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.

Francis Report

Aidan Burley Excerpts

Wednesday 5th March 2014 Commons Chamber

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

It is a pleasure to follow the right hon. Member for Cynon Valley (Ann Clwyd). I, too, pay tribute to her work in championing patients. The calm silence with which the House listened to her speech speaks volumes, as do the many nods of heads of colleagues around the Chamber.

I declare an interest, as my local hospital, Cannock Chase, is the other hospital in the Mid Staffs trust, so my constituents, like those of my hon. Friend the Member for Stafford (Jeremy Lefroy), have been deeply affected by the fall-out from Mid Staffs and the Francis report. I echo some the comments that have been made: I would not wish a public inquiry or trust special administration on any Member of Parliament, as it is an horrendously long drawn-out process and incredibly stressful for everyone involved, not least the patients who use the hospitals affected and the staff who work in them. However, the outcome is worth it, as today’s debate shows it was, if we learn the right lessons,.

I praise the staff at both Stafford and Cannock Chase hospitals for getting on with the job even when they are not sure what the future will be. I urge the Minister once more to move to the new organisational structure, with Royal Wolverhampton Hospitals NHS Trust running Cannock Chase and University Hospital of North Staffordshire NHS Trust running Stafford, as soon as possible to end the insecurity that the staff at both hospitals have suffered for too long.

[Andy Burnham]

I am grateful to the hon. Gentleman for giving way so early in his speech, to which I am listening carefully. He says that the TSA process was worth it. May I press him on that? Does he really think that that was ever going to deliver a fair outcome for his local hospital, given that it followed a three-year public inquiry and the hospital lost patients and staff as a result? In the spirit of the call made by the hon. Member for Stafford (Jeremy Lefroy), should we not all unite to recognise the exceptional circumstances that the local trust has been through? Is it not the case that a TSA process could never capture the exceptional nature of what has happened to the local health economy and, in fact, it looked narrowly at the trust’s finances and sustainability? Should we not call on the Government to look at that?

[Mr Burley]

The right hon. Gentleman asks a number of questions. I am still not clear about his position and whether he thinks that the public inquiry was the right decision or not. The inquiry led to recommendations and the improvements we have seen. To answer his question about whether “the TSA process was worth it”—that was the phrase he used—as we speak in the Chamber today, my local hospital is 50% empty. Cannock Chase hospital was run down by the management of Mid Staffs to near closure, and half of it lies empty. Any building that is half empty has a sword of Damocles hanging over it, and no one from the Opposition complained locally as services were slowly stripped out by stealth over the past 10 years. As a result of the TSA process, Royal Wolverhampton Hospitals NHS Trust will take over running of Cannock hospital, increase utilisation from 50% to 100%, and invest £20 million in refurbishing it. That shows that the TSA process has been fantastic from a Cannock Chase perspective, even though it has been a stressful and drawn-out process.

I praise my hon. Friend the Member for Stafford for his tireless work on this issue and for his technical and clinical knowledge of local services, which is second to none in the House. His campaigning has led us a long way from the point at which A and E, maternity and paediatrics would all be closed, which is a hell of a legacy of public service to the people of Stafford who, I am sure, will return him at the next election for a second term—one which I hope is not dominated by the issue of Stafford hospital, as his first term has been.

As we know, the Government introduced measures in the Care Bill as their legislative response to the Francis inquiry. Those measures include the introduction of Ofsted-style ratings for hospitals and care homes, creating a single regime to deal with financial and care failures at NHS hospitals, introducing a duty of candour, and making it a criminal offence for care providers to give false and misleading information about their performance. It may surprise many that those measures do not already exist. Local parents in my constituency send their children to schools in Cannock that have an Ofsted rating, and they can speak to teachers about any documented problems in the school. Those same parents take their elderly relatives to Stafford hospital and are surprised when they receive appalling care—indeed, some even die suddenly—because there is simply no clear ranking of how that hospital is performing as there is for their children’s school.

Worse still, nursing management and staff had actively been covering up the problems. As we have seen locally, the events at Mid Staffs clearly demonstrate that a culture had been allowed to develop in the NHS in which defensiveness and secrecy were put ahead of patient care. Think about that for a moment: they were put ahead of patient care. In the 21st century, is that not a damning indictment of an institution that was set up to improve the health of its people, but has been encouraged over the years to protect itself and its reputation more than the people it exists to serve? I think that all Members should reflect on that before rushing to defend the reputation of the NHS. We should remember why the NHS exists: to serve the patients, not itself or any political party.

In the time available, I want to talk about two things: prioritising the patient experience and the TSA process. Before doing so, I think that it is worth remembering how we got to this point today. Macmillan Cancer Support’s briefing for this debate, which the hon. Member for Stoke-on-Trent South (Robert Flello) has already quoted, gets it spot on:

“The failure at Mid Staffordshire NHS Foundation Trust to put patients and their priorities at the centre of their work was a key finding from Robert Francis’ report… In particular, the report found that the trust prioritised its finances and Foundation Trust application over providing a high quality of care that put patients first.”

To quote a source that we on the Government side of the House all read regularly, the World Socialist Web Site:

“Under the 1997-2010 Labour government, Stafford was pressured to transform into a Foundation Trust—an initiative aimed at making hospitals semi-independent of the Department of Health by ‘freeing’ them to find private funding sources. In the process, £10 million was cut from the Trust’s budget and 150 jobs lost, leading to nursing staff shortages, overwork and the inability to provide a high-quality service to vulnerable patients. Any excess deaths at the hospital must be attributed to this shift.”

[Mr Cash]

Does my hon. Friend recall—it might be difficult for him as he was not a Member of the House at the time, but perhaps he can refer to previous documents—that when the meeting on granting trust status took place, the then head of Monitor, William Moyes, asked the trust a series of 48 questions, of which 39 were about finance? In other words, that was the priority at the time. That is where things were going badly wrong.

[Mr Burley]

I am grateful to my hon. Friend, who has a longer history in this House than I do, and indeed a longer future. He is right that finance was put far above patient care. People in Staffordshire are still astonished that the trust was ever granted FT status. I asked Robert Francis himself, and he said that he had no idea how, in the climate my hon. Friend has just described, that failing trust, which was bankrupt at the time, was able to shed staff for no clinical reason at all in order to achieve FT status, and that FT status was granted while all those problems were lurking beneath the surface. I would welcome any intervention from an Opposition Member to say why that was signed off.

The Conservatives are not alone in saying that Labour created a culture of targets in the NHS that led to thousands of unnecessary deaths at Mid Staffordshire hospital. It is also being said by the World Socialist Web Site and by independent charities such as Macmillan Cancer Support, which says that the trust prioritised its FT application over providing high-quality care that put patients first. Let us be clear what that means. The management of the Mid Staffs trust shed 150 nurses, many of them my constituents; it sacked them from their jobs, which were clearly vital, given the appalling care that followed, simply to hit financial targets. Those financial targets were not due to budget constraints—to be fair to the previous Labour Government, they did not reduce the NHS budget in Staffordshire. The job cuts were made deliberately to meet an aspirational organisational form. What a strange position to arrive at in the 21st century, where management think that it is acceptable to shed necessary nursing jobs simply to achieve an organisational form, as though that is in some way more important than serving the health needs of patients.

The Francis report is so important because it states for the first time: that the patient, not a foundation trust application, should come first; that there should be a statutory duty of candour, rather than a culture of cover-up; that feedback from patients should be valued and listened to, not ignored, as was the case in Stafford; and that hospitals should be rated, as Ofsted rates schools, and publicly assessed so that patients can make informed choices about their care.

The figures show that NHS care has changed for the better just one year on from the Francis inquiry. The 14 hospitals now in special measures are slowly being turned around, with 650 extra nurses and nursing assistants hired, strong leaders installed and 49 board-level managers replaced. Some 2,400 extra hospital nurses have been hired. Since May 2010, 3,300 more nurses and 6,000 more clinical staff are working on NHS hospital wards overall and—this is the crucial figure—nearly 1.6 million patients have given direct feedback on what they thought about their treatment through the friends and family test.

There is clearly a shift of priorities going on within the NHS, which is to be welcomed, but it would never have happened were it not for the Francis inquiry—an inquiry, of course, that would never have happened under the previous Government. I repeat my earlier point about the importance of not protecting the reputation of the NHS as an institution, but above all else focusing on the care of the patients that it exists to serve.

Mid Staffordshire NHS Foundation Trust

Aidan Burley Excerpts

Tuesday 7th January 2014 Westminster Hall

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

I congratulate my hon. Friend on securing this debate. I do not think that any other hon. Member has had to deal with a local hospital issue as all consuming and difficult as the one in Stafford. I congratulate him, on behalf of everyone, on his tireless dedication to getting the best deal for his constituents.

My hon. Friend mentions Cannock Chase hospital, in my constituency—the other hospital run by Mid Staffordshire NHS Foundation Trust—which will be taken over by Wolverhampton as part of the administration process. I welcome the abolition of that trust, which left my hospital 50% empty and which, even as we speak today, has just closed Littleton ward, to decant nurses to Stafford to try to shore up the hospital there.

Does my hon. Friend agree that we cannot wait until later—until sometime this year; perhaps even the back end of the year—for Wolverhampton to take over running Cannock and for UHNS to take over running Stafford, and that we need to move to the new organisational structure as soon as possible? I mean weeks, not months, so that both of our hospitals can have a secure future and the staff can know that their jobs are safe.

[Jeremy Lefroy]

I agree. I welcome my hon. Friend’s huge support, both for Stafford and Cannock, throughout this process.

Mid Staffordshire NHS Foundation Trust

Aidan Burley Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

We have set up a new inspection regime with a new chief inspector of hospitals under the Care Quality Commission. The CQC will look at the figures that are published every month on a trust-by-trust basis, alongside other safety data such as MRSA rates, bedsore rates, numbers of complaints, and other information that is crucial to its decisions. It is then its absolute duty and responsibility to swoop quickly if it thinks there is any cause for concern.

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

We now know that poor care was allowed to continue at Mid Staffs because staff were simply too afraid to speak out and, if they did, they were ignored or, worse, their careers were threatened. The high death rates at Stafford hospital were not taken seriously enough at the time and were merely explained away rather than used as an alarm signal that should have triggered further investigations. There was clearly a culture of fear among NHS staff, many of whom witnessed the appalling care of my constituents. Will my right hon. Friend make it his legacy to instil a culture of candour and openness in the NHS whereby concerns are acted on and high standardised mortality ratios are no longer brushed under the carpet to protect the NHS’s reputation but are instead properly investigated so that patient safety finally comes first?

[Mr Hunt]

My hon. Friend is absolutely right. These problems of high mortality rates date back very many years, and nothing, or too little, was done to sort them out. We must therefore make sure that we have a system where that cannot happen. Concealing poor care does not protect the reputation of the NHS, because in the end it gets out and destroys public confidence. I hope his constituents will feel that today’s announcements will create a new culture of openness and transparency that gives them confidence, so that if these awful things were ever to happen again—we hope they do not—we would find out quickly and action would be taken.

Stafford Hospital

Aidan Burley Excerpts

Thursday 4th July 2013 Commons Chamber

[Jeremy Lefroy]

I entirely agree with my hon. Friend. Many people, including those with more experience of these matters than I have, have said the same.

The coincidence of the publication of the Francis report—which was commissioned by my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), whom I am glad to see in his place—and Monitor’s contingency planning team report into the future of services at Stafford and Cannock was, I have to say, unfortunate. Both organisations were running to independent timetables, but the coincidence gave rise to the incorrect impression that the proposed downgrading of services at Stafford was somehow the direct consequence of the failures in care until 2009. Let us be absolutely clear: it is not. In fact, the financial problems of the trust are long standing. It should never have been granted foundation trust status by Monitor back in 2008.

However, the impression that exposing poor care somehow resulted in threats to services had a double effect. First, blame was completely unjustifiably put on those who spoke out. Secondly, the impression was given that if people speak out in future anywhere else, local services might be at risk. The result is that Stafford has experienced ups and downs in the last few months. They include the wonderful coming together of a community of all ages and a group supporting the services at the hospital working across the political divide. Sadly, however, we have also seen cases of threatening behaviour against Julie Bailey and members of Cure the NHS, who courageously brought the serious problems at Stafford to light. I will not mince my words: it has been heartbreaking to hear people—good people, with the welfare of the community at heart—on opposite sides of an argument that should never have happened.

At the same time, hundreds of people in the community have put in a huge amount of time and effort to support Stafford hospital. I want to mention some by name. They include Sue Hawkins, Cheryl Porter, Karen Howell, Brian Henderson, Diana Smith, James Cantrill, Chris Thomas, James Nixon, Councillors Mike Heenan, Rowan Draper and Ann Edgeller, and Ken Lownds—who has put in a huge amount of expert work—together with my hon. Friends the Members for Stone (Mr Cash), for Cannock Chase (Mr Burley) and for South Staffordshire (Gavin Williamson).

But I wish to focus on the future, and I am going to concentrate on Stafford hospital although Cannock, too, is vital. Stafford is one of the many small district general hospitals up and down the country that play a vital part in our emergency and acute infrastructure. The number of acute beds has fallen substantially in the past 20 years, including in Staffordshire. The new PFI-funded hospital that opened recently in Stoke has 250 fewer beds than its predecessor, although it is none the less a wonderful hospital. We all welcome the fact that the length of hospital stays has fallen sharply, to an average of less than four days, but a report from the Royal College of Physicians published last year pointed out that there is little room for further reduction. Indeed, as the population begins to age, the average length of stay might start to creep up again.

The only way to manage acute beds, even at the current capacity, is to ensure that people do not have to be admitted in the first place. I am sure that we all want to see that happen, but it will depend on expanded community provision and the better integration of health and social care. That will happen, but it is not happening yet. Even when it does, my firm belief is that although it might halt the increase in demand for acute services, it will not reduce it at this time of a rising and ageing population. The Government are listening to experts who say that we need substantially increased rail capacity by 2035, so I am sure that they will also listen to the experts who say that we cannot cut any further the local and regional capacity for emergency, acute and maternity care. I say to Monitor and to the Government that Stafford is ready to be a national leader in such integration, with patients and the provision of the highest quality of care put first. However, that demands time and co-operation.

The first element of co-operation involves a larger acute trust. In the case of Stafford, the obvious partner is the University Hospital of North Staffordshire in Stoke. Working with UHNS as one team will bring advantages to both hospitals and both communities. For Stafford, the chance to become part of a university hospital will be an exciting prospect. We already welcome third, fourth and fifth-year medical students from Keele university medical school, and they report that they value the experience of working in a busy district general hospital. For the clinical staff at Stafford and at Stoke, the chance to work as a much bigger team across two sites would bring greater opportunities for them to develop their skills and experience. Frankly, for Stafford, it would also ensure that there was much less chance of a return to the complacent culture of the past that the Francis report identified as a major problem in parts of the hospital. For Stoke, which is already under considerable pressure as a result of the reduction in beds and has had to reopen up to 100 old ones, coming together with Stafford would offer welcome additional capacity. It would also create a larger catchment area, which would make some specialties that are currently marginal at Stoke much more viable.

But this would not be easy, as UHNS also has a substantial deficit and a PFI cost that is frankly unsustainable. I urge the Government to do everything within their power to cut the cost of UHNS’s PFI so that the 750,000 and more people who would rely on a combined major acute trust—whether in Stoke, Newcastle-under-Lyme, Leek Stafford, Cannock or further afield—can continue to have access to services delivered as locally as possible.

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

I congratulate my hon. Friend on securing this timely debate as we await the final report from Monitor at the end of this month. We must oppose any serious downgrading of Stafford hospital, but the other hospital that was poorly managed by the former Mid Staffordshire NHS Foundation Trust was Cannock Chase hospital, which has been mismanaged to the point that 50% of its hospital buildings are currently lying empty. There is therefore a threat to its future. Does my hon. Friend agree that any solution provided in the report at the end of the month must involve Cannock hospital being fully utilised, and Stafford hospital not being downgraded?

[Jeremy Lefroy]

I entirely agree with my hon. Friend, and I congratulate him on the huge amount of work that he has put into ensuring that Cannock Chase hospital can be better utilised.

The second part of co-operation involves community services. Instead of seeing acute hospitals as buildings into which people disappear and then re-emerge at some point, let us make them a full partner in community services. In fact, they should be a hub for those services. Stafford, Stoke and Cannock can be groundbreakers in this, and set an example to the rest of the country. In Stafford, we long for the chance to show the country that we provide the highest standards of care, and that we will never again let patients be treated in the shocking way that many experienced in the past.

Mid Staffordshire NHS Foundation Trust

Aidan Burley Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

We have not had those discussions yet, but we will be introducing them through pilot schemes to give the devolved Administrations plenty of time to talk to us about any knock-on impacts they may have in their areas.

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

Does the Secretary of State agree that the decision to grant foundation trust status to Mid Staffs in 2008 was catastrophic in terms of the trust taking its eye off the ball and focusing on targets rather than on care, and that, now it is being abolished just five years later, never again must a Government pressurise a trust into a particular organisational form just to validate its ideological policy, rather than because it improves the care of patients?

[Mr Hunt]

I would also like to thank my hon. Friend for the work that he does for his local hospital in difficult circumstances directly involved in this terrible scandal. I agree with him: the corporate objective to become a foundation trust overrode everything else in the hospital, at huge expense to patient care. We must never allow that to happen again.

Accountability and Transparency in the NHS

Aidan Burley Excerpts

Thursday 14th March 2013 Commons Chamber

[Andy Burnham]

No, I am making some progress.

The second area where more transparency and accountability is urgently needed is on staffing levels. If the Government are not yet able to commit to all the recommendations, I ask them to expedite their response to Robert Francis’s important recommendation on patient-staff ratios. The board of Mid Staffs embarked on a dangerous programme of staff cuts, and yet public and staff representatives had no outside guidance to challenge it. The chief nursing officer said yesterday that staffing should be a local decision. Surely the lesson of Mid Staffs is that there is a need for much clearer national standards and guidelines, as suggested by the Francis report?

This week, the Care Quality Commission reported that one in 10 hospitals in England and, worse, one in five learning disability and mental health services do not have adequate staffing levels. Surely that should ring alarm bells in the Department as it suggests that parts of the NHS are already forgetting the lessons of the recent past.

The third area on which we need a clear statement from the Government today is the accountability and transparency of all organisations providing NHS services. Under “any qualified provider”, the Government are persisting with their assumption that all NHS contracts should be open to full competitive tender. Despite a promise to rewrite the section 75 regulations that are being made under the 2012 Act, my reading of the rewritten regulations is that regulation 5 will not let doctors decide, but will in effect force clinical commissioning groups to open tender for contracts. That raises the prospect that there will be a significant increase in the coming years in the number of private and voluntary sector organisations providing NHS services.

If we believe in transparency and accountability, surely they have to apply across the board and on a level playing field. The problem is that private and voluntary sector organisations are not subject to the same strictures on freedom of information and whistleblowing. If action is not taken, we face the prospect of a serious reduction in transparency and accountability. Our attempts to find out new information under FOI requests on providers selected under AQP have hit the brick wall of “commercial confidentiality”. I say to the Secretary of State that that is not good enough. Accountability and transparency must always be paramount, as the motion says.

Will the Secretary of State require all providers of NHS services to adhere to FOI principles, and will he ensure that whistleblowers working in organisations that provide NHS services have the legal protections that he has announced today? I draw the attention of the Secretary of State to an early-day motion tabled by my hon. Friend the Member for Easington (Grahame M. Morris) on this subject, which has attracted the support of 109 Members.

The fourth area on which the people of Stafford need openness and transparency is the future of their hospital. They will understandably be worried about the recent recommendation from Monitor that the trust should be placed into administration. People will recall, as I said to the hon. Member for Stone (Mr Cash) a moment ago, that I commissioned Robert Francis in July 2009 to conduct an independent inquiry. I know that many people, including the hon. Gentleman, wanted me to go further and order a full public inquiry, but I stopped short because I was concerned about the effect that that would have on the hospital and its viability.

All of us in this House now have a responsibility to help this hospital heal. After all that they have been through, it would be highly unfair to the people of Stafford if, at the end of all this, they were to lose their hospital or their A and E. They deserve a safe and sustainable hospital and I hope that the Secretary of State’s response to Monitor’s recommendation will map out a way to achieve that.

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

rose—

[Nick de Bois (Enfield North) (Con)]

rose—

[Andy Burnham]

I will give way one final time—to the hon. Member for Cannock Chase (Mr Burley).

[Mr Burley]

I represent the other constituency that is served by Mid Staffordshire NHS Foundation Trust. Is the right hon. Gentleman implying that it is the holding of a public inquiry that has led to the threat to Stafford and Cannock Chase hospitals?

[Andy Burnham]

No, that is not what I am saying. I commissioned a second-stage—[Interruption.] The hon. Member for Cannock Chase should listen to the answer. I commissioned a second-stage review before the general election after Robert Francis delivered his first-stage review to me. I simply said that I took that judgment because I was worried that if there was ongoing uncertainty about the hospital for a long period, it may affect its viability. I have seen the statements from Monitor that there is a concern about the future viability of the hospital. I am making an appeal, on a cross-party basis, to say that all of us owe the people of Stafford a safe and sustainable hospital. I hope that the hon. Gentleman would agree with that sentiment.

My fifth and final point concerns staff morale.

--- Later in debate ---

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

May I thank the right hon. Member for Cynon Valley (Ann Clwyd) and say how sobering it was to listen to those stories? I join my hon. Friend the Member for Stafford (Jeremy Lefroy) in paying tribute to the families and loved ones of patients from Stafford and Cannock who had such appalling care and praise them for their strength in telling their stories. My hon. Friend and I will fight against any serious downgrading of Stafford hospital and, more importantly, from my perspective, any possible closure of Cannock hospital, which is managed by the same trust. I note that the Staffordshire Newsletter today launched its “Support Stafford Hospital” campaign, which I am sure we will both be supporting.

Today’s motion calls for accountability and transparency in the NHS. In relation to Mid Staffordshire NHS Foundation Trust, there are three areas that most need accountability and transparency: the granting of foundation trust status in 2009; the opposition to the public inquiry into what went on; and the “targets at all costs” culture. I will deal with each in turn.

We have the indignity and embarrassment of Mid Staffordshire NHS Foundation Trust being abolished by Monitor only five years after being granted that status. I want Members to think about that for a second. Only five years ago it was considered so outstanding and such an exemplar of compassionate care and sound finances that the right hon. Member for Leigh (Andy Burnham) awarded it foundation trust status on 1 February 2008.

[Andy Burnham]

May I just correct the hon. Gentleman? I was not a Minister in the Department of Health on 1 February 2008. Furthermore, the awarding of foundation trust status was the responsibility of Monitor, not Ministers in the Department.

[Mr Burley]

I believe that the right hon. Gentleman’s second point is incorrect; as I understand it, the Secretary of State—I accept that that was the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson)—signs off the awarding of foundation trust status. We know that he admitted to the public inquiry that he looked at just four lines of civil service evidence about foundation trust status before signing it off. Is that good enough for a Secretary of State? Why did he not look at it in more detail? Was he not really bothered? I think that was a dereliction of his duty to ensure public health in Staffordshire and that he should have the decency to apologise to the people in the Public Gallery who have come here today from my constituency and that of my hon. Friend the Member for Stafford.

Alternatively, was the foundation trust status signed off because of the culture of targets at any cost under the previous Government? Was organisational form, whatever it means, more important than patient care? We know locally that they wanted to prove that their foundation trust policy was a success, and that took priority over what it really meant for patients and their care. Members do not have to listen only to me on that point. Here is what a Mid Staffordshire NHS Foundation Trust non-executive said just this week in a public meeting in Rugeley in my constituency:

“Our problems started when they made 200 nurses redundant in 2008 to achieve an acceptable financial footing for Foundation status, but care standards slipped thereafter and by 2009 they had a £2m deficit.”

Everyone knows that huge pressure was put on David Nicholson by his political masters to have a foundation trust in the west midlands, and poor little Mid Staffordshire was the one that was forced through. In the interests of the accountability and transparency that the motion calls for, I want to hear an apology from those who forced through foundation trust status at a time when people were dying from appalling care and the trust was going bankrupt.

This is not just about politicians. If anybody is in any doubt about how ingrained the targets culture had become, let me quote from an old press release from Mid Staffordshire trust that I found, dated 3 October 2002. It has been taken off its website but is still findable if one looks around on the internet. It says, under the heading, “Babies’ Service of Remembrance”:

“A short service of Remembrance for those whose babies have died in the past few years is being held in the Pilgrim Chapel at Stafford General Hospital.”

Just seven days later, under the heading, “Good News from Mid Staffordshire General Hospitals NHS Trust”, it said that David O’Neill, the chief executive, was

“delighted to announce that the Trust has been short-listed to the last three for the National Partnership Industry Award for our Bed Management System”.

This culture is absolutely astonishing, and it simply has to change.

We have now had the public inquiry and Robert Francis has laid out in full gory detail the horrendous failings at Stafford hospital. One might have thought, given what went wrong, that there would have been cross-party support for a public inquiry, but not so. I presume that Labour Members now support the findings of the Francis inquiry. There were certainly many Labour MPs at the all-party health group meeting with Robert Francis on Tuesday, but I want to know how many of them were among the 260 Labour MPs who voted against a Commons motion calling for a public inquiry on 18 May 2009. [Interruption.] These might be uncomfortable facts for the right hon. Member for Kingston upon Hull West and Hessle, but let me point out that Labour Members ignored 81 requests for a full public inquiry into Mid Staffs between January 2009 and May 2010. They received 20 letters from MPs, 36 letters from members of the public and 25 letters from organisations. They ignored the families who protested outside the Department of Health for a public inquiry, including people from Cure the NHS.

The right hon. Member for Leigh, as he has said today, rejected a full public inquiry on the grounds that it would “distract the management”. He is welcome to intervene to tell me whether he now accepts that that judgment was wrong.

[Andy Burnham]

Will the hon. Gentleman acknowledge that I asked Robert Francis to conduct two independent inquiries into what happened? It is not the case that I was not doing anything. I made that judgment because I wanted to get to the truth of what happened while not overburdening the hospital with the job of getting better. I tried to strike that balance, and that is why I reached the judgment that I did.

[Mr Burley]

I will accept, as will, I think, everyone in this House, that the right hon. Gentleman has refused to answer the question again. He will not say whether that judgment was a mistake, and until he does so we cannot take what he says seriously.

The then Health Secretary, the right hon. Member for Kingston upon Hull West and Hessle, joined in the refusal to have a full public inquiry. He said to The Birmingham Post on 19 March 2009,

“I really don’t think with the greatest respect that a public inquiry is going to take us any further forward”.

Will he intervene to tell me whether he will be writing to The Birmingham Post to tell people whether it has taken us any further forward? He can scowl across the Chamber, but I am afraid that that is no answer.

In the interests of accountability and transparency, we need to know why the Labour Government opposed a full public inquiry into Mid Staffordshire. Why were they so afraid of finding out the truth of what went on? Is it really so important to protect the reputation of the NHS as an institution rather than to protect the patients whom it serves and who ultimately pay for it?

There are now abounding claims and counter-claims about Stafford and Cannock hospitals as a result of the indignity of having our foundation trust abolished. One would have thought that having forced through foundation trust status and opposed a public inquiry, Labour locally would have some contrition, but sadly not. The Labour leader of my local council and Labour’s prospective parliamentary candidate for Cannock Chase are now teaming up to

“fight plans they feel are aimed at privatising Cannock hospital.”

The leader of the council said that he was launching a petition against being

“victims of Tory privatisation plans”.

There are no plans in the Monitor report to privatise Cannock hospital, so I want to know where the local Labour party is getting its information from. In fact, as a result of the FT status, private providers are already operating in Cannock hospital. I note that there were no protests from Labour councillors when private health facilities were introduced into Cannock hospital. Again in the interests of accountability and transparency in the NHS, I call on Labour Front Benchers to stop their parliamentary candidates and council leaders scaremongering among local people for political ends. They cannot fight privatisation if there are no plans to privatise anything. They cannot start a petition to save Cannock Chase hospital if the Monitor report suggests making it a centre of excellence for orthopaedic elective surgery in the west midlands. They cannot oppose a public inquiry and then welcome all of its findings. They cannot force through foundation trust status for its own sake rather than for what it will achieve for patients; and if someone does force it through and it has the reverse, perverse effect of causing appalling care, unnecessary deaths and the bankrupting of the trust and its abolishment just five years later, they should be man enough to apologise.

I agree that we need to be more accountable and transparent. That starts from the top with Secretaries of State and goes down to the bottom to the local council leaders and their parliamentary candidates.

--- Later in debate ---

[Stephen Barclay]

I do agree with my hon. Friend, and that does seem at odds with the Government’s welcome commitment to promoting individual accountability. In response to the Robert Francis report, the Prime Minister talked about three fundamental problems with the culture of the NHS. Of course that went beyond one individual.

I am concerned about the timing of the announcement of the appointment of Barbara Hakin, a close ally of Sir David Nicholson. It is important to note that she is innocent of any allegations being made against her, but I understand that she is under investigation at the moment. The timing of the appointment, then, seems strange. I invite my right hon. Friend the Secretary of State to intervene to clarify whether he was told of Barbara Hakin’s appointment prior to it being made. If he was not told, does not that say something about the power that Sir David wields within Richmond House?.

A further issue is whether Parliament knows the quantum or scale of the payments made to whistleblowers. I have repeatedly raised this matter over the last two years and was finally given a figure of £15 million paid over three years—silencing quite a lot of people. It now emerges, however, that that is not the whole story, as it does not cover payments such as the one for Gary Walker, which was paid through judicial mediation.

As seen in the NHS manual for accounts, each NHS body or trust is required to compile a register detailing all special payments made, including those through mediation. As I understand it, even the Department of Health does not know how many such payments have been made—and that applies to the Treasury, too. In a response to my parliamentary question this Tuesday, the Minister said:

“Approval has not hitherto been required by the Chancellor or the Secretary of State for Health for special severance payments made as a result of judicial mediation. However, as of 11 March”—

this Monday—

“approval will be required.”—[Official Report, 12 March 2013; Vol. 560, c. 182W.]

The position seems to be moving as of this week. Parliament does not know how much has been paid to whistleblowers, so will the Minister clarify when we will know?

In my Adjournment debate of a week last Monday, my hon. Friend the Member for Bracknell (Dr Lee) asked whether the chief executive of Mid Staffs was subject to a gagging clause. We received a welcome reassurance that we would be given an answer, but when we were on our way to the Chamber for this debate, my hon. Friend told me that he had received none. I hope that the Minister will clarify whether Mr Yeates was subject to a gagging clause.

[Mr Burley]

Is my hon. Friend aware that Mr Yeates left in 2009 with an £80,000 pay-off and a six-figure pension lump sum before moving to a job with a charity called IMPACT Alcohol and Addition Services, based in Shropshire, and that he refused to give oral evidence to the inquiry because of a unique form of post-traumatic stress disorder? Where is his accountability?

[Stephen Barclay]

My hon. Friend is right. Not only did Mr Yeates leave with, I understand, a significant payout, but he went to work for a charity that was in receipt of Department of Health funds. I think that as a matter of urgency we should clarify the terms on which Mr Yeates left the NHS, what Ministers knew, and what senior officials—in particular, David Flory—were aware of at the time of his departure.

I fear that we are in danger of sending a confused message to staff and families of patients in the NHS. On the one hand we say that the culture needs to change, but on the other we say that the people who are responsible for that culture—the people who are paid significant sums to lead it—should stay.

My hon. Friend the Member for Totnes (Dr Wollaston) is absolutely right: there is much in our NHS that we should celebrate and of which we should be proud. However, we do it a disservice if we are not prepared to identify where it is going wrong, and to be transparent about the areas with high mortality and about the existing culture which has a chilling effect on those who are brave enough to speak out. Is it not informative that the one person who spoke out at the Bristol inquiry, and who did so much good, is the one person who has never worked in the NHS again?

I think that the challenge for the House today, and in subsequent weeks, is to ensure that this time it learns the lessons that were clearly not learnt then.

Oral Answers to Questions

Aidan Burley Excerpts

Tuesday 27th November 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I thank the hon. Gentleman for that question and for his concern about this matter. One of the key challenges for the NHS is to ensure that we deliver better care in the community, deliver more preventive care and provide better support to people with long-term conditions, such as muscular dystrophy and diabetes, in their own homes. A key part of the reforms is to make sure that a lot of services are commissioned from the community by the local commissioning groups. We have already seen that that has reduced inappropriate admissions. For example, in my part of the world in Suffolk, they have been reduced by 15% for older people.

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

T4. Yesterday, I received a letter from the chief executive of Monitor, which asked me and the Asset Transfer Unit to undertake feasibility work to develop a professional business case for the local community to take ownership of Cannock Chase hospital. This would be done through its transfer to a community interest company, which would then take over running the hospital estate, securing the building for the people of Cannock Chase. Will the Secretary of State welcome these proposals, which would be the first of their kind in the UK, and work with us as we develop a plan for the local community to own its hospital?

[Mr Jeremy Hunt]

I congratulate my hon. Friend on his campaigning and hard work on this issue, which represents an interesting way forward for community hospitals. I wish him every success and I know that hon. Members in all parts of the House will watch carefully what happens in Cannock.

Community Hospitals

Aidan Burley Excerpts

Thursday 6th September 2012 Commons Chamber

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

I, too, thank my hon. Friend the Member for Totnes (Dr Wollaston) for securing this very important debate, which, as she will see from my speech, is very timely given what is happening in my constituency. I also congratulate the Under-Secretary of State for Health, my hon. Friend the Member for Broxtowe (Anna Soubry), on her elevation to the Front Bench. It is always fantastic to see someone from the midlands in that position.

I want to pick up on points that were made in the last two speeches. My hon. Friend the Member for Newton Abbot (Anne Marie Morris) spoke about the ownership of the hospital and the future and the hon. Member for Southport (John Pugh) said that market forces determined the future of some hospitals. That was apt given what is happening in Cannock, where we have a situation with our community hospital.

Cannock community hospital was built in the 1980s. It is a fantastic facility with many years of life left in it, but over the past 20 years it has seen a gradual decline in use and is now chronically underused. It has gone from having nine wards when it was opened to having only two, and just last week the kitchens were closed to save £200,000-odd a year. Cannock forms part of the Mid Staffordshire NHS Foundation Trust and shares it with Stafford hospital, and many colleagues will be aware of the problems there and the extra funding the Government have had to put in. The trust that controls Cannock and Stafford hospitals has a problem, as it is losing £15 million a year and £8 million of that through running Cannock community hospital. That cannot go on.

There are only three options for Cannock. First, it could be sold off and the remaining services could be transferred to Stafford hospital, which is a bigger acute hospital, with some of the receipts from the sale being used to expand services at Stafford and to accommodate them. That is unacceptable to my constituents, local people and local politicians on both sides of the divide. We are not willing to see our local hospital close—a hospital that was bought with local money from the National Coal Board and with local donations. There are therefore only two other options to secure the future of Cannock hospital, given that it is such a loss-making enterprise; it costs some £34 million a year to run and pulls in about £24 million from the commissioning of services.

The first of those options is for the GPs to fill the hospital. I am sceptical about that because they have not filled it so far and it takes a brave man to persuade the clinical commissioning groups that they must fill the hospital so that it becomes a going concern that does not lose any money and is fully utilised. GPs simply have not done that in the past. If we cannot fill it with services, I have come to the conclusion—I have just come from giving interviews to the local media on this point—that the only solution to secure the future of our community hospital is for the district council to purchase the facility or purchase a controlling part of the hospital estate. A clause in the contract would mean that the council could use the part of the estate it owned only to meet health and social care needs.

I think the future for our hospital will be for Cannock Chase district council to buy 50% or 60% of the estate—or even all of it—and decant some of the health and social care services that it runs into it, including GPs’ surgeries, walk-in clinics, polyclinics, advice centres and so on. The hospital would once again be a going concern. It was valued just four months ago at £34 million, so Members can see that even buying 50% of it would cost the council £16 million to £17 million. As a council with a turnover of several million pounds a year that can borrow £80 million a year, that is feasible. I hope today to set up a working group of local hospital bosses, council leaders and officers, the friends of Cannock hospital and any local stakeholder who wants to be involved. I do not know what the answer is or how feasible this might be, but I see no other way of securing our hospital’s future and getting it utilised again unless the district council steps in, buys part of the estate and utilises it itself, or even buys the whole estate and leases part of it back to the trust, which currently uses part of it for rheumatology, orthopaedics and eye surgery but not all of it.

I will conclude briefly by asking the Minister whether she and her Department would approve, in principle, of district councils helping to secure the future of our beloved community hospitals in that way. If so, perhaps she would consider sending an official from the Department to serve on the steering committee we are setting up to investigate the possibility so that they can guide us on how best to secure the future of our community hospital and retain its use for health and social care services, as the current reality is that it is losing money and financially is not a going concern in the long term.

Stafford Hospital

Aidan Burley Excerpts

Tuesday 20th December 2011 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. It is also a pleasure to see the Minister in her place. I am expecting my colleagues from Staffordshire to come into the Chamber during this debate and to intervene if they so wish.

On 1 December this year, Stafford hospital started a temporary night-time closure of the accident and emergency department from 10 pm to 8 am. That happened principally as a result of a shortage of A and E specialists and the need to maintain a safe service. The hospital has been unable to recruit such specialists, partly as a result of a national shortage and partly owing to problems that Stafford has experienced. I wish to set out why it is important for the hospital’s A and E department to return to full-time working and to draw out some more general conclusions.

The hospital is part of the Mid Staffordshire NHS Foundation Trust, which also runs the non-acute Cannock hospital. Stafford serves a population of some 250,000 to 300,000 people in the middle and south-west of the county. As my intention is to highlight the importance of A and E, I will dwell only briefly on the Francis public inquiry, which is completing its work and will report next year. The inquiry is considering the lessons that can be learned from what happened. Certainly, lessons learned from the initial Francis investigation into the hospital have largely been put into practice. There continue to be major improvements, though clearly there is no complacency. It has been very encouraging to hear from constituents about the quality of care that they receive and their praise for staff.

I have heard some say that the Francis inquiry is not necessary, but I disagree profoundly. Let me simply report the words of a senior member of the Royal College of Physicians who said that that is the most important inquiry into the NHS in a generation. I am most grateful to the Government for their support for the hospital and the trust through a particularly difficult time for Stafford and the whole surrounding area. I ask for that support to continue, as the trust develops its plans to provide high-quality and financially sustainable services.

The importance that people in Stafford, Cannock, Rugeley and beyond place on the A and E department is shown by the more than 18,000 people who have signed petitions that support it. Stafford borough council has also shown strong support by passing a unanimous resolution at full council. Since the temporary night-time closure, a number of people have told me how concerned people, particularly the elderly, are that they no longer have a night-time emergency service relatively close to hand. We need to remember that, across the country, A and E departments not only treat people in medical need and save lives, but provide reassurance, whether to parents with a child who becomes sick in the middle of the night, or elderly people who have no transport of their own and are worried about imposing themselves by calling out an ambulance and overburdening the service. For them, an emergency service that is as local as possible is essential.

Let me make it clear that the closure was necessary. The decision was not taken lightly, but was made in the interests of patient safety. The temporary night-time closure is giving the hospital time to recruit the necessary staff and to improve training, which is difficult when one is overstretched.

I should like to thank the Minister and the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), as well as the Secretary of State for Health and the Department of Health for their help and support. I also thank the Ministers and staff of the Ministry of Defence for providing armed forces medical staff to assist for some 12 weeks. They have been invaluable both in providing additional cover and in helping with training.

I should like to thank the leadership and staff of the University hospital of North Staffordshire, New Cross hospital in Wolverhampton, Manor hospital in Walsall and Burton hospitals for taking the strain of additional patients during the temporary night-time closure. I also thank the staff of the West Midlands ambulance service for providing the necessary additional cover.

I should now like to turn to the reasons why Stafford requires a 24-hour A and E department. First, the population of the area is growing. Stafford itself is a growth point and expects to see another 15,000 to 20,000 people settle in the area in the coming 20 years, with 2,000 to 3,000 from the armed forces returning from Germany to MOD Stafford between 2015 and 2018. Cannock and Rugeley are also growing.

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

I congratulate my hon. Friend on securing this debate. He mentions Cannock, which is my constituency. Does he agree that the answer to all the problems that we have seen in Stafford is not to close Cannock but to impose a two-site solution, with services both at Stafford and at Cannock and an improved and more vibrant Cannock hospital? That is the only way forward and a solution on which we both agree as neighbouring constituency MPs.

[Jeremy Lefroy]

I entirely agree with my hon. Friend. It is essential that we have services both in Cannock and Stafford. Both hospitals are vital to their local communities, although they perform different services.

Secondly, we have an increasing elderly population who rely on local accident and emergency services. Increasing life expectancy is welcome, but when the elderly become ill, they tend to be more acutely ill. The combination of population growth and more elderly people will inevitably lead to more demand for emergency and acute services. Successive Governments have tried, with varying degrees of success, to persuade people who are not seriously ill to use alternatives to A and E. That is important—I welcome the Government’s moves in that direction—but it will only relieve a small part of the pressure on these departments.

Thirdly, Stafford’s accident and emergency department is extremely busy. The admissions for the past 12 months, up to November 2011, numbered 52,255. That is some two thirds of the number of admissions to Manor hospital in Walsall and slightly more than half of the admissions to the University hospital of North Staffordshire and New Cross hospital in Wolverhampton.