Healthier Together Programme (Greater Manchester)

David Nuttall Excerpts

Tuesday 22nd July 2014 Westminster Hall

[Mr David Nuttall (Bury North) (Con)]

It is a great pleasure to serve under your chairmanship, Mrs Riordan.

Some may find it surprising, given our political differences, that I agree with much of what has been said by the hon. Members for Blackley and Broughton (Graham Stringer) and for Stretford and Urmston (Kate Green). Like them, I entirely accept that things cannot always remain as they always have been in our NHS. There have to be changes in any large organisation, from time to time.

Of course, I am speaking purely from the perspective of my constituents in Bury North, including the townships of Bury Ramsbottom and Tottington. They are only too aware of the repercussions of health service reorganisation, having recently lost the children’s services at Bury Fairfield hospital. Pledges were made before the last general election. The process of the “Making it Better” scheme was stopped. Local GPs had an opportunity to say, “We will keep the services”. I do not know about 98% of people on Twitter agreeing with this. I always used to say it was about 99% of people in Bury, when I asked them. I could hardly find anybody who thought it was a good idea to close maternity in Fairfield. Notwithstanding that, and notwithstanding the clear steer of the Secretary of State about wanting to keep those services open, local health officials, backed by local doctors—the GPs—said, “No, we’re too far down the line. We’ve got to stick with the ‘Making it Better’ scheme and with what has been agreed.” Those services at Fairfield have now been lost.

Residents in Bury could be forgiven for being somewhat sceptical about the nature of consultation. I share that. I took part in the after-the-event analysis that was done by some professional surveyors. I said to them, “Look, if you’re going to do a genuine consultation, you’ve got to be clear about what the options are. It’s got to be a genuine consultation and the public have not got to be left thinking that, actually, it is a foregone conclusion and the decisions have already been made.”

A proposal is before the people of Greater Manchester now. Out of all the hospitals in the area, only at Wigan, Bolton, South Manchester and Stockport is there some element of choice. With all the others, it is the same: it is a done deal. So I understand why many of my constituents will say, “Well, there’s not much point in us taking part in all this. Nobody listened to us last time; nobody will listen to us this time.”

[Lisa Nandy]

I agree with almost everything the hon. Gentleman has said. Is not the tragedy of this process that, as he and my hon. Friend the Member for Blackley and Broughton (Graham Stringer) said, most of us could get behind some principles underlying the proposal, including greater care in the community locally when people need it, greater specialism and supporting people to get care outside hospital? There is consensus on all those things, but the way the process has been handled, as has been compellingly outlined, has left people feeling that there is simply no point getting involved.

[Mr Nuttall]

The hon. Lady makes a good point. The vast majority of the public would, in an ideal world, like every service to be provided at their local hospital, so that they could have everything just by travelling a couple of miles. In a perfect world, they would have every conceivable treatment available at their nearest hospital. However, they have long since accepted, and we all know, that that is not possible. The clearest example of that in Manchester is, of course, cancer care and Christie’s. People accept that if, sadly, they are diagnosed with cancer, they will have to travel to a specialist cancer care hospital, where they will get better treatment.

It gets a bit more difficult when moving further down the specialism chain. Certainly, we were at the front line in that regard, as were Rochdale and other areas in Greater Manchester, when maternity services were being considered, because people felt that such services ought to be available everywhere. Of course, there are drivers behind this, if truth be known—if truth could be expounded by the health chiefs—in that, whether we like it or not, it comes back to the working time directive, for example, which has had an effect on the configuration of doctors’ working hours.

Medical negligence claims against the health service have also had an impact in this regard. I can understand that, coming from a legal background. People are better protected if they are in an environment where greater numbers of people are working together to watch each other’s backs. That is another driver of these reconfigurations, as some people like to call them.

To get back to the points I was making before that intervention, one of the problems with this consultation, which the hon. Member for Blackley and Broughton mentioned, is that the website and the documents are littered with unintelligible gobbledegook half the time. I am not being patronising, because I do not understand half of it myself, to be perfectly honest. Most people will look at that website and think, “Frankly, it goes over my head.” That will be their general view. I accept that the website and the documents sway wildly the other way as well and have apple pie and motherhood statements that absolutely everyone will agree with, such as “Do I want mum to get that good treatment if she goes into hospital?” No one will say no to that, will they? It is a complete waste of time and effort, and I cannot believe that highly qualified individuals have put together this mishmash of a website and consultation. It is not clearly thought through.

I have no idea of where this will end in terms of the hospitals where there is an option, but I know that my constituents in Bury want access to an accident and emergency department at their local hospital. Going back to what I said about the specialism ladder, by definition, one expects things such as accident and emergency to be available at the nearest general hospital. That is what my constituents will be looking for. If these services are salami-sliced away from Bury, my constituents will be concerned that they will be left with a hospital in name only—one that does not provide them with the services that they have come to expect.

I echo what has been said about Healthwatch England. Bury Healthwatch has e-mailed me and wants me to put on record its concerns about its involvement in this process. I appreciate that it is a new body, but clearly there are problems with the introduction of the legislative order for clinical commissioning groups, the Legislative Reform (Clinical Commissioning Groups) Order 2014. Healthwatch England has written to the Secretary of State about that. I understand that the order will come into force on 1 October. I can only assume that, to meet that deadline, those problems will be dealt with in our September sitting.

To be perfectly honest, demand for health care services will always outstrip supply, under any Government. It does not matter whether it is a Labour Government or a Conservative Government; people’s desire to be healthy and their need to feel that they and their loved ones are receiving the best possible treatment will always result in demand being greater than the ability of the public purse to meet that demand. That is of course largely driven by the fact that so many people think that our NHS is free. Of course it is not free. We all know that it is not free.

In the current year, the NHS is spending something like £119 billion. It is a huge consumer of public funds, and rightly so. It is right that the Government have protected the health care budget. Notwithstanding that, there are pressures, because the population is getting older and new treatments are being discovered and becoming available all the time. I am grateful for the opportunity to put on record my constituents’ concerns, and I am conscious of the fact that others want to put similar concerns on the record.