(9 years, 12 months ago)
Commons ChamberT9. Do Ministers agree that the patient transport guidance should be interpreted with an understanding of rural needs, rather than telling my elderly constituents to report to a hospital 60 miles away and to get three buses there and three back that do not connect with each other in order to have treatment or consultation?
It is particularly important in rural areas that patients with complex medical needs who have difficulties mobilising or who perhaps do not have access to a car are supported by the local NHS to access the services they need. There is provision for local hospitals, as well as for CCGs, to give financial assistance to support patients in accessing services and to give them lifts to hospitals, as appropriate.
(12 years, 1 month ago)
Commons ChamberPart of reorganising services and delivering good health care is about clinical leadership—I hope that is supported across the House—and local doctors, nurses and health care professionals saying what is important for their patients and what local health care priorities are. Obviously, local communities need to be engaged in that process, but what really matters is what is good for patients and delivers high-quality care for them. We need to deliver more care in the community, and in doing so we have to recognise that some of the ways we have delivered care in the past—picking up the pieces in hospitals when people are broken—need to change. We have to do more to keep people well at home and in their own communities.
Given that the maternity unit at Berwick infirmary has been suspended since the beginning of August for safety reasons, with births being referred to a hospital 50 miles away, will the Minister take into account the urgent need to provide the necessary clinical support for community hospitals in remote areas so that they can provide local essential services to the highest standards?
I thank my right hon. Friend for that question. We discussed this issue in the Adjournment debate before the autumn recess. He is a strong advocate for his local maternity services. The concern was that only 13 births take place at his local maternity unit every year, and whether staff can continue to deliver high-quality care with such a low number of births. Of course, his local providers will want to consider the rurality of the area and the potential, as outlined in the Birthplace study, of rotating staff in and out of the hospital to support his local unit.
(13 years, 11 months ago)
Commons ChamberThere is always a blame culture, and we would have to be careful that a simple form that a doctor had to sign on one day of the year could not be used as a sledgehammer to hit that doctor or medical practitioner over the head later on because somebody perpetrated a bad act. As I have said, and as I think my hon. Friend accepted in making his point, someone’s mental state can deteriorate quickly—a switch can be flicked in someone’s mind and it is impossible to legislate for that. Simply involving a doctor in this process will not make that any less possible.
It is not only with gun crime that a switch can be flicked in that way, as we saw in north Wales with the Peter Moore case. In 1995, he killed four men with a knife in a random rampage. It is not just with gun crime that people temporarily lose control and go on a rampage—it happens with other weapons. In America there have been cases with samurai swords. We have to be careful not to legislate on the basis of one or two terrible tragedies, such as that in Cumbria. That is an important point for the House to consider.
I am interested in this argument and I agree that a box-ticking exercise is no use, but GPs in rural communities will often be aware if patients are gun licence holders and might well pass on information if they are seriously concerned. The question is what to do in urban communities in which GPs might be unaware who is a gun licence holder. As my hon. Friend says, the problem is often the illicit gun holder who does not have a licence anyway.
My right hon. Friend makes a very good point. Let us consider how effective that piece of paper—that box-ticking exercise—would be in an urban community. The turnover of patients in most GP practices in areas such as Camberwell, where I was a medical student, is a third of patients every year. Therefore, such a measure might not work because, with such a high turnover, it is not easy to keep track of patients who move and migrate around London and fall in and out of registers. As my right hon. Friend said, the people we are dealing with in urban areas are not those with licences but those who possess handguns illegally. Community engagement and education in schools is so important in addressing those issues.
We have had a very good debate and I will not talk for much longer. Members need to ask whether further legislation that would give doctors more onerous responsibilities to fill out forms, and that would make it more difficult for people to have gun licences, would make anybody safer. I think the answer is conclusively no. We cannot legislate for terrible tragedies such as that in Cumbria. Unfortunately, they will happen no matter what we do. It is easy, as the right hon. Member for Leicester East said, for us and the media to get the retrospectoscope out and judge things retrospectively in the hysteria of political debate. We need to legislate for the reality, which is that law-abiding gun owners who have a licence do not tend to misuse them. For the reasons I have given, I do not think that there is a conclusive case for strengthening the legislation.