Covid-19: PPE Procurement

James Wild Excerpts

Thursday 24th November 2022 Commons Chamber

[Neil O'Brien]

I cannot comment on the latest goings-on in the jungle but the answer to the hon. Gentleman’s point is the same as I have given before: there is a clear process, which every PPE supply bid, regardless of where it came from, went through.

[James Wild (North West Norfolk) (Con)]

During my time as a member of the Public Accounts Committee, we have looked closely at the procurement of PPE. The National Audit Office found that

“ministers had properly declared their interests”,

and that Ministers were not involved in procurement decisions. Is the reality not that the civil servants making these decisions were doing their best to secure PPE supplies for the NHS and the frontline in the face of a global pandemic? While we need to learn lessons from how this was handled, some of the people commenting here seem to forget the intense pressure we were under at the time.

Oral Answers to Questions

James Wild Excerpts

Tuesday 14th June 2022 Commons Chamber

[Sajid Javid]

The hon. Gentleman is right to talk about the importance of timely access to GPs, whether in Bradford or across the country. There are, of course, challenges across the country, which is one reason why we put in place an action plan, including some £500 million of extra funding, during the pandemic. On his plea for an urgent treatment centre, I will make sure that the Health Minister will meet him.

[James Wild (North West Norfolk) (Con)]

Before the jubilee weekend, I was pleased to welcome the Minister to the Queen Elizabeth Hospital to see the cracking RAAC—reinforced autoclaved aerated concrete—which the Department understands needs to be replaced. So will he take the opportunity to build a new QEH, fit for the future? When will the patients and staff at QEH know that they are on the list? They are impatient for a decision.

Health and Social Care Leadership Review

James Wild Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

The hon. Gentleman will know that the review specifically looked at the NHS and care in England, but there are important lessons here that can be drawn on by, for example, the health service in Northern Ireland. On the issue of retaining staff, the NHS is undertaking many initiatives to improve that, but I hope he will agree with me that one key way to retain staff is to ensure we have good leadership and good managers.

[James Wild (North West Norfolk) (Con)]

The review underlines how vital leadership is to driving change and improvements in care. I put on record my thanks to the chief executive and board of the Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, who have taken that hospital out of special measures, thanks to the hard work of the staff. As my right hon. Friend knows, to continue to improve care and to retain and recruit staff there is a pressing need for a new hospital for the QEH. I urge him to make an announcement on the new hospitals programme and to back QEH’s bid.

[Sajid Javid]

My hon. Friend rightly never misses an opportunity to make the case for his local hospital. I have heard him carefully and I am happy to meet him to discuss it.

Queen Elizabeth Hospital, King’s Lynn

James Wild Excerpts

Wednesday 23rd March 2022 Westminster Hall

[Stewart Hosie (in the Chair)]

I will call James Wild to move the motion and then call the Minister to respond. The Member in charge will not have the opportunity to wind up, as is the convention in 30-minute debates.

[James Wild (North West Norfolk) (Con)]

I beg to move,

That this House has considered quality of care and the estate at the Queen Elizabeth Hospital, King’s Lynn.

It is a pleasure to serve under your chairmanship, Mr Hosie. I am grateful to Mr Speaker for granting this important debate, which gives me the opportunity to highlight the significant improvements at Queen Elizabeth Hospital, while once again making the compelling case for it to be one of the new hospital schemes that the Government have committed to building. I also want to recognise the close interest that my hon. Friend the Minister has taken in QEH and to thank him for the many meetings and discussions we have had about it so far. Of course, I also encourage him to back the bid.

QEH serves 330,000 people across Norfolk, Lincolnshire and Cambridgeshire, providing a comprehensive range of specialist, acute and community-based services. It is a busy hospital, with 55,000 in-patient admissions, a quarter of a million out-patient appointments and 70,000 emergency department admissions last year. However, QEH has suffered from poor Care Quality Commission ratings and an historic lack of investment, and has therefore been in special measures for some time. However, under the leadership of Caroline Shaw, the chief executive, and the chairman, Steve Barnett—who is moving on shortly, having done a lot of good work—things have changed.

In the last three years, there have been significant improvements in care. However, you do not have to take my word for it, Mr Hosie; that was the verdict of the CQC’s report a month ago. The core services it inspected—medicine, urgent and emergency care, and critical care—were all rated good overall. Indeed, critical care was recognised as having outstanding elements in many areas. That means that QEH is now rated good in three domains: caring, well led and effective. The CQC found that

“Staff provided good care and treatment…treated patients with compassion and kindness, respected their privacy and dignity, took account of…individual needs…and made it easy for people to give feedback.”

The report shows how far QEH has come. As a result, the Care Quality Commission’s chief inspector of hospitals has recommended that QEH come out of special measures, which is very welcome for the area.

It is frankly remarkable that all this has been achieved during a period when covid posed such huge challenges to QEH and other hospitals, and to other parts of the health and social care sector. This has not happened by luck; it is due to the leadership, hard work and commitment of all the staff at QEH. I have seen that dedication at first hand when I have met doctors, nurses, the infection control teams, the porters and all the others who make up the hospital during my regular visits. I commend them for all that they have achieved in the report. As the CQC said, staff were

“passionate about…providing the best possible care for patients”,

and leaders understood

“the priorities and issues the trust faced”

and were

“visible and approachable…for patients and staff.”

Clearly further improvements are required, as the hospital recognises, but it is important that we acknowledge the huge step forward that has been taken, as reflected in the report.

Those improvements have been made despite the decaying and ageing buildings that staff and patients have to experience and operate in. As my hon. Friend the Minister knows, QEH is one of the best-buy hospitals and has major issues with reinforced autoclaved aerated concrete planks—which I think we should refer to as RAAC planks for the rest of the debate—which are structurally deficient. The hospital was built with a 30-year design life, but it is now in its 42nd year. Some 79% of hospital estate buildings have RAAC planks, and I am sorry to say that it is the most propped hospital in the country, with 470 steel and timber supports across 56 parts of the hospital.

Being in a ward or another part of the hospital, surrounded by props holding up the roof, is a poor experience for patients. It makes it harder for staff to care for them. It is not something that we should accept, and we do not. This is a serious situation, and the trust’s risk register has a red rating for direct risk to life and the safety of patients, visitors and staff, due to the potentially catastrophic risk of failure of the roof structure. Last year, the critical care unit had to close for some weeks due to precisely those safety issues. The urgent need for a new hospital, and the strength of that case, is underlined by the fact that over a third of all reported RAAC issues in the east of England were at QEH in the last year.

I know that my hon. Friend recognises the seriousness of the situation, and the £20.6 million of emergency capital funding that he approved last year is very welcome. That is making a difference: a new endoscopy unit is taking shape to modernise facilities, and to create space to enable installation of fail-safe roof supports. In addition, there is £3 million of funding for a west Norfolk eye centre, which along with other projects, including digital, means that QEH is currently delivering a more than £30 million capital programme.

[Duncan Baker (North Norfolk) (Con)]

I thank my hon. Friend for giving way and for securing this incredibly important debate. It is a very poor situation to have a hospital in Norfolk in this position, when it clearly needs a rebuild. I thank my hon. Friend for everything he has done; we would not be in this position without his tireless work to raise this matter with the Secretary of State. May I raise one point? We have three hospitals in Norfolk. We want a new hospital at QEH. That will benefit not just his constituents, but those all over Norfolk, particularly in my constituency of North Norfolk, who will also use its fantastic services when it is rebuilt.

[James Wild]

I am grateful to my hon. Friend for his support and words. He is absolutely right; I think his constituency has the oldest average age in the country, and that poses particular needs. My constituency and that of my hon. Friend the Member for Broadland (Jerome Mayhew), who has joined to support the debate, also have challenges, so we need to ensure that the care is in place. There is also a lot of planned housing growth in the area. The demand is strong across our constituencies, and in Lincolnshire and Cambridgeshire, which is why it is important to show the strength of support for the hospital across Norfolk and beyond.

When compared with the turnover, the level of capital programme is significant, and it is important to acknowledge that the programme is being managed well. QEH has submitted a further bid for £18 million for an orthopaedic centre, as part of the funding to tackle the backlog. Given that it is the area with one of the longest waiting lists for QEH, I strongly endorse that bid, and encourage the Minister to approve it when it comes to his desk. Seeing is believing. When the Secretary of State visits QEH—which he has agreed to and I hope will happen soon—he will see those improvements, but he will also see the props and the very real need for investment. My hon. Friend the Member for North Norfolk (Duncan Baker) will be able to join him on that occasion or another, as he will be very welcome.

As well as the structural issues, the hospital has outgrown its footprint. The emergency department sees 70,000 patients a year—more than double what it was designed for. The layout of the hospital does not meet modern care pathways, with too few consulting rooms, and wards well below the recommended size.

[Jerome Mayhew (Broadland) (Con)]

I am grateful to my hon. Friend for giving way. I wish to add my voice to the support he received from my hon. Friend the Member for North Norfolk (Duncan Baker), and to highlight the importance of this hospital as a regional centre of excellence. It does not support only the constituency of my hon. Friend the Member for North West Norfolk (James Wild), but also those of North Norfolk, Broadland and further afield.

I pose this question: what impact does receiving care in a building where the ceiling is maintained by acrow props have on the patient’s confidence in the care received?

[James Wild]

My hon. Friend gets to the nub of the issue, which is the impact of this situation on patients. The previous Secretary of State for Health came to the hospital, saw that and spoke to patients in those beds. They made light-hearted remarks, but they were concerned about the safety of the building after seeing props and timber supports. Of course, the trust is doing all that it can to manage that risk, but the risk of catastrophic failure remains, which is why it is rated red on the risk register.

The hospital cannot cope with the current demand. NHS modelling shows a 64% increase in overall floor space is needed to maintain services and meet future demand, with lots of housing planned in the area. In short, QEH needs to be replaced. The case is compelling to take this once-in-a-generation opportunity to have a hospital fit for the future. QEH has submitted proposals to the new hospitals programme for a single-phase new build on the existing site to meet current and future demand. The plans put forward would eliminate RAAC, and transform and modernise local healthcare, integrating primary, community, mental health, acute, social care and the third sector in a health and wellbeing village.

However, this is not about having shiny new buildings for their own sake; it is about delivering better health outcomes in some of the most deprived areas in the country that the Government have recognised as priority 1 areas for levelling up. It is also about an anchor institution—the QEH in west Norfolk—combining with the new school of nursing studies, which will be funded through the Government’s town deal, to help the NHS workforce by boosting local opportunities to develop skills and careers in our healthcare sector. It is also about promoting sustainability by using modern methods of construction and net zero principles, and maximising the use of digital technology.

It is important to recognise that the trust going from inadequate to good in the well-led domain in this inspection is a significant achievement, which provides confidence that this is a trust capable of delivering the new hospital that the patients and staff in west Norfolk need. A lot of hard work and engagement has gone into developing the plans and the scheme is highly deliverable, with a strategic outline case well advanced and on track to go to the June board meeting.

QEH’s bid is backed by 4,000 staff at the hospital. Stuart Dark—the leader of West Norfolk Borough Council—as well as all the councillors and the county council are supportive, as is the Norfolk and Waveney integrated care system, and at least seven right hon. and hon. Members, including my hon. Friends the Members for North Norfolk and for Broadland. The Prime Minister’s Chief of Staff—the Chancellor of the Duchy of Lancaster, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay)—and the Foreign Secretary also back the bid, and it enjoys local support, with more than 15,000 people having signed a petition backing a new hospital. It is essential that we have an acute hospital in this geographic area. The plans that have been put forward would deliver major improvements to care, patient outcomes and staff experiences. An alternative multi-phase approach has also been put forward. It would, of course, be an improvement on the status quo, but it would not deliver the same benefits or value for money as a single-phase build and would not be delivered in the required timeframe.

My constituents in North West Norfolk are frustrated by the delays in the timelines for the new hospital selection process, as am I. That will not come as any surprise to my hon. Friend the Minister; I confess publicly to bugging him and my right hon. Friend the Secretary of State repeatedly for decisions on the shortlisting of these hospitals. I press the Minister today: when can we expect to hear a decision on the hospitals that will go through to the next phase of the programme? What implications does the delay have for the final decision on the eight schemes to be selected, and for getting design and construction under way? I encourage him to do all he can to move this process forward as rapidly as possible.

Over the last three years, there have been real changes at QEH and patients are getting better care. The leadership has demonstrated that it can drive sustained improvements, and move to a position where staff feel supported and valued, and where there is a strong focus on improved patient care and outcomes. Now we have an opportunity to build—literally—on that progress, to provide the major investment to modernise the hospital, to improve care further and to support the trust’s strategy to be the best rural district general hospital.

The Government and the Department of Health have already committed to removing deficient RAAC from the estate by 2035. However, experts on RAAC have said that for QEH the end-of-life deadline is 2030 and that the risk will only worsen. There comes a point where it no longer makes sense or represents value for money to keep propping up the roof. I would contend that we are past that point. Indeed, in the report that set out the significant improvements needed to QEH, the CQC said that

“The trust’s most substantial risk was the safety of the roof structure”

and that there is a

“need for long term solutions to the estate problems.”

As well as having serious structural issues, the current hospital cannot meet the current or future demand. The only long-term solution is a new hospital to deal with the RAAC issues, meet demand and serve patients. By selecting QEH as one of the eight new hospital schemes, that inevitable need for replacement will become part of a funded programme, rather than an unplanned demand requiring repeated emergency funding. I urge the Government to include QEH as one of the schemes. The people of North West Norfolk and beyond deserve nothing less.

[The Minister for Health (Edward Argar)]

It is a pleasure to serve under your chairmanship, Mr Hosie, and to respond to this debate, which was secured by my hon. Friend the Member for North West Norfolk (James Wild), about the quality of care and the estate at Queen Elizabeth Hospital, King’s Lynn.

As my hon. Friend has already alluded to, this is an important subject for him. It is rare that I pass him in the corridors of this place without him gently but firmly drawing me aside to raise this issue with me. I know that he does so because it matters hugely to his constituents. Indeed, as my hon. Friend the Member for Broadland (Jerome Mayhew) said, it also matters hugely to other people living in the region—the wider Norfolk area—and beyond.

My hon. Friend the Member for North West Norfolk rightly highlights the close interest that a large number of right hon. and hon. Members take in this subject. Indeed, I am conscious that even some Members in their lordships’ House take a close interest in this issue. I am grateful to my hon. Friend the Member for North Norfolk (Duncan Baker) for his words. He is absolutely right to highlight the dedication of our hon. Friend the Member for North West Norfolk to this cause. His constituents and, indeed, those represented by all hon. Members here today are lucky to have them, as they continue forcefully and firmly to argue the cause of the Queen Elizabeth Hospital, King’s Lynn.

As my hon. Friend the Member for North West Norfolk will be aware, the Government are backing our NHS with a significant capital settlement that will create a step change in the quality and efficiency of care up and down the country, including in Norfolk. We are pleased to confirm that an initial £3.7 billion has been provided over a four-year period—this spending review period—to begin making progress on delivering 48 new hospitals by 2030, with 30 of the hospitals already announced to be built outside London and the south-east. I am pleased that six of the 48 hospitals are already in construction and one has already been completed. Of course, this hospital building programme is in addition to the 70 upgrades, worth £1.7 billion, that are part of the wider programme of capital investment. Those commitments will result in outdated infrastructure being replaced by facilities for staff and patients that are at the cutting edge of modern technology, innovation and sustainability.

My hon. Friend the Member for North West Norfolk is, as always, passionate in putting the case for his local hospital to be among the next eight to be announced—I will turn to the process and timelines for that shortly. As he highlights, the Queen Elizabeth Hospital King’s Lynn NHS Foundation Trust has been provided in recent times with significant national funding, including £5 million in 2021-22 from our targeted investment fund for the establishment of an eye care unit at the Queen Elizabeth and a modular endoscopy unit, and £2.65 million in 2020-21 for the emergency department expansion works and to address backlog maintenance across its locations. My hon. Friend advocated for both those investments.

Let me turn to a point that I know is a significant concern for my hon. Friend. We remain publicly committed to eradicating reinforced autoclaved aerated concrete from the NHS estate by 2035-36—I note my hon. Friend’s point highlighting that in his view and the view of others, that needs to happen more swiftly—and to protecting patient and staff safety in the interim period. As he said, we awarded the Queen Elizabeth £20.7 million this financial year as part of SR20 £110 million ring-fenced funding to address the most serious and immediate risks posed by reinforced autoclaved aerated concrete. In addition, further funding confirmed in the autumn Budget and spending review will allow for the continuation of this remediation work in the Queen Elizabeth Hospital and, indeed, on the wider NHS estate.

Let me turn to the next eight new hospitals. The proposal for trusts to submit an expression of interest to be one of the next eight was announced last year and, as my hon. Friend knows, his local hospital submitted its expression of interest. We have been reviewing all submissions against our robust assessment process, to identify a longlist of schemes to progress to the next phase. We will communicate with trusts in due course about the next stage of the process, and will announce the selected eight schemes later in the year.

I am conscious that my hon. Friend, his local trust and his constituents will be keen to see that progress as swiftly as possible. There is a challenge there. We want to ensure that the assessment is fair and rigorous. I am also sensitive to the upcoming purdah period for local election campaigns across the country, but I do take my hon. Friend’s point about the need for speed. I suspect that his local trust will wish to know swiftly whether it is successful or unsuccessful and, if it is successful, what it needs to do for the next stage. I hope that my hon. Friend will appreciate that I cannot comment, beyond those process points, on the specific bid that his local trust has submitted, save to say that it will receive very, very careful consideration in that process.

Let me turn to, more broadly, the quality of patient care and the points that my hon. Friend made in that respect. The CQC plays an important role, as he knows, in ensuring that NHS providers meet the standards of care expected by patients, families and carers. I recognise that the Queen Elizabeth had long struggled with financial and performance challenges, as previously identified by the CQC. The trust had previously been removed from special measures, now known as the recovery support programme, after being placed in the regime between 2013 and 2015, only for the CQC to subsequently recommend that it should fall back into those measures in 2018 when the regulator identified concerns across several core services.

Recent inspections in December 2021 and January 2022, which my hon. Friend highlighted, found significant improvements in the governance, leadership and culture of the trust. Although its overall rating was “requires improvement”, this represents a significant step forward from its previous rating of “inadequate”. I join my hon. Friend in paying tribute to the hard work and commitment of the chief executive, Caroline Shaw, the rest of the leadership of the trust and, crucially, all the staff at the Queen Elizabeth Hospital, King’s Lynn, who have clearly worked incredibly hard through even more challenging circumstances than they would usually encounter in the course of their work, and still made improvements in patient care and in the CQC rating. I pay tribute to all of them for the work they have done.

I welcome the commitment given to the CQC by the leadership to ensure that those improvements are sustainable and continue to be built on. As we would expect, the CQC will monitor the trust’s performance in order that the improvements are embedded and that further improvements in care and services are made for the benefit of patients and their families.

[James Wild]

I appreciate that my hon. Friend cannot get into the specifics, but can he assure me that the fact that this is the No.1 bid for the east of England will play heavily in the consideration of whether it will be on the shortlist and then chosen as one of the eight schemes?

[Edward Argar]

As my hon. Friend knows, each region will feed in its views about which of the schemes and bids in its area are the highest priority. Without prejudging that assessment process, I hope I can reassure him that one factor that I know he considers to be of significant importance—RAAC—will be considered. Patient safety and the safety of the buildings will be a factor in the analysis of which bids should go forward to the long list, but I do not want to go further than that at this point, however much he may charmingly seek to tempt me to do so.

Elective recovery is an area of real focus for the Department and for the whole Government, and I am aware that covid-19 has placed an unprecedented strain on routine and planned care, with waiting lists in England reaching a record high, at just over 6 million in January 2022. I understand that 19,366 of those patients are waiting for treatment at the Queen Elizabeth Hospital.

In February, the NHS published the “Delivery plan for tackling the COVID-19 backlog of elective care”, which set out a clear vision for how the NHS will recover and expand elective services over the next three years. That delivery plan commits to eradicate waits of longer than a year for elective care by March 2025. Within that, by July 2022, no one will wait longer than two years, and we will aim to eliminate waits of over 18 months by April 2023 and of over 65 weeks by March 2024.

To support elective recovery specifically, the Department plans to spend more than £8 billion from 2022-23 to 2024-25, in addition to the £2 billion elective recovery fund and £700 million targeted investment fund already made available this year to help drive up and protect elective activity. Taken together, this funding could deliver the equivalent of around 9 million more checks, scans and procedures, and will mean that the NHS in England can aim to deliver around 30% more elective activity by 2024-25 than it was delivering before the pandemic.

In highlighting the extra resources that we are putting into our NHS, it is vital to understand that this is not about the inputs; it is about the outcomes for patients and how those resources are used wisely to deliver improved patient outcomes and improved experiences for patients, with shorter waits. With regard to what is needed to achieve those outcomes, a significant part of that funding will be invested in staff, in terms of both capacity and skills.

I understand that an orthopaedic unit bid for about £18 million has been submitted by my hon. Friend’s local hospital trust. That is in the context of the £5.9 billion elective recovery funding, and the £1.5 billion from that for capacity and social hub improvements. Those bids will be carefully considered. They will need to meet the recommendations arising from the pilots that took place in London and the getting it right first time review, but I certainly look forward to considering the bid from my hon. Friend’s trust in due course.

Access to NHS Dentistry

James Wild Excerpts

Thursday 10th February 2022 Westminster Hall

[James Wild (North West Norfolk) (Con)]

I congratulate the hon. Member for Bradford South (Judith Cummins) and my hon. Friend the Member for Waveney (Peter Aldous) on securing this important debate. Our constituents in Norfolk and Waveney face similar challenges in getting access to NHS dentists.

This is a long-running problem, which my predecessor also pursued following the closure of a dentist in Snettisham. I raised this issue in my maiden speech and I have focused on it ever since due to the inadequate provision in west Norfolk. Of course, the restrictions put in place during covid have further reduced access, as others have said. The British Dental Association estimates that 40 million appointments were lost overall, but the situation before covid was poor.

The National Audit Office found that my constituency had the lowest number of dentists per head in the country. Moreover, Norfolk had the lowest level of dental activity delivered in the country, with only 65% of contracted NHS activity delivered compared with the national median figure of 96%. My right hon. Friend the Member for Basingstoke (Mrs Miller) also made that point. And, at 17.5%, Norfolk had the highest percentage of people who were unsuccessful in trying to get an NHS dental appointment.

Since being elected I have met the NHS East of England team regularly to press for better access to dentists, particularly following the closure of the mydentist practice in King’s Lynn. I am pleased that those discussions led to a procurement process, which, although delayed by covid, took place from summer last year, and that that procurement has been successful, with the NHS having just announced two new contracts for Smile Care Norfolk to increase access to dentists in King’s Lynn. I want to put on the record my thanks to the NHS East of England team for its efforts in successfully completing the procurement, which will mean that from 1 July my constituents will have better access.

As my hon. Friend the Member for Waveney said, it is disappointing that Fakenham and Thetford have not been successful in the procurement process. If my hon. Friend the Member for Broadland (Jerome Mayhew) catches your eye, Mr Efford, I am sure that he will speak about that.

Members have also touched on the supply of dentists. Office for Students figures show that there were 895 dental students in 2020, rising to 983 in 2020, compared with 810 in 2019. The 2022 intake, however, is just 809. Given the challenges in dentistry provision, we should be increasing that number, not reducing it. We should consider measures that enable those who are undertaking training to spend time in those areas where coverage is weakest. We should also be more direct and require those who have qualified to spend time in those areas as well.

I note that none of the 11 dental schools in England is in East Anglia. Given the low levels of dental coverage, I join the hon. Member for York Central (Rachael Maskell) in putting in a bid for one in East Anglia, Norfolk, King’s Lynn, to help address that gap.

Another issue that has been raised is that the contract dates from 2006. My hon Friend the Minister candidly referred to it last month as a “disastrous contract” with perverse incentives—or disincentives—for NHS dentists to take on NHS work. I am sure she will be able to update us on when new measures will be introduced to provide a greater focus on prevention and care for individual patients.

In conclusion, the new services coming to King’s Lynn are warmly welcome and will improve access. However, further reforms are needed, including to training and the contract, to ensure that people have the access to dentistry that they need and deserve.

[Clive Efford (in the Chair)]

You have all been very disciplined in keeping speeches brief, so I am grateful for that. We are well on time. I call Wera Hobhouse.

Hospital Building Programme

James Wild Excerpts

Wednesday 3rd November 2021 Westminster Hall

[James Wild (North West Norfolk) (Con)]

It is a pleasure to serve under your chairmanship, Mr Sharma. I congratulate my hon. Friend the Member for Crewe and Nantwich (Dr Mullan) on securing this important debate on the new hospitals building programme. I warmly welcome the Government’s commitment to 48 new hospitals and the funding that was included in the spending review.

My local hospital, the Queen Elizabeth Hospital in King’s Lynn, serves 300,000 people across Norfolk, Cambridgeshire and Lincolnshire, and is in dire need of modernisation. QEH is one of the best-buy hospitals that have proved to be anything but. It is more than a decade beyond its planned life span and has real issues with planks of reinforced autoclaved aerated concrete—RAAC—that are structurally deficient.

The Standing Committee on Structural Safety issued an alert regarding RAAC planks two years ago, having first warned in 1999 of problems with them. That warning came after the collapse of a school roof. As much as 80% of QEH’s decaying and ageing estate is RAAC-planked; it is the most propped hospital in the country, which is nothing to boast about, with more than 200 props supporting the cracking roof in more than 50 areas across the hospital. The trust’s risk register has a red rating, with a direct risk to life and safety of patients, visitors and staff, due to the potential catastrophic failure of the roof structure. The critical care unit had to close for two weeks earlier this year as a result, while mitigation measures were put in place.

Although the trust is managing that risk, and the £20 million provided by the Department of Health and Social Care and the Minister for some of the most immediate issues is very welcome, the funding is but a sticking-plaster for the problem. The Minister knows he has an invitation to come and look at the modular endoscopy unit that is being constructed to allow the decant and fixing of fail-safes. As well as the very real structural issues, the layout of the hospital does not meet modern care pathways. There are too few consulting rooms, there is poor co-location of services and there are wards less than half the size of national guidance. That impacts on both patient experience and infection control.

In short, the hospital needs to be replaced. There is a once in a generation opportunity to fix this and a compelling case for QEH to be one of the new eight schemes for which the Government are currently holding a competition. The Queen Elizabeth Trust has submitted an expression of interest for a single-phase new build that will meet current and future demand, with many thousands of homes planned in the area. The need is strong; QEH covers areas of deprivation, with poor health outcomes, and is in the Government’s priority areas for levelling up.

The plans put forward by the trust will eliminate RAAC from the hospital, but it is not just about replacing defective buildings. It is also an opportunity to transform and modernise local health care, integrating primary, community, mental health, acute, social care and third sectors in a health and wellbeing village. It will also promote sustainability, using modern methods of construction and net-zero principles, incorporating the digital-first approach.

The project is well advanced and highly deliverable, with a strategic outline case well developed. It is backed by 4,000 staff at the hospital, and more than 15,000 people have signed a petition in support. The borough and county councils are on board, the regional NHS and at least seven right hon. and hon. Members whose constituents are served by the Queen Elizabeth. An acute hospital is essential in the area and the plans would deliver major improvements in care, patient outcomes and staff experience. An alternative multi-phased plan has also been submitted, although that would not deliver the same benefits or value for money.

Now is the opportunity to deliver a new hospital and support the trust’s strategy to be rated “good”, then “outstanding”, and to be the best rural district general hospital in the country. The Department of Health and Social Care has already committed to the removal of RAAC from the estate, and its risk will only continue to worsen. By including QEH in the new hospital programme, the inevitable need for replacement will become a funded programme, rather than an unplanned demand repeatedly requiring emergency capital funding. The people of North West Norfolk and beyond deserve nothing less.

Health Incentives Scheme

James Wild Excerpts

Friday 22nd October 2021 Commons Chamber

[James Wild (North West Norfolk) (Con)]

Three weeks ago, I joined my hon. Friend the Member for North Norfolk (Duncan Baker) and other hon. Members in running the London marathon. Modesty precludes me from saying which of us finished fastest. Does my hon. Friend agree that running, particularly the daily mile, is great exercise? Will she join me in congratulating everyone involved in King’s Lynn park run, which has just celebrated its 100,000th finisher?

[Maggie Throup]

I am delighted to congratulate King’s Lynn park run on its achievements, as well as park runs across the whole country. I am not a great runner—I am more of a sprinter—so I tend to avoid them, but I know the enjoyment that can be achieved by going along and improving one’s fitness, as well as the sense of community they bring with them.

Cawston Park Hospital: Norfolk Safeguarding Adults Board Review

James Wild Excerpts

Tuesday 21st September 2021 Commons Chamber

[Jerome Mayhew (Broadland) (Con)]

We are here this evening because of Joanna, Jon and Ben. Joanna had autism and was epileptic, Jon was autistic too, and Ben had Down’s syndrome. Their learning disabilities led to mental health difficulties, and they were consequently sectioned under the Mental Health Act 1983 and sent to the private Jeesal Cawston Park Hospital in my constituency. It is an assessment and treatment unit, and assessment and treatment is exactly what was meant to happen to these people: they were meant to be assessed and then treated, the objective being their discharge back into community care. But that did not happen.

Joanna was kept in the hospital for 11 months before she died in April 2018. Jon was kept in the hospital for 24 months before he died in October 2019. Ben was kept in the hospital for 17 months before he, too, died, in July 2020. All of them were in their early 30s, and all of them suffered from neglect. They were neglected through uncontrolled weight gain, through a lack of meaningful physical or mental activities, and through a lack of effective treatment through continuous positive airway pressure—CPAP—machines, which help people to sleep at night. The staff neglected the raising of concerns by members of their families; and, worst of all, they neglected even to attempt to resuscitate them when resuscitation was desperately needed.

Joanna was found unresponsive in her bed. A nurse and five carers—all of them trained—attended, but not a single one attempted resuscitation. Joanna died. Jon had swallowed a piece of a plastic cup. He told staff:

“I cannot breathe. I am dying.”

The CCTV footage proves that the staff just stood there for several minutes without attempting resuscitation. He died.

The day before Ben died, it was obvious that he was extremely unwell. He had blue lips and blue nails because of a lack of saturated oxygen in his blood. His mother was there on a visit and she raised the alarm. She demanded that an ambulance be called, but the hospital refused. Even later that day when Ben’s oxygen saturation levels were measured and found to be 35%, no ambulance was called. He died. The hospital neglected the families, and neglected to use their expertise and experience.

The families describe indifferent, harmful hospital practices, excessive use of restraint and seclusion by unqualified staff, and overmedication. A mother has contacted me in the past week to describe her child’s matted hair, her uncut fingernails and toenails, and the soiled clothing piled in a corner of the room. By chance, CCTV footage reviewed after Ben’s death uncovered a casual physical assault on him by a carer on the day he died. He was pulled down by his arms and then slapped around the head. What have we not seen?

This was supposed to be a specialist assessment and treatment unit, yet records were not even kept by the hospital for prolonged periods. Joanna was at the hospital for 11 months, but there are no records for 179 days of those 11 months. Ben was there for 17 months, but for an amazing 450 days during that 17-month period, no records were kept. So what assessment was undertaken? What treatment was given? My first request of the Minister is this: we need to acknowledge the scale of this scandal and its impact on real people, the most vulnerable in our society. We also need to acknowledge that we should all be ashamed.

This is not unique. We have heard this before. It sounds familiar, and that is because exactly the same thing happened at Winterbourne View Hospital back in 2012. We have had the report. This was another assessment and treatment unit where people with learning disabilities or autism were abused. The 2012 report criticised the development of assessment and treatment units, saying that they were

“not part of current policy, and certainly not recommended practice…Containment rather than personalised care and support has too easily become the pattern in these institutions.”

Of course lessons were learned. Department of Health reports described the abuse of people at Winterbourne View Hospital as “horrifying”. A Department of Health programme of action was agreed, and I have it with me today. Following the statement:

“We the undersigned commit to a programme for change”,

the very first undertaking is that

“Health and Care Commissioners will review all current hospital placements and support everyone inappropriately placed in hospital to move to community-based support as quickly as possible and no later than 1 June 2014.”

That did not happen. Today, in 2021, more than 2,000 patients are still contained in assessment and treatment units. I use the word advisedly: they are “contained”.

This is my second request to the Minister. Will she, on behalf of the Government, recommit this evening to the needed closure of all assessment and treatment units? That is what the coalition Government committed to doing in 2012, but by 2014 it had still not been done. We need to do it now. Why do we need to do it? There is a monumental conflict of interest for these private hospitals. Beyond being merely inhumane, there is a huge commercial incentive to maintain residency, because each of these patients comes with a fat cheque of £26,000 per month.

We can see where the conflict lies and why one family member, when they went to Cawston Park Hospital, was handed a piece of paper on which was written the address of a firm of solicitors. Her statement said:

“Once people are in Cawston Park Hospital you can’t get them out.”

Patients did not leave Cawston Park Hospital, and the problem is structural. If a hospital is paid £26,000 a month to assess and treat a patient, is it surprising that the hospital does not release them?

We have had another review of this latest scandal, and the Norfolk Safeguarding Adults Board’s review of Cawston Park Hospital is excellent. I have read it. It is 105 pages long and there are 13 recommendations. I recommend it wholeheartedly to the Minister, and the Government should apply all the recommendations.

The report has been followed by the usual handwringing responses from the agencies. Action plans have been created and there have been multidisciplinary stakeholder reviews. Profound apologies have been given, and I believe they are profound apologies. Lessons have been learned, but in my submission they have not really been learned, because without a profound culture change in residential care, we will be back here again. We all know it and the public know it.

[James Wild (North West Norfolk) (Con)]

I am grateful to my hon. Friend for securing this debate on the tragic events in Norfolk and for the powerful case he is making.

One of the most alarming elements of this very shocking report is the final hours of Ben, which my hon. Friend mentioned. Ben’s mum, Gina, said:

“If you ill-treat an animal, you get put in prison. But people ill-treated my son and they’re still free.”

That is completely unacceptable, and the police and the authorities should look again at all the leads and all the evidence to hold those people to account.

[Jerome Mayhew]

My hon. Friend is absolutely right that management teams and owners should personally fear prison as a response to a culture failure. If a culture of neglect is tolerated by their acts or, more likely, by their omissions, there needs to be personal liability. People need to fear prison, because there will be no change without individuals being held personally to account for allowing this culture of indifference. I profoundly hope that the most rigorous investigations are undertaken by the police and the Care Quality Commission, with a focus on individual prosecutions if justified by the evidence. There have been no prosecutions to date.

More generally, and widening the conversation away from the individual, directors need to be held to account if we are to restore public trust in the system. The Law Commission is aware of this, and it is undertaking a consultation on the issue of corporate criminal liability. It is consulting on how we can make improvements primarily, in the first instance, in economic crime, but how much more important is it to get equity where the victims are the most vulnerable in society, people in care, people who cannot argue their own case because of their age, because of illness or because of their condition?

The current rules on the definition of a controlling mind are often too narrow for individual prosecutions to succeed. The legislation has been on the statute book since about 2007, and there have been hardly any successful prosecutions because of that narrow definition. This needs to be changed.

I am meeting the Law Commission in October, along with the authors of the Safeguarding Adults Board review, to press the case for a widening of the definition to make the people who run such hospitals fear personal prosecution, because that is how we will change the culture.

That leads me to my third request of the Minister. If she really wants to prevent a repeat, will her Department commit to making a submission to the Law Commission consultation on criminal corporate liability so that we strengthen the personal responsibility for providers of residential care? The Chinese general Sun Tzu, who is very famous now, said “Kill one, terrify 1,000”, and he was right. The problem is that families of patients are concerned; they are the ones who are fearful and have no confidence in the current system. They fear the consequences and we need to change that; it should be the directors of care businesses. If they allow abuse and neglect, they should be fearful—they should pay with the fear of a prison sentence. Only then will we get change.

Covid-19 Update

James Wild Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

I can tell my hon. Friend that we keep that under review. At the moment, we have found that the quickest way to encourage 16 and 17-year-olds to take up the offer is through the schools and colleges network, and through GPs in particular. We keep that under review, but he might be interested to know the latest numbers are that over 54% of 16 and 17-year-olds are vaccinated. There is progress to be made, but that is good progress so far.

[James Wild (North West Norfolk) (Con)]

My local hospital, the Queen Elizabeth Hospital, which as my right hon. Friend knows needs to be rebuilt, currently has 46 covid patients. Is not the best way to ensure that the QEH and the NHS have the capacity to cope with winter pressures to increase the level of vaccine take-up? Will he ensure that evidence of what works in doing that is shared across the country?

[Sajid Javid]

I very much agree with my hon. Friend. That is one reason why we are constantly publishing more and more information on the impact and effectiveness of vaccines, including the data from the ONS today, which I referred to earlier.

Oral Answers to Questions

James Wild Excerpts

Tuesday 13th July 2021 Commons Chamber

[Nadhim Zahawi]

The European Medicines Agency and our regulator, the Medicines and Healthcare Products Regulatory Agency, work incredibly closely together, and the EMA has authorised the vaccines that are approved by the MHRA. All vaccines that are authorised and deployed in the UK have been subjected to rigorous checks, including individual batch testing and site inspection. Our two regulators work incredibly closely together and I am confident that we will continue to do so and ensure that any issues are resolved as quickly as possible, working with the manufacturers as well.

[James Wild (North West Norfolk) (Con)]

What progress his Department has made on selecting the eight new hospital programme schemes invited to bid for funding announced in the spending review 2020.

[The Minister for Health (Edward Argar)]

On 2 October last year, we announced 40 new hospitals to be built by 2030 and committed to an open process to confirm a further eight new schemes. Taken together, those 48 schemes should represent the biggest hospital building programme in a generation. As my hon. Friend would expect, my right hon. Friend the new Secretary of State is taking a close interest in the detail of this process, and I hope to be able to offer a further update on the selection process for the next eight hospitals very soon.

[James Wild]

Spending hundreds of millions of pounds patching up buildings long past their planned lifespan—such as the Queen Elizabeth Hospital in King’s Lynn, which currently has 200 safety props holding up the concrete roof—does not represent value for money. What reassurance can my hon. Friend give to the thousands of my constituents who in recent days have signed a petition for a new hospital to replace the QEH that the Government are looking seriously at the urgent and compelling case for a new fit-for-purpose hospital for staff, patients and visitors?

[Edward Argar]

My hon. Friend’s constituents will know that, in him, they have a doughty champion of their cause and a strong advocate for his hospital. He and I have spoken on many occasions, and I recognise the challenges facing the Queen Elizabeth Hospital, which he has been very clear about. The spending review 2020 included £4.2 billion this financial year for NHS operational capital investment to allow hospitals to maintain and refurbish their infrastructure, including a ring-fenced £110 million allocation for the most serious and immediate risk posed by reinforced autoclaved aerated concrete. My hon. Friend’s hospital has received just over £20 million of that funding to help to mitigate the most urgent RAAC risk, but he will also have heard me say, without prejudging any announcement my right hon. Friend will make about the criteria for the future eight, that safety will be one of the considerations.