Stafford Hospital

Debate between Aidan Burley and Jeremy Lefroy

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.

Mid Staffordshire NHS Foundation Trust

Debate between Aidan Burley and Jeremy Lefroy

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.

Stafford Hospital

Debate between Aidan Burley and Jeremy Lefroy

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.

Stafford Hospital

Debate between Aidan Burley and Jeremy Lefroy

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.