Click 'more' for full text of his speech.2.30 pm
Mr. Philip Dunne (Ludlow) (Con): I am extremely grateful for this opportunity to the draw hon. Members' attention to the crisis that is currently engulfing the NHS in Shropshire and I am pleased that hon. Members from all parties are hoping to participate. That crisis is affecting not only Shropshire, but its neighbouring counties, and that is indicative of a systemic problem; one that has only just started to reach the public consciousness. That problem is the chronic mismanagement of the NHS, which stems from a sustained period in which the Government have imposed targets, interfered in clinical priorities and introduced new cost structures, while at the same time seeking to abdicate any responsibility for the financial management of health care at the local level.
The consequence of that crisis, and the reason why I have called this debate, is that all three community hospitals in my constituency-in Bridgnorth, Ludlow and Bishop's Castle-are under imminent threat of closure, along with the community hospital in Whitchurch, in the constituency of my hon. Friend the Member for North Shropshire (Mr. Paterson), about which I am sure we shall hear more shortly. That could result in the closure of all four community hospitals in Shropshire. Such things are, however, happening all over the country, not only in Shropshire.
I have joined the steering group of Community Hospitals Acting Nationally Together, which is a campaign group that exists to save community hospitals throughout the country. CHANT has evidence that 80 of the 322 community hospitals in England are at risk of closure or are threatened with substantial cuts in services, and I cannot overstate the impact that such closures would have on my constituents. With no hospital in an area of more than 600 square miles, and no hospital near the boundary of my constituency, many of my constituents would have to travel more than 30 miles to reach an acute hospital. The Minister may not know this, but given the lack of public transport infrastructure in much of Shropshire, it could take the best part of a day to make the round trip for an out-patient appointment or to visit a relative.
That is but one of a host of reasons why, on the first Saturday in January, more than 10,000 people marched through sleet and rain in all four of the towns where Shropshire community hospitals are at risk to support the continued provision of services at those hospitals. I addressed crowds of more than 4,000 people in both Bridgnorth and Ludlow that day and I am glad for the Minister's sake that it was me who addressed those crowds, not her, such was the clear strength of feeling. I do not know whether she has ever faced a crowd of that many people who were determined to preserve their hospital, but if she has not, I would be very happy to arrange a meeting-she would get the message soon enough.
To reinforce the point, I delivered two petitions on the Floor of the House last week. They contained more than 22,000 signatures-one third of the electorate in my constituency-in support of our community hospitals. Today, I have announced the results of a survey that I conducted among all the GPs in my constituency, and everyone who responded confirmed their full support for our community hospitals. The League of Friends of Ludlow Hospital has received letters in support of maintaining all existing services at Ludlow community hospital from all nine of the consultants who hold periodic clinics there.
Let me set the funding crisis in Shropshire in context by explaining the scale of the problem that our health care services face under the Government's funding rules for the NHS. Between them, the four NHS trusts in Shropshire and the unitary authority of Telford have a historic debt that is currently estimated at £36 million and are running a collective annual deficit of £25 million. Under the Government's current funding rules for the NHS, that historic debt must be repaid over the next three financial years and the annual deficit must be eliminated in the financial year starting in April. That means that the Government have tasked local health care managers with finding cuts of £37 million from the health care budget for the area of more than £400 million, which represents a cut of nearly 10 per cent. in the amount spent on health care in Shropshire effectively for each of the next three years.
I wish to ask the Minister three main questions. What went wrong? What does it mean to our local communities and, on a more positive note, what can be done? Two decisions affect Shropshire specifically, when the Government have to accept some responsibility over and above the overall impact of their so-called management of the NHS nationally. I refer first to the decision back in 2003 when the two trusts that ran the acute hospitals, the Royal Shrewsbury hospital and the Princess Royal hospital in Telford, were merged into a single NHS trust. At the time, the trusts had debts in the order of £6 million.
I understand from the new chief executive of the combined trust that it is clear from his review of the merger agreements and the drafts, in particular, of the agreements that part of the political price for securing public acceptance of the merger, which was controversial at the time, was for the debts to be assumed by the Government. At the last minute, that did not happen so, in my view, the Government shoulder direct responsibility for at least part of the historic debt, which has now compounded considerably.
Daniel Kawczynski (Shrewsbury and Atcham) (Con): On my hon. Friend's last point, one of my constituents, Mr. Frank Jones, cast the deciding vote to merge the two hospitals. Unfortunately, he died last month, but he had told me how much he was influenced by the promise that the debts would be written off.
Mr. Dunne : I am grateful to my hon. Friend for confirming the historic state of affairs.
David Wright (Telford) (Lab): I opposed the merger at the time that it took place, but I recall a debate in the House when the then Under-Secretary of State at the Department of Health, the Under-Secretary of State for Culture, Media and Sport, the hon. Member for Tottenham (Mr. Lammy), made it clear in response to my question that no deal was on the table to wipe off the historic debt. I agree with the hon. Member for Ludlow (Mr. Dunne) that there was certainly confusion between what was happening in the health economy in Shropshire and what was being said in London, and that it became mixed up in the debate about the merger proposals, which I say again that I opposed at the time.
Mr. Dunne : I am grateful for clarification of the debate in the House. From my understanding, it still stands that, in the penultimate draft of the merger agreement, the debt position was due to have been assumed by the Government.
Mark Pritchard (The Wrekin) (Con): My hon. Friend is generous to give way to so many hon. Members. To be helpful in the context of the comments of the hon. Member for Telford (David Wright), I know that in a letter dated 17 October 2004 the then Under-Secretary of State for Health said that there would be no reduction in services as a result of the merger. Clearly, reductions are on the way.
Mr. Dunne : I am sure that we shall be getting into the implications of the reductions during the debate.
The second issue that I hold at the Government's door is that there has clearly been chronic financial mismanagement within the acute trust since its formation. The scale of the financial difficulties of the trust only became apparent last year. Those directly responsible were finally found out and fired. It transpired that the chief executive of the trust had got his job on or around the time of the merger on the basis of a fake CV. The whole appointment process for senior administration and board positions within the trust was at fault. There was inadequate monitoring of the financial performance and control. Nothing was done about the mounting debt and deficit until they had escalated last year into the present crisis management. The whole sorry saga raises fundamental questions about the Government's failure to impose proper oversight of board appointment decisions, financial monitoring and the governance of NHS trusts.
Lembit
