Health and Social Care (Kettering)

Debate between Peter Bone and Philip Hollobone

Wednesday 23rd October 2019 Westminster Hall

[Mr Hollobone]

I am delighted to take that intervention from my hon. Friend, who is a superb representative for his constituents in Northampton and is very much in touch with the importance of local healthcare issues to our constituents. He is absolutely right.

I am delighted to welcome the Government’s commitment to include Kettering General Hospital on the list of hospitals that will be considered for health infrastructure plan 2—or HIP2—funding from 2025. That is important for Kettering, because the hospital has been there for 122 years, 70% of the buildings on the main hospital site are more than 30 years old and there is a maintenance backlog of £42 million. We need the reconstruction of many wards at the hospital. I welcome the Government’s commitment to investment in the hospital site from 2025 onwards, which could transform the whole of Kettering General Hospital. The point about the urgent care hub is that we need the money now to address the pressure on the A&E department.

The second part of the debate is about the need for us to use the opportunity of local government reorganisation in Northamptonshire to create in the county a combined health and social care pilot that will put responsibility for healthcare and social care under one organisation. Northamptonshire County Council has faced tremendous financial difficulties. The Government appointed an inspector, who concluded that it was not possible to turn around the organisation. The Government’s solution is to create two unitary councils in the county: a “north” council and a “west” council that will take over all the responsibilities of the eight different councils in the county from May 2021. We can use that once-in-a-generation opportunity to create a new organisation on a pilot basis to combine health and social care in Northamptonshire.

That is important for Kettering General Hospital because it has 531 beds; at any one time 110 of those beds—21%—are occupied by patients who should not be in hospital at all, but in a social care or other setting. In Government jargon, they are defined as super-stranded patients who have been in hospital for more than 21 days. If the hospital discharges 87 patients a day from the A&E department to the hospital, and 110 of the beds are occupied by patients who should be in a different setting, it creates huge problems for the A&E department, so finding a solution to the social care issue is also important for the A&E department.

[Mr Peter Bone (Wellingborough) (Con)]

I congratulate my hon. Friend on having led a seven-and-a-half-year campaign to get the expansion at Kettering General Hospital. It has been my great pleasure and that of my hon. Friend the Member for Corby (Tom Pursglove) to support him, but he has led this magnificent campaign and I hope that today he will succeed in his objective. Does he agree with me that the reorganisation he has talked about could possibly—hopefully—lead to an urgent care centre at the Isebrook Hospital in my constituency, which would reduce the number of people who go to Kettering A&E by 40%?

[Mr Hollobone]

I would be delighted to support my hon. Friend’s campaign. He is a very effective champion for his constituents. He, along with my hon. Friend the Member for Corby, has been an integral part of a joint effort to campaign for the urgent care hub at Kettering. I would be delighted to reciprocate, because health investment in our local constituencies is very important for our local residents.

My hon. Friend the Member for Wellingborough will join me in welcoming any proposals that the Government introduce to create a health and social care pilot in the county. We simply have to make sure that elderly, frail residents in hospital, who need not be there and should be in a social care setting, are given the social care that they need in the right place at the right time. With social care now the responsibility of Northamptonshire County Council, I am afraid it simply is not working.

Evidence shows that the longer an elderly person stays in hospital, the more they lose critical muscle mass and strength, which affects their ability to return to their home or social care setting without appropriate support. Patients with long lengths of stay in hospital become revolving door patients. They get better and could go to a community setting of care, but they become unwell again because they wait so long for an appropriate out-of-hospital placement, so we need to get that sorted out. Financially, it does not make sense, either. If a patient stays in hospital, it costs £2,500 a week. If they are put into a social care setting, the cost to the taxpayer is £700 a week. Not only is the setting more appropriate, but it is financially beneficial for our health and social care providers.

I am pleased that the Secretary of State for Health and Social Care, together with the appropriate Minister in the Ministry of Housing, Communities and Local Government, wrote to all Northamptonshire MPs on 24 July, encouraging Northamptonshire County Council and the local NHS providers to knock their heads together to thrash out an appropriate plan. The Secretary of State wrote:

“I agree that the unitarisation process offers an excellent opportunity to re-imagine the delivery of health and social care services across Northamptonshire. I believe that local leaders should be bold in their ambitions for integration”.

He stated that he and the Housing, Communities and Local Government Minister

“are happy to back a bolder plan for integrated services in Northamptonshire, learning from other areas that are further ahead in the integration journey”,

such as Greater Manchester. Since that letter of 24 July, my colleagues and I, as parliamentary representatives from Northamptonshire, have seen little evidence of any concrete proposals from the county council and the local NHS. It is time for the Government to knock heads together locally, because the Government will want a pilot to pioneer their reform of health and social care. We have a wonderful opportunity in Northamptonshire to be the first in a shire setting to get it right.

Local organisations are doing their best in the present circumstances—I declare my interest as a member of Kettering Borough Council. To give one example, Karen Clarke, a housing options adviser at Kettering Borough Council, has been working extremely hard to make sure that patients can come out of hospital and find appropriate accommodation if they have difficulties in doing so. She recently wrote:

“I think the majority of the public assume everyone goes in to hospital, receives their treatment and is discharged home, but what if that patient doesn’t have a home? Or what if their home is no longer accessible? What if someone needs more than just independent living? Where does the patient go then?”

Karen has seen more than 250 patients in the past two years. She has managed to return home, or to secure permanent accommodation for, approximately 7% of those referrals, and 25% have gone into some level of temporary accommodation. That pioneering initiative is at Kettering’s health and housing partnership, where Kettering Borough Council, the local mental health trust and Kettering General Hospital work together. It has been pioneered by John Conway, the inspirational head of housing at Kettering Borough Council. It is a superb initiative.

However, such local initiatives are not enough. We need one organisation, preferably NHS-led, to sort out health and social care provision in Northamptonshire. The Government have a golden opportunity to pioneer a pilot in the county, so I hope they will press ahead. There are two issues: we need £46 million for an urgent care hub at Kettering General Hospital, and we need the Government to seize the initiative, knock heads together locally, and make sure we can have a pilot for health and social care in Northamptonshire.

Oral Answers to Questions

Debate between Peter Bone and Philip Hollobone

Thursday 6th June 2019 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

rose—

[Mr Peter Bone (Wellingborough) (Con)]

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Oral Answers to Questions

Debate between Peter Bone and Philip Hollobone

Thursday 15th March 2018 Commons Chamber

[Mr Peter Bone (Wellingborough) (Con)]

rose—

[Mr Philip Hollobone (Kettering) (Con)]

rose—

Kettering General Hospital

Debate between Peter Bone and Philip Hollobone

Thursday 29th June 2017 Commons Chamber

[Mr Peter Bone (Wellingborough) (Con)]

Will my hon. Friend give way?

[Mr Hollobone]

Well, it is very difficult for me to choose, but since our younger and fitter colleague was faster on his feet I am going to give way first to my hon. Friend the Member for Corby (Tom Pursglove).

[Mr Hollobone]

I am very grateful for that most kind invitation. I have visited the urgent care centre and I would be happy to do so again. I offer my hon. Friend my 100% support as he advances the importance of the urgent care centre with local funding bodies. He knows that he can always rely on me to support him in his endeavours. I am happy to give way to my hon. Friend the Member for Wellingborough (Mr Bone).

[Mr Bone]

I am very grateful to my hon. Friend for giving way to the older and more experienced Member from Northamptonshire. I congratulate him enormously on securing the debate and on how he is speaking so powerfully for Kettering hospital. The one bit of the triangle that is not there is an urgent care centre or minor injuries unit at the Isebrook hospital in Wellingborough. That is part of the plan approved by several Ministers from the Department of Health. I have great trouble getting commissioners to engage with that, but we need it to relieve pressure on the A&E at Kettering.

[Mr Hollobone]

As so often in this place, my hon. Friend speaks words of great wisdom and insight. He represents his constituents extremely well in repeating that point. The current draft sustainability and transformation plan for Northamptonshire is simply not good enough, because it does not place enough emphasis on developing the facilities my hon. Friend is speaking about. Effectively treating people nearer to where they live so they do not have to come into Kettering general hospital makes sense. It would be better for the patients, it would mean that they received more appropriate treatment closer to home, it would be more cost-effective and it would relieve pressure on Kettering general hospital. I therefore urge the Minister, with the contacts he has with NHS England, to pay close attention to the development of the STP in Northamptonshire, which is not good enough yet. It needs to place more emphasis on primary care, urgent care centres and local facilities, as my hon. Friends the Members for Corby and for Wellingborough have both mentioned.

The A&E department at Kettering general hospital is under huge pressure, the bulk of which comes from the lack of bed space. Ninety-eight per cent. of people who present at Kettering A&E with minor injuries are seen within the target, while 96% of those who are not admitted to the hospital are seen within the four-hour target. However, somewhere between only 60% and 90% of those who require admission to the hospital are hitting the target. The problem is the number of beds occupied by people whose treatment has been completed but who have not yet been moved to rehabilitative or local social care.

There have been problems with that in Northamptonshire, which I have raised before on the Floor of the House. However, I am pleased to say that I understand that closer co-operation between the hospital and the local county council is likely to mean that the better care funds allocated by the Government will be used more effectively, so that people can be moved more quickly out of the hospital and into more appropriate care in their local communities. This is an urgent priority, but I understand that we are about to see some rapid improvement.

Having said that, even if Kettering general hospital does everything right, I have to tell the Minister that I am being told that it has a structural deficit of £10 million a year. That means that even if it does everything right and meets all the targets that the Government set, the way in which the health service is structured in Northamptonshire means that it can do no better every year than to have a deficit of £10 million. In 2015-16 the deficit was £11 million and in 2016-17 it was £25 million. This year it is likely to be £20 million, so things have clearly not worked as they should have, but I have to tell the Minister directly that even if everything worked right, there would be a structural deficit of £10 million, which is clearly not sustainable. That needs to be looked at.

There has recently been a problem with referral to treatment targets. In the past, waiting list data have not been recorded correctly at the hospital. Everyone is agreed about that, and I am pleased that the Care Quality Commission is investigating and has referred the matter to NHS Protect. I think everyone agrees that the data are now being collected correctly, but historically they have been inaccurate, and patients may have been harmed as a result. I therefore ask the Minister directly whether he is satisfied that the issue is being investigated appropriately and that the investigation will be concluded as speedily as possible, so that local people can get to the bottom of what has been a historical problem.

Kettering general hospital is perhaps the most important facility to local people in Kettering. I know that it is important to my hon. Friends the Members for Wellingborough and for Corby as well, and we will not let any opportunity go by in this place without reminding Her Majesty’s Government how important the hospital is to local people. All is not well with the hospital, and these things can be put right. There has been a problem of the chief executive changing too often. We have lost some good people and replacements have not stayed for too long. The Minister has met Fiona Wise, the acting interim chief executive, but she will not be there for too much longer, because a more permanent replacement is being sought. There have also been leadership issues at the hospital in the past, which we need to tackle. The chairman, Graham Foster, is doing his level best—I commend him for his efforts—and there is tremendous team spirit at the hospital. It got extremely good marks in the CQC inspection for the quality of the care that all staff provide to local patients.

All is not well, however, and we need the Minister’s continuing attention to ensure that we can address the issues involved. In particular, will he urge NHS Improvement to prioritise its analysis of the urgent care hub proposals? I understand that NHSI, which used to be called Monitor, has now approved the funding for the preparation of the business case for the hub. That is likely to be submitted to NHSI in September, and I hope that it will be at the top of its in-tray so that we can get a move on with a project that everyone—the Government, the hospital, the patients and the CCG—agrees is the key development that needs to take place if we are to continue the distinguished history of a hospital that has been going for 120 years.