Kettering General Hospital

Peter Bone Excerpts

Tuesday 24th March 2015 Westminster Hall

[Mr Hollobone]

The hon. Gentleman is right, of course. He gives a tantalising flavour of the climax of my speech, which will be about the urgent care hub proposal for Kettering general hospital, on which he, I and my hon. Friend the Member for Wellingborough have been working together.

[Mr Peter Bone (Wellingborough) (Con)]

It is a pleasure to serve under your chairmanship, Mr Gray. I congratulate my hon. Friend on securing this important debate. Before he moves on to the climax, which we are all waiting to hear, may I mention, in addition to the work of the hospital and its staff, the contribution of support organisations? One of those is Crazy Hats, a local breast cancer charity run by Glennis Hooper, who is a remarkable lady. All three of us MPs took part in the charity walk on Sunday.

[Mr Hollobone]

Yes—not only have we three north Northamptonshire Members worked on a cross-party basis to secure the future of our local hospital, but we all dressed up in funny outfits on Sunday to walk around Wicksteed park in Kettering in support of Glennis Hooper and the marvellous work she does for Crazy Hats, which raises money for cancer treatment and care for our constituents. I suppose that it is part of an MP’s job on occasion to dress up in a funny costume and look silly for the benefit of constituents, and we are all pleased to do that.

Some further good news about Kettering general hospital, from Department of Health statistics, is that finished consultant episodes when any procedure took place in the hospital—which I think is bureaucracy-speak for the number of operations—went up from 49,638 in 2010 to 53,869 in 2013. I am told that there are 43 more hospital doctors and 55 more nurses than in 2010 and there is a 24% increase in diagnostic tests, a one third increase in the number of people treated for cancer and a 71% increase in the number of MRI scans performed. Of course just two years ago the £30 million foundation wing was opened. It has a 16-bed intensive care unit, a 28-bed cardiac unit and a 32-bed children’s unit. That was massive new investment in our local hospital.

It should not be forgotten—and we three Members of Parliament for the area do not forget—that increasingly Kettering general hospital offers our constituents world-class health care. The latest example of that is the cardiac investigations department, which has received national recognition for its high standards in heart ultrasound scanning. Every year 8,000 of our constituents are patients through that unit, which provides ultrasound scans of the heart. Those can reveal diseases such as heart failure and valve diseases.

[Mr Hollobone]

The hon. Gentleman is right. That is a good example of the way Kettering general hospital has raised its game to tackle local health needs. Increasingly, our constituents do not have to go to Glenfield, because they can get better care at their local hospital. In the case in question, that is because of the £300,000 investment in three state-of-the-art ultrasound scanners, which can show the heart in three dimensions. The 16-strong cardiac investigations team has been awarded accreditation by the British Society of Echocardiography, which is an affiliate of the British Cardiovascular Society. That accolade is not given lightly. Kettering hospital is one of only 38 in the country to have achieved that accreditation; some specialist centres, such as Glenfield, Papworth, John Radcliffe and Coventry, have not yet attained it.

The £4 million upgrade of the maternity department at Kettering general hospital started in December. An average of 10 babies per day are delivered at the hospital—including the babies of Members who are here today. It is part of an £18 million investment in the hospital.

In coming to the climax of my remarks, I want to talk about the innovative proposal for an urgent care hub at the hospital—my colleagues will appreciate this, because we have been working on it together. Over the past few months, the hospital has been liaising with partners and developing a strategic case for an urgent care hub on the hospital site to tackle long-term, urgent care pressure relating to population growth, about which we have spoken; age and acuity; and increasing public demand for prompt access to urgent care.

In December, the trust shared its strategic case with the foundation trust regulator, Monitor, which is currently considering the proposal. If Monitor approves the case, it will go on to an outline business case and finally a full business case for approval by Monitor, the Department of Health and the Treasury. The key to its success is that the hospital has been working in close collaboration with its health and social care partners. It is developing what is essentially a one-stop shop for our constituents who need urgent medical care.

The aim is to develop a £30 million urgent care hub on the hospital site that will combine secondary care, hospital A and E and urgent care assessment with primary care—in other words, GP services, minor injury care and social and community care services. The proposal has arisen because there has been significant growth in demand for that type of urgent care in the local health economy of our three constituencies, partly due to a 30% population growth over the past 19 years, with another 9% expected by 2020, and a rise in the population of older people, about which we have spoken. There has also been a massive 83% increase in the use of A and E over the past 20 years as a means of accessing urgent care.

[Mr Bone]

My hon. Friend is outlining an exciting new project. The scheme will include a minor injuries and accidents unit at the Isebrook hospital, which will relieve up to 40% of my constituents from having to go to Kettering. It is bang next to a 24-hour GP service, so that is exciting for my constituents, too.

[Mr Hollobone]

My hon. Friend has rightly made that issue a priority for his constituents, and he has led an effective campaign on it. That facility will be similar to the facility currently in operation in Corby. The idea is to treat people as locally as possible so they do not have to present themselves at Kettering’s A and E department. It is all part of making local health care delivery more efficient and effective, and my hon. Friend is right to highlight it.

Human Fertilisation and Embryology

Peter Bone Excerpts

Tuesday 3rd February 2015 Commons Chamber

[Luciana Berger]

I thank the hon. Gentleman for that intervention. It was clear last night when we heard from the affected families that they wanted that choice, and these regulations very specifically only apply to those families that are affected by mitochondrial disease.

[Mr Peter Bone (Wellingborough) (Con)]

Will the hon. Lady give way?

[Luciana Berger]

I am going to finish my point, if I may.

In the intervening years the science and ethics of these techniques have been extensively debated. The Nuffield Council on Bioethics and the HFEA held extensive public consultations in 2012 and identified broad public support for the use of these techniques. There have been three expert scientific review panels—in April 2011, March 2013 and June 2014—all of which found no evidence to suggest that the techniques are unsafe for clinical use, and only last week a group of eminent scientists and experts in medical ethics, including Professor Sir John Sulston, Baroness Warnock and Sir Paul Nurse, wrote to The Times urging Parliament to approve the new regulations. They argued that the question parliamentarians must consider is not whether we would want to use this technique ourselves, but whether there are grounds to prevent affected families from doing so. I again reiterate what we have heard in the representations from families, and particularly women of child-bearing age: they want the opportunity to use these techniques.

[Mr Bone]

The hon. Lady is making a very good speech and is trying to make it balanced. She talked about last night’s meeting, which I understand went on for quite some time, and there has been a lot of debate outside this Chamber, but is she satisfied that we come here to the Chamber this afternoon with only 90 minutes to discuss this? Would it not be better if we were to withdraw this motion today and come back with more time to debate it next week?

[Luciana Berger]

Unfortunately, it is not in the Opposition’s gift to determine the time allocated for these debates. I would have welcomed further debate, and we had an opportunity in a previous Backbench Business Committee-initiated debate to discuss these matters.

--- Later in debate ---

[Robert Flello]

It is simply that this legislation will open up research that is illegal, as I shall describe in a moment. I also think there are greater concerns about generations down the line.

The EU clinical trials directive, which applies to all clinical work, states:

“No gene therapy trials may be carried out that result in modification to the subject’s germline genetic identity.”

The HFEA itself has said that this procedure does. In the legal opinion on the regulations, Lord Brennan QC has said that they are caught by the directive and that they are

“likely to be in breach of EU law”

on clinical trials.

The Department of Health examined the legal opinion but rejected it, saying that the licence will not be granted for clinical trial but for treatment and therefore will not be caught by that law. Apparently, this is not about clinical trials and furthering the science but about going straight for treatment.

Lord Brennan’s opinion anticipated that. He set out the relevant paragraphs from the 2011 report on safety from the review panel set up by the Secretary of State to monitor the procedures to the HFEA, which said:

“Once assessed as safe to use in clinical practice, the panel strongly recommends that permission is sought from the parents of the children born from MST and PNT to be followed up for an extensive period”

and that such permission should be sought from the children themselves once they are old enough. In the case of females, that should ideally be to the next generation. Those recommendations should also apply to pre-implantation genetic diagnosis for mitochondrial DNA genetic disease.

[Mr Bone]

Why, in the hon. Gentleman’s opinion, are the Government trying to rush this through?

[Robert Flello]

I think they are doing that because the legislation on the EU clinical trials directive will be tightened up even more next year.

Until knowledge has built up that says otherwise, the panel recommends that any female born following MST or PNT should be advised, when old enough, that she herself might be at risk of having a child with a significant level of mutant mitochondrial DNA. The HFEA is putting that child and, if they are female, subsequent generations at risk.

I have only a minute left but my speech would cover more than that time. It is nonsense to try to ram through this statutory instrument in no time at all. This is not about whether we should be helping families afflicted by this appalling disease but about saying we should get things right. We should ensure that this is done properly, with proper parliamentary scrutiny. The ultimate role of Government is to protect the safety of the citizens of this country and the regulations do not do that. They open the gates to a procedure that is completely untested, with no pre-clinical trials or clinical trials. The regulations talk about going straight to treatment and that has all been done so that the Department of Health can wangle its way around the legislation, or so it thinks. This is terrible. It is not good for the families with this chronic, horrible disease. We need proper and considered research. If these regulations were on genetically modified crops, we would all be up in arms. That is what is happening here.

NHS Major Incidents

Peter Bone Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

That advice was issued in the west midlands, and not in Salford. The hon. Lady talked about the reorganisation. Well, that reorganisation means that we have been able to afford 82 more hospital doctors and 589 more nurses in her area, which is helping her constituents. Salford is one of the best examples of integrated care in the country, which is why any hospital declaring a major incident should think about the impact on the rest of the NHS locally. That is what the guidance says.

[Mr Peter Bone (Wellingborough) (Con)]

The shadow Secretary of State is a very honourable gentleman, but he might live to regret this political football stuff. In north Northamptonshire, my hon. Friend the Member for Kettering (Mr Hollobone), the hon. Member for Corby (Andy Sawford) and I are working together on local decisions about our A and E. Surely that, and not political football, is the way forward.

[Mr Hunt]

My hon. Friend is absolutely right. I have spoken to the chief executive of Northamptonshire county council and I have heard about the excellent integration of services that is now starting to happen between the local authority and the local hospital. That is the way forward. The guidance simply says that trusts must pay attention to the impact on the local health economy before they make a local decision. It is time that Labour stopped playing politics with something that they know is a disgrace.

NHS Specialised Services

Peter Bone Excerpts

Thursday 15th January 2015 Westminster Hall

[Norman Lamb]

That is a legitimate concern and fear, but the arrangements have the potential to avoid that risk, so that those concerns and fears are not realised; I will expand on that in a moment.

Guidance will be issued later this month setting out the detail of the proposed changes, alongside the criteria that determines which service is commissioned at which level. The engagement programme will include a number of patient and public engagement events and workshops in February, led by regional and area teams, to help to co-design the process for implementing the changes with CCGs. I encourage involvement with that programme, and as part of it NHS England will seek views on the criteria to decide which service is best commissioned at which level.

NHS England acknowledges that people are concerned about the re-emergence of a “postcode lottery”—the hon. Member for Alyn and Deeside specifically mentioned that point—as a result of a more collaborative approach. In particular, people are concerned that specialised services could once again be commissioned in a variety of ways across the country, resulting in patients experiencing difficulties in accessing services.

I totally understand why people have that anxiety, but let me be clear that NHS England would remain the accountable commissioner for any services commissioned collaboratively with CCGs. My hon. Friend the Member for St Austell and Newquay referred to the Health Committee’s concerns about the previous arrangements. However, because NHS England would remain the accountable commissioner and because commissioning would be done collaboratively, I think that concern has been sufficiently addressed.

Since April 2013, NHS England has achieved significant progress in developing a set of nationally consistent service standards and commissioning policies, which have been widely welcomed. They ensure equity of access to high quality services; the point about access was referred to by a number of hon. Members. These standards and policies will still apply for specialised services that are jointly commissioned by NHS England and CCGs, and NHS England will continue to improve on those in the years to come. I think that the shadow Minister, the hon. Member for Copeland (Mr Reed), also raised concerns about access and I hope that he finds what I have said about it reassuring.

For any services that are fully devolved to CCGs, allocations will be made on the basis of activity. Data from NHS England area teams would be used to trace historical activity levels and CCG funding allocations would be based on those, with adequate adjustments for population increase.

The purpose of the move to collaborative commissioning is to support more effective joint working and to allow discussions about service redesign to take place across the local health economy, engaging both national level and local level to try to build capacity.

In the short term, patients should not notice any difference to the service they receive, and in the medium to long term NHS England is confident that these changes should result in improvements, rather than a deterioration—including improved outcomes for patients, more integrated pathways and a better patient experience. We continue to work closely with NHS England as it develops these proposals and engages with all those involved in the commissioning of specialised services, including CCGs, individual patients and—critically—patient groups, area team commissioners and providers of services.

I thank all hon. Members and the sole right hon. Member here today, the right hon. Member for Wolverhampton South East, for contributing to this debate in a constructive way. The issues that have been discussed are of real concern, and it is right that they should have been raised. However, I think we have the potential to improve the way in which the system operates.

[Mr Peter Bone (in the Chair)]

I thank all right hon. and hon. Members for this excellent debate.

Question put and agreed to.

A and E (Major Incidents)

Peter Bone Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

I say gently to the hon. Gentleman that if we are to solve the problems in his area and others, we should listen to the doctors about the structures that will work best. The structures that we put in place are the structures that doctors advised us to set up. That is why we are supporting them.

[Mr Peter Bone (Wellingborough) (Con)]

Mrs Bone would like to offer best wishes for the new year to the Secretary of State. The reason she can do this is the excellent health care provided by the NHS in both Kettering general hospital and Northampton general hospital. Locally, the commissioners and the acute hospitals are together working out a plan to deal with accident and emergency. Is not that the way forward?

[Mr Hunt]

Indeed. I pass on my best wishes for the new year to Mrs Bone. Like many people, she has benefited from superb NHS care. A million more people are having operations every year under this Government, and 700,000 more people are being seen within four hours at A and E under this Government.

Oral Answers to Questions

Peter Bone Excerpts

Tuesday 10th June 2014 Commons Chamber

[Jane Ellison]

I absolutely join my hon. Friend in congratulating everyone involved in turning that performance around—it is really, really impressive. He is right to say there are lessons to be learnt everywhere from people innovating, joining up services and the various things that have gone on in the background. I know that the local Members have been involved and engaged in the process and I congratulate them on that. That is really valuable and I urge everyone to get involved. We should congratulate A and E staff everywhere on dealing with the pressures they are under. We know they are considerable, but they do a great job.

[Mr Peter Bone (Wellingborough) (Con)]

May I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on the work he has done to help with this amazing turnaround? The Minister is aware of the plans to have a community urgent care centre at Isebrook hospital in my constituency, which will mean that my constituents will not have to go to Kettering hospital. Is this not another way forward to improve A and E results?

[Jane Ellison]

My hon. Friend highlights that there are a lot of different approaches to reducing the pressures on A and E. The great thing is that we are seeing real innovation from local clinicians, supported by local Members of Parliament. That shows what can be done when we address these problems with an innovative approach, and think about how we can reduce these pressures and ensure that as many people as possible are served in the right way and treated outside A and E, if that is not the place they should be.

Mental Health Services (South-East Essex)

Peter Bone Excerpts

Wednesday 5th March 2014 Westminster Hall

[Norman Lamb]

I am conscious that I am close to running out of time, but community services often do enormously good work in their local areas. The focus on mental health must shift towards a prevention approach. We must intervene early rather than allowing a problem to deteriorate and acting only after something has happened. We must also focus much more on recovery. So often, we seek to contain people’s ill health rather than helping them to recover in a meaningful sense.

Finally, I would like to mention our crisis care concordat, which will set high standards of crisis care in mental health that have never existed before. We expect every area to implement that concordat to ensure that people, wherever they are in the country, get access to the right standards of care.

[Mr Peter Bone (in the Chair)]

Order. I apologise to Members for having to curtail the debate, because I am sure that it could continue.

Accident and Emergency

Peter Bone Excerpts

Wednesday 18th December 2013 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

Kettering general hospital will be well known to the Secretary of State, because he was good enough to visit it a year ago to see the excellent service provided by its doctors, nurses and ancillary staff. The hospital has been in existence for 116 years and it is badly needed and much loved. At one time or other, every resident of Kettering has had a member of their family go through the hospital.

The hon. Member for Corby (Andy Sawford), my hon. Friend the Member for Wellingborough (Mr Bone) and I have put our party political differences aside and joined forces to campaign for extra investment for the accident and emergency facility at Kettering general hospital, because it is needed by all of our constituents. We are working as one on the issue. The other good news is that both the hospital trust and the local clinical commissioning groups are working as one on the issue.

I thank the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who is not in his place, for meeting all three of us, together with representatives from the hospital and the CCGs, over the summer. He has been good enough to agree to meet us again on 15 January.

All the professionals have come together and agreed that, despite their best efforts and despite following the advice of the Department of Health’s intensive support team to the letter, whichever Government are in power would have to face the fact that the A and E at Kettering is, sadly, not fit for purpose and needs extra capital investment. Their bid to the Department of Health will be for £20 million for Kettering A and E and an extra £3 million to create community hubs—in other words, urgent care centres-plus—in Corby, Kettering and Wellingborough. The three hon. Members, the CCGs and the hospital trust will make a joint bid for that money when we meet the Minister in January.

The challenge the A and E at Kettering general hospital faces is serving one of the fastest growing populations in the country. In the last decade, Kettering’s population growth ranked 31st out of 348 districts around the country and it had the sixth highest increase in the number of households. Few other parts of the country are growing as fast as the Kettering area, which also has an increasingly ageing population.

The A and E department at Kettering general hospital was constructed in the 1970s for about 25,000 to 30,000 attendances a year. In 2001 attendances had hit 56,000 and that figure is now 85,000. The A and E centre is effectively bursting at the seams, and attendances show absolutely no sign of falling off. Typically, there could be between 170 and 230 attendances a day—the highest has been 260 in a 24-hour period this year.

The professional staff—the clinicians—in the A and E have made multiple operational changes. They have adopted all the best practice ideas provided by the Department’s intensive support team, but the key issue remains the estate, and the only way to solve that problem is an injection of capital investment. With that investment and with the development of community facilities in Corby, Kettering and Wellingborough, the professional clinicians are confident that the A and E department could at long last start hitting its A and E targets. At the moment, it is treating only 89% —well below the 98% target specified by the Government—of patients within a four-hour period.

[Mr Peter Bone (Wellingborough) (Con)]

I apologise for being out of breath, Madam Deputy Speaker, but I just wanted to ask my hon. Friend whether the proposal he is talking about has all-party support in the north of the county?

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Mr Peter Bone has just arrived in the Chamber, but one is normally expected to be in the Chamber for more than just a few seconds so as to hear the debate before intervening. I am sure the hon. Gentleman apologises to the House.

[Mr Hollobone]

I am very grateful for the intervention from my hon. Friend the Member for Wellingborough because he has many duties to attend to in this House on behalf of his constituents and he has been at the forefront of the campaign to get extra investment into Kettering’s A and E, and also to develop the community hub patient facilities in Corby, Kettering and Wellingborough.

With the £3 million capital expenditure bid going to the Department, one of the options would be for a community hub at the Isebrook hospital, which would help to serve my hon. Friend’s constituents in Wellingborough and, by doing so, would take the pressure off the A and E at Kettering. If we are successful in this cross-party bid, the A and E at Kettering would be transformed into an A and E plus an urgent care centre on the site of Kettering general hospital. It would be a one-stop shop for local patients. The A and E at Kettering has the confidence of local people, but the local population growth means that capital investment is needed more than ever, and we look to the Government to provide that in early January.

[Mr Bone]

On a point of order, Madam Deputy Speaker. I apologise to the House for the discourtesy shown, but I was very surprised that my hon. Friend the Member for Kettering (Mr Hollobone) was called so early in the debate.

[Madam Deputy Speaker (Dawn Primarolo)]

I do not think that is a point of order, but the House has noted it and we will move on now so we do not waste any more time.

Tobacco Packaging

Peter Bone Excerpts

Thursday 28th November 2013 Commons Chamber

[Mr Speaker]

The sedentary remarks of the hon. Member for Shipley (Philip Davies) are almost as entertaining as those he makes when he is on his feet.

[Mr Peter Bone (Wellingborough) (Con)]

I sometimes feel sorry for the Government. We have an excellent Minister at the Dispatch Box who is listening to Parliament and asking for an independent report, yet she gets Members of Parliament complaining about that. That is ridiculous. I think I understood her to say that if regulation is to be introduced, it will be done by statutory instrument. I hope that the Government are not going to proceed in that way, because we can only reject or approve a statutory instrument—we cannot amend it. Will she think again on that point?

[Jane Ellison]

I thank my hon. Friend for his support. The exact technicalities are still under review. As I said, we are strongly minded to use the affirmative procedure, but that matter is not completely resolved. Of course, we do have a little time, because we expect the review to report in March 2014.

Mid Staffordshire NHS Foundation Trust

Peter Bone Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

Absolutely. It is a sign of great confidence when a hospital is open about things that have gone wrong. When I meet the top chief executives who are running the best hospitals in the country, I am always struck by how willing they are to be open about the problems that they have had. It is often in the less well-performing hospitals that the management feel less confident and willing to talk about the problems. That culture is really important. I hope that today is a step in the right direction.

[Mr Peter Bone (Wellingborough) (Con)]

I thank the Secretary of State for coming to the House and making such a detailed statement. I served under the previous Chairman of the Select Committee on Health, the right hon. Member for Rother Valley (Mr Barron), during the inquiry into patient safety. The Secretary of State has a point. The problem at the moment is that people make a complaint after something goes terribly wrong, but the complaints system is deliberately long, drawn-out and delayed. One never actually reaches the ombudsman. If we are to have a change in culture, we have to stop the managements of hospitals delaying the complaints system deliberately.

[Mr Hunt]

I totally agree with my hon. Friend. That is why I hope that what we have announced today will bring about a transformation in the way in which hospitals manage complaints. Some excellent work has been done to help us do that. The heart of the matter is that hospitals should be really interested in the complaints that they receive, because that will enable them to understand where they are not delivering good care and what they can do to put it right. That does not happen everywhere. Too often, the complaints system is treated as a process, in effect, to fob people off, rather than to get to the heart of what people are talking about. We absolutely need to change that.