Princess Royal Hospital Telford

Daniel Kawczynski Excerpts

Tuesday 12th September 2017 Westminster Hall

[Lucy Allan (Telford) (Con)]

I beg to move,

That this House has considered Shropshire’s NHS Future Fit process and the future of services at the Princess Royal Hospital, Telford.

It is a great pleasure to serve under your chairmanship, Mr Gray. Like all Members, I come to the House to champion the needs and concerns of my constituents at every opportunity that presents itself. That is what the people of Telford have sent me here to do. Without doubt, the issue that has caused the most concern and anxiety to my constituents over the years is the future of our Princess Royal Hospital. I am delighted that my hon. Friend the Member for The Wrekin (Mark Pritchard) is here, as the hospital is sited in his constituency and his constituents are as affected by the issue as mine.

The reason our hospital has caused our constituents so much concern and anxiety is that for the past four years our local hospital trust has been deliberating how best to deliver emergency care for Shropshire in the future. While we would all agree that that is an important decision that is worth getting right, no one could have imagined that no resolution would have been found four years after the deliberations began.

Despite very public and sometimes acrimonious debates playing out in the media, not a single communication has been sent to my constituents explaining to them what the hospital trust proposes for the future of our hospital. By contrast, my constituents have received a constant barrage of claims directly from our local council. Every time they get a council tax bill or email from the council, the council claims that our A&E and our women and children’s centre—a brand new and much-valued asset in our town—are under threat of closure. Although the hospital trust tells me and others that those claims are entirely untrue and wholly misleading, the trust has not at any time publicly contradicted the council; nor has it told my residents that the information they have received is misleading or untrue. As the deliberations have dragged on without any resolution, my constituents have become increasingly anxious and uncertain about the future, and they are becoming angry.

It is worth putting this into context. Telford is a rapidly growing new town, with an expanding population, set in the heart of rural Shropshire. We have significant pockets of deprivation and health inequalities, and worse health outcomes and lower incomes than our more affluent neighbours in rural Shropshire. We also have lower car ownership, so residents are much less able to travel long distances to access care. The council has told us that our A&E and women and children’s unit are definitely being considered for closure. We are told that those services will be taken from an area of greatest need and moved to the more affluent neighbouring county town of Shrewsbury—is it pronounced “Shrowsbury” or “Shroosbury”?

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

“Shrowsbury”.

[Lucy Allan]

My hon. Friend says “Shrowsbury; I say “Shroosbury” and so do all my constituents. That highlights one of our great differences.

The hospital trust has reassured me that it is not the case that services are being moved, but it is my constituents who need reassurance. I make the simple plea that the Minister put on the record that, whatever delivery model the hospital bosses decide for the future of emergency care in Shropshire, our Princess Royal Hospital will continue to have A&E care delivered by emergency consultants, and that our brand new women and children’s unit will continue to deliver services to women and children.

[Lucy Allan]

My hon. Friend is absolutely right: the women and children’s unit is a vital resource in an expanding population with many young women and children. That is because Telford is a new town; many people come to build a new life and build their family. That resource is vital to us, and the concept of moving it elsewhere so soon after it has been brought to Telford is farcical. I am assured that that is not happening, but we need clarity. At the end of the day, if people keep telling us something, ultimately we are going to believe it is true.

[Daniel Kawczynski]

I congratulate my hon. Friend on securing this important debate. She will know that both our hospitals—Shrewsbury and Telford—are in the same hospital trust. I pay tribute to the way that she has campaigned on this issue. Does she agree that the Labour-controlled Telford and Wrekin Council is behaving highly irresponsibly in whipping up these fearful campaigns and trying to frighten constituents about the long-term consequences of Future Fit? Will she go further in encouraging it to act more responsibly and in telling the Minister that the council ought to be spoken to about not whipping up such levels of concern?

[Lucy Allan]

My hon. Friend is absolutely right: we have seen some shameless politicking around this issue. The local council has weaponised our hospital year after year, which is not helping the process of reaching a decision. I will talk about that in more detail later, because it is a vital point. The council should be working constructively with my hon. Friend the Member for The Wrekin and me to try to get the best possible hospital emergency care for all our constituents, but that is not happening now. That is why it is important to highlight this issue and bring it to the Minister’s attention.

There is no avoiding the fact that the body charged with deciding what our future emergency services will look like has been inept in its communications. Despite the growing uncertainty, anxiety and ultimately anger of my constituents, not once has that body been willing to communicate with them. Although a consultation is planned at some point, year after year goes by and that has not happened. Each year, my hon. Friend the Member for The Wrekin and I come to this House to beg the Secretary of State for Health to intervene, and each time nothing happens. We have moved no further forward.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

It is a pleasure to serve under your chairmanship this morning, Mr Gray. It is also a great pleasure to respond to my hon. Friend the Member for Telford (Lucy Allan). She articulated the case on behalf of her constituents with considerable passion, and I will do my best to address some of the points she made.

My hon. Friend talked about the activities of the council with regard to this ongoing issue. I have to say, as the Conservative MP for Thurrock, which has a Labour council, that it all sounded very familiar. I am afraid that perpetrating fake news is in the DNA, and Labour does not like to have lost successive elections. I am sorry that she has had to tolerate that, but I am even more sorry that her constituents have had to.

When we discuss the future of our local health services, we want to take the community with us. Naturally our constituents get worried about change; they are always worried about the possible diminution of services. The only way we take the community with us is by having real dialogue, based on real proposals and real facts. The fact of the matter is that all the council is doing is engaging in speculation, and I personally find that deeply irresponsible. It is not the job of anybody involved in local leadership to foment fear, and I really do regret those actions. Sadly, I am afraid we cannot expect any better. I am really pleased that my hon. Friend has taken advantage of the opportunity today to make the case for her constituents and to highlight those issues. The way we will take people with us on any change in the health service is by mature discussion and reflection and by advocating on our constituents’ behalf.

[Daniel Kawczynski]

I would like to reiterate the point that my hon. Friend the Member for The Wrekin (Mark Pritchard) made. We all voted for the Bill to ensure that local communities were empowered to make these decisions. It is right and proper that local people at the coalface of providing these services are empowered to make the decisions to improve them and make them future-proof. However, in our case, it really has broken down. The most important thing the Minister can do is to work with her officials to ensure that changes are made when we cannot get an agreement in a locality, because, as my hon. Friend the Member for Telford (Lucy Allan) said, this has continued for four years, causing a great deal of concern and instability for the hospital trust.

[Jackie Doyle-Price]

I thank my hon. Friend for that intervention and will make two points in response. He is absolutely right; the whole purpose of how we structure the NHS now is that communities are empowered to make decisions. That is why it is all the more irresponsible for the council to be engaged in this speculation. The reality is that no decision will be taken on the future of services until the consultation has taken place and all those responses have been analysed. The community will have its say before any change, and anyone who suggests otherwise and is engaged in speculation really should not. Could my hon. Friend remind me of the second point he made?

[Daniel Kawczynski]

The point I wanted to make was that certain communities in the United Kingdom have come together, across parties and across the whole of the county. Northumberland, where this process has worked very well, is a case in point. Unfortunately, in areas such as ours, where a council is acting deliberately provocatively and from a political perspective, that has not come to fruition. I want the Minister to ensure that her Department takes that on board when planning for future ways to improve this process.

[Jackie Doyle-Price]

It is a matter for reflection that this has been going on for four years, which generates considerable uncertainty. Clearly we should reflect on that, to ensure that the process becomes more efficient. Equally, it takes time to have those debates. I know that the particular issues under consideration here are quite difficult to grapple with. The important thing is that the local NHS is seen to be leading the debate and not allowing anyone else to fill that vacuum when there are decisions to be taken.

My hon. Friend the Member for Telford invited me to make some comments. Obviously there are limits, but perhaps I could set out the process, so that we can put in context exactly where we are now. As I mentioned, all service changes will be based on the fact that they deliver real outcomes for patients and will be taken forward in consultation with the local community. Ultimately, the most important factor is that this is what is best for the health service in the area, driven by clinical leadership. Again, it really should be the local NHS leading this debate, and not local authorities filling the vacuum.

The issues that my hon. Friend raised affect not only her and my hon. Friends the Members for The Wrekin (Mark Pritchard) and for Shrewsbury and Atcham (Daniel Kawczynski), but also service users in Wales. As she alluded to, it has now been four years, so everyone knows that change is in the air. Until the vacuum is filled, there will continue to be uncertainty. I expect the CCG to bring forward a consultation, to have an open discussion as soon as it can. I urge everyone to participate fully in the consultation and I encourage my hon. Friend the Member for Telford to lead that debate. Where there are issues that she is concerned about, she should challenge the local NHS leadership, and where there are things that she welcomes, she should highlight them.

The proposed service changes should meet four key tests: they should have support from GP commissioners, be based on clinical evidence, demonstrate public and patient engagement, and consider patient choice. Until those four criteria can be met, no decision can be taken.

--- Later in debate ---

[Jackie Doyle-Price]

It surprises me that the report is not in the public domain, according to what my hon. Friend has just said, if it is informing the approach that is being taken. I tend to take the view that sunlight is the best disinfectant, and if things are not done in an open and transparent way, the conditions are created for exactly the kind of speculation and scaremongering that we have been talking about. Having said that, I reiterate that the consultation has not yet started. It is very important that when the consultation does start, the CCG makes extremely clear the basis on which it is going forward with the proposals that it chooses.

I do not need to advise my hon. Friends of exactly what we are talking about. Clearly, they know more about their local healthcare situation than I do, and it is clear that local NHS leaders have to address significant challenges in bringing forward the entirety of their proposals as they affect the Royal Shrewsbury Hospital and the Princess Royal Hospital in Telford. I understand that they are 18 miles apart. In some areas of the country, that might not seem far at all, but when we are dealing with communities that have very separate identities, they could be oceans apart. That is another reason why we need to be very clear in our dialogue with those communities about why we are bringing forward the conclusions that we are.

Clearly, at a time when there is no money, things that it would be nice to have are not possible. It would be nice to duplicate services in both locations, but frankly that is not a luxury open to us at this stage in the economy, so where there is duplication of services, where we could bring them together and make a better service as a result, we should explore that. It is up to the local clinical leadership—there is a clear task and challenge for them—to demonstrate that whatever they bring forward will deliver better outcomes for patients. When it comes to winning over public hearts and minds, the public will not get away from the fact that services are being moved away from them. Automatically, there is a diminution of service in their mind, but bringing services together can often make a better service. We can see, with patient outcomes in particular circumstances, where that has been achieved. I therefore encourage the CCG to bring forward as much evidence as possible in making its case.

Of course, we all understand that whenever the consultation takes place, after four years of quite feverish speculation on some parts, people will be nervous. I encourage all my hon. Friends to continue this debate in public and with Ministers, so that we can reassure the public that we have their best interests and those of patients at heart with whatever decision is taken. As I have said, the more transparent and open the debate is, the better. Perhaps between them, my hon. Friends can lead the CCG to have those public discussions, away from the council, away from organised intimidation at public meetings, which will not lead to the best outcomes for patients at all. I have witnessed this myself. The left is very good at organising mobs at public meetings, but the last thing we want is for local clinical leaders to bring forward proposals in the best interests of serving the community and then be intimidated, by those who shout loudest, into changing their views because they are faced by a herd.

[Daniel Kawczynski]

This is a very important point for the Minister to perhaps share with the Department for Communities and Local Government and other Ministers. Of course councils have the right to challenge processes. Even though Telford Council’s leader and all his team are completely bereft of any medical credentials, they have the right to challenge, but we need to consider whether they have the right to use taxpayers’ money for political campaigns. I think that the Minister will be interested to see some of the literature that Telford Council has sent out and perhaps share it with her colleagues at the DCLG, to see whether we can do anything more to tighten up the rules on how councils spend their council money.

[Jackie Doyle-Price]

My hon. Friend makes an excellent point. Local authorities are all a function of who leads them, and some leaders are prepared to go further than others when it comes to engaging in debate. I also observe that there is currently an inquiry by the Committee on Standards in Public Life into abuse. Perhaps it could look beyond the abuse of parliamentary candidates and consider the kind of intimidation of clinical leaders at public meetings that my hon. Friend the Member for Telford has referred to, because this is all part of the space of public debate, and it is not helping our democracy that debates are taking place in unhelpfully fevered situations. We recognise of course that emotions will run high and that people will be passionate about the issue. We live in a mature democracy; we should be able to have our debates and discussions based on mutual respect and fact, but I am afraid, from things that my hon. Friend has described, that that has perhaps been missing.

In the short time I have left, I will just say that I hope the CCG brings forward its proposals as soon as possible, because the sooner the debate gets out in the public domain, the more informed it will be.

Question put and agreed to.

Oral Answers to Questions

Daniel Kawczynski Excerpts

Tuesday 4th July 2017 Commons Chamber

[Jackie Doyle-Price]

The amount of resource that is dedicated locally is a matter for clinical commissioning groups, and we continue to make sure that funding is fair. I suggest the hon. Gentleman takes that up with his CCG.

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

9. What guidance he provides to clinical commissioning groups on decision-making processes to improve healthcare provision.

[The Parliamentary Under-Secretary of State for Health (Steve Brine)]

Clinical commissioning groups, as statutory organisations, have a duty to deliver the best possible services and outcomes for patients within their financial allocation. NHS England supports them in this by providing several sets of guidance, as do the National Institute for Health and Care Excellence and other arm’s length bodies.

[Daniel Kawczynski]

I thank the Minister for that answer. He will know that the clinically driven Future Fit process in Shropshire could lead to hundreds of millions of pounds of investment in our local hospital. That is being jeopardised by Telford CCG and Labour-controlled Telford council. When there is this gridlock and impasse between two local CCGs over a long period of time, what more can the Government do to break the deadlock?

[Steve Brine]

I am aware that my hon. Friend has been concerned about this for a long time. An independent review of Future Fit is taking place, and he will know that Professor Simon Brake has been appointed as the independent chair of the joint committee of CCGs, agreed between them both. The review will report in July and be considered by the local CCGs before next steps, including on public consultation, are decided. Clear rules apply to any significant reconfigurations and I expect these to be followed in Shropshire as anywhere else.

A&E Provision: Shropshire and Mid-Wales

Daniel Kawczynski Excerpts

Wednesday 11th January 2017 Commons Chamber

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

In the previous Parliament, we took action to empower local doctors, surgeons and clinicians to think about the optimum way of providing hospital services under ever-changing circumstances, namely the demographic and other changes that are taking place in our society. That was the right step to take. Rather than remote civil servants in Whitehall making those decisions, we wanted to ensure that the people at the coalface provided those services—people who already provide services to our constituents; people with medical expertise; people who have dedicated their lives to improving the care and safety of others. We wanted to empower them to make those decisions.

I stand by the decision that we took, but I want to tell the Minister this evening about some of the practical problems that have ensued in Shropshire as a result of that devolution of power. I do so because I believe in the process and want to ensure that it is retained and protected for future programmes.

We have two hospitals in Shropshire: one in Shrewsbury and one in Telford. They do not just look after the people in those two towns; they look after all the people throughout the whole of Shropshire and mid-Wales. I am not going to go into all the specifics of the Future Fit programme with the Minister, as I and the other Shropshire MPs have briefed him repeatedly about the process over the past few days, weeks and months. However, I would like to thank, in a genuine and heartfelt way, the 300 surgeons, doctors, GPs and medical consultants in our community in Shropshire, who, despite the extraordinary pressures they face already in their day-to-day work in the NHS, have been able to dedicate themselves to and persevere with, despite the many problems and obstacles in their way, coming up with the Future Fit proposals for a reconfiguration of accident and emergency services in Shropshire and mid-Wales. A decision has been achieved after three years and £3 million of taxpayers’ money.

There was going to be a public consultation on that decision. Unfortunately, it has been blocked by Telford clinical commissioning group and Telford Council. Telford CCG has been a part of the process from its inception and it was consulted throughout. At the eleventh hour, however, when the decision did not go the way it thought it would or the way it wanted it to go, it decided, to a man, to vote against the proposals—even though it was party to the whole methodology and process.

In addition to Telford CCG voting against the changes, Telford Council—an esteemed body no doubt, but one, I would argue, with somewhat limited medical experience—has decided to threaten the Future Fit programme with a judicial review if the public are allowed to have the final public consultation. Of course, in a democracy Telford Council has the right to challenge things. Of course, in a democracy Telford Council may even have the right to use taxpayers’ money to instigate a judicial review. What the Minister must remember and retain from our experience, however, is that these two parties were a part and parcel of the whole process from its inception. I have a real and genuine concern about the integrity of the process if we do not back the local clinicians and doctors.

[Lucy Allan (Telford) (Con)]

Will my hon. Friend give way?

[Daniel Kawczynski]

I will of course give way to my hard-working neighbour from Telford.

[Lucy Allan]

I thank my hon. Friend for securing this debate. I tried to secure a debate with a very similar title. Does he agree that the Telford clinicians have an absolute right to express their views, just as the Shropshire clinicians do? The fact that they did not come to the same view is no indication that the Shropshire clinicians came to the wrong view.

[Daniel Kawczynski]

As I said earlier, of course they have the right to do so. Let me take this opportunity to acknowledge the work my hon. Friend has done since she became a Member of Parliament to campaign for Telford, and to campaign very strongly and effectively on this issue without being overtly political or personal, unlike some other people. I will come on to talk about the CCG a little later.

I reiterate that my concern is for us all to put our cards on the table. We all went along with the Future Fit process. The decision could have gone against Shrewsbury. Ultimately, the decision has been made to have the urgent care centre in Telford and that the main A&E service should be provided by Shrewsbury. That decision could have gone the other way. It could have gone to Telford, and we would have lost out. At the end of the day, it should not be about winning or losing—that is the biggest problem.

My right hon. Friend the Member for North Shropshire (Mr Paterson) has talked about the pillow fight that has gone on between Shrewsbury and Telford ever since he became an MP. Over the past 11 years, I have lost more sleepless nights over the constant fighting between Shrewsbury and Telford about hospital services than over anything else. At the end of the day, we are one county and we must fight collectively as one county for all the people of Shropshire, and of course for our friends across the border in Wales.

[Mr Owen Paterson (North Shropshire) (Con)]

I congratulate my hon. Friend on landing this debate. He is absolutely right. This bickering between Shrewsbury and Telford has dogged my nearly 20 years in Parliament. I thoroughly back Future Fit because it provides a solution that benefits everybody. I like the idea that the two existing A&Es carry on doing 80% of their current work, albeit—possibly—having been renamed as urgent care centres, while we get a £300 million emergency care centre. Some of my rural areas look to Shrewsbury, some look to Telford, but we will also gain from urgent care centres being built in the rural areas. What is utterly exasperating for my constituents is this indecision. We have had three years and £3 million spent, and still no decision. I am delighted that the Minister is listening so carefully and I very much hope that at the end of the debate we will have a clear recommendation for a decisive mechanism to deliver the will of the local commissions.

[Daniel Kawczynski]

I could not agree with my right hon. Friend more, and I pay tribute to him for the work he has done on this over the last few years.

I would like the Minister to intervene to ensure that the process allows for a decision. In our case, all six members of the Shropshire CCG voted for the proposals and all six members in Telford voted against. I am very concerned—I want him to take this away—about this. What sort of a process is it when we can get a tie? There needs to be a casting vote or perhaps some independent third party who can arbitrate in such a hotly contested issue where the two local CCGs cannot come to an agreement. So I would like to hear from him on that.

I appeal to constituents from the whole of Shropshire and mid Wales to lobby Telford Council, to get behind the concept of us all working together, as my right hon. Friend said, and to lobby the Government more effectively for more resources, rather than fighting one another in a rather parochial way over where these services are going to be. Let us not forget how close these two hospitals are to one another. We are not talking about 50 miles, 30 miles or 20 miles. Somebody might correct me if I am wrong, but I think they are only 13 miles apart. We ought to be thinking about how to improve and modernise the provision of healthcare for all the people of Shropshire and mid-Wales and listening to the proposals of the medical experts, who have done so much work to put these proposals together.

[Chris Davies (Brecon and Radnorshire) (Con)]

I thank my hon. Friend for bringing this debate forward. Both my hon. Friend the Member for Montgomeryshire (Glyn Davies) and I represent seats in Powys, in mid-Wales, which, as he said, does not have a general hospital. It is one of the few councils not to have one. We rely heavily on both Telford and Shrewsbury, certainly in the top end of my constituency. I appeal to the Minister: our constituents are very concerned. Even though health is devolved in Wales, many of our constituents travel across the border, and for them this is a vital issue.

[Daniel Kawczynski]

I thank my hon. Friend for his intervention. He is absolutely right. In fact, my colleague from just across the border, my hon. Friend the Member for Montgomeryshire (Glyn Davies), always joins us at our meetings with our hospital trust. We almost think of him as a Salopian. [Hon. Members: “Steady!”] Not quite, but he does so much to represent his constituents in Wales, who already have to travel long distances to get to the Royal Shrewsbury hospital. He might correct me if I am wrong, but I think that some of them, from the extreme west of his constituency, already have to travel for over an hour to access A&E services in Shrewsbury. So any movement even further away from Shrewsbury would be completely unacceptable to his constituents.

[Mr Mark Williams (Ceredigion) (LD)]

I come from a peripheral position, further to the west of Montgomeryshire. I congratulate the hon. Gentleman on securing this debate and stress the importance of getting this right, because it has an impact further to the west. If this issue is not resolved, it will impact on the capacity of my district general hospital in Aberystwyth to serve the people of mid-Wales as well. It is crucial to address this issue.

[Daniel Kawczynski]

I concur with the hon. Gentleman, and I am grateful for his intervention.

I shall start to end because I want to give the Minister as much time as possible to answer these questions. Let us not forget that if we get this right, it could result in an investment of £300 million into the NHS in Shropshire. I do not know about all my colleagues—I know that my right hon. Friend the Member for North Shropshire has been an MP for longer than me—but I certainly do not remember a time during my 11 years as an MP when we have had such an investment in the local NHS. As I say, if we get this right, we could see an investment of £300 million in Shropshire to implement these changes.

I know that there is more work to be done to secure this money. I know that more work will have to be done in innovative ways, both locally and nationally, to secure all the funding. If we do not sort ourselves out, however, we are going to get further and further behind, while other areas in the United Kingdom—this is not an issue peculiar to Shropshire—that are going through this process in a more cordial and mutually effective way are going to jump the queue, and Shropshire will be left right at the end. I am not prepared to see that happen.

Finally, Telford Council would obviously have us believe that as part of this programme, women and children’s services have to be moved from Telford to Shrewsbury, because the main A&E will need to have women’s and children’s services next to the main A&E provider at the Royal Shrewsbury hospital. The council says—this is an important point that I want the Minister to note—that because these services were moved from Shrewsbury to Telford a few years ago, such a move would lead to the waste of £28 million. It repeatedly talks about this through the local media. No, no, no. It is not a waste. The building will be used for other purposes, and all the equipment in it, which is easily moved, will be moved to Royal Shrewsbury hospital. So I refute any proposal that there has been a waste of the £28 million invested in women’s and children’s services because of the changes that will take place.

[Lucy Allan]

I thank my hon. Friend for giving way on that incredibly important point. Will he accept that the brand-new women and children’s unit in Telford has been there only since 2015 when it was opened and that the proposal to close it is of huge concern to all my constituents? I am sure he will understand why that is.

[Daniel Kawczynski]

I do understand that concern, and the previous chief executive of the trust responsible for those changes is, I believe, now working in Qatar. It caused a great deal of controversy at the time. Of course, the Government, Ministers and Future Fit will have to do more to alleviate those concerns, but at the end of the day, as my right hon. Friend the Member for North Shropshire has stated, a decision has to be made.

With that, I end my speech and thank you, Madam Deputy Speaker.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

In the few minutes available I shall give the House a recap, describing the process that we have undergone, the impasse that we have reached, and what it has been suggested we do to bring about a decision. I agree with my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) that it is important for us to make that decision and to get it right. The provision of better A&E services for the whole county in a way that works for everyone should not be the divisive issue that it has become.

First, however, I think it appropriate to reflect on the 2.7 million people who work in the NHS and the care system and to acknowledge and congratulate them on the work that they do. Today, as every day, some 2 million people have used A&E services across the country. Let me also say that my hon. Friend the Member for Shrewsbury and Atcham has worked diligently on this issue, as have other Members, including my hon. Friend the Member for Telford (Lucy Allan). I know that it is difficult for them to get this right for their constituents.

At the beginning of his speech, my hon. Friend the Member for Shrewsbury and Atcham made the important point that, ultimately, this must be a local decision. It is not a decision for Ministers, and it will not be imposed. It will be made by the local governance bodies that have been established, notwithstanding the present impasse.

Let me summarise what has been happening. This is a tale of two CCGs and a hospital trust providing services across Shropshire—in Ludlow, Bridgnorth, Oswestry and Shrewsbury—and, indeed, in mid-Wales, including Powys. I agree with my hon. Friend the Member for Montgomeryshire (Glyn Davies) that we need to get this right for the people of Wales as well. The process has been going on for a long time, but the driver for change is not financial. We are finding it increasingly difficult to staff the two A&E centres in Telford and Shrewsbury. Rotas are not being filled, and it is feared that unless we find a robust solution, there will be safety issues and it will not be possible to keep the centres open for as long as we want.

My hon. Friend the Member for Shrewsbury and Atcham observed that this was not a new issue, and that is certainly true. I understand that it is being discussed locally and that projects have been reviewing it since about 2005 without a solution being found. The Future Fit project was set up in 2013. As has been said, the process ended at the end of last year with a preferred option, which was, in broad terms, that emergency care should be centralised in Shrewsbury, with urgent care continuing to be in both locations. I heard it said in the debate earlier that that would mean most patients would continue to be served closer to where they are, either at Telford or Shrewsbury.

On the governance issue, the report of the Future Fit process was voted on by members of the two CCGs, who have broadly a 50% share in that decision, and the result was a tie. Indeed, Telford CCG raised concerns about the methodology of the process and the appraisal techniques used and whether it was robust and fair. As a consequence, there has been no agreement and we have reached our current impasse.

I understand that at the end of December an editorial in the Shrewsbury Star—

[Daniel Kawczynski]

Shropshire Star.

[David Mowat]

Sorry, an editorial in the Shropshire Star—it is not a newspaper I read—made the point that we now need to get this right; we need to make a decision and to stick by it. I think everybody in the Chamber would agree with that, with the caveat that in the end it has to be a local decision. There are very real battle lines here; I think my hon. Friend the Member for Telford met the Secretary of State yesterday on this with other Members and council leaders.

What is the proposed way forward? My briefing from the CCGs is that a week today there will be a meeting at which the intention is that two things happen. The joint committee will be reconstituted and an independent chair appointed who will have a casting vote. In parallel with that, there will be an appraisal, or review of the appraisal process, that Future Fit takes, with the intent to address the concerns raised by Telford about whether it was robust. At the end of the review—depending on the outcome, I guess—there will be a new vote with a view to potentially having a majority on one side or the other and therefore there will be a local direction. That is my understanding of the way forward.

[David Mowat]

I have been advised that the timescale is in the order of eight to 12 weeks, but it remains a local decision. That is what we hope and expect to be the case.

In finalising my comments, I want to make a couple of observations.

[Daniel Kawczynski]

I am pleased with the Minister’s announcement; hopefully we will see a conclusion to this. May I appeal to him to take an active interest in the process in these eight to 12 weeks because the integrity of this devolution of power is at stake unless we empower the clinicians to take the decisions we have ultimately empowered them to take?

[David Mowat]

I am happy to agree to that, although I should have said at the start of my remarks that in the normal course of events this debate would have been answered by my ministerial colleague, my hon. Friend the Member for Ludlow (Mr Dunne), as he is the Minister with this responsibility, although he is not independent on this, so it is appropriate that I answer for the Government.

Once the decision has been taken and a consultation occurs, a component of the proposal will require capital. Various numbers have been floated around, one of which is £300 million. I do not believe that NHS England has yet confirmed that that capital is available, so there is a hurdle to be overcome once a local decision has been taken. I do not want to raise expectations that the process will necessarily be straightforward. This is the way in which the process will occur, as I am sure colleagues would expect. If, as a result of that stage, capital is awarded, there is the potential for those on either side of this discussion to take the configuration proposal to the independent reconfiguration panel. That is always the case in such processes, and the panel can accept or not accept what has been suggested. That is the normal process in the NHS.

I want to make one final point to all my colleagues, who are so keen to get this right for their constituents in Telford and in Shrewsbury. I ask them to remember that the NHS is not just about bricks and mortar. We often have discussions about the bricks and mortar, but I want gently to point out to right hon. and hon. Members that there are other things that they should be holding their clinical commissioning groups to account for. They should be looking at cancer performance, cancer survival rates and maternity performance, for example. There are many aspects of the NHS that are not about bricks and mortar, and it is important that Members should recognise that when we debate these matters.

Question put and agreed to.

Oral Answers to Questions

Daniel Kawczynski Excerpts

Tuesday 9th February 2016 Commons Chamber

[Rehman Chishti (Gillingham and Rainham) (Con)]

2. What progress his Department has made on improving the performance of hospital trusts in special measures.

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

9. What progress his Department has made on improving the performance of hospital trusts in special measures.

[Nigel Huddleston (Mid Worcestershire) (Con)]

12. What progress his Department has made on improving the performance of hospital trusts in special measures.

--- Later in debate ---

[Mr Hunt]

I thank my hon. Friend for his enormous support for that hospital, which has been through a very difficult patch. I had a long meeting with the chief inspector of hospitals about the Medway yesterday. My hon. Friend will be pleased to know that, over the past five years, we got 106 more doctors and 26 more nurses into the trust. We now have a link with Guy’s and St Thomas’s that is beginning to bear fruit. There is a lot more to do, but we are determined to ensure that we do not sweep these problems under the carpet and that we deal with them quickly and deliver safer care for my hon. Friend’s constituents.

[Daniel Kawczynski]

My right hon. Friend will know of some of the terrible problems experienced in Shropshire with respect to clinical commissioning groups and the trust, particularly over the future fit programme and A&E services in the county. The Royal Shrewsbury hospital covers a huge area—not just Shropshire, but the whole of mid-Wales. Will my right hon. Friend give me an assurance that he will do everything possible to support me and the residents of Shrewsbury to guarantee that A&E services remain at the Royal Shrewsbury hospital?

[Mr Hunt]

First, I thank my hon. Friend for his campaigning on behalf of the Royal Shrewsbury; no one could do more than he has over many years. I encourage him to engage carefully with the future fit programme. In the end, it is incredibly important to get the right answer for patients. My hon. Friend has been supportive of the process, but like him, I would like to see it concluded sooner rather than later.

Oral Answers to Questions

Daniel Kawczynski Excerpts

Tuesday 5th January 2016 Commons Chamber

[George Freeman]

I congratulate my hon. Friend on being a diligent advocate for his constituent Mr Vann. I am delighted to tell him that the result of the STAMPEDE clinical trial has now been published. Today NICE is publishing an evidence review. NHS England will shortly be publishing its interim commissioning policy based on that evidence. That is very encouraging.

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

9. What assessment his Department has made of the need for wi-fi infrastructure in hospitals to facilitate use of developing healthcare technologies.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

Digitalisation of healthcare is absolutely essential for the 21st-century NHS—for individual care, for system performance and safety, and for research. Wi-fi is an important part of that, with benefits for doctors, nurses, hospital management and patients. That is why I am delighted that my right hon. Friend the Secretary of State secured the necessary funding in the comprehensive spending review to fund fully the NHS’s plans for digitalisation and transformation. We have announced that we are implementing Baroness Martha Lane Fox’s recommendation of free wi-fi in all NHS hospitals.

[Daniel Kawczynski]

I am grateful for that answer. The new chief executive of the Royal Shrewsbury hospital informed me that people can receive wi-fi in only half of the hospital area. Can the Minister give me an assurance that everything will be done to ensure that wi-fi is available throughout the Royal Shrewsbury hospital?

[George Freeman]

That is an important point. It is up to each hospital to implement digitalisation in its own way, but we are putting in place a series of steps to make sure that all parts of the NHS are supported and encouraged in the drive for delivery of a paperless NHS by 2020. In the new year, we are requiring the clinical commissioning group digital index, which will measure the digitalisation of all health economies, and we are launching a review of best practice. We are absolutely committed to driving digitalisation so that the 21st-century NHS is not running on paper and cardboard.

Oral Answers to Questions

Daniel Kawczynski Excerpts

Tuesday 26th November 2013 Commons Chamber

[Jane Ellison]

Of course, it is possible, depending on clinical need, for clinicians to recommend treatment in England. The hon. Gentleman knows that there are ongoing discussions, some of which are quite difficult, but the intention is obviously to ensure that we get the best health care for everyone. I would urge the Welsh Government, in particular, to consider ways in which they can review how arrangements are made in Wales. There have been calls for a review of hospitals in Wales, not least the one today from the Royal College of Surgeons.

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

Hospitals such as the Royal Shrewsbury hospital, dealing with patients from both sides of the border, have historically incurred additional administration costs in dealing with the two separate authorities. What work is the Minister doing to find out what the costs are and whether she can help meet them in the future?

[Jane Ellison]

We are aware of those additional costs, and I know that my hon. Friend recently met my right hon. and noble Friend the Under-Secretary of State for Health. We are very conscious of those costs and of the difficult decisions. It is the subject of ongoing negotiation between the Welsh Government and NHS England.

Hospital Services (Shropshire)

Daniel Kawczynski Excerpts

Wednesday 9th February 2011 Westminster Hall

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

This important debate is on the reconfiguration of hospital services in Shropshire, and in almost six years as Member of Parliament for Shrewsbury, I have never received so many letters, e-mails and telephone calls from concerned constituents over a single issue. Many of those calls have been emotional, and even though the consultation process is still ongoing, I feel it is my duty to use the platform that I have in the House of Commons to highlight a few of the concerns to the Minister.

Part of the reconfiguration proposals would involve maternity and paediatric services moving from Shrewsbury to Telford. I want the Minister to imagine the geography of Shropshire and mid-Wales. The Royal Shrewsbury hospital covers not just the whole of Shropshire, but the whole of mid-Wales—a vast expanse just across the border. I am pleased that my hon. Friend the Member for Montgomeryshire (Glyn Davies) is present in the debate today.

Picture the wheel of a bicycle, and at the centre, the spokes coming into the middle. That is where Shrewsbury is in the area. Now imagine moving paediatric and maternity services right to the edge of the wheel. How would that wheel function? Telford is at the edge of the area, on the extreme eastern border close to Staffordshire. What is the sense in moving services so far away from the rest of central Shropshire and mid-Wales?

I am so passionate about this issue that I raised it during Prime Minister’s Question Time last week. The Prime Minister referred to the importance of public engagement and consultation, which he said was a fundamental aspect of any reconfiguration proposals. Therefore, I have asked the chief executive and the primary care trust for a public meeting to be held in Shrewsbury on 11 February at the football stadium in our town. I believe that hundreds and hundreds of people will attend. I intend to make a transcript of that meeting and of all questions put to the PCT and the chief executive, and I will be sending that transcript to the Minister.

[Glyn Davies (Montgomeryshire) (Con)]

My hon. Friend knows that I also have a huge interest in this issue as I represent Montgomeryshire over the border. Does he agree that the meetings that will be held in Montgomeryshire on 18, 23 and 24 February are of equal importance, and that it is crucial for the health board and PCTs to take notice of them? We also depend on the services in Shropshire.

[Daniel Kawczynski]

I agree with my hon. Friend. We are cognisant of the fact that his constituents, the citizens of mid-Wales, do not have facilities across the border and are dependent on the Royal Shrewsbury hospital. The people of Wales must be listened to equally, in the same way as the people of Shropshire.

I have slight concerns about the lack of sufficient engagement by the authorities with local people. I pay tribute to the chief executive and his colleagues. There have been public meetings, and the chief executive has met some of my constituents who have serious questions to ask on a one-to-one basis. Nevertheless, many letters and e-mails have not been answered in a timely way or to the degree that people wished for. Some people who have written in are retired senior consultants and experts in the field. I hope that all their questions will be answered.

I am also concerned about the dates of the public consultation. In began on 9 December and will finish on 14 March. I find 9 December a rather strange time to start a public consultation. We all know how stressful Christmas is at the best of times, and we would have been gearing up to buy the Christmas tree and presents and get our homes ready for festivities. A lot of people in Shropshire will not have been thinking about the consultation as intently and with as much time and focus as they might have done, because they were distracted by the coming festivities. If we are to have a public consultation, it must be held at the right time of the year and there must be sufficient time for people to make their views heard.

[David Wright (Telford) (Lab)]

I am grateful to my hon. Friend—I use that phrase pointedly—for giving way. There will be a consultation in Telford next week, and I hope that people will come to it. It is important that people across Shropshire express their opinions. Does my hon. Friend accept that under the proposals, both hospitals have to give something in order to sustain health services in Shropshire? Acute surgery would move to Shrewsbury, and some elements of paediatric and maternity services would move to Telford. There will be a balance between the two hospitals. We do not want to see services move out of the county, and if we are to sustain services in Shropshire, I think this is the best plan we are going to get.

[Daniel Kawczynski]

I will reciprocate by referring to the hon. Gentleman as my hon. Friend. We are from different parties but we are colleagues. We get on well, and across the parties we have a passion for Shropshire. I will come later to the importance of retaining services in Shropshire. However, constituents do not pay attention to services that come to their area; they are focused on those that are leaving. That is why they are pressing me to highlight these issues in Parliament.

My other concern is that there is no plan B. This is a consultation process in which the chief executive and the board come forward with proposals. However, there are no shades of grey—it is take it or leave it. I speak purely as a layman, but if there is only one option, it is difficult for a large group of people, many of whom do not have medical experience, to scrutinise that proposal. Surely, if we are to genuinely engage with local people, differences and alternative options could be put forward so that the community as a whole could come together, debate them and make recommendations.

[Mark Pritchard (The Wrekin) (Con)]

Does my hon. Friend accept that in an ideal world, both hospital sites would have all-singing, all-dancing acute and clinical services? However, we do not live in an ideal world, but in a time of constrained public finances. Does he accept that the current consultation recognises the importance of having an accident and emergency ward at both Shrewsbury and Telford? That is a breakthrough from the original consultation process and shows that the hospital trust has listened to Shrewsbury and Telford on that important point.

[Daniel Kawczynski]

I concur with my hon. Friend and with the point that he makes in his usual eloquent way. I have been told by the chief executive, and others, that if we do not go for the proposals, we will potentially put our foundation trust status at risk. If we put that at risk, there is the possibility of losing services—and the management of those services—out of the county. Again, I speak without medical experience, but I do not understand how we could enter into a consultation process but be told that if we do not go for the proposals, services will be lost from Shropshire.

I cannot envisage a time when we have no maternity or paediatric services in the whole of Shropshire. That is unthinkable to me, so I do not understand the logic of the trust. It is saying, “Take it or leave it, but if you leave it, that’s it. We won’t get our foundation trust status and you’ll lose your services.” That position needs to be clarified because many people see it as a gun being pointed at their heads and are therefore frightened to challenge the proposals.

[Glyn Davies]

I am grateful to my hon. Friend for his tolerance in allowing me to make a second intervention. The point that he has just raised is key. Everyone, including, I am sure, my hon. Friend, recognises that there must be a reconfiguration of services. The points that have been made are crucial. However, that does not necessarily mean that the reconfiguration of services that is before us has to be the case. The argument is not about whether there should be a reconfiguration of services, but about how that should take place. In the interests of the people of Montgomeryshire, I think that services are best placed not where it is convenient for a balance in Shropshire, but where they are accessible to the people who will use them.

[Daniel Kawczynski]

I completely concur with my hon. Friend on that point.

I shall briefly relate a couple of specific cases. I have been inundated with hundreds of letters on this issue. My own daughter was born at the Royal Shrewsbury hospital, and it was the proudest day of my life when my daughter was born within the community that I represent. She is not just a Salopian; she is a Shrewsbury girl and she will have that with her for the rest of her life. For us in Shrewsbury, being a Salopian is important, but being a Shrewsbury girl? Now that is something special. I feel so passionately about that.

One constituent’s family is directly affected by the proposals, as her three-year-old son needs 24-hour open access to the children’s ward at the Royal Shrewsbury hospital because he suffers from severe haemophilia. He needs treatment to be administered every other day and any additional treatment on demand if he should cut himself. I was told that it was vital for my constituent’s son to be admitted immediately to the children’s ward via A and E and not to be sent down the motorway to the Princess Royal hospital. How can that mother of a son with haemophilia empower herself to make her views known if the overview and scrutiny committee is not minded to refer this issue to the Minister?

The issue has also been raised with me by the father of a child who was previously a cancer patient treated at the Royal Shrewsbury hospital. He talks about the appeal in 2003 for a designated children’s cancer unit at the Shrewsbury hospital. It raised £500,000 and the unit was completed in 2005. My constituent told me that

“many people across Shropshire and Mid Wales donated or gave up many hours to fundraise, only to now find that the purpose built unit will…stand unused as Children’s services are being moved to Telford with no provision for this desperately needed unit which provides an essential service to families facing unimaginable turmoil whose children are being treated for cancer.”

I have been told of the severe disruption and anguish that will result from the need for seriously ill patients to travel from Shrewsbury if it is left with no consultant-led surgery, which may result in a catastrophic delay in emergency treatment.

I also want to mention Joshua, a young boy in my constituency who has chronic lung disease. His mother, Hayley Corfield, wrote to me about him. He has had bronchial problems since birth and is now 14 and constantly in and out of hospital. I have been given the most extraordinary list, which I will send to the Minister, of the medications that this poor young boy is on. He lives in Shrewsbury. His mother tells me that there have been many near misses in the last few years in terms of saving his life—resuscitating him. She is desperately worried about the impact on her son and the chances of his survival if, suffering from this chronic disease, he has to travel for an extra 20 minutes to Telford. I am therefore raising these issues with the Minister today.

The Minister kindly wrote to me. In his letter, he notes that I am planning to call a public meeting and encourages me

“to ensure views from that meeting are fed back to the local NHS via the consultation mechanism, so local concerns are fully taken into account.”

The next part is the bit that I am excited and happy about and grateful to him for—I know that he is one of the best Ministers we have. He says:

“The Department will be watching the outcomes from the consultation exercise with interest.”

I know that he cannot get involved at this stage, but I am extremely grateful that he has said that he will be watching with interest the outcome of that consultation process.

I have today written to all the general practitioners who practise in Shrewsbury and Atcham. Again, the Prime Minister stated at Prime Minister’s questions, and it was reconfirmed to me by my right hon. Friend the Secretary of State for Health, that the views of local general practitioners would have to be taken into account before any reconfiguration process could occur. I wanted an independent assessment of their views, rather than it being handed to me by the PCT or anyone else. I have therefore written today to all the general practitioners in my constituency and I urge my hon. Friends to do likewise if they so wish. I will compile the results of the views of local general practitioners in Shrewsbury and will share their views anonymously. I will not refer to specific people, but I will share their views with the Minister.

I am extremely grateful for the 15 minutes that I have had and for the constructive way in which we have debated this issue. It is extremely emotive. I do not want to get into a Shrewsbury-Telford pillow fight. We have had enough of that over the years. I want to work constructively with my colleagues and with the trust to come up with the best possible solution for our beautiful county.

Maternity Services

Daniel Kawczynski Excerpts

Tuesday 1st February 2011 Westminster Hall

[Ms Stuart]

That leads me to my next point. We have clearly not come up with systems in the NHS that allow us to learn properly from mistakes when things go wrong. I fully accept that we have the NHS Litigation Authority, and that the NHS insures itself. We try to deal with negligence effectively and efficiently. However, there is still a mentality of institutions, when something goes wrong, closing in on themselves. I wonder whether we should look at the way the aviation industry deals with accidents. Fault is not allocated; the facts are looked at, and the real outcome is what to do as a result of the problem. Rather than understanding the errors that have gone further and further, we should consider what is to be done as a result.

Going through newspaper cuttings, I found one over Christmas about Good Hope hospital. There was a very unfortunate incident when a lady who had miscarried was left for four hours in sight of other patients. She complained to the hospital, which simply apologised and said it hoped to do better. Hoping to do better simply has not done us any good, if that experience is anything to go by.

It is not clear to me who has responsibility for this matter. In the current structure we have PCTs and strategic health authorities, where at least theoretically we could allocate responsibility. In the new NHS, who will do that? I will return to that point.

We need national maternity data sets that are much more standardised and allow us to make us comparisons across the country. That is not a question of money. Given that we are told that the NHS is one area that is ring-fenced, there is much we can do within existing provision.

I now come to the promise that the right hon. Member for Witney made during the election campaign. We all know what happens during elections; not keeping election promises is not particularly new. However, let us look at what he said in January 2010. Maternity and childbirth is an immensely emotive subject. It is not an illness; it is one of the most joyful events in life. In the majority of cases, a healthy baby is born and we try to keep the medics out of the process as much as possible. When politicians go into election campaigns and talk about maternity services—particularly when they do so in The Sun—it is a pretty toxic mix. The right hon. Member for Witney went to a maternity unit and said:

“Having a baby might be the most natural thing in the world.”

Fine, I agree with him. He continued:

“Every parent wants…to give birth in a relaxed local setting, where they get the personal attention they need. So, why isn’t that happening? It’s because after a decade of constant reorganisation, Labour are giving us bigger and bigger baby factories where mums can feel neglected and midwives are stretched to breaking point.”

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

Will the hon. Lady give way?

[Ms Stuart]

I assume that the hon. Gentleman comes in on the bigger and better baby factories.

[Daniel Kawczynski]

The hon. Lady surely understands that after 13 years, the previous Administration had still not managed to achieve some of its long-term goals and aspirations. She almost indicates that the promises made by the Prime Minister should have been met seven or eight months into a new Administration. Given the state of the public finances, she must acknowledge that it will not be as easy to deliver on those promises as quickly as she—or I—would like.

[Ms Stuart]

I am sure the Minister will be grateful for that helpful intervention. However, have we not been told that the NHS is ring-fenced? That is how I understand it. Therefore, the financial argument really does not hold.

I would like to analyse what the Prime Minister said a little more. He went on:

“It doesn’t have to be like this…First, we’re going to create new maternity networks…Second, we are going to make our midwives’ lives a lot easier. They are crucial to making a mum’s experience of birth as good as it can possibly be, but today they are overworked and demoralised. So we will increase the number of midwives by 3,000. This is the maternity care parents want: more local and more personal. And under a Conservative Government, it is what they’ll get.”

--- Later in debate ---

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

I congratulate the hon. Member for Birmingham, Edgbaston (Ms Stuart) on securing the debate. Maternity services are an extremely emotive issue. When my daughter, Alexis, was born at the Royal Shrewsbury hospital, it was the most emotional day of my life. As a non-smoker, I smoked two packets of cigarettes that day.

I pay tribute to the hospital’s staff, whom I found extraordinarily professional, hard-working and dedicated. However, there has been a lack of funding for maternity services in Shropshire hospitals over the past 13 years. The hon. Lady talked about broken promises, and I want to highlight my concerns about the huge inequality in funding for maternity services around the United Kingdom. I sometimes go to Birmingham and I see the hospitals there, and there are huge differences between the quality of the buildings, equipment and resources in Birmingham and the quality of those in Shrewsbury and rural shire counties.

The Royal Shrewsbury hospital covers not only Shrewsbury and the whole of Shropshire, but the whole of mid-Wales, and I hope that my hon. Friend the Member for Montgomeryshire (Glyn Davies) will have the chance to explain the benefits of the maternity services for his constituents. The population of Shropshire and mid-Wales is not that much smaller than the population of Birmingham. Yes, the populations of those areas, even when combined, are smaller than that of Birmingham, but not by much. However, we have only two hospitals to cover our whole area. I am not sure how many hospitals there are in Birmingham. The hon. Lady said that there was a hospital for women’s services in Birmingham. My goodness, I wish we could have a hospital dedicated to women’s services covering my county and the whole of mid-Wales. I will find out how many hospitals there are in Birmingham, but I want to stress that my county lacks facilities.

As a result of the debate, I am also going to research the outcomes in Shropshire and mid-Wales versus those in Birmingham and to look at the resources that both receive. From all the league tables I have seen, many of the outcomes in maternity services are better in Shropshire than they are in Birmingham. Why is Shropshire so far ahead of Birmingham in the league table when it gets a fraction of the resources? The hon. Lady seemed to imply that greater resources needed to be provided, but I would say that we need to learn from Shropshire how it manages to provide such excellent maternity services when it receives such limited funding compared with Birmingham. When I have done that research, I will send it to the Minister.

During the 13 years of the previous Labour Administration—I briefed the Minister on this last night—there was a chronic lack of funding. I am not embarrassed to say that I think the previous Government deliberately targeted inner-city Labour areas with investment and deliberately stripped it from rural counties, which are predominantly Tory. That was done in a political way to put investment into Labour heartlands, and although the hon. Lady won her seat because she is an assiduous and hard-working MP, many other Labour MPs were re-elected because of that direct channelling of resources into Labour inner-city areas at the expense of rural shire counties.

As a result of that chronic lack of funding for Shropshire, a consultation is under way on proposals for a mass reconfiguration of maternity services. That will see in-patient children’s services and consultant maternity services move from Shrewsbury to Telford. My constituents expressed extreme concern about that at a public meeting on Sunday, as they have over the past few weeks. In the six years that I have been an MP, I have never received as many e-mails, telephone calls and letters from concerned parents, clinicians and GPs as I have over these reconfiguration proposals—there is a lot of concern.

I should stress that I expect any proposals put forward by local hospitals and primary care trusts robustly to meet the stringent tests set out by the Secretary of State for Health in relation to support from GP commissioners, public and patient engagement, clinical evidence and patient choice. If those stringent criteria are not met, I very much hope and expect my local council’s overview and scrutiny committee to refer the proposals to the Secretary of State, in anticipation of their being reviewed by an independent reconfiguration panel.

Today, I will write personally to all the GPs in Shropshire to find out their views about the reconfiguration proposals for maternity services, rather than being told by the PCT or the chief executive that GPs are in favour of them. If they are against the plans, I will share that information with the Minister, and I hope she will support me in challenging them.

Yesterday, I had a meeting with the deputy general secretary of the Royal College of Midwives, Louise Silverton, who has promised to help me get the Royal College of Midwives involved. I will also write to the Royal College of Obstetricians and Gynaecologists to find out its views. I have spoken to the Minister, who has kindly agreed to meet me and a delegation of concerned constituents so that we can raise these issues with her.

I do not want to speak for too long, because I hope that my hon. Friend the Member for Montgomeryshire will get a chance to speak. I would not wish a reconfiguration of maternity services on my worst enemy. It is turning my hair grey and I am extremely upset about it. I am cognisant of the views of my constituents and I want to stress that they are very concerned at the prospect of Shrewsbury losing maternity services. People expect maternity services to be ever closer to them, not further away. Our services cover the largest landlocked county in the United Kingdom, with a vast rural expanse, as well as the whole population of mid-Wales, and we hope and expect that maternity services will stay in Shrewsbury and not be moved to the extreme east of the county, to Telford.

[Andrew George]

I do not want to intrude on concerns about reconfiguration in Shropshire. However, on the basis of yesterday’s debate, the Government’s intentions and the principle of “No decision about me, without me”—as well as the intention, at least, under the proposed Government health reforms, that many decisions will in future be made by communities working through their health and well-being boards with the GP commissioning consortia, and with the political support of the Government—presumably the community and GPs in Shropshire have a greater say in the present culture than they might have in the past. I should have thought that my hon. Friend might be reassured by that and would not necessarily need to get Ministers involved in the dispute.

[Daniel Kawczynski]

Yes, I concur with a lot of what my hon. Friend has said. However, I listen to members of the public, because I am directly accountable to them as their Member of Parliament, and often my voting and other decisions are affected by them. There is a bond of accountability between each one of us and our constituents. Unfortunately, chief executives and managers of trusts and PCTs do not necessarily have that bond of accountability. They are here one minute and gone the next. That is the problem. Many of my constituents are trying to engage in the consultation process and put questions directly to the PCT and chief executive, but they are not getting answers. I should like the Minister to be aware of that. If the Government are putting forward public and patient engagement as a stringent criterion of whether a reconfiguration of service should go ahead, it is important that the Secretary of State should have confidence that that aspect of the process has been fully and robustly carried out. My understanding is that the only method of referral is by the council’s local overview and scrutiny committee, but if the council is not minded to do it, what can local people who still have concerns do?

I have been approached about extraordinarily emotive cases, involving women who have major issues to do with maternity and paediatric services. They are very emotional about the prospect of those services being moved away from their community. I want them to be heard.

[Ms Gisela Stuart]

An important thing we have learned in the past 15 to 20 years is that when it comes to extremely complex and difficult clinical cases, a hospital must perform a particular function a minimum number of times if it is to be at its clinical best. Some of the hon. Gentleman’s constituents will end up in Birmingham. He questions why Birmingham has received investment, but it is because we provide national centres of excellence. Some of the mothers from his area will come to the women’s hospital because their case is so complex that only the women’s hospital can deal with it. There can be only two or three centres in the country able to provide that clinical excellence. There is always that tension between the local and the centralised.

The hon. Gentleman is unhappy about the reconfiguration, but does he have an objective assessment of how good, clinically, his area’s maternity services are? He may feel good about them, but does he have a professional assessment of whether they could be better?

[Daniel Kawczynski]

That is a very good question. The chief executive of the trust and the PCT and many others believe that there must be a reconfiguration and specialisation at both hospitals. The argument is that without it, we shall lose services, which will go out of the county. We shall not get our NHS trust foundation status and services will be moved out even further away. That is the gun being pointed at my head—not to rock the boat too much on this issue, because there is the possibility of services moving away. I understand that. I feel that the maternity services at the Royal Shrewsbury hospital are good. When my daughter was born there I found the services tremendous. Speaking emotionally, obviously I want them to stay in Shrewsbury. I understand that we must have the reconfiguration debate and that the professionals and clinicians must make the decision, and that is why I shall write to local GPs and consultants to gauge their views. I shall keep the Minister informed.

I congratulate the hon. Member for Birmingham, Edgbaston on raising an important issue, and look forward to hearing what the Minister has to say.

[Jim Dobbin (in the Chair)]

I call the shadow Minister.

--- Later in debate ---

[Emily Thornberry]

I respectfully agree with my hon. Friend. In a moment, I shall be speaking about another part of the work force, health visitors. They suffer exactly the same problem. The majority of the work force is over 55. It is important to retain such valuable and experienced people—they are mostly women—but we cannot increase their number if we continue to lose existing staff at the current rate.

According to the Library, the number of births in the UK was projected to fall in 2009-10, in 2010-11 and in 2011-12. If the Prime Minister’s pledge was based on the latest birth projections, perhaps he expects to cut the number of midwives. That is clearly nonsense. We need to consider what is needed and ensure that it is fulfilled.

My hon. Friend the Member for Birmingham, Edgbaston made a devastating analysis of the difficulties that will be caused by the changes the Government propose. How can we make forward projections and how are we to manage the national health service if we give NHS commissioning to doctors? They will simply consider the needs of the local area and not our national needs.

In passing, may I briefly touch on the important issue of Sure Start? During the election, the Prime Minister claimed that Labour was scaremongering when we said that there would be difficulties in relation to Sure Start. He said:

“Yes, we back Sure Start. It’s a disgrace that Gordon Brown has been trying to frighten people about this.”

The Under-Secretary of State for Work and Pensions, the hon. Member for Basingstoke (Maria Miller), then the shadow Minister for the family, said:

“It’s unforgiveable that Labour has used the tactics of creating fear and anxiety amongst families and Sure Start staff”.

[Mr Roger Gale in the Chair]

The Minister of State, Department for Education, the hon. Member for Brent Central (Sarah Teather), has said:

“Sure Start is at the heart of our vision for early intervention”

If that is true, why did the charities 4Children and the Daycare Trust find out that 250 centres, which serve 60,000 families, are certain either to close or be earmarked for closure? There are 3,578 children’s centres in England, 3,100 of which have been told that their budgets will be cut this year. About 2,000 services will be cutting their services as a result. The findings are based on responses from almost 1,000 Sure Start managers to a questionnaire sent out by 4Children and the Daycare Trust.

It is hugely important for a new mother to be able to find a friend, get guidance and go to a children’s centre. Nevertheless, centres offering such services are being cut. The other friend that mothers need is the health visitor. Again, when the Prime Minister was in opposition, he made a big thing about increasing the number of health visitors:

“The substantial increase in the number of health visitors will mean that families get more support—from properly trained professionals. Health visitors will be able to spend time with families, have the opportunity to spot parenting issues, and build the trusted relationships needed to help with them. For instance, if they feel a mother is not bonding with her baby, and recognise the cause as post-natal depression, they might gently recommend that she visit her GP, or steer her towards a local counsellor.”

He was absolutely right; no one can disagree with that. However, when I met London health visitors from the Community Practitioners and Health Visitors Association earlier this year, they told me that there was a huge problem in recruiting new health visitors. They were losing a lot of older, experienced staff through early retirement. Nearly a third of health visitors in London are over 55 and they have dangerous work loads. In some cases, there are more than 1,000 children per five health visitors. That is four times higher than Lord Laming—the writer of the Baby P and the Victoria Climbié reports—recommended. His recommendation is for health visitors to have a quarter of their current work load.

In an area such as London, which is very demanding, current work loads are dangerous. We need more health visitors. The Government recognise that a health visitor should have no more than 250 children under five and no more than 100 in highly vulnerable areas, as was recommended by Lord Laming and the Community Practitioners and Health Visitors Association. Will the Government consider that recommendation when they look again at how many health visitors are needed?

When I asked the Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), whether the Government would take responsibility for recruiting and training the extra 4,200 health visitors promised, the answer I received was odd. She said that she will learn from the decisions on the case loads and they will be “locally determined”. In the same answer, she says that the Department is shortly to publish plans to

“conduct a demographic and geographical analysis to establish location and population need and match with trainees and training places; and ensure positive correlation between work force growth and population need.”—[Official Report, 27 January 2011; Vol. 522, c. 460W.]

On the one hand, the Government say they will look nationally and decide what the need is, and on the other they say that it will be left to localities to decide. We really cannot have it both ways. What we have is a lack of health visitors.

[Daniel Kawczynski]

The hon. Lady talks about the need for more health visitors and staff and maternity services. If there were a Labour Government, the NHS would not be ring-fenced and there would be cuts in the NHS budget. Only our party has promised to ring-fence the NHS budget. How can she promise additional services when there would have been cuts in the NHS budget under Labour?

[Emily Thornberry]

Although the Government have said that, in principle, there is a ring fence to the NHS budget, a closer analysis will show that that is not true. The real position is that there is double-counting of over £2 billion—

Termination of Pregnancy (Information Provided)

Daniel Kawczynski Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

I am very pleased that my hon. Friend has raised the issue of the rights of women in this context, but what about the fathers? I hope she agrees with me that the law needs to be examined to ensure that the rights of the potential father are taken into consideration.

[Nadine Dorries]

I thank my hon. Friend for his contribution, but I am afraid that I must stick to the point of the debate, because otherwise we shall run out of time.

Does not the way in which abortions are carried out in this country today almost amount to abuse? We need to take lessons from our European neighbours. In Germany, women are offered counselling and a cooling-off period. That gives them a chance to breathe and think. It gives them support. They are informed about the procedure, and of the possible consequences. They are provided with alternative routes other than the surgical removal of a life. They are given information about adoption—and yes, I know that people throw up their hands in horror when that is mentioned, but it is not our pregnancy, and it is not our baby.

We have no right to institutionalise and frame a decision-making process that is void of choice for the women who seek information. It is a woman’s right to choose, and women should have the right to be given every shred of information that we have and every alternative option. If a woman wants to continue with her pregnancy and deliver her baby for adoption, she should have the right to choose to do so. If she does not, at least she can emerge from the abortion process feeling that she made an informed decision. She can emerge feeling that she went in empowered and not helpless, strong and not vulnerable, and believing that she did the best thing because she knew exactly what she was doing and had full knowledge of every available option. She will be able to draw strength from that in future.

Women are entitled to an option. They are entitled to give informed consent, which should be explicitly supported by pro-choice and pro-life campaigners. When it comes to a decision of such magnitude, it is vital for women to receive information that is absolutely accurate and is given calmly, without coercion or a principled bias and, in particular, without political ideology. Last month ComRes, the pollsters, revealed after an extensive survey that 89% of people agreed with that. They think that women should be entitled to have more information when requesting an abortion. Given that overwhelmingly high figure, it is time that this House paid some attention. I hope the Minister agrees that it is time that we took a little more care of women undergoing such a procedure. It is time that we introduced a statutory process of informed consent and a cooling-off period. The European evidence shows that that could provide us with a considerable reduction in the number of abortions, and everyone would surely welcome that.

I shall finish by mentioning a book which is to be launched this month. It is published by the charity Forsaken, which is neither pro-life nor pro-choice: it is pro-women. For two years, the charity has put together the stories of women suffering from post-abortion syndrome. Reading the book is so heart-wrenching that we just want to reach out and take their pain away, but we cannot. There is no going back. We cannot make it better; abortion is a procedure to end life—it is final.

The women interviewed for this book feel that talking about abortion is taboo. That forces them into silence, leaving them unable to express their suffering. Abortion really is a taboo subject. We will never see an abortion filmed on television; we will never see that screened. It is still the taboo subject that we do not talk about.

One woman in the book describes how even when she told the anaesthetist that she was changing her mind and was having doubts, he pushed her to go ahead. He did so because, if she changed her mind, he would not have been paid. There is the same process as for the counselling. If the woman does not go ahead with the abortion, the clinics are not paid for the counselling, and therefore they need to know that she is going ahead before she is given the counselling—and we can imagine the process that ensues.

I will conclude by reading a paragraph from the book, giving a young girl’s account:

“An uncle dropped me off at the clinic with a letter to give to them. I don’t know what that letter was. At this point, I was holding onto the thought that they were only checking me. The staff at the clinic were very nice there, seemingly courteous and kind. It was not my usual surgery, I did not realise it was an abortion clinic until I was shown into a counsellor’s room. When I went to the counsellor’s room, I was asked: ‘Why don’t you want to keep this pregnancy?’

‘I want it but my family don’t want it,’ I replied, and promptly burst into tears. ‘They won’t support me and I can’t look after it myself.’

Nothing more was said that I remember...I was given a bed—there must have been 20 of us crowded into that ward. I was the first in line. As I waited, I scanned the corridors for some means of escape, but I was already wearing my hospital gown and no underwear. It wasn’t long before a man brought a wheelchair to take me to the operating theatre. For a brief moment I wondered if I had the strength to run away, but instead I sat obediently into the chair.”

That is a story of loneliness, suffering, emptiness and loss that many thousands of women live with day after day. It is they who become the 30%.

It is time for the UK to catch up with the rest of Europe and introduce informed consent in an attempt to ensure that stories like this become a rare exception. It is time for this country to start looking after our young girls and women at the most vulnerable time in their lives and treat them with some respect.