Care Bill [Lords]

Debate between Heidi Alexander and Jeremy Lefroy

Tuesday 11th March 2014 Commons Chamber

[Jeremy Lefroy]

In our case, we had a public meeting where about 400 people were outside trying to get into a meeting of 1,500 people.

[Heidi Alexander]

The experiences in Stafford and in Lewisham have probably been very similar. Multiple public meetings were run in a chaotic and haphazard fashion, and if I had not intervened in this particular meeting in Catford to try to calm the audience down and enable them to ask questions, I am not sure whether it would have been able to proceed.

We have heard about the quality of the consultation in Lewisham. The fact that the online consultation did not include a direct question about the closure of accident and emergency services and maternity services at Lewisham hospital beggars belief. My constituents were asked whether they agreed that acute services should be consolidated on four instead of five sites in south-east London. It is no wonder they came to me asking, “Where is the question about Lewisham A and E?” As my right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) said, the consultation contained no direct question about the sale of two thirds of the land. There was a question about the sale of land at the hospitals that were placed in administration, but there was no such question about Lewisham hospital. We must be under no illusion that if clause 119 had been on the statute book at the time the administrator made recommendations about Lewisham hospital, its full A and E, its full maternity service and its excellent paediatric unit would now be closing.

Many people have said to me that I am somehow against change in the NHS, but nothing could be further from the truth. We have already heard about the successful changes to stroke care in the capital. They did not come about overnight, or over 45 nights or 75 nights; they came about as a result of clear and calm consultation and communication with residents. They came about as a result of clinicians, not accountants, being in the driving seat. The public rightly care about their NHS and the local health services to which they have access. As I said on Second Reading, that is because people experience the best and the worst moment of their lives in our hospitals. It is right that they have their say in a process that is fit for purpose, but an extended and augmented TSA process, which the Government propose through clause 119, is not the right way to take decisions of such significance and which excite such public interest.

The Government have tried to spin clause 119 as some sort of clarification of existing policy. That is nonsense. It is a direct result of the Lewisham hospital case that was heard in the courts. We know that the previous Government produced guidance that said that the TSA regime should not be used as a back-door approach to reconfiguration. This is a fundamental change in policy. It removes the legal protection that currently exists for successful hospitals located adjacent to failing hospitals that have been placed into administration.

The Government also claim that such a process would be used only in exceptional circumstances, but how do we know how often it will be used in future? I press the Minister to respond to the point made by the shadow Health Secretary about whether he has had any discussions with his officials about other hospital trusts being placed into administration and about applying the unsustainable provider regime elsewhere.

Christmas Adjournment

Debate between Heidi Alexander and Jeremy Lefroy

Thursday 19th December 2013 Commons Chamber

[Jeremy Lefroy]

I am most grateful to my hon. Friend. We all share his sentiments, and our thoughts and prayers are with 3 Mercian and the other regiments and units serving in Afghanistan, including the tactical supply wing of the RAF, which is also based in my constituency.

I want to dwell for a moment on the report of the trust special administrators on the Mid Staffordshire NHS Foundation Trust, which came out yesterday. There are a number of good things in the report. Within the remit they were given—I think that that will need to be considered by this House because it needs quite a lot of change—they have done some good things. Those include recommending a merger of the University Hospital of North Staffordshire with the Stafford element of the Mid Staffordshire NHS Foundation Trust. They have also recommended that Cannock hospital goes to the Royal Wolverhampton Hospitals Trust. For Stafford, that is a good thing. We will become part of a large university hospital trust and be able to share services across a wider area. In addition to the excellent staff that we already have, we will be able to attract high-quality staff from across the country.

We are also retaining our accident and emergency department. At the moment, it is open for only 14 hours a day, but that is better than the nothing that was proposed earlier this year. However, I still believe that we need a 24/7 A and E department. Perhaps our use of the current department will reveal the need for an increase in hours, but at least we have retained the department and we can build on it in the future.

We have also retained acute services. At the start of the year, it was thought that Stafford would become a community hospital—not an acute hospital. I am glad to say that those fears have not been realised. The recommendations also include, for the first time, provision for a frail elderly unit, which is incredibly important as it builds on the work of the Cure the NHS group, founded by Julie Bailey, and the Francis report that came out as a result of that. I hope it will be a beacon for the care of elderly people across the country. It will show that in Stafford we can do such things to the highest standards. We will also have a large range of other services. The trust special administrators have said that 90% or more of current attendees at Stafford and Cannock will be able to continue to use those services. Cannock hospital has also been retained. In fact, more work will go on at Cannock, 60% of which has been unused for many years. I welcome that, as does my hon. Friend the Member for Cannock Chase (Mr Burley).

A lot of good things are going on in Stafford, and I welcome that. However—and this is a big however—there are things that I oppose and will continue to oppose, the most important of which revolves around paediatric services. Yes, there will be a paediatric assessment unit, but it will be linked with A and E and, therefore, open for only 14 hours a day. That means that children who get sick overnight will have to travel 20 or more miles to the nearest unit. That is not acceptable for my constituents or indeed for the constituents of surrounding constituencies. In addition, it will not be a consultant-led paediatric unit, and it will have no in-patient beds for children. That is a problem for children who turn up at night with serious illnesses, or perhaps a very high temperature. Their parents will be extremely worried and will want their child to be taken in and observed for perhaps a day or two before they return home. If the child’s condition is more serious, they will want them sent to a major unit such as in Stoke or Birmingham.

Provision for those who need in-patient child and adolescent mental health services in Staffordshire—indeed, throughout the country—is not nearly sufficient. Our general hospital in Stafford takes in a number of such young people, some of whom are suicidal. It should not have to do that, but it takes them in because there is nowhere else for them to go. I do not believe that the administrators’ proposals take that into account, although the issue was raised in the consultation.

The original proposals said that no women could give birth in Stafford, unless they were having a home delivery, but I am glad to say that the administrators have listened to the people and have recommended that we should have a midwife-led maternity unit. However, that is still not enough, because we need a consultant-led unit. With our growing town, the Army coming in and the number of houses being built, we will get up to the 2,500 to 3,000 births a year in the coming year, and that will justify such provision, networked together with the University Hospital of North Staffordshire. I will continue to make that case to Monitor and to the Secretary of State.

The question of the critical care unit was also raised. I am glad to say that the administrators accepted the need for a level 3 critical care unit at Stafford, but we need to look at the details in the report, because I want to ensure that the unit is robust and will be maintained and sustained. There are question marks over that, but as I am not an expert on the matter, I will have to wait for the consultants and clinicians in my constituency to get back to me with the details.

I pay tribute to the community in Stafford, Cannock and the surrounding areas who have shown such resilience. When downgrading the hospital to a community hospital was first proposed, they showed tremendous support for its work. As is well known, the hospital has been greatly troubled over the years, but it has come on tremendously in the past two or three years. Only two weeks ago Stafford had the best hospital standardised mortality ratio in the whole of the west midlands. That is a far cry from where it was four or five years ago. I pay great tribute to the community for coming together in marches of up to 50,000 people.

[Heidi Alexander (Lewisham East) (Lab)]

Many of the things that the hon. Gentleman describes are of course familiar to me, given that Lewisham also experienced the first ever use of the trust special administration process. Earlier in his remarks, he referred to the remit that the TSA had been given in Staffordshire. He said that that remit may have to be looked at in future. What are his thoughts on clause 118 of the Care Bill, which looks to extend and augment the powers of trust special administrators in the future?

[Jeremy Lefroy]

I am pretty sceptical about it. When that Bill comes back to the House, I will make some remarks on it if I am given the opportunity to do so. In fact, I would take my remarks much wider than that. I have written a paper to Monitor on all the faults of the TSA process that I have experienced at first hand. One in particular is that when an administrator is installed, the trust loses its board. The chief executives and the executives lose their support. I am not saying that the TSAs do not try to do some work, but their focus is on the financial side and the future. Inevitably, they are not so focused on running the hospital now, and that is a serious omission. There are many other serious points that I want to make, and I would welcome a debate on the whole matter.

We have had two experiences of TSAs. One was under the National Health Service Act 2006, which affected Lewisham, and the other was under the Health and Social Care Act 2012, which affected Stafford. We should look at the matter carefully, because there will be others in the future. Indeed, we need to assess whether the whole process of a company-like administration is the best way to cope with a failure in the hospital context, and I am pretty sceptical about that. Perhaps we can use our mutual experience to consider that.

I want to return to the enormous support of the community. It was exemplified in two marches in April and then again in September. There were also rallies, at which I had the honour to speak. Indeed, at a children’s disco in Stafford, which was organised by the Support Stafford Hospital group, more than 200 children and their families came together to show their support for the paediatric services offered by the hospital. We have come a long way since the beginning of the year with our support for the hospital and, more importantly, for the services for my constituents, but we have much more to do.

I want to touch on a number of other areas that affect my constituents. We have already heard today at some length about High Speed 2. I will not go into too many details other than to say that the railway line runs straight through four villages in my constituency. I understand the national need for increased capacity, but I do not think that this is the right solution. I wish that the approach to HS2 and rail capacity had been similar to that of aviation. Instead, what we seem to do with railway capacity is to come up with a solution and then look around for problems for it to address. With aviation, we are doing it the other way around, although I know that the hon. Member for Hayes and Harlington (John McDonnell) and others might not necessarily agree with some of the solutions. On rail, we need to look again at whether this line drawn on a map is the right line.

We also need to consider mitigation measures and compensation. It comes back to what I have said time and time again to my right hon. Friend the Secretary of State for Transport: we need to be reasonable and fair in our compensation, as the French are with such schemes, not miserly. I am afraid that I have seen instances of my constituents who were dealt with in a less than generous manner when their whole life was affected. We are talking about a railway whose construction is not due to start in my constituency until 2026. That means 30 years of blight and waiting for this thing to happen, if it ever does.

I also want to mention Staffordshire university. It has an important campus in my town, but it is considering moving away perhaps partially and perhaps fully. That would be a major error. The university is very good for Stafford and Stafford is very good for the university. When it was a polytechnic in the 1960s, it was one of the first in the country to introduce a course in computing, through English Electric. It has produced many fine graduates over the years. I will continue to support tertiary education in Stafford with all my might and I hope that it will continue to be provided by Staffordshire university.

Let me also raise the question of a western access road in Stafford. I was talking to somebody from a neighbouring village last night who said that they never come to Stafford because of the congestion and traffic. That is partly because of the popularity of the town, but it also shows that the road network—the town has two rivers, a canal and two main line railways, the one from Birmingham and the west coast main line, that merge—has an infrastructure problem. The western access road, for which we need £25 million, would help in some way to alleviate the congestion and make Stafford an even more attractive place for people to come to.

Many good things have happened this year in Stafford. The unemployment rate for jobseekers has fallen to 2.2% from about 3.6% three years ago. The number of apprentices has more than doubled in the past two years. Two new business parks are being built. I apologise to my constituents for the problems with traffic congestion that those roadworks are causing, but the parks will result in many hundreds if not thousands of highly skilled jobs being created for the area. We had the great news earlier this year that two more signal regiments will come to Stafford from 2015, with 1,000 servicemen and women and their families. Stafford is a very loyal town that is tremendously supportive of the armed forces and we will welcome them with open arms.

We also have a town centre development that will, I hope, start fairly soon. A brand new Marks and Spencer, a brand new Debenhams and many other shops will be coming to the town centre. We are also seeing housing development. I am not someone who believes that we should not build many more houses—we need more houses for our young people and families. However, they need to be the right kind of houses. We need to ensure that they are fit for older people, who might want smaller properties, less of a garden or a bungalow that it is all on one level. We need to build houses that enable families to have a side room or side apartment to care for relatives. We need to be imaginative.