Hospitals (Sussex)

Debate between Henry Smith and Stephen Lloyd

Wednesday 20th June 2012 Westminster Hall

[Stephen Lloyd (Eastbourne) (LD)]

It is an honour to serve under your chairmanship, Mrs Brooke.

I am grateful that Mr Speaker has given me an opportunity to address an important local issue—the proposed reconfiguration of my local Sussex NHS trust, the East Sussex Hospitals NHS Trust. A number of reconfigurations have already taken place in Sussex, such as the transfer in March of in-patient elderly care and orthopaedics in the Western Sussex Hospitals NHS Trust from Southlands hospital to Worthing hospital. It appears that the latest direction of travel for Southlands is to become a day surgery and out-patients-only hospital, with which I expect few local residents would agree.

Let me give the Minister the details of the proposed changes to my local trust and hospital, Eastbourne district general hospital. Four or five years ago, the trust board wished to downgrade maternity at the DGH while maintaining consultant-led maternity at our sister hospital in the trust, Conquest hospital in Hastings. There was a substantial campaign against the proposals in which all parties were involved, and eventually the matter was referred to the Independent Reconfiguration Panel for consideration. It found against the proposals, and the trust-proposed strategy was sent to the then Secretary of State for a decision. I am glad to say that he backed the IRP and our campaign to retain consultant-led maternity on both sites.

As I am sure the Minister is aware, there was a number of reasons why the IRP found against the trust, but essentially the main reason was the poor road link between Hastings and Eastbourne, which would have meant a blue-light ambulance potentially taking upwards of 50 minutes to travel from hospital to hospital. From a patient safety perspective—for example, for a mother facing a complicated birth—that was considered far too long. Hon. Members can imagine my surprise to find out a few weeks ago that the new trust board is recommending a similar change—to be precise, that there should be a consultant-led maternity unit on one site and a midwifery-led unit on the other site. For the record, the road links between the DGH and the Conquest are even worse than they were five years ago, when the IRP found in our favour.

[Henry Smith (Crawley) (Con)]

I congratulate the hon. Gentleman on securing this debate. The story elsewhere in Sussex has been similar. A decade ago, we lost maternity services from Crawley hospital, which was a very retrograde step. Mothers now have to travel long distances and a difficult journey to East Surrey hospital for maternity services. The proximity argument is important.

[Stephen Lloyd]

I thank the hon. Gentleman for that important intervention, not least because he demonstrates that if the proposed downgrades go through, the backlog will be even worse. Patients coming from his constituency would have an even longer wait, which an expectant mum with a complicated birth cannot afford.

Along with maternity, the proposed clinical changes recommend significant further reductions to trauma and orthopaedics, general surgery, stroke, emergency care, acute medicine, cardiology, paediatrics and child health provision. I am no medical expert, but even I can see that if some of the proposals are carried through, they will lead to a substantial downgrade of core services at Eastbourne district general hospital. We are talking about a possible downgrading of a much loved hospital in one of the fastest growing towns in the south-east, where the fastest growing age group is the 25 to 45s. I am simply not prepared to stand idly by and allow that to happen. The people of Eastbourne and the surrounding area are not prepared to do so, and none of the local political parties is prepared to accept the proposals.

On that note, I am grateful to the Under-Secretary of State for Transport, my hon. Friend the Member for Lewes (Norman Baker), who is here supporting me in this debate, as he has done throughout the past few years. He was very heavily involved five years ago, when we won the last campaign. I also acknowledge the support I have received from the Minister of State, Department of Energy and Climate Change, the hon. Member for Wealden (Charles Hendry), the hon. Member for Hastings and Rye (Amber Rudd) and the Minister of State, Department of Energy and Climate Change, the hon. Member for Bexhill and Battle (Gregory Barker). They send their apologies for not being here, but they are very supportive of what we are trying to achieve. The local business community and the voluntary sector are also not prepared to stand by while our hospital’s core services face such a proposed downgrade. We will all fight the proposals vigorously and tenaciously. I cannot emphasise that strongly enough to the Minister.

Why are we so determined to fight? Let me flesh out just a little of what we believe the consequences will be if the proposed clinical strategy goes ahead. The first issue is travel distance. The travel time between Conquest and the DGH is 50 minutes. Even when the planned Bexhill-Hastings bypass is built, in however many years’ time, that journey time will be reduced by only five-and-a-half minutes. That is still way outside the guidance from the Royal College of Midwives on mothers giving birth safely. The IRP and the Secretary of State agreed with us on that five years or so ago.

Secondly, although I wholly accept that very specialised procedures—for instance, children’s cardiac surgery or even specialist oncology and cancer—are better in the fewer, larger specialist expert centres, the vast majority of Sussex patients also need good-quality local care for simple conditions. Why would the Department of Health encourage care closer to home and then sanction the massive movement of patients, which would be an inevitable consequence of some of the proposed changes?

Thirdly, there will continue to be two hospitals admitting medical emergencies, as there are too many patients to move them all into one giant hospital. The reality is that it is often difficult to make a diagnosis for elderly people, but the proposals mean that one unit will have a surgeon on call and one will not. An elderly person admitted to a hospital with no surgeon who proves to have a burst appendix or to be bleeding internally will have to travel from the DGH to Conquest. That simply cannot be safe.

Fourthly, both hospitals fix fractured bones, but under the proposed strategy, if someone has a fracture, they will have to travel. The number of elderly and frail patients with hip fractures having to travel will increase exponentially. It will take longer for them to get an operation, and the inherent delay will lead to worse outcomes. In addition, there is likely to be a longer waiting period to sort out social services, and the individual patient will have to be sent home from a greater distance. Surely that cannot be better for the patient. In fact, pretty much anyone with a broken arm, leg or hip that needs fixing will have to travel further. The service will not be better quality, Minister; it will just be slower.

Let us take a look at the nearby trusts that will, apparently, take up the slack. This is patently absurd. Brighton more often than not has huge waits, and Pembury is full, so that is no answer. In stroke care, elderly patients will be moved, making it doubly hard for their similarly-aged husbands and wives to visit. Is that good practice for the patient? I do not think so. There is more, but I am that sure the Minister gets my drift. If he does not, let me draw his attention to the contents of a very important letter that was leaked to me a couple of weeks ago—I am happy to share the contents of the letter with him afterwards.

The letter was sent to the trust board from the consultant advisory committee that represents the most senior clinicians at Eastbourne district general hospital, following a meeting that 63 consultants attended. I quote:

“The main body of Consultant Opinion expressed little or no confidence in significant elements of the strategy… Concerns repeatedly expressed (by the Consultants) were that proposals would not advance the desire for improved access and quality of care for patients in East Sussex”.

These are direct quotes. The letter continues:

“There was frustration that clinical input from the majority of CAC members into the strategy has not been taken into account. Furthermore, concern was expressed that although Management has described the strategy as clinically led, this has been by a few invited individuals and the majority Consultant opinion expressing concerns regarding many aspects of the strategy has not been adequately expressed… the clinical strategy as explained and understood by the CAC does not deliver clear benefits to patients and therefore cannot be supported in its current form”.

The CAC letter further states:

“our local population rightly expects key services should be maintained at both sites and that these include stroke care, orthopaedics and trauma, general surgery and other core services. The strong recommendation of the CAC was that both sites should be developed to improve quality of care, training issues and access for local patients”.

I shall conclude my speech, because I am very keen to listen to the Minister’s response. Time precludes me from going into detail about the cross-party “Save the DGH” campaign group, which has been working together for years. It succeeded five years ago and has come back together stronger than ever. Time precludes me from talking about the fantastic work that has been done by our chair, Liz Waike, the strong determination in my constituency to protect core services at the DGH, and the important support provided by our local paper, the Eastbourne Herald.

I also do not have enough time to talk about the details of the utter financial shambles. The trust has been under successive managements since it was merged with the Conquest more than 10 years ago. I am well aware that, like me, the Minister has a business background. The financial inefficiency of the trust for many years has been mind-blowing. I would be happy to give the right hon. Gentleman more details at another time.

Time precludes me from giving details of the severe morale challenges felt by community nurses, who face reductions while at the same time being told ad nauseum that they must keep people in the community, so as not to take up expensive hospital beds. Time precludes me from telling the Minister of the sheer frustration that my constituents and I feel as we have to fight a similar battle around maternity all over again, despite the IRP’s clear conclusions five years or so ago.

Time precludes me from presenting details of how, if necessary, we should seriously consider de-merging the trust and setting Eastbourne DGH up as a separate foundation trust. We have been doing this work for many months now, as we suspected that proposals to downgrade DGH core services from the current trust board were in the pipeline. I have even had a number of key people in the DGH campaign visit an equivalent sized trust in Yeovil in the west country. We came back from that visit with some very useful data and plans for if we were to de-merge.

As time is an issue, I will finish with a direct quote from our mutual friend and colleague, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), who wrote in a letter that I received yesterday:

“The Government has said that, in future, all service changes must be led by clinicians and patients”.

The clinicians, as I have already reported, have profound concerns. I can assure the Minister of State that patients—former and future, from Eastbourne, Willingdon, Lewes and beyond—also have profound concerns about the proposed clinical strategy currently presented by East Sussex Hospitals NHS Trust managers.

I ask the Minister to take on board our concerns, to do what is necessary to address them, and to ensure that our hospital, Eastbourne DGH, is continues to perform as a fully functioning district general hospital for many years to come. Eastbourne is a growing town—in many ways, we are bucking the economic trend—and I am working closely with business and the council. We are rolling up our sleeves up in this difficult economic climate. I have already mentioned that the fastest-growing demographic in my constituency is the 25-to-45 age group. I need a proper hospital for Eastbourne. I need a district general hospital for the long term. I would welcome any comments that the Minister has to make.

Police Reform and Social Responsibility Bill

Debate between Henry Smith and Stephen Lloyd

Monday 13th December 2010 Commons Chamber

[Stephen Lloyd (Eastbourne) (LD)]

I pay tribute to many who have spoken this evening, including my hon. Friend the Member for Harlow (Robert Halfon), who made a number of rational and intelligent suggestions in respect of the Australian system that I have not heard before, which I commend.

I also pay tribute to the police force in my constituency. I work closely with it, and spoke with the operational commander on Sunday morning. The force is swift, efficient and effective, as it has been for quite a few years, and it is very targeted, so it is no surprise that crime rates have gone down.

I support a charity called Families Fighting for Justice, which came to my attention in a rather unusual way. A constituent of mine sadly suffered two tragedies in her family—her children were brutally murdered—and as she went through that process, she felt that the system supported the perpetrator far more than the victim. I need tell no one in the House how appallingly bleak it must be for any parent to lose a child, but to lose two is beyond compare. Through meeting her I did a lot of research and came across the charity Families Fighting for Justice. I do not agree with everything it wants, but a number of the issues it is interested in and has been pushing concern the flippant guilty pleas that change just as a person gets to court. This Bill could begin to address issues where perpetrators have been perceived as getting away with murder—to coin a phrase—and level the playing field more. Speaking on behalf of Families Fighting for Justice, I think that the Bill is taking a step in the right direction for people such as my constituent who have been through such tragic circumstances.

I fully support the Bill. The key thing is that it will improve police accountability, allow the Home Secretary to react quickly to the constantly evolving criminal narcotics industry and tackle some of the root causes of antisocial behaviour. It covers some broad strategic issues that hon. Members on both sides of the House have tackled, but I would like to concentrate on antisocial behaviour, which might be seen as a relatively minor issue. I come from a family of police officers—an uncle, grandfather and great grandfather were policemen. So there has been a considerable number of policemen in my family. If it is any consolation, they are mostly supporters of the party of my coalition colleagues—but bless them. They are relatives, and I love them dearly.

I have always supported and had a great interest in the police force. I suppose that I might be termed as being on the robust wing of the Liberals. I am aware, as all MPs are from their constituency experience, that antisocial behaviour is appalling, particularly in disadvantaged areas where it is possible for one close or cul-de-sac to contain just one or two families who make life a misery for everyone. I have always been very strong on that. In fact, I was supportive of the broken window policy started in New York by Mayor Giuliani a few years ago through an elected police commissioner. He started dealing with crime at its root causes—for instance, broken windows and graffiti—and coming down on them very hard. As a result, the bigger crimes also began to reduce.

Antisocial behaviour in all its forms, especially at night, can be devastating for those it affects, which is why I am glad that part 2 of the Bill will amend the Licensing Act 2003 to shift the balance of power from pubs and clubs to local authorities and, more importantly, local communities. As is well known, a significant proportion of antisocial behaviour has alcohol at its root. I was stopped yesterday by a constituent in Eastbourne, which I hasten to add is a paragon of peace—it is also the sunniest town in England, so hon. Members should visit it in their holidays and spend all their money there. Over the weekend, I was walking around my constituency, talking, meeting and listening to people—as we all do—when I was stopped by a chap who works as a street pastor. He goes out late at night working with others, helping people and being there for young people, old people and middle-aged people in case of trouble. He told me that he once came across a young woman of about 16 or 17—lord knows how she got hold of the alcohol—who was comatose. Fortuitously, the ambulance arrived within 20 minutes or so, but this man, who is an experienced older man and former pastor, said, “Stephen, frankly, if the ambulance had been another 30 minutes, if there had been a hold-up, she probably would have died.”

[Henry Smith (Crawley) (Con)]

My hon. Friend makes a powerful point. Not so long ago, I went on patrol with my local police in Crawley on a Friday night and into the early hours of Saturday morning. I was astounded to discover that, I would say, nine out of 10 of the incidents that we responded to were alcohol related.

[Stephen Lloyd]

My hon. Friend is absolutely right, and I thank him for his intervention. The overall statistics show that well over 50% of violent crimes involve alcohol. It is absolutely shocking. A number of colleagues talked about the cheap price of alcohol. The right hon. Member for Leicester East (Keith Vaz) declared that he did not drink cheap drinks or what-have-you—I am sure that he does not, and neither do I for that matter—but there is one cider in particular called White Lightning. I know of shops in Eastbourne where, sadly, it is used by young and old people specifically to get absolutely blitzed, and I am sure that there are similar shops in every town in the constituency. Given the damage that White Lightning causes, and especially because of its price, it is commendable that the Bill is beginning to look at such issues seriously.

A key part of this Bill comes back to antisocial behaviour. The more that we can give the power back to the people—back to the local authority—to challenge those establishments where alcohol is freely served and abused, the more that life will be made easier for many constituents around the country. I go back to the fact that it is often the smaller, perhaps less notorious aspects of crime that can cause so much damage. Antisocial behaviour is one of those, and it is clearly linked to alcohol. The changes in licensing will make things more efficient and, crucially, will give power back to the people. Those provisions are highly sensible, and I commend the Bill to the House.