Andrew Murrison

Andrew Murrison will be attending Warminster Civic Trust's 'Open Meeting' on Friday 29th September starting at 7pm. The venue will be Dewey House, North Row, Warminster. 'Warminster - in the future' is the topic for discussion which will include ideas on where to build new homes, improving the town's road infrastructure and how to promote a great market town to live in.

Andrew Murrison will attend an evening of music organised by Warminster Fairtrade Group on Friday 29th September at 8pm at Kingdown School in Warminster.

The evening will consist of music played by two professional guitarists/singer-songwriters who are undertaking a national Fairtrade Tour this autumn and a short performance by some students, plus Fairtrade refreshments, information stands and Tradecraft sales tables.

Andrew Murrison has said that his constituents will not be sorry to see the back of West Wiltshire PCT.

The unloved organization that has spearheaded plans to close all four community hospitals in Andrew's constituency, its maternity unit and the district's in-patient mental health unit will be dissolved on 30 September to make way for the new Wiltshire-wide PCT on 1 October.

"I am looking forward to working more productively with the new PCT than has proved possible under the old regimen. The first challenge for the county-wide organization is to pick up the pieces of the Pathways for Change consultation which its predecessor body has left behind.

"I shall be pressing it to come up with some fresh proposals for local healthcare that truly reflect the views of residents.

Following the announcement on Friday that the new rail franchise was to be awarded to South west Trains, a subsidiary of Stagecoach, confusion reigned over the future of the direct Bristol-Waterloo service stopping at Salisbury and stations in West Wiltshire.

On Tuesday, it emerged that no final decision has yet been made on the service that has been the subject of much local anxiety and a number of ministerial meetings attended by the local MP and rail activists including West Wiltshire Rail Users Group.

The service remains as a 'priced option' that can be exercised by the government at any stage.

Therefore, Andrew has written to the new trains minister Tom Harris MP who will decide the fate of the service. Mr Harris is known to Dr Murrison since they both served on the Science and Technology Select Committee in the 2001-2005 Parliament.

"The government has committed to the service for the life of the current franchise which expires in February 2007. It is important that the new trains minister commits to exercising his option to continue it in a seamless fashion from February to avoid a damaging hiatus of the sort that we have seen in the past.

Andrew Murrison will attend the West Wiltshire Housing Society's Annual General Meeting on Tuesday 26th September to be held at Cumberwell Park Golf Club, Bradford on Avon at 7pm.

Andrew Murrison will attend the Trowbridge Community Area Forum to be held on Tuesday 26th September from 10.30am - 9.00pm in the Civic Hall, Trowbridge.

Andrew Murrison will be visiting The Mead Community Primary School, Hackett Place, Hilperton on Friday 22 September. The school is holding a Grand Exhibition between 6pm and 9pm. The exhibition titled 'Festival of Five' is a celebration of the schools five years through five kinds of art-music, poetry, dance, drama and visual art.

Andrew Murrison will tomorrow visit the Hope Nature Centre at Southwick. The MP, who has taken an active interest in the project throughout its genesis, will be touring the site and discussing a number of issues that have arisen with the project's founder Mrs June Fleming BEM who has asked him to call in.

"Anyone that has come into contact with June in the course of her work on behalf of the community will have been bowled over by her extraordinary energy and single-minded determination to get things done.

"The Hope Nature Centre is well named. It gives hope to people that might otherwise have very little to look forward to at the end of their schooling.

MP: Alarm sounds at Lib-Lab plans to tax West Wiltshire homes with new house price tax

Andrew Murrison has expressed concern at joint moves by Labour's Gordon Brown and Liberal Democrats' 'Ming' Campbell to hit Wiltshire with a new house price tax.

• New house price tax say LibDems : Liberal Democrats have recently endorsed new tax plans, backing a controversial new house price tax. It calls for taxing "unearned economic rent" to "stabilise the property market" by introducing the "satisfactory" Danish model of a "national 1 per cent property tax". This would be on top of plans for a new local income tax of up to 5 per cent on both basic and higher rates of income tax.

• House tax backed by Labour : This house price tax already being introduced in the UK by Labour Ministers. From April 2007, Northern Ireland residents will hit with a house price tax of 0.63 per cent of their home's value every year (local taxes in the Province are lower than in mainland Britain ). Gordon Brown's review of town hall finances is actively considering how to implement such a scheme across Britain . The Government has sheepishly admitted that middle classes will pay more under such a tax.

• IN WEST WILTSHIRE - Under a 1 per cent house price tax, the average property in our area would have a local tax bill of £1813 a year.

"Gordon Brown and 'Ming' Campbell are planning a house price tax that will hammer home owners. It's very nice when your house rises in value but you've got to live somewhere and property-based taxes are turning homes into an unaffordable liability for many.

Andrew Murrison says analysis released this week on the PCT's Pathways for Change consultation is a firm thumbs down for West Wiltshire PCT and all three of the options it has offered.

790 responses were received and have been examined by the independent consultants Redbridge.

"If the PCT is serious about using public opinion to shape its plans, this analysis will mean it has to go back to the drawing board.

"In particular, its Option One, the only one that would have saved the PCT much money has been completely rejected. This and the disaster it would have represented for mental health in the district surely means it's been comprehensively torpedoed.

The MP has questioned the amount of money that has been spent on the consultation exercise. He said;

"Tens of thousands have gone on producing this report, money diverted from front-line healthcare. The results, such as they are, come as no surprise and accord with what I and others have been saying all along.

"It's a pity the PCT didn't listen to us - had it done so, much time, effort and money might have been saved.

Andrew Murrison has welcomed the adoption by West Wiltshire district council of new housing allocation rules that will prioritize the needs of local homeless people.

The council has written to the MP with its revision to the rules that it passed earlier this month. Andrew had written to the council to challenge it on the way in which it allocated homes.

"There had been a suspicion that the council has been relaxed about taking all comers rather than give local applicants the priority they surely deserve.

"The council plans to built many more homes for rent in the district and I felt it was important to get an assurance that the new build will be used to address the homelessness that currently exists in West Wiltshire rather than to sort out problems elsewhere.

The letter to the MP highlights the new policy which states that people that do not live locally will be placed in the low priority band C. It says;

"Applicants who live outside of West Wiltshire will be awarded band C. Applicants area of residence will override all other priorities, even if the other priorities would put the applicant in a higher band."

"I hope the change in allocation policy will go some way to reassure people that are concerned about the council's use of parcels of land that it owns for social housing. Some of the sites have provoked a great deal of controversy among people living nearby.

Andrew Murrison has welcomed the decision from outgoing PCT Chief Exec Carol Clarke to delay a decision on the future of community hospitals to allow the new wiltshire-wide PCT to bed down from 1 October. He said;

"It's pretty obvious that the consultation will have given a big thumbs-down to the PCT and this delay will avoid much embarrassment at West Wiltshire PCT in its dying days. More importantly it gives us some breathing space in which people can think again about the lunacy of closing all four community hospitals in my constituency, the maternity unit and Charter House.

The MP says that this allows time to go back to the public to ask if their views have changed following the announcement of the new Independent Sector Treatment Centre at Devizes. He said;

"Even before the new centre was announced there was a strong feeling that the PCT was engaged in a scorched earth policy that stripped out healthcare assets from west wiltshire in favour of projects in the already well served north of the county.

"Those feelings will run even more strongly after the announcemnt by the department of health that it will build a new treatment centre in Devizes and it seems to me that a further period of consultation and reflection is in order.

"My constituents have little to thank West Wiltshire PCT for and most of us will be delighted when it goes at the end of the month. I hope very much that we get a more visionary approach from the new Wiltshire-wide PCT and that it will look at our community hospitals afresh.

Andrew Murrison will today be viewing new plans drawn up by developer Taylor Woodrow for Bradford on Avon 's Kingston Mill site.

The MP was highly critical of previous plans, not least because of the lack of much needed affordable housing in the proposals for the flagship centre of town development.

Andrew has been keeping tabs on the Kingston Mill saga since 2001, latterly through the Prince of Wales' Planning By Design process that he supports. He hopes that at long last a satisfactory blueprint will be forthcoming that addresses the needs of the various sections of the town's population including those of seldom heard groups, notably those without anywhere satisfactory to live.

He will make his views known on the latest proposals after his visit to the exhibition at the Priory Barn this afternoon (Friday) at 2pm.

Andrew Murrison met with Wiltshire County Council Leader Jane Scott on monday to discuss the future of adult social services in his constituency.

The MP has condemned the withdrawal of NHS funding from Sonas House in Hilperton that will mean that the unit closes in April and has written to the PCT and Health Secretary Patricia Hewitt to ask for interim funding that will ensure that respite care is available to cover the gap before the larger, modern unit is opened in October 2007.

"I am pleased that there will ultimately be more respite care available in a modern setting. However, I regret that precipitous unilateral action by West Wiltshire's failed Primary Care Trust has put essential respite care for the most vulnerable of my constituents and their carers at risk for much of next year.

"We must ensure that respite care is seamless and that early plans are made for transport so that the new unit in Devizes is accessible to people from West Wiltshire.

Dr Andrew Murrison MP, Shadow Health Minister, will meet pioneering doctors of the Gloucestershire Aneurysm Screening Programme at Gloucestershire Royal Hospital on Wednesday 6 September. He will support calls for the establishment of a national abdominal aortic aneurysm (AAA) screening programme that aims to slash deaths from big burst blood vessels.

Meeting consultants, Mr Brian Heather and Mr Jonothan Earnshaw, of the Gloucestershire Aneurysm Screening Programme, Dr Murrison will discuss how a national programme would save thousands of lives. The MP, whose was a locum Consultant at the Gloucestershire Royal before being elected in 2001 will learn how screening is carried out using a portable ultrasound scanner.

AAA is overwhelmingly a disease of men. The cost of the one-off screening involved in its detection is half that of breast cancer screening and would save as many lives each year .

Tomorrow's visit follows a meeting Dr Murrison had with the Vascular Surgical Society at the House of Commons in June to discuss the recommendations of the National Screening Committee that a screening programme should be implemented. Dr Murrison subsequently wrote to Health Minister Rosie Winterton to ask if she would meet the Society with a view to the early roll-out of the programme that would save between two and three thousand lives a year.

In her reply of 27 July the minister declined saying that, whilst her National Screening Committee had determined that "screening of men aged 56 for abdominal aortic aneurysm can be recommended in principle", she was setting up a sub-committee to develop "information and support materials" and to determine "the configuration of treatment services to achieve best outcomes."

"I am disappointed that ministers have chosen to procrastinate whilst hundreds of men die needlessly. The case for a national screening programme is compelling and there has been a long lead-in time for ministers to prepare for its roll-out.

"The department of health's complacency and the lack of a sense of urgency on the part of ministers is deeply disturbing.

"Whilst there is insufficient evidence to recommend routine screening for a number of diseases, we have known of the benefits of screening for AAA since 2002. A national screening programme would be relatively cheap and highly effective saving thousands of lives every year. It's time the Government gave it the green light.

Andrew Murrison has been contacted by local residents inconvenienced by the traffic gridlock caused by the Red Bull air race at Longleat on Saturday 2 September. He has also had angry messages from visitors to the aborted event complaining about the appalling traffic.

"I could see the heavy traffic building up from my house and can only imagine the misery it must have caused quite apart from the potential problems for emergency services.

"I understand that the Police and local authorities will be meeting with Longleat and with Red Bull to examine what went wrong. Events like this are generally fun and welcome locally and I am sorry that bad weather caused it to be cancelled. However, unless an adequate plan can devised that will ensure that we do not risk this chaos again, I hope that Red Bull will be invited to look for alternative venues.

Andrew Murrison has slammed health ministers for awarding their constituents hundreds of pounds more per head than people living in West Wiltshire.

Figures released recently show that West Wiltshire PCT received £1090 per head this year rising to £1207 for the financial year 07/08 a rise of £117. Meanwhile the average for the constituencies of the five government health minister in the Commons is £1328 for 06/07 and £1450 for 07/08, a rise of £122.

The average spend per head for England is £1274 for 06/07 and £1388 for 07/08.

"It's easy to see why areas like ours are in deficit and are having to close down their community hospitals.

Ministers say their constituencies need more because they're less healthy. If that's the case they need to say what all the extra money is going on and how it will rectify the relative health disadvantage they've identified in their constituencies.

Otherwise, as the cost of things like a GP consultation, a midwife visit or a hospital stay is broadly the same throughout England, constituencies receiving more per head will be getting more than their fair share.

Andrew Murrison today added his support to Built to Last - a document launched by David Cameron outlining his aims and values.

Built to Last maintains that individuals, communities and businesses should be helped and encouraged to increase their social, civic and personal responsibility.

Over 50 key policy proposals are outlined in the publication, including pledges of:

Abolishing the unelected regional assemblies and returning the powers to local councils. Andrew is a longstanding critic of the South West Regional Assembly

A national programme for young people as they move from childhood to adult life. Andrew is particularly concerned about the plight of young people with special needs in this respect following his experience as a school governor (see below).

Supporting special schools, to maintain the valuable parental choice which they offer. Andrew used to be a school governor of a special school.

Encouraging more eco-conscious use of our resources through energy and water conservation and recycling.

Increasing support for shared ownership schemes to help people onto the housing ladder and giving local people a greater say on where we build new homes.

"David Cameron's call for a responsibility revolution is very welcome. We must encourage people and local communities to take charge. Central government should interfere less in our lives.

Andrew Murrison has expressed surprise at proposals from the Sentencing Advisory Panel that would mean that imprisonment would no longer be an option in most shoplifting offences.

The Sentencing Advisory Panel is consulting on proposals that would mean jail sentences would be reserved for cases with 'aggravating' factors, such as violence. The proposals also suggest that "seriously persistent" shoplifters should be jailed for up to eight weeks.

"Shoplifters impose costs estimated at about £665 million each year and there is an average of twenty-eight incidents of shoplifting for every shop at a cost of £108 per incident. I know that the government wants to free up prison capacity but trivialising theft is not the answer.

"I hope the Sentencing Guidelines Council will reflect carefully on this thoroughly bad idea. I shall be championing the needs of the many small shops in my constituency for which shoplifting poses a significant threat.

Andrew Murrison has written to PCT Chief Executive Carol Clarke to question the validity of her consultation exercise Pathways for Change given today's announcement by her boss at the South West Strategic Health Authority of new Independent Sector Treatment Centres (ISTCs) including one in Devizes.

Under the SHA's plans ISTCs will do surgical operations and diagnostic procedures will be undertaken from mobile centres. The nearest centre to West Wiltshire will be Devizes.

"Hundreds of my constituents have taken part in the PCT's consultation exercise without knowing about this major initiative.

"Some of the services that ISTCs undertake are currently provided in our major hospitals and some would more appropriately be carried out by community hospitals and the PCT's proposed new primary care centres. Therefore, people that have responded to the PCT consultation exercise may feel that their submissions have been overtaken by today's announcement and may want to amend their submission in the light of it.

"Today's announcement has destabilised the consultation. It seems to me that the PCT must either re-run it or at the very least least write to responders inviting them to amend their comments if they want to. Either way there will be a delay and much expense that could have been avoided if the PCT and SHA had operated in a more joined-up way. I look forward to hearing the PCT's proposals.

Dr Andrew Murrison, local MP and Shadow Health Minister, has given plans for an independent sector treatment centre in Devizes announced today a cautious welcome. He said;

"If this improves surgical treatment and choice for my constituents I will be very pleased. However, Devizes is hardly ideal for most of my West Wiltshire constituents who are already feeling sore at the PCT's plans to close down all of our community hospitals.

"Although I do not hold objections in principle to partnerships between the NHS and the independent sector, under this government such arrangements have been very much 'jam today'. Because of the maladroit way in which ministers have set them up, many have a long and very costly tail that will ultimately have to be absorbed by patients years from now.

Andrew Murrison says that a new report from the NHS Confederation and the Local Government Association warning that nationwide local councils are now having to cut social care because of the impact of NHS deficits is precisely in line with his experience locally.

In the nationwide survey, seven of out ten local authorities are withdrawing services because of cuts in spending from NHS Trusts. Many NHS organisations have stopped funding joint projects and referred patients on to social services which would normally be dealt with by hospitals. In turn, councils are being forced to reduce provision for low-level care needs, increase waiting times and cut funding from other budgets like leisure or transport. These funding pressures could also feed through to higher council tax bills next year.

Andrew has been corresponding with Wiltshire social services about threatened closures and cuts that have arisen as a result of the transfer of NHS deficits. He said;

"Despite the hard work of public sector workers, financial mismanagement by Whitehall and its agents is leading to cuts in frontline services. Across the country, local hospitals are having to sack staff and cancel operations because their budgets are in the red.

"But worse, these NHS cuts are now hitting local councils, since health and social services are so closely linked. Elderly and vulnerable people are suffering as hospitals cut care provision, and councils do not have the funds to cope.

"Patients, carers and frontline healthcare staff deserve far more from the government than botched reorganisations, cutbacks and closures."

Andrew Murrison was elected Vice Chairman of the All Party Morocco Group at the Group's AGM in the House of Commons this afternoon. Andrew, whose constituency is home to the largest Moroccan community outside the Capital said;

"I'm very pleased to be asked to serve in this way. It's important that ties between Morocco and the UK are strengthened and I hope that the Group will continue to play its part."

Andrew is involved with plans to twin Trowbridge with Ouija in Morocco , the original home of many of his Moroccan community constituents.

Andrew Murrison has written to West Wilts PCT Chief Executive Carol Clarke to find out what bids she has put in for the extra money announced by Health Secretary Patricia Hewitt for community hospitals on 5 July 2006.

"Although it is capital funding, not revenue, the Health Secretary's endorsement of community hospitals is welcome and clearly we need a slice of it in West Wiltshire. If the PCT isn't quick off the mark we'll lose out.

"The minister's announcement talks of upgrading existing community hospitals which is a new development and gives me some hope for the future. However, we are handicapped by our PCT and its reluctance to listen to the views of local people and healthcare professionals.

"The PCT is forever trying to convince us that our hospitals are too old and not fit for purpose. Well, if that's so this announcement of cash for modernising community hospitals is its cue to put things right.

Andrew Murrison will be on the Trowbridge Hospital march in the county town on Saturday.

Andrew Murrison, Member of Parliament for Westbury, today welcomed proposals by the Government to make it easier for homes to install small-scale renewable energy, such as solar water heating or mini-wind turbines. The move by the Government to change planning rules comes after a Conservative campaign to push for more green energy and micro-generation.

Also recently, David Cameron has made a major speech calling for:
. a level playing field between renewable and other forms of energy generation.
. encouraging local generators to sell any spare electricity they generate back to the National Grid.
. improving and streamlining planning procedures for green energy.

Dr Murrison explained,
"I welcome that the Government has responded to cross-party pressure to make it easier for homes in Wiltshire and across the country to install renewable energy like solar panels or mini-wind turbines. Where the Government offers positive, constructive and reasonable policies, they will have my support.

"But the Government could do far more to promote green energy, rather than giving unfair subsidies to new nuclear power stations. Conservatives want to enhance our environment by seeking a long-term cross-party consensus on sustainable development and climate change."

Responding to the publication of an audit by the All-Party Parliamentary Hepatology Group which found that only 8% of Primary Care Trusts have taken effective action to improve hepatitis C services, Andrew Murrison MP said:

"The Government published in 2004 an Action Plan to improve hepatitis C services but there seems to have been little but inaction since then from too many parts of the NHS. Hepatitis C is a public health time bomb and it needs addressing now. It is unacceptable that so many PCTs are ignoring the scale of the problem."

The audit was conducted on behalf the Group by The Hepatitis C Trust. With the help and advice from a panel of healthcare professionals, The Hepatitis C Trust conducted the audit on the basis of 10 criteria, scoring PCTs out of 10 depending on whether or not they had fulfilled each of the criteria.

A score of between 8 and 10 indicates that a PCT has made a major effort and significant progress in implementing the Action Plan, whilst a score of 3 or less suggests the Plan is only being implemented minimally or not at all. A score of between 4 and 7 indicates that some progress has been made to implement the Plan, but that more needs to be done.

Andrew has written to both PCTs that serve his constituents to ask why they did not respond to the survey and to find out what they are doing to address Hepatitis C services locally.

I am grateful for the opportunity of commenting on Pathways for Change and Mainstreaming Mental Health.

In the opening paragraphs of their consultation document Ken net and North Wiltshire Primary Care Trust and West Wiltshire Primary Care Trust (PCT) state that the options on offer have been drawn from the views of local people. These options would strip out all four community hospitals in my constituency, the elderly mentally infirm unit Charterhouse and West Wiltshire's maternity unit.

The PCT has, in my opinion, distorted the views expressed by residents. Even a casual acquaintance with the aspirations of my constituents would have told it that each of its three options is completely unacceptable.

The two consultations are heavily intertwined and so I have provided a joint response. My contribution has been informed by the considerable representation I have had on the direction of travel that PCT and Avon and Wiltshire Mental Health Partnership NHS Trust (MHT) have taken. Very little has been positive.

The plans are the result of the need for the PCT and MHT to address deficits created by mismanagement and some of the lowest health care spending per capita provided by central government.

PCT antipathy towards community hospitals may in part be driven by accounting artifact that makes them look expensive despite their cost-effectiveness if robust admission protocols are applied. For example the immaturity of the NHS tariff system that cannot yet be easily unbundled means that step-down patients in community hospitals effectively costs the PCT twice - once as a commissioner and once as a provider of the same care. A visionary blueprint for the future would anticipate maturity in the system and the likely effects of developments such as Practice Based Commissioning in an area where community hospitals have traditionally be supported by GPs.

It would have been helpful if a fuller explanation of the background to the deficits could have been given beyond the PCT Chief Executive's assertion that her organization is living beyond its means. My constituents do not feel that they are enjoying the better than average service that her words imply. Indeed, a discussion of the implications of the current adverse funding formula might have given the Trust a slightly easier time at the often boisterous public consultation meetings that have taken place.

The PCT's consultation document might have indicated how it intends to make good the larger part of its deficit that will not be touched by even by the most optimistic forecasts that are contingent on its three options. It looks like the new-look services (such as they are) will be launched against a backdrop of continuing financial crisis. It is reasonable to assume, therefore, that many of the services promised, like neighborhood nursing teams, will be vestigial in character.

The government white paper (GWP) 'Our health, our care, our say - a new direction for community services' published in January 2006 contains at paras 6.42 and .6.43 unequivocal support for community hospitals. Ironically, Trowbridge hospital which the PCT wants to shut is cited on page 145 as an example of best practice. The PCT stretches credulity on page 1 by praying-in-aid the GWP to support its case for cuts in community services. Its assertion on page 12 in the box marked 'strategic future vision/development' that each of the options 'Implements recommendations from Government White Paper' is based on a very strange interpretation of the GWP indeed.

Turning now to what the GWP does say. The document makes a point of encouraging PCTs to consider when making decisions on community hospitals 'options such as developing new pathways, new partnerships and new ownership possibilities.' I strongly suspect that West Wiltshire PCT's response to this enjoinder has been lukewarm. My suspicion is heightened by its refusal to provide me with any details of the negotiations it says it has had with non-NHS providers. I believe the PCT's secrecy to be contrary to the public interest and have referred the matter to the Information Commissioner under the Freedom of Information Act.

On 5 July 2006 in a statement to the House of Commons, the Health Secretary reiterated her government's commitment to community hospitals given in the GWP and went further with funds to allow not only for new generation community hospitals but also 'the redevelopment of existing cottage hospitals.' The latter had not previously been volunteered in either published government papers or ministerial announcements.

At the same time the minister announced a new approach called 'Community Venture' which she envisaged providing 'opportunity for a wide range of public, voluntary and private parties to pool their skills for the benefit of the local community.' I take this to mean the active involvement of non-NHS partners in a way that the PCT has failed to do hitherto.

The minister's announcement and the supporting publication 'Our health, our care, our community: investing in the future of community hospitals and services' published on the same day signal a subtle but distinct firming-up of the government's presumption in favour of community hospitals that is, necessarily, not reflected in the consultation documents but must be in any final decision taken.

The government quite correctly insists that public bodies should 'rural-proof' policy by which it means that initiatives should be examined to see how they will affect people living in remote or rural areas. There is no evidence that the PCT has bothered to do this. Indeed, its scant regard for access and transport issues suggests it has not. The PCT's options would disadvantage the most rural parts of the population it serves.

There is considerable doubt over the funding assumptions contained in the PCT's consultation document.

When questioned officials have been vague on the make-up of neighborhood nursing teams and the services that new primary care centres and so-called new generation community hospitals will provide. With this lack of clarity it is difficult to put much store by the accounts given in the consultation documents. Indeed, given the margin for error implicit in any major reorganization of this sort and the tendency for estimates to be conservative it seems quite likely that the modest saving offered by under Option 2, at least, would be reversed negating the whole purpose of this exercise.

Given the maladroit way in which the PCT has historically managed its finances, it seems optimistic to suppose that any of the options outlined would come in on budget under its stewardship.

The PCT has adopted a silo approach to budgeting which is understandable given the pressures that it is forced to operate under. However, it would have been reasonable to explain in this public document that some at least of your savings will translate into cost to other agencies - social services, acute hospitals through bed blocking and the voluntary and charitable sector. This last will bear particularly heavily on palliative care, a service that is mentioned not once in the consultation document.

I fear that the new neighborhood nursing teams would not be resourced to offer much more than a 'tea and sympathy' version of hospital-at-home. Warminster was promised enhanced community nursing when Ward 2 closed but it was not forthcoming and posts in West Wiltshire remain frozen.

The PCT needs to outline its estimate for the number of nurses and therapists that will be needed with particular reference to traveling down-time in the service of a widely dispersed population. Regrettably this was not included in its consultation document.

During its presentations the PCT has suggested that treatment in a community hospital is more expensive than in an acute hospital. It has made this assertion without providing supporting evidence. In fact we know that, providing admission and discharge protocols are applied, the reverse is the case as demonstrated asrecently as May 2006 (BMJ volume 328 page 605).

The PCT implies that it is able to use capital receipts from the sale of sites it considers redundant or that it can re-use property it holds (page 10). Disposal of community hospital sites has been aired in debate at Westminster recently. Unfortunately it seems that the PCT is guilty of over-simplification as the disposal of health service assets is governed by Treasury rules that may mean that benefit accruing to local healthcare from sales is limited as has been found elsewhere. The PCT has not said what arrangement it has reached with the Treasury over the hospital sites in West Wiltshire.

On questioning PCT officials it becomes clear that there is a reluctant acceptance that in-patients beds will still be needed after the community hospitals have shut. It transpires that the PCT's answer is to commission beds from the commercial sector. Given the shortage of nursing home bed space that exists already this seems ambitious. Although assurances are readily given that negotiations with providers have taken place, no details have emerged and there is no mention of anticipated costs in the consultation document. It can only be assumed that if there have been negotiations they have been exploratory in nature.

The PCT has given an uncosted wish list of extra services that the new arrangements might provide. I share its aspirations for more and better services outside acute hospitals but note that those given could be provided equally from existing GP surgeries and community hospitals - for example scans and dermatology clinics - the provision of which is generally limited by the availability of practitioners, for example GPs with specialist interests (GPwSI), rather than custom-built premises.

Digital X-ray services are cited more than once in the document and their roll-out would be welcome and indeed expected regardless of the consultation. But the implication that they can only be provided from new premises is false. It remains unclear how new primary care centres 'will provide more care than is traditional from a GP practice, through integrated GP and community health services' (page 5).

This lack of focus on what is needed and what can be provided is alarming as the case for new primary care centres and new generation community hospitals must be based around service provision and not simply 'bricks and mortar.' Indeed in failing to understand this the authors of the consultation document demonstrate the same obsession with and sentimental attachment to bricks and mortar that the PCT's Chief Executive has tried, unfairly, to associate with hospital campaigners throughout the consultation period.

The PCT's document talks at page 3 about old community hospitals that are not 'fit for purpose'. It is clear that Bradford on Avon hospital's accommodation is poor and I hope that a modern facility may replace it. However, the description does not apply to the remaining hospitals - particularly Westbury - in my constituency. I was irritated at having to correct the brief that the PCT had evidently provided the Health Secretary when Patricia Hewitt parroted its words at a meeting at Westminster to discuss the healthcare crisis in West Wiltshire.

The PCT fails to elaborate on what it means by 'fit for purpose' given the services that are currently being provided by the community hospitals of West Wiltshire to the satisfaction both of my constituents and of any external scrutiny that has been carried out. It needs to say what purpose it has in mind and why it considers bright, new Westbury hospital unfit for it against a backdrop of national audit laurels for its stroke unit and plaudits for its cataract unit.

The PCT, whilst content to remove Malmesbury community hospital in the north of its area from the consultation on the grounds that it is new, is content to write-off the considerable investment that has gone into Westbury. It is also silent on the new out-patient suite established recently at Warminster.

The consultation document does not make clear that the residual community hospital beds will have to accommodate the needs of Mainstreaming Mental Health following the closure of Charterhouse. This emerged on question the MHT Chief Executive.

The documents contain no reassurance that the promised new facilities will be operational before community hospitals are closed.

The PCT proposes the closure of the Trowbridge midwife-led maternity unit. The district's deliveries would then be directed to Chippenham. The consultation document observes that more women now wish to deliver at home and goes on to say that the PCT will 'actively promote NHS home births.' This assertion of course predates draft guidance from the National Institute for Clinical Excellence (NICE) that appeared in June suggesting that such births are attended by a higher perinatal mortality rate. It also supposes that women will continue to opt for home births and ignores the added risks involved with home delivery in relatively remote areas. Finally, the PCT's proposals fail to give due weight to its own Maternity Reference Group that in 2005 gave strong endorsement to the Trowbridge unit where there are more births annually than at its sister establishment in Chippenham.

It emerged during my tour of Trowbridge maternity unit on 24 June in the company of the senior midwife Balwinda Dhanowa that she had not been consulted in any meaningful way by the PCT in the course of the drafting of its three options. I find this astonishing.

Balwinda Dhanowa and her staff have unresolved issues around domiciliary visits. For example, they are concerned that no provision appears to have been made for driver escorts, a sensible safety feature in the often highly charged situations in which they operate.

There is little evidence that professionals that might relocate from community hospitals to the community have been consulted. There appears to be an assumption based on anecdote that staff will be content to re-train for domicilary work. Some may, but it seems likely from my discussions that many highly trained and dedicated people will be lost to the NHS.

Patchy engagement with healthcare professionals has been a recurring theme throughout the PCT's consultation exercise. I note from the Avenue Surgery's submission that it has been poorly consulted despite the profound implications that the proposals have for it and for other GPs in the district. It is difficult to see how the hostility that the PCT has managed to generate can be translated into the cooperation that it would need to drive its plans forward

The MHT's proposals appear more thoughtful than those of the PCT. I am grateful to its Chief Executive Peter Wilson for his careful explanation of how mental health services, particularly those relating to the elderly mentally infirm, might be improved to reflect best practice. I also note the benchmarking he has done with surrounding counties to determine Wiltshire's correct number of bed spaces.

The changes proposed will remove both in-patient and day hospital provision at Charterhouse. In return, provision for older adults will revolve around a community mental health team with integrated beds in a new generation community hospital that will be able to cater for the physical as well as the mental health problems of patients. I concede that there is virtue in the latter. However, it surely rules out the PCT's option 1 which would make provision hopelessly remote for patients in West Wiltshire.

I remain concerned that the MHT's proposals will increase pressure on carers. There are few plans to obviate the burden that will inevitably fall on them as a result of reducing the reliance on in-patient and day hospital care. At its presentations, the MHT has described how assistance might be given to carers. However, I remain cautious given the residual financial pressures that will apply following the implementation of the Trust's proposals.

I share the concerns expressed by many at the apparent lack of planning for the transition phase of the shift to the new arrangements heralded in the PCT's three options.

The PCT's options will not be welcomed throughout its area of responsibility. However, they are especially harsh for my constituents as the denuded basket of services it intends to replace the current provision will be shifted north closer to the major centres at Bath and Swindon . Warminster, twenty miles from Bath and Salisbury , will be particularly isolated and any new generation community hospital in Chippenham will largely be an irrelevance to its residents and to its extensive rural hinterland.

I am very surprised that the PCT has not reflected in its proposals the Regional Spatial Strategy (RSS), the bare bones of which were available in advance of the publication of its three options. Trowbridge is Wiltshire's county town. Not only does it contain the greatest amount of relative deprivation and by extension, under the government's own formula healthcare need, in the PCT's area but it likely to expand substantially under the RSS. It is a large and increasingly important settlement that surely warrants the services available from a community hospital, including maternity services and the capacity to admit elderly mentally infirm patients.

I have not had a satisfactory answer to questions I have put to the PCT about the exclusion of Malmesbury community hospital from the consultation. Whilst I am sure that it is worthy of retention, it seems remarkable that it should be set aside from consideration on the grounds of that the PCT decided on its future in 2004. If that decision was premature and has produced an incongruity the PCT should come clean. Alternatively, if Malmesbury provides a model for other small towns to emulate the PCT should say so. Similarly, the retention of Savernake community hospital in a relatively prosperous small town that enjoys easy access to the Great Western Hospital Swindon in two of the options requires explanation. My constituents will note that this sits ill with the PCT's scorched earth policy further south and west.

The PCT is fond of citing the fact that Salisbury district, which is covered by South Wiltshire PCT, does not have any community hospitals as if to justify the leveling down of those districts that do have them.. Its logic is specious and betrays an appalling ignorance of the way the county is arranged. With the exception of Salisbury and the abutting town of Wilton containing the impressive Salisbury District (foundation) Hospital and Fountain Way , operated by the MHT, South Wiltshire is characterized by villages and very small towns - I live in one of them. I would challenge the PCT to equate any of them with the towns in my constituency that currently have a community hospital.

The statutory Health Overview and Scrutiny Committee of Wiltshire County Council set up a task group under the chairmanship of Peter Biggs that also including a number of persons who like him are not elected representatives. It obsessed with what it was pleased to call community hospital 'have-nots' and 'equity.' This preoccupation appears to be a thinly disguised attack on those settlements that have community hospitals within them. Yet the only example other than Salisbury district as a whole ( vide supra ) that the task group could cite is the small town of Calne with its very close proximity to Chippenham and, a little further north, the services of Swindon's new acute hospital.

The logic of the task group's argument is that because Calne and the very small towns in the district of Salisbury do not have community hospitals within their curtilage, they should, in the interests of 'equity', be expunged from the rest of the county. This would clearly be a nonsense even if we ignored the fact that those the task group labels 'have-nots' of course benefit directly or indirectly from existing community hospitals.

The contribution to community hospitals from the public appears to have been discounted by the PCT but it is significant. Historically community hospitals were often either the gift of local benefactors or raised by voluntary subscription. In 1948 they were effectively nationalized. Nevertheless an admirable sense of community ownership and self-help has continued and local charitable effort has sustained community hospitals, often in very substantial way. It is unfortunate that the financial support and palpable goodwill of residents for their local hospitals that is so characteristic of West Wiltshire has not been recognized by the PCT.

In summary, I question the financial premises and assumptions on which the PCT's options are based, note that each option would propel healthcare northwards away from my constituents and towards more favored parts of the county and consider that if implemented the plans overall would be to the very great detriment of people living in Wiltshire generally and to my constituents in particular.

None of the PCT's options are remotely acceptable. I recommend that its successor body submits revised proposals that incorporate the recent developments cited. Although the MHT's proposals appear more robust they are interlinked with those of the PCT and consequently I regret that I am unable to give them my support.

Andrew Murrison will deliver his response to the Primary Care Trust's Consultation Document on the future of primary and intermediate healthcare in his constituency in person tomorrow (Friday) at 11.30am. He will also hand in representations he has had from constituents so that the points they contain can be registered as part of the consultation. He said;

"The feedback to the consultation that I have had from residents has been almost universally hostile. None of the options given by the PCT are in my view remotely acceptable and I very much hope that there will be a major re-think.

Murrison: seller's packs will increase stress of moving home, increase costs and undermine the housing market

Dr Andrew Murrison, Member of Parliament for Westbury in Wiltshire, today warned that Government plans to introduce 'Home Information Packs' next June could undermine the housing market and increase the cost of buying and selling a home. From 2007, anyone wanting to put their home on the market will have to pay up to £1,000 to produce a Pack, or else face a £200 fine. Yet new information in recent weeks has significantly undermined the case for this extra red tape:

. Fewer homes on the market : A new independent survey by economic experts, Oxford Economic Forecasting, has warned that they will cut the number of housing transactions, reduce labour mobility and depress consumer spending, potentially resulting in higher unemployment.

. Deficit on home risks : Packs will not be forced to include details on flood risk, natural subsidence, radon gas or land contamination. Such information is only voluntary, meaning many buyers will not trust the limited information in the Pack, and will still want to pay to commission further research.

. First time buyers will still need valuations : Buyers will still have to commission and pay for valuations, particularly if the Loan to Value ratio of the mortgage is over 80 per cent (e.g. for most first time buyers).

"These packs are an expensive, bureaucratic job creation scheme that will be an unwelcome additional burden to people struggling to buy and sell their homes. They will do little for buyers who will have to make their own enquiries before being able to buy with any confidence and they'll cost sellers a great deal.

Local MP and hospitals campaigner Andrew Murrison has welcomed the government's re-stated commitment to community hospitals and the extra funding announced today. However he has pointed out that providing capital funds for new hospitals will not address the PCT revenue crisis that is causing the closure of all four of the community hospitals in his constituency.

"Listening to the minister speaking as the despatch box ia an unworldly experience as whilst she is pledging her support for community hospital her agents at PCT level are busy closing them down.

"She's promised capital investment but the hospital closures are not the result of insufficient capital but an inadequate PCT revenue stream that has generated massive deficits.

"The NHS tarfiff system that can mean the PCT effectively paying twice if a person is in a community hospital has also contributed to the closure plans. It desperately needs sorting out but so far the minister has failed to do so.

Dr Murrison welcomed some subtle changes in departmental languages that suggested that smaller communities than previously envisaged might support community hospitals and that existing community hospitals might be re-developed under the government's plans. Patricia Hewitt also firmed up the language on seeking community, voluntary or commercial partners in managing community hospitals as part of what she described as 'Community Venture.'

Health Secretary to make statement this afternoon in Commons on community hospitals

Patricia Hewitt MP will make a statement of community hospitals at 12.30 today directly after Prime Minister's Questions.

Andrew Murrison has given a cautious welcome to news that the department of health will be spending more money on community health services.

The MP has welcomed the minister's stated intention to fund community hospitals but notes that Bradford on Avon in his constituency has already closed under her stewardship and that the remaining three face the axe under proposals tabled by her officials at West Wiltshire Primary Care Trust.

"If this announcement replaces the minister's rhetoric with real action in support of local health care I will give it my unequivocal support. However, it remains unclear to what extent this is simply a re-announcement of money that has already been committed and how it will reverse the scorched earth policy of Primary Care Trusts in districts like West Wiltshire.

Wiltshire MP and Shadow Health Minister Dr Andrew Murrison is calling for last-minute responses to the consultation documents on the future of healthcare in Wiltshire. The MP has condemned the Primary Care Trust's scorched earth policy that seeks to close all four community hospitals in his constituency together with the elderly mentally infirm unit and the maternity unit in Trowbridge,

"None of the options that healthcare managers have cooked up are remotely acceptable. I hope everybody concerned for the future of high quality local healthcare will submit their views by the deadline on Friday.

The MP will be delivering his own response in person to PCT HQ in Trowbridge on Friday together with letters and e.mails he has received from constituents on the subject.

Or by phone 01225 759886/FAX 01225 754648 or e.mail pathwaysforchange@wiltshire.nhs.uk

Andrew Murrison cashed in the Steeple Ashton village shop token he won at the Steeple Ashton Safari Supper on 24 June to buy some Wiltshire products with low 'food miles'. His basket contained beetroot from Bromham, a bottle of white wine from the Wylye Valley vineyard, some Wiltshire honey and green tea from the Wiltshire Tea Company in Corsham.

"I had the privilege of opening the shop a year ago and its great to see how well it has done.

"Village shops are gradually making a come-back, usually with the help of volunteers, and they're helping to put the heart back into many of our communities that would otherwise risk becoming dormitories.