Sir Robert Peel Hospital

Debate between Dan Poulter and Christopher Pincher

Tuesday 1st April 2014 Commons Chamber

[Dr Poulter]

I will be delighted to meet my hon. Friends to talk further about local issues. There are long-standing concerns, not least the processes triggered by the Keogh review in the trust and the wider health economy.

I turn to the local reconfiguration process. To ensure that the foundation trust would continue to provide the best level of service to the local population, the trust commissioned a report from Deloitte in December 2012. The intention was to address the long-term challenges faced by the trust by refocusing community services, such as those provided at the Sir Robert Peel community hospital, and concentrating on the most vulnerable patient groups.

The Deloitte report set out a number of options. However, as we are all aware, in 2013 the trust was inspected under the Keogh review, which we took forward following the Francis report on Mid Staffordshire foundation trust. Burton was inspected because it had higher than expected mortality rates. The Keogh review was not reassured by what it found. As a result of the inspection, the foundation trust was placed in special measures by Monitor, the regulator of foundation trusts. Monitor continues to work with foundation trusts in special measures to ensure that they return to safe and efficient services as soon as possible. The Keogh review made six urgent recommendations for Burton. Those recommendations have been the drivers for the changes at Burton and at the Sir Robert Peel community hospital.

Sir Bruce Keogh challenged the foundation trust on what its long-term plans would be for the community hospitals. For example, patient activity at both sites in Lichfield and Tamworth has been decreasing across minor injuries, in-patient and out-patient services for a number of years, and is, I understand, on a steadily decreasing trend. There is a need to make changes because, as well as the higher than expected mortality rates, the trust and its local commissioners believe that the health needs of the population they serve are changing.

As a nation, we face changing challenges in health care—for example, the demographic pressures imposed by an ageing population. As the health needs of the population change, it is right that the services provided at local hospitals and in the local health economy also change and that a more integrated approach is taken between local authorities and the NHS in delivering more personalised care, particularly for the frail elderly, and more care in people’s homes and communities.

The foundation trust has already responded to the Keogh review challenge, although much is still to be done. I understand that the reconfiguration to which my hon. Friend the Member for Tamworth refers follows on from and continues the response to the Keogh review. Certainly, the aims are the same—to ensure that health care services are of high quality and meet the needs of local patients.

The Keogh review has affected the Sir Robert Peel community hospital, which currently offers local services for people living in and around Tamworth—including, for example, a 24/7 minor injuries unit, in-patient, X-ray and ultrasound department, and an out-patient service. There is one ward providing rehabilitation, care of older people, general medical care and palliative care. Consultant and nurse-led clinics accommodate consultations, investigations, minor procedures, post-treatment follow-up and health promotion.

That is not the full range of services that one would expect at larger NHS hospitals. However, having close-to-home community-based facilities is an important part of meeting the challenge of looking after older people in their own homes. Some such facilities are found at Sir Robert Peel community hospital. I am sure that the local population welcome that and believe it important in delivering high-quality health care in the months and years ahead.

There are currently discussions about the relocation of day case surgery and there is a review of endoscopy. I understand that that would affect about 30 patients a week, with services moving to local GP surgeries, Good Hope hospital at Sutton Coldfield about eight miles away, or the main trust site at Burton.

I understand that further changes are being considered in response to Keogh. However, planning is at a very early stage. I understand that the trust board will be receiving an outline paper this coming Thursday and that no decisions have yet been taken. I am sure that my hon. Friend will agree that it would be highly inappropriate for me to speculate about what option or options might be considered or chosen by the local NHS. I would certainly not want to suggest that there is a Government-preferred option that should be followed; I am not in a position to do that. Whitehall micro-management of the local NHS invariably leads to bad things happening; that is what we have tried to avoid through the health reforms that we instigated in 2012. As I said a few minutes ago, such decisions are local decisions and must be seen to be taken by the local NHS and local commissioners, in consultation with local patients.

[Christopher Pincher]

Of course my hon. Friend is absolutely right. These are local decisions for local communities and their local NHS. It is not for Ministers to dictate what services should or should not be provided for any particular hospital; it is for the local community to determine that, based on need. Does he agree, however, that when the local community decides, it should be based on proper consultation, and that listening exercises should be based on what people want and not what the clinical professionals and managers want?

[Dr Poulter]

My hon. Friend makes an important point. Of course clinical leadership in the NHS is important in designing services, but he is absolutely right that it is important that patients and the public locally are properly consulted in decisions about health care services. That is something that we believe in. Far too often in the past, patients have felt that decision making is done to them rather than their being involved in it. That is exactly why we introduced new tests for the reconfiguration of services that put patient and public consultation at the very heart of designing how medical and health care needs are addressed in the future.

As I am sure my hon. Friend agrees, the heart of the matter—this is certainly my reading of the situation from what he has said—is that there is a need for good communication from the foundation trust. That means proper engagement by the trust with local communities, patients and the public and local commissioners in all decisions. It is understandable that people will respond negatively to speculation in the media, and sometimes by word of mouth, about any change or improvement to services unless there is proper communication. It seems that in this case that communication has not been of the highest standard, and that has led to some of the concerns raised by my hon. Friend. I know that he has recently met the chair and chief executive of the trust, and I encourage him to build on that contact. I am sure that the local NHS would welcome the opportunity further to share its thinking with him. That would be very desirable for all hon. Members, including my hon. Friend the Member for Burton (Andrew Griffiths).

I hope that the trust and local GP commissioners will continue to work together to explain clearly what they are doing and why. Elected representatives also play a strong leadership role in helping to work with trusts. It is in the interests of trusts to work with local MPs to ensure that there is a proper understanding of what they are trying to achieve in the way that they deliver health care to the local community.

I was pleased to hear that my hon. Friend has received reassurances from the trust about a strong future for Sir Robert Peel hospital; that is good news. However, there is clearly a need for the trust to focus on improving its communications in future to ensure that the people of Tamworth and surrounding areas fully understand that delivering high-quality health care is about listening to the public. The public must feel that their views are being listened to and properly responded to when health care services are designed. To be absolutely clear, as my hon. Friend said, this is about making sure that patients and public in Tamworth do not feel that decisions are being done to them but that they are making decisions on their own behalf and are fully engaged in the process with local commissioners in deciding on the future health care needs of the local area. Hospital reconfiguration and good health care means listening to patients and the public and making sure that hospital services are improved and delivered in a better way.

That is all the more important in this case because of the consequences of the Keogh review. I know that my hon. Friend will go back from this debate and further engage with the local trust. As I said, I am very happy to meet him and my hon. Friend the Member for Burton to ensure that we can help to achieve better engagement with local health care commissioners and the trust.

I am glad to have had the opportunity to place on record this Government’s support for the local NHS in taking forward the difficult challenge of responding to the Keogh review. We would also like to put on record our gratitude to the local front-line staff who work very hard at the Burton trust. I am sure that as a result of their work and this debate, we will be in a much better position to make sure that the trust engages more fully with the public in Tamworth and surrounding areas when it comes to making decisions about future health care services.

Question put and agreed to.

Care Bill [Lords]

Debate between Dan Poulter and Christopher Pincher

Tuesday 11th March 2014 Commons Chamber

[Dr Poulter]

As part of our changes in the wake of the Mid Staffordshire inquiry—changes the right hon. Gentleman would be wise to heed and learn lessons from, if he should be lucky enough ever to be on the Government Benches again—we have made it clear that we need to ensure that where there are care quality failures, hospitals learn to put such problems right much more promptly than they have done in the past. That is why we put in place buddying mechanisms and why we put trusts in special measures, to deal with issues quickly and effectively to ensure that hospital services are put back on track and patients can be properly protected.

[Christopher Pincher (Tamworth) (Con)]

Does the Minister recognise that the reason why there is concern about clause 119—with due respect to the shadow Secretary of State, I would say it is misplaced concern—is that there is legitimate concern about the way routine reconfiguration mechanisms work? Time after time, consultation does not appear to work on the ground. I have some experience of that in my constituency, where the Burton hospital trust is attempting to reconfigure our services.

[Dr Poulter]

My hon. Friend makes a good point, which has been made by Government Members throughout this debate. Under the previous Government, in particular, many people felt that things were done to them with their local NHS, rather than done in the best interests of local patients. Importantly, decisions were very rarely made with clinical leadership under the previous Government. Proper patient consultation and patient engagement did not take place. I have a list with me of maternity units downgraded under Labour; it is right to say that individual reconfiguration decisions need to be looked at on their merits, but there was a long and tragic history under the previous Government of the public, patients and local clinicians not being properly engaged in the process. That is why our Government have introduced a better process whereby, as my right hon. Friend the Member for Chelmsford (Mr Burns) pointed out, decisions about local health care services under our 2012 Act are led now by clinicians through the clinical commissioning groups. We now have health and wellbeing boards, which is an important step forward in better joining up and integrating the health and care system that we all believe in, and in ensuring that democratically elected local authorities have more oversight of our health and care system. Those are important steps forward and this Government should be proud of them. They indicate that decisions should be made locally for the benefit of local people, and that is how things routinely happen.

The trust special administrator regime is not used lightly; it is used in extremis, which is why it has been used only twice in the past five years.

Oral Answers to Questions

Debate between Dan Poulter and Christopher Pincher

Tuesday 16th April 2013 Commons Chamber

[Christopher Pincher (Tamworth) (Con)]

4. What support his Department has given to local authorities and NHS commissioners to improve cardiovascular disease outcomes.

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

On 5 March, we published the cardiovascular disease outcomes strategy, which included 10 key actions for commissioners and providers to ensure patients and carers get the best possible support. As set out in the strategy, we will continue to make data available to local authorities to see where their areas of greatest need are and to shape their own response accordingly.

[Christopher Pincher]

Will my hon. Friend support the efforts of local clinicians, Tamworth borough council and charities such as Tamworth in the Community, which are working with parents, teachers and children to educate them about the importance of healthy eating and exercise, to deal with the health challenges we have in Tamworth and tackle the rather unfair notoriety that Tamworth gained in the press?