Accident and Emergency Departments

Andy Sawford Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

Absolutely. I have visited Airedale hospital, which I think is excellent. It is one of the few hospitals in the country where the A and E department has access to GP records, which means it can give patients a much better service. It also has fantastically innovative ways of looking after the frail elderly in the community. I think that some of the smaller rural hospitals are blazing a trail when it comes to the changes we need to make elsewhere.

[Andy Sawford (Corby) (Lab/Co-op)]

Kettering general hospital’s A and E department was built for 20,000 people a year but is now trying to meet the needs of 80,000 people. The money announced today is of course welcome, but I ask the Secretary of State to look seriously at our bid—a joint bid from neighbouring MPs too—for capital investment in Kettering’s A and E.

[Mr Hunt]

I will of course look at that closely. I have been to Kettering hospital and recognise that it is very busy and that people there are working very hard, but I think that the staff are doing a fantastic job.

Oral Answers to Questions

Andy Sawford Excerpts

Tuesday 16th July 2013 Commons Chamber

[Dr Poulter]

I am happy to commend Kettering general hospital for some of the improvements in care that have been made recently. My hon. Friend will, of course, want to ensure that that progress is sustained during the weeks and months ahead. As he will know, Monitor is still overseeing the trust to ensure that patient care and performance remain up to standard.

[Andy Sawford (Corby) (Lab/Co-op)]

I welcome the comments of the hon. Member for Kettering (Mr Hollobone). Kettering general hospital also serves my constituents, and I look forward to meeting the Minister this week to discuss the pressures that are being imposed on it. One of the trust’s main problems is having to spend money from its acute budget on local care home beds. Does the Minister recognise that that should not be happening?

[Dr Poulter]

The approach that must be adopted to ensure that health and social care services are joined up in the way that we need will vary in different parts of the country, and in accordance with differing health care needs and demographic challenges. I look forward to discussing that and other issues further when I meet the hon. Gentleman and my hon. Friend the Member for Kettering (Mr Hollobone) tomorrow or on Thursday.

Kettering General Hospital A and E

Andy Sawford Excerpts

Wednesday 26th June 2013 Westminster Hall

[Andy Sawford (Corby) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mrs Brooke. I am grateful for the opportunity to debate the future of Kettering General hospital’s accident and emergency services.

Kettering General hospital has served the people of my constituency for 115 years. It is where my children were born, and where my granddads received care at the end of their lives—where I said goodbye to them—and today it is a place that is relied on by my family and my constituents. I declare an interest in that it is where my mum, like many thousands of local people, works. Kettering General hospital is a huge part of the community, because of the care it provides and because it is one of the major local employers. Many of my constituents are employed there, as nurses, doctors and auxiliary staff, and I take this opportunity to thank them, in whatever capacity they work. Working in our health services is demanding and, for most health workers, not particularly well paid. The hours are long and the demands are great, but the overwhelming majority of my constituents receive good care, and for that we are all grateful.

However, we have to face some hard truths. The quality of care at the hospital is not good for everyone. It is not realistic to think that 100% of my constituents will get perfect care every time, but it is something for which we should surely strive. All the evidence shows that too many people do not get the care they need. Kettering General hospital employs more than 3,000 staff, and has more than 600 in-patient and day-case beds and 17 operating theatres. The hospital has a consultant-led level 2 trauma unit in its 24-hours-a-day, seven-days-a-week accident and emergency department, and there are currently two locums and five consultants who are on site until 11 o’clock in the evening and on call until 8 o’clock in the morning. Some cases, such as severe burns and head injuries, are transferred, often by air ambulance, to Coventry, which has a level 3 trauma facility, but Kettering General hospital is where most trauma patients go. It serves the accident and emergency needs of a wide population across north Northamptonshire.

The hospital’s location, right next to one of the busiest arteries in the midlands—the A14—makes it the most accessible accident and emergency for many people, not only in north Northamptonshire but across the whole county and in neighbouring counties, particularly Leicestershire. The core of the hospital’s patients, however, is from my constituency and that of my two neighbours, the hon. Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone).

Today, I want to speak about the challenges that our accident and emergency services face, and to seek Government support in meeting them. The context is highly political, and the Minister and I will strongly disagree on some health policies, but I would much prefer us to have as constructive a debate as possible today. Much of what I have to say will be supported by the hon. Members for Kettering and for Wellingborough who are unable to be here, but with whom I am working closely and regularly in support of the hospital. We have formed a campaign group, consisting not only of the three of us, but of the local media, the local authorities and many other interested local organisations.

As three Members of Parliament, we meet regularly with the chair and the chief executive of the hospital, and I am pleased to say that, as of last night, we have a meeting arranged with the Minister’s colleague, the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter). We are also in dialogue with the local clinical commissioning groups. A and E services are our top priority.

The Minister will be aware of the Healthier Together proposals for the south midlands area. Last autumn, there was a hurried timetable and inadequate consultation on the proposals. The public gradually became aware of them, the thrust of which was for five hospitals to go into three for some of the services, particularly full accident and emergency, obstetrics and maternity, and in-patient paediatrics. The detailed model underpinning the proposals stated that the best option, according to their criteria, was that Kettering lose its full accident and emergency.

I am pleased to say that, in response to a strong cross-party community campaign, Healthier Together and all those involved, including the clinical commissioning groups and the hospitals, recognised that communities in my constituency and across the north of Northamptonshire would not support the proposals. Our nearest accident and emergency would be at Northampton general, and anyone who knows the county and understands its geography will recognise that that is not acceptable. We do not need the independent experts—as they were called—employed by the Healthier Together team to tell us that it is almost impossible to get from Corby to Northampton along the A43 during peak times without coming to a standstill. There is no rail link between the towns in the north of the county and Northampton, and the bus service is intermittent.

The Department says that it expects proposals for local health service changes to meet four key criteria: support from GPs; strengthened public and patient engagement; sound clinical evidence; and that the proposals support patient choice. I do not believe, nor do the hon. Members for Kettering and for Wellingborough, that those four criteria were met in the Healthier Together work. And it is not just in my area. Councillor Hannah O’Neill, the deputy leader of the Labour group on Milton Keynes council, told me that Healthier Together caused uncertainty across Milton Keynes, that neither communities nor the council was properly consulted, and that they were left with no information about the future of the programme for their hospital. A critical issue for the whole south midlands Healthier Together area is that we do not know where the proposals will take us next.

The final Healthier Together report, published in March, states:

“Current A&E staffing levels do not meet national guidance, which recommends a minimum of ten consultants for a medium-sized A&E department.”

It also raises concerns about the long-term viability of retaining five acute surgical rotas:

“Concentrating A&E and general surgeons onto fewer sites could improve sustainability, but there would still be a need to recruit further A&E consultants to provide consultant presence.”

The report proposes an alternative model of four fully supported accident and emergency sites, with the fifth being a “warm” site, managing and transferring some patients under protocols. In the north of Northamptonshire, the worst case scenario is that we would have to assume, based on the previous detailed proposals, that Kettering would be in line to be that “warm” accident and emergency. That is simply not on, not just because of the geography, but because of the demand from the area that Kettering serves.

We recognise, however, that there is a challenge to improve accident and emergency at Kettering. The hospital had to save £11 million last year, and has to save a further £12 million next year, but the answer lies not in taking away our proper accident and emergency and maternity services but in improving the health system. We need a more integrated health and social care system. I will study the detail of today’s spending review announcements, and if they reflect the integration policies that my right hon. Friend the Member for Leigh (Andy Burnham) and my hon. Friend the Member for Leicester West (Liz Kendall) have been championing, they will have my support.

We need local authorities to act more quickly to get elderly patients out of hospital once they have been treated, so that they can have the care they need in the community and so that hospital beds are freed up. That happened just last year with my nan, after she had a stroke. A critical issue is how primary and acute care will work together in the future. It is also about prevention, about which I heard the Minister speak last week at an event organised by Cambridge Manufacturing, a great Corby-based company that exports across the world and helps people become fitter. If the Minister is wondering, the event was at the National Obesity Forum, and Cambridge Manufacturing was the partner organisation. The issue is also about the hospital itself becoming as efficient and effective as possible.

I am sorry to tell the Minister that instead of moving towards an improved service, there are very serious issues at Kettering A and E. This is a very worrying time. The hospital simply cannot cope with demand; we have rising demand, and an ageing and growing population. There are issues relating to the local doctor services and the out-of-hour services, and twice this year the general hospital had to close the doors of the A and E to patients other than those arriving by ambulance, announcing it to the media and asking local Members of Parliament to tell patients not to turn up. We have been told that the principal factor in that was the 111 changes.

Corby is the fastest-growing town in the UK and has the highest birth rate, but there is population growth right across north Northamptonshire. The number of people attending the A and E department at Kettering General has doubled over the past 20 years, from 40,000 in 1992 to 80,000 in 2012. That 100% increase is far greater than the rate of population growth, and growth continued last year. We have continued growth in Northamptonshire’s elderly population, so an increase in acuity, for example, is to be expected, with more people with more complex problems who really do need A and E care. The trust’s emergency department was not designed to see that many patients. In the hospital’s own words, it is now “not fit for purpose”: it is too small and does not have enough rooms to provide appropriate care.

There are significant issues around the inappropriate use of accident and emergency. A recent patient education project in Northamptonshire showed that 70% of patients did not try to contact out-of-hours GP services before going to A and E. The trust is currently investigating and pricing ways in which it could expand its emergency care department’s footprint to make it more suitable for patients and to make it more efficient to help reduce waiting times.

On accident and emergency waiting times, there has been a dramatic increase in the number of people waiting for more than four hours. In April 2012, 262 people waited more than four hours, but in April 2013 that figure stood at 1,530 people. A year on, we can see how significant the rise in the number of people waiting for more than four hours is. Breaches of the target are largely because of patients waiting in A and E for hospital beds to become available. Kettering General hospital’s bed base runs very hot: 95% to 100% of beds are full. It is therefore often bed availability in the whole hospital, rather than issues in A and E, that leads to breaches of the transit time.

The hospital has launched a transformation programme, which local MPs support, by creating new direct access services for GPs, putting in a new discharge team to improve discharges and expanding the A and E department—for example, with an observation bay for patients needing short-term observation and tests. The hospital is investigating the creation of more of its own step-down facilities in the community.

There are other positive developments. The Corby urgent care centre has improved facilities, particularly for my constituents in Corby. It is not the hospital that Corby people really wanted, but it brings many services closer to my constituency. It is open from 8 am to 8 pm, and it reduces the need for patients to travel to A and E. It is only now coming fully into use, so it will be some time before it takes significant pressure off A and E at Kettering.

I went to the opening of the new foundation wing at Kettering, which is a fantastic new facility. It will improve some of the problems in the hospital, and it increases the number of beds. The hospital is to be congratulated on developing the proposals for that wing. It has been 10 years in the making, and there was a delay in its opening, but it is a significant improvement.

In a few weeks, with the hon. Members for Kettering and for Wellingborough, I will meet the local clinical commissioning groups to discuss GP out-of-hours services. A key issue relates to people using a GP where appropriate, rather than presenting at accident and emergency.

I hope that the Minister will comment on the seriousness of the Care Quality Commission report published in March. It stated that action is needed on cleanliness and infection control, on supporting workers and, in particular, on assessing and monitoring the quality of service provision. In fact, so severe were its findings that it has taken enforcement action against the hospital.

The report makes mixed reading. Most patients seen by the CQC generally commend the hospital. As I said at the outset, most people’s experience is good, but where it is not good, it can be very disappointing. For example, because of that huge rise in demand in accident and emergency, the CQC found open storage of needles and syringes, containers overflowing with syringes, and noisy and rusty bins in areas of the department, and it observed that the public toilets were dirty and that floors appeared dirty and stained.

As the CQC has stated, that situation was not because the hospital staff were not working incredibly hard—it observed that the staff were working with clear protocols and trying to do the right thing—but the facility is now frankly too small for what is really needed to serve the north of Northamptonshire. It is cramped, which really affects the quality of care.

The CQC specifically mentioned long waiting times. I have heard cases of people waiting up to 10 hours, which is clearly unacceptable. Not only are there the waits in accident and emergency, but, having been seen in A and E, there are the waits to be transferred to wards in the hospital. There are also knock-on effects. The CQC highlighted issues in orthopaedic and surgical wards, where other medical admissions from A and E have become a way of life, because the beds are needed, but those wards do not have the staff, the expertise or the capacity to meet the needs of the patients transferred.

I want to hear from the Minister an understanding of the pressures facing us in Kettering General hospital’s accident and emergency, and support for initiatives that the local chair, chief executive, trust and staff are taking and which we are trying to support. We want to support this incredibly important hospital. We also want a commitment to capital improvements in accident and emergency. Whether that comes from what I understand is a dedicated fund in the Department of Health for capital improvements for A and E that is underspent or from the general NHS underspend, I hope that we will hear about it today. I also hope that she will comment on the issues about how the health system works locally.

--- Later in debate ---

[Anna Soubry]

I am sorry.

The hon. Member for Corby has raised important issues about accident and emergency services, although I will not be dealing with the national situation. As we know, there have been some issues and problems in emergency departments throughout the country, many of which have been well rehearsed in this place.

Underlying themes and problems are often common to all our accident and emergency departments. Undoubtedly, many of the problems at Kettering’s accident and emergency are exactly the same as those that have caused so much difficulty in other A and E departments in this country. I am pleased that huge progress has been made and that overall performance is improving across the country as might be expected, especially given my Department’s efforts.

The hon. Gentleman has pointed out how health services are under pressure in his constituency and having a knock-on effect at Kettering, and those pressures are being experienced across the whole system. He quite properly identified that the reasons for that are complex. Dealing with those pressures means looking at the underlying causes, which the Department has been doing by working with NHS England.

The hon. Gentleman pointed out that Kettering General Hospital NHS Foundation Trust is experiencing many of the issues that I have highlighted. I am aware that, as he told us, the trust has not met the A and E standard. It has struggled with that difficulty for some time. He will know that Monitor, as the regulator of foundation trusts, has unfortunately found that the trust is in breach of its licence in relation to its A and E performance, as well as wider financial and governance issues. That will cause concern not only to the people who use the hospital, but to its outstanding staff.

Monitor has required the trust to implement an urgent care action plan to ensure that it can return to compliance against the A and E standard. The deadline for that is 1 July, so it will not be long before the trust has to implement it. Monitor is working with local commissioners and NHS England to support the trust to meet that requirement.

I appreciate that the hon. Gentleman feels that further investment is needed to expand facilities at the trust to improve its position. It is right that, as I understand it, he has had meetings with the chair of the trust and other Members of Parliament, and that letters have been written, to request assistance in securing extra capital funding. Some £5 million to £10 million has been requested, so that the trust can redevelop and expand its A and E department.

Of course it is for NHS foundation trusts to develop and take forward their own capital investment proposals, and trusts such as Kettering can apply to the Department for a capital investment loan. We understand that the trust has allocated some of its capital budget this year to make improvements within A and E, and it has worked with commissioners to redesign what we call pathways to improve flow. Hot clinics and ambulatory pathways have been developed, which divert patients away from A and E and avoid GP admissions, which, as we know, often stack up in the Department.

On the matter of whether Kettering has ever closed its doors, I am told that its accident and emergency department has never done so, and it is important to put that on the record. I am told that there was a period in February when the hospital trust effectively advised members of the public—I think that this sounds like a sensible piece of advice—to ensure that they only went to A and E if they had had an accident or an emergency. In other words, to use the jargon, they were told to use the department appropriately, because the trust had become aware of a sudden and acute rise in people using A and E. Actually, that is a good message for all of us to take back to our constituents. The department is not called “accident and emergency” for no good reason; it is for accidents and emergencies.

When we had a debate on A and E in the main Chamber, Members from both sides told stories about people presenting at A and E when they could have gone to the pharmacy or just taken a paracetamol. The point I am making is that, often for understandable reasons, people attend A and E when they cannot get the appointment they want at the GP surgery. There is this wider issue that perhaps we do not do what we used to do in the past, which was to self-administer, take advice from our brilliant pharmacies or ring the GP surgery for advice before simply turning up at A and E.

As I have said, meetings have taken place, and, as I understand it, the trust has been working with local commissioners in the way that I have described. The hon. Gentleman mentioned the new Corby urgent care centre. I think I saw it before I was in this position—I was there for other reasons which I am sure the hon. Gentleman will understand—when it was in the process of being constructed. I am delighted that it is now open. It is called an urgent care centre. To be frank, we do not always use the best language when it comes to naming places where patients can go. In fact, the review, which is being conducted in the Department of Health, is looking at the sort of language that should be used, so that people understand where they have to go when they have a particular problem. I am delighted that the centre has opened in Corby and is providing additional urgent care services to the hon. Gentleman’s constituents, which should help to ease the unnecessary attendances at the A and E department of Kettering General.

I also want to mention the East Midlands Ambulance Service NHS Trust, because it is of concern to all of us who represent seats in the east midlands. I know that the hon. Gentleman has rightly talked about how problems with EMAS have affected services in his constituency.

[Andy Sawford]

I wanted to cover more issues in my opening remarks. The Minister is absolutely right to say that EMAS is a huge concern for all MPs across the region. I am sure that she is aware that the proposal is for the hub that would serve my constituents now to be at Kettering and for the level of service to be reduced at Corby, which is a concern for us.

[Anna Soubry]

Indeed, and it is right that the hon. Gentleman should raise that concern. I think I am right in saying that Earl Howe, who is the Minister with responsibility for the ambulance service, has agreed to meet the hon. Gentleman. If he has not agreed that, then he just has. In any event, Earl Howe will be more than happy to meet the hon. Gentleman to talk about the various issues.

The hon. Gentleman will also be aware that the NHS Trust Development Authority has intervened at the East Midlands Ambulance Service NHS Trust and is working with local commissioners to ensure that it has robust turnaround plans in place to improve its performance. The fact that the ambulance service has not been meeting the high standards that we all expect of it has been a long-standing problem in the east midlands. It is now implementing proposals to improve the way it delivers services across the east midlands through its “being the best” programme. That includes the replacement of some ambulance stations, including the one in Corby. It is creating 108 community ambulance posts, 19 ambulance stations and nine purpose-built hubs or superstations to enable ambulances to be dispatched from strategic points across the region to meet demand. I know that the “being the best” proposals have been referred to the Secretary of State by Lincolnshire county council. I do not know whether Northamptonshire will now take the same course, but it may not need to as Lincolnshire has already made the referral. As a result, the Independent Reconfiguration Panel is due to advise in the next few days, so it would not be right for me to make any further comments on that matter.

I will conclude now unless of course the hon. Gentleman wants to intervene again, which I am more than happy about because we still have four minutes.

[Andy Sawford]

I thank the Minister for giving way again and I am delighted to take up the opportunity to use up a little more of the time we have available. It is of course very welcome news that those proposals have been referred to the Independent Reconfiguration Panel. However, I must say to her that, irrespective of how those proposals proceed, I have no confidence in the trust board of the East Midlands Ambulance Service NHS Trust or in its leadership and management.

I will be interested to hear the Minister’s comments about what role, if any, the Department of Health can play in intervening when there are concerns about the management of an ambulance trust. I know that hon. Members from across the eastern region ambulance service, which also serves some of my constituency, have—frankly—successfully changed the leadership of that service. I feel that we may need to make some progress in that regard ourselves.

[Anna Soubry]

The diplomatic answer to that is to say that, yes indeed, east of England MPs have quite rightly taken their concerns to the highest level and there has been some serious intervention. There has been a report; we had a 90-minute debate here in Westminster Hall only yesterday on it. I have to say that apparently most members of the board of that ambulance service still remain in place, but the board has a new chair. There has been a full report into the service and there is hope that many of the report’s recommendations will now be put forward.

I must say that the Care Quality Commission, notwithstanding some of the comments that were made last week, can play a hugely important role in looking at the performance of ambulance trusts. I speak now as a constituency MP when I say that I myself have been in contact with the CQC and I urge the hon. Gentleman perhaps to take the same course, because the CQC can really play an important role in ensuring that ambulance services and indeed many other providers of health care are absolutely up to standard and providing the services that they should be providing. That may be of some assistance, but I must say that I think things have improved.

[Andy Sawford]

The Minister says that there are issues at Kettering General hospital’s A and E department that are in common with those in other hospitals. Finally, I draw her attention to the exceptional case for investment in Kettering General hospital, because of the growth in population locally. Corby has the highest birth rate in the country; it is the fastest growing town in the country; and the Northamptonshire area is one of the fastest growing areas in the country, so this is an exceptional case.

Carers

Andy Sawford Excerpts

Thursday 20th June 2013 Commons Chamber

[Andy Sawford (Corby) (Lab/Co-op)]

I am grateful for the opportunity to take part in this important debate, which affects so many of our constituents around the country. I add my appreciation and congratulate the Members who requested the Backbench Business Committee to provide time for this debate, and indeed the Backbench Business Committee itself on recognising the significance of this issue. This debate is timely because many Bills and other measures either before the House or to be debated over the coming weeks and months will have a huge impact on carers.

Before dealing with that, I want to speak about why this issue is so important to many of my constituents. There are 14,980 carers in Corby and East Northamptonshire —a rise of 23% over the last 10 years, which is higher than the 11% rise nationally. There are nearly 3,500 carers in Corby and East Northamptonshire who care for more than 50 hours a week—a rise of 40% over the last 10 years, which is far higher again than the national average increase of 25%. Of those nearly 15,000 carers in my constituency, more than 8,000 are juggling work and caring, which presents many issues.

I support the points that other hon. Members have made about the need for employers to demonstrate really good practice in this area and support employees who have caring responsibilities. I agree with my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) in deploring the fact that the Independent Parliamentary Standards Authority is not prepared to set a good standard in this place, where Members are not allowed to grant their staff compassionate leave. I think we should be an exemplar in this and should work together across the House to urge IPSA to change its practice.

In my constituency, many people are employed through employment agencies. Even where there are opportunities for employers to show their employees that they are good and caring, many of my constituents will not be touched by that. They will find that they are not able to continue working and caring. My hon. Friend the Member for Inverclyde (Mr McKenzie) referred to the amount of the carer’s allowance. It does not compare well with jobseeker’s allowance, for example. We should have an aspiration to improve it. In recognising the significant number of people involved and the huge cost implications of trying to increase the support for carers out there, we must also recognise that the carer’s allowance provides a very small amount for our constituents to live on. The financial challenges, as other Members have said, are getting much tougher at the moment.

I attended various events during national carers week, including the event here in Parliament. I want to congratulate all the organisations that came together to organise national carers week. I met people from the Multiple Sclerosis Society, Marie Curie and other organisations, who told me about their experiences. I think they were absolutely right to bring carers themselves to talk to us here in Parliament about their experiences. They reflected many of the conversations I have had with my own constituents. I met a carer who cares for his wife who has MS and a former carer who cared for her husband who had cancer. They both asked me to champion raising the carer’s allowance. That is what I want to do today.

Carers UK’s analysis of the recent census shows that the fastest-growing group of carers are people over 65 with caring responsibilities. There has again been a much more significant rise in those numbers in my constituency than nationally, with a 35% rise of older carers nationally compared with a 62% rise in Corby and East Northamptonshire. I am determined to engage with local organisations—including charitable and voluntary organisations that work with carers, but also local authority and local health bodies—to try to understand why the rise is so significant in my constituency, the extent to which those bodies have been able to respond to it and whether that trend will continue.

Carers over 65 who receive the state pension are, as hon. Members have said, unable to receive carer’s allowance—despite the fact that they still face additional costs as a result of caring and have often lost earnings from retiring early to care. What plans do the Government have to provide more practical and financial support to people who spend their retirement caring for their partners, adult disabled children or their own older parents? My own parents are approaching retirement and they, like many people nowadays, find themselves part of what is called the sandwich generation. They not only help me to bring up my children, providing lots of extra help and support for child care, but increasingly find that they are taking on a care and support role for their parents. That matter should concern all of us. It is particularly important in the context of our full knowledge that we have an ageing population, which will present a growing challenge for us.

Carers UK figures show that carers are out of work for an average of five years as a result of giving up work to care for an older or disabled loved one. Many struggle to return to work afterwards, yet find that their carer’s allowance stops very quickly. What support can be provided to help carers when caring comes to an end to ensure that they do not fall into financial hardship as a result of losing carers’ benefits? What can we do to help them return to work, retraining where necessary?

I recently met a lady who came to my surgery in Raunds to talk to me about her experience. Her particular concern was about the impact of the bedroom tax, but she also told me how her life of caring for her husband had come to an end as he sadly passed away. She told me how unsupported she felt in the months afterwards, as some of the help and support she had hoped for—previously in place in part because of her caring responsibility—was taken away from her. She then found she had to contend with the bedroom tax on her large family house. She had no choice—either move from her family home quickly as she grieved for her husband or face financial destitution. I felt incredibly sad that she faced that situation.

I was recently visited by my constituent, Mags Maguire, who told me about her mum, Mrs McKay. She asked for my help in trying to ensure that a care package was in place for her mother. I have tried on her behalf; I have, unfortunately, not made sufficient progress, but I will keep trying. Mags herself is a resourceful person. She recently contacted the occupational therapist again to describe the situation she faced. The occupational therapist replied:

“Hi Mags, just to let you know...We rarely prioritise cases as critical, as this is for cases where if something is not done immediately it will be a case of life or death and if there is nothing else that can be done and provided to reduce that risk in the interim and the major adaptations are the only way to reduce risk. We can still be waiting 12+ months for works to be done under a ‘critical’ priority as the amount of funding available will affect the waiting list times.”

Mags is merely requesting some small adaptations to the home in which her mum lives, and it seems to me that that ought to be possible.

The occupational therapist continued:

“I could not prioritise the case as urgent as Mrs McKay has a care package to meet her personal care needs and meals and also family to support.”

The “care package” is, in fact, the family support. The family get Mrs McKay up in the morning, and the family provide the meals. The “care package” is not provided by anyone other than the family members themselves.

I have personal experience, in that my granddad cared for my nan for many years. He died on the day after Boxing Day, 18 months ago. He undertook those caring responsibilities without any help or support—which, of course, saved the taxpayer a huge amount of money—and he undertook them willingly because he loved my nan hugely and they had spent their whole lives together, but by the end of his life his own health had suffered greatly because of the extra responsibility that he had taken on as a carer. He would have been happy to continue that responsibility, but an intervention should have been made earlier to provide him with at least some additional help and support.

What was even worse was that after granddad died, we tried to arrange care and support for my nan, but for a long time were unable to do so. Then, late last year, I walked up her garden path to find that she was not sitting in her usual chair. I tapped gently on the window, as I always do, in order not to alarm her, and saw that she was lying on the floor. Fortunately there was a key in a safe and I was able to get into the house, where I called 999. My nan was unconscious for four days, and only after that were we able to obtain the care and support package that she needed. It should not take a stroke to secure a decent package of help and support, it should not take such a long time, and it should not be at the huge cost of the health of a partner, children or other carers.

I think it important to look at the opportunities with which Parliament will be presented in the coming weeks and months. The Care Bill will consolidate and simplify decades of social care legislation in England, and I welcome some aspects of it, but it is disappointing that the new rights that it confers will apply only to adults. I was a member of the Committee that considered the Children and Families Bill. We pressed the points about young carers, and we were given some assurances. We received the same assurances on Third Reading, but the Government have still not explained fully how young carers will be supported in the same way as adults. I should like to see the details of their amendments as soon as possible.

There are, of course, significant areas of disagreement between Government and Opposition on both those Bills, but we also welcome their positive aspects, which are due in no small measure to all the outside organisations that have helped to inform Parliament throughout the passage of the two Bills. Those organisations have contributed a huge amount, but I fear that, unless we see those amendments soon, they will have no real opportunity to contribute to the shaping of measures to help young carers.

I want to say something about social care funding, but I must be briefer than I intended to be, so that other Members can speak. I should like the Government to think about the fact that the Dilnot cap does not cover charges for carers’ services. They may say that they do not intend local authorities to charge for those services, but we must recognise that all authorities face a huge funding challenge, and charges are therefore quite possible.

As for the Welfare Reform Act 2012, the carers to whom I have spoken welcome the Government’s decision to retain carers allowance as an independent benefit rather than subsuming it in universal credit. However, there is serious concern about other aspects of the Act. Following the introduction of personal independence payments, 600,000 fewer disabled people will be entitled to support—600,000 people whom I think we should be trying to help. Moreover, 10,000 fewer carers will be entitled to carers allowance and about 5,000 will be subject to the household benefit cap, losing an average of more than £100 a week.

Two thirds of those affected by the bedroom tax are disabled, but the discretionary money set aside for councils to support disabled people would be sufficient to support only one in 10 of them. Local authorities are in a very difficult position. I have been in touch with my own council in an attempt to secure discretionary support, but it simply does not have the money to provide the help that it knows is needed.

[Mark Durkan (Foyle) (SDLP)]

As the hon. Gentleman knows, the Government constantly say that their aim is to help those who play by the rules and do the right thing. It is clear from what he and other Members have said that carers are people who do the right thing—who are motivated to do the right thing—and who play by the rules. Why should they be victimised by cruel rules that are being introduced as part of the Government’s welfare reform measures?

[Andy Sawford]

I entirely agree with the hon. Gentleman. Some of my constituents who are affected by those measures do feel victimised. What the hon. Gentleman said about fairness is absolutely right. We all want changes to be made in a fair way, but many of my constituents—not just the disabled people and carers who are affected—recognise the unfairness of the measures. The Government should think again about many of their proposals. I urge them in particular to take account of what Members have said today about the bedroom tax.

There is much more that I could say, but I know that other Members wish to speak, so I shall end my speech.

A and E Departments

Andy Sawford Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

Handover delays are unacceptable, and the short-term and longer-term measures that I am putting in place will, I hope, help to reduce them. The hon. Lady might want to talk to her own Front Benchers about this, however, because they seem to be setting their face against improving primary care as a way of reducing the pressures on A and E departments, even though that goes against the grain of what the public and the NHS want.

[Andy Sawford (Corby) (Lab/Co-op)]

I support the request from the hon. Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone) for a meeting with the Secretary of State to discuss resources for Kettering general hospital, which is in a fast-growing area. Corby has the highest birth rate in England and is one of the fastest growing towns in Europe. I urge the Secretary of State also to recognise that the issues with the 111 service are rather more than “teething problems”. Twice this year, Kettering general hospital’s A and E has had to close its doors to all patients other than those arriving by ambulance and to notify the public not to come to the unit. That is extremely worrying for my constituents.

[Mr Hunt]

As I said, we need to address all the problems with 111. The lack of confidence in GP out-of-hours care is one of the contributing factors to a lack of public confidence. The meeting that the hon. Gentleman mentions will be going ahead.

Mental Health

Andy Sawford Excerpts

Thursday 16th May 2013 Commons Chamber

[Mr Charles Walker (Broxbourne) (Con)]

It is a pleasure to follow the hon. Member for Bridgend (Mrs Moon), who made an important speech on the mental health of military veterans who serve this country so bravely in many theatres.

I am in the Chamber because this debate is extraordinarily important. I could spend this Thursday knocking on doors in my constituency and pressing the flesh. If I was lucky, I might meet 100 people, but by being here, I can represent the interests of many thousands of people. That is why the Chamber of the House of Commons is so important. I hope that, this afternoon, I speak up for the interests of many thousands of my constituents who suffer directly from mental health problems and illness, and many thousands in their families who support them.

We have come a long way in the past year. In June 2012, we had a great debate in the Chamber. Many familiar faces who took part in that debate are in the Chamber this afternoon. In a sense, the lid has been lifted. People now feel much more confident speaking not only of their own mental health experiences, but of mental health in general, and the hopes, aspirations, fears and expectations of their constituents.

Although I have been involved in mental health for about seven years as vice-chairman and now chairman of the all-party group on mental health, I have met an enormous number of organisations in the past year. I have written a few of their names down on a piece of paper. I will not read them all out—that would not look too good in Hansard tomorrow—but I will focus on two or three special people I have met.

Daniel Macnamee from Changing Our Lives has suffered from psychosis and has been very unwell for significant periods. He is well at the moment and recognises the signs when he is about to become ill, so the process and his drug therapies can be managed. Daniel is doing extraordinary things. He is an advocate for people with mental health problems and who are ill, including within hospitals—people who have been either detained or who are there of their own volition.

[Andy Sawford (Corby) (Lab/Co-op)]

The hon. Gentleman mentions a constituent who becomes aware before he has a psychotic episode. In that situation, he would want acute and crisis services. Is the hon. Gentleman aware of Mind’s work on that? It recently surveyed all primary care trusts, which are now clinical commissioning groups, and mental health trusts about their acute and crisis care services. Does he agree that we ought to ensure that such services are available to people such as his constituent and my constituents?

[Mr Walker]

I thank the hon. Gentleman for that information. I have campaigned alongside Mind for many years to ensure that people have such services. We talk about support within the community, but it is variable and people’s experience of it is variable. If we are to get things right when people go into crisis or feel a crisis coming on, they need to be confident that the support they require will be there for them. That is why having a crisis plan is so important: people’s wishes can be respected. We too often talk over the heads of people with mental health problems, unwellness or illness—however we define it. We need to be aware of their wishes, because have an absolute obligation to their welfare and to respect their wishes.

Daniel, from Changing Our Lives, is not a constituent; he is just one of the most inspirational people I have met in the 45 years I have tottered along this mortal coil. He is a wonderful man and I am full of admiration for what he is doing.

A couple of days ago, I met Liz Johnson from UK Changes, who works in Staffordshire to ensure that people with mental health issues can remain and keep a foothold in the workplace. For those who are out of the workplace due to illness, her organisation provides mechanisms to help them get back in. The organisation has some reach and I strongly recommend that the Minister meets its representatives. I know there is a drive to ensure that people who have suffered from mental health problems have the opportunity to re-engage with the labour market. One great sadness is that the chance of being in work for those with a diagnosis of psychosis or schizophrenia is approximately 8%. A 92% unemployment rate is unacceptable.

Oral Answers to Questions

Andy Sawford Excerpts

Tuesday 16th April 2013 Commons Chamber

[Dr Poulter]

My hon. Friend makes a very good point. I will take up the matter further with the NHS Commissioning Board because it is important that when we are commissioning services we take into account future population growth.

[Andy Sawford (Corby) (Lab/Co-op)]

Along with the hon. Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone), I shall meet the chief executive and chair of Kettering general hospital this Friday to discuss the latest steps in the Healthier Together review. Does the Minister agree that it is important that we urge on Kettering general hospital and all the other decision makers that we must maintain our proper accident and emergency and other vital services at Kettering general hospital?

[Dr Poulter]

It certainly sounds as though there is a need for an accident and emergency department in Kettering. These are matters for the local commissioning boards to take forward, but it would be wrong for the hon. Gentleman or anyone else to say that as part of the Healthier Together programme there are any site-specific proposals that would in any way threaten Kettering accident and emergency department.

NHS Funding

Andy Sawford Excerpts

Wednesday 12th December 2012 Commons Chamber

[Andy Sawford (Corby) (Lab/Co-op)]

My right hon. Friend will be aware that my constituents have similar concerns about the future of their local hospital in Kettering, despite assurances that changes are being driven by the best clinical advice and guidance and by clinical outcomes. Contrary to the unrecognisable picture described by those on the Government Benches, we know that the cuts in Kettering hospital’s services, which will affect my constituents in Corby and east Northamptonshire, are a result of a £48 million deficit that is a direct result of the Government’s policies. Does my right hon. Friend share my concern that this is about those cuts in funding rather than the clinical outcomes?

[Dame Joan Ruddock]

I thank my hon. Friend for his intervention. If all hon. Members are honest in providing a record of what is happening on the ground, we will see that the reality is, indeed, cuts and reductions in services.

It is a case of not only how much money we spend on the NHS, but how wisely we can spend it, and there may be agreement throughout the House on that. [Interruption.] I say to the hon. Member for Beverley and Holderness (Mr Stuart) that just four years ago, Lewisham hospital gained a new wing through a successful and affordable private finance initiative contract. Just two years ago, a state of the art new birthing centre was opened, and only in April of this year the £12 million refurbishment of the A and E department was completed.

Now, however, the trust special administrator proposes to close both the full A and E service and the full maternity service at Lewisham hospital. The consequence of closing the A and E department and replacing it with an urgent care centre means the closure of the intensive care unit, the coronary care unit and the acute medical and elderly medical services. Every year, more than 13,000 people benefit from those acute services, 4,500 babies are born in the maternity unit, and more than 120,000 people use the A and E department.

The proposals are, to be frank, catastrophic—they will remove vital services from a growing population of more than 270,000 people. This is an accountant’s solution to a problem that does not even exist in Lewisham itself. Not a single constituent, patient, GP or hospital specialist has come to me in support of the plans.

My colleagues, Lewisham hospital trust and I are not opposed to change aimed at greater efficiencies and higher standards. Indeed, that was the Labour Government’s policy and philosophy for the NHS all along. We know that closures of small hospitals have led to safer services. We know that paramedic services and blue-light ambulances taking people to highly specialised centres save lives every day. We also know that the NHS could be more efficient, but there is no evidence that the needs of Lewisham people for A and E or maternity services can be safely met elsewhere in south-east London. All other existing provision is full to capacity, and travel from most of Lewisham to Woolwich is highly problematic.

The TSA report is full of assertions and aspirations that are completely divorced from the realities of people’s lives in a borough that contains some of the most deprived wards in the UK. If the proposals were to go ahead, the 750,000 residents in the boroughs of Lewisham, Greenwich and Bromley would be dependent on a single A and E department. As the report says, hospitals are part of a bigger NHS family, which is why the Secretary of State must look at London as a whole. It cannot be just or sensible to try to find enormous financial savings to rescue one health trust by destroying another.

The public have had just 30 days to respond to the extraordinary proposals in what is a deeply flawed consultation process, but such is the anger that more than 32,000 people, including more than 100 local GPs, had added their names to a petition started by my hon. Friend the Member for Lewisham East (Heidi Alexander) by the time we presented it to No. 10 last Friday.

Last week the trust board of Lewisham hospital issued its response. It supports in principle the merger of Lewisham with Queen Elizabeth hospital in Woolwich, and I must say that that is worth considering, but the trust says:

“We are concerned that the financial modelling completed by the TSA team at pace will include errors that will work against financial viability of the proposed Lewisham Healthcare NHS Trust and Queen Elizabeth hospital reorganisation.”

That would simply repeat the history of the hospitals in the South London Healthcare NHS Trust that have had continuing financial problems.

The trust board goes on to say:

“The TSA process has made it impossible to have the engagement and involvement that proposals such as these would normally warrant, and our clinicians do not feel they have been listened to in this process.”

The rest of its submission to the TSA is entirely damning. It says:

“We do not believe there is a convincing case for the major change of services proposed in Lewisham. The TSA has overlooked the significant role that LHT provides in the broader provision of services to local people. The TSA recommendations will result in worse, rather than better, care for the people of Lewisham. We believe a health and equalities impact assessment would show this but has not yet been completed—a significant weakness of the TSA Report.”

When the Secretary of State comes to view the TSA’s report, whatever form it takes, I urge him also to review all of the evidence that has been presented by local people, local experts, local consultants, GPs and the hospital trust itself. As the local Save Lewisham Hospital campaign says, this is not a difficult decision for the Government—it is potentially a deadly one. I urge him to give the most careful consideration to what is being said. The criticisms are damning and we have absolutely no faith in the proposals that the TSA will put before him.

--- Later in debate ---

[Mr Dorrell]

I have made the point more than once that we should look across the traditional divide between the national health service and the social care system towards a health and care system. The only way of responding to the efficiency challenge that the right hon. Member for Leigh was the first Secretary of State to set out—what the Select Committee has described as the Nicholson challenge—is to rethink the way in which services are delivered across the health and social care divide. The National Audit Office, another independent body, has stated that 30% of non-emergency hospital admissions are avoidable—not unnecessary, but avoidable. We need decent community-based services that meet the demand early in the development of the condition to avoid the unnecessary development of acute cases that have to be treated though hospital admission.

[Andy Sawford]

The right hon. Gentleman has been a vocal advocate for a long-term solution to the issues relating to the integration of health and social care. I have enjoyed engaging with him on those issues in the past. Does he agree that it is incredibly disappointing that we are not making the progress that we should be making in finding consensus on the future of social care funding and, in the short term, on diverting more funding, particularly from NHS underspends, to prevention?

[Mr Dorrell]

I agree completely with the hon. Gentleman’s characterisation of the challenge. I was looking forward to him congratulating the Government on taking a step in the right direction, although it is not a total solution, by investing in prevention some of the resources in the health care. [Interruption.] The hon. Gentleman indicates that it is only a little and that it should be more.

We need to look across the statutory divide that reflects history, but not the demands of today’s generation of patients. The key thing that we must recognise in the debate about health and care is that we have inherited a system, which all of us have supported through most of its history, that is built on the assumption that the typical patient will be restored to good health. In Bevan’s day, that was true of the typical patient in the health and care system, but it is not true of the typical patient in today’s system. The majority of the resources in today’s health and care system go towards delivering care to people who will not be restored to full health. That, not surprisingly, requires a different set of institutions, shaped in a different way from the institutions that we have inherited from history.

The challenge that faces all of us in this House who care about the health and care system is not to protect the different bits of the system as though they were listed buildings, but to change the system so that it uses today’s technologies to meet the needs of today’s patients. That is the core challenge that faces my right hon. Friend the Secretary of State and his colleagues and, if I may say so, the right hon. Member for Leigh and his shadow ministerial colleagues.

--- Later in debate ---

[John Pugh (Southport) (LD)]

While you were not in the Chair, Mr Speaker, you missed a lively and interesting but predictably arid debate. We have reached a kind of stalemate. Those who understand the dark art of political messaging tell me that it is important to say the same things again and again, and psychologists tell me that those who do that are more likely to be believed. Prior to the election, the Tories were unique in having as an important part of their messaging the wish to ring-fence and preserve NHS spending.

That message was then embodied in the coalition agreement and has influenced subsequent spending decisions. We all recognise that there are good reasons for that—the NHS is a demand-led service. It is therefore perfectly sensible, in the Westminster bubble, for the Opposition to make an issue of it. Members have come to the debate with predictable information from the Whips-SpAd axis about the private finance initiative, the misdemeanours of Wales, evidence of unexpected service rationing, reconfiguration trouble, positive and negative variations in waiting lists and ambiguous data on productivity. We have all been given that stuff, and we can use it as we wish.

Meanwhile, the public have clocked that we have a real problem. The demands on and expectations of the NHS will continue to rise, resources are tight and there will potentially be a huge problem. They know that politicians cannot be seen to reduce the NHS offer—they simply would not tolerate that. They do not know quite how all the sums will ultimately stack up, and nor do we. That is the big question.

[Andy Sawford]

Will the hon. Gentleman accept, though, in the interests of being transparent with the public, last week’s letter from Andrew Dilnot, the chair of the UK Statistics Authority?

[Mr Graham Stuart]

Move on.

[Andy Sawford]

The letter stated unequivocally that

“we would conclude that expenditure on the NHS in real terms was lower in 2011-12 than it was in 2009-10.”

Until both Government parties acknowledge that truth, which independent experts have told us about, they will not have any credibility in health debates.

[John Pugh]

I think I will take the advice of my hon. Friend the Member for Beverley and Holderness (Mr Stuart) and move on.

I think we all agree that the only acceptable answer to the problem is to spend public money wisely. Currently, the NHS is holding up—sort of—by making economies and savings, largely off the back of a wage freeze, which is not sustainable. However, I am starting to be alarmed by the disagreement about what else we can do and what strategies we should follow. I will run briefly through the suggested options.

It has been suggested that we should keep people out of hospital, but we already have fewer hospital beds than almost anywhere else in Europe, and according to the NHS Confederation there is no clear evidence that treating people outside hospital would necessarily be cheaper.

Some people recommend personalisation and personal budgets, but it can be argued that that would not lead to better use of scarce resources, despite the fact that it would be more popular than some current service configurations. Telehealth has also been suggested, and I am a great enthusiast for it—it is my personal favourite suggestion, and I am chair of the all-party telehealth group. However, although there are cost-effective pilots, the Nuffield Trust has expressed some criticism of telehealth, saying that it may not save us anything like the money that we believe it will. The industry itself is concerned that if the roll-out is not efficient and effective enough, telehealth simply will not take off.

--- Later in debate ---

[Andy Sawford (Corby) (Lab/Co-op)]

I am grateful for the opportunity to speak in a debate that is incredibly important to my constituents. I thank my right hon. Friend the Member for Leigh (Andy Burnham) for opening the debate. He is aware of my grave concerns about the future of hospital services that serve people in Corby and east Northamptonshire.

It has long been the ambition of people in Corby—a large, important town that is growing—to have their own hospital. I hope that in future we can realise that ambition. For a long time, however—and for the foreseeable future—we will be served by Kettering general hospital for most of our hospital needs. At Kettering general hospital there are 650 beds and more than 3,000 staff. The hospital is more than 115 years old, and received massive investment, including under the Labour Government. I make that point not so much politically point but as a local person who remembers driving down Hospital hill in Kettering and seeing the fundraising barometer outside the hospital and wondering why we relied on car-boot sales to fund vital hospital services.

My right hon. Friend the Member for Leigh, a former Health Secretary, and his predecessors began to put that right, and there was huge investment. Kettering general hospital now has 17 operating theatres and an obstetrics unit that delivers more than 3,500 babies a year. It has something that serves only a few of my constituents but is incredibly important to all of us—a neonatal intensive care unit, or special care baby unit. My own family has had cause to be grateful to that unit and its brilliant staff.

Kettering general hospital offers a 24-hour accident and emergency service, with level 2 trauma services, which sees more than 2,000 trauma patients a year. There are concerns, however, and I have agreed with the hospital and local people to champion certain issues in the House as the local Member of Parliament, including per capita funding of Kettering general hospital, which we believe is inadequate and lower than average compared with other areas. With a growing population and growing health needs, that must be addressed.

Recently, a report on the hospital by Monitor raised serious concerns, particularly about accident and emergency. I have met the hospital chief executive and the chair of the trust to discuss those concerns, and to assure them that I will seek to do whatever I can, including making sure that a case for adequate funding for the hospital is made, so that those concerns are addressed.

The big issue that causes us all concern locally is a major review of health services—the kind of review that other Members have experienced in their areas. In Kettering, the Healthier Together review of five hospitals has already cost more than £2 million; that was the figure in the summer, and I have no doubt that it is rising rapidly. The review has also taken a great deal of time and effort. In early September, together with local nurses and others, I met the people leading that review, as a public member of the trust, and I was incredibly worried about what I heard, both as a user of the services, and as a representative of local people.

The Healthier Together team gave us a pledge card telling us about their plans and giving us some assurances. The context was also set. We were told that the review was driven by a desire for the best clinical outcomes, by expertise, and by research on how local people could be provided with the best health care. We were told that there were considerations to do with more services being provided in the community, and a shift to prevention, which are things I recognise it is important for our local hospital and its partners—the clinical commissioning group and the other hospitals—to consider.

It was slide 2 that really got to the heart of the problem. It told us that the five hospitals face a combined funding gap of £48 million, and that my local hospital, Kettering general hospital, faces a future funding gap of £6 million a year. I have no doubt that the comments that Andrew Dilnot recently made about the real-terms reduction in funding are very much connected to that, but I do not want to make that wider political point again; it has already been made eloquently by my right hon. Friend the shadow Secretary of State. I simply say that all local people recognise that resources are getting tighter and tighter at the hospital.

[Norman Lamb]

Does the hon. Gentleman share my view that in many local health economies, private finance initiatives are causing a massive strain on resources?

[Andy Sawford]

I want to keep my remarks to Kettering general hospital, and I do not think that PFI is the issue there.

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

The hon. Gentleman mentioned the Healthier Together programme; it is clear that many of the hospitals in that programme have very high PFI debts. We will get the figures for him, to clarify that, in the closing remarks.

[Andy Sawford]

A few weeks ago, the hon. Gentleman—I am sure that he had no intention of misleading the House—talked about the funding issues at Kettering general hospital being driven by PFI deals in Anglian hospitals, which are not really part of the group that I am talking about.

[Dr Poulter]

rose—

[Andy Sawford]

I will not give way; I want to make important points for my constituents. It is important that these things are put on record, so I shall not be giving way to the hon. Gentleman again. He has not done a great service to people in my constituency in the way that he has addressed these issues.

[Mr Andy Slaughter (Hammersmith) (Lab)]

I had the pleasure of visiting my hon. Friend’s constituency earlier this year, and I am sorry to hear about Kettering. Both the accident and emergency departments and one 500-bed hospital in my constituency are due to close. Neither of those A and E departments is PFI, and none of the four A and Es closing in west London is PFI, so is that point not a complete red herring?

--- Later in debate ---

[Andy Sawford]

I have had some experience of my hon. Friend in the past, and as ever, he talks a great deal of sense. Certainly, in Kettering, we are looking at something driven by funding cuts.

I want to address the issues, because I seek real answers from the Front Benchers, and real assurances about the future of my local hospital. Healthier Together has assured us that no hospitals in the group of five of which Kettering is part will close. I have never heard any claims that those hospitals will close. The local media have been very clear that they are not aware of any assertions that Kettering hospital will close. There has, at times, been the presentation of an Aunt Sally by some of my political opponents, who have sought to say, “The hospital won’t close, so there’s nothing to worry about.”

Let us be clear what is being talked about. The Healthier Together review had six different models, and it has refined that to two options. The status quo is very clearly not an option, and it is not consulting on it. One of the two options would see five hospitals going into three for some of the services, though all the hospitals would remain open and provide some services. The services that are at real risk in two of the five hospitals include in-patient paediatrics. Last year I took my son, who had pneumonia, late at night to the Dolphin ward at Kettering general hospital. It concerns me deeply that paediatrics might not be there. I would have had to go elsewhere, and so will local people in the future if the paediatric ward goes.

Under the proposals, obstetrics would go at two of the five hospitals and be replaced by a midwife-led unit. People in Corby have experience of a midwife-led unit. At one time there was a births in the community facility in Corby, as there still is in some other smaller midwife-led hospitals around the country. Where those exist, if local people want them to continue, they should have that opportunity, but we have a full maternity service in my area and people are very concerned that that could be lost under the proposals.

I have talked to midwives who tell me that during labour it would not be possible to give an epidural, for example, if the labour became more painful for the mother. Among my family and friends, I have heard about people who hoped their children would be born at Melton hospital, which is a midwife-led unit, describing the worst hour of their life as following a blue light on an ambulance taking their wife and hoped-for child across to Leicester royal infirmary or another available hospital so that the care that was needed could be given. We want our proper obstetrics-led unit to remain and we do not want it downgraded to a midwife-led unit.

At two of the five hospitals, trauma services would be lost. I have already described how Kettering general hospital provides level 2 trauma and treats more than 2,000 trauma patients a year.

As to where we go from here, it is important for Healthier Together and the Government to be honest about the proposals. It is important for geography to be recognised as a critical factor. Healthier Together will talk about the clinical evidence and the clinical drivers, but it must recognise that local people are very concerned that Luton and Dunstable hospital is 50 miles away, and that the nearest hospital in the group is 45 minutes away from Corby at Northampton along a very busy road. The journey takes 45 minutes at the best of times; the road is seriously in need of upgrading and improving. People are really concerned about the geography, and that has to be balanced with specialisms which people understand. There are already specialisms in our local health care system at other hospitals.

I am pleased that despite the empty assurances from Government Front Benchers, the hon. Member for Kettering (Mr Hollobone) had the courage to raise these issues on 9 November—notwithstanding the by-election inconvenience for Government Front Benchers. I now look to work with him as we seek real assurances from the Healthier Together team and from the hospital that they will not proceed with the proposals if they mean that we will lose all those vital services for my constituents.

Oral Answers to Questions

Andy Sawford Excerpts

Tuesday 27th November 2012 Commons Chamber

[Mr Speaker]

We are extremely grateful. Extreme brevity is now required from Back and Front Benchers alike.

[Andy Sawford (Corby) (Lab/Co-op)]

On 12 November the Secretary of State gave a categorical assurance to my constituents that there was absolutely no threat to accident and emergency and maternity services at Kettering general hospital. Does he stand by it, will he repeat it today and will he specifically confirm that obstetrics and major injury and trauma services in accident and emergency are no longer at risk at Kettering general hospital?

[Dr Poulter]

I thank the hon. Gentleman for his question, and I welcome him to the House and congratulate him on his victory in the recent Corby by-election. I think he has already admitted on the record that there was a lot of scaremongering during the by-election campaign about the NHS locally. One of the main reasons for concerns about the NHS is the indebtedness of many hospitals in the east of England region, because of the record of the previous Government, who signed many of them up to private finance initiative deals. I will restate for the record once again today that, as I understand it, A and E and maternity services at Kettering at the moment are safe, and there is no consultation directly on the table at the moment. He should make sure he gets his facts right before he raises questions in the House.