Health Care (Gloucestershire)

Jane Ellison Excerpts

Wednesday 19th March 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I congratulate my hon. Friend the Member for Kingswood (Chris Skidmore) on securing this debate, as well as my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti), on his speech. It is good that all three of south Gloucestershire’s MPs are in the Chamber, including the hon. Member for Thornbury and Yate (Steve Webb), who I know is listening to the debate with great interest, because it also affects his constituents.

Before I respond to some of the points that have been made, may I, as I always like to do, take the opportunity to highlight the wonderful work carried out every day by those who work in the NHS, particularly those in my hon. Friends’ constituencies? Carrying on great work and serving the public against a backdrop of uncertainty, as we have heard about this evening, is sometimes quite difficult, but I pay tribute to the staff there and right across the country.

As my hon. Friend the Member for Kingswood will be aware, the South Gloucestershire CCG is leading proposals for the future provision of health care services provided in the area, under the auspices of the Bristol health services plan. I hope that he will forgive me if, for the benefit of the House, I put on the record some of the twists and turns of the past 10 years. I recognise the frustration that has been expressed today. I felt some sense of it just on being briefed about the situation, so I can understand how it must feel from a local MP’s point of view.

The 10-year strategic plan, which began in September 2004 with an extensive public consultation, aims to improve the quality of care provided in the region; to move services closer to people’s homes and reduce travelling time for patients and carers; to bring together specialist hospital services; and to improve the quality of old hospital buildings. Under the plans, Southmead was selected as the location for a new acute hospital to replace acute services at the existing hospital in Southmead and the Frenchay hospital in south Gloucestershire. The new acute hospital at Southmead is due to open this spring. The West Gate centre in Yate and Cossham hospital will continue to play a role by providing medical and surgical out-patient services, hosting therapy out-patient services and providing X-ray, ultrasound and echocardiogram services.

I will turn first to the proposals for Frenchay. As my hon. Friends are aware, the 2010 proposals called for a new community hospital at the Frenchay site to provide up to 68 in-patient rehabilitation beds, out-patient therapy and diagnostic services. However, a 2012 review by the primary care trust concluded that the proposals for out-patient and diagnostic services were unaffordable and inflexible, and duplicated other services.

I understand that that was disappointing, but CCGs are charged with using their resources in the most effective way for the benefit of all residents. I am assured that the local NHS is committed to finding a long-term solution for the provision of in-patient beds at Frenchay. Although the CCG is commissioning 68 beds at Southmead for May 2014, that is a temporary measure while the Frenchay site is being improved to accommodate them after April 2016.

I will turn to the questions about the recent council referrals. My hon. Friend the Member for Filton and Bradley Stoke said that my right hon. Friend the Secretary of State had seized the challenge to refer the matter, and he mentioned some of the comments of the Independent Reconfiguration Panel. As he said, South Gloucestershire council’s public health and health scrutiny committee has the power to examine the proposals for service change and refer them to the Secretary of State if it considers that there are grounds to do so. The committee made two referrals to the Secretary of State. The first, which was made in October 2013, concerned the temporary provision of rehabilitation beds at Southmead hospital. The Secretary of State asked the IRP for initial advice on that referral on 2 November 2013.

Before that advice was completed, a second referral was received in December 2013 regarding the wider set of proposals under the plan, including the decision no longer to provide out-patient, therapy and diagnostic services at the Frenchay site. Specifically, the committee cited concerns that the new proposals for diagnostics and out-patient services would not be as convenient for patients as the option of maintaining three sites at Frenchay, Yate and Cossham. Additionally, the committee raised concerns about rehabilitation capacity in the light of population growth and financial sustainability.

In January 2014, the Secretary of State asked the IRP for further advice to take into account both referrals. That has now been received, as we have heard. After careful consideration, the panel does not believe that the referral warrants a full review. Acting on the advice of the IRP, the Secretary of State has decided that there should be no barrier to the local NHS continuing the implementation of the proposals in their current state. The Secretary of State wrote to South Gloucestershire council on Monday to confirm that he accepts the IRP’s advice and to agree that the implementation programme should be allowed to proceed. Both sets of initial advice are available on the IRP’s website.

The panel acknowledged, and I acknowledge from the Dispatch Box tonight, that the debate about the provision of health services in the area has been long and difficult. Delays, changes, pauses and amendments to the plans have all played a role, and the progress to date has suffered from a lack of trust and from poor communication. As I have said, I can only imagine the frustration that is felt by the local community at seeing that stop-start approach to commissioning and the reconfiguration of its local health services. My hon. Friends are right to raise these issues on the Floor of the House. Their constituents are fortunate that they have done so with such tenacity.

I will turn briefly to Cossham. As my hon. Friend the Member for Kingswood will be aware, the 2009 business case for Cossham hospital highlighted the fact that it serves a fast-growing population in the Kingswood catchment that has more older people and people suffering from long-term health conditions than other parts of south Gloucestershire. I understand that the growth in the number of older people has put increased pressure on local urgent and emergency care services, posing a significant challenge for commissioners.

My hon. Friends will be aware that in 2013, NHS England commissioned Sir Bruce Keogh to undertake a comprehensive review of how urgent and emergency care services are organised and provided in England. The report from the first phase of the review was published in November 2013. I think it is fair to say that it has transformed our national debate about the future of such services, and that all parts of the NHS in England are having to judge themselves against Sir Bruce’s recommendations and his road map for future excellence in urgent and emergency care. The subsequent phases of that review could have implications for how those services are organised for the benefit of local communities in future.

In parallel with that, the CCG decided to revisit the plans for a minor injuries unit at Cossham, in order to take account of local evidence and the themes emerging from the national review. It is clear that many local people want to see the MIU that was originally planned, which has been so ably argued for this evening, open as soon as possible and are frustrated about the decision to revisit previously agreed plans. For urgent care as for all services, the CCG’s priority has to be to ensure that the best possible combination of services is provided to meet the needs of the whole population, and that those services are sustainable and excellent for the long term. Achieving the right mix of services at Cossham will be an important part of the solution.

My hon. Friends the Members for Kingswood and for Filton and Bradley Stoke have made powerful cases. Although the task of getting the right mix of local health services is ultimately a decision for local clinicians, I would of course be happy to meet them to discuss the matter and hear their case, so that I can ensure that I have the clearest possible understanding of the issues that affect their area.

Once again, I pay tribute to my hon. Friends for their work on behalf of their constituents on the proposals. They have ensured that they have explored every possibility to ensure that they are part of an engaged process that will ultimately deliver what we all want for our constituents—excellent local health care. I congratulate them on that and look forward to continuing to engage with them on the issue.

Question put and agreed to.