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Hospital Services (Shropshire)

I congratulate my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) on securing this debate on hospital services in Shropshire. I am sure that his constituents will be pleased to know that he has raised an issue of such great importance to his local community. I also pay tribute to the staff of the NHS across the whole of the county of Shropshire, who do such an incredible job caring for the constituents of my hon. Friend and the hon. Member for Telford (David Wright). They deserve and will receive the Government's full support. Before I come to the specifics of Shropshire, I shall set out the Government's general approach to the reconfiguration of health services, as my hon. Friend referred to the answer that he received from my right hon. Friend the Prime Minister last week. The Government passionately believe that local decision making is essential to improve outcomes for patients and to drive up quality. We do more than just talk about pushing power to the local level; we are doing it. In May 2010, my right hon. Friend the Secretary of State for Health identified four crucial tests that all reconfigurations must pass. First, they must have the support of GP commissioners. Secondly, arrangements for public and patient engagement, including local authorities, must be further strengthened. Thirdly, there must be greater clarity about the clinical evidence base underpinning any proposals. Fourthly, any proposals must take into account the need to develop and support patient choice. I understand that NHS West Midlands has given an assurance that the case for change is underpinned by those tests. Let me be clear what that means. Hospital closures that do not have the support of GPs, local clinicians, patients and the local community should not happen. There should be ample opportunity for patients, local GPs and clinicians and local councils to have a far greater role in how services are shaped and to ensure that these changes will lead to the best outcomes for patients. It is important to remember that local public consultation is the vehicle through which to ensure that everyone with an active interest in proposed changes to their local health service gets their say. In this case, local consultations began on 9 December 2010 and are scheduled to conclude on 14 March 2011. My hon. Friend mentioned it, but if it is any consolation to him, Christmas and the new year holidays came during that period. The normal consultation time is 12 weeks, and if my maths is right this consultation process will take 13 and a half weeks including the holidays. It should be stressed that consultation is by no means a fait accompli. It is a democratic process that allows full and open participation in considering all the options for service change. If an overview and scrutiny committee is not satisfied that adequate NHS consultation has taken place, or decides that proposals do not meet the needs of the local community, it may refer the matter to the Secretary of State for Health. I understand that there has been a long history of debate on the best way to organise hospital services in Shropshire. A previous review failed to provide a lasting way forward for the county. Local organisations are now taking this review forward, and they believe that changes need to be made in the near future to ensure that services continue to be provided safely. Over the last decade, the NHS in Shropshire has identified a number of services, including accident and emergency, acute surgery, maternity, neo-natal, in-patient, paediatrics and urology, that face an increasing challenge in trying to provide 24-hour cover by senior medical staff at local hospitals. As the public consultation document explains, there are five main reasons for that. First, the increasing specialisation of staff means that fewer consultants are able to provide general emergency cover. That is a particular problem in general surgery if it is split between two sites. Secondly, out-of-hours arrangements mean that some consultants have to cover a number of services and sites at the same time. That places unrealistic pressure on staff, and it can put patients at risk. Thirdly, the European working time directive limits the time that medical staff are allowed to work to an average of 48 hours a week. Fourthly, due to the relatively spread-out nature of the Shropshire sites and the area's rurality, it can be difficult for junior doctors to see the wide range of patients necessary for their training. Fifthly, those factors collectively could make it difficult to recruit high-quality medical staff, particularly consultants. The current configuration of services results in duplication between the Royal Shrewsbury and Princess Royal hospitals. It also limits the ability to develop the more specialised services that could be provided in Shropshire, Telford and The Wrekin. That is not sustainable. This is the opportunity for all those with an interest in making changes to local health services to become involved. My hon. Friend has called for an additional public meeting in Shrewsbury; that takes place on Friday 11 February. As I said in my letter, I strongly encourage my hon. Friend to note the views raised at the public meeting, so that they can be fed in to the consultation process. Before a final decision is made following the conclusion of the consultation process, those views will have been heard and considered. The consultation document explores four options. Option 1 is to do nothing. That is not considered feasible by the local NHS. A second option is to concentrate all major and emergency activity on the site of one or other of the existing two hospitals, with planned activity at the other. That has been looked at carefully, and I understand that that is not considered feasible either. A third option is to build a new hospital, but that has been discounted because of the financial climate. A fourth option, the preferred local NHS option, means moving services between the two sites to make the most effective use of staff, equipment, and buildings. The consultation document suggests that this is likely to mean that the bulk of in-patient, children and maternity services— Sitting suspended for a Division in the House. On resuming—