Accident and Emergency Waiting Times

Henry Smith Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

Thank you, Mr Deputy Speaker.

I repeat: it was one of the poorest speeches ever given by an Opposition on the NHS, and I predict that the right hon. Member for Leigh (Andy Burnham) will bitterly regret choosing to make an issue of A and E pressures, because the root causes of the problem have Labour’s fingerprints all over them.

The right hon. Gentleman was right on one thing, however: there is complacency on this issue—not from the Government, who have been gripping it right from the start, but rather from Labour, which still does not understand why things went so badly wrong in the NHS on its watch.

Labour’s narrative has, I am afraid, a single political purpose at its heart: to undermine public confidence in one of our greatest institutions—an institution which, in challenging circumstances, is performing extremely well for the millions of vulnerable people who depend on it day in, day out.

Labour’s story today is a totally irresponsible misrepresentation of reality. One million more people are now going through A and Es every year than in 2010, which creates a lot of pressure, so how are A and E departments actually performing? The latest figures show performance, against the 95% target, of 96.7%. The week before it was 96.5%, then before that 96.3%, 96.6% and 95.6%. Yes, we had a difficult winter and a cold Easter, and I will come to the causes of the problems we had then, but, thanks to the hard work of NHS doctors and nurses, our A and E departments are performing extremely well.

[Henry Smith (Crawley) (Con)]

The Secretary of State is absolutely right to say that we should point to the record of the previous Government, who closed the A and E department in Crawley.

[Mr Hunt]

Indeed. We were having a discussion about walk-in centres. It is true that Labour opened a lot of those, just as it closed or downgraded 12 A and E departments during its time in office. That is one of the reasons we face the problems we have today.

A and E Departments

Henry Smith Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

As the hon. Gentleman knows, the decision has been taken, but the A and E department has not been closed and will not be closed until it is clinically safe to do so.

[Henry Smith (Crawley) (Con)]

The last Labour Government closed accident and emergency at Crawley hospital, but in the last few years the urgent treatment centre has been able to see more and more patients. Does my right hon. Friend agree that upskilling urgent treatment centres is part of the answer to the problem?

[Mr Hunt]

I do, and my hon. Friend is right to point out that the last Labour Government closed or downgraded 12 A and E departments. The Opposition have criticised us in the press—indeed, the shadow Minister, the hon. Member for Copeland (Mr Reed), who is sitting on the Front Bench, has criticised me for not getting on and closing more A and E departments, which is what he seems to want to happen. Every time there has been a controversial reconfiguration, Labour has opposed it all the way. I think we could expect a bit more consistency from a shadow Secretary of State who was once a Health Secretary.

Immigrants (NHS Treatment)

Henry Smith Excerpts

Monday 25th March 2013 Commons Chamber

[Mr Hunt]

If the hon. Lady is worried about that, perhaps she might like to complain to her own party leadership, which, during Labour’s last five years in office, had an average underspend in the NHS of £2 billion.

[Henry Smith (Crawley) (Con)]

I, too, congratulate the right hon. Member for Birkenhead (Mr Field) on his urgent question, and my right hon. Friend the Secretary of State for Health on following my private Member’s Bill, the NHS Audit Requirements (Foreign Nationals) Bill. When will that primary legislation receive Government time to start its passage through this place?

[Mr Hunt]

I congratulate my hon. Friend on his excellent private Member’s Bill, which looked forward to many of the problems we are trying to address. Our first step is to identify the scale of the problem. We will then identify the right legislative response, but the response will not all be legislative. That is when we will consider including it in the parliamentary timetable.

Oral Answers to Questions

Henry Smith Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Speaker]

If the hon. Member for Crawley (Henry Smith) wishes to come in on this question, he may, but he is not obliged to do so.

[Henry Smith (Crawley) (Con)]

On Question 13, sir.

[Mr Speaker]

We will get to No. 13 in due course. Never mind.

--- Later in debate ---

[Norman Lamb]

There are plans to increase the number of training places for GPs, with the aim of providing more than 3,000 extra places by 2015. That will fully meet the needs to which the hon. Lady has referred.

[Henry Smith (Crawley) (Con)]

13. What steps he has taken to support research on the most common causes of premature mortality.

[The Secretary of State for Health (Mr Jeremy Hunt)]

We are still far too low in the European league tables for premature mortality, particularly in respect of cancer, liver disease and respiratory diseases. I have therefore made improving our performance a key priority.

[Henry Smith]

Can the Minister say a little more about what is being done to prevent early mortality as a result of heart disease?

[Mr Hunt]

We are investing £34 million in cardiovascular research. Much excellent work is being done at, in particular, the Oxford Biomedical Research Centre, which will help us to make great strides.

NHS Commissioning Board (Mandate)

Henry Smith Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

I hope we can move beyond the debate about public good, private bad and private good, public bad that has dogged the NHS for many years. I believe there is a role for the independent sector and the voluntary sector. Of course, the primary role will be for the traditional NHS. However, when the private and voluntary sectors are used will not be a matter not for politicians or parties; but for local doctors on the ground. I think that in the vast majority of cases, they will want to use and contract with traditional NHS services, but it is important that they have the choice to do what is in the interests of the patients for whom they are responsible.

[Henry Smith (Crawley) (Con)]

For too many years in my Crawley constituency health decisions were made by people who were nowhere near that location. I am delighted that under this Government decisions are being returned to local clinicians and local people. We have seen results already—the local CCG has started a dementia pilot with money from the Department of Health. Will my right hon. Friend join me in congratulating that kind of vision, both in Crawley and elsewhere?

[Mr Hunt]

I am more than happy to do that, because when it comes to conditions such as dementia there is no one right solution, and doctors’ surgeries and hospitals will have different approaches in different parts of the country. We want everyone to take ownership of the problem. I hope that what is happening in Crawley will be noticed by other parts of the country, so that we can spread best practice everywhere. That is the point—we want to allow innovation to happen in a way that has never happened before.

Regional Pay (NHS)

Henry Smith Excerpts

Wednesday 7th November 2012 Commons Chamber

[Andy Burnham]

I know that many Members want to speak in the debate, so I shall give way once or twice, to ensure that there is time left for others to contribute.

[Henry Smith (Crawley) (Con)]

The right hon. Gentleman is right that it is a national health service that this country enjoys. Why, therefore, is a Labour Administration reducing funding to the health service in Wales?

[Andy Burnham]

I am here to talk about the NHS in England. I will come on to the Conservative Government’s record on funding the NHS in England, so I would not be so smug if I were the hon. Gentleman.

The drive to turn collaboration into competition depends on breaking national standards—breaking the “N” in NHS. The former Health Secretary’s request to the pay review body to consider the case for “market-facing pay” needs to be seen alongside his Health and Social Care Act 2012. Breaking national pay in the NHS is an essential step towards creating the free market in health that many in the Conservative party have long wanted, and which the Liberals now seem willing to let them have.

Business of the House

Henry Smith Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I must confess that I am slightly staggered that the hon. Gentleman now seeks to make a virtue of the fact that he and his party voted by a substantial majority for the principle of House of Lords reform, and then effectively sought to obstruct any progress. My definition of opposition is not obstruction. It may be his definition, but it is not mine.

[Henry Smith (Crawley) (Con)]

I warmly welcome my right hon. Friend to his position. Will he consider arranging a debate on over-zealous health and safety regulation? Apparently my local authority, Crawley borough council, has been told to remove all park benches that are under trees.

[Mr Lansley]

I hope my hon. Friend will not be surprised to learn that we in the Government have been working actively over the last two and a half years to ensure that common sense is at the heart of the way in which we apply health and safety regulations. It must be evidence-based, common-sense and proportionate. Measures have been taken, but I will certainly draw my hon. Friend’s comments to the attention of my colleagues in the Department for Business, Innovation and Skills so that they can continue the process.

National Health Service

Henry Smith Excerpts

Monday 16th July 2012 Commons Chamber

[Mr Burns]

I will give way to my hon. Friend the Member for Crawley (Henry Smith), then I will give way to the right hon. Member for Knowsley (Mr Howarth) and the hon. Member for Walsall South (Valerie Vaz), then I will stop giving way for a time to make progress.

[Henry Smith (Crawley) (Con)]

Earlier this year I was delighted to be able to open a new digital mammography unit at Crawley hospital, a hospital which under the previous Government saw its accident and emergency unit closed down. Does my right hon. Friend find it odd that the Opposition refuse to match the spending commitments on the NHS that this Government are delivering?

[Mr Burns]

My hon. Friend is right. As he would probably expect, I shall deal with that issue later in my speech. While I am responding to his intervention, let me say that not only was his hospital fortunate in having that fantastic equipment to look after his constituents, but I had the pleasure last week to be in his constituency to visit Elekta and Varian, which are world leaders in making equipment to help with radiotherapy.

Hospitals (Sussex)

Henry Smith Excerpts

Wednesday 20th June 2012 Westminster Hall

[Stephen Lloyd (Eastbourne) (LD)]

It is an honour to serve under your chairmanship, Mrs Brooke.

I am grateful that Mr Speaker has given me an opportunity to address an important local issue—the proposed reconfiguration of my local Sussex NHS trust, the East Sussex Hospitals NHS Trust. A number of reconfigurations have already taken place in Sussex, such as the transfer in March of in-patient elderly care and orthopaedics in the Western Sussex Hospitals NHS Trust from Southlands hospital to Worthing hospital. It appears that the latest direction of travel for Southlands is to become a day surgery and out-patients-only hospital, with which I expect few local residents would agree.

Let me give the Minister the details of the proposed changes to my local trust and hospital, Eastbourne district general hospital. Four or five years ago, the trust board wished to downgrade maternity at the DGH while maintaining consultant-led maternity at our sister hospital in the trust, Conquest hospital in Hastings. There was a substantial campaign against the proposals in which all parties were involved, and eventually the matter was referred to the Independent Reconfiguration Panel for consideration. It found against the proposals, and the trust-proposed strategy was sent to the then Secretary of State for a decision. I am glad to say that he backed the IRP and our campaign to retain consultant-led maternity on both sites.

As I am sure the Minister is aware, there was a number of reasons why the IRP found against the trust, but essentially the main reason was the poor road link between Hastings and Eastbourne, which would have meant a blue-light ambulance potentially taking upwards of 50 minutes to travel from hospital to hospital. From a patient safety perspective—for example, for a mother facing a complicated birth—that was considered far too long. Hon. Members can imagine my surprise to find out a few weeks ago that the new trust board is recommending a similar change—to be precise, that there should be a consultant-led maternity unit on one site and a midwifery-led unit on the other site. For the record, the road links between the DGH and the Conquest are even worse than they were five years ago, when the IRP found in our favour.

[Henry Smith (Crawley) (Con)]

I congratulate the hon. Gentleman on securing this debate. The story elsewhere in Sussex has been similar. A decade ago, we lost maternity services from Crawley hospital, which was a very retrograde step. Mothers now have to travel long distances and a difficult journey to East Surrey hospital for maternity services. The proximity argument is important.

[Stephen Lloyd]

I thank the hon. Gentleman for that important intervention, not least because he demonstrates that if the proposed downgrades go through, the backlog will be even worse. Patients coming from his constituency would have an even longer wait, which an expectant mum with a complicated birth cannot afford.

Along with maternity, the proposed clinical changes recommend significant further reductions to trauma and orthopaedics, general surgery, stroke, emergency care, acute medicine, cardiology, paediatrics and child health provision. I am no medical expert, but even I can see that if some of the proposals are carried through, they will lead to a substantial downgrade of core services at Eastbourne district general hospital. We are talking about a possible downgrading of a much loved hospital in one of the fastest growing towns in the south-east, where the fastest growing age group is the 25 to 45s. I am simply not prepared to stand idly by and allow that to happen. The people of Eastbourne and the surrounding area are not prepared to do so, and none of the local political parties is prepared to accept the proposals.

On that note, I am grateful to the Under-Secretary of State for Transport, my hon. Friend the Member for Lewes (Norman Baker), who is here supporting me in this debate, as he has done throughout the past few years. He was very heavily involved five years ago, when we won the last campaign. I also acknowledge the support I have received from the Minister of State, Department of Energy and Climate Change, the hon. Member for Wealden (Charles Hendry), the hon. Member for Hastings and Rye (Amber Rudd) and the Minister of State, Department of Energy and Climate Change, the hon. Member for Bexhill and Battle (Gregory Barker). They send their apologies for not being here, but they are very supportive of what we are trying to achieve. The local business community and the voluntary sector are also not prepared to stand by while our hospital’s core services face such a proposed downgrade. We will all fight the proposals vigorously and tenaciously. I cannot emphasise that strongly enough to the Minister.

Why are we so determined to fight? Let me flesh out just a little of what we believe the consequences will be if the proposed clinical strategy goes ahead. The first issue is travel distance. The travel time between Conquest and the DGH is 50 minutes. Even when the planned Bexhill-Hastings bypass is built, in however many years’ time, that journey time will be reduced by only five-and-a-half minutes. That is still way outside the guidance from the Royal College of Midwives on mothers giving birth safely. The IRP and the Secretary of State agreed with us on that five years or so ago.

Secondly, although I wholly accept that very specialised procedures—for instance, children’s cardiac surgery or even specialist oncology and cancer—are better in the fewer, larger specialist expert centres, the vast majority of Sussex patients also need good-quality local care for simple conditions. Why would the Department of Health encourage care closer to home and then sanction the massive movement of patients, which would be an inevitable consequence of some of the proposed changes?

Thirdly, there will continue to be two hospitals admitting medical emergencies, as there are too many patients to move them all into one giant hospital. The reality is that it is often difficult to make a diagnosis for elderly people, but the proposals mean that one unit will have a surgeon on call and one will not. An elderly person admitted to a hospital with no surgeon who proves to have a burst appendix or to be bleeding internally will have to travel from the DGH to Conquest. That simply cannot be safe.

Fourthly, both hospitals fix fractured bones, but under the proposed strategy, if someone has a fracture, they will have to travel. The number of elderly and frail patients with hip fractures having to travel will increase exponentially. It will take longer for them to get an operation, and the inherent delay will lead to worse outcomes. In addition, there is likely to be a longer waiting period to sort out social services, and the individual patient will have to be sent home from a greater distance. Surely that cannot be better for the patient. In fact, pretty much anyone with a broken arm, leg or hip that needs fixing will have to travel further. The service will not be better quality, Minister; it will just be slower.

Let us take a look at the nearby trusts that will, apparently, take up the slack. This is patently absurd. Brighton more often than not has huge waits, and Pembury is full, so that is no answer. In stroke care, elderly patients will be moved, making it doubly hard for their similarly-aged husbands and wives to visit. Is that good practice for the patient? I do not think so. There is more, but I am that sure the Minister gets my drift. If he does not, let me draw his attention to the contents of a very important letter that was leaked to me a couple of weeks ago—I am happy to share the contents of the letter with him afterwards.

The letter was sent to the trust board from the consultant advisory committee that represents the most senior clinicians at Eastbourne district general hospital, following a meeting that 63 consultants attended. I quote:

“The main body of Consultant Opinion expressed little or no confidence in significant elements of the strategy… Concerns repeatedly expressed (by the Consultants) were that proposals would not advance the desire for improved access and quality of care for patients in East Sussex”.

These are direct quotes. The letter continues:

“There was frustration that clinical input from the majority of CAC members into the strategy has not been taken into account. Furthermore, concern was expressed that although Management has described the strategy as clinically led, this has been by a few invited individuals and the majority Consultant opinion expressing concerns regarding many aspects of the strategy has not been adequately expressed… the clinical strategy as explained and understood by the CAC does not deliver clear benefits to patients and therefore cannot be supported in its current form”.

The CAC letter further states:

“our local population rightly expects key services should be maintained at both sites and that these include stroke care, orthopaedics and trauma, general surgery and other core services. The strong recommendation of the CAC was that both sites should be developed to improve quality of care, training issues and access for local patients”.

I shall conclude my speech, because I am very keen to listen to the Minister’s response. Time precludes me from going into detail about the cross-party “Save the DGH” campaign group, which has been working together for years. It succeeded five years ago and has come back together stronger than ever. Time precludes me from talking about the fantastic work that has been done by our chair, Liz Waike, the strong determination in my constituency to protect core services at the DGH, and the important support provided by our local paper, the Eastbourne Herald.

I also do not have enough time to talk about the details of the utter financial shambles. The trust has been under successive managements since it was merged with the Conquest more than 10 years ago. I am well aware that, like me, the Minister has a business background. The financial inefficiency of the trust for many years has been mind-blowing. I would be happy to give the right hon. Gentleman more details at another time.

Time precludes me from giving details of the severe morale challenges felt by community nurses, who face reductions while at the same time being told ad nauseum that they must keep people in the community, so as not to take up expensive hospital beds. Time precludes me from telling the Minister of the sheer frustration that my constituents and I feel as we have to fight a similar battle around maternity all over again, despite the IRP’s clear conclusions five years or so ago.

Time precludes me from presenting details of how, if necessary, we should seriously consider de-merging the trust and setting Eastbourne DGH up as a separate foundation trust. We have been doing this work for many months now, as we suspected that proposals to downgrade DGH core services from the current trust board were in the pipeline. I have even had a number of key people in the DGH campaign visit an equivalent sized trust in Yeovil in the west country. We came back from that visit with some very useful data and plans for if we were to de-merge.

As time is an issue, I will finish with a direct quote from our mutual friend and colleague, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), who wrote in a letter that I received yesterday:

“The Government has said that, in future, all service changes must be led by clinicians and patients”.

The clinicians, as I have already reported, have profound concerns. I can assure the Minister of State that patients—former and future, from Eastbourne, Willingdon, Lewes and beyond—also have profound concerns about the proposed clinical strategy currently presented by East Sussex Hospitals NHS Trust managers.

I ask the Minister to take on board our concerns, to do what is necessary to address them, and to ensure that our hospital, Eastbourne DGH, is continues to perform as a fully functioning district general hospital for many years to come. Eastbourne is a growing town—in many ways, we are bucking the economic trend—and I am working closely with business and the council. We are rolling up our sleeves up in this difficult economic climate. I have already mentioned that the fastest-growing demographic in my constituency is the 25-to-45 age group. I need a proper hospital for Eastbourne. I need a district general hospital for the long term. I would welcome any comments that the Minister has to make.

Health and Social Care Bill

Henry Smith Excerpts

Tuesday 20th March 2012 Commons Chamber

[Henry Smith (Crawley) (Con)]

It is a great honour to take part once again in a debate on the Health and Social Care Bill. I first made a contribution to these debates in 2010 and, as the right hon. Member for Wentworth and Dearne (John Healey) said, since then there have been 14 months of detailed and careful consideration of the Bill’s provisions. That says a lot. There has been criticism both in this debate and previously that the Bill is ill-considered and has been rushed through, but given the consideration of it that there has been over such a long period, and with so much public involvement and comment, that is clearly not the case.

The right hon. Gentleman also said that our NHS is truly a precious institution for each and every one of us—our own family members as well as all our constituents—and I agree. People rely on the health service and hold it very dear, and it is therefore right for passionate feelings to be expressed about its future both in this Chamber and outside. I contend that because we have a changing demographic and magnificent advances in medical technology, the way our national health service is run cannot stay still.

[Helen Jones (Warrington North) (Lab)]

No one on the Opposition Benches has argued that the NHS does not need to continue to improve. That is not what we are discussing; we are discussing the risk register. Does the hon. Gentleman believe that the Government should abide by the tribunal’s decision, or does he believe they should continue to ignore that lawfully made decision?

[Henry Smith]

I think the biggest risk to the national health service is if we do not reform it and move it forward. It needs reform to stay relevant to the needs of all our constituents. I find the Opposition’s position strange—I would put it down to political opportunism, but I am happy to take another intervention if Opposition Members want to state their case—given what happened with the three requests made when the right hon. Member for Leigh (Andy Burnham) was Secretary of State and under his predecessor.

[Andy Burnham]

Does the hon. Gentleman understand the difference between a strategic risk register and a transition risk register?

[Henry Smith]

I believe I do understand the difference between the different types of risk register, but if we simply stand still and have inertia in our health service, it will become less relevant.

The right hon. Member for Holborn and St Pancras (Frank Dobson) accused members of my party of being chancers. I prefer to consider us as reformers, and only if we embrace reform will we be able to provide a better NHS.

[Fiona Mactaggart (Slough) (Lab)]

One reform that I imagine the hon. Gentleman will welcome is the Chancellor’s proposal, which we gather we will learn about tomorrow, that every taxpayer can find out where their taxes go. As the taxpayers have paid for the compiling of the risk register, why should they and we not be able to read it?

[Henry Smith]

I am a great supporter of transparency across all our public services, and the people of this country thirst for transparency about how their hard-earned money is spent.

The Health and Social Care Bill provides for the democratisation of the national health service. The experience of the NHS in my constituency over the past decade was the sad loss of the maternity department at Crawley hospital, followed four years later by the closure of its accident and emergency department. One reason why those two units and others were transferred from my constituents’ local hospital was that decisions about the national health service were made nowhere near where they took effect.

The Bill will allow local clinicians, in conjunction with their patients—and, I might add, with democratically elected local government—to have a much greater say in how the NHS is delivered and greater scrutiny of it. We will have a far more responsive health service. It has been almost decades since health decisions in Crawley were made by clinicians, patients and elected councillors. By repatriating many decisions, we will have a more transparent and responsive health service.

It was a great privilege to be able to open the new digital mammography unit at Crawley hospital a few weeks ago. That is a classic example of a health service that develops in line with technology and with the changing needs of our population. I am confident that the Bill will give local clinicians, patients and democratically elected local representatives the tools to provide a far safer and more relevant national health service to the people of my constituency and constituencies up and down the country.

In conclusion, after 14 months of careful consideration of the Bill, it is time we get on with the reform of the national health service, which goes hand in hand with the increased investment in it that the Government have guaranteed at least to the end of this Parliament. I might add that that is in stark contrast to what is happening in Wales, where Labour is in control of the NHS and where budgets have been cut. The people of Wales are feeling the result. I want to resist that happening to patients in England and therefore believe that it is time to get on and pass this legislation for the good of our NHS.