The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
My right hon. Friend the Member for Lewes (Norman Baker) has raised a number of issues and I will do my best to address them in the limited time available. I will, of course, write to him about any issues I am unable to get on to today.
I congratulate my right hon. Friend on securing the debate. A number of the points he has made are of great importance to both him and his constituents. Before I continue, I want to highlight the extra work carried out every day by all those who work in the NHS in his constituency, including staff alongside whom I have worked during my time in the NHS. During a busy time in winter, we should be proud of our front-line staff and the hard work they continue to do, even with the increased demand caused by winter pressure on our health service.
My right hon. Friend was right to say that there is now less bureaucracy in our health service and more money for the front line. Thanks to our having stripped out some of the bureaucracy, we will have £6.5 billion more for front-line care over this Parliament than we would otherwise have had. That has been independently audited, and I am sure that all patients in Lewes and elsewhere are very pleased with that.
Primary care trusts have been replaced with clinical commissioning groups. My right hon. Friend talked about some of the historical frustrations with PCTs in his constituency. I hope that the changes made on the introduction of CCGs—their clinical leadership is provided by clinicians who have actually looked after patients and understand their needs—will already have led to improvements in care in his constituency. The fact that some of the reviews now taking place are led by clinicians who run the process of allocating local health care funding will ensure that the right decisions are made about local health care priorities and about meeting the needs of patients.
Health and wellbeing boards now ensure that health and social care services are better joined up, which is important for looking after vulnerable patients, the disabled and the frail elderly. Health and wellbeing boards provide an opportunity to integrate services further, which is particularly important in a very diverse county, such as East Sussex, with rural as well as urban areas. East Sussex health and wellbeing board is grasping the opportunity to join up the local provision of primary community care, the acute sector and social services care.
An important part of meeting some of the challenges faced by the local NHS—my right hon. Friend mentioned the issue of the throughput of patients at Brighton—is to join up adult social care with NHS services better to ensure that acute beds can be freed as quickly as possible for those who are the most sick, with others being transferred into the most appropriate care setting. I know that the local health and wellbeing board takes an active interest in that issue.
My right hon. Friend raised issues about health services in Seaford and Polegate. As he rightly outlined, high-quality premises are an important part of ensuring high-quality primary care services. I understand that NHS England’s Surrey and Sussex area team is working with the Old School surgery in Seaford to explore options for the improvement of its facilities. The capital funding to create new consultation rooms for the Downlands surgery in Polegate has been agreed, and the work is intended to be completed by April 2015. That will bring improvements to patients who attend that surgery. I understand that there have been some quality issues with the premises of another practice in Polegate, the Manor Park medical centre. From memory, it is on a crossroads in the town centre. That issue is in the forefront of the mind of the Surrey and Sussex area team, which reassured me yesterday that it is looking at how to improve the situation.
Such issues are not just for the local clinical commission group; there might be a role for the local authority—perhaps with contributions from developers, where available—to support the local NHS by building new facilities. In areas of housing growth, such as around Eastbourne, the local authority could work collaboratively to collect developers’ contributions to put in place local infrastructure for schools and the local NHS. I am sure that that will be considered as a result of this debate. There is also an opportunity for the local NHS to work more collaboratively with the local authority to address some of the premises issues and to improve the quality, size and capacity of places in which local patients are treated.
As I have said, local clinicians and local authorities have been empowered through the creation of clinical commissioning groups and health and wellbeing boards to bring together health and social care. That is particularly important in the context of the issues relating to Seaford that were raised by my right hon. Friend. I am aware of the changes made at Seaford day hospital, and he outlined some long-standing frustrations with earlier decisions made by the PCT. I understand, however, that Horder Healthcare has taken over the hospital to run services, and that physiotherapy services are being provided there, which is at least a step in the right direction.
As part of the East Sussex Better Together programme, plans are being developed to bring as many services as possible, such as out-patient and diagnostic services, closer to people’s homes and communities. It is particularly important to minimise the travel that frail and elderly patients have to undertake when they need access to local health care services. Seaford is one of the key local communities that is under consideration as part of the Better Together programme. More generally, the Better Together programme is about the three local CCGs in East Sussex and the county council working together to ensure that there is a more integrated approach to delivering more community-based care across the county. That is a welcome step forward.
I am sure that the important addition of clinical input now that clinicians are leading CCGs will ensure that there is more joined-up working. The Better Together programme will look at where it is possible to join up primary and community health services, as well as at where out-patient clinics can appropriately be provided in a primary care setting. As far as is possible, we should have a one-stop shop for patients, particularly older patients. There could be blood testing for warfarin control, diagnostic services, GP services and other high-quality local community health care services in one location. Where that can be offered, it is of huge benefit to patients. In my conversations with the CCG yesterday, I was very pleased to hear that the Better Together programme is looking at exactly how to achieve that in the Seaford area. I have asked it to discuss further with my right hon. Friend how it intends to take that forward over the next few months.
It is important to talk briefly about the issues that my right hon. Friend raised about the future of Lewes Victoria hospital, which I know well, having performed some day operations there in the past with my then consultant. I understand that in October 2014, High Weald Lewes Havens CCG initiated a formal procurement process to enhance and improve the community services contract. As part of the general review of services, community services will clearly play a key part in delivering services closer to home. Lewes Victoria hospital has a track record of delivering high-quality community-based care.
A new contract for the hospital is expected to be awarded in spring 2015. That will be followed by a period of transition planning, with a view to having the new community services contract in place by the autumn. The CCG has confirmed that it plans to continue providing community health services from Lewes Victoria hospital and it is keen to ensure that the skills and expertise of the existing community services staff and the three community hospitals in the area are at the heart of plans to improve patient care and experience. I am very reassured by my conversations with the CCG that the future of Lewes Victoria hospital as a centre for delivering community-based care, day case operations and other high-quality care for people in Lewes and the surrounding areas is very secure. I am sure that that will be welcomed by the people of Lewes and the surrounding areas.
In the time that is left, I turn to the services at Eastbourne district general hospital. The hospital continues to offer a wide range of services, including emergency, out-patient, medical, surgical, diagnostic and day surgery services. I am aware that some of the services provided by East Sussex Healthcare NHS Trust have been relocated since 2013 and that improvements in patient safety have been achieved through that. I will come back to that a little later.
Although consultant-led maternity services, overnight paediatrics, orthopaedics and emergency general surgery have been sited at the Conquest in Hastings, other services, such as acute stroke care and ear, nose and throat services, have been centralised at Eastbourne, so it would not be fair to say that Eastbourne district general hospital has been the loser in the redistribution of services. It has gained from the addition of acute stroke care and ear, nose and throat services. I will turn to maternity services in a moment.
Health care commissioners are assured that there have been significant improvements in patient outcomes since stroke services have been centralised at Eastbourne. Better care is being delivered to patients as a result, which is something that both my right hon. Friend and I welcome. The trust is performing above the national average against a number of standards for stroke care.
Maternity care has been a challenge for the trust, and an emotive and controversial issue locally. One historical issue concerned safe staffing levels for maternity units, because I believe that the Conquest and district general hospitals both managed fewer than 2,000 births a year. There was a particular challenge with a lack of consultant senior cover out of hours—that is important to protect patient safety—and a challenge in encouraging and recruiting junior doctors to staff the middle-grade rotas at those trusts. Although I understand that the changes are emotive and controversial, they were about ensuring that the highest quality of care could be delivered for women, and a midwifery-led unit at the DGH now promotes choice. There are ongoing enhancements to the midwifery-led unit in Crowborough, and acute obstetric services are being centralised at the Conquest.
Perhaps it will reassure my right hon. Friend to know that following the changes, the number of serious incidents at the trust decreased from 17 between June 2012 and May 2013, to six for the same period in 2013-14. Clinical evidence points to a safer and better service for women, although I understand that these are emotive issues. East Sussex county council’s health, overview and scrutiny committee continues to provide rigorous scrutiny of those services, and has agreed that the decision to single-site consultant level maternity and in-patient paediatric services was in the best interests of the health service and the residents of East Sussex.
I am running out of time so I will wrote to my right hon. Friend about the issues he raised about St George’s park and ambulance response times, but I congratulate him again on securing this debate on an issue that I know is of great importance to him and his constituents. I encourage him to liaise directly with the local NHS and to continue championing these important issues.
Question put and agreed to.