Motion made, and Question proposed, That this House do now adjourn- [Mr.Pope]
I am grateful for the opportunity to raise this important issue in an Adjournment debate. The future of Wharfedale general has long been a subject of local debate and concern in the communities it serves. The hospital is highly regarded. Performance indicators prove that it provides quality care, efficiently and effectively, to more than 6,000 in-patients and day-case patients a year, as well as to many out-patients.A business plan produced by the United Leeds Teaching Hospitals NHS trust to justify the continuation of the hospital listed a number of strengths. They included the loyalty of purchasers, the commitment of staff and the community, the range of services and accessibility, the availability of parking, no or low waiting lists—a crucial issue—a broad range of open-access therapy services, a wide range of purchasers, a strong minor injuries unit, and a potentially valuable site. About 40 per cent. of the hospital's patients are drawn from the Guiseley, Yeadon, Rawdon and Horsforth communities within my constituency. A similar number come from that of my hon. Friend the Member for Leeds, North-West (Mr. Best). I trust that he will succeed in catching your eye at the appropriate moment, Mr. Deputy Speaker. One of the hospital's greatest advantages is that it provides such excellent care away from the expensive, high-tech, congested, city-centre-based teaching hospital of Leeds general infirmary. Two years ago, the debate on the future of the hospital appeared to have reached a critical, yet positive, watershed. The United Leeds hospital trust began a consultation process on where a new Wharfedale general might be built. That seemed to imply that the hospital's future was secure. That sense of security has been backed up in a variety of planning documents in recent years—for example, the trust's own business plan and strategy, and the Leeds review—a major examination of acute health care in the city—and more recently in Leeds health authority's consultation document, "The Future of Health Services in Leeds". Each of those important documents has acknowledged the vital future role of the hospital. Given all that apparent commitment, why have I insisted on keeping my hon. Friend the Minister from his cocoa? In July 1995, almost two and a half years ago, the trust submitted an outline business plan to the regional office of the national health service executive. It was at that point that the circumstances that gave rise to tonight's debate began to unfold, and then to fold up. Initially, the issue became a ping-pong game between the NHS executive and the United Leeds hospital trust. Ping—the trust served up its outline business plan in July 1995. Pong—the regional office eventually returned it requiring more information. Ping—the trust went for an outright winner by supplying more information, but— pong—the region lobbed it back. Backwards and forwards it went. The game was an infuriating spectacle for the local community that is served by the hospital. But worse was to come, for there came a time when there was neither ping nor pong, but merely a deafening silence. It seemed that the ball had disappeared, and each side seemed to be claiming that the other had it in their pocket. I do not want to take up valuable time relating all the minutiae of this Byzantine farce. Three short quotes will serve to sum up the impasse that I hope this debate will help to remove. David Hall, the chair of the trust, told me two weeks ago:
Mr. Ron De Witt, the chief executive of Leeds health authority stated during the same discussion:"We have done everything humanly possible to meet the requirements of the Regional Office in producing our outline business plan."
However, Dr. Bill Kirkup, director of the region's NHS trusts division told me:"The Trust's business plan is one of the best I have ever seen."
I am reminded of the much-quoted song from the Fred Astaire musical—Leeds says "potayto", the region says "potahto", Leeds says "tomayto", the region says "tomahto", and so on. The crunch comes in the song's punch line:"We definitely see a future for Wharfedale General, but we cannot approve the Trust's Outline Business Plan on the strength of a business case from 1995 updated by a series of addenda."
Local people fear that, if this continues, the whole thing will eventually be called off. Their fear is understandable. As I have tried to show, precious little progress has been made in planning the hospital's long-term future. However, day by day, a great deal is happening, and it is not good. In the past month, a ward has closed. Last week, the trust agreed a package of further cuts that will dramatically affect the hospital. The hospital is like a cherished old friend dying of starvation because his doting hosts cannot decide what to feed him on. Whether the menu is potato or potahto, the planning process is, at best, in a persistent vegetative state. Some might say that, bereft of life, it lies extinct. I do not ask the Minister to play the pathologist and carry out a post mortem; I would prefer him to cast himself in the role of casualty consultant and resuscitate the ailing patient. To be cruder, I hope that he will figuratively, if not literally, apply some firm shoe leather to the appropriate part of the NHS management anatomy to jolt it back into some form of activity. I realise that such treatment is contained in no medical text, but everyone connected with the hospital despairs of the planning paralysis. I conclude with three appeals to my hon. Friend the Minister. First, please intervene to end the state of paralysis. Secondly, please ensure that everyone concerned is clear about what needs to be done. Thirdly, please lay down a time scale within which we can expect those objectives to be achieved."Let's call the whole thing off."
I wholeheartedly endorse observations of my hon Friend the Member for Pudsey (Mr. Truswell). I too have been involved with the sort of confusing and bemusing delays that I hope this evening's debate will help to resolve.Wharfedale hospital, which is in my constituency, has been at the centre of several campaigns, not least during the general election, in which it made a considerable contribution to the outcome in my constituency. It is one of those wonderful parts of our health service that is at once a community hospital and a general hospital. It serves both functions exceptionally well. It covers a wide area, and several Labour Members present tonight have had and will have constituents in it. I have been in the hospital three times. I live about 13 miles from it. It is often easier to travel the 13 miles to the hospital than it is to travel to the centre of Leeds. The hospital is in Otley, which is in the beautiful part of lower Wharfedale which I am pleased to represent. The hospital has benefited from generation after generation of community commitment through fund raising and volunteer services. Everyone concerned considers the hospital essential for the provision of the one-class, first-class health service to which I referred in my maiden speech. The people of its catchment area, the people who serve those people, and various bodies including clinicians, have all given credence to the observations of my hon. Friend the Member for Pudsey. It is a fine hospital. Among those notable bodies is no less a body than Otley town council, which has campaigned for many years to defend the hospital and the services that it offers to the community in its wide geographical band. Some hon. Members who are not present have constituents who benefit from the hospital. It is only fair to say that that campaign by Otley town council has in recent times received considerable support from the local business community. One business has made the offer of land and is prepared to assist with capital in the development of a new hospital in the area. In short, we have a united group of people in Wharfedale who are in desperate need of a modernised, well-appointed hospital. We are being confounded by what appears to be a lack of concentrated and serious effort to bring about that which is commonly held to be needed. What my hon. Friend the Member for Pudsey had to say is that which we should consider here tonight. I look forward to hearing from my hon. Friend the Minister what he hopes to do. The need is desperate. There is a need beyond easy measure tonight for a modern and secure Wharfedale hospital. It is my hope that that need will be met soon. I look forward to it, and to hearing what our Minister has to say and what he might do.
I congratulate my hon. Friend the Member for Pudsey (Mr. Truswell) on securing the debate, and my hon. Friend the Member for Leeds, North-West (Mr. Best) on contributing to it. They have both raised issues which are clearly significant for the people of the area that they represent, and those nearby. The issues that they have raised have wider implications for the national health service, and the way in which we plan our local health services.As both my hon. Friends have made clear, Wharfedale hospital is above all else a popular hospital, but it is an old hospital. It has its origins in the last century. Most of the present buildings were developed in a piecemeal fashion between the second world war and the 1960s. I understand from what I have heard this evening and from earlier conversations with my hon. Friends that the accommodation is in poor condition, and that it is unsuitable for providing health care into the next century. As my hon. Friend the Member for Pudsey implied, proposals to replace the hospital with more suitable premises go back over 10 years. Sadly, none has made much progress. I understand the frustration that this must have caused my hon. Friend and his constituents. My hon. Friend the Member for Leeds, North-West described the process as bemusing, and I understand why. As recently as 1995, responsibility for Wharfedale hospital passed to the United Leeds Teaching Hospitals NHS trust, which concluded that the hospital was unsustainable in its present buildings. At that time, I ask my hon. Friends to recall, the NHS around Leeds, as elsewhere, was being asked to operate in an environment of competition, in an internal market for health care. The populations served by Wharfedale hospital were the responsibility of three health authorities—Leeds, Bradford and North Yorkshire—and significant services were also purchased by fund-holding GPs. Hospital and community services trusts in Airedale, Bradford and Leeds would have been affected by any change in the nature and extent of services provided at Wharfedale, perhaps in some cases critically affected. The problem was that there was no mechanism to enable a co-ordinated approach to be taken across those various organisations, to ensure that plans were integrated and coherent. In this context, it is important to note that Wharfedale hospital is situated in a town of some 12,000 people, but its catchment population amounts to almost 200,000. My hon. Friend the Member for Leeds, North-West made that point graphically when he spoke about his own experiences of Wharfedale. My hon. Friend the Member for Pudsey described what had gone on as a game of ping-pong. Certainly people in the local community must not have known whether they were coming or going. My hon. Friend asked me to play the role of a casualty consultant. I am not sure that I am up to that, but perhaps I can play the role of a management consultant and try to explain what happened in the past under the previous Administration, and bring some clarity to what will happen in the future under Labour Administration. When any investment is planned in health services— especially a major one—it is vital that, the proposal can demonstrate, first, that the health care needs of the population have been identified; secondly, that they would be met by the investment; thirdly, that the proposed service is sustainable in the future; and finally, that it represents good value for money and is affordable within the overall resources available. All those requirements have to be met for plans to be approvable as a good use of taxpayers' money. Taking into account those requirements and the fact that, under the internal market system, there was no mechanism for integrated planning, I am not surprised that it was not possible to come up with a sound proposal that got the agreement of all parties and secured the approval of the NHS executive. Nor would I regard that as due to any shortcoming on the part of those involved. It was the product instead of a set of policies—those of the previous Government—which put competition ahead of collaboration, which prized opportunism above partnership and which led to fragmentation instead of integration. All this will clearly not do for the people who look to Wharfedale hospital. In bringing to an end the idea of an internal market for health care, the Government will be putting forward a better approach that involves partnerships between all of those who should be involved in the provision of local services. However, I agree with my hon. Friends that this matter can and should wait no longer for resolution. I have therefore already asked officials to look at the matter afresh in the new climate that we have created for planning in the NHS. From the work that has already been carried out, I have been assured that several key principles have been established. First, there is no doubt that there is a need for a modern health care facility in the vicinity of the present Wharfedale hospital. Secondly, because of the unsuitable state of the existing buildings, new accommodation must be provided. Thirdly, I can assure my hon. Friends that there is no "hidden agenda" to run down the present level of provision in Wharfedale hospital until it becomes unviable. I know that there are real concerns in the community that there is such an agenda, but I assure my hon. Friends that there is not. In the new environment that we are creating to foster the sensible planning of health services, I am confident that approvable proposals can be drawn up without further delay. I have been assured that my confidence is not misplaced and that discussions to this effect have already occurred between NHS executive officials and local trust managers. I shall insist that a clear timetable is produced, so that public uncertainty surrounding the future of the hospital can be resolved as quickly as possible. Towards the end of his speech, my hon. Friend the Member for Pudsey asked me to respond to three appeals, and I am happy to do so. First, it is clear that the planning paralysis has already ended. Our intentions for the future of the NHS have played a part in that, but my hon. Friends' intervention this evening has helped to concentrate the minds of all those involved in the process. Secondly, everyone is clear about what is now needed. Useful and productive discussions have already begun, and I shall ensure that they continue. Thirdly, I have referred previously to the need for a clear timetable, which I shall require of the local managers. I will write to both my hon. Friends when that timetable has been drawn up. It is vital that there is careful consideration, with clinicians, of the services provided now and in future at Wharfedale hospital to ensure that they represent the most clinically effective arrangements possible for the care of the resident population. I am confident that we now have an environment in the NHS in which such planning can take place in partnership with all the relevant agencies. The result will be the production of a proposal to replace Wharfedale hospital with modern facilities able to offer clinically effective services to meet the health care needs of local people in a way that is both sustainable and affordable. Any proposal will be the subject of full local consultation. Local people continue to demonstrate strong commitment to Wharfedale hospital, and they deserve an early response, which I am pleased to say can and will now take place.
Question put and agreed to.
Adjourned accordingly at twenty-three minutes past Ten o'clock.