Kettering General Hospital

Debate between Andy Sawford and Philip Hollobone

Tuesday 24th March 2015 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

It is a huge pleasure and privilege to serve under your chairmanship, Mr Gray. May I, through you, thank Mr Speaker for giving me the honour of debating what is an important subject for my constituents?

I welcome the Minister to his place. He has taken a keen personal interest in the future of Kettering general hospital. The hon. Member for Corby (Andy Sawford) and my hon. Friend the Member for Wellingborough (Mr Bone) are also here, and I hope they will make many interventions to stress the role they have played in working with me to secure the hospital’s future. Indeed, I am pleased to report that the three of us have been working closely together on a cross-party basis for the past few years, because we recognise that local people want party politics taken out of the future of our local hospital. It is a personal issue for the three of us, because we and our relatives use it, as do local people.

Kettering general hospital has been on its present site for 118 years. Local people have been born there and treated there, and they have died there. It is a much-loved district general hospital at the heart of the community of Kettering and north Northamptonshire. It is a key priority for local people that its future should be secure, so that it can continue to offer the best treatment to the increasing number of people living in the area. Kettering and north Northamptonshire are growing rapidly. Over the past decade the borough of Kettering had the sixth most rapid household growth out of 348 districts in the country, and that population increase is set to continue into the next decade.

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

I thank the hon. Gentleman for his kind remarks about our cross-party working, which our constituents throughout north Northamptonshire welcome. It has helped us in our approaches to the Minister and local health partners, and in bringing them together.

On the point about population, does the hon. Gentleman agree that we should emphasise the fact that as well as having, like most of the country, an ageing population, we also have one of the highest birth rates? Indeed, my constituency has the highest, but the birth rate is high throughout north Northamptonshire. There is demand at both ends of the population, as well as, of course, from people of working age.

[Mr Hollobone]

That is very pertinent. Demographic pressures are hitting us from every angle. There is a high birth rate in Corby and east Northamptonshire. Increasingly, in my constituency as well as the hon. Gentleman’s and that of my hon. Friend the Member for Wellingborough, the population is ageing. Whereas 30 years ago an elderly patient might go to hospital with a particular condition, now it is even older people who are going there, with multiple conditions needing treatment at the same time. Kettering general hospital, like all hospitals, must raise its game when treating such vulnerable members of the community. It is not only population numbers, but the number of young and old patients that creates a challenge.

Although Kettering general hospital has difficulties and challenges, it is raising its game, and that is due largely to the tremendous dedication of the doctors, nurses, ancillary staff, management and clerical staff at the hospital, who are in a joint endeavour to deliver the best care they can. There is extremely good news to report. The Department of Health tells me that in 2012-13 there were 85,497 in-patient finished consultant episodes at the hospital, compared with 84,602 in 2011-12. There has been a focus on accident and emergency waiting time targets, and in the past few years Kettering general hospital has moved from being one of the worst in the country to one of the best. All hospitals in the country have been under pressure this winter, but it would be wrong to give the impression that fewer people are being treated at Kettering A and E. The reverse is true. In 2010-11 76,099 people presented themselves to A and E. In 2012-13 the number was 84,055. Record numbers of people are being treated there.

[Andy Sawford]

The hon. Gentleman will have been struck, as I was, at being told that the accident and emergency department was built for 20,000 patient visits a year, given that recent figure of 84,000. I endorse his remarks about change and progress in the past few years. To what does he attribute that? He mentioned the staff, and I agree. There has also been a change in the leadership of the hospital. However, perhaps it is also to do with the way the local health partners and organisations, including the clinical commissioning groups, have come together with the hospital more effectively through the work that we have been involved in with them, particularly with a view to improving A and E.

[Mr Hollobone]

The hon. Gentleman is right, of course. He gives a tantalising flavour of the climax of my speech, which will be about the urgent care hub proposal for Kettering general hospital, on which he, I and my hon. Friend the Member for Wellingborough have been working together.

[Mr Hollobone]

Yes—not only have we three north Northamptonshire Members worked on a cross-party basis to secure the future of our local hospital, but we all dressed up in funny outfits on Sunday to walk around Wicksteed park in Kettering in support of Glennis Hooper and the marvellous work she does for Crazy Hats, which raises money for cancer treatment and care for our constituents. I suppose that it is part of an MP’s job on occasion to dress up in a funny costume and look silly for the benefit of constituents, and we are all pleased to do that.

Some further good news about Kettering general hospital, from Department of Health statistics, is that finished consultant episodes when any procedure took place in the hospital—which I think is bureaucracy-speak for the number of operations—went up from 49,638 in 2010 to 53,869 in 2013. I am told that there are 43 more hospital doctors and 55 more nurses than in 2010 and there is a 24% increase in diagnostic tests, a one third increase in the number of people treated for cancer and a 71% increase in the number of MRI scans performed. Of course just two years ago the £30 million foundation wing was opened. It has a 16-bed intensive care unit, a 28-bed cardiac unit and a 32-bed children’s unit. That was massive new investment in our local hospital.

It should not be forgotten—and we three Members of Parliament for the area do not forget—that increasingly Kettering general hospital offers our constituents world-class health care. The latest example of that is the cardiac investigations department, which has received national recognition for its high standards in heart ultrasound scanning. Every year 8,000 of our constituents are patients through that unit, which provides ultrasound scans of the heart. Those can reveal diseases such as heart failure and valve diseases.

[Andy Sawford]

That shows what huge progress has been made. A little over 10 years ago, my granddad had a heart attack and had to wait in a bed in Kettering general for six weeks to be transferred to Glenfield hospital in Leicester for a stent. Such operations can now be done as a day case at Kettering general.

[Mr Hollobone]

The hon. Gentleman is right. That is a good example of the way Kettering general hospital has raised its game to tackle local health needs. Increasingly, our constituents do not have to go to Glenfield, because they can get better care at their local hospital. In the case in question, that is because of the £300,000 investment in three state-of-the-art ultrasound scanners, which can show the heart in three dimensions. The 16-strong cardiac investigations team has been awarded accreditation by the British Society of Echocardiography, which is an affiliate of the British Cardiovascular Society. That accolade is not given lightly. Kettering hospital is one of only 38 in the country to have achieved that accreditation; some specialist centres, such as Glenfield, Papworth, John Radcliffe and Coventry, have not yet attained it.

The £4 million upgrade of the maternity department at Kettering general hospital started in December. An average of 10 babies per day are delivered at the hospital—including the babies of Members who are here today. It is part of an £18 million investment in the hospital.

In coming to the climax of my remarks, I want to talk about the innovative proposal for an urgent care hub at the hospital—my colleagues will appreciate this, because we have been working on it together. Over the past few months, the hospital has been liaising with partners and developing a strategic case for an urgent care hub on the hospital site to tackle long-term, urgent care pressure relating to population growth, about which we have spoken; age and acuity; and increasing public demand for prompt access to urgent care.

In December, the trust shared its strategic case with the foundation trust regulator, Monitor, which is currently considering the proposal. If Monitor approves the case, it will go on to an outline business case and finally a full business case for approval by Monitor, the Department of Health and the Treasury. The key to its success is that the hospital has been working in close collaboration with its health and social care partners. It is developing what is essentially a one-stop shop for our constituents who need urgent medical care.

The aim is to develop a £30 million urgent care hub on the hospital site that will combine secondary care, hospital A and E and urgent care assessment with primary care—in other words, GP services, minor injury care and social and community care services. The proposal has arisen because there has been significant growth in demand for that type of urgent care in the local health economy of our three constituencies, partly due to a 30% population growth over the past 19 years, with another 9% expected by 2020, and a rise in the population of older people, about which we have spoken. There has also been a massive 83% increase in the use of A and E over the past 20 years as a means of accessing urgent care.

[Mr Hollobone]

My hon. Friend has rightly made that issue a priority for his constituents, and he has led an effective campaign on it. That facility will be similar to the facility currently in operation in Corby. The idea is to treat people as locally as possible so they do not have to present themselves at Kettering’s A and E department. It is all part of making local health care delivery more efficient and effective, and my hon. Friend is right to highlight it.

[Andy Sawford]

Does the hon. Gentleman agree about one of the things we have made progress on—particularly through the cross-party campaign and the cross-working of the organisations involved? Although there are sometimes particular interests in individual towns and communities, we have looked at the bigger picture for the whole of our area. There are benefits for individual towns. The hon. Gentleman is right to say that I want to build on the success of the urgent care centre, but, in the end, when A and E—in particular, trauma services—is needed, it is going to be there relatively locally for everybody in north Northamptonshire.

[Mr Hollobone]

The hon. Gentleman is absolutely right. Although we want to see far more local delivery of efficient NHS services in particular constituencies, all three of us accept that the vital part of the local health economy is the success of Kettering general hospital. If it were not there—if it were in Northampton, Milton Keynes, Bedford or Luton—local NHS delivery for our constituents would be far worse. We have to make Kettering general hospital a success. We can help it along its way with the innovative establishment of success stories such as the urgent care centre in Corby and the new facility at Isebrook, but the key to success for all our constituents is to make Kettering general hospital a success story for the future.

The hub concept developed by the trust and supported by all three of us is a partnership with the bodies that purchase NHS services, such as the clinical commissioning groups, the Northamptonshire Healthcare NHS Foundation Trust and the social care provider, Northamptonshire county council. If successful, the urgent care hub would effectively provide a one-stop shop for GP services and out-of-hours care; an on-site pharmacy; a minor injuries unit; facilities for social services and mental health care; access to community care services for the frail elderly; a replacement for the hospital’s A and E department, which is now 20 years old; and a new A and E services area, which will provide even better acute emergency care and integrated assessment to ensure that patients see the right specialists right away.

The three of us have been to see the Minister with the hospital and the CCGs, so the Minister knows that we are all as one in believing that the urgent care hub concept is the right one for the health economy in north Northamptonshire. It mirrors the way in which NHS England would like to see pioneering health care delivered in the future. As David Sissling, the chief executive of the hospital, said,

“This integrated approach is also something that NHS England has highlighted is an important principle in its Five Year Forward View for the NHS and it also fits with”

the collaborative programme happening in Northampton- shire.

I hope that when the Minister responds to this debate, in which all three MPs have sung from the same hymn sheet and said with one voice that we need the urgent care hub for the betterment of our constituents’ health, he will reiterate his support for the proposal. Whoever wins the election in our three constituencies and whoever forms the next Government, this important proposal must happen, for all our constituents.

Podiatry Services

Debate between Andy Sawford and Philip Hollobone

Wednesday 4th December 2013 Westminster Hall

[Andy Sawford]

The hon. Gentleman is absolutely right, and I shall turn to that point in describing the consequences of some of the changes in my area. There is a pattern across the country. I am sure that he, too, will be concerned to ensure that services are available in his area.

On 30 July this year, the clinical commissioning groups announced that their governing bodies would approve the cessation of “low risk” podiatry. They have been unable to explain to me what the standard assessment process will be for categorising patients in that way. They qualified the announcement by stating that the decision would not apply to children or vulnerable groups, which was a response to the strong feedback that the public and I, and perhaps other hon. Members, gave. I challenged the Nene CCG on the definition of “vulnerable groups”, and it told me that the term refers to

“The frail elderly and people who are likely to neglect foot-care for financial reasons”.

That is good to hear, but it is not clear who will make that assessment, and on what basis. We must ensure that the most vulnerable can access care.

[Mr Philip Hollobone (Kettering) (Con)]

I congratulate the hon. Gentleman on securing the debate. He is serving his constituents extremely well on this issue. I had an e-mail from a constituent who says:

“I have an appointment this morning, where I am expecting to be told that I shall not be receiving any more services from”

the podiatrist.

“I have Psoriatic Arthritis in my hand and feet and other joints”,

and

“insoles made to help me walk. ‘I am unable to reach down to do my feet myself’ I told the podiatrist, to which he replied, It can’t be helped. He then said I would have to get my husband to do my feet.”

She goes on to say that her husband

“has issues himself, I cannot ask him to do yet another task for me.”

That is an example of a vulnerable person who clearly does not feel that she has been included in the exemptions that the hon. Gentleman describes.

[Andy Sawford]

I thank the hon. Gentleman for his intervention. I welcome his support for the debate. He is assiduous in working on local health matters; indeed, we have worked together on some issues. I welcome him raising his constituent’s concern. It illustrates the worry about the impact of the changes and the reality of people already being advised that services will be withdrawn—even those who the hon. Gentleman and I would hope would fall under the definition of “frail” or “vulnerable”, including those who may not be able to afford care.

Access is part of the problem. At the same time when the consultation exercise was carried out, the foundation trust reviewed its estates and facilities to make savings. It closed some podiatry clinics and relocated some services, making them more difficult to access. We are talking about people who may not have transport or who may have mobility issues, so difficulty in accessing services is a further problem.

In Northamptonshire, 107 private podiatrists are registered with the Society of Chiropodists and Podiatrists. I am grateful to the society for its helpful briefing for today’s debate. Those private podiatrists are expected to provide care to low-risk patients. Costs vary across the area, so will the Minister comment on how we can safeguard our constituents’ interests by ensuring that costs are affordable where people are told that they must meet costs themselves and that as many people as possible are not charged at all where there is a clear need, in accordance with the CCG’s stated wish to include the frail and vulnerable?

I have received letters from Northamptonshire Healthcare NHS Foundation Trust podiatry staff, who told me that their jobs were being put at risk. There have been 16 whole-time equivalent podiatry posts lost, including leadership posts and the posts of musculoskeletal and diabetes specialists. That is inconsistent with the Government’s stated aim of maintaining high-quality clinical services. The reductions will create a high level of clinical risk by putting patients at an increased risk of falls, ulceration and amputation. We all want to ensure that our local hospital services, for example, can meet growing needs. We do not want more people presenting at accident and emergency or needing hospital admissions because they were not effectively treated through podiatry services.

The staff in the local podiatry service down-banded to bands 5 and 6 will be expected to carry out the same role that they currently deliver at bands 6 and 7. The view of the Society of Chiropodists and Podiatrists is that that is a deskilling or de-professionalisation of the service. I am concerned about that. Podiatry is not the most glamorous or attractive part of medicine. Not everybody wants to deal with people’s feet, for reasons we can all understand, but such work is incredibly important. Those who do it are proud of their professional skills, and we do not want them diminished, or want people not to be paid at the right level for their qualifications, because in the end that will lead to a recruitment problem

I understand the importance of the quality, innovation, productivity and prevention challenge to the national NHS strategy. I met the chief executive of the Northamptonshire Healthcare NHS Foundation Trust on Friday to discuss the issues. She talked to me about the rationale behind the changes, but she also said that there had been “learnings”. What I am learning is that the term “learnings” in health care usually means, “We recognise that we didn’t go about this in the right way. We perhaps rushed too quickly.”

Does the Minister accept that if people cannot access services where they are needed, the changes in Northamptonshire, and perhaps other areas, could create long-term problems and prove to be a false economy? I hope she agrees with that. Will she look at the staffing changes in Northamptonshire? I was asked on BBC Radio Northampton this morning what an Adjournment debate achieves, and I said that one thing is that the Minister will take an interest in what is happening in my area. I hope that one outcome of today’s debate will be that she will look at the changes in Northamptonshire, if she has not had a chance to do so already.

I do not want the Minister to override the proper role of local decision makers in deciding on the best pattern of services in our area, but a sense check on the Government’s intentions around the shift to prevention and the best use of resources, and how short-term decisions are made locally to find savings, may be a counter to that.

There seems to be a contradiction between the Department of Health’s vulnerable older people’s plan and policies that put older people at higher risk through the downgrading of incredibly important and much valued services. Along with the demographic time bomb that the NHS is facing, there is also a diabetes challenge; 2.9 million people, or 4% of those in the UK, have been diagnosed with diabetes.