The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
I congratulate my hon. Friend the Member for Newark (Patrick Mercer) on securing this debate and on his continued, long-standing dedication to and strong advocacy for his constituents, and his local health care services and all the patients who use them. It was good to hear interventions from hon. Members on both sides of the House; we heard from my hon. Friends the Members for Sherwood (Mr Spencer) and for Lincoln (Karl MᶜCartney), and the hon. Member for Mansfield (Sir Alan Meale). That shows that on important issues such as local hospitals we can put party differences aside to come together for the benefit of the people who matter most in the NHS—local patients. I was pleased to hear that party politics had been put aside today and I was glad to hear the hon. Member for Mansfield say that he will continue to do so in the future for the benefit of patients in Nottinghamshire.
As has been articulately outlined by my hon. Friend the Member for Newark, Newark hospital provides an extensive range of consultant-led out-patient services and does so with short waiting times. It provides many high-quality day-case procedures, and diagnostic and other services. It also has a high-quality minor injuries unit and urgent care centre. Some 35 beds are available across two medical wards, with 21 more beds in the surgical ward. As my hon. Friend rightly outlined, one challenge that faces the NHS as a whole and patient provision in Newark is the fact that many people are now living longer and need high-quality, close-to-home community health care services. That is exactly what is provided at his hospital.
We also know that a new 12-bed facility is to open in Newark hospital in February 2013. The Fernwood community unit will be a specialist unit of single-sex bays and private rooms that will meet the needs of the growing number of elderly patients we have discussed, ensuring that people have the right to recuperation and recovery in an appropriate intermediate care setting before they return to their own homes.
The hospital receives full back-up from the teams at King’s Mill and the services provided by the two hospitals are compatible and work well in synergy. I want to put on record my congratulations on and gratitude for the dedication and hard work of all the NHS staff who work on the King’s Mill site and at Newark and who do excellent work to look after patients to a very high standard. I will be happy to take up my hon. Friend’s offer of a visit to Newark hospital when time permits later in the year, so that I can meet the staff and see first hand the excellent care provided there.
It is worth highlighting that there was a local agreement on Newark services, which was signed off on 18 December. Newark and Sherwood district council agreed across party lines to work with the Newark and Sherwood clinical commissioning group and the Sherwood Forest Hospitals NHS Foundation Trust to maintain what they see as essential elements for local services. When looking after older people, it is good to have cross-agency integrated care and working and a commitment to those principles from not only the NHS but local authorities, which play such an important part in the care of older people through housing and social services.
The commitments made in the agreement were that there should be high-quality primary and secondary health care for the people of Newark and Sherwood; a strong and positive future for Newark hospital within Sherwood Forest Hospitals NHS Foundation Trust; and accessible and safe health care services for patients across Newark and Sherwood district that are as close to people’s homes as possible. As has been outlined throughout the debate, it is important that we ensure that older people do not have to travel many miles to receive high-quality care and that they receive that care, if not in their own homes, as close to their homes as possible. That is why I am confident that Newark hospital will always have a strong and viable future as a setting for the provision of high-quality care for many older people and for all the other patients it looks after so well.
My hon. Friend also raised the question of the PFI debt at the hospital trust and he was right to do so. Monitor, the independent regulator of foundation trusts, recently expressed concern about the financial situation at Sherwood Forest Hospitals NHS Foundation Trust. The trust signed its £320 million PFI deal in November 2005 for the redevelopment of King’s Mill, and in 2012-13 the trust’s PFI cash outflow is £42.5 million, which equates to 17% of the trust’s income—a very large PFI debt, with 17% of the income spent on PFI repayments. If we were not already aware of the great damage inflicted on our NHS by PFI agreements, which were sometimes signed in haste and which we have often lived to regret, that agreement would make the case very clearly.
On 21 September, Monitor published a breach of compliance report which referenced a McKinsey’s report it had commissioned. The report concluded that the trust’s PFI commitments were affordable only with additional activity from the local health economy. That means it does not qualify for Department of Health national PFI support. The report outlined the fact that the trust has potential for additional health care activity, which would benefit it financially and put it on a more stable financial footing. The emphasis on additional activity in the report seems to suggest that more can be done potentially at Newark to develop services for the benefit of local patients. That could bring revenue and income into the trust and would do more better to serve the needs of a growing population and its future health care demand.
To answer one of the points my hon. Friend raised, enhancing facilities in the minor injuries unit could play a part in putting the trust on to a more stable financial footing. The new chief executive is keen to look into the issues, as my hon. Friend said, and he is right to highlight the fact that good, dynamic leadership can turn around the trust’s financial fortunes, notwithstanding the massive PFI debt repayments. There are clearly further opportunities to develop what the hospital can do to put itself on a stable financial footing while doing more to look after local patients better. I know that the chief executive and the team at the trust are listening to the debate, and that they will take on board what I have said and the concerns that my hon. Friend raised.
My hon. Friend talked about ambulance services in the Newark area. It is worth pointing out the distances that some patients have to travel to reach a fully functioning, 24-hour A and E service. King’s Mill hospital, one of the acute settings, is 23 miles away, which is about 42 minutes by road. The Queen’s Medical Centre in Nottingham is 22 miles away, a 50-minute road journey, and Lincoln county hospital is 20 miles away, which is 45 minutes from Newark by car. Those are average journey times; there may be busy times and road congestion.
There are particular challenges in making sure that in an emergency patients can get to an appropriate A and E care setting in a timely manner. My hon. Friend pointed out that according to East Midlands Ambulance Service NHS Trust figures, in the years 2009-10 and 2010-11 and in the first quarter of 2012-13, Nottinghamshire did not reach its A8 response targets. Sometimes, those targets are skewed: they can be better in urban areas, such as Nottingham, but worse in more rural settings. I am sure my hon. Friend will want to take things further with the ambulance service and drill into the data for Newark by postcode, to compare response times in a more rural area, where there is a long distance to travel to an A and E, with those in some of the more urban settings in Nottinghamshire. It is obviously unacceptable to all of us if patients in rural communities have to wait a long time for an ambulance and life-saving treatment.
In the ambulance service review and the consultation on its proposals, it is vital that rurality and travel distances to A and Es and other urgent care settings are taken into account in any changes to the service. From the figures I referred to, we already know about the challenge the ambulance service in Nottinghamshire faces, because it is not meeting response targets. If we break down those targets by postcode and by area, we may find that rural areas are even further behind. When the review takes place, it is important that the rurality of Newark is properly taken into account so that patients in rural areas have the same quality of ambulance response as those in more urban settings.
In conclusion, I am pleased to confirm that there is a strong and viable future for services for local patients at Newark hospital. I very much look forward to taking the discussions further with my hon. Friend in early February, and to visiting the hospital later in the year.
Question put and agreed to.