Huddersfield Royal Infirmary

Jo Cox Excerpts

Tuesday 2nd February 2016 Westminster Hall

[Jason McCartney (Colne Valley) (Con)]

I beg to move,

That this House has considered A&E services at Huddersfield Royal Infirmary.

It is a pleasure to serve under your chairmanship, Mr Pritchard. Labour’s ruinous private finance initiative deal; Tory top-down reorganisation; socialist independents’ sniping; Lib Dem opportunism; UKIP wanting to privatise the NHS; Socialist Workers using the issue to scrap Trident and bring down capitalism—that’s all the party politics done. Let us put that to one side. I hope that for the next 89 minutes, we can continue with our cross-party consensus to make a compelling case for keeping our full A&E services at Huddersfield Royal infirmary.

I would like to thank my parliamentary colleagues for attending today, particularly the hon. Members for Huddersfield (Mr Sheerman) and for Dewsbury (Paula Sherriff), who applied for this debate along with me. I was fortunate enough to be successful, but we are all here together, along with the hon. Member for Batley and Spen (Jo Cox), with one strong local voice.

The background to this issue is that the Greater Huddersfield and Calderdale clinical commissioning groups have unanimously voted to put their “Right Care, Right Time, Right Place” proposal to a public consultation, which could lead to Huddersfield losing its A&E service. We anticipate that the 12-week consultation could start next Monday, 8 February.

The CCG’s preferred option is to close Huddersfield’s A&E and keep the provision at Calderdale Royal hospital in Halifax. The background to that proposal is the ruinous PFI deal negotiated in the 1990s and signed in 1998. The initial cost of Calderdale Royal hospital was £64.6 million, but it will end up costing the Calderdale and Huddersfield NHS Foundation Trust an incredible £773.2 million when the deal expires in 2058. That scandalous PFI deal is now influencing clinical and community health decisions, with an enormously detrimental effect. That dodgy deal is set to cost lives, and we are set to lose our A&E in Huddersfield while the PFI money makers stuff their pockets.

Throughout the past 12 months, our local CCGs have been mooting a reorganisation and reconfiguration of emergency and acute care and high-risk planned care, with HRI being the preferred location. In fact, the CCG’s own modelling of option 5B stated that Huddersfield Royal infirmary should provide all acute and emergency care and clinically high-risk planned care, because it was “in line with” the clinical model of safer and higher quality services, 24-hour consultant-led care, undisturbed planned care and a more resilient workforce model. It was only when the PFI financial considerations were factored in that the appalling proposition of closing A&E at Huddersfield suddenly emerged.

What has been the reaction to that plan? I was shocked at the proposal, and so was our community. I live in the village of Honley; I do not live anywhere else or have a second home—that is where I live. I have had to use HRI A&E a number of times, and I have always received excellent care. I put on the record my thanks to the wonderful staff there. In 1995, I fell seriously ill on my return from deployment in Turkey and northern Iraq while serving in the Royal Air Force and had to go to A&E. Eighteen months ago, I fractured my elbow in a fall while running the Honley 10 km race—being fit is not good for your health, by the way. My parents, who live just up the valley, have used our A&E. My mum had a bad fall on the ice a couple of years ago and had severe facial injuries, so getting to our local A&E in wintery conditions was crucial.

I am so proud that our community has come together to fight to keep our A&E at HRI. Karl Deitch set up a Facebook group, which now has more than 46,000 members. From that, we have already seen a rally in St George’s Square in Huddersfield, where more than 1,000 local people came together. The group has formed a campaign committee, which is meeting again tonight to plan the way forward. I would like to say a huge thanks to Karl and the whole team of volunteers for their superb community campaign. We are right behind them.

I have told my story of using HRI A&E. On Saturday, at the Huddersfield Town match, Sean Doyle, a constituent and friend of mine from Brockholes, spoke movingly on the pitch at half time about when he had a massive heart attack in Greenhead Park in Huddersfield. He owes his life to the emergency care he received at HRI, which was just up the road, where A&E staff used a new electronically powered chest compression system. Sean says he would not have survived if he had had to go to Halifax. I have received many emails from other constituents telling me how they owe their lives to the location and proximity of HRI A&E and how the golden hour saved them.

The campaign to save our A&E is by far and away the biggest local issue I have dealt with while I have been the Member of Parliament for Colne Valley. There are posters everywhere. Volunteers are taking petitions from door to door. The hashtag #handsoffHRI is being projected on to public buildings, and we are all receiving hundreds of individual emails. It is so clear that this proposal is just plain wrong.

[Jo Cox (Batley and Spen) (Lab)]

The proposed reorganisation, which would leave Huddersfield without an A&E, is being done under the rationale that there will be no change of provision in the other half of Kirklees district. However, the diminution of services at Dewsbury and District hospital, which sits within my constituency, is a significant change—not least for the A&E, which is a key service for local constituents in neighbouring Dewsbury and elsewhere. Does the hon. Gentleman agree that that is an embarrassing oversight, with the potential to leave the eleventh largest district in England without a fully functioning A&E? That is not in the public interest and not in our constituents’ interest.

[Jason McCartney]

Absolutely—the hon. Lady makes a great point; she must have read my speech, because I will make that exact point in about three pages’ time. She is spot on.

Huddersfield Royal infirmary is in my constituency of Colne Valley, which includes the western side of Huddersfield, Colne Valley itself and Holme Valley, where I live. That means that if any of my 81,000 constituents or their children need to go to A&E in the back of an ambulance, they will have to pass HRI before undertaking the congested trek over to Halifax. In fact, most signatories to the parliamentary petition are from my constituency. I thank the 46,000-plus people who have signed the petition so far and the volunteers who are working tirelessly to get more folk signed up.

May I also say a big thank you to our local Huddersfield Examiner newspaper? In an era of digital online media and falling newspaper sales, we are so lucky to have a quality six-day-a-week local paper that is backing this campaign 100%. I thank the editor, Roy Wright, and his energetic and committed team of local journalists. Their excellent in-depth analysis has included an interview with Mike Ramsden, chairman of Hull and East Yorkshire Hospitals NHS Trust, who is quoted as saying:

“The reality is the CCG in Huddersfield exists to represent the health issues of the local population. If the proposals are now being delivered because of the financial pressure on a hospital in Halifax, then it’s my belief that it’s not a matter for Huddersfield CCG… it can’t be seen to be fair that a PFI deal in Halifax is taken on by people in Huddersfield.”

That is the view of a top NHS boss.

Let me address the issue of this proposal coming from the CCG. It is a panel of local doctors, and yes, I voted for CCGs to take over from primary care trusts, because I saw the faceless bureaucrats of the old PCT downgrade maternity care at HRI. Remember that, back in 2008? I believe that healthcare professionals will, at the end of the day—and they will need a lot of support and encouragement from us—make the right decisions for patients.

We need to make sure that the voices of all our local doctors are heard, and not just those on the CCG. A doctor from a surgery in my constituency wrote to me to say that moving A&E services to the town with the smallest population is “crazy”. Unfortunately, she is not one of the doctors on the CCG panel, although perhaps we wish she was. Another local GP from Colne Valley—a high-profile one—says that care for patients in Kirklees and Calderdale should not be driven by the PFI. Strategy should be driven by care needs, not financial concerns.

As I said, we have excellent cross-party parliamentary co-operation on this campaign. Local folk have really appreciated that, and my colleagues and I are committed to continuing that unity. I do not know whether the Minister has ever visited Huddersfield—he is trying to remember—but we are a growing, vibrant university town. If this appalling proposal goes ahead, we would be the largest town in our country not to have an A&E within five miles.

Huddersfield has a population of 146,000, and it is growing. We have more than 20,000 students, with thousands of international students, at our award-winning University of Huddersfield. Sadly, I have already had an email from a father whose son is now not going to apply to the university for fear of not having a local A&E. If Dewsbury loses its A&E, the whole Kirklees council area will be without one, as the hon. Member for Batley and Spen rightly said—442,500 residents who would be without an A&E in their council area. The hon. Member for Huddersfield and his team have calculated that that would potentially lead to an extra 157 deaths a year, and I am sure that he will elaborate on that later.

In this debate, it would be very easy to go down the route of just being emotional, but as the Minister is seeing we are laying out hard facts about why the proposal is plainly wrong. We will all make these points and arguments to the CCG as well once the consultation starts. However, I would like to highlight two other main areas.

Syngenta on Leeds Road is a top-tier COMAH—control of major accident hazards—safety site. It handles parquet, sodium cyanide and methyl chloride, and other operators on site handle toxic and carcinogenic chemicals. Its community safety plan states that

“we handle chemical substances which are classified under the regulations as toxic, very toxic, oxidising and flammable.”

Just imagine if there were an incident; the proximity of an A&E would be crucial. Has the CCG looked at that? In response to such an incident, response times and getting to an emergency treatment centre close by would be everything. The CCG has not mentioned Syngenta in its consultation document.

I turn to travel times, which really are a key issue—remember the golden hour. It is all well and good talking about average travel times to an A&E, but emergency care is not about averages. My constituents have been sending me Garmin and TomTom reports—other satnavs are available—of their recent journeys from Huddersfield to Halifax. It can take up to 45 minutes and in some instances, even longer. It is an extremely congested journey. Bad weather, floods, damaged bridges, increasing housing developments in the Lindley area, and the Ainley Top roundabout see our local road system creaking at the seams. That is before we even start analysing peak travel times from, say, Hade Edge or Marsden in my constituency.

My constituent Elaine writes that she has regular appointments on a Thursday morning at 9.15 am at Calderdale and has told me that the Elland bypass is regularly blocked twice a day, with her average journey time taking over an hour. It recently took a Huddersfield Examiner photographer 52 minutes in morning rush-hour traffic to get from the centre of Huddersfield to Calderdale Royal hospital. Hepworth in my constituency to Calderdale Royal is 13.7 miles. Most parts of my constituency and Kirklees will have to travel past Huddersfield Royal infirmary, or what is left of it, to get to CRH.

HRI serves a number of outlying and rural communities. My team and I have been scouring the consultation document and there are some really interesting little facts in there. Page 215 of the consultation document acknowledges that

“the population of Calderdale and Greater Huddersfield is aging slightly faster in the rural areas than in urban areas.”

On page 239, we learn that A&E attendances are high among those aged between 65 to 80 and highest for those aged over 80—so, those most likely to need A&E will now have further to travel, and that will cost lives.

Page 76 states that most journeys to A&E under the dual sites are less than 30 minutes—we may want to dispute that, by the way. However, the document goes on to admit—this is the official consultation document—that a single site could push travel times well over that, particularly at peak times. Let me repeat that: the consultation document states that travel times could be pushed well over 30 minutes, particularly at peak times.

My constituents at the top of the valleys in Holme village or Marsden could face an hour to get to Halifax. That brings me to the point made by the hon. Member for Batley and Spen. Patients who live at the tops of the valleys are already being diverted to Oldham and Barnsley, so the predicted patient models just do not stack up. My mum and dad are regularly sent to Barnsley from Holmbridge for routine tests. Huddersfield needs to be at the heart of our region’s emergency care. This proposal just has not been thought through. The whole proposal needs to be scrapped, with Barnsley, Oldham, Wakefield, Bradford and Halifax all part of a proper plan for emergency healthcare for where we live.

[Jo Cox]

I just want to reinforce that point for the Minister. It seems as though there is a lack of regional oversight about the implications of both this public consultation and what is happening at Dewsbury and District hospital. We have raised that issue directly with the Minister, and I raised it with the Mid Yorkshire Hospitals NHS Trust last Friday to ask who holds responsibility for the pan-Kirklees, pan-Yorkshire, strategy, to make sure that none of our constituents loses out from these individual public consultations and reconfigurations. It would be very helpful if the Minister focused on that oversight.

[Jason McCartney]

Thank you very much for that incredibly constructive comment.

I have been talking about how we need a regional plan. I have been trying, as I come to the end of my speech, to dispel some myths. Some party political activists have been bleating on about budget cuts, but that is just a myth—it is plain wrong. This proposal, if it goes ahead, could actually end up costing £490 million, as it would see HRI knocked down and replaced with a much smaller hospital on an adjacent site. Surely that financial injection, if secured—and that is a big “if”—would make better sense if it was invested in A&E in both Halifax and Huddersfield.

What happens next? I have specific questions for the Minister. The hon. Member for Huddersfield and I wrote to the Secretary of State last week. Will the Minister expedite an urgent meeting for me and the hon. Members for Huddersfield, for Dewsbury and for Batley and Spen, and others who are not here, with the Secretary of State to discuss the future of emergency healthcare in Huddersfield and Calderdale? In an ideal world, I would like the Minister to intervene to avert this appalling proposal and I hope he will explain the process. In the meantime, will he launch an investigation into the PFI deal, which many are calling one of the worst ever signed?

When the Prime Minister visited Halifax last year, he said:

“After the election we want to do what we’ve done with other hospitals, which is sort out the PFI mess and financial mess that they’re in.”

Will the Minister explore the potential of uncoupling the Calderdale and Huddersfield NHS Foundation Trust so that the PFI deal can be tackled and removed from clinical decision making? For the record, we want Calderdale Royal hospital to keep its A&E. Calderdale’s population is increasing, as is that of Huddersfield and Kirklees.

In conclusion, I think, we think, the campaigners think and all our community thinks that Huddersfield and Halifax require and deserve excellent A&E services. The decisions should be based on saving more lives, improving experiences and delivering better outcomes, not short-term financial implications. Patient safety must come first, which means keeping our A&E, so hands off our Huddersfield Royal infirmary!

[Paula Sherriff (Dewsbury) (Lab)]

It is indeed an honour to serve under your chairmanship, Mr Pritchard. Before I start my speech, I congratulate the hon. Member for Colne Valley (Jason McCartney) on securing this incredibly important debate and on his constructive and reasoned speech.

Kirklees is an area with a population of over 430,000. My constituency has a population of 110,000. The majority of my constituents access emergency care at either Dewsbury and district hospital or Huddersfield Royal infirmary. Dewsbury district hospital is already subject to a planned downgrade, which hospital bosses propose to bring forward. It will take place this year. It will see the accident and emergency department downgraded to an urgent care centre with no provision for acute emergency care.

Dewsbury district hospital’s A&E currently sees around 80,000 patients a year. The downgrade was referred to the Secretary of State for Health by the Kirklees and Wakefield joint health scrutiny committee because its members believe there remains sufficient doubt to provide the necessary assurance and confidence that the proposals are in the best interests of the local population. The planned downgrade hinged on the fact that many of the patients who currently access Dewsbury and district hospital would travel to Huddersfield for emergency care.

The loss of full emergency services in Dewsbury was a bitter blow. We now hear that Calderdale and Greater Huddersfield clinical commissioning groups are planning their own hospital downgrade. The plan, as we have heard, is to close the A&E department at Huddersfield and to transfer all emergency services to Calderdale Royal hospital in Halifax. Those plans will see the whole of Kirklees without any accident and emergency provision. Over 430,000 people will have to travel outside the borough for vital emergency healthcare for themselves and their loved ones. How on earth can that be acceptable? Kirklees is a vast geographical area that spans many towns and rural and semi-rural areas. Many people rely solely on public transport as a means of travel and parts of the borough are in the bottom 10% of the country’s most deprived areas, which brings about huge health issues and inequalities.

The hon. Member for Colne Valley alluded to Huddersfield being a university town with over 24,000 students, many of whom come from outside the area. Many of them are not registered with a local GP, so are more likely to attend A&E.

A large part of my constituency nestles between Huddersfield and Dewsbury hospital. My constituents will be among those hit hardest by the closure. We have heard in recent days that the proposed changes could result in 157 more deaths a year. We know that the closure will not improve life chances or enhance health care provision, but is purely a cost-cutting exercise that could result in lives being put at risk.

In 2007, prior to being elected Prime Minister, David Cameron said:

“I can promise what I've called a bare-knuckle fight with the government over the future of district general hospitals.

We believe in them, we want to save them and we want them enhanced, and we will fight the government all the way.”

We welcome the Prime Minister’s possible intervention. If any Health Minister, the Secretary of State or the Prime Minister would like to visit our beautiful part of Yorkshire, I am sure that we would, on a cross-party basis, be delighted to show him the issues that the closure would cause.

Hospital downgrades and closures are happening up and down the country. Two out of three NHS trusts are in deficit and the situation is only set to get worse. Headlines in our national newspapers scream of “NHS facing…worst financial crisis in a generation”, “NHS deficit soars to £1.6bn” and “Will 2016 push the NHS over the edge of chaos?” Searching “hospital closures” on the internet shows the full scale of the problem nationally.

A pledge was made that the PFI deal in Calderdale would be sorted out, but that neither hospital would close. It is beyond absurd that the price to pay for keeping Halifax A&E open is the closure of the Huddersfield facility. Across the two hospital sites, there are 141,000 A&E visits a year. How can one hospital, which is already buckling under the pressure, cope with that many emergency patients in one year? In addition, there will be further pressure on Yorkshire Ambulance Service to transfer acutely ill patients away from Kirklees to hospitals on routes that are often congested and severely gridlocked. Current proposals would see the average ambulance transfer time increase from 16 to 21 minutes. I reiterate that that is an average, so many patients would be in an ambulance for much longer.

I have received a number of emails, as I am sure have my hon. Friends, from understandably concerned constituents who have recounted extremely problematic journeys between the two sites, leading to real fear that there could be a catastrophe in a life and death situation. I recently undertook the journey between Huddersfield and Halifax after the recent rally in Huddersfield centre. I was caught in severe traffic and saw an ambulance held up. I would have hated it if a loved one or someone I knew had been in that ambulance being prevented from getting essential emergency care.

[Jo Cox]

Another issue for cross-party consensus is the lack of a coherent, integrated transport assessment of all the reconfigurations across Kirklees, in Dewsbury and in Huddersfield. Many of our constituents are on low incomes and rely on public transport. With congested roads, moving people around is not easy. I am not reassured that either trust has looked fully at the transport implications of these reorganisations and what they will mean for our constituents.

[Paula Sherriff]

I thank my hon. Friend for her contribution. She has almost read my mind. I have just come out of a meeting with the chief executive of the Yorkshire Ambulance Service NHS Trust and put that exact point to him. I was incredibly alarmed to hear him say that it is working on the modelling for how to transfer patients between hospital sites given the number of reconfigurations in the area. I emphasised that that should have been resolved before, and he acknowledged that perhaps it should have been. The work has not even been carried out, yet there are proposals on the table that hospitals should be downgraded.

Yorkshire Ambulance Service has its own financial pressures and is struggling to meet its current performance targets. We have heard this afternoon that it is failing to meet performance targets for red 1 and red 2 ambulance patients. The question needs to be asked. Have they been consulted about these plans and can they deliver on the promises made by the clinical commissioning groups, despite the fact that we have received an acknowledgement this afternoon that the work is ongoing?

Other factors that need to be seriously considered include the looming adult social care crisis, impending pharmacy cuts—which could mean that 25% of community pharmacies close—lack of GP provision and uncertainty regarding junior doctors. All these factors impact on our local hospitals, and we need to be confident that they are addressed and answered.

Just yesterday evening we learnt that Calderdale Royal hospital and Huddersfield Royal infirmary were on black alert, which meant that they were unable to take any more patients because of a shortage of beds. The trust was said to have implemented the senior level gold command arrangements. Let us imagine the situation had that occurred when only one of the A&E services was functioning.

In the less than two weeks since the plans were announced, we have seen a massive public outcry—bigger than anything that I have witnessed before. Like the hon. Member for Colne Valley, I thank, applaud and pay tribute to all the people involved in the campaign. We have seen the message “Hands off HRI” projected on to many public buildings and looking absolutely fantastic. Sweatshirts and T-shirts have been printed. There are car stickers. People have been going door to door with petitions. There has been a wonderful community response. There is a Facebook campaign with more than 45,000 members—I wish that my MP page got that level of support—and there is an online petition with more than 46,000 signatures. I am pleased to say that at a recent Kirklees Council meeting, councillors voted to work cross party to oppose the changes. All those voices need to be heard, and we must have as long a consultation period as possible to ensure that they are.

Casually sitting back and watching this situation develop is simply not an option. Action must be taken, and it is our job, as elected representatives, to stand up and fight for our constituents. I for one will not be lying down on this issue and I welcome the cross-party pledge from all my MP colleagues—I know that they feel exactly the same way about this issue—that we will work together for a better funding deal and a solution to the chaos that we now find ourselves in.