South London Healthcare NHS Trust

Debate between Earl Howe and Baroness Wheatcroft

Thursday 31st January 2013 Lords Chamber

[Earl Howe]

My advice is that there is no case for waiving that practice. As I said, it is a long-standing principle and indeed the practice of successive Governments that legal advice is given to Ministers in confidence. Therefore I am afraid that I cannot accommodate the noble Lord’s suggestion.

To answer the question asked by the noble Lord, Lord Kennedy, about visiting Lewisham Hospital, I have not done so personally. I try to visit as many hospitals as I can. If I am able to fit Lewisham into my programme, I would be happy to do so.

[Baroness Wheatcroft]

My Lords, I declare an interest—as so many have—in that my three children were all born in Lewisham Hospital. Thus I share the emotional feeling of many that it seems unfair that Lewisham should be penalised for the spendthrift ways of other NHS trusts. However, my understanding is that Sir Bruce was asked to look not at the financial implications but at the patient implications of restructuring. He has done that and is satisfied with the result. One thing he points out is that, in the future, not every hospital would have the capacity to offer intensive care after maternity care. One of my three children needed intensive care. If Lewisham cannot provide the highest of high-tech intensive care, then some hospitals in London will have to. The issue is that, given the high technology that is now coming in to medicine, not every hospital can be a centre of excellence. We have to spread the resource. That means some hospitals will specialise. As somebody who benefited from what was then the best of intensive care, I am very keen to see that London, and in particular south-east London, should be able to offer that. However, I accept that not every hospital that provides maternity services will be able to. Can the Minister tell me whether he can see—because I cannot—any reason why Sir Bruce would have reached the conclusions that he had, in print, if he did not actually believe them?

[Earl Howe]

I am grateful to my noble friend and agree with all that she has said. In making this very difficult decision, my right honourable friend’s primary concern has been to protect outcomes for local patients. Indeed, the logic behind these proposals comes from the clinicians themselves, who came together from across London—way before the TSA was appointed—to develop a series of standards for certain conditions. These are based on the simple principle that a critical mass of highly qualified specialist consultants in one place, on a 24/7 basis, available to see patients within one hour and backed up by the latest medical equipment, will give patients better outcomes. At present, no south-east London hospital meets all the emergency or maternity clinical quality standards. Achieving those standards will mean accommodating acute in-patient care across fewer sites. The result will be that people in south-east London will continue to have much better access to A&E and specialist maternity units than the majority of the population in England, and the prediction is that up to 100 lives a year will be saved by this rearrangement of services. My noble friend has raised a very important point because this is about better patient outcomes.

NHS: Private Finance Initiative Costs

Debate between Earl Howe and Baroness Wheatcroft

Wednesday 11th July 2012 Lords Chamber

[Earl Howe]

The noble Baroness makes an important point and it is one that I was aware of some years ago when I visited a PFI-funded hospital. She is right; it does sometimes depend on the relationship established between the contractor and the hospital management but many of these contracts do result in exactly the kind of sclerosis that she has described. It is a lesson that we need to learn for future PFI schemes.

[Baroness Wheatcroft]

Will the Minister tell the House whether the Government have investigated the possibility of clawing back fees from those private sector advisers who helped the previous Administration construct those PFI contracts?

[Earl Howe]

My Lords, I am not aware that we are doing that particular thing, although I understand my noble friend’s concern. There are contracts in place which are legally binding. Nevertheless, within the framework of those contracts there is often scope for looking creatively and flexibly at their provisions. We are endeavouring to do this in order to help the trusts work their way through their problems.