London's health service : minutes of evidence, Wednesday 2 March 1994 ... / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
1994
Catalogue details

Licence: Open Government Licence

Credit: London's health service : minutes of evidence, Wednesday 2 March 1994 ... / Health Committee. Source: Wellcome Collection.

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    Mr Michael Bates Mr Roger Sims Mr David Congdon Rev Martin Smyth Mr Iain Duncan Smith Mr John Whittingdale Tessa Jowell Audrey Wise Alice Mahon Examination of Witnesses Chairman 1. Good afternoon, Ladies and Gentlemen. One of our witnesses appears to be missing, but I intend to start our meeting because we have a great deal of ground to cover over the next hour or so. This is the fourth occasion on which the Health Select Committee has taken evidence on London’s health services since Professor Tomlinson published his report. I have the greatest pleasure to welcome on behalf of the Committee the Rt Hon Mrs Virginia Bottomley, Secretary of State for Health, the Rt Hon Dr Brian Mawhinney, Minister of State, Department of Health, and I am hoping, in due course, to welcome Mr Bob Nicholls who is the Executive Director of the London Implementation Group. We are very pleased to see you here this afternoon. I know that we have many questions to put to you, Secretary of State, and to your colleagues. I remind Members of the Committee and our witnesses, if I may, that we should like to keep the questions and answers as short as possible because there are so many aspects of this issue that we would like to cover during the afternoon. I ask you to co-operate so that we can cover as much as possible. Secretary of State, I should like to put the first question to you. Can you tell the Committee what progress has been made in implementing the recommendations set out in Making London Better since last you gave evidence on this subject in March 1993? What do you see as the difficult tasks which still lie ahead? (Mrs Bottomley) Thank you very much. When we announced Making London Better we said that our overall objectives were to improve the quality of patient care for Londoners, to improve the family doctor and other community-based health services, to ensure that hospital services respond to the changing demands of patients and to ensure that changes in medical practice, such as the growth of day surgery, are accommodated, to ensure that the high costs of overheads in London hospitals are progressively addressed and, importantly, to preserve and enhance London’s reputation as a centre of excellence in treatment, in teaching and in research. I believe that over the past year we have made very substantial progress on all those matters. Notably there has been a substantial further investment in primary health care, £43.5 million, with something like 100 projects across London, to redress the balance towards primary care. This year we have been able to announce £85 million for primary care and even more initiatives, a further £24 million to go to voluntary organisations, to develop alternatives to hospital care and more community projects. In addition now all of the London hospitals except for two special health authorities and a number of other directly-managed units, will become NHS trusts. There has been a profound change towards the establishment of trusts, with the completion of the purchaser-provider division within London. More specifically, the decision to bring together the Royal London, St Bartholomew’s and the London Chest Hospital as a single trust, gives them a strategic direction on the basis of which they can build for the future. The future of University College Hospital, a great national and international centre of excellence, is safeguarded. The strategic direction is clear for Guy’s and St Thomas’s and a number of the specialist services are able to plan for the future, for example, the neurosciences going to Denmark Hill. Other hospitals have been affected by the changes. A £25 million development at the Homerton hospital will enable them to service a large local population. St Mark’s is to move to Northwick Park and there is to be a very substantial investment in the London Ambulance Service. We have always said that a good quality ambulance service was fundamental to meeting the basic needs of Londoners, and similarly that we had to invest in primary care before we took forward the changes in secondary care. We have made good progress in establishing a clearing house for the staff who will inevitably be involved and, lastly—the point identified in our objectives of enhancing London’s position as a centre of medical research and teaching—we are making good progress on the establishment of the multi-faculty medical schools. There is progress with Guy’s and St Thomas’ coming together with King’s, there is progress with the Royal Free coming together with UC Middlesex, there is progress with the Royal London and St