Healthcare: East Midlands

Debate between Jim Shannon and David Tredinnick

Tuesday 30th April 2019 Westminster Hall

[David Tredinnick (Bosworth) (Con)]

Thank you, Mr Hollobone, for allowing me to speak first. I think it is the first time I have heard a Chair say that there is no time constraint, but I will not detain the House for too long. At the risk of being called to order, I had planned to raise the work that you have done for Kettering General Hospital and your impassioned demands for improvements to it over the years, which no doubt the Minister has listened to many times. I was with some friends last week who said, “Ah, Northamptonshire. That’s the Bones—Peter and Philip—isn’t it?” Kettering General Hospital came up. At the risk of being called to order—I do not see you doing that—let me say what a good job you have done for that hospital. As was said in the Chamber this week, your whole identity in the House is linked to the work you have done there.

I congratulate the hon. Member for Lincoln (Karen Lee) on securing not just half an hour but an hour and a half in what used to be called the Grand Committee Room but is now Westminster Hall. She spoke passionately and with detailed knowledge, as a former nurse, about the problems in her area. I listened to her speech, and I have sympathy with what she said about some of the consolidation that has taken place, but inevitably there have to be some changes and rationalisations in the health service.

I will talk mainly about the changes in the great town of Hinckley, in my west Leicestershire constituency of Bosworth, which is some way from Lincoln. We were very fortunate that the Secretary of State himself—ipse—recently came to Hinckley to look at the changes that will be made thanks to the £8 million grant that has been secured for upgrading the facilities in Hinckley. Mayur Lakhani, the chair of the West Leicestershire clinical commissioning group, spoke warmly about the way the Secretary of State had responded to their bid, and the support of Hinckley and Bosworth Borough Council, which happens to be Conservative-controlled, and which I will refer to later.

I was lucky to be elected to this House a long time ago—in fact, so long ago that I sometimes forget the date. I have been a Member for more than 30 years, and the one health issue that has bedevilled my constituency above all others in that period is what to do with the Mount Road hospital—the old hospital in the middle of Hinckley. Because of the £8 million grant that the Secretary of State awarded to the clinical commissioning group, we are now able to make some substantial changes to the health improvements in Hinckley. Given your interest in Kettering General Hospital, Mr Hollobone, you will understand my joy at seeing the improvements that are about to take place—consultations are going on at the moment.

I have a letter from the West Leicestershire clinical commissioning group setting out exactly where we are now. It says that the investment supports plans to provide modern, fit-for-purpose facilities, and more services in the local community and closer to home in Hinckley. I say to the hon. Member for Lincoln that part of that will be about shutting down old facilities. One is a portakabin and another is the old hospital. In exchange, the investment will make better use of all available existing space in Hinckley Health Centre on Hill Street, not far from the old hospital, and Hinckley and Bosworth Community Hospital, which we call Sunnyside because it is on a hill and gets the sun all day long—it is a marvellous place for a hospital.

As part of the £8 million package, the Hinckley Health Centre will be refurbished to accommodate X-ray, ultrasound and physiotherapy, and to increase the number of consulting rooms, which is extremely important. Out-of-hours primary care services will be relocated from Hinckley and Bosworth Community Hospital—Sunnyside—to the newly developed urgent care hub in the Hinckley Health Centre, which will provide out-of-hours urgent care for local patients. A combined day case surgery and endoscopy unit with day case beds will be created. That will provide an increased range of day case procedures and cancer screening services for local patients. We will be removing services from the old Hinckley and District Hospital and the physiotherapy portakabin, which are unfortunately not fit for purpose, and physiotherapy services will be relocated to Hinckley Health Centre.

As I have the luxury of time, I say to people who have campaigned for years to save the old Hinckley and District Hospital that as it is such an old building, upgrading the hospital to the highest standards would require a phenomenal amount of work at a very high cost, with a low return on investment because all the special cables now have to be run with special conduits for oxygen and monitoring. It simply cannot be done efficiently in such an old structure. Although many of my constituents will have an emotional attachment to the old hospital, the decision that has been taken by the clinical commissioning group is right: it needed to close. In exchange, we are now getting an £8 million grant, which will provide much better facilities. As I mentioned earlier, some of the facilities are coming into the town from the outskirts—from Sunnyside to the health centre. It is quite an achievement.

We were lucky to get the grant of £8 million. My father always said to me that you generate your own luck in life, which is true. In this case, one of the drivers that made it possible for the Department and Secretary of State to agree to the clinical commissioning group’s bid was the extraordinary co-operation in west Leicestershire between the different service providers, particularly in Hinckley in my constituency.

At the beginning of the 2005 Parliament, I was lucky enough to get elected to the Health Committee under the new procedures. Subsequently, I chaired it for a short time. When I was elected to the Committee, I asked the then leader of the council, “Would you like me to come and talk about health on a regular basis?” It was agreed that I would, and that developed into a health and wellbeing partnership, which meets quarterly with the clinical commissioning group; the director of public health for Leicestershire County Council, Mike Sands; and senior officers at Hinckley and Bosworth Borough Council, including Bill Cullen, Simon Jones, Councillor Maureen Cook and many other excellent Conservative councillors over time. We also have doctors from the local surgeries attend.

Over a period of some years, we saw the meeting change from participants sitting with their arms folded and leaning back, to sitting up and listening attentively. We have learned to work together, and the partnership has been leakproof—there is nothing to gain from talking outside. We have had an extraordinary degree of co-operation, and I am absolutely convinced that it has improved the health services in my constituency and the county as a whole. It has reduced costs and brought up a whole a range of new ideas, some of which I shall go through today. The work of the secondary provider, Hinckley and Bosworth Borough Council, has been really remarkable and hugely encouraging, and it is something that all local people in my constituency can be proud of. Leicestershire County Council has done a good job, too, but I am particularly proud of what Hinckley and Bosworth has done through its health and wellbeing partnership—its contribution to health delivered through that partnership.

It might be instructive if I run through some of the areas that Hinckley and Bosworth Borough Council has worked on. I am pleased to see the Minister of State in his place rather than a Parliamentary Under-Secretary; he is the deputy of the Secretary of State. It illustrates how seriously the Government take the issue of health funding in the east midlands. I want to share with him what is going on in Hinckley. First, I reiterate that we have a local delivery of preventive services through co-operation. I mentioned the councils, but we also talk to the voluntary and community sector. We have patient participation groups, school participation groups and elderly patient participation groups.

The information pyramid is broad-based, and the lines of communication are fluid. Information can come from the bottom to the top very easily. From those ideas, the Conservative-controlled Hinckley and Bosworth Borough Council has produced a comprehensive prevention strategy, which sets out the work that the authority will undertake with its partners. The first objective is to prevent issues from escalating by taking action as early as possible. The second is to reduce demand for high-cost services and dependency on statutory services, thereby making spending more efficient.

Another objective is to develop self-help approaches to enable communities to take responsibility for their own health and wellbeing, which is something that the Department of Health and Social Care worked on under the Secretary of State’s predecessor, and the Health Committee in the 2005 Parliament looked at personal budgets and how they work. It was about getting people to think about their own health. With an ageing population, that is one of the areas that really must be brought to the fore in the future. However much money we ask for the NHS, we will never have enough supply of resources to meet demand unless we encourage people to take greater care of themselves. In this respect, the initiatives that Hinckley and Bosworth Borough Council has taken are hugely important in encouraging people to do that.

I will come on to what the council has done in a moment, but the overall aim of the strategy is to ensure that, together with its key partners, the council enables communities—especially people who are most at risk—to keep safe, keep well, stay independent and enjoy life. To support those aims and achieve those objectives, the council provides integrated locality teams, which identify and support people in a more co-ordinated way, focusing on two specific areas. The first is:

“Proactive identification via risk stratification of patients (18+, frail, multiple LTCs) at risk of a hospital admission and assessing the ‘whole person’ and their needs to keep them safe and well at home where it is appropriate to do so.”

I quote from this document—“whole person”—because a key thrust of health policy in the future should be holistic healthcare, which has become slightly muddled up and seen as definitely not mainstream. Actually, it should be at the core of the mainstream, treating the patient as a whole. I will come on to long-term care and conditions when I discuss the Health Committee’s report, “Managing the care of people with long-term conditions”, which I signed off as Chairman.

In Hinckley and Bosworth, we have a council that is proactively segmenting the population to treat people who are most in need as priorities, which I absolutely applaud. It also does that through the use of health ambassadors, who are

“uniformed volunteers who support and encourage people to get more active more often. They undertake this by playing to their strengths. Some give presentations, some lead activities, some encourage and support new participants on current schemes. Some are happy to have a coffee after an activity and talk to new participants. The big thing is they are positive role models who are empathetic with people and can support them to change and be more active in a way that is natural and comfortable to them.”

The programme is particularly effective when dealing with older people. In my beautiful constituency, Desford sports centre provides classes for elderly people, to keep them active. They have a chance to talk to experts—not doctors particularly, but sports therapists. They can play table tennis, sit down and do quizzes, play tennis—there is even tennis for people who are disabled. The whole idea is to get people who are a bit tired of life, or a bit sad by themselves, to meet other people and to engage in activities, thereby making them happier and healthier, and reducing the burden on the health service.

We are trying to divert away from A&E—the Leicester Royal Infirmary has one of the highest patient inputs in the country relative to its geographical footprint. I will not talk about the royal infirmary and the wonderful work of its health workers, but when the chair of the clinical commissioning group came to see what we were doing in Desford—on another visit, without the Secretary of State—we saw the Steady Steps programme. It is a 24-week free postural and stability exercise programme for older adults, aimed at those aged 65 and over who are at risk of falling, unsteady on their feet, lacking in confidence or likely to lose their balance.

One therapy that the sports centre is not employing, but to which I should like to draw the House’s attention, is the Alexander technique, which I have used in the past. Alexander was an opera singer, and he found that he could not sing. Part of the problem was that his chest was constricted all the time, so he could not project his voice—something that politicians are also quite keen to do at time when on the soapbox, if they can ever get there. Alexander discovered that breathing was connected to posture, and most people do not stand correctly with their hips as part of their back; they tend to have a break and swivel around the second and third lumbar vertebrae. He managed to get people to stand correctly to get their weight right. With their weight right, their lungs could perform properly. Those techniques, which have been developed by experts over the years, should be looked at carefully by the Department of Health and Social Care, but I will come to ways that we can take pressure off the Department generally.

Through the Steady Steps programme, it is so exciting and empowering to see elderly people who have become immobile actually get back into the community. Some of them have mental health problems, and Hinckley and Bosworth Borough Council has an active mental health support programme with five main objectives. They are to create networks to co-ordinate comprehensive and integrated mental health services in the community; to implement activities and events for promotion and early intervention and prevention in mental health; to improve awareness of mental health issues among children and young people, so that they do not think it strange that an older person is perhaps not as with it as they were in their 20s; to improve mental health and the impacts in the workplace; and to improve the quality of life of people living with dementia, and of their families and carers.

That is not rocket science; it explains to people simple facts of life about health. The programme brings the community together—it is a project that speaks to cohesion—makes it less likely that people will be upset by the behaviour of other people, and enables instructors to identify core problems. In the Hinckley and Bosworth area, we have over 6,500 dementia friends and 40 dementia champions. That is a lot of people in a constituency of 100,000 with 70,000 electors, and a very serious intervention.

Suicide is another issue that we as MPs deal with regularly. Most colleagues will have had cases in their surgeries about which they have had to approach care agencies. Leicestershire and Hinckley and Bosworth Borough Council have taken very decisive steps, with the Start a Conversation suicide prevention campaign for Leicester, Leicestershire and Rutland. The Start a Conversation website was launched on 10 September to coincide with World Suicide Prevention Day, and aims to provide information and signposting to people who are experiencing distress, to those worried about someone else, or those bereaved by suicide. The website is still in development, but will offer support and training to professionals.

[Jim Shannon (Strangford) (DUP)]

Whether we are discussing healthcare in the east midlands or in Northern Ireland, the issue of suicide is prominent in my constituency. When I became its MP in 2010, the level of suicide among young people was at its highest. That was dealt with through the involvement of community groups and of people in the community who had lost loved ones. There was also interaction with church groups and those of faith. By coming together, we reduced the incidence of suicide, and by working alongside healthcare in Northern Ireland, which is a devolved matter, we found that together, we could address the issue. It took both the community and healthcare to make that happen.

Homeopathy: Veterinary Medicine

Debate between Jim Shannon and David Tredinnick

Tuesday 8th May 2018 Commons Chamber

[David Tredinnick (Bosworth) (Con)]

This debate is very timely because of the recent changes that the Royal College of Veterinary Surgeons has made to its guidelines, which have angered the public and homeopathic vets alike and triggered two marches to the headquarters of the RCVS and a rally in Parliament Square, at which I had the honour of speaking. I am happy to see the Minister for Agriculture, Fisheries and Food, my hon. Friend the Member for Camborne and Redruth (George Eustice), in his place, not least because my family come from Redruth and were mining engineers—I am attempting to engender a little sympathy from him before I proceed.

The key issue is a new requirement in the guidelines that homeopathy should only be used in conjunction with conventional medicine. The second issue is the highly contentious assertions made by the Royal College of Veterinary Surgeons about a lack of evidence and safety and animal welfare, which are apparently related in this instance. The third issue is a lack of consultation.

The RCVS did not consult at all the people who know the subject—the Faculty of Homeopathy, the British Association of Homeopathic Veterinary Surgeons, the International Association for Veterinary Homeopathy, the European Committee for Homeopathy and the Homeopathy Research Institute. None of those organisations was consulted prior to the issuing of these guidelines. After the second march, the RCVS graciously agreed to meet a delegation, but sadly the delegation wrote to me afterwards saying:

“It became apparent that there was a total lack of understanding of the principles of homeopathy.”

It invited the RCVS to visit a practice, but I am not sure that that offer has been accepted.

I wrote to the RCVS, and it replied to my letter with, I regret to say, three glaring errors. First, it cited the 2010 report of the Science and Technology Committee, which it said

“concluded that the evidence base shows that homeopathy is not efficacious”.

It never did anything of the sort. I attended that Committee, and it was an evidence check. It only found that there was no evidence; it did not make any findings about effectiveness.

Secondly, the RCVS claims:

“we have not sought to remove choice as this remains”.

It does not. Choice has been removed, because before these guidelines came out, homeopaths could practise without using homeopathy and conventional medicine together.

Thirdly, the RCVS made claims about animal welfare issues. This is very important, and I asked a parliamentary question, to which my hon. Friend the Minister graciously replied:

“The Department does not have any evidence that shows that homeopathic vets are a risk to animal welfare by using homeopathy as an alternative treatment to conventional medicine options.”

[Jim Shannon (Strangford) (DUP)]

I sought the hon. Gentleman’s permission to intervene, and I thank him for letting me do so. Does he not agree that with the rise in antibiotic use in animals—it is very pertinent at this time—anything that can prevent the introduction of antibiotics can only be a good thing and must be given full consideration? Perhaps the Minister could tell us in his response what he is doing through his Department to reduce antibiotic use in animals.

[David Tredinnick]

The hon. Gentleman speaks with wisdom and experience. No doubt, he too has looked at the European position, which is completely the opposite of the one taken by the RCVS. There is a European directive on organic products, which states in article 24(2) of Commission regulation (EC) No. 889/2008, that

“Phytotherapeutic”—

that is, herbal—

“and homeopathic products, trace elements…shall be used in preference to chemically-synthesised allopathic veterinary treatment or antibiotics”.

That was because the European Union as a whole was so worried about the abuse of antibiotics, and I started speaking about the use of antibiotics in animals in the 1987 Parliament.

Let me give my hon. Friend the Minister the view of a farmer, who wrote to me, saying

“did you know that farmers often like using homeopathy for cows with mastitis because if they do so, they can sell the milk. If they use antibiotics, the milk must be thrown out.”

Safety is very important, and I hope the Minister will dispose of that point later as some homeopathic vets have simply stopped practising because they perceive themselves to be under a legal threat.

This is at a time when, according to the British Association of Homeopathic Veterinary Surgeons, there is an explosion of interest in homeopathy, largely I would suggest because of the antibiotics problem. It says that

“there is an explosion of interest in CAM”—

complementary and alternative medicine—

“including Homeopathy”, in the agricultural sector where the drive is to reduce and replace dependence on antibiotics in light of Antibiotic Resistance…concerns”.