Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what the criteria are for making a ministerial directive against the closure or downsizing of a hospital.

The Government is clear the reconfiguration of front line health services is a matter for the local National Health Service. Services should be tailored to meet the needs of the local population and proposals for substantial service change must meet the four tests of reconfiguration which are (i) support from general practitioner commissioners (ii) strengthened public and patient engagement (iii) clarity on the clinical evidence base and (iv) support for patient choice.

A local authority has the power to refer NHS substantial reconfiguration proposals to the Secretary of State if they consider:

― the consultation has been inadequate in relation to the content or the amount of time allowed;

― the NHS body has given inadequate reasons where it has not consulted for reasons of urgency relating to the safety or welfare of patients or staff; or

― a proposal would not be in the interests of the health service in its area.

Upon receipt of a local authority referral, the Secretary of State can refer the matter to the Independent Reconfiguration Panel (IRP) for its advice. The Panel will consider whether the proposals will provide safe, sustainable and accessible services for the local population, taking account of factors including: clinical and service quality, patient and public involvement, the surrounding local services and national policies.

On receipt of IRP advice, the Secretary of State would then decide whether or not to accept it. Since its inception in 2003, all Secretaries of State have used the IRP advice to inform their decisions.