(7 months, 3 weeks ago)
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Sir John Whittingdale (Maldon) (Con)
It is a pleasure to have a fellow Essex Member in the Chair, Madam Deputy Speaker. I also welcome my hon. Friend the Minister, and I am glad to see my constituency neighbours, my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—on the opposite side of the River Crouch—and my right hon. Friend the Member for Witham (Priti Patel). She and I share the Maldon district between us, and we are working very closely on an issue that is of huge importance to both my constituents and hers.
St Peter’s Hospital in Maldon is a much-loved community hospital. It has been delivering care since the NHS was founded, but the building itself is a former workhouse and is more than 150 years old. We have known for some time that the building has significant problems, although, thanks to the dedication of the staff, the quality of care has been superb. There are significant challenges, which have become worse over time. The hallways are too narrow for stretchers, the floors have not been able to take the weight of the beds, the lift has repeatedly broken down, and there are leaking roofs, asbestos and potentially even a risk of legionnaires’ disease. While money has been spent over the years to maintain the building and keep it going, it has long been recognised that a new purpose-built facility is needed, either on the present site or in a different location. That has been the subject of debate and discussion for a number of years.
In 2003, the annual report of the Maldon and South Chelmsford Primary Care Trust stated that two preferred sites had been identified, that a provisional outline business case approval had been given, and that the new build was scheduled to open at some time towards the end of 2007. It never happened. There were difficulties with establishing ownership of part of the land off Limebrook Way, where it was due to be sited. Since then, we have had a succession of studies and debates about what a new hospital should offer and whether it should be a health hub. Most recently, plans were being drawn up for a new site to be developed to the west of Maldon, on Wycke Hill. However, this proposal became stuck due to the lack of sufficient funding for the access road, and a reduction in the contribution available from the developer and from the section 106 money for the housing being developed nearby.
To meet the anticipated winter pressures, it was announced in August last year that the in-patient beds would be relocated to Brentwood and Rochford, and the birthing unit transferred to St Michael’s Hospital in Braintree. We were told that these changes were only temporary while long-term solutions were found. Despite that, the Mid and South Essex integrated care board announced in January that it was proposing to make the changes permanent and that the out-patient services at St Peter’s would be relocated elsewhere, allowing the building to be eventually closed.
The proposals are subject to a consultation, which has recently been extended to 4 April. The ICB says that 2,600 of its surveys have already been returned. Over 400 people attended a public meeting that I organised with the mayor of Maldon, Councillor Andrew Lay, and another 100 had to be turned away. I have also received nearly 700 email responses to my own survey, and I am currently distributing across the constituency 25,000 leaflets containing a survey. It is already clear that my constituents are unanimous in wanting to see medical services continue in the town. They also believe that the consultation is a cosmetic exercise, with decisions already taken. I have to say that this belief is reinforced by the fact that the two alternative options presented for the in-patient beds currently in St Peter’s both involve closing the wards in the hospital and moving them elsewhere.
The Maldon district is growing steadily. We have something like 3,000 houses currently under construction in Maldon and Heybridge, with another 1,500 across the district. Demand for NHS services is rising steadily, with the GP to patient ratio already one of the worst in the country. Rather than closing NHS facilities, we need more. In addition, Maldon district is geographically spread, with some villages already half an hour’s travel time from Maldon. The travel time to Broomfield, Braintree or Brentwood can be up to an hour or more from villages such as Tillingham or Southminster in the Dengie peninsula, and the idea that an expectant mother in the early stages of giving birth should have to travel an hour is appalling.
The ICB suggested last year that there was an average of just six births per month at the maternity unit in St Peter’s, but the unit was actually closed for a large part of that time, because staff were sent to Chelmsford. Ten years ago, there were over 300 births per year, and the population has grown steadily since that time. As one of the midwives wrote in response to the survey that I am conducting:
“Our unit has seen 1000’s of births over its 75 years, over the past 5 years we have had over a 1000 postnatal stays, mothers who have birthed at Broomfield, then needed ongoing support coming to stay with us, we have taken readmissions from the community with baby’s not feeding well, which in turn warded off a remission to Broomfield where beds are always in short supply. We do in excess of 50 community visits weekly, 80+ clinic appointments weekly, over 20 new bookings a week, and anything between 5-10 appointments a day on our ward for anything extra…We are so much more than the ‘6 births a month’ that was widely reported and made us as a team so very angry and undervalued.”
The availability of in-patient services and a maternity unit are of huge importance to my constituents, but it is the out-patient services on which thousands depend. There are some 80,000 out-patient appointments each year, with a huge range of specialties such as X-rays, blood tests and ophthalmology. Although, unlike my right hon. Friend the Member for Witham, I have not used the birthing unit, I have received physiotherapy at the hospital and am due to have an abdominal aortic aneurysm screening there in the next few weeks.
I welcome the ICB’s assurance that out-patient services will be maintained at St Peter’s until alternative locations in the town are found, but it is essential that they are maintained in Maldon without a break or cessation of service. It is not good enough simply to divide up the different services and to try to slot them into buildings across the town. We need the new hospital or health hub that has been promised for so long. We have seen the new hospital at Braintree and the expansion of Broomfield and Southend, but Maldon has been consistently overlooked.
It was announced in last week’s Budget that the Maldon district is being allocated £5 million of levelling-up money for cultural projects, which I welcome, but what my constituents want is not cultural projects but a new hospital. Essex County Council and the district council have money set aside, but it is unlikely to be sufficient.
I applaud the Government’s continuing investment in the NHS, of which we saw further proof last week, but I ask the Minister to tell the Mid and South Essex ICB to think again and, rather than cutting services, to maintain and expand them so that my constituents have the high-quality, easily accessible healthcare they deserve.
Madam Deputy Speaker (Dame Eleanor Laing)
The right hon. Lady has not asked me, the Minister or the right hon. Member for Maldon (Sir John Whittingdale) whether she can take part in the debate, but she can ask now.
The Minister for Social Care (Helen Whately)
indicated assent.
Priti Patel (Witham) (Con)
Thank you, Madam Deputy Speaker.
I congratulate my right hon. Friend the Member for Maldon (Sir John Whittingdale) on securing the debate, and I echo everything he said in illustrating the sorry and sad situation in which our constituents find themselves with regard to what is a much-loved local hospital. Naturally, we both speak from our personal experience, but it is fair to say that both he and my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) will have received hefty mailbags of angry correspondence from our constituents who believe that the ICB’s consultation is effectively a slippery slope to permanent closure and the running down of services after last summer’s announcement, which we clearly do not support. It is right that we stand up for our constituents.
I reiterate and echo the points raised by my right hon. Friend the Member for Maldon, particularly on the incredible maternity and birthing facility. Nurses from the facility were present at the public meeting held in Witham on Monday evening, and I emphasise the due diligence, care and compassion they provide not just in the birthing unit but in the wider community. The support that the facility gives to new mothers was echoed by everyone in that public meeting.
The reality is that Essex is a very large county, and relocating these services is simply not good enough because of the time it takes to travel to the alternative facilities, and public transport is not available. I emphasise that Maldon is a growing district in both our constituencies; the Westcombe Park development in Heybridge straddles my right hon. Friend’s constituency and mine, and it now has more than 1,000 homes under development.The current local plan runs until 2029 and will see the development of another 5,000 homes. It is simply unsustainable that we have a proposal to close St Peter’s Hospital and relocate services elsewhere in Essex, because we can guarantee that in future years there will be calls to stand up those local medical facilities again. That is why, as my right hon. Friend the Member for Maldon said, we must have new facilities in Maldon town, and they have to be future-proofed to meet growing need.
Finally, it is vital that we recognise the overall impact of an ageing and growing population. We have to provide the right kind of medical facilities and give our constituents the assurance that whatever happens with their health, they can have health provision on their doorstep.
The Minister for Social Care (Helen Whately)
I thank my right hon. Friend the Member for Maldon (Sir John Whittingdale) for securing this important debate about the future of NHS services for his constituents. I know that St Peter’s Hospital, which has a long history of delivering local NHS services, is close to his heart and those of many people in his area. He spoke of the dedication of the staff who have worked there over the years and of many debates about the future. I welcome his sustained efforts to bring together stakeholders and ensure that his constituents’ voices are heard. We also heard from my right hon. Friend the Member for Witham (Priti Patel); she, too, made sure that her constituents’ voices are heard in this place. It is not the first time that she has raised this matter with me.
I want to assure both my right hon. Friends that the Government believe that NHS reconfigurations should be locally led, and based on clinically evidenced decisions. Any decision about St Peter’s will reflect our commitment to investing in health and care services for Maldon and Mid and South Essex. Let me start by reiterating that no decision has been made on the future of St Peter’s, and that a local consultation will run until 4 April 2024. As my right hon. Friend the Member for Maldon is aware, the local NHS is concerned that the hospital does not meet the required standards for services because of issues with the age, condition and suitability of its buildings. Indeed, he spoke about that a moment ago. St Peter’s was built as a Victorian workhouse and has deteriorated in recent years. That makes the building costly to maintain and it would be expensive to refurbish. The cost of getting the facility up to the standard needed is estimated at more than £18 million.
The St Peter’s site has also struggled to staff services properly, despite the increase in the NHS workforce in the past few years. When the birthing unit was at St Peter’s, it had to be periodically closed due to staff shortages, and there were also clinical safety concerns about the isolation of the unit; there were no other 24-hour services in the building. I heard my right hon. Friend explain that in the past there had been more than 300 births a year in the maternity unit, and I believe that my right hon. Friend the Member for Witham had her baby there.
I understand that stroke rehabilitation services in Essex community hospitals are not currently staffed in line with national best practice for specialist stroke units. I am sure that my right hon. Friends’ constituents want services not only on the doorstep, but to be staffed to provide the best possible care. That will be crucial, be it for mothers giving birth and their new babies, or for patients recovering from a stroke, for whom getting the right rehabilitation can make a huge difference to future quality of life. That is why ways to treat and care for patients and better equip facilities with the right level of specialist staff are being considered by the integrated care board.
I understand that other locations in and around Maldon are being considered by the ICB for the other patient services provided at St Peter’s; this will keep services such as out-patient appointments close to the current location. It is crucial that the ICB gets a full understanding of how these proposals will affect local people—of whether expected standards are met, not only of care, but of access. People usually understand that they may need to travel to get to a more specialised service, but it is essential that the services that people need are accessible. As well as considering patients, the ICB must consider families, carers, who need to be able to visit, and of course staff.
My right hon. Friend the Member for Witham emphasised the size and scale of Essex, and both she and my right hon. Friend the Member for Maldon spoke of house building and the growing population in the area, which clearly needs to be taken into account by the ICB. I have been assured that the local NHS is engaging and seeking to understand the views of residents before making any final decision. When that decision is made, the ICB must clearly set out how a decision will benefit the constituents of my right hon. Friends and people in the wider area.
I understand that my right hon. Friends are concerned about the adequacy of local consultation on the proposed changes. I am assured by the local NHS that multiple events are being held to discuss the proposals, and at least three have already taken place in Maldon. As we heard earlier, public meetings have already been held, involving my right hon. Friend the Member for Witham. Almost 3,000 people have already completed the online survey since 25 January.
I thank my right hon. Friend the Member for Witham for raising the closure of St Peter’s in a Westminster Hall debate earlier; my right hon. Friend the Member for Maldon raised it in oral questions the other day. I am glad to hear that the NHS will consider the results of a survey undertaken by my right hon. Friend the Member for Maldon, and that those views will be fed into any decision. The local NHS is giving people more time to come forward, and this week it announced an extension to the consultation by an additional two weeks.
Mid and South Essex is already one of the best parts of the country for the NHS getting patients back home and to appropriate care settings to recover from a stay in hospital. That strong performance has been supported by Government investment. That includes significant capital funding of £20 million for accident and emergency across 2020-21 and 2021-22; £18 million for the targeted investment fund in 2021-22 and 2022-23; and £7 million for a community diagnostic centre across the same two years. We have invested £61 million in operational capital in 2023-24, and £182 million across the 2023 spending review, which can be used for capital projects and work. I am sure that my right hon. Friends will be in no doubt about the Government’s commitment to the health of their constituents.
I can also assure my right hon. Friends that we have now delivered on our manifesto commitment for 50 million more general practice appointments per year, with nearly 370 million appointments booked across the last 18 months. Our primary care recovery plan is making it quicker and easier for patients to get the help that they need from primary care. On facilities for GPs in Maldon, integrated care boards have delegated responsibility for commissioning primary care services and can prioritise capital funding for an essential system of allocation to invest in primary care estates as needed.
In closing, I thank my right hon. Friends the Members for Maldon, and for Witham, for speaking in the debate and focusing our attention on healthcare in Essex, specifically on the future of St Peter’s Hospital. They have both done an excellent job of ensuring that the views of their constituents are heard, and I have no doubt that they will continue to do so. I am very much looking forward to meeting them to discuss in greater detail the questions we debated today. I am confident that the local NHS has been listening, and I know the importance of St Peter’s to the area. Any change in NHS services must be made with the utmost sensitivity to local views.
Question put and agreed to.