Accident and Emergency Services: Merseyside and Cheshire

David Rutley Excerpts

Tuesday 22nd November 2016 Westminster Hall

[John Pugh (Southport) (LD)]

I beg to move,

That this House has considered accident and emergency services in Merseyside and Cheshire.

It is a pleasure to serve under your chairmanship, Sir Roger, and a pleasure to see the Minister in his place. We spent many a happy hour on the Public Accounts Committee in years gone by, and I have great respect for him. I am sure he will give due consideration to what I say.

The debate title is a slight misnomer, however, because it was intended to entice other colleagues from the Cheshire and Merseyside region. Sadly, they have not taken the bait, perhaps because of the limited time available, so I will talk largely and almost exclusively about my own patch.

Southport is a large seaside town on the Lancashire coast, with one of the most elderly populations in the UK. I have to point that out, because for some reason I am often confused with the Member for Stockport and I am referred to as such. Southport, however, is nothing like Stockport. Southport is a seaside town and has one district general hospital on a split site with Ormskirk. The accident and emergency provision, though, is split by age between the two sites, which is a bone of contention in Southport.

For the purpose of the sustainability and transformation review, Southport was grouped with other hospitals ringing Liverpool, including those in Aintree, St Helens, Whiston and Warrington. Southport has recently had a poor Care Quality Commission report on its A&E department and an equally poor review of its surgery. It has responded positively with further investment of £600,000 into the A&E department, so that now, according to the stats—I checked this with the chief executive only this week—it has one of the best-performing A&E departments in the north-west.

That might have been the end of the story, because the CQC report dates from some time back and because of the improvements, but for suppressed drafts of the Cheshire and Lancashire sustainability and transformation review that have been leaked. The leak showed a number of things, including a possible downgrading of Southport A&E and of other A&E departments in the area—the hon. Member for Macclesfield (David Rutley) is now in the Chamber, and his is one of the areas affected, as we have discussed—as part of a cost-saving exercise.

That is not the first time that the suggestion has been made apropos of Southport, but the Minister knows from his own experience in Ludlow how politically explosive such suggestions can be and have been. He will also appreciate that those suggestions are sometimes entirely simplistic and often linked to another further bright suggestion that people come up with, which is to close down wards. The consultants charged with balancing the books, and often deferred to by the national health service, might come up with the brilliant suggestion that the best thing to be done with a loss-making hospital is to get it to do less—to stop admitting people to A&E, and finding space for them in wards, and therefore to close down A&E and shut down a few wards.

The Cheshire and Merseyside sustainability and transformation plan proposals were reneged on somewhat in the final draft, so they fell short of actually advocating downgrades. However, that is not to say that that is not in mind as an ultimate objective.

[David Rutley (Macclesfield) (Con)]

I congratulate the hon. Gentleman on securing the debate. Like him, I am concerned about the proposals set out in the STP and, with regards to east Cheshire, the document actually sets out that options being considered include downgrading from an A&E to an urgent care centre in Macclesfield. There needs to be greater transparency about the options and a frank conversation with people. There is already a Macclesfield petition signed by 8,000 people opposing any downgrading of A&E services in our area.

[John Pugh]

There is also a petition in Southport, and I am sure there will be petitions wherever in the country this sort of thing happens. As the hon. Gentleman suggests, the ownership of the sustainability and transformation reviews is wholly unclear. No one quite knows who writes the plans, or how they are agreed, and few democratically elected bodies or people, or patients, have any kind of input. In fact, the Liverpool local authorities wrote in some indignation to the authors of the report to ask, “How can we be involved? It alleges in your report that we are involved, but we do not appear to be.” Furthermore, no one quite knows why the hospitals have been grouped as they are.

Southport hospital is in a particularly unfortunate position, because it has changed its chair recently and suspended its chief executive over a period of a year, so it is unclear to me how Southport and Ormskirk’s views could have been represented in any review. Roadshows were organised by the clinical commissioning groups to talk about the financial plight of the local NHS and things that need to be done, and I have attended some of them, but they spend all their time talking about things such as savings on prescriptions and none on the big league stuff that is agreed and discussed in NHS boardrooms. There is absolutely no transparency, and I am sure hon. Members share in my cynicism. We await the real cost-saving proposals—or, in some cases, the empire-building proposals that are often disguised by blather about clinical efficiency and safety, which come almost after the event.

I speak with some cynicism, because I am a veteran of such carryings-on. I regret all the back-stage manoeuvres and, in particular, that no one has been around to champion my local hospital in the review. There is a good case for keeping our A&E—elderly people throughout the country are the major clients of A&E, for obvious reasons.