Inside Parliament: Conservatives lose patience as Mrs Bottomley loses hospitals

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Virginia Bottomley's political judgement was questioned by senior Conservatives in an extraordinary Commons performance yesterday as the last day before the Easter recess became one of impassioned 11th-hour appeals.

Dennis Skinner wanted to save the jobs of 74 disabled people at a Remploy factory in Derbyshire; his Labour colleague Ann Campbell urged the Government to intervene to save murderer Nicholas Ingram from the electric chair, and Tony Banks wanted to unscramble the £60m sale of London's County Hall to the Japanese company Shirayama.

But the loudest appeal was against the "death warrant" served by the Secretary of State for Health on historic St Bartholomew's hospital in the City, on accident and emergency services at Guy's and on locally-valued units elsewhere in London.

Peter Brooke, MP for the City of London, forced his former Cabinet colleague Mrs Bottomley to come to the Commons to defend the closures for a gruelling 64 minutes.

In a succession of damaging exchanges, senior Tories accused her of insensitivity to public opinion and questioned her competence as a Cabinet minister. Sir Edward Heath murmured darkly about the "political implications" of Mrs Bottomley's decisions for Conservatives representing London seats. On Tuesday, Mr Brooke criticised the Secretary of State's lack of "moral courage" after she confirmed the closure of Bart's and the transfer of most of Guy's patients to St Thomas's in a Commons written reply rather than making a statement.

Raising the issue yesterday, he told the House: "If a hospital has been around for 900 years, for it to receive its death warrant through a written answer doesn't seem to me to be wholly worthy of the traditions of our party." Barts was founded in 1123.

Later, having obliged Mrs Bottomley to make a statement by tabling a private notice question, Mr Brooke was comparatively restrained. "Bart's is a national and international asset and in the post-industrial society such assets are of the highest importance in communicating British medical excellence to the world," he said.

A former minister, Sir Rhodes Boyson, compared the closures to the abolition of grammar schools he fought against. "We are now, on this side of the House, destroying the same traditions in the hospitals, which to my mind is a form of vandalism."

The normally loyal Roger Sims, MP for Chislehurst and vice-chairman of the Tory backbench health committee, praised Mrs Bottomley's "courage" in grasping the nettle of reorganisation but pleaded with her to show "rather more sensitivity". "Consultation implies listening to what people have to say and taking account of their views," he said.

With closure of the accident and emergency unit at Edgware hospital raising as much passion as Bart's, Sir John Gorst, MP for Hendon North, asked if Mrs Bottomley accepted "that democratic politics is about delivering to people what the majority want, and not about telling the majority of people what they should have?

"Does she not accept now that she is doing the wrong thing in the wrong way at the wrong time and in the wrong place?"

But the most wounding criticism came from Hugh Dykes, MP for Harrow East: "Mrs Bottomley has not succeeded as a senior member of the Cabinet because she has not - having listened to the half-baked account of some bureaucrat in her department or elsewhere, reached her own essential, human, social, clinical, medical and indeed political judgements on these matters."

Mr Dykes said the proposal to close the Edgware A&E unit was "outrageous" and Mrs Bottomley should think again.

Mrs Bottomley was supported by out-of-London Tories who have long complained that the capital's hospitals get too big a share of resources and by her husband, Peter Bottomley, MP for Eltham.

Simon Hughes, Liberal Democrat MP for Guy's, said more than 1 million people had signed a petition in support of the hospital and only 23 people had taken the opposite view. Wasn't there something wrong with public consultation when the Secretary of State had sided with the 23? Her work largely done by others, Margaret Beckett, the Labour health spokeswoman, told Mrs Bottomley: "I hope you now recognise that your case is as dubious as your excuses for not putting that case to the House?"

But though sounding nervous at times, the Secretary of State, stuck by her plans. They enjoyed "widespread support within the clinical and academic worlds" she said, and quoted so many eminent figures that Speaker Betty Boothroyd lost patience.

Mrs Bottomley's vision was of "multi-faculty colleges with hospital clusters around them. That is the way to be world-class centres for research and education". Longer journeys to hospital would be met by increased use of paramedics at the scene, she suggested.

She said the changes - covering hospitals in south and east London and around Barnet and Edgware - would be backed by £400m of capital investment on top of the £210m already being spent on improving primary care.

Revenue savings would amount to some £75m a year compared to a cost of £28m at the moment from duplication and fragmentation.

"My job must be, if we are to have a comprehensive service, free at the point of use, able to pioneer new treatments ... to address the need for change," Mrs Bottomley insisted.

But the shouts of "resign" from the Opposition benches and the steam from Tory MPs spoke more of a change for the minister.