Glenfield Hospital Children’s Heart Surgery Unit

Gloria De Piero Excerpts

Wednesday 19th October 2016 Westminster Hall

[Liz Kendall]

I completely agree with the right hon. and learned Gentleman. I am sure that not only the 57 patients from his constituency who are currently receiving treatment but the thousands of patients who receive ongoing care, including for extracorporeal membrane oxygenation, which I will come back to, rightly value the high standards at Glenfield. It would be a huge and terrible mistake to close the centre.

In a recent letter to the hospital, NHS England raised concerns that more complex cases are being referred to Birmingham from Glenfield. I take issue with that. I would like the Minister to confirm that, in fact, only four such cases have been referred to Birmingham in the past three years, and that it is a professional obligation to seek second opinions when that is in the best interests of patients. That is enshrined in General Medical Council good practice guidelines and was recommended by the paediatric and congenital services review group in its recommendations in 2003. Few complex cases are referred but, when they are, it is in the best interests of patients. That should not be used as a reason to close the unit.

A second part of the standards that NHS England has set out is ensuring that sustainable numbers of children have surgery in each unit every year. The aim is to have 375 operations per year over the next three years, with 500 a year in the longer run. I want to make this clear: the hospital has told me and NHS England that it is on track for 375 cases this year and that, if it does not quite achieve that, it will not be by significant numbers. It therefore rightly asks: “Why put a centre on track to reach those standards at risk by this proposal?”

On the longer term goal of achieving 500 cases a year, there is an important question. More than 500 children in the east midlands need congenital heart surgery every year but do not all go to Glenfield. NHS England claims that that is due to patient choice. Some patients in Peterborough or Northampton will choose to go to places such as Great Ormond Street, but the claim that all patients in Northampton choose to go to Great Ormond Street while all patients from Peterborough choose to go to Leicester suggests the goals are more about historic referral patterns than about genuine patient choice.

[Gloria De Piero (Ashfield) (Lab)]

I thank my hon. Friend for securing the debate and for all the campaigning she is doing on this important issue. I could raise many constituency cases, but I will raise just one. Scarlett from Kirkby was minutes from dying by the time she arrived at Glenfield. Her mum, Zoë, told me that she would not have made it any further than Glenfield. Keeping Glenfield open is a matter of life and death for so many children.

[Liz Kendall]

I thank my hon. Friend for raising that point. She is absolutely right. Many patients and their families have told me that they simply would not be alive if they had had to travel much further. If the proposal goes ahead, the east midlands will be the only region in the country without a children’s heart surgery unit. It does not have to be this way, because if we properly manage the number of referrals across the east midlands, there will be enough for Glenfield and other surgery units to keep going. It is a balance between getting the right numbers and having quick access to a centre.

Health

Gloria De Piero Excerpts

Tuesday 14th October 2014 Ministerial Corrections

Nurses: Recruitment

[Gloria De Piero]

To ask the Secretary of State for Health how many training posts for nurses were commissioned in England in each of the last five years.

[Official Report, 7 May 2014, Vol. 580, c. 241-43W.]

Letter of correction from Dr Poulter:

An error has been identified in the written answer given to the hon. Member for Ashfield (Gloria De Piero) on 7 May 2014.

The full answer given was as follows:

[Dr Poulter]

The following table shows the number of new pre-registration nursing places that were filled in the last five years. The table includes the students enrolled on the degree and diploma courses.

Hospital Mortality Rates

Gloria De Piero Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

I welcome that, and I am delighted that my hon. Friend’s trust was not one of the ones that it was necessary to put into special measures. We have learnt a lesson from the successful way in which the schools system is regulated. Ofsted distinguishes between failing schools that have in place good management who are able to turn the school round and those where a change of leadership is required, and I am pleased that the report found that Dudley had the right leadership in place.

[Gloria De Piero (Ashfield) (Lab)]

I welcome the report and I hope that the new chief executive at King’s Mill hospital in my constituency will provide the leadership that has been lacking in recent years. He assures me that he will implement all the report’s recommendations. The report mentions

“significant concerns around staffing levels at…King’s Mill Hospital”.

The trust has lost more than 200 nurses since 2010. Can we have them back?

[Mr Hunt]

Staffing levels are indeed one of the issues that contribute to poor care, if we get them wrong. That is why we are committed to implementing the Francis recommendations on safe staffing levels, and why, having protected and increased the NHS budget—contrary to what the shadow Secretary of State wanted—we now have 6,000 additional doctors working in the NHS. [Interruption.] In these individual cases, if staffing levels are the issue, they will be addressed.

Accident and Emergency Waiting Times

Gloria De Piero Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

I think the hon. Gentleman should listen to this. Professor John Temple described that as having the biggest impact on the emergency and out-of-hours parts of the NHS, which is why the Government are now having to increase recruitment into A and E through the mandate that the Government have set Health Education England. Or there is the total failure—

[Gloria De Piero (Ashfield) (Lab)]

In one week in April 2012, 75 people in Sherwood Forest trust waited longer than four hours at A and E. In the same week in April this year, 266 people waited longer than four hours at A and E. That is a 255% increase. How does the Secretary of State account for that?

[Mr Hunt]

I agree that A and E departments are under huge pressure, and that is why we are taking a lot of measures to deal with them, which is what I am talking about. But I am saying that we have to deal with the root causes, which were things that the shadow Secretary of State’s Government failed to deal with. [Interruption.] Labour Members need to listen. We listened to the shadow Secretary of State’s solutions, which were not really solutions; now I am telling them what we think needs to happen.

We welcome the fact that the Labour party has now seen the light and recognises the need for integration, but Labour Members need to show some humility, because it was the Labour Government who put in place many of the barriers—in particular payment by results mechanisms—that make that so hard to achieve. We are now trying to make integration a reality through the 10 pilots on removing barriers to integration announced by the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), as part of the vulnerable older people’s plan announced to the House last month. Without integration, we will not solve the problem of bed blocking, which is at the heart of the pressures on A and E.

Mental Health

Gloria De Piero Excerpts

Thursday 16th May 2013 Commons Chamber

[Mr Walker]

It is not a crime to be ill. It is not a crime to have cancer, it is not a crime to have heart disease and it should not be a crime to have a mental health illness. What we need is compassion.

[Gloria De Piero (Ashfield) (Lab)]

rose—

[Mr Walker]

I give way to the hon. Lady, although I am going to get in terrible trouble in a minute for taking up too much time.

[Gloria De Piero]

I wanted to intervene because people were talking about family members. I have a close family member with a severe mental illness. It was a big part of my childhood and early adulthood, and remains a big part of my life to this day. It is so important that we have this conversation. It is not something that people share or talk about because of the stigma that surrounds it. Instead, people internalise it, deal with it and become their own expert, so I would like to thank the Backbench Business Committee for returning to this important issue. It is time to talk and time to change, and I thank the hon. Gentleman, along with Rethink and Mind, for their work in this area.

[Mr Walker]

I know that the hon. Lady is an expert on these matters. I was going to say in response to the hon. Member for Bridgend that there are experts in this place. I did not want to identify the hon. Member for Ashfield (Gloria De Piero), but, to her enormous credit, she has identified herself. She is a fantastic representative of her constituents, and it is a delight to have her here today.

We have to make progress on drug therapies. Lord Stevenson of Coddenham, who is known to me and the hon. Member for North Durham (Mr Jones) very well, is doing enormously good things in this area. He has established a charity with a significant budget to look into new treatments, pathways and the brain. The charity is called MQ, its chief executive is Cynthia Joyce and I commend its work to the Minister. I would also like to thank my hon. Friend the Member for Loughborough (Nicky Morgan), who cannot speak today because, according to some bizarre convention, Whips cannot speak in the Chamber, which is a great sadness, because I wish she could. I also thank my hon. Friend the Member for Halesowen and Rowley Regis (James Morris), who has done much in this area, and of course the hon. Member for North Durham, who has become a great friend over the past year and is a fellow musketeer in these areas.

I said that I would touch on suicide. We need to build mental health resilience in our schools. That should start at a very young age. It is a great tragedy that many young men and girls decide to end their lives in their teens and early 20s. It is a public health issue, and we need to address it.

East Midlands Ambulance Service

Gloria De Piero Excerpts

Monday 21st January 2013 Commons Chamber

[Gloria De Piero (Ashfield) (Lab)]

The loss of ambulance stations in semi-rural areas is a particular concern. The town of Eastwood in my constituency faces the loss of its ambulance station. Does my hon. Friend agree that closing an ambulance station cannot help already poor response times?

[John Mann]

The figures I have presented to the House show this in-built bias against rural and semi-rural areas, and, not least, former mining communities. We have the proposals to close Worksop and Retford ambulance stations and to have one hub in Ashfield’s King’s Mill hospital to serve my population. The population of Bassetlaw will have a parking lot with a potential portakabin under the original proposals.

NHS Funding

Gloria De Piero Excerpts

Wednesday 12th December 2012 Commons Chamber

[Stephen McPartland]

I do not represent a rural constituency, but I think everybody in every part of the country should have access to the best possible heath service and there should not be any postcode rationing issues. My hon. Friend’s constituents should have access to the best NHS care; indeed, I hope it is almost as good as the care my constituents get.

NHS spending should be focused on improving the quality of care and the experience of patients and their families. We all know that things go wrong, and one of the problems is that when things go wrong, doors get closed and people feel very vulnerable and lonely. People put their mother, father, brother, sister, son or daughter in the hands of someone whom they consider a professional, and they place their trust in them. I hope all of us feel able to put our trust in those professionals.

[Gloria De Piero (Ashfield) (Lab)]

In Ashfield, there are proposals to close down wards at the community hospital. If the closure goes ahead, the situation will be particularly difficult for some patients who suffer from severe dementia, as their relatives will have to travel 17 miles to see them. Does the hon. Gentleman agree that that is unacceptable?

[Stephen McPartland]

I understand that the hon. Lady has a specific issue in her constituency, and I would like to point out one in mine: anyone in my constituency who requires radiotherapy treatment has to travel to Hillingdon in London to have access to the linear accelerators, with the typical journey being more than 4,000 miles during the course of the treatment. I do not want to blame any particular Government or party, but the reality is that there are difficulties everywhere. I have a campaign, which I would love all hon. Members to join, to bring cancer care closer to people’s homes, and I want to have a radiotherapy unit based in my constituency. There are discrepancies and disparities all over the country, and it would be great if we could iron them out.

NHS Annual Report and Care Objectives

Gloria De Piero Excerpts

Wednesday 4th July 2012 Commons Chamber

[Mr Lansley]

Yes. I am grateful to my hon. Friend. He is absolutely right. I had the pleasure of meeting Dr Paul Bowen from his clinical commissioning group when I visited Blue Coat school in Liverpool. Leaders of clinical commissioning groups from across the north-west came together and many of them are already exercising 100% delegated responsibility for local commissioning budgets and showing how they can improve services using that. We know that in a financially challenging environment reducing cost is important, but redesigning services to deliver care more effectively with the resources available is even more important, and that is precisely what the clinical leadership in those groups is doing.

[Gloria De Piero (Ashfield) (Lab)]

In Ashfield in the past year the number of people waiting in accident and emergency for more than four hours has almost doubled, we have lost our NHS walk-in centre, and there are now proposals to close our community hospital. Why does the Secretary of State think these things are happening?

[Mr Lansley]

As I made clear in my statement, according to the latest data 96.5% of patients in A and E are assessed, treated and discharged within four hours. The right hon. Member for Leigh (Andy Burnham) asked about the difference between a target and an outcome, but the point is that it is not enough to measure whether a patient has been seen and treated within four hours; the issue is the quality of treatment they receive, which is why our A and E quality indicators go further. The hon. Lady and I have had correspondence on this—I will be glad to look back and ensure that I have kept it up to date—so she knows that there has been a review of walk-in centres and that there is a need for people to have access not only to emergency departments, but to urgent care in a way that does not entail having to wait for a long time in A and E. I do not remember all the details, but I recall that some of the services offered in one walk-in centre in her constituency were being transferred to another that was adjacent to the A and E.

King's Mill Hospital

Gloria De Piero Excerpts

Monday 25th June 2012 Ministerial Corrections

[Gloria De Piero]

To ask the Secretary of State for Health (1) how many patients waited longer than four hours in the accident and emergency ward at Kings Mill Hospital, Nottinghamshire between (a) January and March 2012 and (b) January and March 2011;

NHS Risk Register

Gloria De Piero Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Mark Simmonds]

I will not give way, because I have done so twice already.

Finally, it was made clear in an earlier intervention that the shadow Secretary of State, were he ever to be Health Secretary again, would not by necessity publish all risk registers, so it is nonsensical to suggest that this out-of-date risk register either informs debate or is necessary for discussing the future reforms of the NHS. Of course, that is not really what this debate is about. It is a cloak to try to put obstacles in the way of what I believe is necessary reform. We know why reform is necessary: a growing and ageing population; increasing levels of co-morbidities and long-term conditions; rising health care costs; and the impact of lifestyle choices. However, listening to the shadow Secretary of State, one would think that the NHS was falling apart. It absolutely is not. It is performing very well at the moment. We are reducing in-patient and out-patient waiting times. The backlog of patients waiting more than 18 weeks is going down, and the number of patients waiting more than a year is half what it was in May 2010.

[Gloria De Piero (Ashfield) (Lab)]

Will the hon. Gentleman give way?

[Mark Simmonds]

I will not, because I have done so twice already.

I could go on with the achievements that the national health service has delivered since the election, but while progress is being made we need to put in place the policy architecture that will enable the national health service to deliver improved patient outcomes, satisfaction and experience and to continue as a free taxpayer-funded service.

So what are these reforms that get Opposition Members so excited? First:

“Patients…will have the right…to choose from any provider.”

Interestingly enough, that was in the 2010 Labour party manifesto. Secondly:

“All hospitals will become Foundation Trusts”.

Interestingly enough, that was in the 2010 Labour party manifesto. Thirdly, there is the plan to

“support an active role for the independent sector”

in providing services. That too was in the 2010 Labour party manifesto. Fourthly,

“Foundation Trusts…given the freedom to expand…their private services”.

That was in the Labour party 2010 manifesto, as was the proposal to ensure that family doctors have more power over their budgets.

Who was the man in charge of putting that in the Labour party manifesto? It was the current shadow Secretary of State, which just shows how far the Labour party has moved to the left since the May 2010 election. If there is one thing that he and his supporters behind him need to understand, it is that general elections are won from the centre ground, not from the extremes of either left or right.

In the time remaining to me, I shall mention two key areas and bust some myths. The first area is competition and choice, which have always been part of the national health service. The original 1948 NHS leaflet stated that patients must choose their own GP. We should be discussing the benefits that choice can bring to patients, and how we can facilitate innovation and better patient outcomes. The evidence is clear: competition based on choice and quality, not on price for elective care, drives and improves not just efficiency and shorter hospital stays, but better management and, most importantly, patient care and outcomes.

The second area, which both the shadow Secretary of State and the Secretary of State mentioned, is integration, and it is absolutely key if we are to improve patient pathways and outcomes. Care is currently fragmented, and the state monopoly is under little pressure to deliver integrated care or new models of care. The national health service to date has been poor at integrating services, and the Secretary of State and his team need to be careful to ensure that the health service understands that the merger of organisations is not the same as integration, which is about integrating care pathways, and must not be used as an excuse to protect poor providers and weak management, or to block clinically led reconfiguration.

The successful integration of patient care, and in particular of chronic disease management, will, however, dramatically improve quality and outcomes. The Secretary of State also needs to address the issue of funding flows, moving them away from episodic care to year-of-care funding to enable integration to take place properly.

In conclusion, the national health service deserves our wholehearted support, but if it is to survive as a taxpayer-funded service free at the point of use, it must evolve and reform.

[Rosie Cooper (West Lancashire) (Lab)]

I congratulate my right hon. Friend the Member for Leigh (Andy Burnham) on his persistence with these Opposition day health debates. I am sure that he shares with me a deep-seated hope that the Secretary of State will soon see the light, publish the risk register and drop the Bill.

“The public can be forgiven for being bewildered by the latest round of plans to reform the National Health Service in England. The set of proposals is large, many are highly technical, why they are needed is not clear and the protests from key respected groups are loud.”

Those are the words of Jennifer Dixon of the Nuffield Trust in her most recent paper for The Political Quarterly, and I am sure that many in the Chamber will agree wholeheartedly with them; I certainly do. They are an incisive analysis of the state of play with regard to the Health and Social Care Bill and the planned NHS reforms. The short opening paragraph of the paper begins to explain why it is essential that the Department of Health publish the transition risk register, as ordered by the Information Commissioner.

As each day passes, there are ever more reasons why the British people need to be able to see for themselves the risks associated with the Bill and how the Department of Health proposes to mitigate them. This is about a broader, more fundamental and more important issue than publication in itself. Many people are fearful about what the Secretary of State’s plans really mean for them and their families, and for the health service that so many people rely on. I cannot understand what is in the risk register that the Government are so frightened of revealing to the people who are actually paying for this.

The message of what the public think is loud and clear: they simply do not believe and do not trust the Government, the Prime Minister or the Health Secretary. A ComRes poll says that 69% of respondents do not trust the Government to get it right on health, while YouGov says that six out of 10 people think that the Prime Minister has failed to deliver.

[Gloria De Piero]

Perhaps one of the reasons why there is such a lack of trust is what is going on in our own constituencies. In my constituency of Ashfield, waiting times have gone up and the NHS walk-in centre has closed. That is the reality of what is happening on the ground.

[Rosie Cooper]

I am dreadfully sorry that my hon. Friend is able to say such a sad thing, and Government Members do not hear any of it.

People have listened to what the Secretary of State has said and they are telling the Government clearly that they think that their proposals are complex, muddled and expensive, and that they do not trust what they have been told. I wonder why they have such difficulty in accepting the Secretary of State’s words of reassurance, but perhaps there is a clue in the track record of the Government, the Prime Minister and the Secretary of State in making promises. They promised no top-down reorganisation and then did it anyway with no mandate, no mention of huge reform having been made by the coalition Government. We have a so-called Government of openness and transparency who will not publish the transition risk register despite being ordered to do so by the Information Commissioner. So much for “No decision about me without me”; these decisions seem to be about us without us—all of us. The Government say that there will be no cuts to front-line services, whereas we have just heard about cuts to front-line staff and the down-banding of members of staff. They say that waiting times will not increase, but they have increased. Yet the Government still press on.

This reminds me of a story about a man who is stranded as flood waters rise. The water is getting higher and higher, and he prays to God to save him. He refuses help from a neighbour in a rowing boat, from someone in a speedboat, and even from someone in a helicopter, saying, “No, thank you—I have faith that God will save me.” Of course, he is washed away. Standing before his maker, he says, “I had faith that you would rescue me,” and is told, “I sent you two boats and a helicopter. What more did you want?” In this case, the Secretary of State has been sent the Royal College of General Practitioners, the Royal College of Midwives, the Royal College of Nursing, the British Medical Association, the physiotherapists and other professions allied to medicine—need I go on? Those are just a few of the signals to the Secretary of State that he has got it wrong.

If the Secretary of State continues with the Bill, before long he will be meeting the Prime Minister on the day of a reshuffle, but by that time the people in the NHS will have suffered hugely for these silly mistakes. The risk register is so potentially damaging that the Department of Health refuses to publish it, thereby spending taxpayers’ money on preventing taxpayers from knowing what it is doing with their money. That is absolutely ridiculous. It is imperative that the transition risk register be published.

The Government have been the architect of their own problems by breaking their promises, failing to demonstrate the need for such extensive reform of the NHS, and not listening to the people who use the service and the people on the front line who deliver the service—the very patients and staff whom the Government keep telling us that we forget about, and who are at the core of this matter.

When the Secretary of State assumed responsibility for the NHS there had been a sustained period of increased funding, lower waiting times had been achieved, the quality of care had improved significantly, and there were some of the highest levels of public satisfaction in the history of the NHS. In a little under two years, that situation is being reversed. I would put it to the Secretary of State, if he were here, that surely even he can see that now is the time to be honest and up front with the people of this country. It is time for the Government to take another deep breath, publish the risk register and put their trust in the people.