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Evesham Community Hospital

: Thank you, Mr. Cook. I think that this is the first time I have served under your chairmanship, and it is a pleasure to do so. I congratulate the hon. Member for Mid-Worcestershire (Peter Luff) on securing this debate on Evesham community hospital. He has taken a keen interest in health matters in Worcestershire, and I know that his expertise does not extend simply to the borders of his own constituency. During his career, he has had some exposure to health matters in the great city of Worcester, which I am glad to see is also represented in this debate by my hon. Friend the Member for Worcester (Mr. Foster). I know, too, that the hon. Gentleman has raised the proposals now under discussion by his local primary care trust in a parliamentary question, to which my hon. Friend the Minister of State replied on 9 June. In what was an eloquent dissertation today, he raised a number of detailed issues. I will address as many of those as I can, and I will write to him on those that I am unable to answer satisfactorily. If the hon. Gentleman will indulge me, I will describe a bit of the backdrop before I turn to address the specifics of the important local issues that he has raised. Perhaps the most prominent feature of that backdrop is the extent to which health care in communities up and down our country, including in places such as Evesham, has changed in the past six or seven years. Massively increased investment has allowed us to hire more staff, build more hospitals, cut waiting times and cut mortality rates, in some cases quite dramatically. I looked at some of the figures as I prepared for an Adjournment debate on Monday with the hon. Member for Wyre Forest (Dr. Taylor), who also knows a great deal about health care in area that we are discussing. Some of the figures bear some repetition. Overall, spending is up by a third. Staff numbers are up by 21 per cent., with GP numbers up 13 per cent., consultant numbers up 44 per cent. and nurse numbers up 25 per cent., and 85 new hospitals have already been delivered. That has allowed us to cut in-patient waiting times first to 12 months, then to nine months and now to six months. Indeed, I understand that nobody in the South Worcestershire PCT area is waiting more than nine months for inpatient appointments. When we look at some of the biggest killers in the country, we can see the results of that investment and improvement. Cancer death rates are down by 12 per cent., and coronary heart disease death rates down by 27 per cent. I was glad when officials told me that that improvement in health outcomes appears to be shared by the residents of Mid-Worcestershire. Indeed, Evesham hospital has benefited from the increased investment. Its budget has increased by more than £1 million, or about 16 or 17 per cent., in the past few years. The larger question that looms over our debate this morning is where we go from here; where do we go nationally, and where do we go in Mid-Worcestershire? The larger question is, on the basis of the investment and success to date, how can we create an NHS that is truly patient centred; an NHS that we would be happy to use and that we would be happy for our constituents and our own families to use. The Government's answer is straightforward. First, we believe in more investment, but it must be coupled with a new degree of choice for patients about where and how they would like to be treated. Secondly, we propose national frameworks, or national standards, for how that care is provided. Some of those standards have been described variously as the envy of the world and among the world's leading definitions of health care, but they must be coupled with a new freedom for local health care professionals working with their local communities to decide how best those standards are met. It is that new freedom which is the real author of today's debate. Here we have a situation where local health care professionals have very properly surveyed the health needs of the local population, and have come to a set of recommendations, or provisional conclusions, about how to invest the resources with which they have been entrusted, and their plans have, as we have heard quite graphically this morning, struck a note of discord.