The Minister of State, Department of Health (Mr Philip Dunne)
What a pleasure it is to join you this afternoon to participate in this debate on Kettering hospital, Madam Deputy Speaker. I congratulate my hon. Friend the Member for Kettering (Mr Hollobone), not just on securing this debate, but on his persistence in keeping Kettering hospital at the forefront of the national debate on what is happening to our health service. He has taken an assiduous interest in promoting it at almost every opportunity, as he suggested today. Indeed, he raised the matter at my first Health questions earlier this month and was on his feet raising it again with the Prime Minister the following day. He is a worthy champion of the cause, and I am therefore fully aware of his interest in local health matters affecting his constituents.
I wish to join my hon. Friend in recognising at the outset the great work done by all our staff in the NHS right across the country, but particularly the staff who work in and around Kettering and the other hospitals we have heard of today from my hon. Friends the Members for Corby (Tom Pursglove) and for Wellingborough (Mr Bone). I was invited by two of the three Members who have spoken to attend their local hospitals—
Mr Dunne
My hon. Friend, from a sedentary position, extends an invitation, too. I am grateful to all three hon. Friends. I am relatively newly in post, and the demands at present are to visit hospitals that are in greater difficulty than any of these cases, but I will endeavour to see what I can do during next year possibly to visit Kettering.
Mr Hollobone
One visit to all three of us would kill three birds with one stone.
Mr Dunne
I have responsibility for the acute sector, not the community sector, so initially my visit would be focused on Kettering hospital. I will certainly do what I can, but I think that it will have to be some time next year. My hon. Friend has previously met my predecessors to discuss health services in his constituency. He has raised a number of issues today, and I will attempt to address most, if not all, of them in the time that I have.
I wish to start with my hon. Friend’s concerns about the underfunding of his local clinical commissioning groups. That was a point also raised by my hon. Friend the Member for Wellingborough. NHS England is working to move CCGs towards their target fair share of funding, but this has to take place at a pace that maintains stability in the system across the country at a time of significant financial challenge. I feel that quite acutely as a local Member of Parliament representing a rural constituency that has been consistently underfunded. We are taking steps, as I mentioned to the House in a debate earlier this week, to look at introducing a fairer share of funding for rural areas and addressing other issues such as social deprivation. A consequence of that has been to try to bring those CCG areas that are recognised to be underfunded closer to the target.
The point was made that Nene and Corby CCGs have been beyond 5% of the target. I am pleased to confirm the figures that were mentioned earlier by my hon. Friend the Member for Kettering: Nene and Corby CCGs received cash increases of 5.2% and 9.4% respectively in the current year. Those increases are significantly above the average for English CCGs and bring them both within 5% of their target allocation in this year. I think that 9.4% is one of the highest increases in allocation that we have seen this year across the country, so I hope that he recognises that we are moving to right that historic challenge. This year, more than £757 million will go into my hon. Friend’s local area, and allocations over the next few years should bring both Nene and Corby CCGs even closer to their funding target.
I will take a moment to touch on the national pressures that are affecting the NHS. The NHS is very busy, but hospitals are generally performing well. The latest figures for August 2016 show that more than nine out of 10 people were seen in A&E within four hours. During 2015-16, nearly 2,500 more people were seen in A&E each day within four hours compared with 2009-10.
Paramedics respond to the majority of life-threatening cases in under eight minutes. More than 567,000 emergency calls received a face-to-face response from the ambulance services across England in August 2016 alone—an average of 18,300 a day. Ambulance services are busy, which is why we are increasing paramedic training places by more than 60% in this year alone, on top of the 2,300 extra paramedics who have joined the NHS since 2010. That allows more than 200 additional ambulances to be deployed by the NHS compared with 2010.
Mr Bone
The Minister is making a very good point. Does he not accept that if an ambulance were to take a patient to the Isebrook hospital, it is 10 minutes’ transport, but if it has to go to Kettering, it is 45 minutes’ transport? Is that not the sort of thing that we should look at as an efficiency saving, which is worth the investment in Isebrook?
Mr Dunne
I would agree with my hon. Friend in the event that the hospital in Wellingborough were able to cope with the condition, but many of the most serious conditions need to go to the best place to deliver the service, even if it takes a bit longer to get there. The quality of treatment in our ambulances now, with the skills of the paramedics who are on board in almost all cases, is such that very few people die while in transit. They are kept stable, and they need to go to the best place for treatment.
Going back to the national picture, the NHS last year treated, on average, 21,000 more outpatients a day and performed more than 4,400 operations a day compared with 2010. There is substantially more activity across the NHS, which is one reason why we have recruited so many more clinicians to help cope with this activity. We now have over 8,500 more doctors and over 2,700 more nurses, paid for in part by having nearly 7,000 fewer managers. Ultimately, we want to reduce pressure on services by reforming the urgent care system and caring for people better in the community, and that is where I think some of the things being done and being planned for the Kettering area are so interesting. It is clear that the NHS in the constituency understands the scale of the challenge and is taking action to address it.
Mr Hollobone
We understand the scale of the challenge. The problem is that the urgent care hub proposals, which are really exciting and could be rolled out across the country, are now with NHS Improvement, and its say-so is required to go to the consultancy phase.
Mr Dunne
Indeed, and our plans for improvement and integration among collaborative NHS areas across the country, including the Kettering area, through the sustainability and transformation plans are being delivered for each area today. NHS England will review those plans and decide to prioritise those that meet the national objectives and are best thought out.
In the past three years, including the current year, the Department has provided just over £37 million of interim revenue support and over £15 million of emergency capital to the trust. Since May 2010, capital expenditure on the hospital has amounted to £68.7 million, so it is receiving quite substantial support from the Department. The intention of the transformation work is to move to a position where the ability to cope with the remaining additional pressures on A&E and across the patient flow in the hospital is built in.
My hon. Friend the Member for Kettering said that the trust’s emergency department was too small and too limited in scope, and he touched on the new construction completed this year to extend the scope of the A&E department. It was originally built 20 years ago for 40,000 attendances a year, but is now dealing with more than 82,000. But the trust has had some success in reducing A&E attendances; there are more than 3,000 fewer than six years ago. The measures to integrate with the surrounding area are therefore having an effect on reducing attendances, despite the growing demand overall.
The trust has recruited and trained additional medical staff. Since 2010, the trust has increased its doctors by 77, or 24%, to 394. That is one of the most significant increases I have seen thus far. Some of this has come from the recruitment of staff through the certificate of eligibility for specialist registration scheme, involving doctors who have, for example, completed their specialist training overseas and chosen to practice in this country.
My hon. Friend and my hon. Friend the Member for Corby referred to proposals to develop the urgent care hub at the hospital. The aim is to develop a one-stop shop, which will enable patients to use primary care facilities, rather than A&E, by having these services co-located on the Kettering general hospital site. These services would enable rapid assessment, diagnosis and treatment by appropriate health and social care professionals. Patients would be streamed into appropriate treatment areas to minimise delays and reduce the need for admissions. This is an example of best practice across the NHS; it is what we are trying to introduce to relieve pressure on clinicians in the A&E department.
My hon. Friend the Member for Kettering raised the possibility of capital investment to develop this hub. The Department’s position has not changed. We are looking to the trust to take responsibility for developing and taking forward its own capital investment proposals. Foundation trusts, such as Kettering, can apply to the Department’s independent trust financing facility for a capital investment loan. They need to work closely with local planning authorities to ensure that developer infrastructure contributions can be taken into account as a source of funding.
I hope that these plans will be successful as they emerge through the STP, and as I have said, I hope that I will find an opportunity to visit Kettering on one of my visits north if I am allowed to do so on a suitable day when not required here in the Chamber.
Question put and agreed to.