Hepatitis C

Debate between Steve Brine and David Amess

Tuesday 12th June 2018 Westminster Hall

[Sir David Amess]

My hon. Friend was a Health Minister and has real expertise in this area. I shall use the expression “joined-up government”. He is absolutely right that we need Departments to work together. That is why it was so good that we visited the prison.

[The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)]

I may be able to help my hon. Friend here. As he knows, the drug strategy board is a cross-government committee. It met yesterday, chaired by the Home Secretary, and its members include the Justice Secretary, Health Ministers, Home Office Ministers, Housing, Communities and Local Government Ministers and representatives from the Department for Work and Pensions, as well as senior police officers, representatives from the National Crime Agency and a representative of the police and crime commissioners. That board takes that cross-government look, and hepatitis C is certainly an issue I would like to see it look at.

[Sir David Amess]

That is excellent news. I thank my hon. Friend for that positive response to looking at this issue.

The testing and treatments initiatives in place will lead to a decline in the prevalence of the disease. However, prevention will come from identifying and educating at-risk groups. To do that, we need the help of substance misuse services, sexual health clinics and peer programmes that can educate those most vulnerable sections of society on the transmission of the virus. I am advised that these services are at risk of closure without sufficient increases in their funding. Perhaps the Minister will have some news on that when he replies.

Harm reduction is another paramount mode of prevention. If we can reduce the harm to at-risk groups, we can combat one way in which the disease is transmitted. That can be achieved by providing clean and sterilised injecting equipment. Our report also emphasises the treatment-as-prevention approach towards tackling newer infections. That approach has been successful in treating drug users and other users engaging in riskier behaviours to prevent the spread of hepatitis C.

As I said earlier, between 40% and 50% of people living with hepatitis C in England are undiagnosed, which is shocking. It is therefore vital that we continue to increase testing and diagnosis levels. It is generally believed that the vast majority of those who have been diagnosed and put in touch with support services have now been treated, which I welcome. The challenge is therefore to locate those people who remain undiagnosed. That is a tricky one; it will be a real challenge.

Southend Hospital

Debate between Steve Brine and David Amess

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

I will, Madam Deputy Speaker. I could feel you bristling at the length of the intervention. I can assure my hon. Friend that none of the options being considered includes the closure of any of the three A&Es, and all will continue to provide emergency care 24 hours a day, seven days a week.

I was mentioning the work of the Mid and South Essex STP, which was published in November 2016 as part of the work to ensure that there are sustainable services in mid and south Essex. There is now a major workstream looking at service configuration across the three hospital sites. Work led by clinicians in 2016 arrived at five possible future configurations for consolidated specialist services across the three hospitals. As well as providing the majority of routine hospital care for its local population, each hospital site would provide some centralised specialist services.

Let me briefly outline the current thinking as it has been set out to me. Southend hospital will continue, as I have said, to provide substantial emergency services 24 hours a day, seven days a week. In addition, it will be a centre of excellence, as my hon. Friend the Member for Southend West rightly said, for planned care, alongside its already well-established cancer centre and radiotherapy services. Basildon hospital will provide enhanced specialist emergency care—for example, specialising in the total management of major life-threatening illness. Broomfield Hospital in Chelmsford will provide a combination of specialist emergency and planned care, with the potential to provide a specialist centre for children. I have to emphasise that these ideas are being further developed by the clinical groups as we speak. No single preferred option for consultation has been arrived at.

Let me now turn to the proposals for emergency care. It is important to note, and I wish to reiterate, that in all potential options for hospital reconfiguration currently being discussed, Southend hospital would continue to provide emergency services 24/7. An options appraisal process was held earlier this year involving clinicians, stakeholders and local people. The higher-scoring options listed one hospital as the provider of specialist emergency care. Basildon was identified as the better location for that. Southend and Chelmsford would continue to provide emergency services, but they would be less specialised than Basildon. Southend would instead specialise in planned care, cancer and radiotherapy, building on the excellent work already being done at the hospital. There would be separate units specially designed to give fast access to assessment and care for older and frail people, children and people who may need emergency surgery. In some cases, that could include an overnight stay, if necessary. Those units would involve both health and social care so that patients could return home as quickly as possible with any continuing support and treatment that they may need.

The potential services in the A&E and assessment units at Southend would be able to respond to a range of emergency needs, some of which could be initiated by a 999 call and may involve an ambulance. The possibility of Basildon hospital being the provider of specialist and complex emergency care has benefits for local patients. It would have several teams of specialists ready to provide immediate access to state-of-the art scans and treatments around the clock, which is not always possible in the current three general hospital A&Es.

I also understand that the practice of taking patients by ambulance from Southend to a specialist centre is already established. For example, people who suffer an acute heart attack in Southend are currently taken by ambulance to the Essex cardiothoracic centre—that was easy for me to say—in Basildon. I have been advised that that arrangement has been in place for many years. Separating some of the major emergency work in that way releases capacity and resources for planned surgery and other treatments.

For the local NHS, new centres of excellence across the hospital group in both planned and emergency care have the potential to compete with the best in the country to attract high-calibre staff and bring the best of modern and world healthcare to mid and south Essex. I emphasise that in all options currently under discussion, about 95% of hospital visits would remain local at each hospital.

As I have stated previously, the programme is currently under discussion and I am advised that the aim is to launch a full public consultation at the end of the year at the earliest, centring on a single preferred option. The public consultation will explore in detail the benefits and implications of the proposals and will inform plans for implementation. Engagement with staff and local people will continue to influence and refine plans at every stage. That is a key principle, as I have said, in local reconfiguration of services, and it has to be right that the process is guided by those who know and understand the local area best.

In conclusion, as a constituency MP I completely appreciate the concerns of my hon. Friend the Member for Southend West, whom I again commend for his work.

[Sir David Amess]

I should have said in my speech that all my literature had headlines such as, “David pledges support for 24/7 A&E service”. I felt that I was not believed, so it is good that my hon. Friend has repeated that we will have 24/7 care. Finally, given that morale at the hospital has been ruined over the past few weeks, it would be great if we could have a ministerial visit at some stage, perhaps even from the Secretary of State.

[Steve Brine]

I thank my hon. Friend for that offer and will pass it on to the Secretary of State, although I am not entirely sure whether he or any of his Ministers can compete with royalty.

In the 30 seconds I have left, I commend my hon. Friend for his work on those issues affecting his constituents. He is a doughty champion for them. I think they do believe him, because they re-elected him admirably just a few weeks ago. I encourage both him and his constituents to maintain an open dialogue with the local NHS, as I know they will, especially during the pre-consultation and consultation phase, and reassure him that Southend A&E will continue to provide substantial A&E services.

Question put and agreed to.