The Parliamentary Under-Secretary of State for Health (Anna Soubry)
First, I congratulate my right hon. Friend the Member for Tonbridge and Malling (Sir John Stanley) on securing the debate and on the many questions that he has raised. As the clock is against me, I shall deal at the beginning of my response to his speech with some of the issues that he has specifically asked me to deal with.
It strikes me that these matters should and could have been dealt with locally. As my right hon. Friend will appreciate, one of the Government’s aims has been to ensure that national politicians do not get involved in the stuff of sorting out the NHS locally. He raises concerns about his local PCT and calls into question procedures undertaken by it. He says that decisions that it has made should have been referred to the overview and scrutiny committee. I do not know whether that is right or wrong. What I do know is that it is incumbent on local politicians to raise such matters, as they do the length and breadth of England. It may be that the horse has bolted from the stable and it is too late, but I think that I can say with some certainty that it is not the role of the Secretary of State for Health to seek legal opinion on whether the PCT has acted lawfully.
With respect to my right hon. Friend the Member for Tonbridge and Malling, I suggest that those are local matters, to be determined locally, and it is for the league of friends, himself, councillors and other concerned people to look into the legality of the decisions that have been made and the processes that have been chosen. It is for the local NHS and local politicians to deal with that. It is not the role of Whitehall and Ministers to get involved in the stuff of local NHS decisions and those processes.
Sir John Stanley
The league of friends and I have pursued these issues in detail over a considerable period with the local PCT. Does the Minister not agree that under primary legislation, the Secretary of State ultimately has a responsibility for addressing issues of NHS trusts’ compliance with statute?
I am grateful to my right hon. Friend for his comments. I will look further into the matter. I cannot give a definitive answer, but in my experience such matters are invariably taken up by local politicians, often led by their local Member of Parliament, who go to the overview and scrutiny committee of the county council to urge upon it all the reviews and challenges that he has sought and raised in this debate. I will, however, look into this further, and if he will forgive me, I will come back to him probably by way of a letter or a meeting between the two of us. May I move on to the future of his community hospitals?
I am reliably informed that there are no plans whatsoever to close either of the two hospitals. I will get through as much of my speech as I can in the time available—I will be guided by you, Mrs Osborne, but I think I have to sit down at half-past 4. I make it absolutely clear again that the future of hospitals is not determined by national Government, but is in effect determined by the local commissioning process. From what I am told, there is no reason to fear for the future of either the Tonbridge Cottage hospital or the Edenbridge and District War Memorial hospital, because the services that they provide will be commissioned by the local clinical commissioning group. They are doing a grand job now, so there is no reason to think that they will not continue to do a grand job, and therefore their services will continue to be commissioned.
Many Members have great affection for their community hospitals, and rightly so. As my right hon. Friend alluded to, they provide a wide range of vital services, from minor injury clinics to intensive rehabilitation. They inspire much love and respect in their communities. They are fiercely defended and rightly inspire loyalty.
My right hon. Friend and the local league of friends have raised the issue of the beds at Tonbridge hospital. I am not the PCT’s mouthpiece, but as he will appreciate, inquiries are made and I am supplied with information. I am assured that the 12 community beds in question were designated as general rehabilitation beds. They were then redesignated as stroke rehabilitation beds and are now housed in the new £400,000 purpose-built stroke unit, which opened at the hospital in September 2011. The PCT then created 12 additional general rehabilitation beds across west Kent, to replace the 12 community beds that had been redesignated. Of those 12, two, as he mentioned, are at Tonbridge hospital. We do not agree that there was a loss of beds, because 12 of the beds became stroke rehabilitation beds. I take the point that there were 12 community beds previously and now there are two community beds, but we should not forget that there are an additional 12 stoke rehabilitation beds.
It was the opinion of the PCT at the time that there was no real change in the use of the beds at Tonbridge hospital, because their primary function had been rehabilitation. The 12 community beds were designated for rehabilitation, and the 12 stroke beds are obviously for rehabilitation, too. The hospital has gained two extra beds for community rehabilitation that were designated specifically for older people. The PCT therefore considered that there was no real service change, so it did not deem formal consultation necessary or appropriate.
The Government have pledged that in future all service changes must be led by clinicians and patients, not driven from the top down. That principle has been at the heart of our reforms for the NHS. To that end, we have outlined and strengthened the criteria that we expect decisions on NHS service changes to meet: they must focus on improving patient outcomes, consider patient choice, have support from GP commissioners and be based on sound clinical evidence.
Everything that we do in central Government is designed to support local clinicians and patients changing the local NHS for the better and to ensure that improvements are made to primary and community services. As a result of the Health and Social Care Act 2012, primary care trusts will be abolished from April 2013 and responsibility for commissioning services will move to clinical commissioning groups, so local doctors, clinicians and experts are in control. I see no reason why they would not commission services from those two excellent community hospitals.
My right hon. Friend mentioned the community hospital estate and its future. The 2012 Act requires new ownership arrangements for current PCT estates. In August last year, the Department of Health announced that NHS providers would have the opportunity to acquire parts of the estate. Therefore, providers, such as community foundation trusts, NHS trusts and NHS foundation trusts, will be able to take over those parts of the PCT estate that are used for clinical services. That of course includes the community hospital estate. We have put safeguards in place, so that providers cannot just dispose of newly acquired land and make a quick profit. I hope that that satisfies him.
Sir John Stanley
Before the Minister concludes, will she respond to my request that before Ministers take a final decision on whether individual hospital properties go to NHS providers or NHS Property Services Ltd, they consult on the proposed final destination of the properties, so that local people have an opportunity to express a view?
I cannot give that undertaking. The point is well made; I will take it back to the Department and ensure that the Secretary of State is aware of it. Many such decisions will be taken locally. My right hon. Friend and the league of friends should continue to make all the representations that they have already made, and I know that they will do so.
The safeguards have been put in place. As my right hon. Friend knows, where any former estate becomes surplus to NHS requirements, 50% of any financial gain made by the provider must be paid back to the Secretary of State for Health and will go straight to front-line NHS services. Based on what I have been told and what I have seen in the 2012 Act, I am of the view that if a community hospital—if this is what occurs—is transferred to NHS Property Services Ltd, it will not in some way be deemed surplus to requirements by NHS Property Services Ltd.
The two hospitals that my right hon. Friend rightly champions would only ever become surplus to requirements if the CCG stopped commissioning their services. I am told that that is extremely unlikely to happen. He should have no fear at all that NHS Property Services Ltd will sit and looking at its assets and simply decide to sell things off for a quick buck. The hospitals’ future is secure. I thank him for securing the debate and for the points that he has made. I have not answered them all, but I will, in either a meeting or a letter.