Stafford Hospital

Jeremy Lefroy Excerpts

Tuesday 20th December 2011 Westminster Hall

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. It is also a pleasure to see the Minister in her place. I am expecting my colleagues from Staffordshire to come into the Chamber during this debate and to intervene if they so wish.

On 1 December this year, Stafford hospital started a temporary night-time closure of the accident and emergency department from 10 pm to 8 am. That happened principally as a result of a shortage of A and E specialists and the need to maintain a safe service. The hospital has been unable to recruit such specialists, partly as a result of a national shortage and partly owing to problems that Stafford has experienced. I wish to set out why it is important for the hospital’s A and E department to return to full-time working and to draw out some more general conclusions.

The hospital is part of the Mid Staffordshire NHS Foundation Trust, which also runs the non-acute Cannock hospital. Stafford serves a population of some 250,000 to 300,000 people in the middle and south-west of the county. As my intention is to highlight the importance of A and E, I will dwell only briefly on the Francis public inquiry, which is completing its work and will report next year. The inquiry is considering the lessons that can be learned from what happened. Certainly, lessons learned from the initial Francis investigation into the hospital have largely been put into practice. There continue to be major improvements, though clearly there is no complacency. It has been very encouraging to hear from constituents about the quality of care that they receive and their praise for staff.

I have heard some say that the Francis inquiry is not necessary, but I disagree profoundly. Let me simply report the words of a senior member of the Royal College of Physicians who said that that is the most important inquiry into the NHS in a generation. I am most grateful to the Government for their support for the hospital and the trust through a particularly difficult time for Stafford and the whole surrounding area. I ask for that support to continue, as the trust develops its plans to provide high-quality and financially sustainable services.

The importance that people in Stafford, Cannock, Rugeley and beyond place on the A and E department is shown by the more than 18,000 people who have signed petitions that support it. Stafford borough council has also shown strong support by passing a unanimous resolution at full council. Since the temporary night-time closure, a number of people have told me how concerned people, particularly the elderly, are that they no longer have a night-time emergency service relatively close to hand. We need to remember that, across the country, A and E departments not only treat people in medical need and save lives, but provide reassurance, whether to parents with a child who becomes sick in the middle of the night, or elderly people who have no transport of their own and are worried about imposing themselves by calling out an ambulance and overburdening the service. For them, an emergency service that is as local as possible is essential.

Let me make it clear that the closure was necessary. The decision was not taken lightly, but was made in the interests of patient safety. The temporary night-time closure is giving the hospital time to recruit the necessary staff and to improve training, which is difficult when one is overstretched.

I should like to thank the Minister and the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), as well as the Secretary of State for Health and the Department of Health for their help and support. I also thank the Ministers and staff of the Ministry of Defence for providing armed forces medical staff to assist for some 12 weeks. They have been invaluable both in providing additional cover and in helping with training.

I should like to thank the leadership and staff of the University hospital of North Staffordshire, New Cross hospital in Wolverhampton, Manor hospital in Walsall and Burton hospitals for taking the strain of additional patients during the temporary night-time closure. I also thank the staff of the West Midlands ambulance service for providing the necessary additional cover.

I should now like to turn to the reasons why Stafford requires a 24-hour A and E department. First, the population of the area is growing. Stafford itself is a growth point and expects to see another 15,000 to 20,000 people settle in the area in the coming 20 years, with 2,000 to 3,000 from the armed forces returning from Germany to MOD Stafford between 2015 and 2018. Cannock and Rugeley are also growing.

[Mr Aidan Burley (Cannock Chase) (Con)]

I congratulate my hon. Friend on securing this debate. He mentions Cannock, which is my constituency. Does he agree that the answer to all the problems that we have seen in Stafford is not to close Cannock but to impose a two-site solution, with services both at Stafford and at Cannock and an improved and more vibrant Cannock hospital? That is the only way forward and a solution on which we both agree as neighbouring constituency MPs.

[Jeremy Lefroy]

I entirely agree with my hon. Friend. It is essential that we have services both in Cannock and Stafford. Both hospitals are vital to their local communities, although they perform different services.

Secondly, we have an increasing elderly population who rely on local accident and emergency services. Increasing life expectancy is welcome, but when the elderly become ill, they tend to be more acutely ill. The combination of population growth and more elderly people will inevitably lead to more demand for emergency and acute services. Successive Governments have tried, with varying degrees of success, to persuade people who are not seriously ill to use alternatives to A and E. That is important—I welcome the Government’s moves in that direction—but it will only relieve a small part of the pressure on these departments.

Thirdly, Stafford’s accident and emergency department is extremely busy. The admissions for the past 12 months, up to November 2011, numbered 52,255. That is some two thirds of the number of admissions to Manor hospital in Walsall and slightly more than half of the admissions to the University hospital of North Staffordshire and New Cross hospital in Wolverhampton.

[Gavin Williamson (South Staffordshire) (Con)]

I congratulate my hon. Friend on securing this debate. He touches on an important point, especially at this time of peak demand for hospitals. New Cross hospital and hospitals in Walsall and Stoke-on-Trent are under a lot of pressure. It is vital that we ensure that this closure is only temporary and that we resume full-time, 24-hour accident and emergency services.

[Jeremy Lefroy]

I am most grateful to my hon. Friend for making that point. I reiterate my thanks to those hospitals for taking on the extra patients in the night-time hours during this difficult time in the winter. Stafford accounts for 14% of the entire number of A and E admissions for the whole region, which includes Staffordshire, Wolverhampton and Walsall.

Fourthly, with Stafford being shut at night, most patients have to travel considerably further for emergency care. The University hospital of North Staffordshire in Stoke is 19 miles away, New Cross in Wolverhampton is 18 miles away, Manor hospital in Walsall is 19 miles away and the hospital in Burton is 27 miles away. The absence of Stafford, even for 10 hours at night, leaves a very large hole in accident and emergency provision for the region. It is a matter not only of distance, but of the amount of traffic on the roads. Night-time travel is usually reasonable in the area, but congestion can be substantial during the day, particularly when the M6 is closed between junctions 12 and 14 and all motorway traffic is diverted through the middle of Stafford.

It has only been possible to cope with the temporary night-time closure with the use of several additional ambulances and increasing staff cover. Such facilities are expensive. Indeed, they are more expensive than keeping the A and E department open 24/7, which emphasises the fact that the decision was taken for reasons not of cost but of patient safety.

It is essential that Stafford hospital has a full-time accident and emergency service, but not every emergency can be treated there. Given the advances in medical science and treatment, it makes sense for some of the most serious emergencies to be treated by top specialists who will only be in the largest hospitals. Patients with major trauma, severe strokes or major heart attacks already go to regional centres such as UHNS. That is understood and generally accepted. However, a district general hospital should be able to respond safely to a number of emergency conditions and provide a minimum set of services, such as acute medical, including rheumatology and geriatric; acute surgical and orthopaedic; paediatric; maternity; and mental health, particularly for overdoses. In some cases, hospitals may have to stabilise a patient before they can be transferred to a specialist centre.

Retaining a core set of emergency services in district general hospitals is important to protect their viability. As John Donne said:

“No man is an island.”

That can equally be said of many acute services. It is not possible to retain acute medicine, which provides the lion’s share of the income of an acute hospital, without having access to surgical opinion on the spot. Any emergency service also needs the full-time support of critical care units and radiology, to name but two. That is not to say that there can be no change—there must be changes to make district general hospitals financially sustainable in a difficult climate—but we must not put so much pressure on them that their only option is to close their doors to emergencies from the communities that they serve, forcing people to travel considerable distances for all but minor injuries.

Changes must be thought through and discussed openly with those communities. There should be no sudden changes and nothing hidden in the small print. The NHS is paid for by the British people and is a service that gives us great reassurance, even if we are fortunate enough rarely to need it.

I have set out clearly why Stafford hospital needs a full-time accident and emergency service. I am making the argument from the point of view not of the hospital itself, the bricks and mortar, but of the patients—my constituents and those of my hon. Friends the Members for Cannock Chase (Mr Burley), for Stone (Mr Cash) and for South Staffordshire (Gavin Williamson), many of whom rely on its services.

Stafford hospital provides a first-class service to many people in our area. The management, the staff, my parliamentary colleagues and I are not complacent; we recognise that there is more to be done. None of us will be satisfied until our hospital is known nationally, as I believe it will be, for its high-quality treatment and care and it has the confidence of all those whom it serves.