Children’s Cardiac Surgery (Glenfield)

Andrew Bridgen Excerpts

Monday 22nd October 2012 Westminster Hall

[Andrew Bridgen (North West Leicestershire) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Hollobone. I welcome my hon. Friend the Minister to her post and congratulate my hon. and learned Friend the Member for Harborough (Sir Edward Garnier) on securing this important debate.

As the Member for North West Leicestershire, I speak for a constituency roughly equidistant, in distance and travel time, from the Glenfield site and the Birmingham children’s hospital site. For my constituents, there is nothing to choose between the two, so I have a position of relative impartiality. I am interested in patient outcomes.

I recently toured the congenital heart centre at Glenfield, and two main concerns from the report were raised with me. The first was the issue of capacity and demand, which was raised by the hon. Member for Leicester South (Jonathan Ashworth) and my hon. Friend the Member for Bosworth (David Tredinnick). The figures given by the Department of Health were queried. It has been calculated that Birmingham children’s hospital will be expected to deal with 611 cases a year. However, clinical teams have suggested that it could be 900 to 1,000 procedures a year. Birmingham children’s hospital, having done its own modelling, expects the number of procedures to be more than 900.

I understand that senior commissioners acknowledge that the number is likely to be significantly higher than the figure of 611 used in the review, as does Sir Roger Boyle, the recently retired cardiac tsar, who initiated the project. The calculations demonstrating that the closure was a safe and sustainable option for the midlands, which considered travel, access, quality, deliverability, sustainability and affordability, were based on 611 operations, not 900 or 1,000. Doctors at Glenfield doubt very much that Birmingham children’s hospital has the capacity to handle that volume of work. In addition, Birmingham children’s hospital has stated that it wishes to move to a new site within 10 years, as it has already reached the limit of what can be achieved in the space that it has. Based on that, I would like the points that I have raised to be addressed to ensure that the Safe and Sustainable exercise was carried out using the correct data.

I turn to extracorporeal membrane oxygenation, or ECMO, a life support service currently delivered at Glenfield. There is a strong argument that the value of the service has not been fully appreciated throughout the review. Glenfield pioneered ECMO treatment in the UK and delivers education, training and clinical support to other ECMO centres in the UK and abroad. Survival after ECMO treatment in the Glenfield unit is far more likely than in other UK and international centres—that is, more children survive.

Several concerns have been raised with me about the Safe and Sustainable process for assessing the risks and practicalities of moving the service. I understand that only two experts were consulted about moving ECMO, and that the Swedish ECMO expert Kenneth Palmer, of the Karolinska Institute, has publicly expressed his anger at how his views have been used to justify the move from Glenfield, and has withdrawn his support for the process. Another issue is how a Sea King helicopter carrying a patient might land in central Birmingham. Glenfield can handle that, because it designed a system to accommodate it. Although the use of a Sea King helicopter is rare, we have heard that when they are used, as in the recent fire in Wales, they are life-savers. I would welcome a further review of the matter.

I remain concerned that Birmingham children’s hospital will not see ECMO as a strategic priority and might contemplate splitting the service among other providers, which would defeat the principles of the Safe and Sustainable review and put at risk the world-class results that we are achieving. The review’s aim is to concentrate expertise and deliver more positive outcomes. However, there are no plans for any other ECMO provider, including Birmingham children’s hospital, to use what my hon. and learned Friend the Member for Harborough termed the mobile retrieval service. That goes against the principle of the whole review.

The mobile retrieval service that Glenfield provides is a fundamental aspect of the service, and it partly explains why Glenfield produces so many positive outcomes. Its team travel by ambulance to the hospital where the sick child is located, taking all the necessary kit with them to start ECMO treatment. ECMO is then started on site and continued in the ambulance on the way back to Glenfield, ensuring that children receive the treatment as soon as possible at a time when their life expectancy without treatment might be measured in hours rather than days, and avoiding a much riskier ambulance journey on a simple ventilator. If that aspect of the service is not taken up by others in Glenfield’s absence, there is a danger that fewer children will survive horrific illnesses.

Will the Minister clarify the level of scrutiny of the results achieved at Glenfield and Birmingham children’s hospital? Since the decision was made, the unit has stated that it invited various members of the Safe and Sustainable review to Glenfield to show them the results of the past 10 years, which, it believes, demonstrate the success of its service. It has no record of that data being shared previously, and I would welcome clarification on what data were looked at during the initial review process.

A significant concern, highlighted by my hon. and learned Friend the Member for Harborough and the hon. Member for Leicester South, is the fact that it cannot be assumed that the staff who deliver the service at Glenfield will relocate to Birmingham. Many live east of Leicester and will find the commute to Birmingham unviable. I understand from Glenfield hospital’s own surveys that a number of staff have indicated that they are unwilling to move to the new unit.

There is also concern regarding the air of uncertainty that surrounds these units. Once a unit is earmarked for closure, the most able and gifted personnel quickly find jobs in other areas. That puts the process under great strain and leads to a rise in mortality rates. I hope the Minister gets on with this review as quickly as possible, so that we have a rapid resolution and can provide some reassurance to staff to ensure that we keep the service at its superb, world-class level.

We need to ensure that the conclusions of the Safe and Sustainable review are safe and sustainable—not only for the remaining structure of the NHS, but for my constituents in North West Leicestershire and all constituents in Leicester, Leicestershire, the east midlands and the midlands as a whole. I hope the Minister will take account of that.

Business of the House

Andrew Bridgen Excerpts

Thursday 6th September 2012 Commons Chamber

[Mr Lansley]

I, too, take an interest in this issue, and welcome the OFT call for evidence. I note that the Backbench Business Committee has selected the oil market as a subject for debate, and it would probably be entirely in order for the issues the hon. Gentleman has just raised to be discussed in the course of that debate.

[Andrew Bridgen (North West Leicestershire) (Con)]

May we urgently have a debate about the effectiveness of the Government’s bursary scheme for 16 to 19-year-olds? The latest figures show that the proportion of 16-year-olds classed as NEETs—not in education, employment or training—has fallen year-on-year in the second quarter of 2012. Given that this is the first cohort to be affected by the transition from education maintenance allowance to the bursary scheme, does this not show that, despite the hysterical reaction of the Opposition, the scrapping of EMA has not had a negative impact on the number of NEETs, and that the money is now being better spent and better targeted?

[Mr Lansley]

My hon. Friend makes important points. The coalition Government have put £180 million into the 16-to-19 bursary fund this year, to enable the most financially disadvantaged young people to participate in education. The most vulnerable young people receive, as a standard amount, £1,200 more than they would have received under EMA.

NHS Annual Report and Care Objectives

Andrew Bridgen Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

No, and I do not think that the staff of ambulance trusts will appreciate the hon. Gentleman generalising from the particular. I have not said that ambulance trusts reach every case in the time we intend, but the figures show that all ambulance trusts across England have met the category A target for responding consistently at a level they have not previously achieved.

[Andrew Bridgen (North West Leicestershire) (Con)]

I welcome the reforms and improvement to the NHS that the Secretary of State is delivering. However, the NHS paid out £1.3 billion in compensation claims last year, a rise of almost 50% on the year before. A spokesman has said that that is partly due to aggressive marketing by no-win, no-fee lawyers. Does my right hon. Friend agree that the current level of compensation claims in this country, in both the public and private sectors, is completely unsustainable and that it is now time to curtail the out-of-control compensation culture?

[Mr Lansley]

My hon. Friend makes an important point. From our point of view, the legislation that passed through this House in the last Session, led by the Under-Secretary of State for Justice, my hon. Friend the Member for Huntingdon (Mr Djanogly), will be important and will help us in relation to some of these matters, not least on the use of no-win, no-fee arrangements. From time to time it has been deeply frustrating for us all to see that, of the money paid out by the NHS as a result of negligence claims, sometimes more is paid in fees, not least to lawyers, than is provided in compensation to those who have suffered harm. In the NHS we recognise the need to provide compensation when harm has occurred. It is extremely costly. The costs have risen and we want to minimise them. Reducing harm in the NHS will be important, but ensuring that we respond to complaints and offer redress more openly will also help us to manage the extent to which people resort expensively to the courts.

EU Working Time Directive (NHS)

Andrew Bridgen Excerpts

Thursday 26th April 2012 Westminster Hall

[Charlotte Leslie]

I know that my hon. Friend has done a tremendous amount of work in this area. The ways in which other countries get round the directive will be the conclusion to my speech. The Minister has a choice whether to prioritise political process in Europe or patients. Will we put everything into finding a way to give patients the care, and the professions the flexibility and respect, that they deserve? I thank my hon. Friend the Member for Daventry (Chris Heaton-Harris) for anticipating that point.

[Andrew Bridgen (North West Leicestershire) (Con)]

I congratulate my hon. Friend on securing this important debate. We will all be aware that it has recently been reported in the media that the mortality rates for someone unfortunate enough to be taken into hospital on a Friday night, Saturday or Sunday are about 20% worse. Does my hon. Friend think that the working time directive is exacerbating the situation and preventing us from dealing with the problem of continuity of care?

[Charlotte Leslie]

I suspect that that is a problem in hospitals in colleagues’ constituencies, and I look forward to hearing about those. It is not just politicians in the Houses of Parliament who say these things, but, crucially, clinicians on the ground, whose prime concern is looking after patients. I certainly agree with my hon. Friend’s point.

One area in which the restrictions of the working time directive become apparent is in the case of a flu pandemic. The guide to the implications of the European working time directive for doctors in training makes it clear that even in a flu pandemic there are no exemptions from, and there is no flexibility about, the 48-hour rule. It is true that individuals can opt out of the directive, but they are still limited by the previous Government’s new deal to working 56 hours a week. However, there is no mechanism to compel doctors to opt out of the 48-hour working time directive.

--- Later in debate ---

[Charlotte Leslie]

I thank my hon. Friend. He has done a tremendous amount of work in this area, and I bow to his expertise. I see the solution as twofold and two-speed. First, we must ask why we are in this situation, and we must look at the treaties. Open Europe has suggested an interesting double-lock mechanism for negotiating our way out of what was the social chapter and creating a situation in which we are not bound by the rulings of the European Court of Justice. Those are big, radical steps and will take time, but it is something that we should look at.

This issue is of great importance on a daily basis. Each year that passes, a new generation of doctors enters a system that is systematically undermining the most important element of our NHS. Because issues to do with Europe are so tangled, difficult and frustrating, we need to look at more practical and instantaneous ways of getting around the directive with which we are inflicted. I take my hon. Friend’s point, but a two-speed approach is vital because of the issue’s importance.

[Andrew Bridgen]

My hon. Friend said something about medical professionals going to work on days when, under the working time directive, they are legally supposed to be at home or on holiday. Is she as concerned as I am that that could raise serious problems and create confusion and grey areas about professional negligence for medical professionals who are supposed to be on holiday but are actually working in the hospital? Will the Minister explain where they would stand on that matter for insurance purposes?

[Charlotte Leslie]

My hon. Friend raises a good point that will be of great interest as things progress. In a culture in which litigation against the NHS is becoming more and more common, what will happen if patients feel that their safety has been compromised because of the lack of training received by their doctors? The European directive raises all sorts of issues about patients’ rightful expectations of those who treat them.

Oral Answers to Questions

Andrew Bridgen Excerpts

Tuesday 27th March 2012 Commons Chamber

The Secretary of State was asked—

[Andrew Bridgen (North West Leicestershire) (Con)]

1. What plans he has to improve individual choice and standards for end-of-life care.

[The Secretary of State for Health (Mr Andrew Lansley)]

We are developing a new patient funding system for all providers of palliative care. It will be fair and transparent and deliver better outcomes for patients and better value for the NHS. Just last week, I announced that we are investing £1.8 million in eight pilot sites to help us in that work. Marie Curie Cancer Care is also providing £2.5 million of funding to support those pilots. The new system will be in place by 2015.

[Andrew Bridgen]

I thank the Secretary of State. Does he agree that current state funding for end-of-life and palliative care provision is at best patchy across the country and needs to be improved? Will he outline the role that he sees for voluntary and charitable organisations in the delivery of improved palliative and end-of-life care in future?

[Mr Lansley]

My hon. Friend will know very well of the vital role that the voluntary sector already plays, whether through the hospice movement or through Marie Curie and other voluntary organisations. As he implies, we not only want to secure more consistent, high-quality end-of-life care, to which effect we are already implementing the end-of-life care strategy and the National Institute for Health and Clinical Excellence quality standard for end-of-life care, but through the implementation of the palliative care funding review pilot schemes we want to ensure that the voluntary sector and other providers are equally able to provide the services that patients and their families desire.

Oral Answers to Questions

Andrew Bridgen Excerpts

Tuesday 21st February 2012 Commons Chamber

[Mr Burns]

I am grateful to my hon. Friend for her question, because it might clarify some of the misinformation being bandied around on the Opposition Benches. Any money generated by private patients or by the private sector within the NHS must be spent on NHS patients, so it will benefit NHS patients and the NHS, and that is to be welcomed.

[Andrew Bridgen (North West Leicestershire) (Con)]

Does my right hon. Friend agree that collaboration between the NHS and the independent sector can deliver real benefits for both patients and the taxpayer?

[Mr Burns]

My hon. Friend is absolutely right, because we need to drive up the quality of care. What we are doing with the Health and Social Care Bill is closing a loophole so that there can be no favouritism towards the private sector, so the travesty introduced under the previous Government, including the right hon. Member for Leigh (Andy Burnham), whereby independent treatment centres had an advantage that put the NHS at a disadvantage in providing care, and were paid more than the NHS, will stop, because it is unacceptable.

Oral Answers to Questions

Andrew Bridgen Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

I am grateful for that question. I will certainly be happy to write to the hon. Gentleman on Guisborough hospital—I will not delay the House with the detail. I have those details, and will be happy to correspond with him.

[Andrew Bridgen (North West Leicestershire) (Con)]

The Prime Minister speaks of the “health and safety monster”; does the Minister believe it is right that advertising for personal injury lawyers should be displayed in hospital A and E departments, which many might think would feed the monster and make it bigger?

[The Minister of State, Department of Health (Mr Simon Burns)]

I am very grateful to my hon. Friend for raising that, because it is an important issue. As he might be aware, there are rules and regulations: it is not acceptable for that sort of advertising in NHS hospitals. I would hope that any trusts behaving in that way immediately review their procedures.

Life Sciences

Andrew Bridgen Excerpts

Monday 5th December 2011 Commons Chamber

[Mr Lansley]

My hon. Friend makes a very good point from his personal experience. It is precisely because we recognised that patients in Britain were not getting access to the latest cancer medicines as quickly as patients in other countries that we were clear at the election that we would introduce a cancer drugs fund. Since the introduction of the fund in October 2010, more than 7,500 patients have accessed new cancer medicines through it. The early access scheme that I have described will go even a step further in anticipating the successful, efficacious introduction of new medicines in a way that allows patients and clinicians sometimes to access medicines even before the point at which they are licensed.

[Andrew Bridgen (North West Leicestershire) (Con)]

As a graduate in biological sciences, I welcome the Secretary of State’s commitment to life sciences in this country. In my opinion, there has been too much of a disconnect between vital research at universities and in the private sector and the NHS. How will the Secretary of State ensure that the biggest beneficiaries of the release of these valuable data are UK patients and universities, and UK-based companies?

[Mr Lansley]

I would instance two things in that respect, the first of which is the developing collaborations that were started under the academic health science centres and that will be continued through the networks that we want to extend. Those partnerships are specifically designed—£800 million was allocated in August, based on a competition—to enable the translation of discovery into new medicines in this country.

Secondly, the £180 million catalyst fund, which the MRC and Technology Strategy Board will implement, is specifically designed to take those ideas—the MRC says that it has some 360 such potential developments in medicines and treatments—through to the point at which they can be developed. Of course, that will be in this country.

National Health Service

Andrew Bridgen Excerpts

Wednesday 26th October 2011 Commons Chamber

[Liz Kendall]

I wish the hon. Gentleman had been here at the start of the debate, when it was made clear that the last real-terms cut in NHS spending was in the last year of the previous Conservative Government.

Doctors, nurses, patients and the public know the truth about this Government’s plans. When the NHS should be focused on meeting the biggest financial challenge of its life and on improving patient care, it has instead been plunged into chaos. At precisely the time that the NHS needs maximum leadership and financial grip, the Government’s reorganisation is creating havoc. First, they said that they would scrap primary care trusts and strategic health authorities, and replace them with GP consortia. Then they changed their mind, merging PCTs and SHAs in supposedly temporary clusters and replacing consortia with clinical commissioning groups and new clinical senates, and now they have changed their mind again: PCT and SHA clusters have apparently been saved as part of the Government’s huge new national quango, the NHS Commissioning Board, which will employ more than 3,000 people.

Professor Malcolm Grant, the Government’s own choice to run the NHS Commissioning Board, last week called the Government’s plans “completely unintelligible”. The very people who are supposed to be running the NHS are confused and wasting time trying to figure out ill-thought-through Government plans. That time and energy should be spent on patients. Far from cutting bureaucracy and saving taxpayers’ money, the Government are creating hundreds of new organisations and wasting more than £2.5 billion in the process, when this money should be spent on front-line patient care.

What has been the result of 18 months of a Conservative and Liberal Democrat Government running our NHS? Thousands of front-line clinical staff are losing their jobs and posts are being frozen, piling pressure on those who remain. [Interruption.] The Secretary of State shakes his head, but this month the Royal College of Nursing has surveyed 6,000 of its staff and made it clear that 20% of the nurses and health care assistants surveyed said that their job is going to be cut, that 40% are seeing recruitment freezes in their trust and that 13% are seeing bed and ward closures in their trust. Who is more likely to be accurate? The nurses and health care assistants working in our NHS, or the Government, who are denying that any of these changes are taking place?

The result is that patient care is going backwards. Far from what Ministers claim about waiting lists being fine, the number of patients waiting longer than four hours in A and E is now double that of last year. Twice as many patients are waiting more than six weeks for their diagnostic test, and six times as many are waiting longer than 13 weeks. Anybody who has waited, or has had a family member who has waited, more than three months even to get their test knows how worrying and frightening it is, yet the Government deny that there is a problem. Furthermore, 48% more patients are now waiting more than 18 weeks for their hospital treatment.

Despite all the evidence, the Government are in denial. They deny that the number of front-line NHS staff and the number of staff training places are being cut, yet a recent survey by the Royal College of Midwives has shown that six out of 10 SHAs have been freezing staff training places because of the cuts. Given that the Government promised 3,000 more midwives, that is a problem, particularly in constituencies such as mine that have increasing birth rates.

[Andrew Bridgen (North West Leicestershire) (Con)]

What is the hon. Lady’s opinion of the £12 billion wasted by the previous Labour Government on the failed NHS IT project?

[Liz Kendall]

The hon. Gentleman, who is a constituency neighbour of mine, would do better focusing his attention on the RCN and RCM in our area, which are asking us why the Government are not fulfilling their commitment on extra midwives. If he goes to the hospitals in Leicester, as his constituents do, he will know that there are concerns about that.

The Government deny that the number of front-line NHS staff is being cut, that waiting lists are rising and, worst of all, that there is still widespread and growing opposition to their NHS plans.

Oral Answers to Questions

Andrew Bridgen Excerpts

Tuesday 18th October 2011 Commons Chamber

[Paul Burstow]

I am sorry if the hon. Gentleman feels that all the issues have not been dealt with following our telephone conversation and subsequent correspondence. I will check the correspondence again, and if I find that something is missing, I will certainly provide an answer.

[Andrew Bridgen (North West Leicestershire) (Con)]

I welcome the policy review of the entitlement of foreign nationals to free NHS care, but will my right hon. Friend assure the House that it will examine the options relating to charges for GP as well as hospital services?

[Mr Burns]

My hon. Friend has asked an extremely reasonable question, and I can give him the assurance that he seeks.