The Minister of State, Department of Health (Paul Burstow)
I congratulate my hon. Friend the Member for New Forest East (Dr Lewis) on securing the debate and on being, as ever, so thorough and detailed in his exposition of the case that he puts before the House. I take this opportunity to pay tribute to the hard work of the staff who work within the NHS in his constituency.
I want to set out the current position, as I understand it from the briefings that I have had over the past few days, and to respond to several of my hon. Friend’s specific points. I assure him that under the proposals for adult mental health redesign set out by Southern Health NHS Foundation Trust, Woodhaven hospital will not close but will change the nature of what is provided. I want to make it clear that there is a continuing NHS future for the facility, albeit not the one that he believes to be appropriate.
While the trust recommends that the acute adult mental health ward is withdrawn from Woodhaven, the excellent hospital which my hon. Friend opened eight years ago and which the community should rightly be proud of will continue to offer specialist adult mental health services. The aim of these changes is to provide the right mix of community and bed-based care—this debate centres on what that balance is—and ultimately the best possible support for people in his constituency who use these services.
My hon. Friend will be aware that during the 18-month engagement with the public that took place prior to the statutory consultation, the majority of patients consulted said—this is one of the areas that he challenges—that they wanted to be treated in the community. As a general principle in any field of health care, the more we can focus on prevention and on supporting people in their homes so that they retain their independence and stay connected with their communities, the better the outcomes we can achieve. The principles behind the trust’s proposed redesign can therefore be pinned squarely to the views of local people, and this is where I want to reassure my hon. Friend a little further. I understand that, through the consultation, the trust has been told this on repeated occasions. I have a quote from one service user:
“I was unfortunate enough to need the services of the home treatment team over Christmas 2008 and New Year 2009, but due to the care I received from the team I didn’t need to be admitted to hospital and I was able to stay at home with my husband and son.”
Clearly, my hon. Friend disputes the evidence that the trust is putting forward about whether patients want to be treated at home, but it is for this reason that it is recommending the integrated model for mental health services in Hampshire and the reinvestment of savings from acute services into community services. However, I will ensure that he is supplied with further evidence on these points so that he can satisfy himself and his constituents that the trust is basing its decisions on reasonable evidence.
Additional community services will ensure that patients receive flexible and bespoke care packages in their home wherever possible, even when acutely unwell. The intention of the proposals will mean that people are admitted to hospital only if it is clear that hospital is the best place for them to receive their treatment. The trust tells me that treatment and care for patients will be provided in the most appropriate and therapeutic environment for the patient and that acute beds should be available for those who need them. However, when local trusts propose changes to existing services, the public should be closely consulted. Again, my hon. Friend obviously feels that that is not what has happened. In the case of Southern Health NHS Foundation Trust, service user involvement projects and carers’ groups from across the county have worked closely with the trust to develop the proposals for the redesign.
I want to deal with a couple of the specific statistical points that my hon. Friend set out so clearly. He has demonstrated something that does not always happen in these debates, in that someone has done a lot of detailed research to try to nail the issue that he is most concerned about. First, I want to deal with the proportion of people detained versus those in voluntary admission. He referred to two days’ worth of data that he had collected and his conclusion that 53% of people were detained in those circumstances. However, I understand that over the past six months, on average, 22% of people admitted to the trust’s adult acute beds have been detained under the Mental Health Act. I have asked the trust to write to my hon. Friend with those figures so that he can see more data.
Dr Julian Lewis
The trust did fax me some figures of that sort. However, they did not make sense because when they were added up, the total was way below the number of beds that had been occupied. I honestly think that the trust is wrong on these proportions.
Paul Burstow
That is why I think it is right for the trust, having read this debate, to follow it up by writing to my hon. Friend. I know that he has been engaging with it face-to-face as well, and I am sure that he will continue to do so.
My hon. Friend made a point about the trust anticipating the effectiveness of the whole clinical pathway and about the focus on the most unwell reducing the number of people admitted under the Mental Health Act, in addition to reducing voluntary admissions.
My hon. Friend mentioned the issue of whether one counts leave beds. It is common for people who have been detained in hospital to have a period of leave from the ward before they are discharged. That can vary from a few days to several months. The beds for leave patients are not kept empty, but are made available for other acute admissions, as my hon. Friend the Member for Broxbourne (Mr Walker) said. It is therefore important to count leave beds when considering capacity. My hon. Friend the Member for New Forest East set out clearly his concern about bed occupancy and the impact of leave beds. I will make sure that the trust considers this issue carefully as it draws together the feedback from the consultation before its forthcoming discussion with the Hampshire overview and scrutiny committee. I will ensure that his concerns about length of stay, which he set out so clearly, are put to it.
My hon. Friend made a request for a pilot. Although I will not go quite as far as he would like tonight, it might help if I provide him with some information about the process that the trust has put in place to evaluate and assess the proposed changes. I understand that it has invited the Centre for Mental Health to do an independent review of the proposals, which is expected to be complete within a month. The trust’s research and development department is also completing a thorough evaluation of proposals, comparing a range of quality measures at baseline and after implementation.
On the next steps, the trust has been in discussions with the Hampshire health overview and scrutiny committee, and it has been agreed that the trust will hold a number of stakeholder meetings. It is expected that the trust will return to the health overview and scrutiny committee at the end of this month and present a written report that describes the themes from the consultation feedback and the progress that has been made in those meetings. The trust will then make suggestions on the next steps, which it will agree with the health overview and scrutiny committee, with a view to reaching final decisions in early 2012. As I understand it, any changes will be implemented by the trust in a phased, transitional approach over a period of time, not as a big bang.
The trust will, of course, keep my hon. Friend fully informed. I know that he has been diligent in pursuing the trust with his concerns. I encourage him to carry on that dialogue. I again congratulate him on securing this debate and for clearly articulating his concerns on behalf of his constituents. I hope that I have been able to articulate some of the points that the trust has put to me and I look forward to a conclusion of this matter in the new year.
Question put and agreed to.