Whitsun Adjournment

May I take the opportunity presented by this traditional recess Adjournment to say a few words about an important subject for south-east London—the reconfiguration of the hospital and health care arrangements in that part of the world. Speaking as the MP for Orpington, I am especially concerned about the impact on my constituency, as well as on the constituency of Bromley. As the Minister will be aware, the Secretary of State for Health has made some momentous decisions in recent weeks and days, which will have a major impact on the provision of health care services in the area. What were those decisions? First, the Secretary of State accepted the findings of the review by the independent reconfiguration panel of the proposals for changes in the location and delivery of health care services under the "A picture of health" programme. The major changes will apply to the area's three big hospitals: the Bromley Hospitals NHS Trust, the Queen Elizabeth hospital, Greenwich, and Queen Mary's hospital, Sidcup. Secondly, as well as looking at the provision of health services, the review looked at the whole business of the trusts and their arrangements. Of the three already quite sizeable trusts, one new trust has been created: the South London Healthcare NHS Trust. That came into being on 1 April, with a new chairman, a new chief executive and further appointments to follow. I say in passing that, for me, that represents the end of a long campaign to get committed management into the health service in south-east London. We previously had managers based there for no longer than six months at a time. With that sort of episodic approach to management—to put it politely—none of the big issues was ever going to be properly tackled. Now we have a management who are committed to the future—for a long time, I hope—and should be able to see through some of the necessary changes. The third aspect, which I would like the Minister to draw to the attention of the Secretary of State for Health or other Health Ministers, has not yet happened, but will begin to happen over the next six months. I refer to the financial restructuring of the new trust, which must accompany its creation and the reconfiguration of services in the area. That is mainly a matter for the London NHS, but none the less, since the money is huge, I am sure that Ministers will play a role—and I certainly hope they do. The financial situation that the new trust has inherited is indeed dire. The total deficit is likely to exceed £200 million in the not too distant future. That is a huge deficit for any NHS hospital trust to have. In addition, the trust continues to have an operating deficit year by year. It amounts to a financial position that I would suggest is almost unprecedented in the history of NHS trusts. How it came about is something that I have sought to explain in previous speeches. I spoke in a Westminster Hall debate on 28 October 2008—from Hansard column 210—so I shall not go over it again; it is now history. The truth is that nobody—not the Government, not NHS London, not the PCT, not the hospitals—emerges with any credit from the circumstances. The Government have a financial obligation to provide a proper financial basis for the new trust in order to get it off to a good start. My understanding is that the management are now working on a financial plan and that it should be delivered over the summer for final consideration in the autumn. I hope that the Government will monitor the position carefully and keep it to plan. The management will obviously have to accept tough targets; they cannot simply be given the money without making serious attempts to meet considered targets. It is to those targets that I now wish briefly to turn. The Government have a sort of bird's eye view of the local circumstances, but I want to present, if I may say so, a worm's eye view. It goes from the bottom up, which is equally important to the top-down view that will influence the Government: both are necessary in order to produce a balanced viewpoint. With the aid of the worm's eye local perspective—that of local users and local patients—I would like to make three or four points. First, let me deal with staffing. With the financial mess that we have seen, the staff of these hospitals have gone through a very difficult period. It is to their great credit that they have turned in such an excellent performance, particularly when some have simply not known what is going to happen to their local hospital or even their job. I pay tribute to them for what they have put up with during this period; that needs to be said. The difficulty for an outer-London hospital is that its consultants, doctors and nurses do not get inner-London weighting, so the hospitals are always at a disadvantage in competing with inner-London hospitals for staff. Understaffing has been a real concern and, in some areas—I do not want to name them—it is potentially dangerous. One of the objectives of the merger, and of the creation of this huge trust, is to provide a proper career structure with more pay bands to overcome the disadvantage of having no inner-London weighting and to attract good staff. I certainly hope that that happens. It is also important that the staff are better consulted than they have been in the past about the proposed reconfiguration of services. The report by the reconfiguration panel says that the future of Orpington hospital should""be clarified urgently and hospital staff be fully involved in all further considerations."" That is important, because the hospital is well loved in the area. It is part of the Bromley Hospitals NHS Trust, along with the Princess Royal University hospital. The staff have not known what will happen, and they must now be given some indication of future planning. That has not happened in the past, but it should happen in the future. Physical access to hospitals is never given sufficient attention by hospital planners. People need to get to hospitals without wasting time or paying too much. When I recently visited my local hospital, the Princess Royal University hospital in Farnborough, it took me half an hour to find somewhere to park my car and in the end, I had to park illegally—I hope that that admission will not be held against me—to get to the hospital on time. If that happens to me, it must also happen to many of my constituents, and something must be done. I have no answer to that problem, but it is a problem. It is said that people can use public transport, but in the real world, people use their cars to get to hospital, especially when public transport is not very good. It has improved a bit in the area, but it could be better.