Defibrillators in Public Areas

Craig Whittaker Excerpts

Monday 16th January 2017 Commons Chamber

[Maria Eagle (Garston and Halewood) (Lab)]

Defibrillators save lives. That is the truth that drives the work of the Oliver King Foundation, a charity that campaigns to ensure that defibrillators are available in public places and that people are trained to use them. Every year, ambulance services in the UK treat about 30,000 people for a non-hospital cardiac arrest, but fewer than 10% of them survive—fewer than one in 10. Of the average 82 people who suffer cardiac arrest outside hospital every day in the UK, just eight live.

Cardio pulmonary resuscitation is often championed as the best way to treat cardiac arrest before the emergency services arrive. Indeed, in some cases it can double the likelihood of survival. But even then the chances of resuscitation are still as low as 20%, and that is only in some cases. Clearly CPR alone is not enough.

[Craig Whittaker (Calder Valley) (Con)]

A little over a year ago, on 7 December 2015, my 28-year-old son had a cardiac arrest. He is one of the few lucky ones who got to hospital in time and survived. He has his own defibrillator, but does the hon. Lady agree that, in conjunction with defibrillator training, it is incredibly important that people are trained in CPR? In my son’s case, his girlfriend was trained in CPR and saw him through the process until the paramedics arrived.

[Maria Eagle]

The hon. Gentleman has had a frightening experience in his family, and also learnt the incredible importance of not only having defibrillators available, but having people who know how to use them. I could hardly better his family’s example of how important that is.

A study by the British Heart Foundation found that for every single minute without defibrillation, chances of survival fall by between 7% and 10%. The Care Quality Commission sets a response target of eight minutes for emergency ambulance services, but we know that ambulances cannot possibly arrive within that time in every case. Even if they did, the chances of survival without immediate defibrillation and CPR will have already plummeted to 20% or lower. Access to a defibrillator can therefore make a huge difference. If cardiac arrest is recognised, basic first aid is given, 999 is called and CPR is applied, in combination with rapid and effective defibrillation, the chances of survival can exceed 50%. In fact, in some cases it can be as high as 80%. However, immediate action is vital. A defibrillator must be at hand for those survival rates to be realised.

Three people who know that better than most are my constituents Mark, Joanne and Ben King. In 2011, Mark and Joanne King lost their son Oliver, and Ben lost his brother. Oliver tragically died following a sudden cardiac arrest while racing in, and winning, a school swimming competition. He was just 12 years old. He had a hidden heart condition, and without access to a defibrillator at school his chances of survival on that day were dramatically reduced. Had he lived, this Saturday would have been his 18th birthday.

I never met Oliver, but I have been struck by talking to those who knew him well. He was clearly a very happy and popular boy, judging by the tributes that poured in from those who knew him following the shock of that terrible day. He was known as a big character at King David High School. His teachers recall his “uncompromising zest for life” and how he was loved and respected by boys and girls and teachers alike. His best friend David recalls Oliver’s charm and how it was deployed on more than one occasion to get them out of a tricky situation. This year is particularly difficult for David, as he will be celebrating the milestone of turning 18 without his best friend.

Everyone mentions Oliver’s love of football—he was a staunch Evertonian. His family and friends all recall his great talent and potential on the pitch. One of his teachers describes him as

“a sportsman at heart and a natural at whatever he turned his hand to”.

Above all, Oliver was caring, loving and incredibly close to his family:

“family was everything to Oliver.”

It goes without saying that Oliver’s death left many who knew and loved him with a great sense of loss. His family and friends are sadly not alone in going through this terrible ordeal. As well as the thousands of people who die every year following sudden cardiac arrest, there are thousands more who are now faced with the agonising reality of living without their loved one.

CQC: NHS Deaths Review

Craig Whittaker Excerpts

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

When the new guidelines are published, we need to investigate, as far as we possibly can, deaths that have already happened. I totally recognise the hon. Gentleman’s picture of Pennine and share his real worry about the standard of care in that trust. The positive thing is that under the leadership of Sir David Dalton—the chief executive of Salford Royal, which is one of the safest trusts in the NHS and a CQC outstanding trust—things are beginning to turn around. I have spoken to him about the situation at Pennine on many occasions. The hon. Gentleman is right to say that there is a lot of work to do there.

[Craig Whittaker (Calder Valley) (Con)]

Many people will be shocked to hear that some trusts do not even know how many in-patients have died in their care. Will my right hon. Friend say more about what action should be taken against boards and leaders who are negligent in that way?

National Health Service Funding

Craig Whittaker Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Craig Whittaker (Calder Valley) (Con)]

Our national health service is, and always has been, valued and cherished by my constituents who rightly expect an excellent standard of care to be provided free at the point of use when they need treatment. We are all deeply committed to the future of the NHS, but to ensure that it can continue to provide the quality of care that our constituents expect, it cannot stand still. It needs to continue to transform the way in which it delivers services so that more resources lead directly to better care for patients.

Both the total NHS budget and the amount of NHS spending as a proportion of total Government spending have increased in every single year since 2010. Spending is now 10.1% higher per head in real terms than in 2010, and that increase has brought our health spending as a proportion of GDP broadly in line with that of our western European neighbours. In order to achieve best value from its resources and to deliver £22 billion of efficiency savings—those are savings that the NHS identified as achievable in its five year forward view—it is necessary to reconfigure the way in which health and social care services are delivered at a local level. That is a huge issue, and until we amalgamate social care budgets with health budgets to deliver a truly health-driven service with proper health-led care in the community, we will struggle with this for many years. I mention that not to cause controversy, but to highlight the difficult decisions ahead. Too often those decisions and the long-term sustainability of our local services are hindered by ideology, local politics and empire protections over budgets.

A few weeks ago, the West Yorkshire and Harrogate STP was published, setting out the vision, ambitions and priorities for the future of health and care in the region. This built on the significant work that was completed locally by both the Calderdale and the Greater Huddersfield clinical commissioning groups, which have been working together to address the significant challenges facing the health economy across our whole area. The decision to proceed with the development of a full business case was met with considerable concern from some members of the public who have been vociferous in their opposition to what they perceive to be a complete withdrawal of urgent care treatment at Huddersfield royal infirmary. Although the process has been challenging, to say the least, I would argue that it has been absolutely essential. What is certain is that the current model through which health services in Calderdale and Huddersfield are delivered is not sustainable in the long term, and that changes are needed to ensure that we have a local health service that continues to provide excellent care.

Amid some of the sensational media headlines from the local press and the comments of some of my opponents at the last general election, it can be easy to forget that these proposals are being put forward not by politicians or by the Government, but by our senior local clinicians and doctors—the very people who understand how our local health services can best be delivered in the long term. They have taken an independent view about how the additional resources that the Government are making available can directly lead to better care for patients locally, and we have to trust their judgment. However, if we are to receive the support of our constituents for transforming the way in which we deliver their care, we must vastly improve the way in which we communicate any proposed changes and not keep scaremongering about cuts and reduced services, especially when the annual NHS budget spend is increasing in real terms.

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[Craig Whittaker]

Does my hon. Friend agree that one lever for discouraging bed-blocking would be to join up some of the budgets around health and social care?

[John Howell]

I do, and that is precisely what the organisations in Oxfordshire have been trying to achieve.

The second point I would make relates to how we produce better-serving hospitals. In my own area, the Townlands Memorial Hospital, which is in Henley but which serves the whole of south Oxfordshire, has recently gone through a major reprovision. It now has an increased number of facilities serving the population of the area, but the beds are not in the hospital. Although limited in number, they are in an adjoining care home, whose opening I happened to attend with the Duke of Gloucester only the other day. It is good to see the issues at the hospital finally resolved.

That is the way forward for local hospitals: better treatment for people in their home through a system of what has come to be called ambulatory care. Such a system prevents the problems I mentioned, with patients suffering when they stay in hospital for a long time. This view comes not from politicians but from clinicians both local and national. The national clinicians I would point to are those in the Royal College of Physicians, who are fully behind this process. This method costs more in the first instance but provides better value for money and increases better patient outcomes.

The third area I want to discuss is what can happen when we integrate the staff providing care who are employed by the county council and those who are employed by the NHS. This allows us to ensure that the pay and service requirements of both groups of people, who are doing exactly the same job, can be harmonised in a much more positive way. That sets out a good scope for efficiency in the operation of social care within the NHS model. I agree with my hon. Friend the Member for Calder Valley (Craig Whittaker), in that I would like to see them fully integrated, but until then I have set out a very good method of being able to operate in those circumstances and to co-operate in order to achieve the outcomes that I have mentioned.

Sustainability and transformation plans focus on organisations working together and are the best hope of improving health and social care services in the long term. That is not my view but that expressed by the King’s Fund when it looked at the plans. I fully agree with its assessment of the situation and of these plans, which are working towards achieving the same outcomes.

Katie Road NHS Walk-in Centre

Craig Whittaker Excerpts

Wednesday 24th February 2016 Commons Chamber

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

Tonight I am seeking an opportunity to shed some light on the continuing saga of the Katie Road NHS walk-in centre in my constituency. Its future status has been in doubt ever since its fate was placed in the hands of one of the new clinical commissioning groups. My constituents have had to live with rumours, on-off consultations and continuing threats to the long-term future of an immensely popular and highly valued service that sees about 70,000 patients a year. The origins of the service lie in concerns that the large number of students in the area, as well as vulnerable individuals—often with mental health conditions and in unstable accommodation—were placing a demand on GP services that could not be met by existing provision, which was in turn placing intolerable strains on the local accident and emergency services.

My own fairly extensive consultations with constituents have established that the centre is regularly used by those who cannot easily secure quick appointments with their own GP. That is often a problem for those in work—especially those who work unsocial hours—and for families with elderly relatives or young children who cannot easily gain access to GPs at weekends or in the evenings. The Katie Road centre sees about 300 to 400 patients during an average weekend.

There is now fairly widespread recognition of the value of walk-in centres. The 2014 Monitor review reported rising demand for the service year on year. About 70% of the centres that were surveyed reported that they were seeing an average of 20,000 to 45,000 patients a year, as opposed to anticipated attendances of between 12,000 and 24,000. Yet despite the demand and support for walk-in centres, local commissioners have closed more than 50 since the start of 2010, reduced services at 23 others and reduced overall capacity by about 20%. I am not aware that, other than the Monitor report, there has been any substantial review into the impact of that loss of provision. I wonder whether the Minister is in a position to enlighten me, and whether he might take this opportunity to say what the Government’s position is on urgent care generally and walk-in centres in particular. I noticed that the Department of Health consultation “Refreshing the Mandate” says that

“we want to improve people’s access to primary care through new forms of provision including rapid walk-in access.”

In early 2013, Birmingham CrossCity clinical commissioning group announced plans to consult on the future of the Katie Road walk-in centre. That was apparently based on a report commissioned by the former South Birmingham primary care trust, a report that remains secret to this day. I first asked to see a copy of it in March 2013. In June 2013, the CCG called off its plans for walk-in centres and it was announced that they had been saved, only for the chair of the clinical commissioning group to reveal later that it planned to renew the contract temporarily and that Katie Road had been saved for 12 to 18 months. Later, the CCG announced that it planned a two-stage consultation, with a pre-consultation phase and then a main consultation with the public.

Naturally, I wanted to ensure that my constituents had their say on the matter. When I consulted them, I discovered that more than 72% had experience of using the centre and were firmly opposed to any plans to close it.

[Craig Whittaker (Calder Valley) (Con)]

I agree that walk-in centres have the ability to take pressure off overworked A&Es, but does the hon. Gentleman agree that the best way to take pressure not just off A&Es but walk-in centres is to have GP surgeries open seven days a week, so that people can access services overall?

[Steve McCabe]

I might agree with that, but one of the problems in my area is that GP surgeries have been cut as well, so that is not the answer.

As I said, more than 72% of the people I consulted had experience of using the centre and were firmly opposed to any plans to close it. I also found that 56% of people had used the centre for out-of-hours emergency treatment, and 55% expressed serious concern about any plans to move the service to or near the A&E unit. My findings are consistent with that of the survey conducted on behalf of the NHS central midlands commissioning support unit in 2012, which found that more than two thirds of patients surveyed at eight walk-in centres and urgent care centres across Birmingham and Solihull indicated that they had attended because of an access-related issue—for example, they could not get an appointment with their GP or had to wait a considerable time to be seen.

There were major objections from my constituents to relocating their walk-in centre to the main hospital. They referred, for example, to the distance, waiting times, parking and accessibility. During a visit to Katie Road, I witnessed an ambulance crew bring into the walk-in centre an elderly lady in need of stitches to a leg injury. They did that rather than take her to the A&E unit because of their concerns over the likely delays. The CCG’s own figures suggest that an average visit to the walk-in centre costs around £45, as opposed to £75 to £100 for an A&E visit.

I am aware that there are many examples of walk-in centres being co-located with other health or social care services, and that some have a pharmacy on site or are co-located with diagnostic services such as X-ray services, dental facilities or family planning, but I should like to ask the Minister whether there is any evidence that shows an obvious advantage in co-locating an urgent care or walk-in centre alongside an A&E unit, especially evidence that would outweigh such negatives as distance, waiting times, parking and accessibility. In fact, is it not the case that most walk-in centres have a limited ability to refer patients on to secondary care services, as patients needing a referral to secondary care are normally referred by GPs, who are the traditional gatekeepers—a role that has, if anything, been strengthened as a result of the reorganisation of the NHS?

In autumn 2013 the CCG commenced its pre-consultation. The chair of the CCG met with a number of my constituents in February 2014, when he heard clearly their desire to retain Katie Road and their objections to a plan being pushed by the CCG to relocate the walk-in centre to a site at the University Hospitals Birmingham NHS Trust site, adjacent to the hospital’s A&E unit. In July 2014 I invited the chair of the CCG and a number of his staff to take part in a second meeting attended by more than 80 constituents—we were limited by the size of the room, or it would have been many more. At that meeting they heard clearly once again that there was total opposition to the closure of the walk-in centre and the plans to relocate to the hospital. That review or consultation eventually fizzled out, with the promise of a bigger and better consultation later in 2014.

NHS (Charitable Trusts Etc) Bill

Craig Whittaker Excerpts

Friday 22nd January 2016 Commons Chamber

[Kit Malthouse]

That may be so, but—I hesitate to stress this point again—in my view these charities are different. They trade off the advantage of being associated with the national health service. People see them as part and parcel of the health service; they are not viewed as separate in the way that Oxfam or the Guide Dogs for the Blind might be. If something is called the Great Ormond Street hospital charity, people see it as a wing of the national health service.

[Craig Whittaker (Calder Valley) (Con)]

My hon. Friend raises a point about charities going off and lobbying. Does he feel that enough safeguards were included in the Transparency of Lobbying, Non-party Campaigning and Trade Union Administration Act 2014, which was designed specifically to prevent charities from taking non-transparent action?

[Kit Malthouse]

This is a difficult area. Some charities are composed in such a way that their entire purpose is a social mission. For War On Want or the Child Poverty Action Group, for example, decisions made by politicians are intrinsic to their objectives. Other charities, including some in the health sector, are more about providing funds and ancillary support to hospitals, and that kind of political campaigning is not intrinsic. I am not knowledgeable about the 2014 Act, but since my hon. Friend has raised it I will go and have a look. He may well be right to suggest that it contains enough protections, but I maintain my point that the special status of these charities, and the fact that they raise their money because of their association with the NHS, means that the Secretary of State must maintain some kind of toe-hold. To set those charities completely free is asking for political disaster at some point in the future.

The second part of amendment 2 would mean that if all trustee positions were vacant for three months, the Secretary of State could—and indeed should—appoint some new trustees to kick-start the organisation. That obviously will not happen often, but much of the business of this House involves planning for the unexpected. If a charity were for some awful reason to lose all its trustees at once—perhaps they are all off on a fact-finding mission together and there is a horrible accident; who knows what may happen, but let us pray to God that it does not—the Secretary of State will have the power to appoint people.

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[Craig Whittaker]

I need to challenge my hon. Friend on the assumption of “Who else better than the Secretary of State?” Of course, our current Secretary of State is a very highly esteemed colleague of great standing—I do not question that at all. What I question is the previous string of people who have appointed politically biased appointees to various quangos around the country. Surely he can see that a Secretary of State would have the potential to be not the best person to make the decision.

[Kit Malthouse]

My hon. Friend will make a great diplomat when the time comes. I agree there is the possibility of misbehaviour by politicians, but we politicians come with a great advantage. We have had a few thousand people vote for us and those few thousand people can vote us out if they think we have behaved badly. There are not many other people in public life who come with that brake on their behaviour.

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[Wendy Morton]

I agree wholeheartedly, and I am grateful to my hon. Friend for sharing with us the example of a hospital charity in her constituency and the fantastic work it does.

I thank my hon. Friend the Member for Mid Dorset and North Poole (Michael Tomlinson) for his amendment that would oblige the Secretary of State to carry out public consultation before making regulations consequential to the removal of his power to appoint trustees to NHS bodies. I understand where he is coming from. In my time as a councillor, many were the days when we discussed the pros and cons of public consultation. On the one hand, we often want more public consultation, but there are times when, as my hon. Friend the Member for North West Hampshire (Kit Malthouse) said, we feel it leads nowhere. It is an interesting point, though, and one that has provoked some lively debate. We, as elected representatives, often ask these questions about public consultation.

[Craig Whittaker]

I am reminded of my family’s frequent trips to Disneyland Paris when my three children were much younger. Their favourite ride was the Peter Pan ride. They played a game to see who could first spot Wendy quivering on the end of the gangplank as Captain Hook chased her into the sea. Does my hon. Friend think that Wendy might be quivering that little bit harder at the thought of yet more public consultation?

Junior Doctors Contract

Craig Whittaker Excerpts

Monday 30th November 2015 Commons Chamber

[Mr Hunt]

I am afraid that I do not agree with the hon. Lady’s characterisation of the situation as a “fiasco”. We are making really important changes that will save patients’ lives by eliminating the weekend effect that we have seen in the NHS for some time, which I think any responsible Government need to deal with. The way to improve morale in the NHS is by making it easier for doctors to give their patients the care they want to give, and at the moment that is very difficult in many places at the weekend. We want to put that right.

[Craig Whittaker (Calder Valley) (Con)]

We have heard about the 20,000 cancelled operations and the inconvenience caused to patients by the planned strikes, but I wonder whether my right hon. Friend could report to the House how serving the needs of patients features in the negotiations with junior doctors so that patients can get the same level of care seven days a week?

[Mr Hunt]

That is the reason we have had this whole dispute with the BMA, and it is disappointing that, rather than it negotiating with us on something that I think every doctor understands we need to address, it has come to the eleventh hour like this. In the end, my hon. Friend is absolutely right that doing the right thing for patients is also doing the right thing for doctors, because doctors go into medicine because they want to look after patients.

Junior Doctors Contract

Craig Whittaker Excerpts

Friday 20th November 2015 Commons Chamber

[Alistair Burt]

I think it is of primary importance for the Secretary of State to work on contingency plans this morning to make sure that we are all safe should there be a strike. That is the task he has been given by the action that has been taken. At the same time, he has repeated that he is open to negotiations to deal with the dispute. Rather than expressing anger, the hon. Gentleman should be expressing concern that a contract that makes an unsafe situation for doctors safer is not being backed more readily by those on the Opposition Front Bench, who should also be rejecting strike action.

[Craig Whittaker (Calder Valley) (Con)]

One group that has not been mentioned by the shadow Secretary of State is, of course, the patients. They receive a poor level of service at weekends, sometimes, sadly, with dire consequences. Will the Minister and the Secretary of State pledge to stand resolute in their commitment to improve weekend care, which, as Sir Bruce Keogh has said, is both a moral and clinical cause?