Mental Health Care (Hampshire)

Caroline Nokes Excerpts

Wednesday 18th April 2012 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

I pay tribute to my parliamentary neighbour and hon. Friend the Member for New Forest East (Dr Lewis), not only for the outstanding work he has done to highlight this important issue, which is of grave concern to his constituents and to many residents of southern Hampshire, but for his tireless work to analyse bed availability within the Southern Health trust area. From what he has told us this morning, there can be little doubt that the work done to analyse and challenge the statistics of bed usage, including the somewhat confusing question of what is an available bed and what is simply a leave bed, has taken a great deal of time.

What many of my constituents and other local residents want is to make sure that the outcome of the process is correct for local users of adult mental health services. As my hon. Friend has correctly indentified, this is not an argument about the philosophy of how best to care for those in need. There will always be a need for acute in-patient beds, although we certainly believe there is potential to improve arrangements and thus avoid in-patient admission for those who can be successfully and safely treated in the community. However, what has not been clarified throughout this process is the number of beds that there are in the system and the number of beds that are needed. My hon. Friend has certainly done sterling work over the past few months analysing bed usage, and I do not intend to repeat any of those statistics—we have heard in great detail what may or may not be available. Suffice it to say that, in the past six months, there have been many occasions when there have been no vacant beds across the service.

On top of that, there are many valid questions from service users in my constituency about the choices made about which beds should remain available in the locality. At the start of the year, I attended a meeting organised and hosted by my hon. Friend to learn more about the concerns of local service users and to hear at first hand how important the provision at Woodhaven is to local people, their families and their carers. Given the location of Woodhaven and the distribution of mental health beds across Hampshire, it is inevitable that this closure will impact on not only the constituents of my good Friend, but those of several Members across southern Hampshire. As my right hon. Friend the Member for New Forest West (Mr Swayne) has indicated, mental health problems are no respecter of, and trust boundaries are not contiguous with, constituency boundaries.

Of course, when discussing reconfiguration of health services, frequently the focus is on location, and service users will emphasise the distance of travel to get to a facility, the availability of public transport and how convenient it is for loved ones to come and visit. Interestingly, when discussing Woodhaven, that was not the message I received from service users or their families. Indeed, if we were to analyse the journey times and the ease of access, it is possible to argue that, for the vast majority of my constituents, Woodhaven is simply not as accessible as alternative provision at Melbury Lodge in Winchester. Woodhaven is a great deal further away for many people, and the public transport links are much poorer.

However, location has simply not been the focus for any of my constituents who have had experience of either Woodhaven or Melbury Lodge, or indeed both. Far from emphasising convenience, my constituents’ concern has been regarding the quality of provision. The questions they have posed have been eminently sensible. Why is it proposed to deprive acutely ill patients of the benefit of 24 modern en-suite beds that were opened only eight years ago? Why would the trust choose to keep the facility that is not as good, that does not afford the same level of privacy and dignity and that has no en-suite facilities at all? I would like to highlight the comments made to me by just two constituents who have contacted me. The first wrote:

“My wife has been an inpatient at both Woodhaven and Melbury Lodge. Melbury Lodge isn’t anywhere near the standard of Woodhaven. Woodhaven is very pleasant, with a lovely atmosphere. Melbury Lodge by comparison is very intimidating with a lock down high security approach. This may be appropriate for some of their patients but for the majority it’s just scary.”

The second constituent provided me with a very detailed account of his mental health issues, a suicide attempt in 2008, and his own stay at Woodhaven under section. He wrote:

“Having been an inpatient at Woodhaven I would emphasise the privacy. Having a breakdown surrounded by others who do not respect your privacy is very difficult. When I was in acute crisis I desperately needed short term care and support, it would be a disaster for local service users if those high quality short term beds were lost in favour of a less good facility, or worst case scenario, no bed at all.”

I pay tribute to one of my hon. Friend’s constituents, who made a lasting impression on me at the meeting mentioned earlier. He had been an in-patient under section at both Melbury Lodge and Woodhaven and, again, it was the privacy aspect he emphasised. While an in-patient at Woodhaven, he felt he had retained his dignity by being able to have his own bathroom. That clearly made an enormous difference to him personally, and I think we can safely draw the conclusion that a feeling of having some personal space and privacy can greatly improve the overall sense of well-being and aid the chances of a swifter recovery.

I have absolutely no doubt that the facility at Woodhaven is of an extremely high standard; we know that from the comments made by consultant psychiatrists. We know that the demand for short-term acute beds is high, and that one in four of the population suffers from some level of mental health problems at one time or other during their life. We also know that the NHS trust’s figures on bed usage and length of stay at the unit have been called into question. Is now the right time to press ahead with a closure, or is it timely to call a pause to the process until such time as the disputed statistics have been independently analysed?

Ovarian Cancer

Caroline Nokes Excerpts

Wednesday 12th October 2011 Westminster Hall

[Caroline Nokes (Romsey and Southampton North) (Con)]

I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on securing the debate. I want to focus on a small area of it, but first I pay tribute to the hon. Member for Slough (Fiona Mactaggart), who gave us a very personal story and identified a key problem—the complexity of the symptoms, the fact that they are sometimes confusing and the general lack of awareness of what they are.

I thank Target Ovarian Cancer for its approach to me, which was quite personal. It was one of those approaches, which I sometimes receive, that make me think, “Ouch!” It would have been great if I had been approached by the Teenage Cancer Trust to be asked to emphasise the number of very young women who suffer, but, unfortunately, as I am approaching a large birthday, Target decided that I was in the key target group of women who really should know more. That is a key point. When I added in some other risk factors, such as lifestyle and weight, I began to scratch my head and think that perhaps I should take it all very seriously and think more closely about the symptoms that present when someone is suffering from ovarian cancer.

Despite the fact that women tend to be more aware of symptoms and keener than men to go to the GP—I apologise, as there are many male MPs present in the Chamber—they also have a serious tendency to grin and bear it, and get on with things. Sadly, symptoms such as bloating are not uncommon. I see the hon. Member for Slough nodding in agreement.

We are missing an opportunity, because by the time women get to a significant birthday they are already well used to some forms of screening for cancer. Great, next year I get mammograms as well—fantastic. That is an opportunity to talk to women about the symptoms of ovarian cancer. I do not want to appear controversial or to denigrate the idea that we need a general awareness campaign, which is important, but as any good advertising company will explain, a targeted message to the audience likely to be most affected is the best way to get something across.

I suggest to the Minister that we need to look at ways to approach the women most likely to be affected. That is not in any way intended to undermine the work of the Teenage Cancer Trust. The incidence in younger women is important and alarming, but age, genetics and hereditary disposition are the largest contributory factors in ovarian cancer, and we need to give close attention to the idea that when women are called for routine cervical smear tests or mammograms they are in exactly the right caring, knowledgeable environment for explaining the symptoms. I hope that the message will get out a little more effectively to those women who are at risk and who could contribute significantly to the Government target on reducing deaths from cancer.

Congenital Cardiac Services for Children

Caroline Nokes Excerpts

Thursday 23rd June 2011 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

I add my congratulations to my hon. Friend the Member for Pudsey (Stuart Andrew) on securing this debate. I thank the Minister for his important comments on, and support for, the motion.

I feel strongly that there should be a change in the configuration of children’s cardiac surgery, but it must create the right configuration. We want the correct answer to the question, and we want the review team to listen to all the arguments and make its decision based on the best possible evidence. I argue strongly, representing as I do part of the city of Southampton, that when we are looking at the important issue of children’s cardiac surgery, we must base our decision on quality.

I have been in regular contact with a constituent of mine, Mr Jim Monro, whose name will be familiar to all Members who have investigated this matter because he is one of the country’s most eminent cardiac surgeons. He is now retired. He first conducted a review into children’s cardiac surgery after the tragedies in Bristol in the 1990s. He feels strongly that he has seen this matter kicked into the long grass for too long. We must crack on and ensure that the review is completed. However, it must take into account the best available evidence and come up with the right outcome. None of us wishes to see a recurrence of the dreadful tragedies in Bristol. That is where the roots of the review lie.

Although I support the need for the review, I do not endorse the process, nor the recommendations in their entirety. I question three elements in particular. Fundamentally, the review must be about quality. We have to ensure that the best outcomes are achieved for the very sickest babies and children. However, the Southampton unit, which has a superb record of outcomes, finds itself in only one option—option B, the so-called quality option. I cannot believe that that is right for one of the highest performing units in the country. It carries out difficult procedures, does not cherry-pick cases where the best outcomes are likely, has proved that it can work collaboratively with Oxford, is widely acknowledged to be one of the best units in the country, and already has three surgeons, with a fourth starting shortly. I have heard colleagues describe it as a perverse outcome that one of the country’s top performing units is included in only one option, in which postcode matters more than the life chances of the sickest babies.

Secondly, and I will not rehearse this argument at great length, there is the additional complication of the Isle of Wight. My hon. Friend the Member for Isle of Wight (Mr Turner) has informed us of that issue clearly. People from Southampton want an answer to that question. Six weeks ago at a consultation meeting, they were promised that more information would be forthcoming from the review team about how significant the Isle of Wight factor was. We are still waiting.

Thirdly, the manner in which the consultation is being conducted has created an adversarial climate in which cardiac unit is put against cardiac unit and surgeon is put against surgeon. I feared that today we would see MP against MP, but we have not. As my hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) said, this has been a collaborative debate that has picked up on the strengths of each case.

I welcome the spirit in which this House has responded to the motion.

Oral Answers to Questions

Caroline Nokes Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Anne Milton]

I point out to the hon. Lady that with the new commissioning consortiums, those decisions will be made at a much more local level. Only 36 of 152 PCTs are currently contributing to the helpline, which is nonsense when one considers that they are being asked for only £422 each. It is right that such decisions should be made locally, particularly in view of the sort of emotional support that the helpline can give.

[Caroline Nokes (Romsey and Southampton North) (Con)]

14. What steps his Department is taking to increase the provision of preventative health care.

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

In addition to what I said in reply to Question 3, I can tell my hon. Friend that we will shortly be publishing a public health White Paper, which for the first time will not only demonstrate a commitment across Government to improving public health and reducing health inequalities, but introduce a strategy and implementation programme to achieve precisely that.

[Caroline Nokes]

I thank my right hon. Friend for that answer. Chronic obstructive pulmonary disease is responsible for 30,000 deaths a year, and it is the second largest cause of emergency hospital admissions in the UK. In response to the consultations that have been received from, among others, groups in my constituency, will the Secretary of State please tell me when the Government plan to publish the clinical strategy on COPD?

Contaminated Blood and Blood Products

Caroline Nokes Excerpts

Thursday 14th October 2010 Commons Chamber

[Caroline Nokes (Romsey and Southampton North) (Con)]

I thank the hon. Member for Coventry North West (Mr Robinson) for opening this debate and all the Members who have spoken in it thus far. Many of them mentioned by name constituents who have suffered as a result of receiving contaminated blood products, but on Monday I received a visit from a constituent who specifically did not wish to be named because she still feels that she suffers a stigma as a result of having hepatitis C. She does not want it talked about and she is embarrassed, but it is not just she who suffers; so, too, does her son.

There is never a good time to get a Government to commit to significant spending, but this is a new Parliament with a bright, shiny new Government and we should celebrate the fact that we finally have the opportunity to hold this debate on the Floor of the House of Commons some 20 years after the subject under discussion became an issue.

Not many people in Romsey and Southampton North have been infected as a result of having received contaminated blood products, but a handful have, and it is tragic to hear some of them say that although they would like to be present today they do not feel they can afford the train fare to come to London. Indeed, even those who have travelled have welcomed the fact that the debate is being held in the afternoon so they do not have to pay peak-time train fares to attend it.

I wish to make a specific point to the Minister, but let me first say that I welcome parts of the written statement, because elements of it represent progress, and the people in the Public Gallery who have travelled here today want to see progress on this issue. They do not want a partisan row to develop on the Floor of the House; they want us to make moves in the right direction.

One constituent who came to see me made some points about insurance. She and her family find it difficult to enjoy a family holiday because it is hard for them to get travel insurance. There are similar difficulties with life insurance and mortgages, and therefore it can be hard for people to buy their own property and have the security that that provides. I therefore welcome the parts of the statement that make reference to insurance because it is important.

The specific point I wish to make is about dentistry. It may not be particularly widely known that hepatitis C sufferers frequently have significant problems with gum disease. A constituent of mine therefore wanted to have easier access to NHS dentistry. I hope the Minister will take that point on board, and be prepared to make some sort of dentistry provision in future.

My constituents are not greedy people. Both those who have travelled here today and those who have not have stressed to me that they wish there to be fair compensation, and that they wish to have help from this Government. They do not wish to apportion blame because there has not been any progress over the past 20 years. What they want is progress now.