Stafford Hospital

Aidan Burley Excerpts

Friday 7th November 2014 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

It is a great pleasure to see the Under-Secretary of State for Health, my hon. Friend the Member for Mid Norfolk (George Freeman) back in his place this afternoon. I apologise for bringing him back to the House. In fact, I do not apologise, because this is a matter of great importance and I know that he shares my interest in it and my concerns.

On the first day of this month, Stafford hospital, now the County hospital, became part of the University Hospitals of North Midlands Trust together with the Royal Stoke University Hospital. The Mid Staffordshire Trust which had run Stafford and Cannock Chase hospitals was dissolved. I wish to speak first about the new arrangements, secondly about the transition and finally about the services that I and my constituents strongly contend are needed in Stafford. I welcome the coming together of our hospital into the larger university trust. I am also very pleased that Cannock Chase hospital will continue to offer an important service as part of the Royal Wolverhampton Hospitals NHS Trust.

[Mr Aidan Burley (Cannock Chase) (Con)]

I congratulate my hon. Friend on securing the debate and on his herculean efforts to support his local hospital. I have no doubt that those efforts will be rewarded at the next general election by his constituents. He has mentioned Cannock Chase hospital. Does he agree that it is important, in this transition phase, that all the services currently provided at Cannock should remain there and be increased and improved as we move towards the new model of ownership under the Royal Wolverhampton Hospitals NHS Trust? Will he also join me in congratulating the new Conservative candidate for Cannock Chase, Amanda Milling, on all her campaigning efforts to ensure that those services stay at Cannock?

[Jeremy Lefroy]

I am most grateful to my hon. Friend for fighting alongside me for the preservation of the Stafford and Cannock hospitals. We said at the time that there was not a cigarette paper between us because, when people were saying that one or other of the hospitals should close, we said, “Absolutely not. Both are essential for our communities.” I thank him for that work.

Stafford becoming part of a university hospitals trust brings many opportunities for patient services, for staff training and development and for the NHS in my constituency. The same opportunities will now be available to Cannock Chase hospital under its new arrangements in the Royal Wolverhampton Hospitals NHS Trust. Our hospital will receive substantial capital investment, resulting in refurbished theatres and wards, chemotherapy and dialysis wards and a larger accident and emergency department.

After the tragic events examined by Sir Robert Francis in his two reports, there has been a great deal of improvement at Stafford. That is not in any way to be complacent, but it is a measure of the hard work of the staff, under Antony Sumara, Lyn Hill-Tout and Maggie Oldham as chief executives, and the chairs, Sir Stephen Moss and Professor John Caldwell. I also pay tribute to the governors and directors of the trust, who have put in so much time and effort in these difficult times. However, the staff must receive the most credit. They have worked tirelessly, under great strain and tremendous scrutiny, to provide excellent care. With so much focus, and rightly so, on our NHS, it would be easy for people to walk away from serving in difficult situations, but most in Stafford have not done so. They wish to serve our community through thick and thin, without much recognition and sometimes facing criticism.

In the past few years, I have heard several predictions about Stafford hospital: that it would close; that it would be privatised; and that it would become a “cottage” hospital. None of those has come to pass. Through the determined efforts of staff and the local community, in particular, through the hard work of the Support Stafford Hospital group and others, and their representatives, we have shown the Government and the NHS that a district general hospital can and must thrive in Stafford, retaining accident and emergency and acute services. As a result, we will see unprecedented investment in Stafford, funded not through an expensive private finance initiative, but directly by the NHS, with refurbished theatres and many other things that I have already described. That is in addition to the new endoscopy unit, which I visited just two weeks ago. It is three times the size of the old one, which I experienced as a patient, with state-of-the-art equipment, and it was designed in full co-operation with the staff.

The investment we are receiving is much greater than was originally proposed; and I wish to pay tribute to the work of all involved in making the case: the University hospital of north Staffordshire, the trust special administrators and Mid Staffs. I have gone on record before, and will continue to do so, about the grave shortcomings of the TSA process, which I would wish on no one in its current form, but the TSAs did fight the corner for Stafford and Cannock, and achieved more than at one stage had seemed possible. The Prime Minister, the Secretary of State and Ministers at the Department of Health have also been extraordinarily supportive, even when being bombarded by e-mails, letters and demands for meetings from me, my hon. Friend the Member for Cannock Chase (Mr Burley) and other parliamentary and council colleagues from around Staffordshire.

The transition period is critical and presents many risks. We have been assured that no service will be moved from the County hospital, Stafford to the Royal Stoke, or indeed from Cannock to Wolverhampton, until it is safe to do so. That means that there should be not just sufficient capacity at the Royal Stoke or Royal Wolverhampton to receive patients, but adequate ambulance capacity to deal with many more patient journeys. I understand that emergency surgery and consultant-led maternity services are likely to be transferred early in 2015, possibly in January. In order for that to happen, we need firm assurances from the hospitals that the capacity is in place and from the West Midlands ambulance service that it will be able to cope with the additional journeys. We have been assured by the University Hospitals of North Midlands NHS Trust that a “double lock” will be put in place to ensure that, first, staff and management and, secondly, an outside independent body, including the clinical commissioning groups, approve any transfer of services and say it is safe for patients. The double lock is essential to public confidence in the process, especially the independence of the independent review—it is vital that we get it right.

The Royal Stoke university hospital’s A and E department has been at level 4— the highest alert—because of bed shortages, several times in the past few weeks. The main reason is that patients cannot be transferred out as there are insufficient step-down and community beds, or social care places. The additional acute beds being added at Stoke are welcome; but they will need to be operating before any service transfer happens. The problems with transfers out will also have to be dealt with. The board papers for the Stafford & Surrounds CCG meeting on 21 October show that the ambulance red 2 indicator—category A calls resulting in an emergency response within eight minutes—for the year to date is at 69.7% against the standard of 75%, and has been below the standard in each month since September 2013. The red 1 indicator has improved in August, but is at 66.7% for the year to date—again, that is against a standard of 75%. Will the Minister confirm what additional vehicles and paramedics the West Midlands ambulance service will have to ensure not only that it can bring its performance up to standard, but that it will be able to deal with extra journeys arising from the transfer of some services away from Stafford? Will he also confirm how closely the Trust Development Authority, to which the University Hospitals of North Midlands NHS Trust is accountable, is monitoring the transition period as County hospital, Stafford becomes part of the expanded trust? What support is the TDA giving to the University Hospitals of North Midlands to cope with any unexpected eventualities in the transition?

Finally, will the Minister also confirm that all the clinical commissioning groups in the area served by UHNM will be supported, too? Some of them, including Stafford and Cannock, face substantial underlying deficits of several million pounds per annum arising from what can only be described as unfair funding formulae. They are working hard to become ever more efficient, but what has been asked of them is almost impossible.

The transition period, which will last up to three years, is therefore extremely challenging. We have a newly expanded trust that is in deficit, an ambulance service that is failing to meet its current red 1 and red 2 targets, and CCGs that are underfunded. I firmly believe that we will succeed in seeing a stronger acute trust in Stoke and Stafford at the end of this, but the problems that I have set out must be addressed.

Finally, I turn to future services at the County hospital, Stafford. As a result of the campaign that we have all fought locally, the vast majority of services will remain. It is estimated that 91% of patient attendances will still take place there, as there will be an A and E department and in-patient beds for acute medical patients. But there are areas in which I will continue to make the case for improved services. The first is to return the A and E department to a 24/7 operation. Even now, staff are attending to patients up until the early hours of the morning. It would not take a great deal to extend the cover so that the A and E can remain open between 10 pm and 8 am.

I have heard of a number of cases of elderly patients who are so concerned about travelling what they see as a long distance, away from their friends and family, that even in emergencies they resist travelling, preferring to wait until the A and E in Stafford opens at 8 am. One such case in particular had tragic consequences.

There is welcome news that a doctor-led overnight service is likely to open early in 2015 at the County hospital, Stafford. That should enable those with non-999 emergencies, including those involving children, to receive advice and some treatment locally. But I see it as a stepping stone back to the service that my constituents need, which is a 24/7 A and E department.

I will also continue to argue for A and E services for children, with the ability to keep them in hospital for a period until they are ready either to return home or to be transferred to a specialist unit. It is vital that, wherever possible, children above all are treated near to or at home—close to their family and friends. It cannot make sense for a parent, who has other children and possibly no private transport, to have to arrange child care and undertake a round trip of perhaps three to four hours by public transport to visit a child who is in hospital but who does not need the most specialist care. I urge the Department of Health and the Royal College of Paediatricians and Child Health to look closely at that matter.

The in-patient paediatrics department in Stafford is not one of the smallest in the country, yet it will go next year, despite the fact that the cost per child is significantly lower than that at surrounding hospitals where they will now be sent. Will that really be the way forward for many other such departments? Surely there is a way to rethink in-patient care for children who do not need specialist treatment and who are likely to be in hospital for only a short period. At the very least, a 24/7 A and E department with a paediatric assessment unit staffed by paediatrically trained consultants would make sense.

Finally, there is the question of consultant-led maternity services. Originally the TSA proposed removing all births from Stafford. As a result of our campaign, it changed that proposal, and our hospital will remain with a midwife-led unit. When the Secretary of State announced that there would also be an NHS England-led review into the possibility of retaining consultant-led services at Stafford, we welcomed it. Stafford’s unit is small, but it is by no means the smallest in England. We contend that, in a network with the larger unit at Royal Stoke university hospital, it should be possible to maintain our unit and thus offer women who need obstetrician-led care the choice of giving birth in a smaller unit, as they do in most other European countries. When it comes to maternity services, I will continue to argue that big is not always better.

The review that was promised has not yet started, although I understand it will happen soon, but it will report after our consultant-led unit has closed. I would like an undertaking from the Minister that if the review recommends that smaller units such as ours should remain, it will reopen at Stafford and the resources will be made available for that.

I should also like the Minister to confirm when the review will begin, who will be doing it and how long it is likely to take. It is also essential that the review of Stafford and surrounding services only takes place first, and as soon as possible, to be followed by a national review coming later. The last thing that the expectant mothers of Stafford need is a long drawn-out process. I was promised a review, as were we all, of Stafford’s maternity in this House, and I should be grateful for the Minister’s confirmation that the commitment stands.

Maternity services, I believe, need to be commissioned more widely than just by CCGs. Government policy is to give women a good choice as to where they have their baby, and I welcome that, but CCGs in places like Stafford are too small to support the commissioning of a local unit. The original intention, I believe, in the run-up to the Health and Social Care Act 2012, was for maternity services to be commissioned by NHS England, not CCGs. That would allow the development of a proper national policy of choice for women, and I would ask the Minister to consider that very carefully.

In Stafford, great progress has been made in recent years. I am determined to do all I can to ensure that we, together with the Royal Stoke university hospital, have one of the finest acute trusts in the country. The retention of the County hospital, Stafford as a district general hospital with acute services and accident and emergency gives us the chance to show that a local acute hospital is not an outmoded institution which, as it was predicted only a few years ago, would soon be extinct. Instead, we can become a prime example of a thriving local acute hospital for the future.