Kettering General Hospital Urgent Care Hub

Chris Skidmore Excerpts

Tuesday 3rd September 2019 Westminster Hall

[The Minister for Health (Chris Skidmore)]

It is an honour to serve under your chairmanship, Mr Bone, in my first debate as the new Minister of State for health.

I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate on the proposed urgent care hub at Kettering General Hospital. This is an important issue for not only my hon. Friend but his constituents in the wider Kettering community, and it is one on which he campaigns tirelessly. I congratulate him on his diligence and determination to continue that, bringing it before the House today.

Kettering General Hospital, as my hon. Friend mentioned, has stood on the same site for nearly 122 years. It plays a vital role in the community, and he set out eloquently the importance of the hospital to that community. In January this year, my predecessor, my hon. Friend the Member for Wimbledon (Stephen Hammond), discussed the urgent care hub proposal with my hon. Friend the Member for Kettering and visited the hospital, following the foundation trust’s unsuccessful £45.7 million sustainability and transformation partnership bid in July 2018. My hon. Friend set out clearly the need to cope with rising demand, with which the urgent care hub could assist.

Given the unsuccessful bid, I am sure that my hon. Friend is aware that the sustainability and transformation partnership programme has been the main funding route for strategic capital development projects. Under that programme, capital has been allocated to more than 170 STP schemes since July 2017, which now amounts to about £3.3 billion. STP investments will modernise and transform NHS buildings and services across the country, including new urgent care centres, integrated care hubs that bring together primary and community services, and investment in new mental health facilities.

On 5 August this year, the Government announced a £1.8 billion increase in NHS capital spending, on top of the additional £3.9 billion announced in the 2017 spring and autumn budgets. Of the increase in NHS capital spending, £1 billion will allow existing upgrade programmes to proceed, to tackle the most urgent infrastructure projects. Some £850 million will allow 20 new hospital upgrades to start as soon as possible. Those hospitals were chosen because they applied for funding in tranche 4 of the sustainability and transformation partnerships, but narrowly missed out. I will set out the short process that we go through to designate the waves, whereby the 20 hospitals that narrowly missed out on upgrades previously will receive funding this time.

[Mr Hollobone]

Kettering General Hospital narrowly missed out on previous funding allocations. Northamptonshire is the only one of the 44 STPs in the country never to have received any capital funding in the four waves that have taken place. I find that staggering, given the overwhelming support from the local NHS for the urgent care hub proposals.

[Chris Skidmore]

NHS Improvement and NHS England follow an independent assessment process. Previous waves, and the allocation of the 20 hospital upgrades that were announced last month, were assessed on the following six criteria: deliverability; patient benefit and demand management; service need and transformation; financial sustainability that delivers savings to both the organisation and the sustainability and transformation partnership; value for money, including return on investment; and estates.

As well as the top-scoring schemes, a number of schemes of critical service importance have been included, such as mental health and learning disability schemes, drawing on the advice from sustainability and transformation partnerships and national and regional NHS leadership. Together, the schemes demonstrate that they will deliver clear improvements to services. That may not be the answer that my hon. Friend wants to hear, but let me reassure him that I am happy for NHS England and NHS Improvement to discuss how the process and the scoring of requirements operate in greater detail with the chief executive, Simon Welden, who is sitting in the Public Gallery. If the trust would like to have that meeting, I will happily help to arrange that feedback for the hospital and my hon. Friend.

On future capital funding, an extra £1.8 billion was announced in August. That money, to enable investments in critical infrastructure, was not previously available, and gives new spending power to the NHS to fund new projects. The £1.8 billion is a brand-new capital injection on top of money announced in previous Budgets and spending reviews. The Department’s capital spending limit has increased accordingly: following the announcement on 5 August, the capital spend on health for 2019-20 has gone up from £5.92 billion to £7.02 billion. It is important to make that clear, given some wish to look for bad news in any good news announcement. It is important to recognise that the £1 billion boost, and the £100 million of the £850 million allocated this year, will be spent on that capital allocation.

[Mr Hollobone]

I join the Minister in welcoming the £1.8 billion of extra capital funding for the NHS and the £1 billion wave of funding at the end of 2018. That is all very good news, but given there is almost £3 billion of extra capital injection, we simply cannot understand why £49 million of that could not find its way to Kettering, particularly as there is already a worked-up business case, to get the project up and running quickly.

[Chris Skidmore]

As a new Health Minister, I have found that the wave approach to the sustainability and transformation partnerships programme has highlighted a wider issue with NHS capital. My hon. Friend’s point about geographical distribution applies not just to bricks and mortar but to diagnostic equipment. We must make sure that our national health service is truly national, by giving every trust equal opportunities to apply for and receive funding. That is why the Secretary of State recently set out that, as a Government, we will establish a new health infrastructure plan. The plan will mean that we take a strategic approach when looking at hospitals that need upgrades, and how that will fit into a wider strategy that will be organised in the Department, taking into account local needs and NHS clinical requirements.

We will put in place a long-term strategy to upgrade and improve our NHS. That will deliver a major strategic hospital rebuilding programme that will provide the necessary health infrastructure across the country. I cannot go into any further detail, apart from to say that the shape of that will be confirmed in due course. To offer a comparison, the road investment strategy—RIS 1 and RIS 2—has a longer term process by which we can move away from a succession of waves. We have waves 1, 2, 3 and 4 of funding as part of the STP processes: some of those projects are further along and more developed than others; some have more advanced business cases than others, as my hon. Friend mentioned. It is important to take a strategic approach for the future.

I understand that my hon. Friend was disappointed that Kettering General Hospital was not selected for funding this time. However, as he mentioned, the trust secured £6 million in emergency capital funding this year, to deal with safety-related estates work. In addition, between 2017-18 and 2018-19, the trust received more than £14 million in capital to fund improvements to the hospital, including £12 million to tackle the urgent capital backlog and other essential capital expenditure. It received £2.4 million for winter pressures and £820,000 for electronic prescribing. That does not make up for what my hon. Friend recognises as an important development and improvement to the estate, but in Kettering the trust has improved enormously and has made great strides in recent years.

I note that while the Care Quality Commission rated the hospital as “needs improvement” after its inspection earlier this year, the trust has been taken out of special measures for quality following the CQC report published in May 2019. I am pleased that, despite the rising demand my hon. Friend mentioned, it is still providing patients with safe and good quality care and is focused on embedding a culture of continuous quality improvement. I am delighted that Kettering General Hospital is participating in a national urgent and emergency care standards pilot, and I await information and learnings on that this year.

[Mr Hollobone]

I am glad that the Minister highlights the huge improvements made at the hospital and the superb leadership we now have in place. Will he accept an invitation to visit the hospital and see the A&E department at first hand?

[Chris Skidmore]

I thank my hon. Friend for that invitation; I would be delighted to visit the hospital. I pay tribute to the staff at Kettering General Hospital, who continue to work hard and who contributed to the hospital’s receiving a good rating for care. I hope we will continue discussions during my visit.

I hope that, if my hon. Friend and the trust are willing, I can arrange the meeting to go through the criteria for STP wave 4 in finer detail. I hope that he understands that we are looking at setting up a new process by which capital infrastructure projects will be delivered. The Government have made significant investments in the NHS as part of their long-term plan. We recognise that we need to mirror that investment in NHS capital. I thank my hon. Friend for raising this important issue, and I look forward to working with him.

Question put and agreed to.

Autism and Learning Disability Training: Healthcare Professionals

Chris Skidmore Excerpts

Monday 22nd October 2018 Westminster Hall

[Chris Skidmore (Kingswood) (Con)]

Thank you for calling me to speak, Dame Cheryl. I recognise your expertise and knowledge in this area. As one of the leading Members of the House, you have worked tirelessly to represent the rights of those with autism, and you took the Autism Act through Parliament. My comments will pale in comparison. Your position today prevents you from speaking, but I want those watching the debate to know how indebted Members on both sides of the House are to you for your efforts.

I speak in my capacity as the Member of Parliament for Kingswood, near Bristol. My constituent, Paula McGowan, has worked tirelessly and courageously to highlight the tragic death of her son, Oliver McGowan, on 11 November 2016. Paula’s work to establish Oliver’s campaign and call for mandatory autism and learning disability training for NHS professionals led to the creation of a petition, which had been signed by 51,310 people as of around 3 pm. I am extremely grateful to the Petitions Committee for scheduling this debate on that petition.

I speak as Paula’s local representative, but what she has achieved in the face of such extreme grief and anguish is so remarkable that, in all honesty, she should be telling Oliver’s story in this debate. That story is awful and harrowing, but it needs to be told. I am grateful to the hon. Member for Cambridge (Daniel Zeichner) for putting Paula’s testimony on the record. She sent me some additional personal words. It is important that I place those words on the record, too, not only for the benefit of Members present but so that they stand as a testament to Oliver and so that his death is remembered eternally in the House’s official record, Hansard.

Paula states:

“From the moment Oliver was born, we knew that he was special and our love for him was overwhelming. Oliver was born premature and developed meningitis at three weeks of age. He was very ill and we were told they did not expect him to survive. However, Oliver began to recover. Everybody who came into contact with Oliver warmed to him and could not resist spending time with this baby.

Sadly, Oliver developed a second episode of meningitis and was incredibly ill. Amazingly, against all odds and many months of hospital treatment, Oliver’s strength and determination shone through and he survived once again, and as always with that beautiful heart warming smile that everybody was drawn to. Oliver—as a result of an infarction caused by the meningitis—was left with mild cerebral palsy, focal epilepsy and later on a diagnosis of high functioning autism.

Oliver’s disabilities did not hold him back. He had a can do attitude and amazed everybody with his achievements. He played for the South and North West Centres of Excellence England development football squads. He was a registered athlete with the Power of 10 and was ranked 3rd best in the country for athletics. Oliver was a member of Team Bath and was being trained to become a Paralympian.

Oliver was a natural leader and became a prefect and chair of the school council, later college. He attained several GCSE and BTEC examinations. He went on to attend National Star College in Cheltenham. Their opinions of Oliver were very complimentary, writing how he was often mistaken to be a member of staff; how friendly and kind he was, supporting students who were less able than himself; his wicked sense of humour; and the aspirations they had for him to start a sports course at a local ski centre.

Oliver brought so much happiness and fun to our lives; he always saw the best in everything and taught all of us how to look at things differently. Oliver never failed to light up a room with the sound of his laughter. He wanted to make everybody happy and did his best to achieve that. Despite his limitations, he never complained or asked, ‘Why me?’ He accepted everything and always with a smile. His courage and enthusiasm was inspirational. We were told by his neurologist that Oliver had a full life expectancy and it was expected he would live an independent life with a little support.

On 15 October 2015, Oliver was admitted to a children’s hospital, having what we—his parents—and college staff recognised to be simple partial seizures. These caused Oliver to be anxious, agitated and confused. After several weeks of tests Oliver was discharged home and given sertraline—an antidepressant medication—to treat his anxiety. We were surprised as Oliver was not depressed. Once this medication was increased, it caused a change to Oliver’s mood and increased his seizures greatly.

He was admitted back to the same hospital on 15 December 2015, but this time was given antipsychotic medications. The doctors were misunderstanding Oliver’s autistic behaviours to be an ictal psychosis, and his normal autistic obsessions to be delusional behaviours. The effect on Oliver was catastrophic. Oliver’s seizures threshold and anxiety deteriorated and he was eventually held against his will under the Mental Health Act, section 2. We challenged this on numerous occasions, stating we felt it was the drugs that were causing the changes to Oliver’s mood and seizures.

A psychiatric bed could not be found and doctors decided to remove the antipsychotic medications. Within days Oliver’s mood and seizure activity improved and he was discharged back home into our care. A community psychiatrist wrote Oliver was sensitive to antipsychotic and benzodiazepine medications.

On 15 April 2016, Oliver was readmitted back to the same hospital having simple partial seizures and was anxious. Sadly, Oliver was again given antipsychotic medications, one or more of which caused a serious side effect called oculogyric crisis. He was left like this for several hours as the doctor at first believed it was behavioural. After four hours he was given procyclidine medication. Again, Oliver’s mood changed significantly. He was hallucinating, having up to 30 seizures a day—something we had never seen happen—and had problems urinating, extreme high blood pressure readings and sweating, all of which were linked to medications.

We strongly believed the drugs were the cause of the decline in Oliver’s mood difficulties. It was obvious that doctors and nurses had little to no understanding of autism and how autistic behaviours could present in a person with ongoing seizures. When in seizure, Oliver was always fully conscious, and because he had no control of the seizures they caused him to be frustrated and scared.

At my request, Oliver was transferred to a specialist adult hospital, which I thought would have understood Oliver’s epilepsy better. Oliver had been provided with a letter stating his reactions to previous medications. Sadly, the use of physical restraint was increased with up to eight staff being involved. Oliver was suddenly not allowed any privacy with his personal care. He had three staff sat around his bed and he was kept in a darkened room. Oliver was very frightened and he told me just how scared the staff were making him feel.

Oliver was again given different antipsychotic medications and consequently detained against his will and transferred to a specialist mental health ward. The different approach from skilled staff allowed Oliver to improve within days. The words from staff including doctors from the unit were that Oliver was not psychotic or mentally ill, and that his placement there was a total misuse of the Mental Health Act. They reduced all antipsychotic medications and Oliver was discharged after a few days into the care of a specialist learning disability team, again with a letter saying that he was sensitive to antipsychotics and benzodiazepines.

The team was very supportive and specialised in people with autism and learning difficulties. A consultant psychiatrist in learning disability wrote that Oliver was not psychotic or mentally ill. He believed Oliver’s behaviours were a result of autism and mild learning difficulties and an environment that was not adapted to meet his needs.

Sadly, on 16 October 2016, Oliver had a cluster of seizures and was admitted to an adult general hospital. Oliver told ambulance staff and also doctors in A&E not to give him antipsychotic medications as they messed with his brain and made his eyes go up. He was reassured by doctors they had no intention of using those medications. We gave doctors a folder of supporting letters stating Oliver’s reaction to antipsychotic medications, and it was subsequently written in bold red ink on Oliver’s medical care sheets he was intolerant to all antipsychotics.

Oliver was intubated. The safeguarding officer was consulted on how to manage Oliver’s anxiety when sedation was reduced. His advice to the doctors was a non-pharmaceutical approach and to use soft handcuffs. We were told we should be present as we would be able to reassure and comfort him. We were told that most people would become highly anxious when woken from being sedated. This advice was not listened to and sedation was reduced without our presence. According to staff, Oliver became anxious. He would have felt scared waking to find tubes in his throat and in unfamiliar surroundings without familiar faces. Full sedation was increased.

We were consulted by a neuropsychiatrist who had met Oliver for two 10 minute appointments in the community. She asked us about giving Oliver an antipsychotic. We made it very clear about Oliver’s previous reactions to this type of medication and that she did NOT have Oliver’s or our permission to administer any antipsychotic medications. Despite this, Oliver was given the antipsychotic medication olanzapine at a low dose that evening without our knowledge. The next day, we again made it clear to all doctors and nurses that they did not have Oliver’s permission to administer this.

Oliver, over the next few days, developed a temperature of 42^°. Because doctors said his liver function was elevated he was not given any medication to control the temperature other than a light blow up mattress filled with cold air. This was not effective. Doctors could not understand the decline in Oliver’s condition and they sent him for a scan of his liver and lungs. Unfortunately, it was several more days before they scanned his brain. It was so badly swollen it was bulging out the base of his skull. We were told Oliver had neuroleptic malignant syndrome, a rare but serious side effect of antipsychotic medications.

A week later, the decision was made to turn Oliver’s life support machines off. Oliver passed away several days later on 11 November 2016: Armistice Day—poignant given we are a military family.”

Paula continues:

“Oliver’s was a life wasted due to doctors not communicating effectively with family and practitioners who knew him well and who were in daily contact with the hospital. We believe the doctors were arrogant and ignorant and believed they knew Oliver better than his parents. They did not consult wider, when there was ample opportunity to do so.

We have since been told by the doctor who administered the antipsychotic drug that she would have given it regardless of our wishes, as she believed it was in Oliver’s best interests, and she would do the same thing again given the same situation knowing that Oliver has lost his life. We understand that many people receive the medications that Oliver was given, often for managing a mental health condition, and do so without suffering the effects that Oliver had. In Oliver’s case, we had clear understanding that he was sensitive to these medications and we believe they should not have been prescribed.

We believe that Oliver’s death was very preventable. We believe that Oliver was given excessive drugs due to medical staff not understanding autism impacted by seizure activity. They did not ever try to adapt the environment to meet his needs, but used excessive restraint methods. They failed to make any communication with community-based professionals who were working with Oliver on a daily basis and knew him well.”

A later inquest into Oliver’s death concluded that the care Oliver received in the lead-up to his death was “appropriate”. It stated that despite warnings from Oliver and his parents, the development of complications from medication could not have been predicted. As a local Member of Parliament, I was in contact with Paula after Oliver passed away to support her when she approached the local police and coroner’s office to ask for an investigation into the death of her son. I will continue to offer all the support that I can.

In spite of that inquest’s conclusions, the Government’s learning disabilities mortality review programme, which investigated Oliver’s case, highlighted the challenges that vulnerable people such as Oliver still face in gaining access to appropriate care. There remain serious disparities in the quality of health support and care received by people with autism and learning disabilities. The evidence shows, as has already been mentioned, that people with learning disabilities die at a far greater rate than others. Often, that can be prevented with the right care and support and better awareness and training.

Recent reports from Mencap, which has been recognised for its ongoing efforts and campaigns, found that one in four doctors and nurses has never had any type of training on learning disability. Clearly, that is unacceptable. Every person should receive the same high quality of care, whether or not they have a learning disability. Although we have made progress in our collective understanding of autism and learning disabilities, much more needs to be done to ensure that vulnerable people receive the right support from our healthcare system when they need it most. I am encouraged that the Government have accepted all the recommendations from the learning disabilities mortality review, including recommendation 6, which proposes the introduction of mandatory training for all health and care staff. I am also pleased that they have committed to delivering that training in partnership with people with experience, including families and parents like Paula.

I welcome the Government’s proposals for a consultation on options for delivering that essential training to staff, which is due to be completed by the end of March 2019. With that in mind, I would welcome it being arranged for Paula to meet the Minister to discuss Oliver’s campaign and its consequences, and for this work to continue. I would also welcome the Minister and the Department continuing their close working with Mencap, the National Autistic Society, other charities and relevant organisations, and indeed Members of Parliament such as the Solicitor General, my hon. and learned Friend the Member for South Swindon (Robert Buckland)—he is in his place but his ministerial role affords that he cannot speak in the debate—who have personal experience of autism. It is right to draw on that.

[Lyn Brown]

I have listened to the hon. Gentleman and have been really affected by his speech; I am sure he has been affected as the local MP. I pay tribute to him for how he is putting his case, but does he not agree that the review is unnecessary and that what we actually need is some action now?

[Chris Skidmore]

I agree that we need clarity, not only extra guidance. The review is one step in a journey that has yet to be completed. I own up to this, having been a Minister previously: there is a commitment to looking at guidance and training, but I am concerned with the implementation. Going forward, we could produce all the training, guidance and material we want, but how will we monitor the outcomes? What are we seeking to achieve?

A couple of months into my job as a Minister in the Cabinet Office, having previously been secretary of the all-party parliamentary group for disability as a Back Bencher, I wanted to look at how we could increase and encourage electoral registration among those with learning disabilities. The answer I got was, “Well, there is guidance out there already, Minister. The Electoral Commission has produced documentation.” However, it was patently clear to me that it was not being implemented in polling stations across the country. I would like to see a commitment from the Minister not just for consultation and guidance to be produced but to ensure that we have accountability. The Care Quality Commission must be involved, and people must be judged on the standards introduced; this must be followed through.

In conclusion—this may chime with what the hon. Member for West Ham (Lyn Brown) said—I return to the words of Paula McGowan:

“If the guidelines and principles from NHS England’s STOMP—stopping the over-medication of people who have learning disabilities—project had been followed with healthcare professionals being able to listen to family and specialist colleagues, then we firmly believe that Oliver would still be here today. We believe that Oliver’s premature death should be in the public’s interest, and I challenge the Government to: ask people with a learning disability, autism or both, their families and carers for their opinion and concerns about treatment; listen to all involved and show respect to those opinions and concerns; and do something about it and work in partnership with us. Specifically, NHS professionals who provide specialist care in learning disability and autism should: put people at the heart of all decision making; respect our point of view; not make decisions without us; and enable us to understand complex decisions in a way that is relevant to all and provide information and explanation.

In particular, check if your patient has a hospital passport. Respect your patient by getting down to the same level as them—don’t stand if your patient is sitting. Give them personal space. Modify your language so that it is clear and precise, and don’t use medical jargon. Check your patient has understood what you are saying. Effectively listen to your patient. Give your patient time. Make them feel valued and included in their treatment plan. Mostly”—

above all—

“offer reassurance. In addition, liaise with healthcare colleagues in general hospitals to raise awareness and understanding of learning disability, autism and the principles of STOMP. And, above all, do everything in your power to prevent a story like Oliver’s from having to be told again.”

From my own point of view, I hope that we can all work together to ensure that we do not have to stand here again, making the case for change. Let us support Oliver’s campaign and ensure that his death marks a watershed moment and a turning point in how we treat those with autism and learning disabilities in the NHS.

Oral Answers to Questions

Chris Skidmore Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Speaker]

Splendid. I call Chris Skidmore.

[Chris Skidmore (Kingswood) (Con)]

Several of my constituents have contacted me to welcome the Government’s recent announcement of additional investment for prostate cancer funding. Will the Minister update the House on what the money is and what it will be spent on?

[Steve Brine]

Gladly. Prostate cancer survival rates are at a record high, but we want to do even better, so last month the Prime Minister announced £75 million to support new research into the early diagnosis and treatment of prostate cancer. The National Institute for Health Research will recruit 40,000 more patients, which is a lot, for more than 60 studies into prostate cancer over the next five years.

Learning Disabilities Mortality Review

Chris Skidmore Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

The hon. Lady is right to raise the inequalities of diagnosis of conditions and illnesses for which catching them early can mean the difference between life and death. That is why we have introduced annual health checks for people with learning disabilities. They mark a huge step forward and will help to reduce recognised health inequalities and ensure that reasonably adjusted care needs are much better communicated to other NHS partners.

[Chris Skidmore (Kingswood) (Con)]

As a Bristol-area MP, I thank the University of Bristol for its rigorous review, which marks a milestone in increased transparency and in setting out appalling healthcare inequalities. I note with interest that the review recommends efforts to improve awareness of the signs of sepsis and pneumonia in patients with learning disabilities in the NHS. Will the Minister reassure the House that the NHS will take up that recommendation urgently?

Breast Cancer Screening

Chris Skidmore Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

Yes, I am happy to give that assurance. The number of people affected is only an estimate at the moment, but there will obviously be great interest in the House and in the country in what the actual number ends up being.

[Chris Skidmore (Kingswood) (Con)]

An additional 200,000 to 300,000 women could be seeking breast cancer screening within the next six months, which works out roughly at an additional 2,000 women a day. What reassurances can the Secretary of State give to the women who were due a screening anyway that their treatment will not be delayed as a result of the additional need?

[Mr Hunt]

That is an important question. One of our top priorities has been to construct a resolution to the problem that will not have an impact on the regular screening programme for women between the ages of 50 and 70, which is so important. All I can say is that a huge amount of trouble has been taken to try to ensure that we are putting additional capacity into the system to deal with the extra work.

Oral Answers to Questions

Chris Skidmore Excerpts

Tuesday 6th February 2018 Commons Chamber

[Stephen Barclay]

My hon. Friend is right to point out the need to give support to this trust. That is why a wider package of £1.6 billion of funding has been given to the NHS to improve accident and emergency and elective care performance. Alongside that, we have specific work through NHS Improvement to address some of the particular issues that he alluded to in his trust.

[Chris Skidmore (Kingswood) (Con)]

rose—

[Fiona Bruce (Congleton) (Con)]

rose—

--- Later in debate ---

[Chris Skidmore (Kingswood) (Con)]

Will the Secretary of State update the House on progress made in reducing the cost of agency nurses so that the money can be reinvested in full-time nursing?

[Mr Hunt]

I am happy to do that. It is one of the great successes of NHS Improvement, which should be celebrated, that it has brought down the amount spent on agency nursing by £1 billion in the last couple of years. That is a huge achievement. Every penny of that goes back into frontline care.

Oral Answers to Questions

Chris Skidmore Excerpts

Tuesday 13th October 2015 Commons Chamber

[Jane Ellison]

My hon. Friend is absolutely right to highlight one of the principal difficulties we face, which is people not having a conversation about donation. Even if people are on the organ donor register, their wishes are sometimes overtaken by those of their families at that very difficult moment. He is right to highlight the brilliant work done by SNODs, as well as initiatives such as the one that will happen this Saturday, when the Daily Mail, together with the organ donor register, will produce a publication that will, we hope, stimulate thousands of conversations across the land. Having a conversation about consent is one of the ways we will crack this problem.

[Chris Skidmore (Kingswood) (Con)]

16. What steps his Department has taken to improve transparency in the NHS.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Last year I launched My NHS, where patients can see how safe their local hospital is and many other things. From next May, there will be overall information on the quality of mental health and cancer care.

[Chris Skidmore]

Does the Secretary of State share my view that driving up standards in the NHS is better achieved through a culture whereby providers can learn from their peers? For example the excellent maternity department at my local Cossham hospital recently received an outstanding rating from the Care Quality Commission. That is better than the old ways of doing things through targets driven by Whitehall.

[Mr Hunt]

I agree, and I congratulate the doctors and nurses working in the Cossham maternity unit. Southmead hospital in Bristol has some of the best maternity survival rates in Europe, so there is a lot of very good practice. The way to get the word out is through transparency of outcomes, not endless new targets, so my hon. Friend is absolutely right.

Health Provision (South Gloucestershire)

Chris Skidmore Excerpts

Tuesday 14th July 2015 Westminster Hall

[Chris Skidmore (Kingswood) (Con)]

I thank my constituency neighbour, my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti), for securing this important debate. Many people in South Gloucestershire are listening, and I put it on record that he has been a strong local champion for his area. At every moment, he has not been afraid to speak truth to power about what we feel is going wrong with healthcare across South Gloucestershire. The Minister will be more than aware that we have put South Gloucestershire on the map in raising our concerns about local healthcare provision. We have met her twice, and the last time was on 23 June. My hon. Friend and I have also met the Health Secretary. Over the past five years, we have secured several such debates in the House, and we will continue to do so until we resolve the issues that need to be resolved on behalf of our constituents.

Today, my hon. Friend has raised the issue of Frenchay. The delay caused by the CCG, for whatever reason, is inexcusable and needs to be solved, but I also want to talk about the situation at Cossham hospital, which is also part of the feted Bristol health services plan that took accident and emergency services from Frenchay to give to Southmead on the other side of Bristol. As part of that health services plan, a minor injuries unit was promised at Cossham hospital. Do not get me wrong—Cossham hospital had a full £20 million refurbishment after it was threatened with closure under the previous Labour Government in 2004, which is fantastic. As a member of the league of friends of Cossham hospital, I have volunteered to make the tea and, before we had our new baby, we turned up for antenatal classes at the hospital. It is a superb facility, but it has an empty room that should have housed a minor injuries unit, which, alongside Frenchay, is an outstanding sore point among my constituents, who were promised a minor injuries unit at Cossham and a community hospital at Frenchay. Those promises have not been delivered.

Cossham hospital is just outside my constituency in Bristol East, but it is used by 80% of South Gloucestershire residents, so it is a critical healthcare facility. There has been a 20,000-signature petition to the House of Commons, of which I delivered 2,500 signatures. That petition led to these debates and, just the other month, a referral to the IRP was published by the Health Secretary, who signed off and agreed the IRP’s recommendations. I understand that no Health Secretary has ever not agreed with the IRP’s recommendations, but the recommendations were that the CCG could go ahead as planned and not provide a minor injuries unit at Cossham. Instead, the CCG wants to pilot the introduction of minor injuries provision at general practitioner centres.

There is a problem for my constituents, and for constituents elsewhere in South Gloucestershire. There is a minor injuries unit in Yate, which I am sure my hon. Friend the Member for Thornbury and Yate (Luke Hall) will discuss. It is a fantastic resource, and only one patient at the unit has not been seen within the four-hour target, but we should have had a minor injuries unit at Cossham because people pay their taxes and it was part of the deal, which has been signed and sealed but not delivered. We have now been grinding away at this for years, and we seem to be going around in circles. The CCG has not come up with any alternative provision, so someone in Kingswood with a minor injury such as a broken leg or a broken arm has to go up to Yate. There is simply no provision in place, which is totally unacceptable. The IRP reported the exasperation that constituents feel about Frenchay, which is happening all over again and is mirrored with the minor injuries unit at Cossham hospital.

I have three points to raise with the Minister as the MP for Kingswood. I will continue to fight for a minor injuries unit at Cossham. At the moment, the CCG has not ruled out a unit. It is common sense that, while a room is empty and there is an X-ray department just down the corridor, it is far simpler for someone with a broken bone to get to the X-ray department than having to go to a GP surgery to be treated by a nurse practitioner before getting in an ambulance to go up to a minor injuries unit at Yate or Southmead. It is that lack of joined-up thinking that I and my constituents find incredibly frustrating.

One of the recommendations in the IRP report published last month—moving forward from its regrettable conclusions—was about the CCG request for external support from NHS England to help to solve its problems with delivering the community hospital at Frenchay and minor injuries unit provision across South Gloucestershire. It has asked for help, citing the problems it has with the deficit it inherited from the PCT. To reassure constituents and campaigners that the CCG will gets the help it requires, can the Minister tell us what kind of support NHS England can provide and how soon that can take place? We need answers and we need a road map.

As CCGs become more embedded and more autonomous organisations, accountability becomes an issue, and I do not believe arrangements are in place. That is general point that could apply across the country. The Secretary of State for Health has rightly copied the model of the Department for Education and introduced an accountability regime into hospitals. We now have a chief inspector of hospitals and hospitals will be graded on whether they are inadequate or need improvements. We need that system for CCGs. We need to be able to turn around, as a local community, and stare at our CCG, and know that if it has failed in public engagement, as South Gloucestershire CCG patently has, it will be branded as needing improvement or even inadequate. I urge the Minister to take that policy proposal away and look at it, because the problem will only grow.

Funding in South Gloucestershire is a well worn theme. My hon. Friend the Member for Filton and Bradley Stoke has raised the fact that we have a rapidly aging population. With 30% growth in the over-65s demographic since 2004, there will be problems with co-morbidities and long-term chronic illnesses, which effect everyone once we reach a certain point in life. That is what we need to deal with in South Gloucestershire, but we can only deal with it with improved funding. When we look at South Gloucestershire and compare it with Bristol, there may as well be a Berlin wall running through the county boundary: on one side is Bristol with several thousand pounds per head more funding than South Gloucestershire. Yes, we have had an incredibly welcome health funding increase of 7% in the past year—17th largest rise in the country—but we need a fairer funding settlement. We have the f40 group for schools, and we need the same in healthcare to ensure that South Gloucestershire residents get the healthcare that they desperately deserve.

Francis Report: Update and Response

Chris Skidmore Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I hope the hon. Lady will be pleased to know that we have now made it a criminal offence to supply false or misleading information, but let me respond to the broad point that she has made, because I think it is important.

The publication of data is indeed welcome, but we do not want it to cause the entire NHS to focus on gaming the system, or changing the way in which data are collected in order to make its organisation look better. The purpose of data is to identify issues. The CQC then makes rounded judgments on the performance of institutions, which are based not just on data but on visits and conversations with patients, doctors and nurses. I think that that system can provide us with the best understanding of how well those institutions are actually doing.

[Chris Skidmore (Kingswood) (Con)]

As the Secretary of State will know, my hon. Friend the Member for Bristol North West (Charlotte Leslie) and I wrote to him about Southmead hospital after a large number of our constituents had written to us about poor quality care there. Today the CQC published its report on North Bristol NHS Trust and Southmead, which states that the urgent and emergency services are inadequate and causing a

“serious risk to patients’ safety”,

and also states:

“Several staff told us they were ‘ashamed’ of the standard of care”

at Southmead.

I have just received a letter from the chief executive of North Bristol trust, which makes no mention whatsoever of the fact that Southmead A and E had been declared inadequate. Instead, she simply refers to

“some teething problems which are being dealt with”.

Does that letter not illustrate the overall culture problem in the NHS, namely that there is active denial among some chief executives who will not admit what is going wrong in their local hospitals?

[Mr Hunt]

I have not seen the letter, so I hope that my hon. Friend will understand if I do not comment on it, but I strongly agree with his broader point. Any chief executive or manager in the NHS needs to understand that the best way in which to reassure the public, and to reassure Members of Parliament who speak out for their constituents, is to be honest about the problems.

My local trust was the first in the country to be given an “outstanding” rating. When I last went to see its chief executive, I said that I had three constituency problems, and I raised all three of them with him. He said, “Yes—we were wrong on that one; we should not have done that; and we were wrong on that one.” One of the best trusts in the country was being totally honest about its problems, and wanted to do better. We need to make managers understand that that is the right thing to do, and that we will back them if they do it.

National Health Service

Chris Skidmore Excerpts

Wednesday 21st January 2015 Commons Chamber

[Chris Skidmore (Kingswood) (Con)]

I thank the Department for recent rises in health care funding in South Gloucestershire. Only yesterday, I received a written answer to a parliamentary question showing that South Gloucestershire CCG will receive £263 million for 2015-16, which is up from £249 million in 2014-15 and from £239 million in 2013-14. That 7% increase in per person funding, from £921 in 2013 to £997 today, is the 16th largest rise out of 211 CCGs. Tomorrow, I will attend the opening of the Leap Valley medical centre in Emersons Green, which is a brand-new, multi-million pound GP centre for the benefit of my constituents in Downend and Emersons Green. Things are therefore looking up for NHS funding in South Gloucestershire and Kingswood.

I was pleased to have a meeting with the Chancellor at which my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti) and I convinced him to give £1 million from LIBOR funds to the Great Western air ambulance, about which the chief executive has said that he is absolutely delighted. As the local MP, I have been pleased to be able to push for such improvements in health care.

I want to raise my concerns about the health care situation in Bristol, particularly in relation to Southmead hospital, a brand-new hospital under a £500 million private finance initiative contract that was signed and sealed under the previous Government. As a consequence of the opening of Southmead hospital, Frenchay accident and emergency was closed. It is no coincidence that Southmead has struggled since that closure. As a candidate and as an MP, I fought to keep the A and E open, after the decision to close it was taken in the Bristol health services plan for 2004 to 2006.

I still believe that the closure of Frenchay A and E was an absolute disgrace for our local community. We all know that it happened when the local North Bristol NHS Trust decided to prioritise Southmead over Frenchay because Frenchay’s more expensive land could be used to build a housing estate. We are now seeing the consequence of the reorganisation that took place under the previous Government. It happened despite the fact that 50,000 people signed a petition to get the then Secretary of State, Patricia Hewitt, to refer the decision to the Independent Reconfiguration Panel, which she refused to do. It was a total mistake for the previous Government to decide to prioritise Southmead over Frenchay.

Cossham hospital, another hospital in my patch, was threatened with closure in 2004. The Save Cossham Hospital campaign group was fantastic in opposing that potential closure by the health chiefs of North Bristol NHS Trust as part of the disastrous Bristol health services plan. As a result, Cossham hospital has had a £19-million refurbishment and looks fantastic. I believe that the shadow Secretary of State visited it a couple of months ago.

However, there is a gaping hole, because the minor injuries unit that was promised for Cossham hospital is yet to be delivered. Along with all the parties and the fantastic Save Cossham Hospital group, which is led by Reg Bennett, we have collected well over 17,000 signatures to call for the minor injuries unit. I have secured several debates in Parliament, as the Minister well knows, to call for a Cossham MIU. Regardless of the status of the minor injuries unit, we were promised it because Frenchay A and E was closing. That decision was taken by the previous Government, as I said, and the final contracts were signed in February 2010.

Having been promised this health resource in Kingswood after Frenchay A and E closed, we deserve to get it. It is too far to get round to the other side of Bristol and there are no proper bus services to Southmead hospital. We must remember that NHS services are funded by the taxpayer, so every taxpayer deserves equitable treatment and access to local health care services. I do not believe that my constituents are getting that because Frenchay A and E has closed and Southmead is too far away. We need our minor injuries unit at Cossham hospital.

Only today, there was a meeting of the public health and health scrutiny committee of South Gloucestershire council. On 19 November, I spoke at the committee in person to call for the decision about the minor injuries unit to be referred to the Secretary of State. The committee agreed in principle. I contacted the Department this week, having had regular meetings with the Health Secretary to discuss Cossham and Frenchay, only to find that no letter has been sent by the committee to the Health Secretary. The Department of Health simply has not received such a letter. Today, it turns out that the committee is yet to refer the decision to the Health Secretary. Without that official referral by the committee, the Health Secretary cannot refer the decision to the Independent Reconfiguration Panel.

I call on South Gloucestershire’s public health and health scrutiny committee to get a move on, pull their finger out and send the letter to the Health Secretary. I hope that Ministers will confirm that once they receive the letter, they will be able to refer the decision about Cossham minor injuries unit to the Independent Reconfiguration Panel. It is simply not good enough for the committee to have this month-on-month delay without sending the referral letter to the Health Secretary. People in Bristol have waited too long. They saw Frenchay A and E close, which was a disgrace and will always be Labour’s worst legacy in my local area. We need the minor injuries unit at Cossham hospital and I will continue to fight for it every single day.