The Parliamentary Under-Secretary of State for Health (Ben Gummer)
I thank the hon. Member for Birmingham, Selly Oak (Steve McCabe) for his clear outlining of the case for his constituents and for Katie Road walk-in centre, and I congratulate him on securing this debate. He touches on an interesting issue for the NHS as a whole, one with which clinicians have been grappling in the past few years: what is the nature of urgent and emergency care in a world where demography is changing rapidly, where demands on the service are changing and where there are incredibly different and disparate populations? He rightly points out that he represents a constituency that has a high student population, that has areas with high levels of deprivation and that has a wide mix of ethnic diversity. Other parts of the country have a significantly ageing profile and do not have the ethnic mix that he is able to enjoy in his part of Birmingham; they have a different socio-economic profile.
What is clear for commissioners and for clinicians is that the answer for urgent and emergency care in one area is different from that in another. I know that might be stating the bleedingly obvious, but it was something that was not observed by the NHS before Professor Sir Bruce Keogh initiated his review of urgent and emergency care in 2013. The result of that was a holistic, sensible and coherent plan for how urgent and emergency care should be delivered across the country. The variation in care, from Northumbria down to Cornwall, is extensive at the moment; there are considerable differences. The hon. Gentleman has highlighted the fact that there are differences even within the city of Birmingham. At the very least, we have made progress in the past few years in having a vision of what urgent and emergency care should look like. The challenge is to try to implement that across the service, which is why, over the past two years, considerable work has been done by clinicians and commissioners to try to understand how the principles of the Keogh review can inform the reshaping of emergency and urgent care in their patches.
As the hon. Gentleman has identified with the issue of one walk-in centre—he can imagine how such local controversies become all the greater when they involve accident and emergency centres and trauma centres—these are matters that are very close to the hearts of constituents, who rely on those services. Those services are there in their moment of need, and they are, in a very real sense, the single greatest embodiment of the NHS and its values. We must treat urgent and emergency care with the utmost care.
The plans that are being worked up across the country are being done carefully with commissioners in co-ordination with NHS England and, ultimately, with Professor Sir Bruce Keogh. Let me give the hon. Gentleman an idea of why that has been so carefully done and the extent of care that has been taken: it was only in the autumn that the route map for the whole country was published. I hope he will therefore understand why his local CCGs have had to revise the timetables by which they have been looking at urgent and emergency care. As he pointed out, they began their own study of this in Birmingham before Professor Sir Bruce Keogh undertook his review. They have had to revise their thinking in the light of that, and I know that they are taking forward their current consultation on the basis of the route maps that have been designed by NHS England with commissioners around the country.
The hon. Gentleman makes a fair point about process. I know why he is frustrated, and I completely understand his frustration. I also understand his irritation at the bureaucratese that can fly in his face as a representative of local people. I cannot specifically talk about the consultation of which he speaks because I do not have a detailed knowledge of it. All I can say is that in the NHS there are good and bad consultations. What we have tried to do over the past five years—and I am trying to do this in my current position—is to ensure that we bring the worst consultations up to the best, that we learn from where they have gone wrong and that they go better. I can of course commit to write to the chairman of his CCG, perhaps highlighting the work that has been done around producing very good consultations, reiterating the points that he has made in his speech, and asking for a clarification around each and every point that he has raised, so that he feels satisfied that he has raised his issues in the Chamber and that he can provide answers to his constituents. Clearly, he feels that, at the moment, there is much confusion and not too much clarity.
I spoke to senior commissioners in the CCG today in advance of this debate to ensure that I was availed of the facts of the situation. They assured me that there is a full intention to continue services at Katie Road. The centre’s value is understood and well known, which is precisely why there was a temporary extension of the hours till 10 pm to deal with the winter pressures that are felt across the service. The commissioners also made it clear that there has not been a predetermination about the location of a further urgent care centre. It will be in Selly Oak, and it will be considerably larger than Katie Road so it will be able to accommodate more services and will be of greater use to the hon. Gentleman’s constituents. The commissioners have not come to a decision yet about where it should be located. I know that they will want to engage fully with him and with the community in order to ensure that it goes to the right place.
Steve McCabe
When the Minister was given an assurance that Katie Road would continue, he was presumably told that the contract was due to come to an end. Was there any indication that there was an intention to have yet another roll-over contract, or whether there is a timescale attached to the consultation—yet another one?
Ben Gummer
No, I was not assured in that level of detail—I can ask for that information in my letter to the chairman of the CCG—but I think that the intentions were clear, and they seemed entirely honourable. They understood the purpose of the centre, and they clearly saw the disadvantage of those services discontinuing before a new urgent care centre opens. I think that they understand the hon. Gentleman’s perfectly reasonable point that there needs to be some sort of continuity of service so that local people know where to go and can feel confident about local service provision.
On the important point about location and co-location, it will be different for different areas. The hon. Gentleman might have local pressures at University Hospitals Birmingham that do not pertain elsewhere in the country. It might be right—we are having exactly the same discussion in my constituency at the moment—to make use of an A&E brand and say, “Right, you have one simple place to go,” or it might be right to locate services on a different site. That will be different for different places. That is why it was decided in 2009, under the previous Labour Government, to give commissioners a greater role in local decisions on urgent and emergency care, because they are the ones who know their patches best, and what I write in Whitehall might not be right for local conditions in Selly Oak, or anywhere else for that matter.
I cannot therefore give the hon. Gentleman an answer on co-location because it will be different in different parts of the country, but what I can tell him is that my letter to the chairman of the CCG will include a particular reference to the fact that he and his constituents wish to be consulted and that there needs to be a clear rationale behind the location so that people feel that it is done not for the ease of NHS-land, but for the betterment of patient service.
The hon. Gentleman asked about consistency with seven-day services. I would like to reassure him that we are building seven-day services on the basis of the urgent and emergency care networks that were outlined by Professor Sir Bruce Keogh in his 2013 review and the consequent work. Contrary to the suggestion of his hon. Friend the Member for Birmingham, Perry Barr (Mr Mahmood), the seven-day services programme is entirely clinically led. It draws on the work that the Academy of Medical Royal Colleges undertook in 2013 to develop 10 clinical standards. That is the basis of the work we are taking forward. The contract reform that we have undertaken, both for junior doctors and for consultants, is based in part on the recommendations of those 10 clinical standards, so it is routed entirely in the need to respond to the top clinicians’ advice on how we achieve consistency of service across seven days of the week.
I would therefore expect the results of any consultation into urgent and emergency care in Birmingham to match precisely the overall work that we are doing to ensure consistency of standards across seven days of the week, good access for patients and a clear and transparent approach to urgent and emergency care, which in parts of the country, as the hon. Gentleman has identified, can at times be both patchy and confusing.
Finally, the hon. Gentleman asked whether there is a threat to walk-in centres. Under this Government he will see continued investment in urgent and emergency care. We will seek to find greater clarity around urgent and emergency care so that there is a clearer brand and more easily recognisable services for local people, so that we eliminate inconsistencies across the service and so that we fulfil the best clinical advice on how to achieve better services in urgent and emergency care by following the recommendations of Professor Sir Bruce Keogh and the work that has been done by local clinicians since. I do not believe therefore that there is a threat to urgent and emergency care services, and I believe they will improve over the next four years.
That is why I am happy to promise the hon. Gentleman that I will continue to answer questions on Katie Road. Should he have any further concerns, I would be delighted if he came to me so that we could talk about them. I will do what I can to allay those concerns and to make representations on his behalf to his clinical commissioning group so that he can get the answers he seeks.
Question put and agreed to.