Frenchay Hospital

Wednesday 14th July 2010 Westminster Hall

16:15

[Chris Skidmore (Kingswood) (Con)]

Thank you, Mr Hood, for allowing me to initiate this important debate on the future of Frenchay hospital. My constituency is currently served by Frenchay hospital’s acute hospital facilities, so its downgrading is one of my constituents’ most important concerns. The decision to downgrade the hospital and establish a new super-hospital at Southmead in Bristol was taken as part of the Bristol health services plan in March 2005. Meanwhile, Frenchay is to become a community hospital, the development of which will take place in 2014.

Five years might seem a long time ago, but over those years the future of the hospital has remained an ongoing point of concern and debate. The decision to downgrade is deeply unpopular and has been challenged by South Gloucestershire council and tens of thousands of local residents, nearly 50,000 of whom petitioned the then Secretary of State for Health, Patricia Hewitt, to allow for the decision to be referred to an independent reconfiguration panel. In my view, those are 50,000 reasons why the hospital should be saved, but the petition was rejected, as was a request by South Gloucestershire council’s health scrutiny sub-committee that the matter be referred to the same panel. Instead, the then Health Minister, Lord Warner, said that he saw

“no reason to ask the Bristol health services plan to reconsider…There is no need to refer the decision to the independent reconfiguration panel.”

The current Health Secretary also supported at the time the move for a referral to the independent reconfiguration panel. In a letter dated 27 July 2005, he wrote to Ms Hewitt, stating:

“Plans to change radically hospital provision on the scale proposed in Bristol and South Gloucestershire clearly need to have the confidence and support of the community served by these hospitals. It seems clear that currently the proposal to downgrade Frenchay does not have the support of tens of thousands of local people…my reason for supporting referral is that I believe the people of South Gloucestershire have the right to expect the decision to deprive them of Frenchay Hospital, as they know it, to be independently scrutinised”.

I agree with that letter; he was right that the decision to downgrade the hospital should have been independently scrutinised, as clearly the decision did not, and still does not, have the support of the local community across south Gloucestershire.

In October 2007, there was further hope that the then Secretary of State for Heath, the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson), might reconsider the case for the decision to downgrade the hospital to be referred to the independent reconfiguration panel. However, he replied to the request by the council’s health select committee simply by stating:

“The previous Secretary of State, Patricia Hewitt, dealt with the referral on this issue ... it is not intended to revisit that decision”.

The leader of the council, John Calway, commented at the time:

“This decision will come as a body blow to everyone who is continuing to desperately search for a lifeline for Frenchay…I believe the anger at this decision has been compounded by the fact that the Government has consistently refused local people’s wish for an independent inquiry into the decision.”

Councillor Calway then stated:

“While we are denied an independent inquiry we will never know whether the decision to downgrade Frenchay was made in the best interests of our residents...Sadly for us in South Gloucestershire, the Government has made it very clear that it is supporting the downgrading of Frenchay a has no intention of intervening to even allow this to be questioned or scrutinised.”

That is a view I continue to share.

Ultimately, the previous Government’s decision not to refer the decision to downgrade Frenchay hospital to an independent reconfiguration panel has resulted in the current situation. Five years after the original proposals for the Bristol health services plan were formulated, the contracts for the new super-hospital at Southmead were finally signed in February 2010. The result, I am informed, is that that has ultimately dealt a death blow to any chance of the hospital retaining its acute hospital facilities. I am also informed that, the contracts having already been signed under the previous Government, reversing that decision seems impossible as it would come at massive cost to the NHS and the Government because of the legal implications.

I would be grateful to the Minister for any comments he might have on that matter. Has the previous Government’s refusal to allow local people to have their say on where their local hospital and acute facilities should be located meant that it is too late to intervene?

I understand that on 20 May 2010 the Secretary of State wrote to all NHS chief executives, advising them that their current and proposed reconfigurations must meet four criteria: they must have the support of GP commissioners; they must have strengthened arrangements to ensure that local people’s views are not ignored; they must be supported by clear clinical evidence; and they must support and develop patient choice.

I am very interested to hear from the Minister whether there has been any response to that letter from North Bristol NHS Trust, as many local people would not agree that those four criteria have been met. I hope that that is not the case but, if it is, does the Minister agree with me that the downgrading of Frenchay hospital was Labour’s downgrading? If Frenchay must lose its acute facilities in 2014, that was not the decision of the current Government, but of the previous one. The downgrading of Frenchay hospital, if it is to take place, is a testament to Labour’s NHS record in Kingswood and south Gloucestershire. That is, in my mind, both a tragedy and a national disgrace.

For my Kingswood constituents, the decision, taken under the previous Government, to downgrade Frenchay hospital will be nothing short of disastrous. In this, the second decade of the 21st century, local services should be becoming more, not less, convenient and local. Many constituents are extremely worried about the consequences of the move to Southmead. They are concerned about how, in times of greatest need and when their lives might depend on it, they will be able to reach a hospital over the other side of Bristol. If Frenchay is to become a community hospital under the previous Government’s downgrading, we need to look forward, to ensure that the maximum possible numbers of facilities remain there.

I do not propose to go into detail about the hospital’s reconfiguration, as I understand that the Frenchay project board has yet to finalise details of its scheme. There is, however, concern over exactly what will remain at Frenchay when it becomes a community hospital. Concern has been voiced over the future of its world-class facilities—for instance, the head injury therapy unit, which deals with brain injury rehabilitation services for the community. There is also the Headway organisation, which is based in the hospital grounds and offers vital support to those who have suffered a brain injury and would like to remain at Frenchay. The organisation stated last year:

“we have been unable to get any answers yet as to our future location.”

Then there are the excellent paediatric burns and neurological units, which will possibly move from Frenchay ahead of its becoming a community hospital, though decisions have yet to be finalised.

As the local MP for an area that depends heavily on Frenchay, I do not want to see the hospital, if it has indeed lost its accident and emergency facilities, to be run down to the ground and stripped of its world-class facilities. I raise these issues today because I would like to see the maximum possible number of facilities remain at Frenchay hospital. It is still an excellent world-class treatment centre, and I would like to pay tribute to all the fantastic staff, who have worked so hard to make it what it is today. Frenchay is, quite simply, too valuable to lose.

16:22

[Jack Lopresti (Filton and Bradley Stoke) (Con)]

It is a pleasure to speak in this important debate. Frenchay hospital is in my constituency, and as the local MP I would like to pay tribute to the doctors, nurses and other staff there. My constituents and I are proud to have it as our local hospital. Indeed, many of my constituents have contacted me about the future of Frenchay—about its downgrading and the loss of its accident and emergency facilities. What they want is simple: to continue to have a great local hospital.

In government, we must work towards and achieve good local health care facilities, so that local communities are able to feel safe and reassured that they, and their loved ones, will be looked after in their time of need. Many of my constituents are rightly concerned about the future of Frenchay and, while I accept that we need investment across the NHS, many of them feel that in south Gloucestershire we seem to be missing out to our neighbour Bristol when it comes to health care investment.

As my hon. Friend the Member for Kingswood (Chris Skidmore) has already explained, the contracts for Frenchay’s downgrading were signed in February this year. It is unlikely that that decision can be reversed without significant legal cost. Yet let us not ignore the fact that access to health care is a huge problem for my constituents. If left unchecked, it will continue to worsen in the years to come as a direct result of Frenchay’s downgrading.

Recent growth predictions by South Gloucestershire council have stated that there will be a requirement for 21,500 extra houses in the local area by 2026. My constituency has already seen significant growth, particularly in the vibrant and thriving community of Bradley Stoke. Given the expanding population and the growth predicted, I have to question the logic of allowing Frenchay to lose its accident and emergency facilities.

Many of the local communities in Filton and Bradley Stoke are in rural areas. In an emergency situation, when they are in urgent need of treatment, people in those locations will have no choice but to travel the longer distance to Southmead hospital. The extra travel time in the most severe situations could be the difference between life and death, and that prospect horrifies and alarms me. It is important that we understand the situation in which we find ourselves. The decision to downgrade Frenchay might seem to be signed and sealed, but I know that I, with the support of my hon. Friend the Member for Kingswood, will continue to fight for what the people of south Gloucestershire deserve.

If—or when, as is more likely—Frenchay is downgraded in 2014, we must remind ourselves that this was not the decision or desire of this coalition Government. It was, as my hon. Friend mentioned, the decision solely of the previous Labour Administration. For my constituents, the people of Filton and Bradley Stoke, the word “Frenchay” will come to represent the failure of that Labour Government in our local area. The word will come to represent how Labour let down every single one of my constituents, by denying them the chance of a good local hospital to treat their growing needs.

My hon. Friend has outlined the continuing fight, and we are tackling it together to ensure that Frenchay secures as many facilities as possible. We need to protect the future of its world-class facilities—the head injuries unit, the burns unit and the staff—and we will also ensure that the promise made about the number of beds is honoured. I will continue, as the local MP, to do all I can to fight for the future of Frenchay. Its future is of vital importance, and I look forward to the Minister’s response and the Government’s view.

Finally, I pay tribute to the Save Frenchay Hospital Group. Many of its leading members are constituents and friends of mine, and it has been my pleasure to work with them on this issue over the past few years. They have done a terrific job of bringing focus and attention to the issue, and their work will not be in vain. We will fight, and together we will win the battle to keep the best services possible at Frenchay for years to come.

16:26

[The Minister of State, Department of Health (Mr Simon Burns)]

I congratulate my hon. Friend the Member for Kingswood (Chris Skidmore) on securing this debate. I know that local health services are a top priority for him, and I am sure that his constituents will appreciate all he has done in fighting for better health care provision for them. I also congratulate my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti) on his contribution, given the constituency interest that he has in the future provision of health care in this area. I pay tribute to the NHS staff, both in Kingswood and across the whole of Bristol and south Gloucestershire, who provide such excellent care for my hon. Friends’ constituents and those of other hon. Members.

My hon. Friend the Member for Kingswood has outlined the strength of feeling in his constituency for the retention of as many services as possible at Frenchay hospital, following the expected completion of the new hospital at Southmead in 2014. I understand that he would like clarification on the Bristol private finance initiative scheme. The Government recently conducted a review of all major public spending commitments made between 1 January 2010 and the general election on 6 May, to ensure that they are affordable and consistent with this Government’s priorities, given the horrendous economic situation that we have inherited and the staggering level of debt, which, we rightly believe, we should bring down as a priority because of its implications for the economy as a whole.

The north Bristol PFI scheme was considered as part of that review, and it was allowed to proceed. After final approval was given by the Treasury in February 2010, the scheme contracts were signed and construction is now under way. As my hon. Friend mentioned, the NHS would incur significant costs were it to cancel the contract, and I am afraid, therefore, that I have to tell him that cancellation is not a feasible option. The new Southmead hospital is going ahead, and is due for completion in 2014.

Both my hon. Friends are absolutely right that the decisions flowing from the reconfiguration in this part of Bristol and south Gloucestershire are the direct result of the actions of the outgoing Labour Government. They are not Conservative decisions. They were taken by the previous Labour Government and, as my hon. Friends will appreciate, it is too late to reverse them, and to prevent the implications for their constituents.

The business case projects that, due to a range of diagnostic tests being performed in the community and a greater number of out-patient appointments, there will be some 45,000 fewer acute hospital visits per year in the area. That will mean a far more convenient service for my hon. Friend’s constituents.

I shall set the issue in context. My hon. Friend will be aware that, following a public consultation in late 2004 on the proposals to develop health services in Bristol, north Somerset and south Gloucestershire, the NHS agreed to centralise acute hospital services for north Bristol and south Gloucestershire at Southmead.

In June 2008, as part of the Bristol health services plan, work began to plan community health services that would provide more care closer to home in general practitioner surgeries, community health centres and community hospitals. The Frenchay project board developed recommendations for commissioning community services at Frenchay, which were presented to the boards of the NHS South Gloucestershire and NHS Bristol primary care trusts at the start of 2010.

At the beginning of this year, the project board shared its recommendations on how services could be developed with local GPs, the then Members of Parliament and a range of community groups. The board has now shared its draft options with the overview and scrutiny committees of South Gloucestershire and Bristol councils. As my hon. Friend will know, local authorities will have a key new role in helping to join up services across the NHS, social care and public health. Overview and scrutiny committees will consider the project board’s final recommendations before they are presented to the boards of NHS South Gloucestershire and NHS Bristol in December 2010 and January 2011 respectively.

Let me explain to my hon. Friends the principles of reconfiguration. I recognise that, in the past, local people have felt that changes to local services have been handled badly. However, given the changes that my right hon. Friend the Secretary of State for Health has made to the criteria for judging reconfigurations, that is a thing of the past, although it is of little consolation to my hon. Friends. If the final recommendations differ significantly from what was agreed as part of the Bristol health services plan, NHS South Gloucestershire will proceed with a formal public consultation that will follow the four crucial tests on service changes set out by my right hon. Friend the Secretary of State.

I understand that, to date, the process meets the new criteria for the involvement of the public and clinicians, because the overview and scrutiny committee has accepted that the correct procedures have been followed by the project board. Indeed, only last week, it commended the PCT on the process that it had undergone.

Although the new Southmead hospital is going ahead, I have been assured that any future consultation on community health services at Frenchay hospital will closely involve GPs, local authorities, local people and local MPs to ensure that any new developments meet the needs and requirements of the local population and satisfy the new criteria laid down by my right hon. Friend. I have also been assured that the project board has completed a needs assessment, taking into account travel requirements, transport routes and population growth.

I can inform my hon. Friend the Member for Kingswood that no decision has yet been made on the location of the brain injury rehabilitation unit that is currently at Frenchay. Recommendations on the service will be put forward for consideration by the end of the year. However, detailed negotiation will be required, as the unit is subject to a private lease.

I am sorry that I have to tell my hon. Friends the Members for Kingswood and for Filton and Bradley Stoke that the burns unit will move to the Southmead acute hospital, as set out in the outline and full business cases in February. In-patient paediatric burns and in-patient paediatric neurological services will be centralised, along with all children’s in-patient services, at the Bristol Royal Hospital for Children. In-patient neurological services for adults will be based at the new Southmead hospital.

On other local services, the NHS treatment centre in Emersons Green opened in late 2009. It provides procedures for ear, nose and throat services, general surgery, gynaecology, minor orthopaedics surgery, ophthalmology and urology. It increases the choice of provider for my hon. Friends’ constituents and reduces their need to travel to larger acute sites in Bristol. The PCT has assured me of its commitment to working with local GPs and patient groups to ensure that services are accessible to my hon. Friends’ constituents. Minor injury services are already provided by a GP-led health centre in Kingswood and at a minor injuries unit in nearby Yate. Another minor injuries unit is due to open at Cossham hospital in 2012.

I applaud the determination that my hon. Friends have shown in championing their local health services. Their constituents, like those of all hon. Members, deserve local health services that have the full support of local GP commissioners and of local people themselves. By empowering local clinicians to decide how best to achieve the right outcomes for local people, this Government will ensure that the residents of Kingswood are provided with the very best NHS services now and in the future.

It is a pity that that attitude—the regard for local people and the bottom-up approach, rather than a top-down one—was not adopted by the previous Government. If more attention had been paid to the interests and concerns of my hon. Friends’ constituents, we might not be in the position that we are in today. As both of them rightly said, this is not—I repeat, not—a decision that has been taken by the current Administration. The coalition Government were not party to the proposals, which are a leftover from the Labour Administration.

As my hon. Friend the Member for Kingswood said, despite all the work that was done by a range of people, including him, to try to save services at his local hospital at Frenchay, their views were disregarded by the previous Administration and in the procedures for considering such things. He finds himself in a straitjacket because of past decisions. However, the new criteria set by my right hon. Friend the Secretary of State will apply to future such decisions, and far greater attention will be paid to the wishes and needs of local people.

My hon. Friend has an important part to play in continuing to engage with the local NHS on the community health services planned for Frenchay hospital, and I am sure that he and my hon. Friend the Member for Filton and Bradley Stoke will do all they can to continue to fight for the interests of their constituents, to ensure that they get good, high-quality NHS provision in their local community.