A&E Services

Iain Wright Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Iain Wright (Hartlepool) (Lab)]

This is the first opportunity I have had to welcome you to the Chair, Madam Deputy Speaker. I am extremely pleased to see you in what I think is your rightful place.

I pay tribute to my hon. Friend the Member for Dewsbury (Paula Sherriff) for her excellent speech. She is part of a very talented 2015 intake—far too talented for my liking, I am afraid to say. She has already demonstrated a strong reputation for standing up for her constituency—often in the face of terrible attacks—in terms of fairness, tolerance and decency in public services. She is a strong asset to this House and I welcome her.

The issue of accident and emergency services is important for Hartlepool, because we lost our A&E in August 2011. That closure has been felt very deeply by my constituents, who now have to travel to North Tees, which is some 13 miles away, for accident and emergency services. Given the appalling provision of public transport, the low level of car ownership and the relative levels of deprivation, that is too far to travel for far too many of my constituents.

[Anna Turley (Redcar) (Lab/Co-op)]

Will my hon. Friend comment on the impact of that A&E closure on, and its implications for, areas below the River Tees, including my constituency? In South Tees, despite the best efforts of our NHS staff, waiting times have increased and the A&E target in particular continues to be missed.

[Mr Wright]

My hon. Friend makes a very important point. Having fewer A&E departments puts further strain on other parts of the system, such as A&E at James Cook hospital, and other parts of the NHS, such as ambulance services. They are queuing up outside James Cook hospital, but it does not have the throughput it needs.

It is important that A&E returns to the town of Hartlepool. Given the level of health inequality, as well as the high proportion of older people relative to the rest of the country, there is a greater risk of accidents and, therefore, I think it is fair to say, greater reliance on A&E than other areas.

To be frank—this is not a party political point—the closure was based on clinical safety factors. The number of medical staff to cover two rotas at both Hartlepool and Stockton was deemed insufficient, and the supervision of junior medical staff was deemed inadequate, as it did not meet modern guidance criteria. Additional resources will need to be provided for adequate staffing to ensure that A&E can return to Hartlepool. North Tees and Hartlepool Hospitals NHS Foundation Trust has a financial deficit of £4 million, which is expected to worsen over the coming years.

[Tulip Siddiq (Hampstead and Kilburn) (Lab)]

In the coming winter months the Royal Free hospital in my constituency will once again face pressure in A&E and other services. Does my hon. Friend agree that the extra winter NHS funding should be allocated sooner rather than later so that hospitals can start planning, and that it should be included in the forthcoming Budget?

[Mr Wright]

My hon. Friend makes a really important point. On the additional resources, the north-east region has not been provided with anything, despite the level of health inequalities and the additional pressure on resources.

Lynne Hodgson, the director of finance at the trust, has said:

“The whole system is stretched financially.”

The situation is so bad that the trust has recently taken out a £2 million loan. That is not for investment in health services—it is not helping to pump prime the return of A&E to Hartlepool—but for paying the wage bills of current staff. When an organisation has to borrow to meet obligations for something as fundamental as its staff’s monthly pay packets, something is fundamentally wrong with the system.

I am arguing for the services to be returned to the town, but given the precarious finances of the trust I am fearful that most services will move further away or simply cease to operate, putting further pressures on the local health economy, such as James Cook hospital, and other parts of health and social care. What will the Government do to ensure that the finances of the North Tees and Hartlepool trust are put on a more secure footing while at the same time allowing such essential services to return to the town?

I fully accept that clinical safety for A&E services is paramount—I will never argue against that—but I have to question the model of acute accident and emergency services in my area. Over the past two decades or so, there has been a tendency to centralise services at North Tees, to the detriment of patients from Hartlepool and those slightly further away in south-east Durham. The momentum programme was going to centralise services on to a single site, culminating in a new hospital at Wynyard that would serve the populations of Hartlepool, Stockton, Easington and Sedgefield. The Government have made it perfectly obvious through their actions that Wynyard will not go ahead, which, together with NHS England’s “Five Year Forward View”, shows that smaller hospitals can thrive. Indeed, we have seen that across the region and the country. Darlington, whose population is only slightly larger than mine and which comes under the County Durham and Darlington NHS Foundation Trust, is able to maintain an A&E. Hexham has a population not of 92,000 like Hartlepool, but of 13,000, and it is able to maintain an A&E at Hexham general hospital. Clearly, centralisation is not the answer everywhere. Different clinical models and reconfigurations are available to allow smaller towns to retain their A&Es.

[Rachael Maskell (York Central) (Lab/Co-op)]

Does my hon. Friend agree that there needs to be more transitional care, with step up, step down facilities, and that we need to address the skill mix of different clinicians in those facilities?

[Mr Wright]

That is an incredibly important point. I started with staffing and I will end on it.

I want to make a vital point. The Minister spoke of local solutions, and the people of Hartlepool, Hartlepool Borough Council and I, as the MP for Hartlepool, want that to be the approach, but we are not being heard. I understand that there are always tensions between the wishes of the public with regard to where health services are located and the essential requirements of clinical safety, but, as shown by the examples I have given, there are other ways. The local trust is simply not listening. Given that I, the people of Hartlepool and the local authority—regardless of its political complexion—want this, what will the Government do to ensure that, in the shaping of local accident and emergency services, the voices of local people and their democratically elected representatives are genuinely heard?

As I said, I started by addressing staffing and I want to finish on that, too. I hope I have made it clear that I want A&E to return to Hartlepool, but it is clear that the pressure on acute services would be reduced if there was more access to primary care. The GP per head of population ratio is low in Hartlepool, with 63 GPs per 100,000. That is significantly lower than the north-east regional average—only Stockton has a lower ratio—and it is lower than the average in England. Greater access to GPs and better integration of all health and social care services has to be the way forward, but that also includes giving the people of Hartlepool what they want, which, put simply, is a fully functioning hospital in the town and an accident and emergency department at its very heart.