Fergus Montgomery – 1985 Speech on Trafford Health Authority

Below is the text of the speech made by Fergus Montgomery, the then Conservative MP for Altrincham and Sale, in the House of Commons on 11 November 1985.

I am very glad to have this opportunity to raise an entirely local question that concerns my constituents and those of my hon. Friend the Member for Davyhulme (Mr. Churchill) and the hon. Member for Stretford (Mr. Lloyd)—the future of the Trafford health authority.

I had an Adjournment debate on 25 April about the long-promised south Trafford district hospital—a promise that has been made over the years but which, for some reason known only to itself, the regional health authority has squashed. That decision has caused enormous aggravation in my constituency, and has been assailed from all sides and all political parties. My hon. Friend will guess that I am not altogether what is known as a member of the fan club for the officers of the regional health authority.

I criticised those officers for not sending a representative to put their case at a large public meeting held in Sale town hall. Many people turned up, but no one from the regional health authority bothered to show his face. Surely if the authority’s case was a good one, its representatives would have attended the meeting. Its case has gone by default because of non-attendance.

At that time, I accused the RHA of lack of consultation, and I regret that that is the accusation that I make against it tonight. Its inept and inappropriate use of the consultation process has caused a great deal of anxiety among my constituents. On 22 October my health authority members had to fight off a cavalier and determined attempt by the chairman of the regional health authority to abolish the Trafford health authority. That arose because of a decision reached in February this year to reject the long-promised district hospital. It was determined that our future hospital needs would be met by developing services at Wythenshawe hospital—which is not in Trafford, but in Manchester—and by the rebuilding and improving of hospital facilities at two hospitals in Altrincham. That represented a change in policy.

Trafford health authority, quite rightly, asked the regional health authority to ensure that the management arrangements for Wythenshawe hospital were reviewed. I think that my hon. Friend the Minister would agree that that makes good sense. Under the change there will be increased use of Wythenshawe hospital by residents of Trafford. My health authority felt that the management of Wythenshawe should be transferred from the South Manchester health authority to the Trafford health authority.

A panel of five members of the RHA, including the chairman and the vice chairman, met on Friday 11 October to consider their response to the consultative document. The report was made public on 16 October and was to be put to the RHA on 22 October, less than a week later.

The report recommended the abolition of Trafford health authority, which was to be carved up and annexed to South Manchester health authority and Salford health authority. My hon. Friend has seen the report and will know that scant justification was offered for that recommendation, but unsubstantiated assertions were ​ made about considerable savings and better health care for patients. I have to tell my hon. Friend that that did not go down well with my constituents.

From the time that the report was published I was bombarded with telephone calls and letters from angry constituents. I held an advice bureau in Altrincham town hall on 19 October, and two separate delegations came to see me. They comprised physiotherapists, speech therapists and chiropodists. They were all reasonable people and put their views sensibly, but they were worried about their jobs and lack of security. They were rightly angry. They were furious that there was less than a week between the publication of the report and the vital meeting of the regional health authority.

Because of the ham-handedness of those in charge of the regional health authority, unnecessary alarm and aggravation were caused. I am glad to say that when the meeting of the regional health authority took place on 22 October sanity prevailed and the majority of regional health authority members refused to accept the strong recommendation from their chairman that the proposal should be adopted. That was mainly due to the lobbying of every member of the regional health authority on the case for the Trafford health authority.

Had it not been for the vigilance of local organisations, and of the majority of the regional health authority members in vigorously and successfully opposing the move, the proposal by Sir John Page, the regional health authority chairman, could have resulted in chaos and confusion, such was his apparent lack of appreciation of how health and social services operate at a local level.

Without doubt, the regional health authority must constantly review the organisation of its services to ensure the most cost-effective means of providing health care. Nobody will dispute that, because it is one of the regional health authority’s jobs. I have no argument with that, because in the long term it must be in the best interests of patients. However, it is equally essential that the regional health authority should act in a caring and competent manner. The standards that one would expect to be applied in a large public service organisation have been totally missing. The consultation process initiated by the regional health authority seemed to be excellent at the time, but many of my constituents will, cynically, believe that their views were treated with contempt and dismissed as being of no account.

The criteria selected by the regional health authority to judge the relative merits of the various options were misapplied, misconstrued or ignored. The criteria were the rules of the game and were based on formal DHSS guidelines. Not only were the rules changed half way through the game, but the goalposts were removed.

The benefits claimed for the proposal were given no substance. First, it was claimed that substantial savings would be made, but that claim has never been assessed in detail. There was never an intention to undertake a financial evaluation between the various options. Secondly, it was claimed that patients would benefit. That claim was so hollow that not a single concrete example could be offered in answer to the question: how will the changes benefit the people of Trafford?

The regional chairman apparently set great store by the good will on which the proposed arrangements would depend for their success. Good will follows in the wake ​ of trusted leadership. It is a mistake to expect good will in response to an imposed, unwarranted and unwanted solution.

The strength of feeling locally against the proposal and the manner in which it was presented is vividly illustrated in a remark by a member of the district health authority who met the regional chairman shortly before the meeting of the regional health authority. The member of the district health authority was attempting to understand the thought processes that led to the recommendation. She said:

“It is incredible that the health of the people of Trafford depends on such inept, perfunctory and arrogant decision making.”

If my hon. Friend thinks that such language is intemperate — and I am sure that he is used to intemperate language, because he and I occasionally play bridge together and on occasions when I have trumped his ace his language has not been particularly mild—it is worth remembering that the proposal to eliminate an employing authority of 2,900 people was made public without advance warning to representatives of that authority a matter of only six days before a decision was due. It had not apparently occurred to anyone at the regional health authority that our health service staff, who give such dedicated and loyal care to those in need in the community, deserved similar consideration.

I have mentioned the enormous anger of people in my constituency. I would like to tell my hon. Friend that one of the Conservative councillors in my constituency called for the resignation of the chairman of the regional health authority. While I do not think that this is likely to happen, I hope that by now my hon. Friend has heard the message loud and clear, that the Sir John Page fan club is devoid of members in the Trafford area. Two enormous kicks in the stomach in one year are more than enough, and they certainly have not made him the pin-up boy of the people in my constituency.

The fact that the recommendation was overturned by the regional health authority, despite the most determined last-ditch stand of the chairman of the RHA, is the most welcome demonstration that the majority of its members have a clear grasp of the fundamental principles on which health care must be based, and of the vital importance of conterminosity between health authorities and local authorities. The regional health authority, however, has acknowledged that while Trafford health authority is regarded as sacrosanct, important organisational issues in Manchester and Trafford still need to be ironed out. I am concerned—and this is the reason for the debate tonight—that these issues are considered in a proper fashion.

I hope, therefore, that when my hon. Friend winds up the debate tonight, he will be able to assure me that the proper administrative processes will this time be observed when the regional health authority makes its assessment of these outstanding issues.