Organ Donation

Glyn Davies Excerpts

Wednesday 9th November 2011 Westminster Hall

[Glyn Davies (Montgomeryshire) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Davies. I particularly want to thank my hon. Friend the Member for Wolverhampton South West (Paul Uppal) for raising an issue that is hugely important to many people. Increasing the number of organs available has become a passion of mine. The comments of the hon. Member for Newport West (Paul Flynn) made an impact on me. We all want to see an increase in the number of organs available for donation. We need to look at the evidence available and decide the best route to go down to achieve the increase. Over the years that I have been involved, one of the main issues looked at has been a change to opt out. We have to look at what happened in countries where they moved towards presumed consent from the position of informed consent.

As well as looking at international examples, it is important to look at the evidence of the taskforce set up by the previous Government in 2008. I have looked at the matter in detail. Spain is often quoted by people who favour presumed consent; it was their exemplar, until perhaps 12 months ago, when it became Belgium. Presumed consent was introduced in Spain in 1979, but nothing happened for 10 years. In 1989, a new law was passed in Spain, which introduced a comprehensive transplant co-ordination system throughout the country to raise awareness and understanding. That is what made the difference. From that date on, there was an increase such that Spain is now one of the best examples in the world for organ transplant.

[Alun Cairns (Vale of Glamorgan) (Con)]

I pay tribute to my hon. Friend for the work that he is doing in this area. Is he aware of the independent analysis of the model in Spain by our former colleagues in the Welsh Assembly? When they went to visit Spain, they were in favour of presumed consent at the outset, but they changed their minds by the time they came back. There is extremely effective evidence that can be contributed to the debate.

[Glyn Davies]

I thank my hon. Friend for that intervention. That is a point that I want to make. Nearly everybody wants to increase the number of organs available, but we must be careful to look at the evidence to ensure we do not introduce changes that will hinder that. I have read the taskforce’s careful evidence. The Prime Minister of the day said that he wanted to move down this road. Members of the taskforce tended to be supportive of that move at the start, but by the end they unanimously said it was dangerous to move in that direction and that there was a real danger of it reducing the number of organs available.

We must be incredibly careful. I welcome this debate—and indeed the debate taking place in Wales, which started yesterday—because it raises awareness of the issue. Family members will know what the wishes of the deceased were and they will be able to give permission without there being a statutory register. There is no such register in Spain—or at least hardly anyone joins it. The family must know. As long as we raise awareness and understanding of what is involved and have people who can speak to those in a difficult position—because someone has just died, or a machine is about to be turned off—in an understanding way, it will encourage the nation. If we go down that road, I think we will produce the extra organs that we need.

Southern Cross Care Homes

Glyn Davies Excerpts

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

I note that the hon. Gentleman seems to be a bit like a stuck record, repeating the point that he made last time. The reality is that the Government are taking the necessary steps, are exercising their responsibilities correctly and are making others responsible and accountable for discharging their legal responsibilities as well. What the hon. Gentleman left out from his question was any suggestion of what specific powers his Government put in place that would have allowed us to deal with this issue. There are no such powers.

[Glyn Davies (Montgomeryshire) (Con)]

Does the Minister feel that there would be value in considering the financial regulation of care homes and the care home sector so that this sort of situation does not occur again in future?

[Paul Burstow]

My hon. Friend is absolutely right. I hope that we can learn the necessary lessons about what regulation should exist at the national level and what powers are in place for regulators to intervene in these circumstances. The reality is that the regulatory powers that this Government inherited from the previous Government are next to non-existent. That is one reason why hon. Members have been able to drag Ministers to account, as has been said, before the House. What we have said as a result is that as we work to produce the White Paper, we will address these issues to make sure that we have a system in place.

Hospital Services (Shropshire)

Glyn Davies Excerpts

Wednesday 9th February 2011 Westminster Hall

[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

This important debate is on the reconfiguration of hospital services in Shropshire, and in almost six years as Member of Parliament for Shrewsbury, I have never received so many letters, e-mails and telephone calls from concerned constituents over a single issue. Many of those calls have been emotional, and even though the consultation process is still ongoing, I feel it is my duty to use the platform that I have in the House of Commons to highlight a few of the concerns to the Minister.

Part of the reconfiguration proposals would involve maternity and paediatric services moving from Shrewsbury to Telford. I want the Minister to imagine the geography of Shropshire and mid-Wales. The Royal Shrewsbury hospital covers not just the whole of Shropshire, but the whole of mid-Wales—a vast expanse just across the border. I am pleased that my hon. Friend the Member for Montgomeryshire (Glyn Davies) is present in the debate today.

Picture the wheel of a bicycle, and at the centre, the spokes coming into the middle. That is where Shrewsbury is in the area. Now imagine moving paediatric and maternity services right to the edge of the wheel. How would that wheel function? Telford is at the edge of the area, on the extreme eastern border close to Staffordshire. What is the sense in moving services so far away from the rest of central Shropshire and mid-Wales?

I am so passionate about this issue that I raised it during Prime Minister’s Question Time last week. The Prime Minister referred to the importance of public engagement and consultation, which he said was a fundamental aspect of any reconfiguration proposals. Therefore, I have asked the chief executive and the primary care trust for a public meeting to be held in Shrewsbury on 11 February at the football stadium in our town. I believe that hundreds and hundreds of people will attend. I intend to make a transcript of that meeting and of all questions put to the PCT and the chief executive, and I will be sending that transcript to the Minister.

[Glyn Davies (Montgomeryshire) (Con)]

My hon. Friend knows that I also have a huge interest in this issue as I represent Montgomeryshire over the border. Does he agree that the meetings that will be held in Montgomeryshire on 18, 23 and 24 February are of equal importance, and that it is crucial for the health board and PCTs to take notice of them? We also depend on the services in Shropshire.

[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.

--- Later in debate ---

[Daniel Kawczynski]

I concur with my hon. Friend and with the point that he makes in his usual eloquent way. I have been told by the chief executive, and others, that if we do not go for the proposals, we will potentially put our foundation trust status at risk. If we put that at risk, there is the possibility of losing services—and the management of those services—out of the county. Again, I speak without medical experience, but I do not understand how we could enter into a consultation process but be told that if we do not go for the proposals, services will be lost from Shropshire.

I cannot envisage a time when we have no maternity or paediatric services in the whole of Shropshire. That is unthinkable to me, so I do not understand the logic of the trust. It is saying, “Take it or leave it, but if you leave it, that’s it. We won’t get our foundation trust status and you’ll lose your services.” That position needs to be clarified because many people see it as a gun being pointed at their heads and are therefore frightened to challenge the proposals.

[Glyn Davies]

I am grateful to my hon. Friend for his tolerance in allowing me to make a second intervention. The point that he has just raised is key. Everyone, including, I am sure, my hon. Friend, recognises that there must be a reconfiguration of services. The points that have been made are crucial. However, that does not necessarily mean that the reconfiguration of services that is before us has to be the case. The argument is not about whether there should be a reconfiguration of services, but about how that should take place. In the interests of the people of Montgomeryshire, I think that services are best placed not where it is convenient for a balance in Shropshire, but where they are accessible to the people who will use them.

[Daniel Kawczynski]

I completely concur with my hon. Friend on that point.

I shall briefly relate a couple of specific cases. I have been inundated with hundreds of letters on this issue. My own daughter was born at the Royal Shrewsbury hospital, and it was the proudest day of my life when my daughter was born within the community that I represent. She is not just a Salopian; she is a Shrewsbury girl and she will have that with her for the rest of her life. For us in Shrewsbury, being a Salopian is important, but being a Shrewsbury girl? Now that is something special. I feel so passionately about that.

One constituent’s family is directly affected by the proposals, as her three-year-old son needs 24-hour open access to the children’s ward at the Royal Shrewsbury hospital because he suffers from severe haemophilia. He needs treatment to be administered every other day and any additional treatment on demand if he should cut himself. I was told that it was vital for my constituent’s son to be admitted immediately to the children’s ward via A and E and not to be sent down the motorway to the Princess Royal hospital. How can that mother of a son with haemophilia empower herself to make her views known if the overview and scrutiny committee is not minded to refer this issue to the Minister?

The issue has also been raised with me by the father of a child who was previously a cancer patient treated at the Royal Shrewsbury hospital. He talks about the appeal in 2003 for a designated children’s cancer unit at the Shrewsbury hospital. It raised £500,000 and the unit was completed in 2005. My constituent told me that

“many people across Shropshire and Mid Wales donated or gave up many hours to fundraise, only to now find that the purpose built unit will…stand unused as Children’s services are being moved to Telford with no provision for this desperately needed unit which provides an essential service to families facing unimaginable turmoil whose children are being treated for cancer.”

I have been told of the severe disruption and anguish that will result from the need for seriously ill patients to travel from Shrewsbury if it is left with no consultant-led surgery, which may result in a catastrophic delay in emergency treatment.

I also want to mention Joshua, a young boy in my constituency who has chronic lung disease. His mother, Hayley Corfield, wrote to me about him. He has had bronchial problems since birth and is now 14 and constantly in and out of hospital. I have been given the most extraordinary list, which I will send to the Minister, of the medications that this poor young boy is on. He lives in Shrewsbury. His mother tells me that there have been many near misses in the last few years in terms of saving his life—resuscitating him. She is desperately worried about the impact on her son and the chances of his survival if, suffering from this chronic disease, he has to travel for an extra 20 minutes to Telford. I am therefore raising these issues with the Minister today.

The Minister kindly wrote to me. In his letter, he notes that I am planning to call a public meeting and encourages me

“to ensure views from that meeting are fed back to the local NHS via the consultation mechanism, so local concerns are fully taken into account.”

The next part is the bit that I am excited and happy about and grateful to him for—I know that he is one of the best Ministers we have. He says:

“The Department will be watching the outcomes from the consultation exercise with interest.”

I know that he cannot get involved at this stage, but I am extremely grateful that he has said that he will be watching with interest the outcome of that consultation process.

I have today written to all the general practitioners who practise in Shrewsbury and Atcham. Again, the Prime Minister stated at Prime Minister’s questions, and it was reconfirmed to me by my right hon. Friend the Secretary of State for Health, that the views of local general practitioners would have to be taken into account before any reconfiguration process could occur. I wanted an independent assessment of their views, rather than it being handed to me by the PCT or anyone else. I have therefore written today to all the general practitioners in my constituency and I urge my hon. Friends to do likewise if they so wish. I will compile the results of the views of local general practitioners in Shrewsbury and will share their views anonymously. I will not refer to specific people, but I will share their views with the Minister.

I am extremely grateful for the 15 minutes that I have had and for the constructive way in which we have debated this issue. It is extremely emotive. I do not want to get into a Shrewsbury-Telford pillow fight. We have had enough of that over the years. I want to work constructively with my colleagues and with the trust to come up with the best possible solution for our beautiful county.

Care for the Elderly (Kent)

Glyn Davies Excerpts

Tuesday 8th February 2011 Westminster Hall

[Charlie Elphicke (Dover) (Con)]

Thank you, Mrs Brooke. I am deeply obliged to you for giving me an extra two minutes for this debate. I am delighted and proud to have secured a debate on this important issue, which matters to all residents in Kent. I shall focus on my constituents and those of my hon. Friend the Member for Dartford (Gareth Johnson).

This matter is extremely dear to the hearts of my constituents. Securing a safe, loving home is of the utmost importance for any family member hoping to make the final years of their relation, normally their parents, nice and happy. It is not always easy, and once people find a good home, they want their family member to settle there for a long time, and not have the disruption of moving from one home to another.

That was the experience I had with my father, who was in residential care for some 10 years. For the last 10 years of his life, he suffered from Alzheimer’s. He barely recognised me and could not communicate very effectively. I had to look after him and ensure that his needs were met. That experience coincided with the period between 1997 and 2002, when regulations were changed and care homes were closing all around Kent. I had to move him from home to home, trying to ensure that he had the love, care, support and, in particular, stability that older people need in residential care.

Hon. Members will recall that we lost some 2,000 care homes during that period. My father’s experience, which was by no means unique, left me with a passion for ensuring that we look after older people who should have dignity in their final years, and the stability and care that they deserve.

[Glyn Davies (Montgomeryshire) (Con)]

I thank my hon. Friend for allowing me to comment. I am clearly not from Kent, but I have a huge interest in the issue that he raises. Does he agree that providing a service for the elderly, particularly those who suffer from neurological illness, is one of the greatest challenges for the current Government over the next few years, and that over the past two decades the British Parliament simply has not met that challenge?

[Charlie Elphicke]

I strongly agree. The population is ageing, and we know that the need for care of the elderly will increase, not lessen, over time. With the triumph of longevity comes the downside that people may well require more care—respite and day care but also residential care—for longer, and that will have a cost. There will be an expense to society, but society can rise to the challenge by ensuring that services are of the standard that we would expect. My hon. Friend’s comment is particularly relevant, given the announcement that Sampson Court, the much loved care home in my town of Deal, is to be closed by Kent county council.

Sampson Court provides a range of services—palliative care, day care and respite care—and specialises in dementia and separate elderly mentally infirm care. It is extremely important to the community and loved not only by residents but by their families, all of whom have been passionate in their support for keeping that important community facility open. Despite that, Sampson Court is no longer classed as meeting care standards—hon. Members will recall that the previous Government introduced the decent homes standard—and because it does not have en-suite bathrooms and the building is costly to maintain and in need of renovation, Kent county council says that it is too expensive to make those changes and that it cannot continue to run the home.

That decision was a challenge to the community, which started a consultation. The community has worked hard and, led by Councillor Julie Rook in Deal, has made a passionate case for not closing the home—a petition with 5,000 signatures was delivered to the council—and for finding an alternative way forward. A transfer of going concern has been raised as a possibility.

The parents of my constituent, Mr Hawker, receive care at Sampson Court. He wrote to me:

“Sampson Court is in no way beyond the end of its life at 25 years old…it’s well maintained, clean and hygienic, and en-suite facilities would be actually hazardous to those who cannot even use a toilet without assistance such as my father who has dementia and is incontinent.”

Kent county council has cited European Union procurement rules as a reason for not doing a transfer of going concern. It says that it is extraordinarily costly to do such a transfer under those rules, and that, because of the complexity, the only realistic possibility is simply to close the home and sell the site, despite the potential interest of other care home operators who might like to take it on.

My constituent Gareth Fowler, whose mother has been at Sampson Court for four years, asked the council representative at a public meeting during the consultation process where the 15 EMI residents would go. The council had no answer other than “the local area”. Mr Fowler rang every EMI care home in the local area, but none had any space. If a decision is taken to close a home, there must be an alternative. There is great concern among my constituents that there is no alternative place for them to go to.

My constituents point to the Kent county council consultation, which states:

“People rightly expect more choice in their care”.

There is no doubt that its decision has left less choice, not more. I would ask the Minister to review whether Kent county council has an effective alternative plan for elderly people. Mr Fowler’s experience suggests that it does not. Sampson Court is a much-loved community resource that is fully workable. That begs the question, why can it not be retained, if not by Kent county council then by another body, to ensure that we have proper care for the elderly in Kent?

As well as criticising Kent county council, I want to be positive about it. I understand the challenge to its budget, the challenge in meeting the decent homes standard, and the challenge of the EU public procurement regime, which is expensive and, frankly, gold-plated—it ought to be minimised. Can anything be done about public procurement in this kind of case?

The other case I have been making to Kent county council is that it could transfer the home, not as a going concern in the market but to a community interest company. That is where my interest particularly lies. Allowing a community outside the regime of Government, the procurement rules and all the regulations to take it on would enable the expertise of local care home operators to be captured so that a home could continue to operate on that site in the future. I am asking for Government support and guidance on how Sampson Court might be transferred to a CIC in partnership with local care home operators.

Hon. Members will no doubt know that a CIC could provide the benefit and excellence of a care home in a local community. It would have flexibility and access to a range of financing options, and would be a solution to the decision that Kent county council has made. It would mean that local people can come together and work to secure a community takeover that would bring the community together, provide better value for money and ensure more freedom to offer extended services. We could turn a community resource that is fast disappearing into one that is expanding.

We should not lose community resources such as Sampson Court, but this debate is not just about Sampson Court or care for the elderly in Kent. I bring the matter to the Minister’s attention because I suspect that this is a wider issue across counties and the country as a whole, and that there are many similar cases involving aged buildings, the decent homes standard and EU public procurement rules. Many communities are in the same boat, so the national picture needs to be examined to ensure that there is effective transition—and enough care for the elderly across the whole of Kent.

Local GP, John Sharvill, wrote to me. He said that, without a doubt, Sampson Court

“is an excellent institution providing fantastic care...there is no other home in this area which provides the level of care that they do in the spacious, airy, surroundings they provide”.

Using the community right to challenge and the community right to buy under the Localism Bill, soon to become an Act, may provide a way forward. There is a right for voluntary and community groups, social enterprises, parish councils and local authority employees to challenge a local authority on delivery of a service by expressing an interest in running a service for which they are responsible. The local authority must consider and respond to such a challenge, which may trigger a procurement exercise for the service, in line with relevant procedure, in which the challenging organisation could bid, alongside others. Such rights are part of the Government’s aim to create a big society. The Minister of State, Department for Communities and Local Government, my right hon. Friend the Member for Tunbridge Wells (Greg Clark), is sitting next to me. He has an interest in the Localism Bill, which is currently before the House.

When listed assets—either the freehold or a long leasehold—come up for disposal, communities will be given the chance to develop a bid and raise the capital to buy the asset when it comes on the open market. However, there are issues with that, which I would like to flag up. First, the local authority does not have to seek out possible community owners, and there is no compulsion for it to do so. That means that communities may struggle if they are up against the local authority, especially as there is no independent monitor to judge a community bid against a local authority’s plans. Secondly, if a local authority wishes to proceed with a sell-off, there is no provision for a temporary stop, a break for consideration, or a certain designated time that would allow community groups time to put together and advance a bid.

John Porter of the “Bowles Lodge Stays!” campaign, run elsewhere in Kent, also flagged up those kind of problems. He pointed out the difficulties he had over the care of his mother, Vera Woylor, who is an 89-year-old resident of the care home and does not want to move. On her behalf, he has made a strong case to Kent county council, which does not think that the right process has been followed. The ideal would be to enable continuity of care. Such issues need to be addressed, and community interest companies should be encouraged.

Ministers may consider the matter to be simply a local issue, but given the terms of the Localism Bill it is a wider national issue of how we can encourage takeovers by community interest companies and what we can do to simplify EU public procurement regulations to ensure that homes, such as Sampson Court and others across Kent, give continuity of care and love under new ownership if they cannot remain under that of Kent county council.

Maternity Services

Glyn Davies Excerpts

Tuesday 1st February 2011 Westminster Hall

[Jim Dobbin (in the Chair)]

I call the shadow Minister.

[Glyn Davies (Montgomeryshire) (Con)]

May I speak?

[Jim Dobbin (in the Chair)]

I was waiting for you to rise.

[Glyn Davies (Montgomeryshire) (Con)]

Thank you, Mr Dobbin. Clearly there are one or two procedures of the House that I am not yet wholly familiar with, and one of them is rising to speak in Westminster Hall. I will not forget that again, because I would have been quite miffed not to have the opportunity to speak in the debate. I am very grateful and shall always remember with fond memories my experience of speaking while you are in the Chair.

[Jim Dobbin (in the Chair)]

Make sure you put that in your memoirs.

[Glyn Davies]

I congratulate the hon. Member for Birmingham, Edgbaston (Ms Stuart) on the timely raising of a hugely important issue. She asked important questions. I am looking forward to hearing the Minister’s response as, I am sure, are other hon. Members.

I can reassure the hon. Lady on one point, because my wife and I had four children—well, my wife had them—and they were all born at home. That was because of the added reassurance it gave my wife. Clearly, had there been any difficulties there would have been a transfer to hospital. The births were not at our home, but our in-laws’ home, which was very near the hospital—we wanted some reassurance.

The context in which I want to speak is cross-border services. It is relevant for several services, including maternity. My constituency is in Wales and health is a devolved issue. The commissioning of maternity services is clearly a matter for the Assembly Government, but because there is no district general hospital in my constituency or, indeed, anywhere in Powys, consultancy-led maternity service provision is in Shropshire. I therefore have a particular interest in the changes taking place over the border there.

The debate is timely because of the consultation document, “Keeping it in the County”, which my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski) mentioned. The local trusts are having to respond to pressure—not just financial pressure, although that is clearly an issue. There are two district general hospitals in Shropshire and the population is not really sufficient, given all the other considerations, to support them both. In addition there are the implications of the working time directive, and the specialisation that now exists among consultants. There is the added difficulty of accessing consultants from overseas, and there is greater expense in delivering specialist services at two hospitals. We have almost reached the stage of it being difficult to reassure everyone that services at these hospitals are clinically safe.

I support the principle of reconfiguration, the three most important aspects of which are consultant maternity and obstetric services, paediatric services, and trauma A and E. Those cover three highly contentious and emotional matters, and people have strong opinions on them. Today, I shall refer to consultancy-led maternity services.

My concern is that the proposals were prepared without sufficient consideration for mid-Wales. They were prepared in the context of Shropshire, and that is a huge problem. I was a member of the National Assembly for eight years. I accept that Wales is devolved, and I am most supportive of a strong and effective Assembly, but we do not want a barrier growing between Wales and England, rather like a Berlin wall along the line of Offa’s dyke. When it comes to specialist services, we remain dependent on England, particularly for consultancy-led maternity services.

The proposals suggest that consultant obstetric services will be moved from the Royal Shrewsbury hospital to the Princess Royal hospital in Telford. As my hon. Friend, the assiduous and hard-working Member for Shrewsbury and Atcham, pointed out, that is causing huge concern—and not only in Shropshire but in mid-Wales. There will be three public meetings over the next three weeks. I expect hundreds to come along, and the main issue will be the provision of maternity services.

The Royal Shrewsbury hospital is just over the border from mid-Wales. All the traditional pathways from there have been to the Royal Shrewsbury. We are used to it, and it is relatively close. Nevertheless, mothers from many parts of my constituency have to travel for an hour to get to the Shrewsbury hospital, but if consultant obstetric services are moved from Shrewsbury to Telford, we are talking about another half an hour. That is causing massive concern.

I support the principle of reconfiguring the two hospitals in Shropshire. The general principle is that instead of having two district general hospitals struggling to survive in the current environment, we have one hospital that is in effect on two sites. That probably is sensible, and I would support it. However, I want the proposals to take account of the whole catchment area of the Shropshire hospitals. Devolution should not rule out mid-Wales from those discussions, as it depends on hospital services in Shropshire. That principle is particularly important to my constituency.

I shall express my view at the public meetings. I want the proposals to be changed. In a sense, it is selfish to argue the case for our constituencies, but we inevitably do so. I do not want services to be moved to Telford. If we were satisfied that that was the only answer, we would reluctantly accept it. As it is, all my constituents will rise up and say that they are not satisfied. They believe that the decision is based on convenience and political balance in order to attract support, and that this is not being done in the best interests of all who live in the catchment area of those hospitals.