In-patient Mental Health Services (Children and Adolescents)

Andrew Percy Excerpts

Wednesday 23rd October 2013 Commons Chamber

[Alan Johnson]

My hon. Friend makes an important point. YoungMinds, the charity that deals specifically with child and adolescent mental health, makes exactly the same point. We need early intervention, and if we are cutting back on tier 3 there will be a bigger problem with tier 4. If the problems are not addressed anyway, we are stacking up a host of problems, and costs, never mind the tragedy to the individuals when they reach adulthood.

It is difficult to escape the conclusion that the changes have nothing to do with improving care, and everything to do with saving money. The closure of the West End unit has had a profound effect. I have a constituent who is a single mother, who works for the NHS as a staff nurse, whose 13-year-old daughter suffered a severe mental breakdown two years ago. Her daughter spent nine months at West End, which opened at weekends specifically to accommodate her needs. Her mother believes that the treatment given by the excellent staff at West End saved her little girl’s life.

When my constituent’s daughter needed further treatment this year, after West End had closed its in-patient facility, she was first of all sent to Leeds, 66 miles away, where the inability of her mother and five-year-old brother to spend as much time with her, led to a further deterioration in her health. She was then incarcerated with young offenders in Cheadle, 103 miles from her home. Her mother, coping with a five-year-old son and a job in the NHS, spent nine hours travelling to have just one hour with her daughter. For the rest of the time she was forced to listen to her deeply unhappy daughter sobbing at the other end of a phone. Is this what the NHS has come to? Is this the kind of treatment that any of us would accept for our children?

[Andrew Percy (Brigg and Goole) (Con)]

I congratulate the right hon. Gentleman on securing the debate. Obviously, this is a matter that affects my constituency too. He is right to raise the issue, but sadly this is nothing new. In 2008, my constituency saw all its in-patient mental health beds go, resulting in patients having to travel much further, often to Hull, and their families struggling to be near them, so I agree with him entirely on this point. Does he agree that it is important that people are treated in the community as much as possible, but where necessary, treated at in-patient units in their localities?

[Alan Johnson]

The hon. Gentleman makes an important point. He is talking about the closure of adult in-patient services, which had to move from Goole to Hull. The irony is that in-patient mental health facilities for adults exist in Hull. Providing care close to home is important for adults, but surely it is even more important for six, seven and eight-year-old children. The further away they are from their parents, the more their mental health situation is likely to deteriorate.

Oral Answers to Questions

Andrew Percy Excerpts

Tuesday 22nd October 2013 Commons Chamber

[Jane Ellison]

As the right hon. Gentleman might know, my first outing as public health Minister was to attend a diabetes think-tank, which I hope indicates how seriously I take the issue. I do not think what he asks for is within my powers, but obviously I will take a close interest in the Department of Health canteen. The right hon. Gentleman is right. We have never said that other measures will not necessarily be taken, but the responsibility deal has taken us a long way when many predicted it would not, and we are keen to inject new energy into it.

[Andrew Percy (Brigg and Goole) (Con)]

When I was in the classroom as a school teacher, people used to come to school having had Micro Chips for breakfast. I do not wish to see a nanny state imposed on anybody, but we must do a lot more education. I urge the Minister’s Department to work cross-departmentally with the Department for Education to ensure that we get proper health and food education in our schools. Those using fast food at the moment are often those who can least afford it.

Managing Risk in the NHS

Andrew Percy Excerpts

Wednesday 17th July 2013 Commons Chamber

“We did point out to him that his plans were written before the big financial challenge, and didn’t that change things? He completely did not see that at all. He completely ignored it”.

[Andrew Percy (Brigg and Goole) (Con)]

Will the right hon. Gentleman way?

[Andy Burnham]

I will give way to the hon. Gentleman, but I hope he will respond to what he has just heard.

[Andrew Percy]

If a few more of the shadow Secretary of State’s colleagues had turned up to this debate, they would be able to respond to those points for him.

If I may take him back to his comments about the challenges in A and E, which have been severe this Christmas and winter, does he accept that one of the things that he and his party got wrong in government was to cut beds and close wards before putting in place proper intermediate care services? People in my constituency could not get into their local hospitals this year because of the beds that were cut when his party was in government.

[Andy Burnham]

The hon. Gentleman is doing what the Conservatives have been doing for quite a few weeks now, which is rewriting history. Does he recall the general chaos in A and E before 1997? Does he remember people waiting for hours on trolleys before they were seen or people spending a day in A and E departments? When we left government, 98% of trusts across the country were meeting the four-hour target. Sadly, we cannot say the same about the NHS on his Government’s watch.

What I have just given to the House was a warning of all warnings not to proceed with a reckless reorganisation at a time when the NHS was facing the biggest financial challenge in its history. Senior civil servants gave those warnings; the Government ploughed on regardless. That was a monumental mistake, combining the biggest ever financial challenge with the biggest ever reorganisation. Eyes were taken off the ball at the worst possible moment.

--- Later in debate ---

[Mr Hunt]

I will give way in a moment.

The right hon. Member for Leigh talked about leadership. I want our NHS to attract the brightest and best leaders that this country has to offer. I have asked the NHS leadership academy to develop a new leadership programme to support clinicians to become clinical chief executives and to fast-track professionals from outside the NHS into leadership roles. We urgently need more talented managers in our NHS, and that will make a big difference.

[Andrew Percy]

I want to take my right hon. Friend back to the comments of the right hon. Member for Leigh, which I found shockingly complacent. I will give the example of Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, which is one of those that is in special measures. Our mortality rates started to go up in 2007 and started to fall in 2011, but our nursing numbers have been increasing over that whole period. I find it shockingly complacent for somebody to suggest that there is not an issue or to downplay those figures. In my area, that has potentially cost hundreds of lives.

[Mr Hunt]

My hon. Friend makes an important point.

I say to the shadow Secretary of State that it is a question not just of whether he responded to the warnings that he received, but of whether he received the warnings that he should have received in the first place because the inspection system might not have been up to scratch.

Oral Answers to Questions

Andrew Percy Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

I do agree with Robert Francis, but as he said in Nursing Times, there is an apparent misunderstanding by many people about what his recommendations actually were. This is what he said:

“I did not recommend there should be a national minimum staffing standard for nursing. The government was criticised for not implementing one, which it is said I recommended, which I didn’t.”

[Andrew Percy (Brigg and Goole) (Con)]

As someone who worked in the public services before my election here, I well understand the pressure put on public servants to cover up bad news. I was contacted by a nurse yesterday who informed me that concerns that were raised at a training day were dismissed by a matron—people were told to put them in the bin. Can the Secretary of State assure us that he will do everything to ensure that nurses who are concerned about staffing levels feel free to speak out and will be protected?

[Mr Hunt]

What my hon. Friend says is incredibly important. We must have a culture of openness and transparency inside the NHS, which means that people at the front line feel empowered to speak up if they think there is a problem. That has not happened in the past, and we are going to put it right.

Hospital Mortality Rates

Andrew Percy Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

The same assurances I have given everyone else representing a hospital with troubles: we are totally committed to sorting out those problems—[Interruption.] Labour Front Benchers ask when, but we have said that these hospitals will be re-inspected in the next year. The structures that we are putting in place to sort them out are a million times tougher than anything that happened when they were in office.

[Andrew Percy (Brigg and Goole) (Con)]

I am proud of our local NHS, especially the examples of good practice highlighted at Goole hospital. However, as someone who works as a volunteer in the NHS every weekend, I meet patients who are frightened of going into local hospitals precisely because of the failings highlighted in the report on North Lincolnshire and Goole Hospitals Foundation NHS Trust. Will the Secretary of State visit Goole and north Lincolnshire to meet my constituents and discuss such individuals as an 88-year-old whose nails were not cut for seven months, whose toilet calls went unanswered and who ultimately died after contracting E.coli in our local hospital?

[Mr Hunt]

Of course I would be delighted to visit my hon. Friend’s local hospital. I am sure there will be a great deal that I can learn, and I hope I will be able to give encouragement to the staff there, who are working very hard in a very difficult situation. I hope today will give them encouragement that this is a Government who are determined to turn around their hospital.

Health Services (North-West)

Andrew Percy Excerpts

Thursday 11th July 2013 Commons Chamber

[Mr Hunt]

First, let me say to the right hon. Gentleman that 25 extra patients a day will have to be absorbed by the three neighbouring hospitals to Trafford, so it is not a large number. We want to make sure that all hospitals, including Wythenshawe, which I have visited—it is a superb hospital—are able to absorb that capacity. It is currently meeting its A and E target. The application that has been made for extra capital grant to help it to expand its A and E department will be treated as a priority.

[Andrew Percy (Brigg and Goole) (Con)]

Safety should always be paramount, but public confidence is also important. As the Secretary of State faces further tough decisions on reconfiguration in the coming years, will he assure me and other Members of this House of two things: that he will be conscious of not applying urban solutions to rural areas; and that where alternative pathways of care can be put in place, that will happen before changes take place?

[Mr Hunt]

My hon. Friend makes two important points. I explicitly said that we will not proceed with any of these changes until neighbouring hospitals have been consistently meeting their A and E standards and any necessary changes have been put in place so that we can be sure that they will improve care for patients. That is really important if we are going to maintain confidence.

On my hon. Friend’s point about urban versus rural, part of the underlying reason for these changes is that we need to get more care out of big hospitals, which are often in urban areas, and into the community—into settings near people’s homes. That is very important for rural communities where there are often large concentrations of older people. Today’s decision will mean an additional investment in those community services. As we look at the big changes we need to make in the NHS, we will need to make more decisions that allow more to be invested in out-of-hospital care if we are to prevent the illnesses that ultimately put so much pressure on our A and E departments.

Health and Care Services

Andrew Percy Excerpts

Wednesday 3rd July 2013 Commons Chamber

[Dr Lee]

I am pleased that services are improving in County Durham; as the hon. Gentleman knows, I have family roots in his part of the world that go back centuries. I am not persuaded of the role of pharmacies, although I am persuaded of the role of pharmacists. I distinguish between the two because I personally think that all GP surgeries should be dispensing drugs. I do not see why the taxpayer should be subsidising pharmacies.

It is no surprise to me that Boots was the biggest ever private equity buy-out in the history of British industry, given that the taxpayer is outside the front door: “Come here for your amoxicillin, and while you’re here you can get your shampoo, conditioner and royal jelly.” I am not convinced about the role of pharmacies in the longer term; pharmacists most certainly have a role and should be included. Community pharmacists should be checking drugs, particularly when patients have polypharmacy—when they have a multitude of medications, another pair of eyes is always appropriate.

To return to the reconfiguration, in my locality we have a number of district general hospitals. Historically, Bracknell itself has been under-served by acute services since it was created in the late ’50s or early ’60s. We have seen services diminish in the area for a variety of reasons and under Governments of both parties, and we are sensitive about that.

Before I was elected as Member of Parliament for Bracknell—I stress that it was before I was elected—I suggested as part of my campaign that we needed to close hospitals in the area and consolidate to improve clinical outcomes. I am not aware that my result at the election was adversely impacted by that. Having worked in the area as a GP for a number of years and looked after 50,000 patients, I guess that people trusted what I was saying, and I recognise that.

I was trying to argue that we could consolidate acute services on a single site and improve community hospital services in appropriate locations around the region. I stress the word “appropriate”, as the problem is often that, for a variety of legacy reasons, hospitals are in inappropriate locations. They are not often on motorways, but on land bequeathed before the war. In my part of the world, the Astor family bequeathed the land for Heatherwood hospital. The local farmer outside Slough bequeathed some land because his daughter was looked after well. People thought, “Okay, we’ll build a hospital in the middle of a farm field nowhere near the population that it seeks to serve.”

There is a legacy problem. There is some need to close and relocate, while in some parts current locations can be enhanced. In my locality, there is the problem with Heatherwood hospital. I must put on the record something bizarre that frustrates me. It is “blue on blue”; if I was in a defence debate, it would be called friendly fire. The Royal Borough of Windsor and Maidenhead has called for a judicial review of the relocation of a minor injuries unit just three miles down the road, would you believe, to Bracknell—an urban centre in a better location and away from a place opposite the Royal Ascot racecourse. That judicial review will delay the move and cost money. I find that baffling and bizarre. It is evidence of the problem that I guess all colleagues of both political colours experience in local politics with regard to health care and trying to change services for the improvement of clinical outcomes, because it is not about cost, although obviously that is a factor, but about improving clinical outcomes. That frustrates me, and I will certainly be dealing with it robustly in local terms. At the moment, it is in the best interests of the general public to have fewer acute hospitals.

[Andrew Percy (Brigg and Goole) (Con)]

My hon. Friend is making an interesting point. Does he agree that in applying solutions such as those he is espousing, we must be careful that we do not apply an urban solution to rural areas? Moving an A and E three miles might be acceptable, but moving it 30 miles would not be acceptable to a lot of us.

[Dr Lee]

My hon. Friend is right: in a rural location the distances become further. I do not know the particular situation in his region, but I would suggest that there are probably location issues with regard to existing hospitals.

Moving neatly on, that is why—yes, you heard it here first: a Conservative calling for a Soviet-style central plan—I have called for a national plan for acute and emergency care. By definition, we cannot have a market interfering in that; we need to look at it in the round and say, “Where would we put these hospitals? Where are the motorways? What is the population density? Where is the rural location? Where is the urban location?” The problem is that if we reconfigure in isolation—I have seen this locally—it has a knock-on effect on other hospital services which then say, “Where are we getting our patients from?”

We should have a national plan that everyone from both parties has bought into. We should have—dare I say it?—a cross-party party committee looking into this. We should take it out of the political exchanges that we all engage in. We know what is going to happen in certain quarters in 2015—it will become a political football. I know that my hon. Friend the Minister is very aware of this. That is dreadful when we are talking about saving lives. Let us try to take this out of party politics. We can have robust exchanges, on principle, about payment, about how services are commissioned or not commissioned, and about whether there should be top-down reorganisation, but the fundamental question of where hospitals—acute and community hospitals—are located should be decided nationally; otherwise we could have perverse decisions whereby some services wither on the vine and we end up with gaps in emergency and acute care across the country. I make a plea for some cross-party activity on this.

Let us put the national health service’s budget into context. This country has debts and liabilities in excess of five times the size of our economy, and the situation is getting worse. Almost 40% of spending is on health and welfare, and it is growing. We know that that will happen; we have heard it this afternoon. Let us be realistic: there is only so much we can afford. I genuinely want a service that is based on clinical need. I genuinely want somebody to arrive at the appropriate location and get the very best care available. I fear that if we continue along this path of denial as regards how the service is paid for and, more important, structured, we will end up with more and more scandals. There are more in the pipeline. The chief executive of Tameside hospital has just resigned.

The public out there want more from us. They want us to make some difficult decisions, for sure, but using evidence, not party politics. I make that plea to everybody. If we can do that, we can structure a service that becomes the envy of the world; it is not that at the moment. However long I end up staying in this House, if that is achieved in the time I have been here, I will retire a happy man.

111 Telephone Service

Andrew Percy Excerpts

Wednesday 5th June 2013 Westminster Hall

[Jim Shannon]

I thank my hon. Friend for his intervention, which clearly outlines exactly what the 111 system should be trying to achieve. Sometimes, when hon. Members ask if I will take an intervention, they are looking over my shoulder to see what I am going to say next. My hon. Friend made exactly the point that I was going to make.

There have been lots of complaints about calls going unanswered and poor advice being given, which reiterates the point made by my hon. Friend. That follows concerns prior to the national roll-out, after pilot schemes showed disastrous results, with tales of patients waiting hours for advice and others being asked to call back later. That situation is quite unsatisfactory and must be addressed. NHS England stated:

“The safety of patients must be our paramount concern”.

So it should be, and if it is not, we want to ask why. It also said:

“NHS England will keep a careful eye on the situation to ensure NHS 111 provides not only a good service to the public, but one which is also safe.”

Examples mentioned by all hon. Members—we have them in front of us—provide information that contradicts that. In Greater Manchester, the 111 service was started and then abandoned. Dr Mary Gibbs, a GP providing out-of-hours cover when the system crashed there, said:

“Calls just weren’t coming through.”

Quite clearly, that is the issue. She stated:

“It was totally inadequate. Patients’ health was put at risk.”

The 111 service tends to be busiest when local surgeries are closed. Dr Laurence Buckman, chairman of the British Medical Association GPs committee, stated:

“We are still receiving reports that patients are facing unacceptably long waits to get through to an NHS 111 operator and suffering from further delays when waiting for calls back with medical advice should they manage to have their call answered… The quality of some of the information being given out appears, from anecdotal sources, to be questionable in some instances.”

The advice that people are being given does not always seem to have been up to scratch and is not of the quality that it should be. He added:

“If any area of the country is failing to meet high standards of care, then its NHS 111 service needs to be suspended.”

This is what the experts in the field are saying. NHS England needs to be more transparent about how the system is functioning across the country.

[Andrew Percy (Brigg and Goole) (Con)]

I met one of my local ambulance service chief executives just last Friday, who told me that, in his experience, the implementation of NHS 111 was going well and was helping to reduce demand on the ambulance service locally—and they were quite happy with the service. Although there have been problems, which the hon. Gentleman is right to highlight, plenty of people have been treated well and professionally by this service, and some health service professionals think that the service is working okay.

[Jim Shannon]

I thank the hon. Gentleman for his intervention. I have stated that the focus of the new system was on trying to make it better. Every hon. Member accepts that. The idea behind it is great, if it works. We elected representatives will always get the complaints. Not often do we get the wee card saying, “Thank you very much for what you’ve done for us,” but we always get the ones saying, “It’s not working well.” The hon. Gentleman is right. I accept that there will be many examples throughout the United Kingdom where the system has, perhaps, worked, but equally there are a lot of examples of where it has not worked. That is the point that I am trying to make.

We highlight such issues for a purpose, not to be dogmatic, angry or always to be negative in our comments, but to try to look towards improvement. I always try to think that my comments will be constructive criticism, which can be taken on board to make things better. My idea as an elected representative over the years, as a councillor and a Member of the Legislative Assembly in a previous life, has always been to try make comments in that way.

I am conscious of my position as a Northern Ireland Member of Parliament, because health is a devolved matter and I am ever mindful of the cuts in funding faced by all Departments in an effort to reduce the deficit—every pound spent must be well spent—but, from my perspective, I urge that the Northern Ireland Direct system continue until the kinks are ironed out here. On health, we will follow, as we often do, what happens here on the UK mainland, so, from a Northern Ireland perspective, I want to make sure that the system’s fall downs and problems are ironed out and sorted out before we take on the system—if we take it on.

I have been looking at the system with great interest, because one of my jobs here as MP for Strangford and my party’s health spokesman is to consider the systems across on the mainland. Many of my queries to Ministers here in questions on health and to my Health Minister back in Northern Ireland come from what colleagues say to me and from what these debates bring out. I am interested in seeing how this system works or will work, or does not work. If it does not work, I will convey that to my Minister in Northern Ireland, to ensure that when making a decision there we will look at how it can happen. I will certainly not be urging our Health Minister in Northern Ireland to use his precious funding to implement this scheme as it stands.

[Mr Jamie Reed (Copeland) (Lab)]

It is a pleasure to be called to speak under your chairmanship for what I think is the first time, Mr Robertson. I extend my most sincere thanks to the hon. Member for Thirsk and Malton (Miss McIntosh) for securing this important debate. We have worked closely on a number of issues during my time in Parliament, and she is rightly respected across the House as an independently minded Member. I must express my most sincere sympathies to her, but also my profound thanks for the real courage she has shown in sharing her family’s experiences with us.

It is a mark of the severity of the crisis our A and Es are experiencing that Members of all shades of political persuasion have spoken at some length about their constituents’ experiences. It is no exaggeration to state that members of the public are very concerned about the situation regarding NHS 111. A and E is arguably the most visible part of our NHS, and what happens there is felt throughout the system. From the patient waiting at home for an ambulance to the person waiting on a trolley for a bed, what happens in A and E touches every patient in the NHS.

The crisis in A and E has happened on this Government’s watch. When Labour left office, A and E was performing well, with 98% of patients seen within four hours. However, the number of patients waiting for more than four hours has now doubled, and ambulance queues have doubled too. Let us not forget that the target for the number of patients seen within four hours in A and E has been reduced under this Government, from 98% to 95%. Today’s debate is therefore extremely important, and the Government must finally offer some real solutions to address the crisis they have caused.

[Andrew Percy]

I find it incredible that the shadow Minister states that the issue was caused by this Government. A lot of my constituents are having to ring 999 because 50,000 beds were taken out of our hospitals nationally on his party’s watch; wards were closed in my local hospital on his party’s watch. Elderly, vulnerable patients who do not have local hospital beds to go to are now forced to ring 999 to get access to emergency services, so it is pretty shameless of the hon. Gentleman to attempt to politicise the issue.

[Mr Reed]

I have to say I am staggered by the hon. Gentleman’s manufactured indignation. I do not know how long he has been a Member of the House, but he will recall that, between 1997 and 2010, the Labour party took the NHS budget from about £30 billion to £110 billion. However, on every occasion the budget was put before the House of Commons, the Conservative party voted against an increase. He should think again about his manufactured indignation.

[Andrew Percy]

rose—

[Mr Reed]

I am going to make some progress, because I want to get on to the substantive issues in play.

When Labour first suggested a new NHS 111 service, we were clear—the hon. Gentleman should listen—that it would not replace NHS Direct. Our manifesto in 2010 said:

“A new national 111 telephone number will make nonemergency services far easier for people to access and book.”

The 111 service was planned to help people find an emergency dentist, a late-night pharmacy or an out-of-hours primary care GP. This Government scrapped that and instead pressed ahead with the botched implementation of a system that just could not cope with what it was expected to do. They were warned, but, as usual, they did not listen.

There is no doubt that the 111 service is not fit for purpose. The statistics show it, the examples given by Members today show it and, most importantly, patient testimonies show it. Indeed, the Minister herself acknowledged it in response to the right hon. Member for Mid Sussex (Nicholas Soames) in late May, when she stated:

“We recognise that the service has not been good enough and we are working closely with NHS England to ensure improvement in performance. NHS England have put a number of measures in place already.”—[Official Report, 21 May 2013; Vol. 563, c. 740W.]

I hope the Minister will outline what those measures are and what their effects have been, because the contributions we have heard today suggest they are having a negligible effect.

The implementation of the system has undoubtedly caused serious problems; indeed, in my area, NHS Direct is having to be maintained alongside the 111 service to cope with demand. The Minister must explain in detail how a botched, fragmented implementation was allowed to happen despite there being a significant pilot scheme.

--- Later in debate ---

[Anna Soubry]

I am not for a moment saying that there are not difficulties and problems in 111. We know there are, but if only the issue were as simple as solving the 111 problems. The out-of-hours service is just one of many factors. [Interruption.] I want to make some progress on this point: 111 is one factor among the failings in relation to the sort of out-of-hours service that people want. We have also had the difficulty of a long, cold winter, which has added pressures—that is something that often happens. Also, there are 1 million more people attending A and E. That is not the fault of the Government. We have not suddenly caused it. It is because of changes—

[Andrew Percy]

rose—

[Anna Soubry]

I will take interventions, but I want to make these points first.

The population is also living considerably longer. That is good and welcome, but there are many frail elderly people with complex illnesses and diseases, so they attend A and E in a way they did not previously. In addition, we suffered under the previous Government from a lack of integration between health and social care. That was one of the things that the Health and Social Care Act 2012 addressed, and will solve. It is about better integration. The hon. Member for Copeland sneers at that.

[Anna Soubry]

He laughs at it, Hansard will record. It is not a laughing matter at all. What I was describing is one of the achievements of the Act. I am confident it will deliver.

[Andrew Percy]

The Minister is making sensible points. As to manufactured indignation, if that is what it is, mine comes from the fact that I spend 30 to 40 hours a week volunteering in the NHS as a first responder, and I spent 30 hours doing so last weekend.

A big issue that creates pressure in the NHS is the lack of integration between social care and health services, and a lack of proper intermediate care facilities. We do not have the step-up, step-down facilities that we need to deal with the ageing population. That is one of the biggest problems in my area and a reason for increased pressure.

[Anna Soubry]

I, too, know that it does no one any favours to make out that someone forcefully and passionately giving a view based on their experience is manufacturing it. I know that that is not true of my hon. Friend, and I thank him for his valuable contribution. He is right.

--- Later in debate ---

[Anna Soubry]

No; forgive me. The most important thing, though, is that things are improving.

[Andrew Percy]

We on the Health Committee were provided with figures yesterday showing that referrals to A and E from NHS 111 were about half the amount of those from NHS Direct, but that there had been an increase in referrals to out-of-hours and GP services. The link between NHS 111 and pressures on A and E is perhaps not proven.

[Anna Soubry]

I am grateful for that intervention. I know that the university of Sheffield specifically examined the pilot and found that in most pilot areas, there was no impact. However, we also know that NHS England is monitoring the situation, reviewing the data and analysing all the different, complex problems causing pressure on A and E to ensure that we make the improvements that we want.

My right hon. Friend the Member for Thirsk and Malton—[Interruption.] Well, I am going to make her right hon. for the moment. It will not be put into Hansard, so no one will know; it is just between us. She made an important point about providing for people receiving palliative care, catheter treatment and so on. She said that perhaps they needed a different script. There is much merit in that. Again, I would hope that the commissioning services would put that aspect in the script. She asked specifically about the script. I am reliably informed that it has been written by clinicians at the highest levels, but I also know that there is concern at a senior level about the fact that it takes an average of 20 minutes to go through a prescriptive script.

There is a wider problem here. We live in an age in which it is increasingly difficult to rely on common sense. When somebody rings up and says, “My father is a retired GP. We’ve been here before, and he has all the symptoms of a urinary tract infection,” they should not be asked whether he is still breathing. A large dose of common sense would mean that that question would not be asked, nor would “Is he bleeding?” and so forth. That is the stuff of nonsense.

Accident and Emergency Waiting Times

Andrew Percy Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

I agree that A and E departments are under huge pressure, and that is why we are taking a lot of measures to deal with them, which is what I am talking about. But I am saying that we have to deal with the root causes, which were things that the shadow Secretary of State’s Government failed to deal with. [Interruption.] Labour Members need to listen. We listened to the shadow Secretary of State’s solutions, which were not really solutions; now I am telling them what we think needs to happen.

We welcome the fact that the Labour party has now seen the light and recognises the need for integration, but Labour Members need to show some humility, because it was the Labour Government who put in place many of the barriers—in particular payment by results mechanisms—that make that so hard to achieve. We are now trying to make integration a reality through the 10 pilots on removing barriers to integration announced by the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), as part of the vulnerable older people’s plan announced to the House last month. Without integration, we will not solve the problem of bed blocking, which is at the heart of the pressures on A and E.

[Andrew Percy (Brigg and Goole) (Con)]

The Secretary of State is right to say that many of the present failures started in the Labour years, particularly the problems with integration. Does he share the concern that I and many of my constituents feel about the 50,000 beds that were lost under Labour Government? We lost the beds, but the intermediate care services and step up, step down facilities were never created to deal with the consequences. That is what is behind a lot of the A and E referrals today.

[Mr Hunt]

That is part of the problem with Labour’s approach to the NHS—a top-down approach of closing or downgrading A and E units and making the NHS sort out the problems. We are not doing that.

It is time that Labour took responsibility for the disastrous changes to the GP contract, which contributed to making it so much harder to get a GP appointment and piled further pressure on A and E departments—[Interruption.] No, they need to listen; this is important. The changes in 2004 handed responsibility for providing out-of-hours services to administrators in primary care trusts, at a stroke removing the 24/7 responsibility for patients that until then had always been a core part of being a family doctor. As we heard earlier today, even a former Labour Health Minister regretted those changes, saying before the last election:

“In many ways, GPs got the best deal they ever had from that 2004 contract and since then we have, in a sense, been recovering.”

It is important that Labour Members hear the list of independent voices all saying that we need fundamental change in primary care if we are to deal with pressures on A and E: the College of Emergency Medicine, the Royal College of Physicians, the NHS Alliance, the Family Doctor Association, the head of the Royal College of General Practitioners, who—surprisingly—said something in support of the Government in The Guardian this morning, the Foundation Trust Network and so on. All those voices were ignored by Labour as it put its head in the sand about that disastrous change to the GP contract.

--- Later in debate ---

[Andrew Percy (Brigg and Goole) (Con)]

This debate has improved as the Back-Bench contributions have gone on. It started off fairly gracelessly, with an attempt to lay all the blame for the pressures in A and E on this Government. That was pretty shameful. I like and respect the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham), but it was graceless of him to suggest that this is entirely of this Government’s making.

As a number of hon. Members have said, there is a broad range of issues behind the pressures on A and E services. Long before I was elected, I campaigned against some of the changes that made a difference in my own constituency and increased pressure on the NHS. We have heard about bed reductions and the lack of joined-up social and health services. I think there is an issue with GPs and I respect the view of the Health Committee Chairman on that. A lot of residents were confused—this was touched on by the right hon. Member for Exeter (Mr Bradshaw)—about where GPs’ services were and how they could access them after the change in 2004 in particular. I think that that has contributed to people choosing to access other services. I confess that I have absolutely no idea how the out-of-hours service in my area works. I am lucky that I have never had to use it, but a lot of people were incredibly confused by their out-of-hours service after 2004. The right hon. Gentleman also mentioned walk-in centres, but my area did not get one. If we are expected to use the one in Scunthorpe, that is not a sufficient local alternative.

We have also heard about a demographic shift, which is clearly a huge issue, as is population growth. After the failure of health services and all Governments to deal properly with palliative care and end-of-life plans, one of my hospitals in Goole experienced massive reductions in services, largely on the previous Government’s watch. Our mental health ward went and all the town’s mental health beds disappeared, as did medical beds in general. Service after service disappeared. When those mental health services were lost and replaced by apparently intensive home support, we ended up with people in crisis and, as my hon. Friend the Member for Totnes (Dr Wollaston) has said, presenting to A and E and other services.

The failure of social care is a problem, but I remember one of my local authorities—East Riding of Yorkshire—changing the criteria for access to its services many years ago as a result of funding pressures from the previous Government. I wish that Labour councillors at my other council, North Lincolnshire council, had listened to the Secretary of State before they tabled their budget for this year, which proposed removing social care from thousands of my constituents and changing the required criterion from “moderate” to “substantial”. If it had not been for Conservative councillors voting down the Labour budget and instead voting to protect social care, there would have been massive social care cuts in my area. I hope that the right hon. Member for Leigh will relay that to his colleagues in my area.

The failure to have proper intermediate care services has also been mentioned. My local authority is trying to address this through a £3.2 million scheme in my constituency to create a 30-bed unit. Bed blocking has been a massive problem in recent years and we all know about it. Plenty of people come in, but not enough go out the other side. The Labour party has to take some responsibility for that problem, because it has not appeared overnight. The issue has been affected by population growth and a demographic shift.

In the brief time remaining, I concur with the Health Committee Chairman that it would be much better to take the politics out of this debate.

Mid Staffordshire NHS Foundation Trust

Andrew Percy Excerpts

Tuesday 26th March 2013 Commons Chamber

[Mr Hunt]

That sounds like something that would definitely encourage the duty of candour that we have been talking about today. I am sure that different hospitals will want to have different ways of doing that, but we will definitely note my hon. Friend’s comments.

[Andrew Percy (Brigg and Goole) (Con)]

Staffing levels are important, but so are bed numbers. Many of the 41,000 beds lost under the previous Government were in my constituency. Consequently, we have massive pressure on beds, wards on purple alerts and very high mortality rates. Will any inspection regime include an assessment of safe bed levels?

[Mr Hunt]

The inspection regime will of course cover such issues as part of its inspection of whether basic standards of care are being met. Yes, of course such issues matter, but there are challenges beyond what an inspection regime can deliver which we will need to address to deal with these issues. In particular, a problem we are wrestling with at the moment is who will take responsibility for the frail elderly when they are discharged from hospital. One reason why they stay in hospital for a long time is because geriatricians are nervous about sending them back into the community. They do not think anyone will take responsibility for them and that is something we have to look at.