Hospital Services (North-East)

Diana Johnson Excerpts

Tuesday 27th July 2010 Westminster Hall

[Diana R. Johnson (Kingston upon Hull North) (Lab)]

I congratulate my hon. Friend the Member for Hartlepool (Mr Wright) on securing the debate this afternoon. He is a worthy champion of his constituency and the region, with respect to a range of matters including health, education and economic regeneration. He spoke passionately about the need to deal with the health inequalities that blight this country, and the problems in his constituency in particular, as well as the need for excellence in health care in the north-east, including the new hospital that is at the heart of the debate.

Like all hon. Members who have spoken, I pay tribute to the staff of the NHS, whose work for and commitment to the people of the north-east and the rest of the country is excellent. It was striking to hear the personal experience that my hon. Friend the Member for Hartlepool had in his local hospital, and what excellent care he and his family received. I pay tribute to all hon. Members who are present today, including my hon. Friends the Members for Stockton North (Alex Cunningham), for Easington (Grahame M. Morris), for Wansbeck (Ian Lavery), for Sedgefield (Phil Wilson), for North Tyneside (Mrs Glindon), and for North Durham (Mr Jones). I know that they all feel strongly and passionately about the issue.

I want to comment on the remarks of my hon. Friend the Member for Easington. He put patient care and safety, which is what the debate is really about, at the centre of his remarks. He set out his concerns about what will happen to patients who are left with the two hospitals, where they will now be treated. Will the abolition of targets affect care and safety? That is an important issue, which I hope the Minister will deal with. My hon. Friend also raised the important issue of finances and how they stack up. I would like to know in particular whether the difference in cost between building a new hospital and repairing and maintaining the two is £11,000 or £11 million. I am sure that the Minister will clarify that.

[Mr Burns]

If it will help the shadow Minister I shall clarify the point yet again. The reason the question ever came into the public domain was that on the morning of the previous debate the right hon. Member for Leigh (Andy Burnham) incorrectly put out a press statement saying that the building of a new hospital would be cheaper than the maintenance and upkeep of the two existing hospitals, over a 35-year period. The figures, which Hansard originally printed wrongly—hence the correction—showed a difference of £11 million. It was cheaper by £11 million to keep the two existing hospitals. The point was merely to show that the right hon. Gentleman was factually incorrect.

[Diana R. Johnson]

I am grateful to the Minister for correcting what he said earlier, when he talked about the figure of £11,000. We understand that the figure is £11 million. I suggest that in the great scheme of things, if the difference in cost between maintaining and repairing two hospitals and building a state-of-the-art new one is £11 million, Labour Members might think that it is £11 million that should be spent.

[Mr Iain Wright]

I just want to make two points. First, I am sure that it was an oversight, but I point out that my hon. Friend the Member for Gateshead (Ian Mearns) is here. In his short time in the House he has been a fantastic representative of that fair area. On the point about net present values and appraisals of the hospital, my hon. Friend may know more than I do about it, but—whatever the talk of £11,000 or £11 million—are the wider savings to the taxpayer from better health outcomes and from ensuring that people do not rely on hospitals for protracted periods also part of the appraisal system? Are they taken into account, or is it a matter of the narrow costs of maintaining existing or new sites?

[Diana R. Johnson]

I apologise to my hon. Friend the Member for Gateshead for not mentioning him; I know that he takes a particular interest in the issue.

I hope that the Minister will explain the rationale for the decision that was made about the hospital, and whether the cost-benefit analysis included the savings that would come about from a healthier population with better access to health services. I am sure that he will explain it. My hon. Friend the Member for Easington also mentioned health inequalities. It is important to ensure that patients and communities have access to high-quality in-patient facilities when they need them.

My hon. Friend the Member for Sedgefield argued compellingly on business grounds that the hospital could help lead the regeneration of the area. He described the hospital as an anchor tenant that could attract up to 12,500 private sector jobs, a telling point for an area of the country that wants to attract private sector business and stand on its own two feet. He made a compelling case. My hon. Friend also said how good the care that he and his family had received from the local NHS was.

[Ian Mearns]

It is important that the Minister has now clarified that the figure is not £11,000, as he stated earlier, but £11 million. I am sorry, but the difference between the figures that he gave was in fact £11,000, and I hope that the record will show that. That said, we now know that the figure is £11 million over 35 years, or £314,000 a year, the lack of which will deprive the people in those five constituencies of a brand spanking new hospital facility that could add significant value over that period to detract from the additional cost.

[Diana R. Johnson]

My hon. Friend makes an important point about the cost over 35 years.

My hon. Friend the Member for Stockton North, who I understand is a former non-executive director of the North Tees and Hartlepool NHS Foundation Trust, spoke clearly about the need for a new hospital. I know that he also tabled early-day motion 273, which attracted a great deal of support, to request a review of the coalition decision about the hospital. He, too, made an important case about health inequalities and why the hospital is needed. He also pointed out that structural upheaval in the NHS at a time when we are facing such financial problems is a recipe for chaos. What is the future for the people represented by him and our hon. Friends? Again, I look to the Minister to explain the coalition Government’s thinking about what will happen to the needs of communities in the north-east.

I do not wish to rehearse the history of this £464 million hospital project—my right hon. Friend the former Secretary of State made it clear that it was a top priority for the NHS, and agreed in March this year that it should go ahead—but it had been in planning for a long time. It was not just signed off close to a general election. As we have heard, the coalition Government decided to cancel the hospital project within the first few weeks of taking up their position in Government. It is clear that the Treasury and other Departments reviewed every significant spending decision made between 1 January and the general election on 6 May. The proposal for the new hospital scheme, which received Government approval only in March, was considered properly during that review, but there are questions about why that particular hospital project was cancelled and others were allowed to proceed when my right hon. Friend had made it clear that the hospital was a top priority for the NHS.

[Mr Burns]

As I said to the hon. Member for Hartlepool, if the hon. Lady studies carefully our debate of 5 July, as I am sure she has—I do not usually recommend that people read my speeches—she will see that column 150 gives in detail the answer to that question.

[Diana R. Johnson]

The Minister will be pleased to know that I took great pleasure in reading his response to that debate, but I am still not satisfied with the explanation given. There is room for further explanation why that particular hospital was chosen.

[Mr Burns]

What precisely does not satisfy her in that explanation? What in particular causes her concern?

[Diana R. Johnson]

I am particularly concerned—I think that my hon. Friend the Member for Hartlepool mentioned this—about the clear view of all the clinical professionals—[Interruption.] I do not have the speech in front of me, but considering that the Secretary of State for Health talks continually about the need for doctors and clinicians to be in the driving seat when decisions are made in the NHS, and considering that, as my hon. Friend said, it is clear that the clinicians and health professionals involved were very centred on having that one hospital, why have those views been suddenly pushed to one side? Will the Minister explain that, given the coalition Government’s new approach of saying that clinicians are at the centre of decision making? If so, I will be pleased.

Also, on the cost of cancelling the project, how much money was spent getting to the point of preparing to proceed? What yearly maintenance and repair bill does the Minister think will now have to be paid for the two hospitals? What is the coalition Government’s plan for in-patient health facilities for that community? What does he see as the future for either a new hospital or a different style of health service provision in the area? What is his thinking? It is certainly not clear.

The Office for Budget Responsibility’s projections, to which one of my hon. Friends referred, show that the actual deficit was lower than was projected before the general election. We have also seen higher-than-expected growth figures this week, which hon. Members might find surprising. I ask the Minister to reconsider the economic impact of refusing to follow through on the decision to build the hospital, taking into account what my hon. Friend the Member for Sedgefield said about the potential for the hospital to be an anchor tenant to attract important private sector businesses and jobs. I know that the coalition Government are committed to helping the private sector grow us out of our present financial situation, so will the Minister reconsider? The range of Members present in the Chamber shows a clear commitment to ensuring that the people of the north-east get their fair share of resources and the kind of hospital service that they so richly deserve.

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

I congratulate the hon. Member for Hartlepool (Mr Wright) on securing this debate. As he and his hon. Friends will know—as the shadow Minister rightly said, they are here in force—we have had a briefer debate on this subject, and I have had the pleasure of welcoming most of the Opposition Members present to a meeting at my Department, where we had a useful exchange of views.

Before I address the main thrust of most of the contributions, which is North Tees and Hartlepool, I will give a brief overview of the health situation in the north-east and will refer to some of the comments made by my hon. Friend the Member for Hexham (Guy Opperman).

Earlier this month, as hon. Members know, we published our vision for the national health service in the White Paper “Equity and excellence: Liberating the NHS”, which signals the beginning of the most profound reform in the NHS’s 62-year history. By taking power away from Ministers and civil servants in Whitehall and handing it to patients and clinicians, we shall transform the health service from the ground up.

[Diana R. Johnson]

Will the Minister give way?

[Mr Burns]

I thought that the shadow Minister might want to intervene.

[Diana R. Johnson]

I am intrigued. I read carefully the coalition agreement, which said that there would be no top-down reorganisation of the NHS and mentioned having elected representation on primary care trust boards, which I understand are now to be scrapped. Will he explain why, in a few weeks, the Government have completely ditched that proposal, which was in the coalition agreement?

[Mr Burns]

I will certainly explain that when I get on to the specific point about Hartlepool because, unfortunately, as will be unveiled to the shadow Minister and the hon. Member for Hartlepool, their comments today are based on a false premise and show that they do not fully understand the previous speeches on the issue, or the meeting we had at the Department of Health. All will be unveiled shortly, and I hope that the shadow Minister will understand the reasoning behind the decision taken.

As I was saying, as part of the vision, and the moving forward on the White Paper, we want every hospital trust in the country to become a foundation trust. We want to direct every aspect of the national health service at delivering clinical outcomes that are as good as, or better than, any in the world. The north-east is already ahead of the game in many respects. In November 2009, it became the first and only region in England to have all of its NHS hospital and mental health trusts awarded foundation trust status. When the Care Quality Commission reviewed hospital services in the region last year, every single hospital trust and every ambulance service was rated either good or excellent for the quality of their services. That gave the north-east the highest score in England for the third year running.

Among those hospital trusts, Gateshead Health NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trust all received double excellent scores for both quality of services and the use of resources. The high quality of services across the north-east is down to the skill, dedication, creativity and sheer hard work of the thousands of NHS staff across the region. I want to take this opportunity to pay tribute to them and wish them well in their continued success in providing first-class care and services to the people of the north-east.

--- Later in debate ---

[Mr Burns]

It is perfectly reasonable for the hon. Gentleman to express concern about and an interest in finding out what would happen. The answer is that that will depend on a combination of factors, including the national commissioning board that will be created, the GP commissioners and the decision of the local health community. If a local health community put forward any proposals to reconfigure health patterns in its area, it would have to go through all the procedures that are currently in place, and there will also be the changes that my right hon. Friend the Secretary of State will put in place to strengthen the community’s input into any proposed reconfiguration. The views and support of clinicians and GPs will be sought, and the focus will be on improving outcomes and affordability, and including the views of local populations.

The hon. Gentleman will know from reading the White Paper and the five related documents that have so far been published, which flesh out the details, that local authorities will have a greatly enhanced role in the provision of health services and the maintenance of health care standards in the local community, and will not be restricted solely to their current role in public health.

The hon. Gentleman asked whether the Government will implement the recommendations of the Darzi review on acute health services north of the River Tees. The recommendations of that review were superseded by advice provided by the independent reconfiguration panel to the then Secretary of State for Health in December 2006. That advice formed the basis of the “Momentum: Pathways to Healthcare” programme, which was developed by the local national health service to provide a new health care system for the people of Stockton, Hartlepool, Easington and Sedgefield. We understand that NHS Hartlepool and NHS Stockton-on-Tees will continue to work closely with North Tees and Hartlepool NHS Foundation Trust on delivering the wider Momentum programme, and will be discussing the options available with the trust. I hope that that goes some way towards satisfying the hon. Gentleman.

The hon. Member for Kingston upon Hull North mentioned the generality of the provision of health care, and new health care facilities, in the region, and I can reassure her by mentioning a number of initiatives that have taken place in the Stockton-on-Tees area in recent years.

[Diana R. Johnson]

In recent years.

[Mr Burns]

Yes, in recent years—there is no point in the hon. Lady sitting there and saying that because, to be frank, anyone who takes a sensible approach to such matters will not try to score cheap party political points. I recognise that for the past 13 years we have had not a Conservative but a Labour Government, and I am mature enough and comfortable enough within myself to recognise that during those years advances in health care were made. I am not one of those narrow politicians who say that, because there was not a Tory Government, everything was awful, or that everything done by a Tory Government is wonderful; it is a mixture of the two. One has to be mature enough to recognise that, as I do. The initiatives I will refer to took place in the past few years, so they were under a Labour Government.

As the hon. Lady will know, 26 of the 46 Momentum business service change projects are under way as part of the “Momentum: Pathway to Healthcare” programme. They consist of detailed service reviews, a revised pathway based on a map of medicine, a value impact assessment and a service implementation plan. Examples of pathways reviewed to date include those on diabetes, respirology, cardiology and haematology. There are also cross-cutting business service change projects under way in the areas of work force and education, IT, and communications and engagement. There is also an integrated care centre at Hartlepool, with which the hon. Member for Hartlepool will be familiar, and an integrated care centre at Billingham, which I expect the hon. Member for Stockton North (Alex Cunningham) and my hon. Friend the Member for Stockton South (James Wharton) will know.

[Diana R. Johnson]

Will the Minister give way?

[Mr Burns]

I will give way briefly for one final intervention.

[Diana R. Johnson]

I am pleased that the Minister has read out a list of initiatives introduced under a Labour Government, but I am interested in the coalition Government’s thinking on health service provision in the north-east. What initiatives do they have planned for dealing with the health inequalities that have been mentioned by Members today?

[Mr Burns]

I thank the hon. Lady for giving me the opportunity once again to tell her that those are all contained in the vision outlined by my right hon. Friend the Secretary of State in the White Paper that was published last week. It is a vision that puts patients at the heart of health care, so that they can have the best health care of the highest quality. It is based on the premise that there should be a local, bottom-up system, rather than one in which politicians and bureaucrats in Whitehall issue diktats and tell local communities with which they are unfamiliar what they should and should not do. That is the way forward for enhancing health care.

Our vision is based not on processes that are distorted for party political purposes, but on the need to improve outcomes so that people get better health care. The patient experience, whether in a hospital setting or when a patient visits their GP, should be tailored to their needs, rather than to what the state tells them that they should have. That move will be spearheaded by GPs, through GP consortiums, as it is they who are closest to patients, know the health care that they need, and know how patients can best access it. That will all be determined by improving outcomes and the patient experience in order to give the finest quality care that the country can provide—the highest in the world. That is the answer to the hon. Lady’s question.