asked Her Majesty's Government:
What plans they have to rebuild the Royal National Orthopaedic Hospital.
My Lords, we recognise that some of the current buildings at the Stanmore site are not ideal. The Royal National Orthopaedic NHS Trust is developing proposals for modernising its service and estates. The London regional office of the NHS Executive is in active discussions with the trust and local health authorities to consider a way forward.
My Lords, I thank the Minister for that reply, although it does not appear to be quite up to date. I understand that the London regional office has agreed that the hospital should be redeveloped on the Stanmore site. Is the Minister aware of the discussions which continued over years as regards whether the hospital should join the Royal Free or another institution? Is he further aware that, of the 6,500 operations performed at the hospital, over half are performed on patients who do not come from the London area? Does he agree that the hospital should live up to its name and become a national hospital? Given that fact, funding provided to rebuild the hospital on the site should not be borne only by the London region.
My Lords, the noble Baroness is right to say that many patients treated at the hospital come from outside the London region. However, the financial arrangements, certainly in relation to revenue, are reflected in the service agreements made between the trust and individual health authorities from where the patients are referred. As regards the capital programme, no such agreement has been made. The trust has put forward a proposal to the London regional office for a capital programme to be completed in a number of phases, totalling around £50 million. That is being considered, but no decision has yet been made.
My Lords, the Minister referred to the situation as regards capital, but can he give a little more detail on revenue for the hospital? Is it not the case that hospitals such as this, which is essentially national in nature, are now dependent on the operation of proper out-of-area treatments?That applies also to Great Ormond Street, Stoke Mandeville and other valuable institutions. Does the Minister plan to review the methods of funding out-of-area treatments and. in particular, will he consider proper national funding of these tertiary centres to ensure that they develop and thrive?
My Lords, I do not agree with the noble Lord. The income breakdown for the hospital is as follows: current revenue runs at around £43.5 million; £28.5 million arises from service agreements with health authorities and primary care groups; £6.6 million is the result of national specialist commissioning; and other moneys come in from income from patient care and non-patient income. Income from out-of-area patient treatments amounts to £1.9 million. I am satisfied that this funding stream is a suitable way for the hospital to be funded. It recognises both the national position it occupies through national specialist commissioning and its provision of services to residents from a large number of health authorities which hold service level agreements with the trust.
My Lords, some time ago I was a patient at the Royal National Orthopaedic Hospital. Does the Minister agree that we should celebrate the achievements of such national centres of excellence—in this case we can celebrate an international centre of excellence? That being the case, should we not, make it a priority to give such institutions the facilities they need in order for them to carry on their pioneering work?
My Lords, I certainly agree that we should be proud of the achievements over many years of the Royal National Orthopaedic Hospital. Other orthopaedic hospitals such as the Nuffield Orthopaedic Centre in Oxford, where I was once employed, also have a proud claim 10 being international centres of excellence.I fully accept that the buildings at the hospital are not ideal at present. That is why the trust has made its proposals and the London regional office is currently considering them.
My Lords, is it not a fact that the hospital is currently housed in what might almost be described as substandard huts? People attend the hospital simply because the quality of the care is so good. In view of his remarks concerning the £50 million, can the Minister comment on the fact that I was told that a scheme of£28 million was agreed with the region? A spare part of land belonging to the hospital would be sold off for £14 million, bringing the net cost to £14 million. Can he comment on those figures?
My Lords, I do not think that I can go further than the comments I made in my previous response. The trust has put forward proposals which would amount to the wholesale redevelopment of the site. In total, the costs will come to £50 million. Those proposals are being considered at the moment. However, I am also aware that the trust has made an interim bid to the regional office for the refurbishment of the operating theatres and the TSSU. Those works would come to around £500,000. The proposal is also being considered by the regional office. It is hoped that the office will come forward with a speedy response.
My Lords, I understand that the trust has an in-patient unit in Bolsover Street in London. Can the Minister say what plans there are for that unit?
My Lords, it is planned that the out-patient unit should move from its current site to the Homeopathic Hospital in Queen Square. The Homeopathic Hospital will decant into the Bolsover Street car park for a couple of years. A newly refurbished hospital will open in 2003 on the site of the Homeopathic Hospital. The consultant "orthopods" will, no doubt, have much to discuss with the homeopathic practitioners.
My Lords, perhaps the Minister can tell me whether my understanding of what he said is correct. He said that £500,000 will be spent on refurbishing operating theatres which, in the near future, one hopes, will be pulled down in order to make space available for new buildings. How long will the consultations take? Is it not a waste of money?
No, my Lords. Even with the "speed-up" that the Government have introduced into the development of new capital programmes it will take some time to build a new hospital, if that is agreed to. It is important that we do not blight the existing use of these theatres by not giving them a lick of paint and refurbishing them in the interim period. It would be very unfortunate if no progress was made on refurbishment over a number of years. We should look at this issue with some sympathy.