NHS Services (Hertfordshire)

My hon. Friend is correct. Anybody with any management experience would know that that is precisely the case. I am delighted to inform hon. Members that the hon. Member for Watford (Claire Ward) has had a baby. I congratulate her on behalf of the Conservatives. That is the best excuse for not attending a debate. However, there is no excuse for the hon. Member for Stevenage (Barbara Follett), who has not had a baby. The savings that I have mentioned, which are equivalent to 8,000 nurses a year, are so high risk that the SHA has told the Department of Health that it requires a control total of £99 million, but expects that downward pressure will be applied to the control total requested by the SHA. With that cash squeeze, it is unsurprising that the SHA area is resorting to drastic measures. In 2006-07, the SHA is reducing education places by 12 per cent. on the previous year—a total of 122 places—and is looking to shed 1,100 whole-time equivalents. In addition, underspends are not being returned and the primary care trusts are required to deliver 3.5 per cent. in cash-releasing efficiency savings. Cuts to mental health services were ably described with deep concern by my hon. Friend the Member for North-East Hertfordshire (Mr. Heald). We are also talking about cuts in podiatry, a transfer of thrombolysis services and cuts to sexual health services. My hon. Friend the Member for St. Albans (Anne Main) also cited a long list of services knowledgeably, robustly and compassionately. The situation is so bad in the west Hertfordshire quadrant that the auditor issued a public interest report in April 2006, which highlighted the apparent weaknesses in the arrangements established by the PCTs to ensure effective financial governance and the poor financial information being presented to the board. The auditors also highlighted the adverse impact of the considerable uncertainty caused by NHS restructuring. Most of all, the auditor’s report shows that Ministers have failed in their duty to oversee our NHS, as my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley) ably illustrated in his contribution. This crisis did not happen overnight. For example, the West Hertfordshire Hospitals NHS Trust’s deficit grew from £4.6 million in 2003-04 to £14.6 million in 2004-05 and £43.2 million in 2005-06. In both 2003-04 and 2004-05, the Audit Commission’s relationship manager for the SHA reported on the weaknesses in financial management and the structural issues contributing to the poor financial standing of all bodies in the Bedfordshire and Hertfordshire SHA area. Furthermore, the public interest report constitutes one of the 20 referrals in 2006 of NHS bodies to the Secretary of State under section 19 of the Audit Commission Act 1998. There were seven referrals in 2005, two in 2004 and none in 2003. This is a worsening picture. In addition, auditors posted 93 qualifications on the accounts last year—accounting for the doubling in the forecast NHS deficit for 2004-05—53 in the previous year and none in any year before that. The problem of NHS deficits has not suddenly appeared; it has been allowed to worsen because of the failings in the Department of Health and among its Ministers. My hon. Friend the Member for Hertford and Stortford (Mr. Prisk) quoted the Secretary of State talking about the best year ever. He also observed rightly that reorganisations are often the Government’s only retreat to try to escape accountability and blame others. Above all, failed managers are being recycled, thereby demoralising the best, who move on and out. We have a downward spiral of morale and performance. Despite the financial difficulties, it is unacceptable that the former SHA area should be forced to make cuts to front-line patient services to find cash, especially where such cuts are driven by financial rather than clinical needs. Regarding the West Hertfordshire Hospitals NHS Trust, we have heard about the scaling down of services at Hemel Hempstead and the building of an independent sector treatment centre there. My hon. Friend the Member for Hemel Hempstead (Mike Penning) eloquently described how the argument for the introduction of the treatment centre puts the cart before the horse. That is no way to manage our NHS. Does the Minister find it acceptable that most of a relatively new hospital should be demolished and turned into a housing estate because it is ““surplus to requirements””? Acute and emergency services are to be centralised at Watford general. Can the Minister guarantee that that will in no way affect patient care? The trust has announced upwards of 700 job losses and 878 bed cuts. East and North Hertfordshire NHS Trust, which has to save £69 million over three years, is set to lose 100 jobs and 1,055 beds, as described in a passionate and sincere speech by my hon. Friend the Member for North-East Hertfordshire. In addition, services are being decimated at the QEII hospital in Welwyn. Part of the difficulty for hospitals has been the financial pressure put on them by primary care trusts, although it is the organisations that do not have payment by results, such as the mental health trusts, that are most at risk from cuts in front-line services by the eight Hertfordshire PCTs, all of which are in deficit. The effect on, for instance, Potters Bar community hospital was rightly and graphically described by my hon. Friend the Member for Hertsmere (Mr. Clappison). Two sites are being forced into one as a ““solution””. Above all, as my hon. Friend and others rightly highlighted, this leads to a serious collapse in trust in the Minister and the ministerial team, because of what they have said about community hospitals. There was, rightly, a huge outcry when confidence was undermined by the various messages that appeared to be coming out of the Government, but then the Secretary of State corrected that impression at the Dispatch Box. As my hon. Friend said, surely this is the time to step in and stop the permanent loss of services to his constituency. Most worrying is the fact that the services are being closed down without hope of substitutes. Both the private finance initiative rebuild at Watford and the PFI super-hospital at Hatfield seem to be frozen. The latter has already been downgraded and there is no indication that either will ever arrive. Auditors have highlighted problems with financial management in the Hertfordshire area, but the struggle in that area is symptomatic of an NHS that has been centrally mismanaged. The fact that deficits are arising in places such as Bedfordshire and Hertfordshire, Thames Valley and Surrey and Sussex—the areas that are hardest done by in the resource allocation—reflects the fact that those areas are becoming too underfunded. Constant central restructuring has contributed to the difficulties, as has the scandalous political meddling in the PFI programmes, such as the one at Hatfield, laid bare in the powerful speech of my hon. Friend the Member for Welwyn Hatfield (Grant Shapps). However much the Secretary of State and her Ministers may dislike the south-east and middle-income Britain, is there any credible effort that the Minister can make in her speech now to start rebuilding the trust between them and the people of Hertfordshire, represented so passionately and ably by my right hon. and hon. Friends? Do this Government govern for all or just for the reducing number of Labour voters in this country? Will the Minister now commit to a simple ministerial duty—fairness to all—and correct here today the deep, damaging unfairness that has been done to the people of Hertfordshire’s health under Labour?