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The Parliamentary Under-Secretary of State for Health (Anne Milton)
It is an outstanding pleasure to speak under your chairmanship, Mr Walker. I congratulate my hon. Friend the Member for Maidstone and The Weald (Mrs Grant) on securing this debate on the future of maternity services at Maidstone hospital and, in particular, the consultant-led maternity services there. I know that the future care of women and their babies in Maidstone is extremely important to her, her constituents and their families. No one could have done more to represent their views. She brought to the debate her own experience as a mother, as indeed do I. Interestingly, I had four children in four different hospitals, so I feel that I have quite wide experience on a personal level of maternity services. We also heard from my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who has professional experience in obstetrics. There is a wealth of experience in the Chamber on an issue that is clearly dear to many people’s hearts.
I want to take this opportunity to pay tribute to the NHS staff in Maidstone and, indeed, across the south-east region, who provide such wonderful care to all the people who use it. I pay tribute in particular to those who deliver babies, by the second, around us, bringing joy to many of us.
It may be helpful if I briefly describe the wider context of NHS reform, before turning to some of the more specific issues. All health care constantly needs to adapt to changes in demography, changing lifestyles, changes in disease patterns, innovation in health care and, indeed, rising health care costs. Change is always unsettling, however. Constituents rely on local health services and, naturally, any suggestion of those services being moved or reorganised always causes concern. However, as my hon. Friend the Member for Maidstone and The Weald stated, that does not always mean that people are resistant or see change as a negative thing. That assertion—people always hate change—is sometimes used unfairly to dismiss concerns, but what is clear about any change is that it must be managed openly and transparently. It should not be dictated by politicians from the Dispatch Box or in this Chamber. It must be a collective, informed and locally made decision, genuinely driven by clinical professionals, genuinely grounded in firm clinical evidence and genuinely recognising the views of the local community.
My right hon. Friend the Secretary of State has therefore been clear about the four crucial tests that any future change to the NHS service must pass. First, it must have the support of GP commissioners. Secondly, the public must be fully involved, with public and patient engagement duly strengthened. Thirdly, there must be greater clarity about the clinical evidence base underpinning any proposals. Fourthly, any proposals should take into account the need to develop and support patient choice. That will mean that patients, local GPs and clinicians, local people and local councils have a far greater say in how services are shaped in the future.
I understand that the proposals to centralise the consultant-led obstetrics and in-patient paediatric service in the Maidstone and Tunbridge Wells area to the new Pembury hospital were consulted on in 2004, and that the plans to consolidate consultant-led obstetrics and in-patient paediatric services at the new Pembury site have been agreed since 2005.
There are often strong arguments for centralisation. It is not, as is often believed, always about saving money, but is sometimes about delivering higher standards of care. There is no doubt that centres of excellence achieve that status by seeing critically high numbers of complex cases. I can cast my mind back to my own experience as a nurse and someone who worked in the NHS for 25 years. Even back in those dark days—it was a long time ago—we had centralisation of neurosurgical services and other specialties for exactly that reason. Critically high numbers of patients being seen produced centres of excellence that could deal with and make better people with rare and not commonly occurring conditions and diseases.
However, I am aware of the considerable public concerns about changes to services in Maidstone. I know that two petitions have been submitted—one to No. 10 Downing street and one to the Department of Health—and that my hon. Friend the Member for Maidstone and The Weald has written on numerous occasions to the Department to express concerns about the transfer of consultant-led obstetric services from Maidstone to the Pembury. Indeed, she has brought with her today a wodge of letters expressing those concerns.
In the light of the concerns, the council’s health overview and scrutiny committee referred the case to the previous Secretary of State in February this year. He asked the independent reconfiguration panel to provide advice, and in its response the panel concluded that due process had been followed. The current Secretary of State accepted those recommendations in July and therefore made it clear that plans for the centralisation of consultant-led obstetrics and in-patient paediatric services at the Pembury should continue.
As I have described, however, the new Government are determined that local voices should be properly heard and that any concerns are taken seriously. The Secretary of State has also asked the local NHS to work with clinicians, GPs, the local council and patient groups, to allay public concerns and demonstrate that those four tests are met. He has asked the strategic health authority to report to him at the end of September, and we would expect that report to set out clearly how the concerns mentioned by my hon. Friend the Member for Maidstone and The Weald—around accessibility, staffing, clinical quality and the huge concerns about transport—have been properly addressed.
I understand that the local NHS has to date conducted 26 one-to-one-interviews, 16 focus groups and addressed various other meetings and groups. Those included a focus group with nursing and midwifery staff, interviews with councils’ representatives and discussions with GPs across the area. Until the SHA report is submitted to the Secretary of State, it would, of course, be inappropriate—albeit, I am sure, disappointing to my hon. Friend the Member for Maidstone and The Weald—to speculate on what the report might say, but we must wait for that report to be published. The Secretary of State will look carefully at what the trust proposes to do, to allay those concerns and ensure that the voice of the whole community is heard in the implementation.
My hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) raised some concerns about the funding for Medway PCT. I understand that the service changes will have no impact on that funding. I also understand that South East Coast SHA has advised my officials that Maidstone and Tunbridge Wells NHS trust has had detailed conversations with all the surrounding trusts about the impact of additional activity. She detailed the large number of births and concerns for a rising number of births. There is no doubt that, for anybody working in the field of maternity and anybody representing constituents who have had babies or are about to, the continuing safety of mothers and babies is absolutely paramount. I want to reassure her that these changes will provide some choice in a birthing setting for local women, who will perhaps have increased rather than decreased choice. However, what will be important is that the SHA takes full account of the impact.
My hon. Friend the Member for Hastings and Rye (Amber Rudd) also detailed some of the issues surrounding the reconfiguration for the Conquest hospital, on which I know she has campaigned. She also raised the issue of the impact on vulnerable people. At times like these, it is extremely important that we remember that there are people out there who do not necessarily get good representation and who rely on their local Members of Parliament to provide that for them. The needs of the vulnerable are critical. I fully understand that these issues arouse strong feelings.
I again congratulate my four hon. Friends who have spoken in this debate on representing their constituents so well. These decisions involve finely based judgments around how available resources should be used to achieve the best possible care for patients. I applaud the determination of my hon. Friend the Member for Maidstone and The Weald to campaign for the best maternity services, and indeed all hospital services, for her constituents. I reassure her that it is a commitment that I share.