Healthcare: East Midlands

Caroline Johnson Excerpts

Tuesday 30th April 2019 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. In case hon. Members are not aware, I am a consultant paediatrician and work in the east midlands as a doctor during times that fit around my parliamentary commitments. I have worked in a number of hospitals around the east midlands: in Lincoln County Hospital, Mansfield Community Hospital, King’s Mill Hospital, and in both of the major Nottingham hospitals, Queen’s Medical Centre and Nottingham City Hospital. I have also worked at Doncaster hospital and I am now at Peterborough. I have a fairly wide experience of the different hospitals serving the east midlands population.

I was proud to hear last week that Peterborough has received a “good” rating from the Care Quality Commission. Not just that; the CQC will shortly return because the trust is not happy with “good”—it wants to receive an “outstanding”. It was somewhat displeased that the visitors focused on the areas they thought might be a problem, rather than on the areas we might have been able to showcase. The CQC will return to see the areas that it knew were very good already, to see whether we are entitled to see the “outstanding” mark. I hope that is achieved.

I congratulate the hon. Member for Lincoln (Karen Lee), my constituency neighbour, on achieving this hour-and-a-half debate. I was pleased to hear her welcome the extra money for the NHS, but disappointed to hear that she does not think it is enough, unlike the former Labour Health Secretary. We need to bear it in mind that a 3.4% average real-terms annual increase—£20 billion more—is a lot more money. I was also disappointed to hear about problems; it is easy to identify the problems and much more difficult to identify the solutions. Money is one of the solutions, but this is about much more than money.

I want to highlight some of the really good things going on in the east midlands. The hon. Lady correctly identified morale as one of the issues with the workforce. One of the things that affects workforce morale is people focusing on problems rather than on the areas in which excellent services are being delivered, which is the focus of most of my constituents—me and my family included—who receive excellent service from the hospitals in our area. The problem with low morale in the workforce is that it causes people to leave. When people leave we have more locum staff, which increases costs. Since less money is available, there is less ability to trial new things, so staff leave—and so the cycle continues. We need to reverse that, so I welcome the new routes into nursing, such as nursing apprenticeships, and the hard work we have done to increase the number of nurses who can train.

As a doctor, I am aware of shortages in medical staff, particularly in paediatrics, which is the area I work in. The University of Lincoln is opening a medical school in the hon. Lady’s constituency. That is a really good intervention. Students commonly stay to work in the area in which they trained, and that medical school will enable that to happen. The Government also need to look at remuneration. The remuneration of my junior medical colleagues is significantly lower in real terms than the remuneration I received as a junior doctor at the same grade.

I would be grateful if the Minister looked at issues with retirement. In my constituency, some GPs and other doctors retire earlier than they might wish to, because if they continued to work they would accrue very high pension contributions that they would not benefit from. If they continued to work but withdrew from the pension scheme, they would lose other benefits, such as death in service benefits. The Government should look at that.

In my rural constituency, once I have visited the GP it takes me 15 minutes to drive to a pharmacy in the nearby towns of Grantham or Sleaford with the prescription I have been given. Some patients at my surgery, including me, are entitled to have their prescriptions dispensed to them on site. How frustrating it is, though, for constituents who do not have that entitlement but would if they moved one house further down the street, not because they live in the wrong area but because they moved practice after they moved house. A constituent recently wrote to tell me that if someone moves into the area and then changes their GP, they are not entitled to dispensing services, but if they move GP and then move home, they are entitled to those services. That seems incongruous. GPs at dispensing practices receive a revenue increase, so they have both an incentive to provide an excellent one-stop service to their patients and a financial incentive to work in a rural area that offers such a dispensing service. I should be grateful if the Minister would look at that.

When I was first elected, I was terribly worried about East Midlands ambulance service. In the preceding few months, I had attended a number of incidents—just as an individual member of the public who had been driving past—where patients waited an inordinate amount of time for an ambulance. That was completely unacceptable, and one of those patients died, although I suspect that was not related to the time the ambulance took to arrive. That is why my first Prime Minister’s question, my first meeting with the Prime Minister and my first meeting with the Health Secretary were all about East Midlands ambulance service.

I was therefore pleased to go back and visit the ambulance service recently and hear how much has been done. The extra money that has been put in has produced 67 new ambulances, of which 27 are brand-new and additional as opposed to new-for-old replacements. The service’s response time for patients in the most acute need—the most unwell patients—has fallen by more than two minutes, which is a good success; we have to bear in mind the rural geography. I was also interested to hear about the research that is going on. Not all improvements in healthcare are delivered by money; some are delivered by research and improvements in knowledge and treatment. The East Midlands ambulance service has a research and audit department, which is looking at ways that the service can deliver better care to its patients; that is excellent.

A number of hon. Members mentioned the challenges of delivering healthcare in rural areas. Hon. Members may know about the joint work between Bishop Grosseteste University in Lincoln, United Lincolnshire Hospitals NHS Trust, Public Health England, Health Education England and others on launching a national centre in Lincoln to look at how we deliver better care to people in rural areas—that is its main focus. That is another attraction for people to come and work in the beautiful county of Lincolnshire. The centre will look at data, research and technology. I would love to have time to go into all the different things it can do to improve healthcare for my constituents and others, but time is short, so I will move on.

Let me touch on orthopaedic services at Grantham. People rightly are terribly concerned about the number of people who prepare for an operation—they build themselves up, take time off work and put plans in place for the care of those who are dependent on them—that is cancelled. We understand the reasons why that might happen, but ULHT has worked really hard on delivering better care. The fantastic Grantham Hospital—it has saved my husband’s life on two occasions—has a designated ward for orthopaedic surgery, which is only for what it calls “cold” operations. That is part of the “Getting It Right First Time” approach, looking at how we ensure that we get the very best care in orthopaedic surgery.

Trauma services have been moved to Lincoln. People might say, “Oh, that’s a dreadful cut,” but it means there are more people on hand in Lincoln to deliver more operations more effectively and more efficiently; more people get their operations done—fewer are cancelled—and there is a dedicated team of people in Grantham who are knowledgeable in orthopaedics and focused on delivering joint replacements and other non-urgent care. Overall, the service has improved massively. I congratulate ULHT and Grantham Hospital on the improvements they have delivered, and I wish they were being shouted about more publicly.

I also want to mention the A&E at Grantham Hospital. My husband, whom I love very much, has had his life saved twice at Grantham Hospital, so maintaining A&E services there and ensuring that people can access them is extremely important to me and my family, not least because we live very close by. I welcome the fact that the A&E will be reopened on a 24-hour basis soon, but I want soon to be now.

I have run out of time, but I thank the hon. Member for Lincoln for securing the debate and I hope to hear some good answers from the Minister.