NHS (Essex)

David Amess Excerpts

Tuesday 15th March 2011 Westminster Hall

[Mr David Amess (Southend West) (Con)]

I congratulate my hon. Friend the Member for Witham (Priti Patel) on securing this debate, and particularly on how she has raised concerns on behalf of her constituents. Witham is very fortunate to have her as its representative.

I served on the Health Committee for a decade; in fact, I was on it for so long that towards the end of that time we were repeating inquiries. We travelled to a number of countries and when we returned home, we always concluded that our health service was the best in the world. We did wonder, however, how on earth we would fund the service if we were starting it from scratch.

Since I first became involved in health matters, the needs and demands of the health service have changed dramatically. I am in a very good position to comment on such matters because when Ann Widdecombe was shadow Secretary of State for Health I was one of her troops, serving on the Committee on the Bill that brought into force primary care groups and primary care trusts. Although the right hon. Member for one of the Southampton constituencies got slightly irritated with my endless questioning and long speeches, if anyone is very sad and wants to read Hansard I recommend the speeches that I made then because everything that I forecast would happen, sadly, has happened. It has taken the present Government to reverse what happened 13 years ago.

I am very familiar with four hospitals: Newham General, the King George in Ilford, Basildon and Southend. I will not share my views of my experiences at those hospitals, because I was there not just as a politician but as a user, along with my family. I shall simply say that the experiences were very different from one another, and they are ongoing.

Let there be no doubt that I agree with everything that my hon. Friend the Member for Witham said. I have to be slightly partisan; I have to tell my hon. Friends who were elected last year that I feel very strongly that during the 13 years of Labour Government the word “deprivation” was not on the register at all for the south of England. There is no doubt that resources shifted from the south to the north. All I say to the Minister, who has a wonderful background, is that I hope we will now be treated fairly. I am confident that that will happen.

I am more concerned now about management generally, particularly that of our hospitals. Why is a school considered good? Because it has leadership from an excellent head. Why are transport facilities good? Again, because there is good leadership. Why is a country successful? It is because of a great Prime Minister. I am challenged on a number of fronts by leadership in our hospitals. I will not go on about matrons, but when people are anxious and have health problems, with which they need to go to A and E for example, they want to know who is in charge. It is not rocket science. Nor is cleanliness and all the rest of it. Leadership is so important, and I do not care if a leader is seen as a bossy boots, like Hattie Jacques. I am fed up with managers who have endless meetings. What are they meeting about? As MPs, we have to take full responsibility for how we represent our constituencies, and if something is not right it is down to a hospital’s chief executive—it is no good their blaming the troops.

My hon. Friend the Member for Witham touched on some matters concerning Essex, for example the demographic pressures and shifts. The council and the NHS have developed, and are continuing to develop, joint commissioning arrangements there. That is very good. In Essex, we are working hard to implement the White Paper, and are progressing well with putting into practice the Government’s flagship reforms. The Secretary of State has been criticised in some areas for rushing the reforms, but in my time in the House I cannot remember a shadow Secretary of State who was in post for as long as my right hon. Friend was, so he had a lot of time to think about the reforms. This is the only job that he wanted, so the idea that he is rushing is wrong.

In Essex, commissioning with the independent voluntary and community sectors is going extremely well, as is the scrutiny of health functions. As the changes—some of which are controversial and challenging—go through, will the Minister reflect on how our hospitals are managed? That is so important. In my previous constituency the fullest age profile was for young people and in my present one we have the most centenarians in the country, so the challenges are very different in different places.

I want to raise a number of quick points. I will not cause the Minister angst, but she will be aware that there is an issue locally with the Essex Cancer Network and the proposal for an increase from seven to 10 linear accelerators. I hope that any increase is in Southend, and that we do not look further afield. The Minister would expect me to say that, and I do not want to put her in a difficult position.

For the past nine months, all health and social care partners and representatives of patients, carers and care homes have been working in a formally governed partnership to deliver an innovative and integrated model of care for the elderly locally. Will my hon. Friend the Minister look at how we are dealing with that? Over the past year, partners have worked together to open a new “step up” intermediate care facility on the Southend hospital site. I wish that many years ago, managers had considered more carefully when deciding to close Rochford hospital. Unlike Basildon hospital, which has plenty of land around it, Southend hospital is landlocked and has nowhere to expand, and we are paying the price.

Demand for care of the elderly is increasing, and I am not entirely convinced that we have a solution at the moment. Children’s services in south-east Essex are doing well. We have been recognised as baby-friendly by UNICEF and have received a certificate of commitment. We are launching a new service for children and young people with disabilities and we are opening a new diabetes rehabilitation suite. Southend hospital has secured a patient safety award. Many good things are happening.

GPs are being asked to deliver health care reforms. When Bernard Ribeiro, who has now been made a peer of the realm, was the lead consultant at Basildon, it was clear where the leadership of consultants was. I am puzzled to know who leads groups now. Endless meetings are held, but we need ownership and someone to take responsibility for what happens when a patient arrives at hospital. Who sees them first? When they go to accident and emergency, are they seen quickly by triage? Who deals with their case afterwards?

We have many wonderful GPs in Southend— Dr Husselbee, Dr Pelta, Dr Lawrence Singer, the Zaidis; the list is endless—and they are all working hard to deliver what the Government want. I believe that my constituency has the only GP pathfinder consortium in south-east Essex, and it has one of only seven partnerships in the east of England announced during the first wave. The group covers a population of nearly 80,000 patients, mainly in the west of Southend.

The practices have been working well together for the past three years and have managed to set up out-of-hospital ear, nose and throat, gynaecology and urology services, which give rapid access to specialist care at less cost to the NHS than at present. The group has implemented a clinical gateway that enhances GP referrals, reduces waste and ensures that patients get to the right specialist first time, which is critical to reducing the amount of money spent and the stress caused to patients waiting for referrals. Practices co-operate closely, with patients attending other surgeries for minor surgical procedures.

As a result of such close working for the past three years, the group is moving forward and seeking to become a sub-committee of the primary care trust, which will not exist within 18 months, and to take greater control of the budgets delegated to it by the PCT. The group has ambitious plans to improve care for the elderly, which I salute, as well as the health of patients with long-term conditions.

When local authority work begins, close working relationships will be vital to align the health and social care budgets to enable—colleagues might be puzzled by this phrase—more integrated working. That will be better for patients and lead to greater efficiencies. Similar joint working is happening between community and mental health programmes. The Health and Social Care Bill clearly puts patients at the centre of the NHS. This is controversial, but when budgets are stretched it is vital that the public are part of the process for deciding how the commissioning budget will be spent. We must take people with us if they are to accept that resources are scarce.

I am delighted to say that our local group has a grant from the Department of Health to define what public involvement should look like. A successful meeting was held recently involving a wide range of stakeholders—that awful word—including patient voluntary organisations, special interest groups and representatives from the local involvement network, Southend and Essex hospitals and the community. It is expected from the initial meeting that an agreement will be reached on how the public can best be involved, both at strategic level and in making decisions about specific projects. One possible outcome involves forming a group of health champions who have received training on commissioned health services.

I will not take up any more of the House’s time, as it is not fair to the colleagues who are waiting to catch your eye, Mr Dobbin, but I say to my hon. Friend the Minister that it would be good for the Department of Health to take seriously any representations made by hon. Members for the great county of Essex.