NHS Funding (North-East and Teesside)

Ian Swales Excerpts

Tuesday 5th November 2013 Westminster Hall

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

This is an important opportunity to discuss concerns that my north-east colleagues and I have. I hope that the Minister takes our points on board, and takes the necessary steps to rectify the issues in the region’s health service.

I will discuss four topics this afternoon. The first is the funding provided by central Government to the region’s accident and emergency departments, particularly in the south Tees area. The second is the funding of the North East Ambulance Service NHS Foundation Trust, and the rising use and cost of private ambulances. The third is the ongoing Monitor investigations into the two foundation trusts—the South Tees Hospitals NHS Foundation Trust and the Tees, Esk and Wear Valleys NHS Foundation Trust—that serve my constituents. Finally, I will seek reassurance from the Minister on future funding allocations to north-east clinical commissioning groups.

Over the past 18 months, the accident and emergency department at James Cook university hospital, which serves my constituency, has come under particular pressure. In the run-up to winter last year, there were problems with handover times; ambulances and paramedics waited up to two and a half hours to admit patients, despite the national target time being 15 minutes. I raised that last year with the Secretary of State for Health, who agreed that the situation was completely unacceptable, and I raised it with the Minister on 13 February 2013 in a Westminster Hall debate on A and E provision in the north-east. In addition to the issues that I raised with the Secretary of State, it has become evident that the James Cook hospital’s A and E department struggled to manage with the pressure caused by winter.

In January and February 2013, the South Tees Hospitals NHS Foundation Trust failed to meet its target of seeing 95% of A and E patients within four hours. With James Cook hospital so clearly overstretched, I admit that I was surprised to discover in September 2013 that the Secretary of State decided not to award it, or any hospital trust in the north-east, funding to alleviate the pressure on A and E departments. It is beyond belief that, of the £250 million awarded by the Secretary of State between 53 trusts, not a penny will reach the north-east, particularly as we live in a region that suffers from some of England’s harshest winter weather and has some of the harshest local government cuts in the country. I hope that the Minister reconsiders that allocation, or at the very least clarifies why the Secretary of State made such a seemingly absurd and regionally disparate decision.

Recurrently, over many weeks, I have received expressions of concern from constituents about the increasing use of private ambulances in response to 999 calls in my constituency. I corresponded with the North East Ambulance Service on two such incidents, and its reply made it clear that central Government funding cuts are eroding that blue-light service:

“Each year we have discussions with our commissioners on the forecast number of incidents in the forthcoming year. The outcome of these discussions for 2013-14 were that commissioners felt it necessary to set our income on activity for the next 12 months at a level less than we were forecasting… So for 2013-14, we have been contracted to respond to 376,000 incidents, although we are forecasting activity at an estimated 415,000. This means that any incidents above 376,000 will be funded on a one-off basis rather than as recurrent annual income. These arrangements do not allow us to enhance our own workforce plan because the money for the additional activity will not be available next year to fund the extra salaries, overheads and vehicles we need to meet the extra demand.”

[Ian Swales (Redcar) (LD)]

The hon. Gentleman is making a powerful speech. Is he aware that Cleveland police vehicles and staff are also being increasingly used as unofficial ambulances?

[Tom Blenkinsop]

Yes, the police, and particularly the police and crime commissioner for Cleveland, have raised that with me in private meetings on first responder calls. They have funding worries about what will happen if such practices continually recur.

The NEAS letter shows that there will be more cuts, more private ambulances and possibly a less responsive service. It is not me saying that, but the chief operating officer of the North East Ambulance Service. The figures are stark. In 2008-09, 865 call-outs were attended by private ambulances in our region, costing £86,000. In 2009-10, some 1,816 call-outs were attended by private ambulances, costing £151,000. In 2010-11, however, 6,429 call-outs were attended by private ambulances, costing £477,000, which is a huge jump. In 2011-12, there were 9,000 call-outs attended by private ambulances, costing £639,000. In 2012-13, 13,524 call-outs were attended by private ambulances, costing £754,000. So since 2010, there has been a fivefold increase in private ambulance costs in the north-east, with the funds going to private contract firms. It is obvious that from 2010 onwards, there has been an explosion of private ambulance usage by the trust, costing a huge amount of taxpayers’ funds. The chief executive states:

“These arrangements do not allow us to enhance our own workforce plan because the money for the additional activity will not be available next year to fund the extra salaries, overheads and vehicles we need to meet the extra demand.”

A third issue of particular concern to my constituents is that both the NHS trusts that serve them—the South Tees Hospitals NHS Foundation Trust, and the Tees, Esk and Wear Valleys NHS Foundation Trust—have found themselves under investigation by Monitor in the past 12 months. Since May 2010, the South Tees trust has failed on seven occasions to meet its referral-to-treatment target, most recently between March and August. That has resulted in the Monitor investigation, because the trust has failed to ensure that 90% of patients commence treatment within 18 weeks of referral. Furthermore, there has been an increase in reported “never” events at the trust, and an increase in the incidence of clostridium difficile.

Despite the seriousness of those issues, Health Ministers have taken no action. My constituents would at the very least expect Ministers to have had conversations with Monitor and the trust on the issue, and on what support the Department of Health can provide, yet the Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), confirmed to me in a written answer that

“No such discussions have taken place with Ministers.”—[Official Report, 22 October 2013; Vol. 569, c. 83W.]

Will the Minister please assure me that he will closely monitor the situation and have discussions with both Monitor and the South Tees trust on how the Department can provide support, including additional funding if necessary?

My final point is on allocations to the north-east’s clinical commissioning groups.

A recent working paper issued by NHS England on allocation and indicative target allocation outlines proposals that will reduce per-capita funding for CCGs across the north-east. People in Sunderland will each face a £146 cut, people in south Tyneside a £124 cut, people in Gateshead a £104 cut, and people in my constituency a £60 cut.