Hospital Car Parking Charges

David Wright Excerpts

Monday 1st September 2014 Commons Chamber

[Nic Dakin (Scunthorpe) (Lab)]

I rise to make a brief contribution to the debate. I congratulate the hon. Members who secured the debate. Already, we can see the value of it, not least from the way in which the last speaker drew attention to the sort of best practice that should be considered by trusts up and down the land.

In my patch, I have been very concerned about the rise in car park charges at Scunthorpe general hospital. I presented a petition to the House on behalf of local residents and patients in September 2013, which argued that the rises in car parking charges should not go ahead. At the time, the Secretary of State advised me that every trust has the autonomy to make decisions locally and that the provision of car parking for patients, visitors and staff should reflect the local situation. I am pleased that he has now gone further in the guidance that he has issued, which I hope will help people such as my constituents, who are taxed for being ill or for visiting the hospital. As the hon. Member for Eastbourne (Stephen Lloyd) pointed out, the impact on parking in the local area is also a problem for local residents. For those two strong reasons, it is important that the movement on this issue is welcomed and that it goes even further.

[David Wright (Telford) (Lab)]

I believe that hospital parking charges should be abolished. The car parks in Telford and Shrewsbury could easily be managed without charges. Some people have expressed the concern that people will overflow-park in hospital parking areas. Tickets could still be issued to ensure that parking spaces are controlled, but it could be made free. The House should push the Government and the Opposition to make a commitment to abolish parking charges at hospitals in the medium to long term.

[Nic Dakin]

I very much agree with my hon. Friend’s point. That has been the thrust of the contributions to the debate. I hope the Minister and the shadow Minister are listening to the voice of the House, which reflects the voice of our constituents as patients and residents who live close to hospitals. Hospital car parking charges should be got rid of in the interests of better, more open and fairer access to health care. The hon. Member for Thurrock (Jackie Doyle-Price) made the point well that increasing the number of visitors increases the speed of recovery. It should therefore be welcomed and facilitated as part of the healing process.

[Nic Dakin]

The hon. Gentleman and I work well together on local issues such as health care. He makes the sound point that as we rationalise the way in which hospitals perform to maximise health outcomes, there will be more travelling by patients. Why should there be an added barrier to that travelling and to access? People should not have to focus on things like that, rather than on better health care, when there have to be discussions about where services will be delivered, as there have to be in north Lincolnshire. That is a sound and positive point that supports the point that was made by my hon. Friends the Members for Bolton South East (Yasmin Qureshi) and for Telford (David Wright), which is that the best way forward would be to have free car parking at every hospital as standard.

[David Wright]

My hon. Friend makes a sound point about rural areas, but it is often difficult for people in urban areas to use public transport as well. Sometimes, people have to change buses several times to get to a hospital. If people in Telford want to go to Shrewsbury, they have to change buses multiple times.

--- Later in debate ---

[Mr Stewart Jackson (Peterborough) (Con)]

I join in the congratulations to my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for Harlow (Robert Halfon). This is precisely the type of issue for which the Backbench Business Committee was established, so that we can try to alleviate the problems of people who feel their voice is rarely heard when set against a big bureaucracy.

Parking charges are an important issue because there are both philosophical and practical problems with them. Philosophically, it was never the intention that patients should be forced into a back-door stealth tax by virtue of the fact that they drive a car and need to park at a hospital. Health care has always been funded through general taxation, not patient charges, and that principle has been established by all parties. Also, surplus income has been ring-fenced for NHS activities. We run the risk of undermining the philosophical underpinning of the NHS. I accept that this is a cross-party matter, because Labour also sought to deal with it when it was in government.

In practical terms, parking charges cause real hardship for the simple reason that they are a regressive type of taxation that hits the elderly, the poorest and the sickest at the most vulnerable times in their lives. We have heard about various cases today. There are bigger issues involved in the debate, too, including our friends the West Lothian question and the Barnett formula. There is a question of fairness and equity, because people in Wales and Scotland do not suffer a similar encumbrance. Effectively, my constituents in England make a capital payment for free parking at health care facilities in Wales and Scotland, which cannot be right.

As my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) said, there is a bigger strategic financial issue to consider—the impact of the private finance initiative, particularly schemes such as that in my local trust, the Peterborough and Stamford Hospitals NHS Foundation Trust, which incidentally has a structural annual deficit of £40 million and so finds it difficult to deal with such matters. Both the Treasury and the Department of Health should consider the irreducibility and intractability of the debt encumbrance on such trusts, which forces them to seek finance in that way. I hope that Ministers will think in such wider strategic terms.

[David Wright]

I agree with pretty much everything that the hon. Gentleman has said. One big problem is that many hospital trusts have gone into fairly long-term contractual arrangements with private sector car parking providers. Alongside the broader points that he makes about hospital funding and PFI, the Government should examine the structure of the parking contracts that hospital trusts have put in place. One of the few ways in which they can help in that regard is through national guidance. The Government should take a lead and say to hospital trusts, “You must review this.”

[Mr Jackson]

The hon. Gentleman is absolutely right, and he touches obliquely on another issue—that of transparency, which some of my hon. Friends have mentioned. It should not just be through freedom of information requests by my hon. Friend the Member for Harlow that we get the relevant data before us. Incidentally, my local trust substantially increased its parking revenue from £1.56 million to £1.71 million in one fiscal year. Transparency throws up some perverse practices, such as the fact that at Stamford hospital, in the constituency of my hon. Friend the Member for Grantham and Stamford (Nick Boles), a small community hospital, there is no requirement to pay for parking, but people have to pay at Peterborough hospital, which serves virtually all my constituents. I do not think that is right.

I believe that there is a direct correlation between a wider lack of NHS transparency and high car parking charges. I cannot prove that, but it is my instinct. I say that having found out only a few weeks ago that the interim chief executive of the Peterborough trust was paid more than £400,000 a year for a four-day week. He did a good job, but at some cost to the taxpayer. Parking charges fall within that narrative, because patients should be allowed to know the costs of parking and the income received from it. As my hon. Friends have said, people parking at hospitals are vulnerable, stressed and upset, and things outside their control—bureaucracy, delay, getting the wrong treatment or whatever—can mean that they have to stay at a health care facility, such as a big acute district hospital, for longer than they would otherwise have to.

My hon. Friend the Member for Harrow East (Bob Blackman) made a good point about centres of excellence. In my area, the eastern region, people have to travel 30 or 40 miles. Someone with a child who has a poorly heart might have to travel from south Lincolnshire to Addenbrooke’s hospital or other places, which is difficult.

It would be churlish not to mention the Government’s guidelines. I welcome them, but we need to be tougher and we need a fiscal incentive for trusts to do the right thing—hopefully, abolishing parking charges. We need to punish trusts if they arbitrarily disregard the Government’s guidelines. Hopefully my hon. Friend the Member for Harlow, with his legendary powers of persuasion that we have seen in the past four years, will ask the Chancellor to take the appropriate action. Ultimately, we should work to abolish parking charges completely, because they are an insidious, pernicious tax on the most vulnerable people in our society.

Oral Answers to Questions

David Wright Excerpts

Tuesday 1st April 2014 Commons Chamber

[Mr Hunt]

I do think that that is a bizarre suggestion. Given our ageing population, we need to make it easier rather than harder for people to see their GPs. I also think it bizarre of the Opposition to set their face against the reforms that my right hon. Friend helped to pilot through the House. Because money has gone to the front line, 800,000 more operations are being performed in the NHS year in, year out than were performed under Labour. We are putting money where it is needed, with doctors and nurses.

[David Wright (Telford) (Lab)]

Will the Secretary of State give us more details about the amount of money that was spent on consultants during the top-down reorganisation? Would that money not have been better spent on nursing?

[Mr Hunt]

I will happily give the hon. Gentleman the figures, but if he is shocked by the amount that was spent on consultancy, he will be even more horrified to learn that it was vastly greater under the last Labour Government. We are paring that down precisely because we want money to be spent on the front line.

--- Later in debate ---

[Dr Poulter]

I will certainly be happy to look into the issue. My hon. Friend will be aware that the closure decisions were made on clinical safety grounds, for the safety of women. It is a temporary issue. One of the outstanding problems in my hon. Friend’s part of the world and elsewhere when we came into government was a historical shortage of midwives. That is why we are investing in more midwives. There are already 1,500 more in the NHS and I believe that six more will be recruited to the local NHS in his area.

[David Wright (Telford) (Lab)]

T9. Mental health services in Telford are under review and the Castle Lodge facility has been closed for a considerable time. It has been heavily used by people in the community who do not have to be admitted into Shrewsbury. Will the Minister confirm that if local people want to retain Castle Lodge, as I believe they do, it will be retained?

[Norman Lamb]

I understand the issue that the hon. Gentleman is raising. If he wants to discuss it further with me, I shall be happy to meet him. Clearly, local opinion and the making of decisions locally are what our reforms are all about.

Oral Answers to Questions

David Wright Excerpts

Tuesday 25th February 2014 Commons Chamber

[Mr Jeremy Hunt]

That is one of the things we need to be much better at—linking up the services offered by ambulance services. I would add that pharmacies have a big role to play in this, as one in 11 or 12 A and E appointments could be dealt with at a pharmacy. My hon. Friend is absolutely right that this is something we need to do better.

[David Wright (Telford) (Lab)]

A hugely expensive review of A and E services is going on in Telford, the Wrekin and Shropshire. The Secretary of State was in Telford a couple of weeks ago but did not have the courtesy to let me know. Will he say whether we will retain full 24-hour, seven-day-a-week services at Telford and whether there will be downgrade of our A and E?

[Mr Hunt]

First, I apologise to the hon. Gentleman if my office did not let him know that I was visiting, an oversight for which I take responsibility. I had a good visit to the Redwoods, a superb mental health in-patient unit where I learned a great deal. I am not aware of any plans to change or downgrade his A and E.

Oral Answers to Questions

David Wright Excerpts

Tuesday 14th January 2014 Commons Chamber

[Mr Hunt]

The Opposition try to talk up a crisis in A and E, but unfortunately, such talk does not withstand the facts. Let us look at the facts on how A and E is doing and perhaps the right hon. Gentleman will understand. We are seeing 2,000 more people every single day within the four-hour target than were seen when Labour was in power; we have 20% more A and E consultants; and the waiting time to be seen in A and E is half what it was under the Labour Government. However, we are doing more: we are addressing the long-term pressures in A and E, including the barriers to the social care system, which were mentioned in an earlier question, and the lack of good primary care alternatives. That is why we are restoring named GPs for the over-75s.

[David Wright (Telford) (Lab)]

A and E is in crisis across the country, but getting people out of hospital in a suitable time frame is also important. What is the Secretary of State doing to better connect the health service with other social care providers? Does he acknowledge that, in places such as Telford and Wrekin, there has been a substantial cut in continuing health care funding, which means the system is in danger?

[Mr Speaker]

Order. Did I hear a mention of winter in the context of this question?

[David Wright]

In the winter, Mr Speaker.

[Mr Hunt]

Thank you for that guidance, Mr Speaker. Let me assure you that this winter, a lot is happening in Telford to break down the barriers between the health and social care systems. One big change we are championing—it is starting to happen for the first time—is a seven-day social care system, so that hospitals can get people assessed and discharge them at weekends. With respect to the hon. Gentleman, if he looks at the facts, he will see that that is beginning to happen in a way that it did not when Labour was in power. He should welcome it.

Health Funding (Telford and Wrekin)

David Wright Excerpts

Tuesday 7th January 2014 Westminster Hall

[David Wright (Telford) (Lab)]

Mr Dobbin, it is a pleasure to see you in the Chair this morning and to have the opportunity to talk about health funding in Telford and Wrekin.

The objective of all of us, across the political divide and in the health community, is to strengthen the links between the formal national health service and local authorities and care providers in the community. That is the general consensus and I think everybody agrees with that as an overarching policy. However, I am concerned about the amount of resource available to tackle issues to do with continuing health care in the community in Telford and Wrekin, and about how that health funding integrates with the work that the local authority is doing.

It is pretty much acknowledged, across the political divide, that Telford and Wrekin council is a good unitary authority. It performs well and is working hard to ensure that it protects local residents as we move through a period of budget restraint and cuts to services. That is difficult and tough for the local authority and it has a major impact on our community. The way we integrate health services with the ongoing provision of front-line social care services is important.

The council is undertaking a consultation on its budget. Real pressure is emanating from Telford and Wrekin clinical commissioning group’s stance on funding continuing health care cases in the town. Some 50% of the council’s revenue budget—the money it spends on day-to-day services, such as caring for the elderly, looking after children and taking care of the environment—comes from the Government, and in the last three years it has been cut by almost £29 million.

By the end of 2015-16, the cut in the council’s funding from the Government will have reached nearly £50 million. These are cuts to cash grants that the Government provide to the council. Clearly, if inflation is taken into account, the real-terms cuts are much greater. At the same time, the council is facing major challenges from the growing cost of caring for increasing numbers of vulnerable people in our community. The CCG has added to the financial pressure by shunting around £8.5 million of costs that it would previously have covered in respect of CHC cases to the local authority. That is being done by the CCG’s taking a much harder line in the assessment of CHC cases. That is impacting seriously on the council and its budget.

Today is about exploring what more we can do to integrate health funding with the work that the local authority is doing in its social care environment. To set this out fairly starkly, in 2009-10 the primary care trust spent some £13.9 million on CHC cases. In 2012-13, the equivalent body in Telford and Wrekin spent just £2.3 million directly on care packages for CHC. I acknowledge that the CCG has topped that money up this year, with an additional £2.4 million, but that is a one-off payment. There is concern that such an enormous reduction in funding for CHC cases is putting enormous pressure on the health service and on front-line integrated health and social care services.

The other important issue to consider is how the funding formula has been calculated in respect of the number of people receiving continuing health care funding in our community, in comparison with surrounding locations. As at 30 June last year, there were 19.4 people per 50,000 population in Telford and Wrekin receiving CHC funding; in Shropshire, the figure was 82.2 per 50,000 population. Considerably fewer people, proportionately, are receiving CHC funding in Telford and Wrekin, but I cannot for the life of me determine why. Some have said that it is because Shropshire has an older population and because its structure is different, but it might be imagined that, given the provision of community hospitals in other parts of Shropshire, the figure would be different and that Telford and Wrekin would be doing far better.

If Telford and Wrekin is compared with similar local authorities—what might be called its Chartered Institute of Public Finance and Accountancy neighbours—we see that we are struggling to match the numbers of people per 50,000 weighted population who are receiving continuing health care funding. For example, in Warrington the figure is 54.6, in Darlington it is 65.1 and in Stoke-on-Trent it is 48.4 of weighted population per eligible 50,000 people. I reiterate that the figure is 19.4 in Telford and Wrekin and I cannot understand why, in that context, so few people are receiving continuing health care funding. This places enormous pressure on the local authority. As people move out of hospital or into care, whether at home or in other settings, the council is having to step in and try to provide care and support that ought to be provided, in my view, by the health service.

Although I accept that the primary care trust, at one time, was generous in its CHC funding compared with national averages—I mentioned the historical figures—the position now seems to have reversed. As I said, the ratio of CHC cases per 50,000 population in Shropshire is almost four times higher than in Telford and Wrekin. The council has calculated that, if the CCG spent at the national average, it would need to spend in the region of £7.65 million. That is significantly different from our current funding profile. I am concerned that the formula is not working effectively for Telford and Wrekin—either that, or the assessment procedure is not being undertaken in the same way as in other areas of the country.

The Prime Minister made it clear in the Conservative manifesto for the last general election that health funding would be protected. I am concerned that costs are being shunted away out of the health service and on to local authorities. The real concern is that these hidden cuts within the health service are being fed through into the local authority sector, so that nobody notices. Well, I hope that after today people will notice. This dilemma will be faced by a range of local authorities that will increasingly have to pick up costs that would previously have been met by the health service.

The Minister is a good man with a good reputation for understanding how the health service works—understandably, given his background—and I am sure that he agrees with my opening remarks. We want to see better integration between the health service and social care, as provided by local authorities. That is what I am calling for today. I should like him to look at the formula for Telford and Wrekin overall, in terms of the work being done by the CCG, and at whether the assessment procedure operating in our area is correct and being applied effectively.

The council is making a lot of savings. It has delivered more than £50 million of ongoing annual revenue savings, and it is considering proposals to cut the remaining £23.7 million that has to be saved over the next two years. Colleagues from mid-Wales will have seen the coverage in the Shropshire Star over the past few days on how the council is working extremely hard to identify where some of the cuts can take place. We have already seen significant cuts in the council’s back-office staff, and large numbers of people have left the structure of the local authority—1,000 posts at the council have been deleted or become subject to voluntary redundancy in recent years—so there has been a lot of work to try to pare back costs.

In the next two years, the council will endeavour to meet the Government’s proposal to freeze council tax too, because we are conscious of the big cost-of-living issues for ordinary people. That means that some of the cuts to front-line social care services will fall on the most vulnerable people in our community. If the continuing health care budget is not correct, and if the health funding that passes through, in partnership with local authorities, to care for the most vulnerable people in our community is not correct, we will have an even greater challenge in the long term.

We are trying to develop proposals to make savings at local authority level, but the Government need to reconsider the issue of continuing health care. I would like the Minister to address direct support for trying to achieve a fairer apportionment of CHC costs between the CCG and the council in future years. The council’s managing director has written formally to the CCG. I understand that, fortuitously, a meeting is taking place today to discuss some of the issues.

I am not pitching for large pots of new money. We just want a fair deal on what we are entitled to, and I hope that the Minister can reassure us today that he is aware of the issues and how important they are for health funding within our community. I also hope that he is aware of the pressure on Telford and Wrekin council, which I think he will agree is a good council that tries to do a good job and is trying to deliver on the Government’s commitments while ensuring that we provide care and support for some of the most vulnerable people in our community.

--- Later in debate ---

[David Wright]

I absolutely agree with everything the Minister says—it is basic common sense. Although I am glad to hear him say it, and it is really positive, it would be helpful if he could address one concern, although I am not necessarily suggesting he will have an answer today.

I accept that we want to get people out of hospital and into their homes if possible to ensure they are cared for effectively. However, he must admit that the figures I highlighted, as well as the local authority’s concerns, suggest there has been a fairly significant reduction in the CHC pot. Given the scale of the local authority’s budget, compared with the health service’s budget, that reduction has an enormous knock-on effect on the local authority. I hope the Minister will take some time to look at that.

[Dr Poulter]

The hon. Gentleman is absolutely right to highlight the issue. The point I was coming on to is that although the region’s funding allocation from the Government through NHS England is going up, the CCG obviously has some local discretion over how that allocation is spent, and that goes to the heart of the matter.

As has been highlighted, continuing health care funding is the crux of this matter, and it is relevant to mention NHS continuing health care, which is a package of ongoing care arranged and funded solely by the NHS where the individual is found to have a primary health need. The NHS provides that throughout the country, and it is vital that it does.

There is sometimes quite a blurred line between where NHS funding and care end and where local authority responsibility starts. The issue is not whose budget is involved or which budget the money comes from, and that is part of the reason why the Government set up the £3.8 billion integrated care fund. This is about joining up budgets. The hon. Gentleman and I, the doctors and nurses on the ground, and the local authority are interested in the person, rather than who pays for treatment. The fund is a recognition of that, and we are setting it up to drive forward joined-up working.

However, we have to look at where we are now and why we have come to the place the hon. Gentleman highlighted. He will be aware that audits were carried out in 2009-10 and 2010-11 of the then PCT’s accounts. It was decided that the continuing health care funding was not being allocated properly, appropriately or even, potentially, legally.

At that point, the PCT was putting a lot of additional money into continuing health care, but a similar approach was not being taken elsewhere in the country. The auditors therefore rightly took the view that funding had to be allocated in accordance with the correct public rules for spending money, including NHS money, and that if money was, potentially, being allocated in an illegal way, that needed to be addressed under the rules at that time.

[David Wright]

rose—

[Dr Poulter]

I absolutely accept—the hon. Gentleman may wish to elaborate on this in his intervention—that, fundamentally, this is not about rules, but about making sure we have a better service for people. That is what we need to focus on.

--- Later in debate ---

[David Wright]

Yes, indeed, I do believe that. My concern is that the figures I highlighted suggest that, in comparison with similar and surrounding authorities, we are doing very badly per head of population in terms of the assessment process for qualification for continuing health care. That suggests to me that the pendulum has swung too far in the other direction and that the assessment procedure is being used to ensure that the figures are kept down.

I am concerned that some people with care needs in the community will lose out—as the Minister rightly said, this is not about structures and silos in the health service, but about individuals and their families in the community who are trying to cope.

[Dr Poulter]

The hon. Gentleman is right. In terms of the per capita spend in CCG allocations, Suffolk similarly has large towns with very rural surrounding areas, and the CCG in the hon. Gentleman’s area has a fairly similar allocation to the one I represent.

There is also an issue about how the money given to CCGs is spent. In a knee-jerk reaction, perhaps, to the auditors’ findings and the fact that the spend was not allocated appropriately, Telford and Wrekin went from being almost one of the highest spenders on continuing health care to being one of the lowest, and that is the crux of the problem. That is down to decisions by the CCG, or the PCT as it was, about how to allocate the budget given to it.

If, in 2009, 2010 and 2011, the PCT was picking up funding responsibilities that should perhaps have been the local authority’s, but then, in response to the audit, changed the amount it allocated to continuing health care, that could clearly have a destabilising effect on the local authority. However, the PCT and then the CCG have done everything they can to mitigate that, and they have given the local authority discretionary funding.

In particular, just over £3 million has gone to the local authority thanks to the fund set up by my right hon. Friend the Member for South Cambridgeshire (Mr Lansley) to facilitate exactly that kind of activity. At its own discretion, the CCG has also given the council £2.4 million on top of that, over and above what the council expected to receive. The CCG has therefore acknowledged and accepted that, in reacting to the auditors, there was perhaps an over-reaction, and it has now righted that by giving the local authority some discretionary additional funding.

That does not detract from the overriding point that, generally throughout the country, and particularly in Telford and Wrekin, we need to see increased emphasis on integration and joined-up care. It is in no one’s interests to have such discussions about funding, which waste a lot of time and effort on the part of the local authority and the CCG. If we can drive more joined-up working, more joint commissioning and more pooled budgets, where appropriate, as the Government will be doing through the Care Bill and the integration fund, the number of these turf wars will be reduced, because the emphasis will be on the patient, rather than the budgetary silo. That must be the right way forward.

I am sorry that, in this instance, the hon. Gentleman’s constituents and local authority have perhaps been caught up in errors made by the former PCT, although I am pleased the CCG is doing all it can to redress the balance by giving the local authority discretionary additional funding. I hope working relationships will improve and that, as we move forward, with further emphasis centrally on integrated health care and joined-up budgets, we will see greater improvements to the local health care economy and, more importantly, continuing improvements to patient care locally. If the hon. Gentleman wants to discuss the matter further or to meet me, I will be happy to do so.

Accident and Emergency

David Wright Excerpts

Wednesday 18th December 2013 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I beg to move,

That this House is concerned about recent Government statements on Accident and Emergency (A&E) and Government claims that it is not in crisis; notes that last week, 79 A&Es and the NHS overall missed the Government’s A&E target; further notes that attendances at hospital A&Es have increased three times faster since 2009-10 than in the period from 2004-05 to 2009-10, and that in the last 12 months more than one million people have waited more than four hours; believes there are a range of reasons for the current pressure on Accident and Emergency but that difficulty in accessing GP services is one of the primary causes; regrets the Government’s decision to cut funding for evening and weekend GP opening and scrap the guarantee of a GP appointment within 48 hours; and, to ease the pressure in Accident and Emergency, calls on the Government to reverse for winter 2013 its scrapping of the 48-hour appointment guarantee.

As we approach the end of 2013, it is becoming clear that this has been the worst year in accident and emergency for at least a decade. All year, the pressure has been relentless. It is not just a winter crisis, but a spring, summer and autumn crisis. Across the 12 months, more than 1 million people have waited more than four hours to be seen, which is a threefold increase since 2010. For the past 22 weeks, hospital accident and emergency departments have missed this Government’s target. Last week, the target was missed by the NHS as a whole, which is a warning sign that winter has now arrived and things are getting even worse.

Accident and emergency is the barometer of the whole health and care system. All year, that barometer has been warning us of severe storms ahead, and yet, three weeks ago, the Secretary of State stood at that Dispatch Box and claimed that this was

“a crisis that is not happening”.—[Official Report, 26 November 2013; Vol. 571, c. 155.]

He should try telling that to the families of people left waiting for hours on trolleys in corridors; to the people who have been ferried to hospital in police cars and taxis because ambulances are trapped in queues at accident and emergency; and to the A and E sister who attended our A and E summit here in Parliament last week and said:

“It feels like we’re fire fighting. It’s crisis management.”

[David Wright (Telford) (Lab)]

Is this problem not compounded by the fact that in many places such as Telford and Wrekin and the wider Shropshire area, the future of full A and E services at many hospitals is in doubt? That situation is bad for morale, and it compounds the other problems such as waiting times. People want some reassurance about the future of their A and E services.

[Andy Burnham]

That is a question for the Secretary of State. How can it make sense to close so many A and E departments in the middle of an A and E crisis? This year, the facts on the ground have changed. As I have said, it has been the worst year for a decade. Any proposal to change A and E in areas such as that of my hon. Friend needs to be considered in the light of that new evidence. We need to consider whether it is safe to proceed. As the A and E sister said, it is crisis management. That is the view from the real world. In here, it is a different story. It is, “Crisis, what crisis?”

My purpose in holding this debate is to cut through the spin. I want to bring into our debate today the voices of those A and E nurses, occupational therapists, paramedics, community nurses, and NHS 111 staff and mental health professionals who came to our summit. For instance, there is the paramedic who told us of his worries about ambulance response times getting longer because ambulances are trapped at A and E; and of the time when a patient who was held a long time at the door of a busy A and E suffered a heart attack and had to be rushed back to the ambulance. Another paramedic told us about being at the scene of a serious incident in a city centre. After calling for back-up, he was joined by a private ambulance which did not appear to have adequately trained staff to take patients to hospital. A community nurse spoke of her frustration at spending an hour and a half on the phone trying to get a GP appointment for a frail patient. An A and E-based occupational therapist said that she was now regularly diagnosing dementia for the first time in older patients who had ended up in A and E. Surely we can do better than that.

--- Later in debate ---

[Mr Hunt]

I will tell the hon. Gentleman why. It was done on clinical advice, for the good reason that there are some patients whom it is better to see, even if it takes longer than four hours, so that they can be discharged and sent home, rather than admitting them to the hospital, which is what was happening under the 98% target. Labour agrees with that, because it is following the same procedure in Wales.

[David Wright]

Will the Secretary of State give way?

[Mr Hunt]

I am going to make some progress.

I want to talk about what is happening in England, because the right hon. Gentleman wanted to know the truth. These are the statistics he did not want to tell the House about the comparison with his time in power, which he said was so good: 1.2 million more people are going through A and E every year, and more than 2,000 are being seen within four hours every single day, compared with when he was Health Secretary. The average wait to be seen is now 33 minutes compared with 77 minutes when he was Health Secretary—that is 44 more minutes longer, on average, to be seen under Labour than under this Government. For treatment, the average wait is now 75 minutes compared with 102 minutes when he was in office.

--- Later in debate ---

[Mr Hunt]

I recognise the hon. Lady’s concern for her constituents. I have looked into the issues in the Manchester and Trafford areas very carefully, and I am assured by people on the ground that the problems and challenges they face do not relate to the changes that have been announced in Trafford.

[David Wright]

rose—

[Mike Gapes (Ilford South) (Lab/Co-op)]

rose—

Oral Answers to Questions

David Wright Excerpts

Tuesday 21st February 2012 Commons Chamber

[David Wright (Telford) (Lab)]

2. What recent assessment he has made of the potential risks of NHS reorganisation.

[The Minister of State, Department of Health (Mr Simon Burns)]

The Department monitors risks associated with the implementation of the health and social care reform programme on an ongoing basis.

[David Wright]

“An open, transparent NHS is a safer NHS”: not my words, but those of the Secretary of State for Health. Is it not amazing that Ministers do not want to release documentation relating to the reorganisation of the NHS? Is it not an absolute scandal that they will not publish the documentation? Is it not the fact that the reorganisation of the NHS is looking a bit like the Norwegian blue? Should it not shuffle off the perch?

[Mr Burns]

No, the hon. Gentleman is wrong. As he, or certainly the right hon. Member for Leigh (Andy Burnham), will know, the risk register is an ongoing document—discussions between Ministers and civil servants on the formulation, implementation and transition of policies—and it would be wrong, in my opinion, for it to be published. That is why my right hon. Friend the Secretary of State appealed to the tribunal following the decision of the Information Commissioner, in line with the precedent adopted by Secretaries of State in the Labour Government in both the Department of Health and the Treasury.

Health and Social Care Bill (Programme) (No. 2)

David Wright Excerpts

Tuesday 21st June 2011 Commons Chamber

[The Minister of State, Department of Health (Mr Simon Burns)]

rose—

[David Wright (Telford) (Lab)]

On a point of order, Mr Deputy Speaker. Will you find out from the parliamentary authorities whether the monitors are working throughout the parliamentary estate? Only one Liberal Democrat Back Bencher is present, and, given that the Liberal Democrats have laid claim to significant alterations to the Bill, it is very important that they are in the Chamber.

[Mr Deputy Speaker (Mr Nigel Evans)]

Good try, but let us move on.

Hospital Services (Shropshire)

David Wright Excerpts

Wednesday 9th February 2011 Westminster Hall

[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.

Oral Answers to Questions

David Wright Excerpts

Tuesday 25th January 2011 Commons Chamber

[Mr Lansley]

Yes. My hon. Friend makes a very important point. I promise I will discuss with John Heyworth of the College of Emergency Medicine precisely the point that my hon. Friend has raised. The College of Emergency Medicine says that it does not recognise what an urgent care centre is. From its point of view, hospitals should either have an emergency department or an A and E or they should not. If they do not, it is very important to be clear that they do not. I feel that we need to be much clearer about the nature of the service provided in A and E departments and the distinction between that and the service provided in minor injury or minor illness centres.

[David Wright (Telford) (Lab)]

Do not the reorganisation plans for the NHS, coupled with cuts to local authority budgets, mean that public health projects in this country will effectively be binned?