Capital Funding: New Hospital in Harlow

Debate between George Howarth and Robert Halfon

Wednesday 18th October 2017 Westminster Hall

[Robert Halfon]

My hon. Friend has set up the all-party parliamentary group on new towns, of which she is the chair and I am pleased to be vice-chairman. We set it up because we have many of the same problems. Our towns were built at the same time and we have the same issues, whether it is to do with our hospitals or regenerating housing and our high streets. I thank her for the work she does on this and the way she represents her new town and her constituents in Telford.

As I was about to say, the hospital secured £1.95 million of emergency department capital funding in April this year, allowing significant building works to support the department’s work, including the expansion of the medical assessments base. That is coupled with an A&E-focused recruitment drive to take advantage of the new facilities.

That leads me on to staff recruitment and retention. While Harlow hospital now has 27 more doctors and 35 more nurses than in 2010, the vacancy rate in recruitment is a perpetual worry. The nurse vacancy rate for September stood at 25%. Staff vacancy rates were picked up in the CQC report in 2016, in which inspectors found that

“staff shortages meant that wards were struggling to cope with the numbers of patients and that staff were moved from one ward to cover staff shortages on others.”

The proximity of Princess Alexandra Hospital to London plays a major role and, although pay weighting is a factor, I have been told by the hospital leadership and Harlow Council’s chief executive, Malcolm Morley, who is in Parliament today, that career development is significant. Princess Alexandra Hospital must compete with Barts and University College Hospital in specialist training and career development. The retention support programme established career clinics and clear career pathways, but there is only so much that the hospital can do to compete with the huge investment and facilities at London hospitals. Harlow needs to be able recruit and retain staff. Recruitment is related partly to the future of the hospital itself and partly to the staff’s ability to develop their careers in Harlow. Of course, both factors relate to the hospital’s infrastructure.

I have tried to make sure that our NHS in Harlow is a top priority for the Government, and I have had many meetings with the Health Secretary and the hospitals Minister. I am pleased to say that they have visited our hospital a number of times, most recently in May, when the Health Secretary visited the Princess Alexandra Hospital to speak to the hospital leadership team about Harlow’s case for a new hospital. He spoke of

“the exciting proposals which are coming together to invest capital in upgrading these facilities, including the option of a brand new hospital.”

He also stated:

“These proposals are at an early stage but upgrading services on this important site will be a priority for a Conservative government”.

Following capital funding announcements for sustainability and transformation partnerships in July, I was informed that

“Princess Alexandra Hospital is still a real priority”

for the Department of Health

“and work is ongoing to take it forward”,

and that the Government are “on hand” to carry on helping to get the Princess Alexandra bid together. Given that the Health Secretary said that Princess Alexandra Hospital is a priority case, will the Minister say what the current budget is for capital funding and how it will be allocated to new hospitals, such as Harlow?

In autumn 2016, the Secretary of State requested that the PAH board, the local clinical commissioning group and local authority partners progress a strategic outline case. After considering a number of options,

“the SOC concluded that a new hospital on a green field site, potentially as part of a broader health campus, to be the most affordable solution for the local system”—

note the expression “most affordable”—

“and the solution that would deliver most benefit to our population.”

The health campus would bring together all the services required to ensure that healthcare in Harlow is fit for the 21st century: emergency and GP services, physio, social care, a new ambulance hub, a centre for nursing and healthcare training.

Having recently met the chief executive of the East of England Ambulance Service, I know that there has been a significant increase in the number of calls from critical patients who need a fast response. Harlow has four new ambulances but the development of a top-class ambulance hub would allow huge improvements in that area. The health campus could also act as a centre for degree apprenticeships in nursing and healthcare, bringing specialist training to the eastern region. It could build on strong links between the Princess Alexandra Hospital and Harlow College and capitalise on the new Anglia Ruskin MedTech innovation centre at the Harlow enterprise zone.

The health campus proposal has been supported by West Essex CCG, the East and North Hertfordshire CCG and the Hertfordshire and West Essex STP, which brings together 13 local bodies and hospital trusts. A joint letter has been signed by more than 10 councils, including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority.

Despite recognition from local authorities and Ministers alike, some NHS England officials—I stress the word “some”—suggest that a refurbishment would be more fitting than the development of a brand-new hospital, due to capital funding constraints. That solution is the equivalent of an Elastoplast—a short-term option that will do nothing to solve real, long-term problems.

Given the support from the Government and key organisations, we need to be sure that plans for a new hospital are not obstructed. Will the Minister give an assurance that NHS England and NHS Improvement will work positively with public, private and voluntary sector partners to progress the plans? A rapid strategic solution is needed, rather than a short-term fix.

The cost of the new campus model would be between £280 million and £490 million, depending on the type and preferred method of funding. The hospital leadership is looking at all the options to maximise public sector investment and bring together the public, private and voluntary sectors. Private investment will not involve any kind of private finance initiative contract. Instead, the leadership will focus on how the private sector works with the NHS and how the development can generate revenue flows through social care, for example. The development also raises the potential development of housing as a source of income and private investment. These are decisions for the future. When the PAH leadership looks at private investment, it will consider supported housing and similar options.

Moreover, Public Health England’s move to Harlow will create a world-class health science hub. Without exaggeration, once Public Health England has completed its move, Harlow will be the health science capital of the world, Atlanta aside. We must ensure that the Princess Alexandra Hospital is an important partner that benefits from and adds to that success. The creation of a health campus is vital not only for Harlow but for the surrounding area. The infrastructure of the campus would be fundamental to the vitality of the community and the economy of the entire region that the Princess Alexandra serves.

I have visited the Princess Alexandra Hospital many times. I defy the Minister to find more professional and dedicated staff, doctors and nurses. They work day and night to look after the people of Harlow and the surrounding area. I have seen the incredible work in A&E, intensive care and the maternity and children’s units. That is why I know that PAH staff are second to none. However, their professionalism and hard work will go to waste unless our hospital is fit for purpose. I know that the Secretary of State recognises that, given his numerous visits to the hospital and what he has said since. I know that the Minister himself recognises that, given his visit to the hospital this time last year. I know that all the key local authorities, neighbouring MPs and trusts are supportive. I urge the Minister to do everything possible to ensure that Harlow has a hospital that is fit for the 21st century.

[Mr George Howarth (in the Chair)]

Before I call Mark Prisk, he needs to be aware that adequate time must be allowed for the Minister to respond. If he does not appear to be finishing his speech in a timely manner, as I am sure he will, I will intervene to bring in the Minister.

East of England Ambulance Service

Debate between George Howarth and Robert Halfon

Tuesday 25th June 2013 Westminster Hall

[Robert Halfon (Harlow) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I give my sincerest congratulations to my near neighbour and hon. Friend the Member for Witham (Priti Patel), who has led the campaign against the shocking performance of the East of England Ambulance Service NHS Trust.

The East of England ambulance service continues to give my constituents and me huge concern. As my hon. Friend said, however, I want to make it clear that those worries are not aimed at front-line staff, for whom I have nothing but admiration, especially the senior staff and the paramedics in Harlow. They do a tough job and give 100% to their work; I am proud that we have such extraordinary people living in Harlow and throughout the east of England. The staff, however, are lions being led by donkeys—that is the truth of the matter, as so brilliantly highlighted by my hon. Friend.

At the end of 2012-13, the East of England ambulance service had failed to reach its targets, whether for category A response times for calls to do with life-threatening situations, the less serious green calls or even the ability to pick up the phone on time. Not only is the trust failing to hit demanding targets, but my post bag is regularly filled with letters from local residents complaining about the service that they have received. I have also had staff contact me to complain that they feel they are offering an inadequate service because of the shocking performance of senior managers.

It is outrageous that when I have raised constituents’ problems with the ambulance service, it has taken an unacceptably long time to respond. For example, I wrote to the trust about a serious case in which one person had, tragically, died. The trust did get back to me and acknowledged that its response was unacceptable, contributing to the man’s death, but it had taken nearly five months to respond to my letter on behalf of the family—that is a disgrace.

We have to see change in three areas: we need better resources, targeted at delivering better patient outcomes; the management system urgently needs restructuring; and we need to show staff that they are valued, increasing their skills, so that they continue to make progress. Only by doing those things can people in Harlow and throughout Essex and the east of England get the treatment that they deserve.

For far too long, I have had residents contacting me about the poor level of service. Nearly all the concerns are focused on delays that their family or friends have suffered when waiting for an ambulance or during the handover time in hospital. A tragic case is that of cyclist Robert Tyler, who died by the roadside in my constituency after waiting 45 minutes for an ambulance, despite being only three minutes away from A and E. Sadly, such anecdotes are borne out by the statistics and, as I said, the trust failed to meet its operational targets last year.

I was glad to receive a letter from Dr Geoffrey Harris that claimed he is starting to see signs of improvement. I hope that is so, but on speaking to a worker from the ambulance service yesterday, it was troubling to hear that they felt that little had improved. The worker made the important point that we need more ambulances on the road, telling me that the rapid response vehicles were only being used to ensure that targets were hit. To deliver the best patient care, according to the worker, rapid response vehicles should be in addition to ambulances, not a replacement for them. That view is held across the trust, with more than 300 staff supporting a move calling on the management to claim the A19 target only when an ambulance arrives.

I was disturbed when a constituent told me about her 97-year-old mother who had fallen, hurt her leg and was unable to stand. The first responder arrived quickly and provided good care, but because no ambulances were available, my constituent was left waiting in pain for eight hours. That is absolutely unacceptable, and the new chairman must look at providing more ambulances, so that we can minimise patient suffering and provide a more efficient service.

When I speak to local staff, time and time again they bring up problems with the management structure and their dissatisfaction with it. Some have pointed to directors whom they hold accountable for the problems in the trust; those directors have not resigned, despite the strong pressure to do so. Dr Marsh’s report, as has been highlighted, is no different: he has made it clear that some trust non-executive directors need to resign. He points to an inability of the board to claim responsibility, a lack of clear vision, too much management and no tangible recruitment plan.

It is good news that the new chairman of the trust has stated that he will be making changes to the board, but I join my hon. Friends in calling for five board members to resign and, if possible, for them to be taken to court to be sued for legal negligence—I wish that could be the case. It is shocking that they have been allowed to continue when their failings have been made so apparent. They have put their people’s lives at risk and they have treated my local residents of Harlow shoddily. The board must be refreshed, replacing those members with people who have a proven track record of driving up standards.

I have heard of other problems from workers and residents. Staff are always praised, but staff morale is the worst of all the ambulance trusts in England—it is chronically low. Staff are embarrassed by how long an ambulance can take to reach patients. Sickness levels are high, with an 8.8% sickness rate—almost double the national average for ambulance trusts in England. Also, there is lack of training, with staff telling me that they feel unsupported; records show that the level of completed training days is abysmally low and last year only 45% of appraisals actually took place.

I am pleased that Dr Harris is making some changes, but action needs to be far quicker. At previous meetings with the trust, it seemed to be suggesting that Government funding was partly to blame, but Dr Marsh’s review blows that excuse out of the water. As my hon. Friend the Member for Witham says, the review found that the trust is funded above the average for ambulance trusts, possibly by several million pounds.

The board must take full responsibility for the problems that have plagued the service over the past few years. Action should be taken, including provision of a proper training programme for existing staff, a coherent recruitment plan to rebalance the staff ratio and direction of resources so that more ambulances are on the roads. I favour the ambulance service being broken up, so that there is an Essex ambulance service, because the East of England service is far too big. Genuinely, with the right management and the right resources, we can deliver some of the best care to my constituents in Harlow, to Essex and throughout the east of England.

[Mr George Howarth (in the Chair)]

I will call Peter Aldous in a moment and the Opposition spokesman at 10.40 am. If the two remaining speakers before the Front-Bencher take five minutes each, that should just about cover the time.