NHS (Contracts and Conditions)

Jo Churchill Excerpts

Monday 14th September 2015 Westminster Hall

[Jo Churchill (Bury St Edmunds) (Con)]

We have a wonderful resource in the national health service, but it cannot be preserved in aspic. I am lucky enough to have been treated by these wonderful consultants, which is why I am here. Society and medical technologies are changing at an alarming pace. The importance of the central asset of NHS staff cannot be overestimated, and the interest from my colleagues today shows how much Government Members value them. I am the daughter of a nurse, and I am the mother of a health professional. I get berated long and hard on how tough things were, as my hon. Friend the Member for Lewes (Maria Caulfield) alluded to, and how tough things are. That is a constant state, but let us be realistic: there will be a deficit this year of enormous proportions. Rather than throw in yet another figure, we know the deficit is large, and we know it is a problem.

Do I believe the premise of this petition? No. Important decisions have to be made if we are to focus on the primary need of patient outcomes. The question is how we treat people efficiently, effectively and with compassion. Hospital managers and consultants may say that the changes will deliver a 21st-century model of care that will safeguard both the patient interest and the cost-effectiveness of services, but that is quite wordy and is making everything the same problem. We do not all have the same problem. I completely concur with my hon. Friend the Member for Totnes (Dr Wollaston) on rural GPs. There are rural GPs in my constituency who are already feeling stretched, and asking them to deliver two more days of cover—seven days in total—with no more staff is not the answer. We must link training and recruitment, and we must work on a delivery mechanism that means not only the 5,000 extra GPs that we have promised but less box-ticking to free up their time, which would not go amiss. It has been said that we do not have enough GPs, but it takes five years to train a GP. Anyone who starts university now will not be qualified by the end of this Parliament. We are dealing with the legacy of the tail end of the Labour Government, which is one reason why we do not have enough doctors.

I am from a business background, and I ask simply how we can do more with less. Do I believe that the way to achieve better care in our hospital settings is not to have access to seven-day patient services? No, I do not. Do I think that if a child is knocked off their bike on a Saturday or a dad has a heart attack on a Sunday, doctors and nurses should struggle to deliver optimal service without the important back-up of diagnostic services? No, I do not. Why is it that, although an acute bed costs about £900 a night, patients in our hospitals cannot be admitted or discharged as easily on Saturdays and Sundays as on Mondays and Thursdays? One problem is that we cannot discharge. It is not all about who is coming in the front door; it is also about who is going out the back door. It is a real strain.

[Victoria Prentis (Banbury) (Con)]

My local trust, Oxford University Hospitals trust, has recently started a “perfect week” scheme, in which it makes all resources available to all those who work in the hospital system. It has discovered that one main barrier to discharge on Saturdays and Sundays is that pharmaceutical staff are not available at all hours of the day and night. Would it be possible to roll out that concept of a perfect week elsewhere?

[Jo Churchill]

It is a very good idea. The lack of pharmacy provision in hospitals is often cited as one obstacle to patient discharge. The cost of not discharging someone on a Friday, meaning that they use a bed on Friday, Saturday and Sunday, is £2,700, which is a lot of money.

[Helen Jones]

The hon. Lady was not in the House when we debated this Government’s change to local government finance, but at the time, many of us warned that it would hit social care and impact on our hospitals. Does she accept that hospitals are having great difficulty discharging patients, not only at weekends but during the week, because social care is not available for them?

[Jo Churchill]

I would say that it is a mixed picture. What I am picking up from care homes in my constituency is that some wards do it more effectively than others, with better services and things better locked together. Although I accept that there may be a problem, again, I look to the leadership.

I gave birth to some of my children on a Saturday and Sunday. Their entrance did not appear any less special to the obstetrician than those of my children who appeared midweek. I am not consultant-bashing; this is reality. The NHS has been delivering consultants and staff who provide outstanding service, but one cannot deny the statistic that patients’ chance of survival is less if they are admitted to a hospital at the weekend. Even if we extrapolate from those figures to account for the fact that the people admitted at the weekend are often very poorly, and often very elderly, they tell us that there is a problem. It would be remiss of this or any Government not to ask why or to investigate the situation and consider how to provide solutions.

I will not talk about people’s pay or anything else; we have done that. Instead, I shall focus on the petition, which in my view is neither constructive nor helpful. I would like the Government to learn from the best practice of consultants and their teams. Brilliant ideas are out there if we can only harness that best practice. For example, at the virtual fracture clinic at my West Suffolk hospital, a consultant told me that he has cut the number of times that patients must visit the hospital. Work can be done remotely; even discharges can be done on the phone, and those who need further specialist help can be sent on. We need to have honest conversations about the NHS. We need to use its finite resources, including staff, more sensibly if we are to survive.

We have 1.4 million great people working in our NHS, and 1.6 million people working in our social care sector. That is one tenth of this country’s population. We all agree that a seamless pathway between the two is the best future, but I leave Members with this question. If we cannot discuss a way forward that allows us to accept change, understand and develop new ways of working, we may struggle to look after the burgeoning health population, and there may be more than contracts to think about.