Community Hospitals (North-East)
(12 years ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)
In December 2011, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow) told me:
“Local community hospitals provide a vital community resource to support patients in need of rehabilitation, recuperation and respite care”,
and that they support
“a rapid return to independence and good health.”—[Official Report, 12 December 2011; Vol. 537, c. 560W.]
It was a pleasant surprise to find myself agreeing with him. Unfortunately, community hospitals, especially those in my constituency and in the north-east, are facing ever more challenges.
Hospitals such as East Cleveland hospital and Guisborough hospital play an essential role in the communities that they serve. My constituents prefer and would ordinarily choose to receive care near their home and their family, whether it be palliative, minor injuries or maternity care. That is also the case elsewhere in the north-east and north Yorkshire, where my colleagues and local residents have been speaking out to protect and extend the services in their local community hospitals and district general hospitals, which are increasingly under threat.
Demographic change means that we are increasingly dealing with social care. Given that community hospitals tend to be truly local and cherished, and the need for health and social care to be seamlessly integrated, it should be painfully obvious that local community hospitals are able to provide effective liaison between NHS staff and local adult social services, especially when discussing arrangements for the discharge of elderly patients and their continued need for community-based care facilities and services. The Government are, at least nominally, following the previous Labour Government’s good example of recognising the importance of patient choice.
Mr Graham Stuart (Beverley and Holderness) (Con)
The hon. Gentleman is giving a powerful speech that rightly highlights the importance of community hospitals. Does he, like me, regret the fact that more than 3,000 beds in community hospitals were closed by the last Labour Government? Does he recognise that only a huge campaign across this House made them see the error of their ways and reverse their savage cuts to this most vital of local assets?
Tom Blenkinsop
Any intervention in this debate must be put in the context of the fact that more than £600 million from my region is going to be relocated to the south-east. I know that, as a Yorkshire MP, the hon. Gentleman will be concerned about the news of the cuts to Yorkshire’s health care services that came out only today in The Northern Echo. We can talk about the whys and wherefores of that, but there is certainly a kernel of truth in it. Community hospitals and secondary hospitals, such as James Cook university hospital on the border of my constituency, are having to consolidate and centralise their services far more than has been the case before.
Alex Cunningham (Stockton North) (Lab)
I congratulate my hon. Friend and fellow Teesside MP on securing this debate. I know how hard he works on behalf of his constituents to secure access to the services that they need, particularly health services. Is he surprised that there will be more cuts, particularly in the light of the £50 million that it is costing to reorganise the NHS on Teesside?
Tom Blenkinsop
I am not surprised, to be honest. A couple of days ago, the Newcastle Journal reported that a freedom of information request had demonstrated that even after the NHS redundancies that we have seen, which I think cost approximately £60 million, a further 1,000 nurses are set to be cut in the north-east region.
The role of community hospitals is as important as ever. Despite the apparent importance of community hospitals, I fear for the future of hospitals such as those in Brotton and Guisborough in my constituency, the five other community hospitals of the South Tees Hospitals NHS Foundation Trust, and the trust’s district general hospital, the Friarage, which is at the heart of the Foreign Secretary’s constituency. All those hospitals are seeing a reduction in services as a consequence of the Government’s health reforms and austerity package—whether the reduction of minor injuries provision, the closure of the Chaloner ward at Guisborough hospital or the downgrading of maternity and paediatric services at the Friarage, which even the Secretary of State has branded “unacceptable”.
Ultimately, communities, patients and employees recognise that only so many services can be cut before the future of the hospitals themselves is brought into question. They are concerned that the Government are failing to do anything whatever to prevent those reductions in services. [Interruption.] I give way to the hon. Member for Redcar (Ian Swales).
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. May I suggest to the hon. Member for Redcar (Ian Swales) that if he wants to intervene, it is better if he actually stands up rather than waving his hand?
Ian Swales
Thank you for your advice, Mr Deputy Speaker.
I congratulate my neighbouring MP, the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop), on securing this important debate. My daughter was born in Guisborough hospital in his constituency, but that would no longer be possible as the maternity unit closed in 2006. The withdrawal of services from older community hospitals, and the failure to put services into new community hospitals such as Redcar, are top-down decisions. Does he support more locally based commissioning driven by clinicians?
Tom Blenkinsop
I believe in an excellent quality of service, and yes, it was regrettable that the maternity unit at Guisborough hospital was closed. As the hon. Gentleman will know, my predecessor fought to save that service. In fact, there was a wide campaign by the local trust and all local politicians to keep it open. Unfortunately, more people opted to use the maternity services at James Cook hospital, which was part of the choice agenda that all parties believe in. I am sure the Minister does as well.
Jim Shannon (Strangford) (DUP)
Will the hon. Gentleman explain why some Members, when they are outside the House, support petitions to retain hospitals and community services, but in the House vote to stop them?
Mr Deputy Speaker
Order. I allowed the intervention, but I am not sure what the connection is between the north-east and Northern Ireland.
Tom Blenkinsop
The current Prime Minister, when he was Leader of the Opposition, identified Northern Ireland and the north-east as areas where the public service cuts should primarily take place. That is the similarity. Of course, the north-east leads all other regions in the United Kingdom on exports, so there was some smoke and mirrors in that argument. There are indeed a number of Members who are introducing petitions against the closure of health services, including a number who are in the Cabinet.
The centralisation process is well under way at Guisborough hospital, in my constituency, and that is just one example of what is happening across the north-east. The hospital has already been forced to operate a reduced service owing to staffing pressures, opening only from 9 am to 5 pm on weekdays and 8 am to 8 pm at weekends instead of the usual round-the-clock service. The Chaloner ward there is an eight-bed unit providing palliative, post-operative and respite care, with dedicated nursing care for a variety of medical conditions. There is also an out-patient suite and a minor injuries unit. Closing the Chaloner ward could eventually mean the end of the hospital. The maternity service has already been lost, and closing the ward would leave only a residual out-patient service and the Priory ward on the site. East Cleveland hospital, in the Brotton area of my constituency, offers even more limited services than Guisborough, and I have often spoken to constituents who have been forced to seek treatment elsewhere.
My main concern is that hospitals such as Guisborough and Brotton will become marginalised owing to a continuous reduction of funding from South Tees Hospitals NHS Foundation Trust, as more and more services are consolidated at James Cook university hospital. It takes nearly an hour to reach that hospital by bus from Guisborough, and even longer from the more rural parts of my constituency—and that is under the very generous assumption that such bus services will still be available.
It may be politically expedient for some to argue that such decisions are solely the responsibility of the relevant trust and are somehow detached from being the responsibility of central Government, but they are unfortunately a worrying national trend. No one trust can take the blame, and the scrutiny must instead be of the Government who force them into such a position. For example, I have read that in Sutton,
“a cloud has gathered over St Helier”
district general hospital, where accident and emergency services are under threat, to such an extent that the Minister of State, the hon. Member for Sutton and Cheam, has started a petition against the closure in his own constituency, despite the fact that it seems to be part of a broader pattern that is perhaps caused by his own Department’s policies.
Given all the campaigns that are emerging throughout the country to save services at local hospitals, I find myself asking why there seems to be such a decline in the provision of services. Despite the Government’s localism agenda, it appears that services are becoming more centralised to larger hospitals, leaving community hospitals with empty beds and abandoned wards.
Dr Phillip Lee (Bracknell) (Con)
Does the hon. Gentleman agree that the consolidation of acute and emergency services, and the reconfiguration of services in the north-east and across the country, are about not just the cuts and austerity to which he refers—I do not agree with him on that—but the changes in how health care is provided? Does he also agree that the community hospitals that he seeks to support are best placed to deliver chronic care, not acute care?
Tom Blenkinsop
There is an element of truth in what the hon. Gentleman says, but I will come to that when I make suggestions. Community hospitals have a role as part of an overall package, but I have seen an erosion of those services in my locality. The reason I have introduced this debate is that a pattern is emerging in the north-east and across the country in how services are allocated by trusts.
Guy Opperman (Hexham) (Con)
I applaud the fact that the hon. Gentleman has introduced this debate on behalf of north-east community hospitals. I want to address the issue of the quality of the service provided by them. We retain maternity services in Hexham. The service is so popular that Northumbria Healthcare NHS Foundation Trust has said that it is hopeful that more women will choose to have their babies there. Does he agree that that is an example of a community hospital going forward?
Tom Blenkinsop
I praise the hon. Gentleman—it sounds like the services in his constituency are going forward and doing very well—but I am addressing the broader pattern in my local area and elsewhere. Some worrying trends are a symptom of the Health and Social Care Act 2012, which I opposed vociferously—that is on the record.
The future of community hospitals is being plunged into uncertainty because of the 2012 Act. With responsibility for commissioning health care services now falling to clinical commissioning groups, and with primary care trusts being axed, centralisation is a real temptation both for the CCGs and for the foundation trusts that have taken over responsibility for the management of primary care hospitals in Teesside.
Another future scenario for community hospitals is the possibility of privatisation. As cuts are made, commissioning groups could look outside the NHS to provide their services. That happened in Suffolk in March, where Serco won a £140 million contract to manage, among other things, the area’s community hospitals. Neither the public, who cherish their NHS, nor workers, want that, and there is a concern that such deals are made solely to save money and not necessarily to improve patient care. In the north-east, where health inequalities are most pronounced, such moves could lead to a significant decrease in the quality of service offered, and to a loss of any long-term strategic vision that might exist to tackle such deeply ingrained public health problems.
When I challenged the Prime Minister about the future of community hospitals and district general hospitals at Prime Minister’s questions last week, all he did was cite a supposed increase in funding to the “primary care trust” in my constituency—he is so oblivious and out of touch that he failed to realise there are, in fact, two primary care trusts: NHS Redcar and Cleveland, and NHS Middlesbrough.
Regardless of what spin the Government put on the state of the NHS, it is clear that the NHS throughout the country is struggling financially. In GP magazine earlier this week, research collected through a series of Freedom of Information Act requests showed that nine out of 10 trusts find themselves “rationing” care such as cataract surgery and knee and hip operations. If trusts have to do that, there is clearly an issue with funding, despite the Government’s assertions, especially when trusts such as Redcar and Cleveland have to spend tens of millions of pounds to deal with the consequences of the 2012 Act.
I worry that many trusts, when faced with the real possibility of having to reduce clinical services, will turn towards centralising them and taking them away from community and district general hospitals. They will certainly be wary of extending the services offered in such hospitals. Redcar primary care hospital, which is in the neighbouring constituency of the hon. Member for Redcar (Ian Swales), needs such an extension, but the localisation agenda is threatened by the lack of funding necessary to pursue it.
The Health Secretary and Prime Minister need to remember the pledge they made in 2007 to protect district general hospitals, and to listen to what communities, patients and medical professionals are saying about the importance of securing the future of community hospitals. It would take some of my constituents, such as those in Cowbar, 45 minutes by car or around three hours by public transport to reach the large hospital 20 miles away into which services are being consolidated. I imagine the situation is even worse in more rural parts of the north-east and north Yorkshire. That is clearly not acceptable. Individual members of the Government, such as the Foreign Secretary and Minister responsible for care services, have been critical of the effect of the Department of Health’s policies on the provision of services in local hospitals following campaigns by angry and worried constituents, but it is time for the rest of the Government and the other Health Ministers to act. Steps need to be taken, and funding provided, to ensure that patients have the choice to receive as many services as is medically possible in hospitals near their homes, not as a replacement to care at home or in more specialised hospitals, but to complement it.
The Minister of State, Department of Health (Mr Simon Burns)
I congratulate the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) on securing this debate, and I pay tribute to NHS staff in his constituency, who do so much for the health and well-being of his and other hon. Members’ constituents.
Robust community services are a vital element of emerging models of care, providing treatment to patients closer to home and improving health outcomes. The Government remain committed to extending and improving access to care and treatment in the community and at home. This includes sharing best practice to enable the smooth discharge and transition of patients from acute settings to robust community services, allowing them to be cared for closer to home.
Community hospitals play an important role in that process. The care that Guisborough hospital provides includes rehabilitation and follow-up care in a community setting. Community hospitals have the potential to make considerable efficiency savings in the local health economy by shifting care, diagnostics, minor injuries and outpatient services, among others, from acute hospitals to the community. They provide both planned and unplanned acute care and diagnostics services for patients closer to home, support best practice in reducing the need for admission to acute hospitals and contribute to the local community by providing employment opportunities and support for community-based groups.
Those are a few reasons the community estate is a core part of the NHS. It can help to transform care pathways, moving care from acute settings to community settings. Local investment in this type of facility is part of a dynamic service model that supports health and well-being for the whole community. The hon. Gentleman will be aware that under the transforming community services programme, responsibility for community services was transferred from primary care trusts to NHS and other providers. To this effect, South Tees Hospitals NHS Foundation Trust took over the operation of Guisborough hospital in April 2011.
The transfer of community services enabled the NHS to develop new innovative models of care using local multi-disciplinary, clinically led teams to improve services and health outcomes for local patients, families and communities. This has enabled the NHS to be creative in its approach to delivering community services. However, I fully appreciate the context within which all NHS organisations operate. They have to provide high quality services while remaining sustainable and efficient in making the best use of limited resources. The Government recognise this challenge, which is why we have protected NHS funding and are increasing funding in real terms during this Parliament.
In the hon. Gentleman’s constituency, Middlesbrough PCT will receive an allocation in 2012-13 of more than £299 million, which is an increase of more than £8 million, and Redcar and Cleveland PCT will receive more than £269 million, which is an increase of more than £7 million. Despite this generous settlement, however, the NHS needs to do more. It needs to find up to £20 billion of efficiency savings over the same period to meet the rising demand for NHS services and to continue to invest in new technologies and drugs to help meet these demands.
We will not dictate from the centre how efficiency savings should be achieved. Decisions about local health services should be made as close to local people as possible. Local NHS commissioners are best placed to identify the scale of the financial challenge and the opportunities for making savings, while driving up and maintaining quality. Every penny of those savings can be reinvested in front-line services and health care.
Guy Opperman
An example of that, I would suggest, is Haltwhistle hospital in west Northumberland, which has been rebuilt by the local NHS trust to provide a hospital facility and an integrated care facility. Does the Minister agree that that is a good example of the Department and the trust supporting a community hospital?
Mr Burns
I am extremely grateful to my hon. Friend, because I understand that the campaign for that decision was kept up for more than 25 years. I congratulate NHS North of Tyne, Haltwhistle council and the friends of the hospital, as well as my hon. Friend, for all their work in ensuring that it is finally happening.
Tom Blenkinsop
It is good to hear that every penny saved will go back into the NHS. My main fear is that the new funding calculations that the Secretary of State for Health is proposing will be based not on deprivation but on age, which means that, as shown by studies by Durham university—a fine institution in my region—more than £600 million of the health funding that is currently given to north-east health services would be redirected south.
Mr Burns
I certainly note the point the hon. Gentleman makes, and I have read a number of his local newspapers, in which he and a number of his hon. Friends have been making it too. I am delighted that he accepts my argument that every single penny that is saved from the £20 billion of efficiency savings—which, of course, we inherited from the last Government and accepted, because it was the right policy to pursue—will be reinvested in the NHS.
I think the hon. Gentleman attended Health questions on 12 June, at which the right hon. Member for Newcastle upon Tyne East (Mr Brown) raised the funding formula and the basis for it with me. I explained that a variety of factors, of which health is one, will determine the allocation of funding—just as it was determined under his Government—and that the question was also being looked at by an independent body. I have seen the newspapers, and I fully appreciate that the hon. Gentleman and his hon. Friends are trying to drum up a storm by suggesting that they are going to be hard done by. However, if he reads the answer I gave to his right hon. Friend the Member for Newcastle upon Tyne East in Hansard, I hope it will reassure him, on reflection, about the current situation.
Mr Graham Stuart
The Minister will recognise that community hospitals in the north-east, as well as in Beverley and Holderness, were starved of funding under the last Government. We saw gross distortions in funding, as the formula used deprivation as a way of pouring funding into urban areas, where there were young people who, regardless of their social background, were not in need of health funding. That starved the community hospitals serving ageing populations, which did need the funding. What we need is not reverse gerrymandering, but health funding that follows clinical health need. We did not have that under the last Government, who starved rural community hospitals of funding. I congratulate the Minister on having the courage to face down the vested interests of the Labour party.
Mr Burns
Let me return my hon. Friend’s compliment in kind by saying that I am grateful for the valid points he makes. He knows as well as I do that this Government, under the leadership of my right hon. Friend the Member for Witney (Mr Cameron), are totally committed to community hospitals. I know that he will also be reassured that, unlike with the last Government, there is no question whatever of this Government gerrymandering the funding formula.
I know that the hon. Member for Middlesbrough South and East Cleveland is aware of the scale of the challenge facing his local NHS. Like every local NHS economy, the NHS organisations that commission and provide services in his constituency must take some fairly tough decisions to deliver sustainable health services in future. Let me also say to him—in the nicest possible way, because I respect him—that we are in the situation of protecting the NHS budget and giving it a modest real-terms increase, given our commitment to the NHS, simply because of the economic mess that we inherited, thanks to the actions of his Government, under the stewardship of the right hon. Member for Kirkcaldy and Cowdenbeath (Mr Brown). That meant that there was not enough money to sustain the levels of real-terms investment that might have been available earlier this century.
I turn now to Guisborough hospital. I am aware that Chaloner ward, which provided palliative care and rehabilitation, closed permanently in February 2012. I am advised, however, that services were transferred to the hospital’s larger Priory ward, which I am assured has adequate room and staffing to continue to provide high quality care. I understand that the decision to close Chaloner ward was based on the need to deliver services safely, efficiently and effectively, as the ward had been under-utilised and was not making the best use of nursing resources. Staff were engaged on the decision. In fact, they advised closure—I hope that the hon. Gentleman heard that. The staff advised closure, and staff at the ward were redeployed within Guisborough hospital and to the nearby Redcar primary care hospital.
I am also aware that temporary changes were made to the opening times of the minor injury unit at Guisborough hospital. The MIU now opens between 9 am and 5 pm from Monday to Friday, and between 8 am and 8 pm at weekends. I understand that patients requiring treatment outside those hours use Redcar hospital, local GP walk-in centres or the accident and emergency department at the James Cook university hospital. I have been informed that the MIU is staffed by a small team of nurses, and that the changes enabled the unit to continue to provide a safe service for patients. I also understand that the South Tees Hospitals NHS Foundation Trust is looking at whether other staff can provide support to the unit.
I have been informed that, in the longer term, South Tees Hospitals NHS Foundation Trust is reviewing the provision of acute and community services across all its sites, including Guisborough hospital. The review is aimed at ensuring the future safety, quality and sustainability of services. The trust has been working with GPs, commissioners and local authorities to establish models of care that will enable more patients to be cared for at home and avoid unnecessary admissions to hospital—whether at the larger acute hospital, James Cook, or community hospitals such as Guisborough. Once that work is completed, the trust expects to take a more definitive view of the future role of community hospitals such as that at Guisborough. It is not yet clear when the review will conclude. However, I am assured by the local NHS that there are no plans in the near future for further service changes at Guisborough hospital. I hope that that will reassure the hon. Gentleman. Should there be any changes in the longer term, once the trust has completed its review of service provision, local stakeholders and the public will be engaged in this process. He might be aware that my right hon. Friend the Secretary of State has set out strengthened criteria for service changes. Any proposals for major service change need to be assured by the local NHS against the Secretary of State’s four tests for service change and, when necessary, to be subject to public consultation.
I am aware that the hon. Gentleman met the chief executive of South Tees Hospitals NHS Foundation Trust to discuss these matters in February 2012. I also understand that the trust provides him with regular briefings on these issues, and I hope that he finds that helpful and useful in formulating his views on the provision of health care in his area. I hope that being briefed personally by his local health service providers will allow him to have a more open mind in regard to what is actually going on in the NHS, rather than simply accepting the propaganda that all too often distorts his views. I strongly encourage him to continue that dialogue with the trust as it completes its review of service provision.
Question put and agreed to.