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Lucy Allan (Telford) (Con)
I beg to move,
That this House has considered Princess Royal Hospital, Telford.
It is a great pleasure to serve under your chairmanship, Mr Betts. Last week the Leader of the House, my right hon. Friend the Member for North East Somerset (Mr Rees-Mogg), said:
“Our main purpose as Members of Parliament is to seek redress of grievance for our constituents”.—[Official Report, 31 October 2019; Vol. 667, c. 509.]
That is what I seek to do today, on the last day of this Parliament and on what might be my last opportunity to speak for Telford. It is a great privilege to have the opportunity to do so.
For the past six years, Telford’s No. 1 concern has been the future of the Princess Royal Hospital. Throughout those years, I have been working with my community to get their concerns heard by the hospital management and in many debates and speeches in this place. Today is different, because in the past few weeks the Secretary of State for Health and Social Care endorsed a decision by hospital management to proceed with a plan that will mean Telford loses vital hospital services and that, simultaneously, will lead to huge investment in Royal Shrewsbury Hospital in the county town of Shrewsbury, some 30 minutes away from Telford. In this debate, I want to put on the record why my constituents feel a sense of loss and a sense of anger.
Telford is not a place that has a sense of entitlement. It is not a place that makes demands or shouts over the voices of others. It is a stoical place and has often had to overcome the odds, face adversity and keep on going. It is a former mining town and is now a rapidly growing new town, lying 20 minutes equidistant between Black Country Wolverhampton and the leafy county town of Shrewsbury. Telford is remote and isolated, because it has poor transport connections and low car ownership. It troubles me that, despite the poorer health outcomes, child poverty and health inequalities that I as the MP see, the hospital management has brought forward a plan for our health that allocates NHS resource not in accordance with need, but for some other reason that has not been explained.
Like many new towns, Telford was resisted by its county neighbours when it first came into being some 50 years ago. It was dismissed as an overspill town of incomers and a blot on the landscape, never quite accepted by its rural hinterland. It was somehow always the poor relation, surrounded by rural, leafy shires and county towns. There was a snobbishness whereby Telford was supposed to know its place and be grateful for the opportunity. We were somehow never quite equal to our neighbours.
However, Telford has ambitions, and overcoming the odds is what it does. Today, Telford is an economic powerhouse of advanced manufacturing and makes a massive contribution to the west midlands economy, offering new jobs and homes. Its population is forecast to grow to 200,000 people in the next 10 years. Telford needs its A&E and its women and children’s centre—anyone who knows Telford knows that—but the hospital management has other plans.
For six years, the management has toyed with a plan to centralise services 30 minutes away. It has been dressed up as local decision making by local clinicians, but, in reality, it was decided by executives from across the country—smart suits and smart cars—with no connection to our area and no concern for our communities. Indeed, the original architect of the plan held many hospital management chief executive officer posts, from Chester and Sherwood Forest to London, and he was last reported to be earning £40,000 per month, having resigned from a previous post for a single day in order to pick up a tax-free retirement package of £252,000 and then resumed the same job the next day. Such are the people behind this plan.
Actual local clinicians opposed the plan, as did all the councillors and local MPs. Protests were held and petitions made, but the decision makers did not want to know what local people had to say. Throughout that time, there was one hope—that once the bureaucrats got to the end of their decision-making process, the Secretary of State for Health and Social Care would call for an independent review to consider all the issues. I thank the former Secretary of State, my right hon. Friend the Member for South West Surrey (Mr Hunt), for his courtesy, consideration and kindness to me and my constituents as he listened to me and to the arguments about why the plan is flawed.
The hospital bureaucrats, whose decision this was, did not have to think about how people feel when they are told they do not need their A&E. It is not part of their role to understand our communities, our history, our geography, our identity, our emotional connectedness to our hospital, our affection for it and our pride in it. After all, they are not accountable to us; it is just one more job before the next one.
We, the representatives of the people, should care about our communities. We should care about how they feel, and about their sense of what is just. It is our job to be on the side of the people—not on the side of those who are well connected and have power and influence, who can speak to the decision makers behind closed doors, but on the side of the stoical, decent people of Telford, who play by the rules and have a right to be treated as fairly and justly as anyone else.
I will quote a constituent who has worked locally in the NHS for 15 years. He says:
“In Telford we are a group of hardworking communities with ambitions for our children’s future. When the brand new women and children’s unit was opened I was ecstatic. It was a turning point for us. I understand how health economics works—none of this proposal makes any sense, not in a business sense nor from a clinical outcome perspective. Shrewsbury is 30 minutes away. That’s too long for stroke, too long for a heart attack and too long for our children. This is a plan that bears all the hallmarks of cronyism at its rampant best. How else can it be explained? The NHS has no colours or banners”—
he is right about that—
“it supports all of us all of the time. It is something worth fighting for, for our children’s sake.”
On the point about children, I want to give voice to another one of my constituents. She wrote to me and said:
“My name is Sarah. I live in Telford. I am a mother to Alfie, who is 5 years old. Alfie has Down’s syndrome. In April 2018, at night, our son began to haemorrhage and he was taken to Telford A&E. Whilst there Alfie started to have a massive haemorrhage (blood was pouring from his mouth and nose and you could not even see his face or his beautiful blond hair). I was immediately told to run with him to Resus. There was so much blood. He was rushed in for an emergency operation to cauterise the bleed. Then our world then truly fell apart. He failed to breathe in air, post surgery. It took the theatre staff three hours to get him stable. The point of telling you this is quite simple. If A&E at PRH had been closed, Alfie would have had his 2nd and massive haemorrhage whilst still being transported to wherever they deemed to take us. I have chills just thinking of what the outcome would have been for our beautiful son. Put simply, having A&E open 24/7 saved Alfie’s life.”
I know the Secretary of State has tried his best to save our A&E from the hospital management’s plan. Indeed, he announced on the Conservative MPs’ WhatsApp group last week:
“Lucy, we’ve saved the A&E at Telford. We have just put a further £5 million into Telford’s hospital just last week.”
That would clearly be fantastic news. If it were indeed the case, I would not be standing here today; I would be writing an election leaflet proclaiming the good news to my constituents. Let us not be flippant and casual about something that is so important. My constituents want to know what an A&E local is and, importantly, whether the hospital management will agree to support it. When I asked the Minster’s parliamentary aide, my hon. Friend the Member for Chichester (Gillian Keegan), whether she could find out more about A&E local, she asked her assistant to respond to me. They said that my inquiry would be passed on to the Department for a response, which, in the light of the impending dissolution of Parliament, would not come until after Christmas at the earliest, in 2020.
It was the Minister’s decision to rush out an announcement in support of the management’s plan. He chose to do so without having worked out what would happen in Telford. Having made that announcement of his own volition, it is not good enough to say, “You’ll just have to wait to find out more.” How do I explain that to my constituents? If the funding for a new 20-bed ward for winter pressures has increased from £4 million to £5 million, that is fantastic, but I want to know and be able to tell my constituents about that. Simply mentioning it in a WhatsApp group is not enough; something has gone wrong with the communication.
My mission as an MP is to stand up for my constituents and take up their needs and concerns, so I know that the Minister will fully understand why I am so aggrieved that my constituents have been treated this way. Their treatment has been shabby and disrespectful. We are talking about the issue that matters most to my constituents, which is why I have helped them to crowdfund the money and seek counsel’s opinion on whether to pursue judicial review. We have nearly hit our target—thank you Telford—but it should not have come to this. A little more respect for the people of Telford would have avoided this situation.
During this lengthy saga, a former hospitals Minister—not my right hon. Friend the Member for Ludlow (Mr Dunne), who is here today—said to me, “They can’t all expect to have an A&E at the end of their road you know, Lucy.” My constituents have never asked for that and nor would they. They ask only to be treated as equal to anyone else in their value, worth and dignity, and that is what they deserve.
Lucy Allan
My right hon. Friend is one of my dearest friends and I would be delighted to give way.
Mr Dunne
My hon. Friend and neighbour makes a powerful case, as she always does when standing up for her constituents in the House. She has given some very moving examples of the messages that she receives and of the strength of feeling in the community that she serves. Does she recognise that the debate on acute services provision in Shropshire and Telford—that is the wider area, which extends to mid-Wales—has been ongoing for decades? In all the time that I have been a Member of Parliament, the difficulty arising from indecision about the reconfiguration of acute services has led to many services being provided out of county.
My hon. Friend mentioned stroke and cardiac services. Many of those are now provided in Staffordshire, so Shropshire has already lost services and people have to make long journeys. A reason for that is the difficulty in persuading enough clinicians with sufficient seniority and experience to provide a safe 24/7 service for our constituents. Although I completely understand her regret—half of my constituents would prefer to see the Telford services remain where they are—does she not see the opportunity to resolve the crisis and to ensure that we retain quality services for our combined populations? The area that she has focused—
Mr Clive Betts (in the Chair)
Order. I am sorry to interrupt, but this should be an intervention rather than a speech.
Lucy Allan
As a former hospitals Minister and long-serving Member of Parliament for the area, my right hon. Friend has a great level of expertise on this subject. He makes some excellent points, some of which I agree with. We are very fortunate that £312 million of Government money is being invested in the area, but I want my constituents to benefit from that, which is why we are having this debate.
If I return to Parliament after 12 December—I suspect the Secretary of State would rather I did not—I will do all I can to ensure that my constituents are treated better than they have been until now. As suggested by the Leader of the House, I will seek redress of grievance for my constituents, whether in Parliament or by working with them to challenge the decision in the courts.
The Minister for Health (Edward Argar)
I thank my hon. Friend the Member for Telford (Lucy Allan) and congratulate her on securing this important debate. As ever, she spoke on behalf of her constituents with passion and determination. She and I entered the House on the same day in 2015, and I would be mortified if she did not return after the election, although I suspect she will. I know that the Secretary of State for Health and Social Care, to whom she referred throughout her speech, would share my sentiments and wish for her to return to the House because she is an exemplary Member of Parliament, even though, on occasion, she may press us to go further when she is speaking up for her constituents.
I echo the spirit of my hon. Friend’s speech by thanking everybody who works in our amazing NHS for everything they do, particularly those who work in her local hospital in Telford. I know that there are strong feelings on all sides of this debate, but whatever the differences of view, everyone involved—particularly my hon. Friend—wants to do the right thing for patients.
As hon. Members will know, major service change in the NHS is complex. My right hon. Friend the Member for Ludlow (Mr Dunne), a distinguished former Minister of State for Health, knows that only too well and alluded to it in his remarks. Major service change involves a number of factors, and it is vital that the voices of local people and their MPs, including my hon. Friend the Member for Telford, are heard and respected at all stages. I am grateful for the opportunity to provide a brief overview of the plans and to update my hon. Friend on our progress in recent days.
My hon. Friend mentioned the Future Fit plans. The set of proposals that fall under that heading have been under development for a number of years. The case for change was first articulated about 10 years ago, and the clinically driven scheme proposed to transform services across Royal Shrewsbury Hospital and Princess Royal Hospital. A 15-week consultation on those proposals ran in summer 2018.
The joint committee of the Shropshire and Telford and Wrekin clinical commissioning groups decided to proceed with the preferred option of the local Future Fit programme. That programme would see the Princess Royal Hospital in Telford become a dedicated planned care site and the Royal Shrewsbury Hospital become a specialist emergency care site. Under those proposals, patients would continue to be able to access 24-hour urgent care services at both hospitals, meaning that 80% of patients would continue to go to the same hospital for emergency and urgent care. The model would also see women and children’s consultant-led in-patient services provided at the Royal Shrewsbury in the future.
As has been alluded to, in March this year Telford and Wrekin Council referred the scheme to the Secretary of State, who in turn referred it to the Independent Reconfiguration Panel, which then provided its advice to the Department on 31 July.
Turning to the crux of my hon. Friend’s concerns about the A&E and urgent and emergency care, she is right that all patients should receive excellent healthcare throughout their life, no matter where they live. Any changes to services are rightly based on clinically led decisions at the local level. I am delighted that, as she mentioned, we are investing £312 million to support acute services in the local area.
The Secretary of State, following thorough consideration, accepted the IRP’s impartial advice, which looked at urgent and emergency care across Shrewsbury and Telford, and recommended that the emergency care centre for the region should remain at the Royal Shrewsbury. My hon. Friend the Member for Telford has been courteous but clear about disagreeing with that advice, on behalf of her constituents.
The Secretary of State also asked NHS England to come forward with proposals within a month on how to keep the A&E in Telford open as an A&E local, to ensure that the Princess Royal Hospital can continue to deliver the urgent and emergency care that the residents of my hon. Friend’s constituency need and value so much. That request drew on the advice provided by the IRP. Plans for A&E locals are being developed by NHS England and NHS Improvement, and the Department has been in close contact about those developments.
NHS England has now published the proposal, following the Secretary of State’s request. He and I are delighted with the development. The Shrewsbury and Telford trust has put forward a model that will enable an enhanced service that is distinct from an urgent treatment centre. The model will increase the volume of activity that can safely be delivered through the proposed urgent treatment centre on the planned care site at PRH.
I understand that the Secretary of State and NHS England have today written to my hon. Friend the Member for Telford. If I may, I will touch on what that letter says. She may well wish to come back on it, once I have let her know what it states. The Secretary of State has been clear: the A&E at the Princess Royal Hospital, Telford, will remain open as an A&E local.
Lucy Allan
In my constituency, there is concern as to what “A&E local” means. I am aware that there is 24/7 walk-in, which is fantastic, although most of my constituents do not know that, but will “A&E local” be defined in more detail? I have not yet received the letter, so will the Minister enlighten me and my constituents?
Edward Argar
I am happy to do so. I hope that what I say will be helpful to my hon. Friend, but I am always happy to have a further conversation, if she so wishes after this debate. If she and I are both successfully returned to this place and doing the same things, I would be delighted to meet her.
The trust and local commissioners will further develop a framework of options for outside core hours. The trust has proposed a model that will increase the volume of activity that can safely be delivered through the proposed UTC on the planned care site. It proposes an emergency medicine consultant presence throughout core hours, a consultant-led ambulatory emergency care service for specific pathways, and additional diagnostic presence. That model means that the PRH will continue to provide A&E services. We are satisfied that that meets the proposed A&E local model.
My hon. Friend will wish to consider that further, and she may wish to have a further conversation with me, but I believe that the proposal is testament to the strong voice that Telford has because she listens to her constituents. It is a victory for my hon. Friend in speaking up for her constituents.
Lucy Allan
I am very grateful indeed to hear the Minister’s comments and, in particular, to see some movement—a shift indicating that we are being listened to and that Telford is not being ignored. I am grateful for that development and progress. As the Minister will understand, I may well continue to push for further progress, but it is a step in the right direction and I am grateful for it.
Edward Argar
I am grateful. It would be a brave Minister who ignored either Telford or my hon. Friend, and I am not sure that I am quite that brave.
I believe that this is welcome news, although I know that my hon. Friend will want to consider and digest it. It also comes on top of the extra £4 million in winter capital funding going to the PRH—again, she argued for that and helped to secure it—which the Secretary of State announced last week, to reduce pressure on the A&E and to prepare for winter.
Lucy Allan
Will the Minister confirm that that winter capital funding is for this winter and an extra 20-bed ward?
Edward Argar
I confirm that that is capital funding for her hospital to prepare for this winter and to meet the challenges it faces.
The detail of the proposal has still to be worked up, and NHS England will work with the trust, its partners and the Royal College of Emergency Medicine to support the development of the model and a timeline for its implementation. I hope my hon. Friend wishes to be involved in that process, and that both of us will be back here to have that conversation later in the year.
Jeremy Lefroy (Stafford) (Con)
I congratulate my hon. Friend the Member for Telford (Lucy Allan) on securing this important debate. A number of constituents from the west side of my constituency rely absolutely on the Princess Royal Hospital in Telford. Will the model mentioned by the Minister include, as it does in Stafford, the reception of blue-light services—that is, 999 ambulances —in the medical sphere at least? It is important to understand that, because the ability to receive blue-light services is what distinguishes an A&E from an urgent care centre.
Edward Argar
May I crave your indulgence, Mr Betts? My hon. Friend the Member for Stafford (Jeremy Lefroy) is retiring from Parliament at this election, so it would be wrong of me not to take the opportunity to pay tribute to him. He has been an extraordinary advocate for Stafford and, more than that, an asset to this Parliament and previous ones. He is a thoroughly decent and honourable man, and Parliament will be a poorer place without him sitting in it. [Hon. Members: “Hear, hear!”]
In respect of the point that my hon. Friend made, my understanding—I will clarify this subsequently, if necessary—is that the model will be underpinned by comprehensive pathways and protocols agreed with the ambulance services for blue-light transfer when the consultant cover is available, or diversion when not. There is, however, direct engagement with the ambulance trust. As I have said, hon. Members will need time and further discussion to consider the proposal, but I think and hope that they will agree with me that it is a useful first step to making progress.
To conclude, this is positive news for Telford, and that is down to my hon. Friend the Member for Telford, who is a strong and determined local champion for her constituents and for the town of Telford. They are incredibly lucky to have her as their representative and their voice in Parliament. I am confident that that voice will be speaking up for them in this House for many years to come. If they want a strong local voice in this House and for their hospital and NHS, every vote that they cast for my hon. Friend in the forthcoming election will deliver exactly that.
Question put and agreed to.