Health and Social Care Budgets

Peter Heaton-Jones Excerpts

Tuesday 14th March 2017 Westminster Hall

[Peter Heaton-Jones (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate the hon. Member for Hackney South and Shoreditch (Meg Hillier) on securing this important debate. It will not surprise colleagues to hear that I am unashamedly here to speak up for Devon, and North Devon in particular. We are part of the south-west, and it is significant, looking around the Chamber, to see so many Members from the south-west from all sides. It is because we are concerned that rural areas in the south-west are not getting our fair share in the distribution of available funds.

I join my hon. Friend the Member for Totnes (Dr Wollaston) in unequivocally welcoming the extra money that the Government have put into health and social care. The £10 billion extra for the NHS over this Parliament and the £2 billion for social care announced in the Budget are extremely welcome, as are the extra revenue-raising powers that have been given to local authorities for social care, and I thank the Minister and his team for those.

However, we need our fair share in areas such as Devon and the south-west. As has been mentioned by the right hon. Member for Exeter (Mr Bradshaw), we face a sustainability and transformation plan that is causing huge concern among my residents in North Devon and among those of other colleagues here from Devon constituencies. There are particular concerns about the future of some acute services at North Devon district hospital. I have said before and I will say again that any cuts to services at that hospital would be absolutely unacceptable. That is because of what I describe as the three Ds: distances, demographics and deprivation. I will not rehearse the arguments here; the Minister knows them well. He has been kind enough to hear me out on many occasions, as have the Secretary of State and many others. Those three factors in Devon and in North Devon in particular mean that we have to look at a fairer way of funding our health service so that we get the services we need. I repeat that any cuts to services at North Devon District Hospital would be absolutely unacceptable.

The holy grail of social care is the integration of the health and social care systems, which many colleagues have mentioned. I want to pay tribute to the Northern Devon Healthcare NHS Trust, which does better than most in working with its social care partners to ensure that packages of care are in place when people are able to move out of hospital. I welcome the hard work of all the people who work in the North Devon services to achieve that.

[Mims Davies (Eastleigh) (Con)]

Will my hon. Friend give way?

[Peter Heaton-Jones]

I will not. The Chair was clear about the time limits; I apologise to my hon. Friend.

I will end by saying we must remember the three Ds. Let us work together across parties to find a long-term solution for the fairer funding of health and social care.

Health and Social Care

Peter Heaton-Jones Excerpts

Monday 27th February 2017 Commons Chamber

[Helen Goodman (Bishop Auckland) (Lab)]

I am pleased to follow my hon. Friend the Member for Bradford South (Judith Cummins), who spoke with great feeling about her constituents’ needs, as she always does.

If my constituents were here and saw the estimates, they might be a bit disappointed. A few weeks ago, we had an interesting public meeting. They said to me, “Helen, it’s marvellous: because of Brexit, we’re going to get £350 million extra for the NHS every week, and our A&E department can be reopened.” There seems to be no mention of that in the estimates.

Under our local sustainability and transformation plan, there is a proposal to close the A&E department at Darlington hospital, which would be an unutterable disaster for my constituents. We are continually told that the purpose of the STP is to improve services, but I really wish the local NHS managers would stop pretending. They have also told us that by 2020 there is going to be a funding shortfall of £281 million, so nobody believes it is about improving services; everybody believes it is about managing on limited resources.

I appreciate that pressures on the health service are increasing because of the ageing population, but this level of austerity in the health service is unnecessary. The British economy is bigger now than it has ever been; it is 14% bigger than it was in 2010. Other hon. Members have pointed to the disparity between spend in the UK, which is $3,235 per capita per year, and in Germany, which is $4,800 per capita per year. In the UK, there are 2.8 hospital beds per 1,000 people, whereas in Germany, the figure is 8.3. It does not need to be like that.

I wish to focus on the needs of rural communities, which we have not spoken about this evening. Were the A&E department in Darlington to close, it would be an extremely serious problem for the people to the west of Darlington, and at the top of Teesdale. People are already travelling 30 miles to get to hospital. The response times of the North East ambulance service are not what they should be. People often wait 20 or 30 minutes for an ambulance to arrive, which means that it could be an hour before they get into the hospital.

One of my local councillors has done an absolutely brilliant piece of analysis, looking at the journey times that would be needed were people to have to go to the James Cook university hospital in Middlesbrough. At the moment, someone living in Bishop Auckland would take 25 minutes to get to hospital. It would go up to 39 minutes. If they live right up in the top of the dale, the journey time is 39 minutes. That would go up to 64 minutes. The STP managers running the review say that they want to treat cardio-vascular and trauma patients in specialist centres where a critical mass of staff can maintain their skills. That sounds reasonable enough, but my constituent Judy Sutherland asked them, “What proportion of emergency journeys are not cardio-vascular or trauma cases?” The answer was 94%. So, for acute asthma, adrenal crisis, anaphylactic shock, appendicitis, diabetic coma, meningitis and renal failure—the list goes on—there would be no benefit to being in a specialist centre.

The extra mortality from the longer travel time goes up quite dramatically. In Bishop Auckland, it goes up by 2.4%, Barnard Castle by 3%, and in Middleton in Teesdale by 3.2%. That is why the pretence that this is about improving the quality of healthcare is not believed by my constituents. They are tired of being told that services should be nearer to home when, in fact, they are being pushed further and further away. There is a question mark over the Richardson community hospital in Barnard Castle. The A&E and the maternity services have been taken out of the hospital at Bishop Auckland. When that was done, we were told that it would be absolutely fine, because people would be able to go to the Darlington A&E, but now that A&E is under threat. People in rural communities are facing this constant process of attrition.

[Peter Heaton-Jones (North Devon) (Con)]

I have similar challenges in my rural constituency of North Devon. The STP is looking at the same issues that the hon. Lady is raising, and they, too, will lead to long travel distances. As Ministers know, that is something that I have raised with them and brought up in this House on a number of occasions. Does the hon. Lady agree that the challenges that the STP is trying to address have not happened in the past 18 months or the past six years; they have built up over many years and over many different Governments?

[Helen Goodman]

The proposal to close Darlington A&E has come up only under this Government. It was not proposed under the coalition Government or the previous Labour Government. This Government must take responsibility for what is happening now.

On Saturday, I went to Alston in Cumbria. The people there are also running a campaign to stop their local hospital closing, because they will then have to go to Carlisle, which is 34 miles away. That is a long way, especially in Cumbria, where the weather is absolutely terrible and the road is often blocked. Ministers need to take more account of this big rural issue. People in Alston are also worried that there will be a cynical saving—the hospital in Copeland—and that they will face even bigger cuts. Perhaps the Minister will give us an assurance about that. The interaction between health and social care is well understood. We all know that cuts to social care mean a worse quality of care and less time for individuals.

Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 15th November 2016 Commons Chamber

[David Mowat]

To be clear, every single STP will be published by Christmas. About 12 have been published so far, and the Cheshire and Merseyside STP will be published tomorrow. When the hon. Lady has access to it, she will see that some of the statements she is making are just scaremongering. She mentioned the King’s Fund, so let me quote it:

“The King’s Fund continues to believe that STPs offer the best hope of delivering long term improvements to health and care services.”

That is what the King’s Fund says.

[Peter Heaton-Jones (North Devon) (Con)]

20. Will the Minister ensure that NHS managers undertaking the STP process affecting North Devon are fully aware of my constituents’ concerns, especially in relation to our geographical isolation? In particular, will he ensure that they are aware of their concerns in Ilfracombe, which has suffered from decades of health inequality because of its location?

[David Mowat]

It is vital that every STP engages with all stakeholders, and that includes North Devon. The public and, indeed, MPs should engage in the process as critical friends to try to make these plans better.

Care Homes for Older People

Peter Heaton-Jones Excerpts

Thursday 3rd November 2016 Commons Chamber

[Peter Heaton-Jones (North Devon) (Con)]

I am delighted to have secured this debate about the regulation, inspection and complaints process for care homes for elderly people. Let me be clear about something from the start. In half an hour on a Thursday afternoon, it is not my intention to tackle the huge, overarching issue of social care provision in this country.

--- Later in debate ---

Motion made, and Question proposed, That this House do now adjourn.—(Andrew Griffiths.)

[Peter Heaton-Jones]

Members on both sides of the House know that social care provision is one of the biggest challenges that we face, but that debate must be for another day. My debate is about something very specific: the way in which privately run care homes for elderly people are inspected and regulated, and the process that exists to raise complaints when relatives believe that something is going wrong. This is vital for two reasons. First, we are talking about nothing less than the welfare of vulnerable elderly people. Secondly, I believe it is possible to make significant improvements at relatively little cost, and I hope in the next 15 minutes or so to set out why.

Before I do so, I will provide a little background. Why have I taken up this cause? Three years ago, while I was still a mere parliamentary candidate, a local resident in North Devon told me a very moving story. John Barrass’s mother, Vera, a former resident at a private care home, died in 2009. Mr Barrass had serious concerns about the care she received in the final weeks of her life, and believed that a poor system of inspection, regulation and complaint handling was a significant factor. Specifically, he believed that a mechanism did not exist to allow him satisfactorily to raise his concerns about shortcomings in his mother’s care.

I do not seek to reopen that case, and neither does my constituent. In the years since his mother died, Mr Barrass pursued all avenues available to him to have her case fully investigated. He invariably hit a brick wall, so he began to look beyond his individual circumstances to examine instead the more general question of how care homes are inspected and regulated, and how complaints are dealt with. He came to the conclusion that the system was simply not fit for purpose, and he met me to explain why. That was the birth of a long campaign, which reaches another milestone with this debate.

Tomorrow marks the first anniversary of my raising this matter in Westminster Hall on 4 November 2015. Since then, I believe we have made some progress, but much of what I said at the time still stands today. What I have to say is based largely on a report produced by Mr Barrass, which I have here, called “Care means care, Justice in care”. The report was created in memory of his late mother Vera who, in Mr Barrass’s words,

“spent a nightmare in care,”

which led him to spend seven years producing this document.

I have helped Mr Barrass to take this to the very top. The previous Prime Minister, my right hon. Friend the former Member for Witney, received a copy and arranged a meeting with the former Minister, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt). I am delighted to see him in the Chamber and pay tribute to him for the work that he did in this area, and for his sincere engagement with me and this campaign. Recently, the document was sent to the current Prime Minister. I quote Mr Barrass’s letter to her:

“I cannot bring my mother back or stop what I have agonisingly had to witness and go through, but I can try to stop this happening to others”.

I agree. An estimated 300,000 older people currently live in some 15,000 registered care homes in England. The average age of those people is 85, and a significant proportion suffer from dementia. They are largely without a voice, and that needs to change.

[Jeremy Quin (Horsham) (Con)]

I congratulate my hon. Friend on his campaign and his persistence with it. The matter affects many of us in this House; my constituents are still concerned about Orchid View care home and the issues that arose out of that. Does he agree that we have to learn from the mistakes of the past? We should have proper inquiries and proper investigations, and we should learn from those mistakes.

[Peter Heaton-Jones]

I thank my hon. Friend; I am sure that the Minister will have heard his comments. We need to move forward, and when things go wrong, we need to put them right.

The body responsible for the regulation and inspection of care homes is the Care Quality Commission, with which I have worked closely since launching this campaign. I believe that it is listening, but there is still considerable room for improvement. Today, the CQC’s website tells us that of the 448 care homes it has inspected most recently, a staggering 200—45%—have been rated as “requires improvement” or “inadequate”. There is no reason to believe that those figures are unrepresentative of the sector as a whole, which means that more than four in 10 of all establishments are not reaching the required standard. Surely the purpose of any system of inspection and regulation must be to drive up standards. The figures alone suggest that the current system simply is not working.

In June 2013, the CQC issued a consultation called, “A new start”, which proposed a whole new approach to inspection across all sectors, including care homes. That approach was confirmed in October 2013, and the new inspection regime was introduced. I broadly welcome it, but there are still huge question marks over its implementation. The original deadline for carrying out an initial inspection of all care homes was February 2016. However, in July 2015, the National Audit Office found that just 9% of care homes had been assessed because of a shortfall of about 160 inspectors. Not surprisingly, the original February 2016 deadline to complete the work was not going to be met, so it was pushed back to this October—last month. Yesterday, when my office asked the CQC for an update, it told us that it is

“committed to completing the first phase of the comprehensive inspection programme by March 2017”.

In other words, this new deadline—the third—is more than a year later than the original target.

I absolutely recognise that the CQC faces many challenges. The managers and inspectors are working hard, but my point is that we would not accept a delay of more than a year in the inspection of NHS services, so we should not accept it just because we are dealing with private sector care homes. We are still talking about vulnerable people who might well be suffering. We need to get a grip on this problem and to challenge the CQC to undertake its inspection programme in as timely a way as possible. I seek to be helpful when I say, “Let us, as a Government, work with the CQC to ensure that it delivers what seems to me to be such an important inspection programme without further delays.”

That brings me to another major area of concern: the CQC’s role in handling complaints, and indeed the role of myriad organisations and authorities involved in this area. What can someone do if they fear that an elderly relative is being neglected or mistreated, or is not being given the right healthcare? What can they do if they fear that their relative’s life might even be in danger, and the care home provider has dismissed the complaint or will not even listen to it?

When things go wrong, and a member of the public needs to make a complaint against a care home, they are faced with a bewildering labyrinth, and that needs to change. The website of the CQC, the body responsible for the regulation, says that the CQC

“is unable to investigate individual complaints”

against providers. To many people, that will seem odd.

Many people are in care homes commissioned by their local authority, so that offers another route for making a complaint. However, the complaints procedures in many local authorities—I speak as a former councillor in a unitary borough—consist of several layers, shall we say, and such a system does not lend itself to a speedy resolution. Not all people in care homes are in places paid for by local authorities, but even if they were, their complaint may fail to get through those many layers.

Should such an individual go to the Parliamentary and Health Service Ombudsman? Again, no, because that is another brick wall. The ombudsman says:

“By law the Ombudsman cannot look into complaints about privately funded healthcare.”

There is another possibility, which is an organisation called the Independent Healthcare Sector Complaints Adjudication Service. The ombudsman’s website states that people “may”—I stress that word—“have the option” of going to that organisation, which covers some independent healthcare providers, but if the healthcare provider of the person concerned is not one of them, they are stuck.

In a nutshell, the system is bewildering. It lacks accountability and transparency, and would leave most people confused and frustrated. People simply do not know who to turn to when they are worried that something is not right. Given that level of confusion, let us imagine what the situation is like for people whose elderly relative is in a care home. They are worried and in an emotional state, yet still have to deal with an incredibly complex complaints procedure.

I believe we could solve this quickly and cheaply, simply by requiring every care home to display a standard notice clearly setting out the complaints procedure with the relevant contact details. It seems incredible—I use the word in its literal sense—that that is not already mandatory. I ask the Minister to investigate with the CQC the possibility of producing such a notice. Something that simple really could make a huge difference.

As for the longer term, in the document I referred to earlier, my constituent John Barrass is convinced that we need one body only to investigate, regulate and handle complaints about care homes, with that being its one and only purpose. That suggestion deserves serious consideration.

A further problem thrown up by this entire process has been highlighted effectively by an organisation in Devon—not in my constituency, as it happens, but elsewhere in the county—called Your Voice Matters. I pay tribute to its founder and director, Jenny Moore, who has done very good work in this area. I have met her a number of times, most recently yesterday, in preparation for this debate. The issue in question is the growing number of cases where relatives are banned from care homes simply for complaining. This can take the form of a complete ban or of restricted visits; in some cases, it has even been known to lead to the eviction of the elderly person from the home.

Your Voice Matters has launched a good campaign called “Rights 2 Speak Up 4 Care”. It has identified the issue succinctly. In a nutshell, it is that private care homes are defined in law as ultimate landlords. Quite simply, they can decide who goes on the premises and who does not. Families who raise concerns are threatened or banned. As I have said, sometimes residents are evicted, and a private paying resident is not protected under any legislation—not the Health and Social Care Act 2012 nor the Human Rights Act 1998, for example. A private care home also has the power to prevent health professionals from visiting the home. Let us think about that for a moment: a care home has the power to stop doctors and nurses going into it to visit its clients.

Something has to change. Recommendations from Your Voice Matters include legislation to close those loopholes and to give protection to all residents and their families, a review of the relevant legislation and an independent panel to offer a fair hearing should a private care home want to place restrictions on a family member or a resident. Your Voice Matters has been working on this for some time, and literally yesterday—just yesterday—there was something of a breakthrough. In the run-up to this debate, there has been a flurry of media activity, with TV and radio programmes covering the issue. Yesterday, the CQC published new guidelines on its website. Care homes will now be required to keep a register of any occasions when relatives are banned or people are evicted. I am not convinced that that goes far enough, but it is a start, and I will keep working with Your Voice Matters to ensure that we go further.

That campaign group has made a number of other recommendations that I will mention briefly, as they have considerable merit. It suggests there should be better protection for whistleblowers who wish to highlight shortcomings in homes, as well as better training, with a mandatory training course for all those who work in or manage care homes.

I have referred several times to my constituent Mr John Barrass. He has carried out an investigation lasting seven years but, as he says, he is only one of the 65 million little people in the UK—those are his words—who are very rarely listened to but whose experiences, and what they have witnessed and suffered, should not be ignored any more. He says:

“I just wish we had been raising these issues before mum had this serious stroke, and helped to change the care system. Maybe, just maybe, my mother would not have had to go through what she did and my father and I would not have gone through 11 years of suffering.”

I want to leave enough time for us to hear from the Minister, but let me be clear about one further thing before I conclude. Many fantastic caring professionals work in care homes. They do their jobs on low wages and care brilliantly for many people. The owners and managers of many care homes are committed to providing the best possible service. They face all the pressures of running a small business and the costs that that entails. There are good managers, investigators and staff at the CQC. I do not wish to criticise those who are doing well, but I do seek to call out those who need to do better.

I should briefly mention the many organisations and individuals who contacted me in advance of the debate. I am unable to name them all, but I have received good representations from the British Medical Association, Independent Age, Hootvox, which is an organisation looking at ways to measure the success or otherwise of care homes, and many other individuals and constituents.

I end with this thought. The problem is that we have a growing number of cases in which care homes are simply not coming up to scratch. I have spent many days, weeks and months on this, discussing it with my constituent John Barrass and the Your Voice Matters campaign group in Devon. Whenever we discuss it, we keep coming back to one thing. I said exactly this a year ago in Westminster Hall and I say it again now: this is not about processes, systems or organisations, but about people—people who do not have a voice in a system in which, let us remember, four in 10 care homes fail to reach a satisfactory standard on the CQC’s measures. That means that some vulnerable, sick and elderly people are not being properly cared for. That cannot be right. I look forward to hearing from the Minister. We have to do something and we have to act now.

Healthcare (Devon)

Peter Heaton-Jones Excerpts

Tuesday 18th October 2016 Westminster Hall

[Peter Heaton-Jones (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. May I congratulate my right hon. Friend the Member for East Devon (Sir Hugo Swire) on securing this debate on a topic that is vital for all us, right across Devon?

It will not be a surprise to anyone that I intend to focus mercilessly on North Devon and to fight our corner very hard indeed against the threat to our acute services at the North Devon district hospital in Barnstaple. Before I go into that in any detail, I want to make a couple of points. First, I would like to thank the Minister, who has on a number of occasions met myself and other colleagues in Devon to address this issue. I know he understands the particular significance of the North Devon district hospital, because I have discussed it with him, as I have with a whole slew—I am not sure what the collective noun is—of managers in the Northern Devon Healthcare NHS Trust and other directors and managers within NHS England, who by now are well aware of the strength of feeling in North Devon. I want to put it on record that the Minister has been very proactive in arranging such meetings.

My right hon. Friend the Member for East Devon talked about community hospital beds. I do not want the impression to be given that that is not a serious issue also in North Devon, although I will not be majoring on it. In North Devon, there is a bit of history. We did the heavy lifting with the loss of many of our community hospital beds about 18 months ago under a different process from the one now being undertaken in the rest of the county. I agree with what my right hon. Friend said about the need to look very carefully at the provision of social care before community hospital beds are removed.

I do not think NHS England has done this in the right order. Community hospital beds have been removed in North Devon, specifically from the Tyrrell hospital in Ilfracombe, and there is a great amount of concern among the local community about what is replacing that provision. Is there integrated and fully functioning health and social care provision in North Devon to replace those beds? My view is that the answer is no. That is also the view of the community in Ilfracombe. Last Friday I met the League of Friends of the Tyrrell Hospital, and that is strongly their view. That is not my major point today, but I want it on record that that remains a concern in North Devon, as it will become in other parts of the county.

My focus today is on acute services in North Devon. The community is extremely concerned. Many constituents have contacted me and shown their strength of feeling through protests on the street, campaign marches and letters to me, as the local MP, and to my hon. and learned Friend the Member for Torridge and West Devon (Mr Cox), whose constituents also use the North Devon district hospital in Barnstaple.

My point is absolutely clear and I will make it up front: there must be no cuts to acute services at North Devon district hospital in Barnstaple. I cannot see any clinical argument to justify even consideration of any such a reduction in services, let alone its implementation. Let me provide some background.

Healthcare in Devon is currently subject to not one but two separate review processes. We have the success regime, and the Northern, Eastern and Western Devon clinical commissioning group area was given this special treatment with only two other areas in the country—one in Essex and one in Cumbria. Because of the need to ensure that we do not fall into a future funding black hole, the success regime was implemented. I fully support that because we need this special treatment.

On top of the success regime we have a sustainability and transformation plan, which, as hon. Members will know, is being implemented in all NHS regions in England. We have this two-tier process and my understanding from conversations with NHS England is that the success regime will probably be folded into the sustainability and transformation plan, so North Devon will find itself subject to a target that we are at least more easily able to identify. The difficulty is that the ideas that are starting to emerge from the two, soon to be one, reviews are simply unpalatable for North Devon.

I put it on the record that I am fully aware that these are not firm proposals or ideas and no public consultation has been launched. None the less, what has started to emerge has, reasonably and understandably, created serious concern in the North Devon community because, looking across the piece at the various documents that have emerged from both the success regime and the sustainability and transformation plan, we see a picture that puts under threat some of the services at North Devon district hospital, which my constituents rely on most keenly and have done for generations. They include vital services such as accident and emergency, stroke and one that I want to focus on now, maternity.

I have here one of the latest documents to emerge, which hon. Members may remember. Unfortunately, NHS England decided not to make this series of documents public. I say gently to the Minister that that has not been helpful. I know it was not his direction, but it has given rise to the belief that stuff is being done in private behind closed doors and that leads to suspicions, rightly, among my constituents and the public in general. That latest document, which is about five weeks old, starts by talking about

“a two-site option for maternity”

and states that the

“Royal Devon and Exeter Hospital would most probably be the second site”—

after Derriford in Plymouth—

“rather than North Devon District Hospital”.

That is a clear indication that consideration is being given to closing the maternity unit at North Devon district hospital. That is not acceptable to my constituents and we will fight any such proposals if they come forward. We will do that forcefully for a couple of reasons.

North Devon is a special case, not least because of our geography. I have said many times in this Chamber, in the House and elsewhere that Devon has been historically underfunded, and North Devon even more so. We are and have been for too long the poor relation in public funding. Let me be clear. This is not something that has happened in the last 18 months or the last six and a half years. It has been an issue under Governments of all colours for many years, if not decades. It is something up with which we will no longer put.

Part of the difficulty of singling out North Devon and Barnstaple as a place that can apparently sustain further reductions in services is that we start from a lower base of funding than in many other regions. That feeds perfectly into the point that my right hon. Friend the Member for East Devon raised about rurality. North Devon is a largely rural constituency, and for many years a series of funding formulae have dealt unfairly with North Devon because of its rurality. There seems to have been a belief that, because we are a rural area with a sparse population, we can somehow do with less funding. In fact, the opposite is true, and I am delighted that this Government are starting to recognise that. Across the piece of funding for local government, the police, education and health services, we are starting to right that wrong and equalise that funding gap, but the history is still there and that is why North Devon is the last place where we should be looking for further cuts.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I am grateful to my hon. Friend for allowing me to intervene during his limited time in this debate, but I would like to respond specifically to his point about funding and allocations.

In the 2016-17 funding round, the allocation formulae have been looked at again and we have, for the first time in several years, introduced three differentials that are relevant to rural areas and that I think will affect my hon. Friends here. They include looking at the combination of rurality, remoteness and sparsity of population to improve the ambulance emergency cost adjustment, to reflect the greater distances travelled in rural areas; an adjustment to support continued provision by hospitals with 24/7 A&E services that are remote from the wider hospital network—my hon. Friend’s North Devon district hospital will be one of those’and an adjustment to remove from the formula supply-induced demand in urban areas where people live close to hospitals. Those three measures have led to a change and I gently suggest that my hon. Friend may care to look at the CCG allocations table which sets that out. For Northern, Eastern and Western Devon CCG, the per capita allocation for 2016-17 is £1,250, which is slightly above the average for England of £1,221 per head.

[Peter Heaton-Jones]

I thank the Minister for his intervention and I welcome it, but I say gently to him and NHS England, which I am sure is monitoring this, that all that good work will be entirely undone if we then lose our acute services at North Devon district hospital. This is not about figures on a spreadsheet; it is about the services and healthcare provision that my constituents will receive in Barnstable.

I am aware of the time, Mrs Main, but I want to raise a second issue, which is important and recognisable to us in North Devon, but perhaps not to those beyond: our unique geography and the distances. An Australian historian once referred to the tyranny of distance, and I think we suffer from that in North Devon. If one looks at a map, it is all too easy to think that there is a decent road network between Barnstaple and Exeter. I can give several reasons why that would be a wrong assumption. First, vast numbers of people live in isolated regions far north of Barnstaple. Secondly, the road network is not all it is cracked up to be—although that is a subject for another day and one on which I am fighting heavily.

My main point is that what no map or distance table shows is that in North Devon we have pockets of serious deprivation. In Ilfracombe, I have two of the most deprived wards in the south-west and by some metrics the most deprived in south England. In those areas car ownership is less than 80%. Put another way, one in five households do not have access to their own private transport and, because of the demographics, some of those who do are elderly and perhaps have their own vehicle but simply would not feel comfortable or up to going long distances to Exeter or Plymouth. Those two reasons alone are sufficient to argue strongly that the last place where we should be looking to make cuts to acute services is at North Devon district hospital.

I am aware of the time, Mrs Main, so I will conclude. I welcome the fact that the Government are looking at the funding. I welcome the repeated assurances that local clinicians will make the final decisions. However, I want it to be in no doubt whatever—the community of North Devon are very clear about this—that North Devon is a special case and needs to be treated as such. In that regard, I make no apologies whatever for fighting for North Devon and for appealing for there to be common sense and no cuts at North Devon district hospital.

[Mrs Anne Main (in the Chair)]

We have approximately 35 minutes before the winding-up speeches and there are five speakers. I am sure we can do the maths.

Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 5th July 2016 Commons Chamber

[Mr Hunt]

I am more than happy to do so. In fact, we have a copy of the report right here, which my Minister of State has handily given to me. When I was shadow Minister for disabled people, I had a lot of contact with parents of autistic children and with people on the autistic spectrum themselves. The hon. Gentleman makes a very important point.

[Peter Heaton-Jones (North Devon) (Con)]

The maternity unit at North Devon district hospital in Barnstaple in my constituency is one of the services being reviewed under the current Success Regime. Can the Secretary of State reassure me and my constituents that maternity care, and the safety thereof in what is a geographically huge region, will be the first priority under this review?

[Mr Hunt]

I can absolutely assure my hon. Friend on that. I know there are very big national and global events happening right now, but I want to tell the House that over the next month one of my big priorities will be to do something to improve our record on maternity safety. We have made huge progress in reducing stillbirth rates and so on, but maternity safety is still not as good as it should be and certainly not as good as in other countries in western Europe. This is an absolute priority and I hope to be able to inform the House more on this before recess.

Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 10th May 2016 Commons Chamber

[Mr Hunt]

We are making sure that neighbouring hospitals have the resources to deal with the temporary closure of Chorley A&E. The more patients that any hospital sees, the more resources it gets. This is none the less a very worrying situation that we are monitoring very closely.

[Peter Heaton-Jones (North Devon) (Con)]

The success regime review in Devon is causing real concern about the future of acute services at North Devon District Hospital. Does the Minister recognise that the unique geographical circumstances of Barnstaple mean that the reduction of any of those services will, for some of my constituents, mean a round journey of more than 120 miles to access them?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I do recognise the unique geographical circumstances in my hon. Friend’s constituency. That is precisely why the success regime is being led by local clinicians. I hope and expect that in formulating plans they take account of all the views and all the clinical needs of his constituents and his own views.

Meningitis B Vaccine

Peter Heaton-Jones Excerpts

Monday 25th April 2016 Westminster Hall

[Peter Heaton-Jones (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate my hon. Friend the Member for Bath (Ben Howlett) and the Petitions Committee on securing this incredibly important debate. I also pay tribute to the many families and charities whose tireless work has been instrumental in bringing us to this stage.

Two months ago, I was visited at my surgery in the village of Braunton in North Devon by my constituents Anthony and Jodie Cross. Mr and Mrs Cross told me about their daughters, Millie and Lydia, who both contracted meningitis B as young children. Millie was seven months old when she suffered from the disease. She went to hospital and was successfully treated, but on the day she returned home from hospital, her sister Lydia, who was nearly three, became ill. As the illness tragically developed, both of Lydia’s legs were badly damaged by septicaemia and had to be amputated below the knee.

That was nearly 12 years ago. Lydia has gone on to become a remarkable young woman and, with her family, a doughty and brave campaigner. Nothing illustrates that better than Lydia’s own words. She wrote an article for my local newspaper, the North Devon Journal, in May 2014, when she was just 13 years of age. Her words sum up better than I could what a remarkable young woman she is and how she has fought this disease so bravely. She says,

“I became a double below knee amputee when I was two due to meningitis and septicaemia. Sometimes having a disability is really hard but then other times it doesn’t really bother me. People may not realise how everyday things that they take for granted are much harder for me to do. I love all sports but I do get upset when I can’t participate because my legs really hurt, or I have sores where they’ve rubbed. I started to really enjoy blade running but due to infections and needing the bones trimmed in my legs, I haven’t been able to do it for months now. Hopefully, soon though, I can get back to training with the North Devon Athletics Club…I can then get my blades altered with new sockets and really train and focus on hopefully going to the next Paralympics in Rio, where I’d like to compete in the 100 metres (fingers crossed). I’m desperate to get back to doing it again. It’s really annoying when you have the determination to do something but your ‘disability’ stops you.

I’ve probably had about seven bone trimming operations and my most recent one was about seven weeks ago. It’s painful, but more annoying because I can’t wear my prosthetic legs for about six to eight weeks afterwards. I’m also unable to attend school—Braunton Academy—during this time so I do a lot of school work at home, but I really miss seeing all my friends. I’ve got an amazing group of friends. They treat me just as Lydia (their mad friend), not a girl who’s an amputee and I love that. I’m happier when people don’t treat me differently because I’m only missing the bottom part of my legs and I’m just the same as any other teenager (loud, annoying, always sleeping in and very untidy)…

Even though I’m only 13, I’ve been able to have the most amazing opportunities, that I’m sure I wouldn’t have had if I hadn’t become an amputee. But the one I’m most proud of is being the youngest patron for Help For Heroes, which is such a huge honour. I’ve met many of our wounded heroes who have lost far more than me… and…are my inspiration and friends. Even though I’m a teenager and an amputee which makes me ‘different’, I still consider myself very lucky and I am definitely very happy. I’ve got an amazing family and friends and I wouldn’t change anything about my life because that’s what makes me ‘me’.”

I thought it was worth reading that quite extraordinary article to the House at some length, because it sums up better than I could why we are here today.

Clearly, this is a matter of huge public interest and concern. When Mr and Mrs Cross came to see me, they told me about the growing petition seeking an extension of the men B vaccine to all children up to the age of 11. Today, that petition has in excess of 820,000 signatures—the most received by any petition since the new process was launched. I agree with hon. Members that it is good that we have changed our procedures in the House to allow such a petition to be debated in this way.

In considering the matter today, it is of course important to put the medical and scientific evidence front and centre. We should base our decision on that and that alone. Our decision must be evidence-based, which is why I agree wholeheartedly with my hon. Friend the Member for Bath that we should ask the JCVI to conduct a thorough review of the medical evidence. It is an important principle that Ministers should not make what amount to clinical decisions. Most Ministers—indeed, most MPs—are not scientists or doctors, although there are notable and extremely respected exceptions to that rule in the Chamber today, to whom we have listened very carefully indeed. We must take account of the expertise and advice of the JCVI, which is why the right approach is to thoroughly review the scientific and medical evidence.

This Government have shown that they are willing to act on this issue. As we have heard, a men B immunisation programme for infants under the age of one was introduced in September 2015, in line with the JCVI’s recommendations. In addition, the Government have requested that the JCVI research the evidence for extending the men B vaccination programme up to the age of two. Those are both welcome steps, and I hope they show that we are pushing on an at least partially open door and that the Government are willing to listen. I know that the Minister is listening today, and I look forward to hearing her summing-up.

The elephant in the room is the cost, which has been referred to, and it cannot be ignored. There is only so much money available in the Department of Health budget—I made that very point two weeks ago in a debate in the House on the need for compensation for those affected by the contaminated blood scandal.

[Mrs Helen Grant]

On cost, does my hon. Friend agree that the earliest possible safe introduction—“safe” being the important word—of a competing product to Bexsero could help patient access by reducing market prices and increasing availability?

[Peter Heaton-Jones]

I thank my hon. Friend for that intervention. I was much taken by comments that two of my hon. Friends made about cost. My hon. Friend the Member for Bury North (Mr Nuttall) made a powerful point in suggesting that we should be looking elsewhere for contributions towards the funding—it should come from those who, frankly, have decided to do harm to themselves rather than from small children who are in no way to blame for the position in which they find themselves. My hon. Friend the Member for The Cotswolds (Geoffrey Clifton-Brown) said—I wrote this down, because I thought it was telling—that we should consider very carefully the cost of not vaccinating, and I am sure the Minister will have taken that important point on board.

Cost is an issue to consider, which is why it is important that we look at the scientific evidence and carefully take on board what the experts from the JCVI and elsewhere say about this issue, as I know we will. We need to get this matter dealt with soon, because time is of the essence. Families are being affected as we speak, in the same tragic way as, in North Devon, Mr and Mrs Cross and their daughters Millie and Lydia have been. Their bravery, selflessness and hard work in pushing this issue forward, along with that of many other families and campaigners, is the reason why we are here today. I say to the Minister that we should listen to them, and we must not let them down.

Contaminated Blood

Peter Heaton-Jones Excerpts

Tuesday 12th April 2016 Commons Chamber

[Peter Heaton-Jones (North Devon) (Con)]

I congratulate the hon. Member for Kingston upon Hull North (Diana Johnson) on securing this debate and on the valuable work that her all-party parliamentary group is doing in this area.

All Members, I am sure, receive a huge number of letters and emails from constituents, and hold face-to-face meetings with them on a huge range of issues. Just occasionally, an email arrives that has the power to stop us in our tracks, simply demanding the wider attention of the whole House. On 2 June last year, just four weeks after being elected to this place for the first time, I received just such an email. It came from my constituent Sue Threakall, from Barnstaple. Mrs Threakall is with us in the Gallery this afternoon, one of many who have travelled long distances to be here today. I pay tribute to them all.

With her permission and with the leave of the House, I would like to read a short extract from the email I received from Mrs Threakall, which sums up better than I could the real human impact of this national tragedy:

“my late husband was a haemophiliac who”,

in the 1980s,

“was given contaminated blood and…died in 1991 with AIDS, Hepatitis B and Hepatitis C. His death ripped my family apart and to this day the effects are still there.”

Her children lead

“compromised lives compared to the ones they should have led. I have severe financial difficulties to this day, despite doing everything possible to help myself recover from a wrecked career as a…teacher, followed by retirement at 50 on a tiny pension. Since then I have worked in hospitals, but following three major surgeries in seven years have now more or less retired.

I have been campaigning for thirty years for truth and justice”.

Those are two crucial elements that we must discuss today: truth and justice.

[Anna Turley (Redcar) (Lab/Co-op)]

I appreciate the hon. Gentleman’s generosity in giving way, and I share his concern about the impact on spouses. My constituent Mr Thomas Farrell was given 11 units of contaminated blood in 1989, and tested positive for hepatitis C nine years later. One of his biggest fears is that his wife will not have the security of knowing that she can pay the mortgage should he pass away before her. Does the hon. Gentleman agree with me that bereaved partners and spouses should have security and proper financial support for the rest of their life?

[Peter Heaton-Jones]

I absolutely agree that we must look beyond those whose are immediately affected personally by the health effects of contaminated blood, and take account of the effects on their wider families and loved ones. I shall say more about that later.

Truth and justice are what this is all about, and I believe that we have reached a stage at which we really could deliver both. The Government’s consultation is under way; the Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), Friend made her announcement in January; and there is now a groundswell of public opinion. Those three factors mean that we are at a crossroads, and we may never have this opportunity again. Campaigners acknowledge that since 2010, the Government have listened. We have made progress—more progress than we have made in the past.

This, however, is the position: the Government’s consultation is due to close in just three days’ time, and it is clear that there is still a great deal of unhappiness with the options on the table. The status quo—the existing scheme, with its confusing and inadequate provision—is not acceptable, but neither is the alternative, which would seem to fail to tackle the fundamental problem of fair financial provision both for those who received the contaminated blood and are living with the health consequences and, importantly, the families and loved ones who care for them or grieve for them.

We must be realistic. Like nearly every decision that we make in this place, this does in the end come down to money, and we know that money is tight. It would be unrealistic, indeed irresponsible, to stand here today and ask for a blank cheque to be written, or for funds to be taken from equally worthwhile projects elsewhere in the health budget. What I appeal for today from the Government—on behalf of my constituent, and other constituents who are with us—are two commodities that are perhaps even more precious: time and understanding. I ask for time for these people, including my constituent, to have their cases adequately heard by the Government, and not to be bounced into accepting one of two options, neither of which they believe to be fair or adequate.

[Mike Kane (Wythenshawe and Sale East) (Lab)]

The hon. Gentleman is making a very powerful speech on behalf of his constituent. Does he agree that it would be a tragedy if, at the end of the consultation, some of the victims were worse off as a result of it?

[Peter Heaton-Jones]

None of us, of course, would want that. We must wait to hear what the Minister says at the end of the debate, but I am sure that we are all aiming for the same result. The least that the people who have fought so hard for truth and justice deserve is a fair hearing, but for many, time is running out. They find themselves in the heartbreaking position of facing the inevitable health consequences of what was, after all, an historical failure of the national health service.

[Rebecca Pow]

I, too, massively applaud the work of the all-party parliamentary group, which has been working for so long. My hon. Friend has mentioned time. I have just received a text from one of my constituents, who does not want to be named, but who points out that the stark reality is that those infected are dying at the rate of one a month. For these people, time really is of the essence.

[Peter Heaton-Jones]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I believe that there was an informal time limit of seven minutes, and the hon. Gentleman has a minute to go. If we cannot get it down to six minutes, I will have to impose a formal time limit, which I do not want to do.

[Peter Heaton-Jones]

I understand, Mr Deputy Speaker; thank you.

My hon. Friend the Member for Taunton Deane (Rebecca Pow) makes the perfectly reasonable point that time is running out, and that these people find themselves in an impossible position. I do not seek to extend this process unnecessarily, but the 15 April deadline cannot and must not be the end of the story. It cannot be a deadline after which a decision is simply handed down. Let us give a proper, respectful hearing to those who believe that an injustice is about to be done, and let us try to put this right.

I also said that we needed understanding. These events have devastated the lives of many people, including my constituent, Sue Threakall. I shall end as I began, by quoting her words in an email. She says:

“At the moment I haven’t the slightest idea how I will be able to manage and am in complete despair. Over the last week it has occurred to me several times that after fighting this for over three decades…I really don’t want to carry on.”

I say to my constituent and to the other campaigners who are with us today: do carry on, and do keep telling us what we need to know. As my hon. Friend the Member for Norwich North (Chloe Smith), who has just left her place, said, it is by hearing the true life stories of those who have been affected that my hon. Friend the Minister, who I know is listening, will be able to take very careful note. Let us do all we can to deliver what my constituent and many thousands of others want and deserve: truth, fairness and justice.

Junior Doctors: Industrial Action

Peter Heaton-Jones Excerpts

Thursday 24th March 2016 Commons Chamber

[Ben Gummer]

I have had this discussion with the hon. Gentleman before, and he is wrong. The Review Body on Doctors’ and Dentists’ Remuneration carefully considered this issue, and its proposals for Saturday pay for junior doctors were improved on by the Government unilaterally. We made a better offer than that in the review body’s independent report, which studied other comparable professions. This comes back to a question for the hon. Gentleman: will he really turn down better terms for junior doctors, in both term and number, than those for Agenda for Change unions? If so, that is a very sad thing for the Labour party.

[Peter Heaton-Jones (North Devon) (Con)]

Does the Minister agree that the most important people in this are the patients? They should be at the forefront of our mind, and it is for their sake that this wholly unnecessary escalation of action must come to an end.

[Ben Gummer]

I agree wholeheartedly with my hon. Friend, which is why it would be helpful to have an unequivocal condemnation of the strike from the Labour party, which would send a message from this House that the withdrawal of emergency care is wrong.