 75 beds. It believes that the health authority should do all it can to keep the cottage hospitals open in North Norfolk. North Norfolk Health's assessment calls for nearly five times the number of beds proposed by the health authority. In the case of Benjamin Court, North Norfolk Health see a minimum need of at least 23 beds, but the health authority see a demand for none.
Those discrepancies are massive and raise grave questions about the health authority's strategy. It is not good enough for the health authority to state:
Because of the discrepancies, the health authority, in October, belatedly and after the end of the consultation exercise, felt obliged to have an independent review of bed requirements by a consultancy firm called RKW. One might feel that that was rather late in the day, rather rushed and somewhat less than satisfactory. Personally, I am wholly underwhelmed by the review, not least because it provided no figures for north Norfolk, only for Norfolk as a whole; yet north Norfolk is a special case and different, because it has more existing community hospitals, more elderly people and, because it is so rural, suffers from public transport problems.
RKW came up with a range of community bed requirements for Norfolk of between 176 and 234. The higher end of the range is some 50 beds more than proposed by the health authority. When RKW announced its findings, it was accompanied by a great flash of intellectual brilliance when a spokesman for the company said, with no obvious irony:
The shambles over community bed numbers is matched by that over rehabilitation bed numbers. The health authority proposes 124 rehabilitation beds for Norfolk, excluding Great Yarmouth. By contrast, the department for medicine for the elderly based at the Norfolk and Norwich hospital believes that 180 beds will be needed--some 56 more. Moreover, RKW has produced another set of numbers which is nearly 50 per cent. higher than the health authority's number, and much closer to the number suggested by the department of medicine for the elderly. The same uncertainty that surrounds community beds also surrounds rehabilitation beds. Which figures are right? Evidently, no real science is involved.
RKW believes that, overall for Norfolk, as many as 416 community and rehabilitation beds may be needed, whereas the health authority thinks that only 316 beds are needed. Decisions about the future of our hospitals must not be taken on the basis of such uncertainty, not least because such decisions are irreversible.
Moreover, a number of other hugely significant factors, some of which are peculiar to Norfolk, also militate against taking any major decision on the basis of the health authority's strategy. First, North Norfolk Health will cease to be a shadow primary care group on 1 April next year when it will come into real existence with real powers. As stated in the Government's 1997 White Paper, the primary care groups
Secondly, the Minister will be aware that a new hospital is currently under construction to replace the Norfolk and Norwich hospital and the West Norwich hospital. The number of beds in the acute hospital will reduce from 1,037 to 809, a reduction of 228. There is already much local concern about that reduction, and it is aggravated by the suspicion that there is already pressure on the Norfolk and Norwich to discharge patients early to cut waiting lists. Many general practitioners in Norfolk talk openly about a revolving door syndrome, by which, to reduce waiting lists, patients are discharged from the acute Norfolk and Norwich hospital too early, only to be readmitted later.
With fewer beds in the new hospital, there will be added dangers of bed blocking and of rising waiting lists if there are too few community and rehabilitation beds. That concern has been highlighted both by Dr. Coni, a retired geriatrician from Addenbrooke's hospital, who has conducted independent clinical research on the health authority's behalf, and by the department of medicine for the elderly. In its submission to the health authority, that department said:
That the draft Education (Grammar School Ballots) Regulations 1998, which were laid before this House on 21st October, be approved.--[Mr. Jamieson.]
Question agreed to.
That the draft Social Security (New Deal Pilot) Regulations 1998, which were laid before this House on 29th October, be approved.
That the draft Parliamentary Constituencies (England) (Miscellaneous Changes) Order 1998, which were laid before this House on 4th November, be approved.
That the draft Jobseeker's Allowance Amendment (New Deal) Regulations 1998, which were laid before this House on 4th November, be approved.
That the draft Civil Procedure (Modification of Enactments) Order 1998, which was laid before this House on 5th November, be approved.--[Mr. Betts.]
Question agreed to.
12.22 am
"Further analysis work will be undertaken with local primary care groups at the implementation stage."
It will be too late by then.
"We are not able to predict what will happen in the future."
Quite. No one knows how many community beds will be needed in the future, and we do not need an expert to tell us that. It would be absurd to make any decisions based on the figures so far presented. If any of those figures are reliable, I would put my money on those from North Norfolk Health, because it is closer to the patients and their clinical requirements.
"understand patient needs and they deliver local services. That is why they will be in the driving seat in shaping local services."
North Norfolk Health has made it clear that it wants to retain the community hospitals, and to use their beds. It cannot be right that the health authority should, only four months before the PCG starts, pre-empt that view on such a critical issue.
"The proposed reduction in rehab and community beds will lead to a large number of patients waiting in the acute hospital for intermediate care, which will in turn seriously affect the acute hospital's ability to meet its waiting list targets for elective surgery . . . Without adequate intermediate services the ability of the acute hospital to function effectively will be seriously compromised . . . Quite clearly the access to intermediate services in community hospitals is of crucial importance to the acute hospital."
Too great a reduction in community hospital beds could undermine the effectiveness of the new hospital and increase waiting lists. That risk cannot be worth taking. We must have some insurance in the system.
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