Mid Yorkshire Hospitals NHS Trust

Jo Cox Excerpts

Monday 21st March 2016 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

Let me start by paying tribute to the doctors, nurses and all the staff working in the Mid Yorkshire Hospitals Trust. As a Member whose constituency is covered by the trust, a local resident and indeed a patient, I have nothing but praise for their hard work, dedication and professionalism. Lord knows, the NHS may be up against it—and this trust perhaps more than most—but I am continually humbled by the quiet and determined way that all the staff at Dewsbury and District hospital, Pontefract hospital and Pinderfields hospital go about providing care and support in the face of what must seem at times like overwhelming odds.

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

I congratulate my hon. Friend and neighbour on securing this critical debate on our local hospital. I back her in what she says and recognise that doctors and nurses and other staff at the hospital have been working in crisis mode for 15 months now. It is difficult to overstate how hard it must be for staff to go to work every day, knowing that they will miss key targets and not be able to give the care and attention that they so want to give.

[Paula Sherriff]

I thank my hon. Friend for her intervention. I absolutely agree with her. We must also pay tribute to our incredible junior doctors.

Whatever difficulties the trust is facing, there can be no doubt that those working there on the frontline are blameless, and deserve our full backing. As Members of Parliament, we owe it to them to make sure that they are given all the support they need.

The trust and its staff have to work in a challenging environment. In the area covered by the trust, the overall health of the population is below the average for England. Deprivation is higher than average, and nearly 20% of children are living in poverty. Life expectancy is lower than the national average for both men and women.

The Care Quality Commission inspected the trust in July 2014, with a follow-up inspection in June 2015. An unannounced inspection of Pontefract hospital emergency department took place in July 2015. A second unannounced inspection took place in August 2015 at Pinderfields hospital, focusing on staffing levels, with a follow-up visit to Pinderfields in September.

Although there were some improvements between the two main inspections of 2014 and June 2015, there were also areas in which the trust’s performance had worryingly deteriorated, and there were still serious concerns about staffing levels. The CQC noted that there was still a significant shortage of nurses, which was having a knock-on effect on patient care, particularly on the medical care wards, in community inpatient services, in the specialist palliative care team and in end of life services.

Two weeks ago, my hon. Friend and I met the trust’s new interim chief executive. We were both very grateful to him for his candour. He told us that the leadership team has effectively been in crisis mode for the past 14 months. He said that the trust had recently put in an additional 120 beds across the trust to cope with increasing demand, but the 100 extra staff who should have accompanied that expansion are nowhere to be seen. The posts simply have not been filled.

[Paula Sherriff]

I thank my hon. Friend for that intervention. I will come to that point later.

To make things more complex on the administrative side, the monthly staffing reports are found to be overly detailed, generally running to over 100 pages, making it difficult to identify the most urgent risks. Likewise, there are concerns that policies and procedures for the escalation of staffing risks were not always followed when they were identified. The trust aims for a ratio of one nurse to every eight patients on adult in-patient wards. The Royal College of Nursing recommends 6.7 patients per nurse on adult wards as a maximum, so one to eight is not too far wide of the mark, though not ideal. However, the CQC found that even the 1:8 ratio was very inconsistently met. During its unannounced visit to Pinderfields hospital in August, of the 17 wards only one was staffed to safe staffing levels. Ten were at minimum level and six were actually below the minimum. Indeed, records show that in August 2015 only 71% of nursing hours were achieved. Staff on the trust’s spinal injuries unit at Pinderfields are constantly reallocated to other wards, in essence robbing Peter to pay Paul. A nurse even told a patient that because they were so short-staffed, if two patients got into respiratory difficulties, which is not uncommon on a spinal injuries ward, the nurses would have to choose which patient they were to save.

The problem is particularly acute at the community in-patient sites at Monument house and Queen Elizabeth house, where between May and June last year 96% of shifts used at least one non-permanent member of staff, either agency staff or staff redeployed from other areas of the trust. Indeed, two shifts had only a single registered nurse on duty. The trust as a whole breached the Department’s cap on charges for agency staff, on average, 132 times a week during December. While it is absolutely right to prioritise patient safety over the Government’s financial targets, that is a clear indication that there has been a failure in long-term workforce planning and that it is struggling to attract and retain appropriately qualified staff.

To give credit where it is due, the trust has been making efforts to address the staffing issue. After the unannounced inspection, a risk summit was held under the leadership of NHS England to look at the actions the trust needs to undertake and the support needed from the wider healthcare community. The high number of registered nurse and care staff vacancies is now noted on the corporate risk register. The trust is looking at a range of different structures for nursing teams to get the best out of the available staff. It has invested in safety guardians to provide support and safeguarding for patients with mental health issues, freeing up time for registered nurses. It is putting extra effort and resources into filling gaps by looking to recruit nurses both locally and from Europe, proactively recruiting rather than waiting for staff to leave.

The CQC rated the safety of services provided by the trust as “inadequate”, largely due to the shortage of staff. For instance, between May 2014 and April 2015, 258 serious incidents were reported, of which 206 were cavity-like grade 3 pressure ulcers. That sort of thing is indicative of nursing staff being rushed off their feet, unable to provide the level of patient care that they would like. Concerns were also raised about patients who required one-to-one care not receiving it, and fluid balance monitoring and nutritional assessments not being properly completed, with charts often not kept fully up to date. In January, 81.4% of accident and emergency admissions were seen within four hours; the target is 95%. More than 2,000 patients waited on A&E trolleys for more than four hours, including six who waited more than 12 hours at Pinderfields.

When looking at such statistics on patient care, we have to be very careful to remember that each number—each percentage point—represents real people. They are people who may be in pain, or vulnerable, worried or nervous. They may be upset or distressed. By any reckoning, the NHS is our nation’s most prized institution, and when people have to make use of it, they rightly expect a certain level of service. NHS staff want to give that level of service, and when they cannot the result is more than just a delay in treatment—the dignity of patients is also compromised.

A few weeks ago I received an email from one of my constituents. Her 84-year-old father had been admitted to Dewsbury hospital with stroke-like symptoms. He was on a trolley in A&E for 14 hours. After he had been admitted to a ward, his daughter came back to visit him. She found that his bed was a complete mess and covered in food, and her father was naked from the waist down. When she asked why he had on only a pyjama top and was sitting on an incontinence pad, she was told that it made it easier when he needed to urinate. When she came back later that afternoon, his bedding had still not been changed, which in the end she did herself. That is a basic outline of one case, but it is by no means the only such correspondence that I have received from concerned constituents. At the moment I receive similar emails more than once a week, which is alarming.

All that, of course, has an inevitable knock-on effect on staff motivation. The results of the 2015 NHS staff survey show just how low morale has sunk. For every key indicator the results are depressing and fall well short of national averages. Only 54% of staff felt that the care of patients was the trust’s top priority, compared with a national average score of 73%, and 55% felt that the trust acts on concerns raised by patients, whereas the national average is 72%. Just 41% of people would recommend the trust as a place to work. Perhaps most damningly of all, only 46% of people would be happy for a friend or relative to receive care at the trust.

The amount of disciplinary action being taken against staff has risen in recent months, which is generally due to staff making minor mistakes or not being able to follow procedures through fully for want of time. That is a symptom of the shorthandedness that has been experienced on the wards, and it contributes to the general air of despondency as staff are effectively penalised for not being able to be in two places at once. I have spoken to a number of past and present members of staff in the trust, who informed me that they have failed to whistleblow for fear of retribution.

The feeling of being worn down is affecting staff at all levels. I was told by the interim chief executive last week that the board has effectively been operating in crisis mode for the past 14 months, which, of course, is now taking its toll. There is a general feeling of chaos, tempers are fraying, and there is severe instability in the personnel in management teams—a sure sign that the trust is struggling to get its problems under control, which is a challenge in itself.

To be fair, there have been some slight improvements recently. The CQC’s follow-up visits noted that staff were more confident than they had been previously, and that senior management were taking some concerns on board and trying to get to grips with the issues. However, that feeling was by no means universal, and that slight improvement from such a low base is hardly a cause for celebration.

On the underlying causes of these problems, the Government must take the lion’s share of the blame. Going right back to slashing nursing training places in 2010, they have failed to ensure that the NHS has the levels of staff it needs to provide a safe and caring service. Thousands of nurses who should have begun training between 2010 and 2012 and would now be qualified—thereby helping to alleviate the difficulties in Mid Yorkshire—are just not there. Applicants for nursing courses outnumber the available places by more than two to one.

The whole ethos of the NHS has been warped from one of service and care to one of financial management. Of course the health service must keep on an even keel, but when a cash-strapped trust feels that it is appropriate to hire city consultants such as Ernst & Young, alarm bells should start ringing. Thankfully, that contract finally came to an end last September, but not before the trust had stumped up more than £15 million. Given that staff are still struggling to keep their heads above water, they could be forgiven for questioning whether that was money well spent.

[Jo Cox]

My hon. Friend makes a powerful and personal case. Does she agree that the Government have responsibility for this issue? They have cut public health funding, and there is a social care crisis locally and problems with the junior doctors contract. The Government must take responsibility for this crisis and not pass the buck to an embattled NHS trust.

[Paula Sherriff]

I absolutely agree that the buck must stop with the Government, and we must see action, not platitudes.

I have now been told several times that the solution to the problems lies in the plans to downgrade Dewsbury’s A&E and maternity services, which will be centralised at Pinderfields. I say that that is putting the cart before the horse. Nearly 70% of in-patient beds will be lost in Dewsbury, and the simple fact is that this will put lives at risk. Leaving aside the arguments about whether the proposed reforms are necessary, it is just not safe to attempt this sort of major restructuring right in the middle of a major staffing crisis.

Once again, financial considerations are overriding clinical concerns. The trust is currently consulting on proposals to bring forward the reconfiguration. I say absolutely unequivocally that, while the trust is in a state of flux, discussions must focus solely on improving safety and quality. I urge the board to abandon these plans.

I have written to the Secretary of State about the serious worries in relation to what is going on at Mid Yorkshire Hospitals NHS Trust. The Minister has kindly agreed to meet me and other concerned MPs next month to discuss this in more detail. However, I want to reinforce the point that we are in danger of forgetting the lessons learned from the Mid Staffordshire situation about the absolute priority that must be given to safe staffing levels. Unless we can crack this by getting the qualified staff we need, no amount of reorganisation will make up for poor care. We must break the spiral of demoralisation and overwork so that we can help both the patients and the staff who are currently getting the short end of the stick.

On this day exactly 70 years ago, Nye Bevan announced his plans for a national health service. His vision of universal healthcare free at the point of delivery and funded collectively is just as valid today as it was then. Bevan said:

“The NHS will last as long as there are folk left with the faith to fight for it.”

We must stand together now for the NHS, and we must support the staff who go above and beyond for the NHS every day. It is our duty as parliamentarians to continue the fight for those who, yet still, have faith in those founding principles—an NHS for all, based on clinical need and free at the point of delivery.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I thank the hon. Member for Dewsbury (Paula Sherriff) for bringing this matter to the House and for her powerful introduction to her constituents’ concerns. I also thank the hon. Member for Batley and Spen (Jo Cox), who intervened. They make a powerful double act for Mid Yorkshire. I have felt the pressure of the concerns they have quite rightly raised with me privately, and I hope that they will be able to do so again in the next couple of weeks.

I very much like the fact that the hon. Member for Dewsbury ended by mentioning this important anniversary. We are a few weeks away from the 70th anniversary of the Second Reading of the National Health Service Bill, as it then was, on 30 April. At that time, Nye Bevan made two points about the introduction of the NHS. The first is the one we all know, and of which we are equally proud, which is that it should be a service free at the point of need.

However, Nye Bevan made another point, which for him was as important in the establishment of a national health service—it has been forgotten by politicians on both sides during the past 70 years—which is the principle of universalising the best. He made a very powerful argument at the time, which was that the reason for a universal NHS was to ensure not just that people could approach the service without having to worry about money, but that someone from a part of the country that traditionally did not have good hospital care could rely on the same quality of service that they would expect in a wealthier or better served part of the country.

In establishing the first part of Nye Bevan’s dream, we have done well, but in establishing the second part, we have not yet succeeded. The hon. Lady’s constituents have, in part, been at the rough end of that. For years, under Governments of all kinds, we have not done well enough in universalising the best across the service. As we discussed when we had our meeting, there are hospitals not far from hers that are delivering exceptionally good and consistent levels of nursing care. They have been able to do so while under similar pressures to those in her own hospital—as she has correctly identified, similar pressures apply across the service.

Clearly, there are historical problems in Mid Yorkshire, and they will be difficult to grapple with. I completely understand why the hon. Lady feels that commissioners might not yet have a full enough grasp of the problems in her area. That is why she questions the basis of the reconfiguration. I understand that the assurance exercise into the reconfiguration is nearing its end, and we will publish that at some point in the near future. I hope that that will provide assurance that the accelerated reconfiguration can take place. I take into account the completely legitimate points that the hon. Lady made about the readiness of the reconfiguration of social care services in the area, but I think we should cross that bridge when we get to it. I am mindful of the fact that I have no power to change reconfiguration decisions—and neither does the Secretary State.

[Jo Cox]

As the Minister will be aware, the Mid Yorkshire Hospitals NHS Trust has the third highest number of admittances to A&E in the country. In that context, I share the concern of my hon. Friend the Member for Dewsbury (Paula Sherriff) about the planned reorganisation and downgrade of the Dewsbury hospital. It is a serious matter for local residents and some of my constituents. It would be wonderful to have a commitment further to discuss whether now is the time to move forward with that plan.

[Ben Gummer]

Of course I understand why it is a matter of concern. I must say what I have also said privately, which is that I must respect the opinion of clinicians and commissioners. That is why I want to hear what they say. Ultimately, there is the approval process that this reconfiguration has already gone through—namely, that of the Independent Reconfiguration Panel. I will, of course, speak to the hon. Lady whenever she wishes. It is not kindness on my part, but my duty to her as a Minister responding to an elected representative.

I spoke today to the director of nursing at the Mid Yorkshire Hospitals NHS Trust and also to representatives of the local trust development authority, and I was glad to be assured on some points. I was pleased to hear that they were co-operating with Lord Carter’s review of safe staffing ratios, which should provide a promising foundation for ensuring that we have the right kind of staffing ratios at the appropriate acuity of patients. This will be good in every hospital where it eventually applies, but for those with very challenged staffing ratios at the moment, the ability to look carefully at the rostering of staff across the service with the kind of skills and international experience that Lord Carter will bring will, I think, be helpful. Unfortunately, I was not made aware of the meeting that the hon. Lady had with the chief executive. I am disappointed about that because she clearly had a robust discussion. I have seen the contents of the letter that she sent to the Secretary of State.

Autism Diagnosis Waiting Times

Jo Cox Excerpts

Tuesday 8th March 2016 Westminster Hall

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

I beg to move,

That this House has considered autism diagnosis waiting times.

It is a pleasure to serve under your chairmanship, Sir Roger, and to lead this important debate.

As hon. Members will know, autism is a lifelong developmental disability that affects how a person communicates with, and relates to, other people. It is a spectrum condition, which affects different people in different ways. Some people with autism are able to lead a substantially or even completely independent life, while others may need a lifetime of specialist, complex support.

Diagnosis, which is what we are here to discuss, is a critical milestone for people on the spectrum. It helps individuals to take control of their lives and can unlock access to essential support and services. Diagnosis is important not only for those who are on the spectrum. It can be just as important for their parents, friends and loved ones, enabling them to better understand their child, friend or partner.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

My hon. Friend may know that I have an autistic child in my family and that I chair the newly formed commission on autism. Would she agree that it is absolutely about the family support that would come from early diagnosis? At the moment, so few people get it.

[Jo Cox]

Absolutely. I bow to my hon. Friend’s experience, expertise and doughty campaigning on this issue, and I could not agree with him more. Tragically, as we know, many thousands of people up and down the country, including children, wait far too long for a diagnosis. For children, on average the current wait is now more than three and a half years.

[Mrs Cheryl Gillan (Chesham and Amersham) (Con)]

I congratulate the hon. Lady on obtaining this debate, which is very important to a large number of people beyond this Chamber. As she knows, I hold the honour of being the elected chair of the all-party group on autism, which has been going for many years now. Diagnosis waiting times are a very important issue for Members of Parliament involved in this area. Does she also hope that we will hear in the Minister’s reply about the importance of NHS England’s collecting and monitoring those diagnosis times for each clinical commissioning group in England? That is important and will mean that we have the data.

[Jo Cox]

I agree entirely. Let us hope that we have an answer on exactly that point from the Minister. I applaud and bow to the right hon. Lady’s commitment and experience on this issue.

While the average waiting time for children is more than three and a half years, many adults receive a diagnosis only five years after concerns first emerge and often two years after seeking professional help. Some 61% of people who responded to a National Autistic Society survey said that they felt relieved to get a diagnosis when it finally came, and more than half—58%—said that it led to their getting new or additional much-needed support. It is of particular concern that children are having to wait so long for a diagnosis. Not only does that place tremendous strain on their whole family, but it means that many children do not receive the early intervention that could have a big impact on their formative years. Indeed, in many cases, children are being locked out of the services available to them, and that support can be life-changing.

Snowflakes is a nursery for children with an autism diagnosis or who are awaiting an autism diagnostic observation schedule assessment. The nursery is run by my sister-in-law, Stacia. One of its children was lucky and got an early diagnosis aged three. He joined Snowflakes and the team worked with him and his family for two years. The dedicated staff managed to help him into a mainstream primary school with support, and he is still in that school and is thriving. Another child came to Snowflakes because her mainstream nursery was unable to cope with her challenging behaviour. She is now on an 18-month waiting list for a diagnosis, but is due to start primary school in just six months’ time. She is making good progress within the specialised setting and is now a role model for other children. Her parents want her to move on to a primary autism resource, but to get a place she needs a diagnosis.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I thank the hon. Lady for securing this important debate, which I feel strongly about. In my constituency, I have had contact with families experiencing exactly the issues that she is raising. Is it not important that more clinicians are trained to diagnose and that teachers are able to pick up very early signs of autistic spectrum disorder?

[Jo Cox]

I thank the hon. Lady for that helpful intervention. I agree with her, and let us hope that the Minister addresses that point in his comments.

To return to the example of a little girl who faces a choice. Without a diagnosis she will be forced to accept a place in a mainstream primary school that will not be able to meet her needs. With a diagnosis, however, she would go to a primary autism resource using the specialised teaching methods she knows and trusts. She would be able to continue her education and in turn increase her life chances.

Many parents tell the National Autistic Society that delays in getting diagnoses have also led to the development of serious mental health problems, both for the individual and for the family. For example, having presented himself to GPs for 20 years, Chris was diagnosed with Asperger’s syndrome in 2007 after finally deciding to go private. Without a diagnosis, appropriate support or an understanding of his needs, he experienced mental health conditions for most of his life, including depression, anxiety, obsessive-compulsive disorder and mild Tourette’s. He was hospitalised when he was 15 and later became suicidal when his needs were not met.

We now know the value and importance of early and fast diagnosis, yet our system continues to fail so many children and adults. Members present will have heard stories from their constituents or family members and will have no doubt been deeply affected by them, as I have. One has to meet only a handful of parents to realise the unbelievable pressures that the waiting times put them under.

I could tell a number of stories from my own constituency—members of some of the families affected are here today—but I want to tell the story of a young man from Batley. He is one of the lucky ones: he now has his diagnosis of Asperger’s syndrome. His mum wrote to me and told me what a blessing the diagnosis has been. It did not just provide access to support and services, but it helped everyone, including him, to understand why he felt and behaved the way he did. He said he wished he had been diagnosed earlier because:

“I always knew I was different, now I know why.”

He is one of the lucky ones, because his parents had the ability to pay for a private diagnosis. They raised £2,500 to fast-track the process, but they should not have had to do that. What about the great many of my constituents who do not have the means to afford a private diagnosis? Another of my constituents, who is also from Batley, has had to give up his job to accompany his son to school every day. Without a diagnosis, the school is not able to fund the additional staff it needs to take care of his complex needs. It is a problem not only in my constituency, but throughout the country.

[Mr Sheerman]

My hon. Friend is being generous in giving way. Is it not also disappointing for constituents and for people we know in the autism field—some very experienced people have intervened on her on that count—when someone goes into a health diagnosis and the health people say, “We can give you the diagnosis, but you will not get any help because the local authority does not have the capacity or the trained people to provide that help”?

[Jo Cox]

Absolutely. My hon. Friend again raises a very valid point. We are talking specifically about diagnosis delays, but once someone has a diagnosis, that opens up a whole range of issues that I hope the Minister will address.

[Mrs Gillan]

Further to the intervention by the hon. Member for Huddersfield (Mr Sheerman), one of the key things that the all-party group has been pushing for is better data collection in local areas so that we can more effectively plan and commission services. Nationally, it would mean that we could then ensure that each area is meeting the needs of its local population. Does the hon. Lady agree that it will be interesting to see whether the Minister can tell us what discussions he has had on that and how he intends to take the subject forward appropriately and properly with NHS England?

[Jo Cox]

I agree entirely, and one of the worrying things that became apparent to me in my research for this speech is the growing regional disparity in autism diagnosis waiting times, as well as in the service someone gets once they have a diagnosis. Let us hope that the Minister addresses that point.

My constituent from Batley has given up his job so that his son can attend school every day. As I have said, the problem exists not just in my constituency, but up and down the country, and stories from the NAS highlight that. There is Mel from Watford, whose son waited nine years. Noah, who is four, waited two years for his diagnosis—that is half his life. Meanwhile, data from Public Health England from the latest adult autism strategy show huge regional variation in adult services, with waiting times between referral and first appointment —not even the whole diagnosis journey—in the south-west reaching 95 weeks. In my region of Yorkshire and the Humber, it is 84 weeks. The NICE quality standard on autism is clear: once referred, people should wait no longer than three months before having their first diagnostic appointment. For this to happen, the Government, local authorities and NHS England need to act.

In my own local authority, Kirklees, despite strong leadership and a clear commitment to protect and safeguard vulnerable children and adults, there is an acknowledged crisis in children’s mental health and autism services. Some families have been waiting more than two years for a diagnosis, often longer. I have been encouraging Kirklees and its clinical commissioning groups to clear the backlog and redesign their services, and I am pleased to announce that, starting last Friday, a plan to clear the backlog within 12 months is now being rolled out regionally. This will quadruple the number of diagnoses that can take place in my constituency.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing this debate. Autism diagnosis across the whole of the United Kingdom of Great Britain and Northern Ireland is a big issue. In Northern Ireland, some 2,000 young people are waiting for a diagnosis, although the Minister has set some money aside. There is a need not only for early diagnosis, but for further stages of the education programme as well. Does the hon. Lady agree that the Minister should consider what has been done regionally—in Northern Ireland, Scotland and Wales—because there are lessons to be learnt that would benefit all of us?

[Jo Cox]

I agree entirely. It is time for the Government to bring a wider discussion about autism services to the Floor of the House.

My local authority’s announcement last Friday now means that we will quadruple the number of diagnoses that can take place in my constituency. It still needs to redesign the service in a way that prevents future backlogs, but this is good news for Batley and Spen and for people across Kirklees. However, it should not go unacknowledged that local authorities such as mine are working hard to reform services in an environment of severe and disproportionate budget constraint, imposed on them by Government. Of course, this is just one local authority; what about the hundreds of others and the desperate families in their care?

We also now have to accept that this failure to diagnose autism early ends up costing taxpayers much more. When developing its guidance for health services, NICE stated:

“Investment in local autism services also contributes to: a reduction in GP appointments, fewer emergency admissions and less use of mental health services in times of crisis, including the use of inpatient psychiatric services.”

[Tom Tugendhat (Tonbridge and Malling) (Con)]

The hon. Lady speaks with great power and passion. I support her absolutely and thank her for securing this debate. In my own constituency, the Grange Park School, which I have often visited, specialises in autism care. The school’s view is that proper care and diagnosis relieves the burden on the police, who are often called in to deal with situations that are not policing matters and not for the judicial system, but for the mental care system, and, if handled properly, for the education system.

[Jo Cox]

The hon. Gentleman makes a fascinating and pertinent point, particularly as we heard about a case this morning that was very tragic and relates to some of the themes he has raised. I know he is personally committed to this issue, and it would be good to have a response from the Minister on his point.

The National Autistic Society tells us that by investing in autism diagnosis, the NHS could save the enormous amounts of money currently spent on mental health services that result from autistic people not getting the support that they need, as they have not got a diagnosis. As well as having negative consequences for someone’s life, acute services are also very expensive, with in-patient mental health care costing between £200 and £300 a day. In other words, the annual cost of supporting two people with autism in a mental health ward would fund a specialist autism team serving an entire borough for a whole year.

Furthermore, identifying and supporting someone on the autism spectrum can save money in the wider public sector. According to the National Audit Office, an 8% identification rate would save £67 million a year. Over the five years to 2020, that is a potential saving to the public purse of £337 million.

[Tom Tugendhat]

We rightly look at pounds, shillings and pence when we talk about the public purse, but does the hon. Lady recognise that identifying and supporting autism saves families from failing? The saving to the public purse is significantly greater than the figure she has given, because it relieves the burden on many other branches of public services that would otherwise have to support a failing family.

[Jo Cox]

I entirely agree. The hon. Gentleman makes a very valid point.

Crises in autism services are a decade or more in the making. The blame cannot and should not be pinned on one party or one Parliament, but now that we are more aware of the problem and the scale of it, this Government should be judged on how they fix it.

I urge the Minister, who I know is personally committed to this issue, to agree to implement in full the National Autistic Society’s key recommendations to help tackle the crisis: first, a new requirement on NHS England to collect, publish and monitor data on diagnosis waiting times, including data on how many people are known to their GP to have autism. Secondly, NHS England should ensure that standard waiting times on mental health reflect the NICE national guidance that no one will wait longer than three months between referral and being seen for diagnosis. Finally, the Government must share in this commitment, ensuring that NHS England now meets the three-month target. To help fulfil that aim, access to an autism diagnosis should be clearly written into the Department of Health’s mandate to NHS England, which means that it will be held to account on this target and it becomes a priority to get it right.

Before I finish, I have three additional questions that I hope the Minister will address directly. What steps has his Department taken to ensure that the work done by NHS England’s information board will improve the collection and recording of data on autism in primary and secondary care? Will the Minister ensure that the recommendations in the King’s Fund’s recent report relating to autism diagnosis waiting times are taken forward? Finally, what assessment has the Minister made of the costs to the NHS of failing to diagnose people with autism in a timely manner?

The fundamental question facing us is this: the crisis is now so acute that some desperate parents and individuals are paying for help that by right they should be able to access on the NHS, but what about those without the resources to pay? They are currently left in a distressing and damaging limbo, often for years. I hope for their sake that when the Minister responds we will hear clear, time-bound commitments and actions, rather than vague assurances. I also hope, along with other Members, that he will commit to more time on the Floor of the House to discuss the many challenges facing individuals and families even after they have received a diagnosis.

I pay enormous tribute to the National Autistic Society, whose relentless campaigning continues to raise awareness and continues to press for action on this critical issue. I also pay tribute to all the parents, carers and professionals who support and love people living with autism.

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.

Oral Answers to Questions

Jo Cox Excerpts

Tuesday 17th November 2015 Commons Chamber

[Alistair Burt]

First, £1.25 billion is going into creating new services for children and young people’s mental health services during the course of this Parliament. The hon. Lady’s party did not make that commitment before the general election. More work is being done in schools to provide a better base for mental health. We have, for the first time, appointed in the Department for Education a Minister with responsibility for mental health in schools.

The pressures on public health budgets are the same as those on every other budget. Those pressures on the national health service were met by my colleagues during the general election, with a commitment to provide an extra £8 billion—the figure is now £10 billion—by the end of this Parliament. That commitment was not made by the hon. Lady or her party. She asks for more money to be spent, but we have committed to do that and we are finding it. It is very important that we take the position that we have to do as much as we can with what we have got. Mental health services are moving forward and we should take the opportunity to say that and welcome what has been done. We have provided the resources in a way that I am afraid the hon. Lady’s party did not.

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

5. If he will take steps to assist hospital trusts to mitigate the cost of car parking on NHS sites for out-patients and visitors.

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

It is for NHS organisations locally to set the cost of car parking, but they should be informed by the principles and guidance set by the Department of Health.

[Jo Cox]

My local trust of Mid Yorks has just increased parking charges at Dewsbury and district hospital and has introduced charges for drivers with disabilities. The trust is clear that that is due to the financial settlement from Government. Does the Minister think it is acceptable that people who are ill or in need of medical attention, and their loved ones, are being penalised in this way?

[Ben Gummer]

The financial settlement from the Government is more generous than the one promised by the hon. Lady’s party at the last election. We are committing £10 billion over the next few years. I would ask her trust to look at the savings suggested by Lord Carter, who has identified considerable savings that can be made within hospitals. If it feels that it needs to increase car parking charges, it should refer to the Department of Health guidance, which makes it clear that there should be concessions for blue badge holders.

Health and Social Care

Jo Cox Excerpts

Tuesday 2nd June 2015 Commons Chamber

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

It was my honour last week to visit Priestley mental health unit at Dewsbury and District hospital. It does amazing work for local people. The welfare changes implemented over the past five years have put an incredible strain on vulnerable people who need mental health care, and, according to the projection for the next five years, the number of people in that terrible situation will increase and our mental health care services will have to meet an increased demand. Does my right hon. Friend share my concern about that?

[Andy Burnham]

As my hon. Friend the Member for Liverpool, Walton (Steve Rotheram) pointed out a moment ago, NHS services are often not there for young people in particular when they need them, but we must also ask ourselves why people end up in that position in the first place. We have seen, in some of the public policy decisions that have been made in recent times, a failure to understand how changes can affect people’s mental health. The work capability assessment, for instance, did not pay sufficient regard to mental health, and that needs to change if we are to give people proper support in this Parliament.

Let me, at the start of the new Parliament, urge all new and all re-elected Members to bear in mind the momentum on mental health that was built in the last Parliament, and to do everything they can to build on it. Given the nature of modern living and the stress and insecurity that we all have to absorb, mental health will remain the issue of our times, and we shall need public policy to match. The last Parliament made huge progress in raising mental health issues, but this Parliament needs to translate those words into action.

Progress was also made on patient safety, and the Secretary of State deserves credit for that, but, again, it is important for the momentum not to be lost in this Parliament. In that context, there appears to be a significant omission from the Gracious Speech. Improving the regulation of health professionals was a central recommendation that emerged from the Francis report, and a Bill to modernise professional regulation has long been anticipated. It would have had cross-party support, and would have enabled the regulators to get on with the job of protecting and safeguarding the public from poor care. The failure to introduce such a Bill means that there is now no prospect of reducing the time it takes to deal with complaints, which, at present, is typically 15 months from start to finish. Jackie Smith, chief executive of the Nursing and Midwifery Council, has said that she is “deeply disappointed” by the omission, and that it is a “major setback” to the response to the Francis report. Can the Secretary of State explain why no such Bill was mentioned in the Queen’s Speech, and tell us when it can be expected? We need a professional regulatory regime that is modern, up to date and fit for purpose.

The issue on which I now intend to focus is finance. For the last five years, we have been treated to repeated lectures from Ministers about the importance of sound management of the public finances. That is the signature of this Government, or so they like to claim. Today I want to put that claim to the test in respect of the NHS, and to look in detail at the Government’s stewardship of NHS finances.

The Government like to talk about the deficit, but they do not often mention the very large deficit they have created at the heart of the NHS. We will put that right today, and consider the promises they made in the run-up to the election: local promises to reopen A&E departments, and national promises to deliver GP opening hours of 8 am to 8 pm and seven-day NHS working. We will ask how all that can be delivered, given that the NHS finances are deteriorating fast.