Oral Answers to Questions
John Whittingdale Excerpts(1 month, 1 week ago)
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Sir John Whittingdale (Maldon) (Con)
The Labour manifesto spoke of the need for a consensus on social care, and the Secretary of State has said that he wants to reach out across the political divide—although the message does not seem quite to have reached the Minister yet. During Health and Social Care questions in July, the Minister said that there would be announcements in the near future, but since then we have heard nothing. We are ready to talk; when will the Government be ready?
Stephen Kinnock
I am not sure if the right hon. Gentleman was listening to my previous answer. We have just set out a groundbreaking piece of legislation to settle the issue of adult social care pay, which is more than the last lot did in 14 years. We are absolutely committed to building cross-party consensus. We know that we need a process that will be sustainable and fix adult social care for the long term. That absolutely includes engagement and dialogue across this House, because we want to build a consensus that works. We recognise that successive Governments have failed to get a grip on this issue, but we recognise the vital role that adult social care will play. It is going to be a hugely important part of our 10-year plan for the future of the NHS, and I look forward to engaging with all hon. Members on this issue.
Oral Answers to Questions
John Whittingdale Excerpts(4 months ago)
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Sir John Whittingdale (Maldon) (Con)
I congratulate the Minister and his Front-Bench colleagues on their appointments. I welcome the suggestion that the Government are considering the possibility of a royal commission on social care and intend to address the issue on a cross-party basis, but that will take time. Can the Minister therefore confirm that, as was suggested during the election campaign, the Government will take forward the Dilnot reforms, and in particular that they will introduce a cap on social care costs, as was planned by the previous Government?
Andrew Gwynne
It was, of course, the right hon. Gentleman’s Government who kicked the can down the road on these issues. They allowed the system to spend the transformation money that had been provided precisely for the purpose of the Dilnot reforms on fixing their broken national health service. He should just be a little bit patient, as we will announce our proposals for social care shortly. He should rest assured that, as I have said to him before, this Labour Government are determined to fix both the broken NHS and the broken social care system that we inherited from 14 years of Tory failure.
Oral Answers to Questions
John Whittingdale Excerpts(7 months ago)
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Victoria Atkins
Again, let us bring ourselves back up to date. I know the Labour party likes looking back to the last time it found favour with the British public, but Wales is the up-to-date record of today. Labour’s lamentable record of running the NHS in Wales speaks for itself. If the hon. Gentleman is so set on reform, why on earth is he not helping his Labour colleagues in Wales to do exactly as he is promising? It is because they are empty promises, and because the hon. Gentleman and, I am afraid, the Labour party will step back from reform rather than grappling with the issues, as we are doing with our recovery plan.
Finally, on the dental recovery plan, within a month of the new patient premium being switched on, hundreds of surgeries have opened to new patients, which means that patients in the hon. Gentleman’s constituency and elsewhere are getting the care they need.
Sir John Whittingdale (Maldon) (Con)
Victoria Atkins
I thank my right hon. Friend for raising that matter. I understand that a consultation was conducted locally and that more than 5,000 local people and staff responded. Their feedback will be analysed by an independent research agency, which will produce a report for the Mid and South Essex ICB, and a meeting is due to take place in public in July. I will, of course, continue to take an interest in this matter.
St Peter’s Hospital, Maldon
John Whittingdale Excerpts(8 months, 2 weeks ago)
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Sir John Whittingdale (Maldon) (Con)
It is a pleasure to have a fellow Essex Member in the Chair, Madam Deputy Speaker. I also welcome my hon. Friend the Minister, and I am glad to see my constituency neighbours, my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—on the opposite side of the River Crouch—and my right hon. Friend the Member for Witham (Priti Patel). She and I share the Maldon district between us, and we are working very closely on an issue that is of huge importance to both my constituents and hers.
St Peter’s Hospital in Maldon is a much-loved community hospital. It has been delivering care since the NHS was founded, but the building itself is a former workhouse and is more than 150 years old. We have known for some time that the building has significant problems, although, thanks to the dedication of the staff, the quality of care has been superb. There are significant challenges, which have become worse over time. The hallways are too narrow for stretchers, the floors have not been able to take the weight of the beds, the lift has repeatedly broken down, and there are leaking roofs, asbestos and potentially even a risk of legionnaires’ disease. While money has been spent over the years to maintain the building and keep it going, it has long been recognised that a new purpose-built facility is needed, either on the present site or in a different location. That has been the subject of debate and discussion for a number of years.
In 2003, the annual report of the Maldon and South Chelmsford Primary Care Trust stated that two preferred sites had been identified, that a provisional outline business case approval had been given, and that the new build was scheduled to open at some time towards the end of 2007. It never happened. There were difficulties with establishing ownership of part of the land off Limebrook Way, where it was due to be sited. Since then, we have had a succession of studies and debates about what a new hospital should offer and whether it should be a health hub. Most recently, plans were being drawn up for a new site to be developed to the west of Maldon, on Wycke Hill. However, this proposal became stuck due to the lack of sufficient funding for the access road, and a reduction in the contribution available from the developer and from the section 106 money for the housing being developed nearby.
To meet the anticipated winter pressures, it was announced in August last year that the in-patient beds would be relocated to Brentwood and Rochford, and the birthing unit transferred to St Michael’s Hospital in Braintree. We were told that these changes were only temporary while long-term solutions were found. Despite that, the Mid and South Essex integrated care board announced in January that it was proposing to make the changes permanent and that the out-patient services at St Peter’s would be relocated elsewhere, allowing the building to be eventually closed.
The proposals are subject to a consultation, which has recently been extended to 4 April. The ICB says that 2,600 of its surveys have already been returned. Over 400 people attended a public meeting that I organised with the mayor of Maldon, Councillor Andrew Lay, and another 100 had to be turned away. I have also received nearly 700 email responses to my own survey, and I am currently distributing across the constituency 25,000 leaflets containing a survey. It is already clear that my constituents are unanimous in wanting to see medical services continue in the town. They also believe that the consultation is a cosmetic exercise, with decisions already taken. I have to say that this belief is reinforced by the fact that the two alternative options presented for the in-patient beds currently in St Peter’s both involve closing the wards in the hospital and moving them elsewhere.
The Maldon district is growing steadily. We have something like 3,000 houses currently under construction in Maldon and Heybridge, with another 1,500 across the district. Demand for NHS services is rising steadily, with the GP to patient ratio already one of the worst in the country. Rather than closing NHS facilities, we need more. In addition, Maldon district is geographically spread, with some villages already half an hour’s travel time from Maldon. The travel time to Broomfield, Braintree or Brentwood can be up to an hour or more from villages such as Tillingham or Southminster in the Dengie peninsula, and the idea that an expectant mother in the early stages of giving birth should have to travel an hour is appalling.
The ICB suggested last year that there was an average of just six births per month at the maternity unit in St Peter’s, but the unit was actually closed for a large part of that time, because staff were sent to Chelmsford. Ten years ago, there were over 300 births per year, and the population has grown steadily since that time. As one of the midwives wrote in response to the survey that I am conducting:
“Our unit has seen 1000’s of births over its 75 years, over the past 5 years we have had over a 1000 postnatal stays, mothers who have birthed at Broomfield, then needed ongoing support coming to stay with us, we have taken readmissions from the community with baby’s not feeding well, which in turn warded off a remission to Broomfield where beds are always in short supply. We do in excess of 50 community visits weekly, 80+ clinic appointments weekly, over 20 new bookings a week, and anything between 5-10 appointments a day on our ward for anything extra…We are so much more than the ‘6 births a month’ that was widely reported and made us as a team so very angry and undervalued.”
The availability of in-patient services and a maternity unit are of huge importance to my constituents, but it is the out-patient services on which thousands depend. There are some 80,000 out-patient appointments each year, with a huge range of specialties such as X-rays, blood tests and ophthalmology. Although, unlike my right hon. Friend the Member for Witham, I have not used the birthing unit, I have received physiotherapy at the hospital and am due to have an abdominal aortic aneurysm screening there in the next few weeks.
I welcome the ICB’s assurance that out-patient services will be maintained at St Peter’s until alternative locations in the town are found, but it is essential that they are maintained in Maldon without a break or cessation of service. It is not good enough simply to divide up the different services and to try to slot them into buildings across the town. We need the new hospital or health hub that has been promised for so long. We have seen the new hospital at Braintree and the expansion of Broomfield and Southend, but Maldon has been consistently overlooked.
It was announced in last week’s Budget that the Maldon district is being allocated £5 million of levelling-up money for cultural projects, which I welcome, but what my constituents want is not cultural projects but a new hospital. Essex County Council and the district council have money set aside, but it is unlikely to be sufficient.
I applaud the Government’s continuing investment in the NHS, of which we saw further proof last week, but I ask the Minister to tell the Mid and South Essex ICB to think again and, rather than cutting services, to maintain and expand them so that my constituents have the high-quality, easily accessible healthcare they deserve.
The Minister for Social Care (Helen Whately)
indicated assent.
Health and Wellbeing Services: Essex
John Whittingdale Excerpts(8 months, 2 weeks ago)
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Sir John Whittingdale (Maldon) (Con)
I thank my right hon. Friend the Member for Witham (Priti Patel) for obtaining this debate. As she said, we who represent the county of Essex work together closely on these matters, and I absolutely endorse everything that she and my hon. Friend the Member for Colchester (Will Quince) said.
I was elected originally for a constituency called South Colchester and Maldon, which included the areas in the Maldon district now represented by my right hon. Friend the Member for Witham and a number of wards in the Colchester constituency. During all the time that I have represented the area, we have been debating the problems of healthcare in the county, particularly the lack of funding.
When I first came to this place, we were part of something called the North East Thames regional health authority. My right hon. Friend is right that the record of NHS funding overall has been very good, but we have suffered consistently from a skew, with more money going originally to the areas of London that were part of the North East Thames RHA, and subsequently, through the various allocation formulas, we have lost out. The funding per head has been consistently below what is needed, and that is reflected in some of the problems we have, particularly because, at the same time that we have been underfunded, we have seen steady and continuing population growth. My right hon. Friend referred to the 1,000-plus houses being built in Heybridge, part of which falls in my constituency. I have another development on the other side of Maldon from Heybridge of another 1,500 houses. About 3,000 houses are going up in Maldon and Heybridge alone, with more houses across the district. They are putting steadily increasing pressure on the health service.
The issue of St Peter’s Hospital, to which my right hon. Friend referred, is of huge importance to the town’s residents, the Maldon district and the surrounding area. I will bring that matter to the House’s attention on Thursday in an Adjournment debate, when we will have a lot more to say about it. However, it is fair to say, in summary, that St Peter’s Hospital is 150 years old, it has been steadily deteriorating and, in all the time that I have represented the area, we have been debating a replacement. We have come very close a number of times, but each time it has never quite happened. It has now reached the point where the hospital can no longer safely provide services in some of the areas, because the original structure is not appropriate, and although money has been spent on it, the hospital has nevertheless deteriorated. We have been debating whether to refurbish or relocate it for all these years, but nothing happened until we reached the point where it is now proposed that the hospital is closed and services—particularly maternity and in-patient services—are moved to other locations far from my constituency and, particularly, some of the more remote areas. I will speak about that in more detail on Thursday, but it is an indicator of the way in which my part of Essex, particularly, has been under-provided for for far too long.
That is also reflected in the access to primary care, which my right hon. Friend mentioned. We have two GP practices in Maldon. They both have patient lists well in excess of 12,000. I know that across the country people struggle to get appointments. We all hear about the difficulty that people have—they ring at five-past 8 and are told that the appointments are all gone—but it is especially acute in Maldon. Both those practices are in buildings that are simply not fit for purpose, and that compounds the problem. In each case, we are looking to reap a benefit from this housing development by obtaining investment into infrastructure.
I share my right hon. Friend’s view that those currently trying to supply health services across the county are doing their best. I join her in congratulating and thanking the leadership of Essex County Council, whom I met last week to discuss these problems, including Kevin Bentley and his colleagues. Equally, I thank the representatives of the ICB, but we have reached a point where action has to be taken, and we are looking to the Government for help. As I say, I will talk more about that on Thursday. I know that every MP will claim that their area needs more support, but our situation is the consequence of decades of underfunding. We have been shouting loudly for too long without being heard, and we have reached a point where something has to change.
My right hon. Friend mentioned the Essex mental health inquiry, now called the Lampard inquiry. Melanie Leahy, originally my constituent but now a constituent of my right hon. Friend, and my constituent Lisa Morris have been calling attention to and ringing alarm bells about what has been going on in mental healthcare in Essex for a long time. When they first started doing so, they asked for an inquiry. For a long time they were denied it, until eventually we recognised that, clearly, something was badly wrong. The number of deaths that happened under the care of the then mental health trust was excessive and needed examination.
The Government eventually agreed and set up an inquiry, but it was not statutory. My constituents came back and said that it has to be statutory. At the time, we said to them that we had discussed this with the then Ministers, who said, “No, but our advantage is in it not being statutory. Therefore, we should not go down that road.” The Government have now accepted that the inquiry does have to be made statutory, and at last a proper examination can take place to identify exactly what has been going on. Concerns are still being expressed by campaigners who have lost family members.
I welcome the meeting that I had with my right hon. Friends, including the Minister, just a week ago to discuss how to proceed with the inquiry. There are real concerns over the timescale, which is being examined, and whether the inquiry can continue to examine deaths that are still taking place. Even very recently, there was a death.
Equally, there is concern that the lawyers, Hodge Jones & Allen, have been working pro bono on this, and they need some kind of remuneration if they are to continue. In other inquiries, lawyers representing family members have received interim payments, and the lawyers in this case also need some support, so I ask the Minister to consider that. Most importantly, however, they have been promised meetings. I know that the Minister is in the process of setting those meetings up, including with the Secretary of State so that she can hear directly from some of the families who have been affected. I know that the Minister is also looking at the terms of reference and the process under which the inquiry proceeds.
This has been going on a very long time. The Minister will understand the frustration, so we would be grateful to hear anything from him this afternoon about whether we can now press ahead and have those meetings with the families and those representing them, and get a proper, full examination of what has happened in the Essex Partnership University NHS Foundation Trust and its predecessor bodies.
I will return some of those themes on Thursday. Again, I thank my right hon. Friend the Member for Witham; we will continue to work together with my hon. Friend the Member for Colchester (Will Quince), and across the county, to ensure that our constituents receive the proper healthcare that they deserve.
Essex Mental Health Independent Inquiry
John Whittingdale Excerpts(1 year, 9 months ago)
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Sir John Whittingdale (Maldon) (Con)
I start by thanking my right hon. Friend the Member for Chelmsford (Vicky Ford) for securing the debate and for allowing me to make a brief contribution.
I, too, represent several family members of those who lost their lives while in the care of EPUT. The matter has been continuing for a long time, and the inquiry is considering 20 years of NHS provision for people suffering from mental illness in Essex. We have had a number of inquests for those who died, and we have had Care Quality Commission investigations and police investigations, but there are still unanswered questions. For that reason, I agreed with and supported the establishment of the mental health inquiry by my right hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who was then a Health Minister.
As my right hon. Friend the Member for Chelmsford has said, real concerns were expressed to us about the fact that the inquiry would not be statutory, but we were assured by the Minister that a non-statutory inquiry could reach conclusions faster than a statutory one and that there were other advantages to such an inquiry, which might lead to people being more willing to come forward than if the inquiry were under statutory control. I listened to the concerns expressed by my constituents who felt strongly that the inquiry should be statutory, but I accepted the assurances of the Minister. I want to say to the families that they were right and we were wrong, and I am sorry that that was the case. I was therefore greatly concerned when I saw the letter from the chair, who says that she has now concluded that statutory powers are needed owing to the lack of co-operation from staff and former staff, although initially she, too, had thought that a non-statutory inquiry was correct.
I have had a long conversation with the chair of the inquiry. I am impressed by her absolute determination to get to the truth and her independence. As my right hon. Friend has said, the chair still hopes very much that not only staff members, but all family members who have evidence to give will come forward, particularly as there will be support available. I understand that the family members still believe the inquiry should be statutory. Therefore, I agree with my right hon. Friend that we have reached the point at which, unless we receive co-operation in a very short time, statutory powers are needed.
We need to get to the bottom of this. A figure of 2,000 deaths has mysteriously and suddenly appeared from the trust, and we need to find out what happened to those people. I say to the Minister that I understand the wish of the Government and the inquiry to obtain testimony from all those concerned, but if it cannot be achieved by the present arrangement, we will move to statutory powers.
Neil O’Brien
It is not for me to put a date on that in this setting. I have had conversations with a number of the hon. Members here, but my hon. Friend can rest assured from the tone of what I am saying that this will not be a long period of time. We are not kicking this into the long grass; we urgently need this change because, as numerous Members have pointed out, this has been going on for a long time and families who have been through the mill are waiting for justice.
Sir John Whittingdale
One of the problems with a non-statutory inquiry is people’s reluctance to come forward. If it becomes statutory, certain consequences obviously follow, including the publication of the names of those who are summoned to appear. Will my hon. Friend the Minister think about making his requirement that the co-operation be achieved in a short space of time more public, so that people understand exactly what will follow if they continue to fail to co-operate?
Neil O'Brien
This debate goes some way to achieving exactly that. My right hon. Friend is exactly right that the current non-statutory approach has the benefit that those who give evidence do not have to be named. That is why it would clearly be more desirable if we could make the non-statutory approach work, but that has not been the case to date and, unless that changes, something else will have to change too.
To continue making progress in how we address issues with mental health services, Members will be aware that we have recently announced a rapid review into patient safety in mental health settings across England. The review will focus on what data and evidence is available to healthcare services. I am pleased that Dr Strathdee will be leading the rapid review over the next couple of weeks, given her knowledge and experience. However, I assure hon. Members that the work of the inquiry in Essex will continue at the same time.
I firmly believe in the importance of transparency and accountability to improve patient safety, and I wish to take all action necessary to assist the inquiry in its work. This is absolutely the last chance to make progress. If staff engagement and access to documents remain unsatisfactory despite these actions, we will consider whether the inquiry should remain on a non-statutory footing. We simply cannot go on as we have, with inadequate co-ordination and documents not being forthcoming. Everyone in the inquiry knows the situation and that there is not a long period of time for things to change.
I thank hon. Members for bringing forward the debate, because it allows us to set out the situation clearly for the public. I thank all who are here today, all who have co-operated with the inquiry, and all who have lost loved ones or been personally affected by this matter and have had the bravery and grit to come forward and talk about their experiences. We are extremely grateful to them.
Question put and agreed to.
Health and Social Care
John Whittingdale Excerpts(2 years, 11 months ago)
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Mr John Whittingdale (Maldon) (Con)
I welcome today’s announcement and join the Minister in paying tribute to all those working for the NHS. The biggest challenge in mid-Essex, and I suspect nationally, is access to primary care, particularly managing to get through on the telephone line and, after that, obtaining an appointment. Can the Minister say any more about what the Government are doing to address that?
Edward Argar
My right hon. Friend is right to highlight primary care, essentially, as the front door for many people into the NHS system. GPs and general practice have done a fantastic job. They have worked very hard, but it has been very challenging. The Secretary of State announced additional money to support GP practices in returning to face-to-face appointments and in seeing more people—we have seen significant investment in that. The percentage of face-to-face appointments continues to go up, which I know matters to a large number of all our constituents.
Childhood Obesity Strategy: Chapter 2
John Whittingdale Excerpts(6 years, 5 months ago)
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Mr John Whittingdale (Maldon) (Con)
I welcome the Government’s multi-pronged approach, but will the Minister bear in mind the fact that, when it comes to calls for banning advertising before 9 o’clock, such a measure would do huge damage to the economics of the commercial broadcasters, just at a time when fewer and fewer young people are watching scheduled television? Instead, they are now watching the on-demand services that are the direct competitors of commercial TV stations.
Steve Brine
I take my right hon. Friend’s views very seriously, but we want to protect children from the advertising of products that are high in saturated fat, salt and sugar, and we are going to consult on introducing a 9 pm watershed. He mentions online, catch-up and social media, and that is one of the reasons that this is an important area for us to consult on. We want to ensure that we get this right, and it is not about punishing the industry. The people who work in the industry and in advertising are also parents, members of society and taxpayers. They also have a stake in this and in the reason for it all to succeed.
Oral Answers to Questions
John Whittingdale Excerpts(6 years, 11 months ago)
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Jackie Doyle-Price
How can I say no to such a proposition? My hon. Friend illustrates the importance of good leadership in all local communities. Where good leaders make something a priority, they will deliver good outcomes at reasonable value for money.
Mr John Whittingdale (Maldon) (Con)
The Secretary of State for Health (Mr Jeremy Hunt)
Next week, many NHS and social care staff will give up their family Christmas to keep NHS patients safe. I know that the whole House would like to thank them for their dedication and commitment over the festive period.
Mr Whittingdale
Is my right hon. Friend aware that, due to the difficulties in recruiting general practitioners, neither of the two GP surgeries in Maldon are taking on any new patients, despite the significant development taking place in the town? May I therefore welcome the 1,500 extra medical training places that the Government have funded, and ask for his support for some of those to go to the excellent Anglia Ruskin medical school in Chelmsford?
Mr Hunt
I have a great deal of sympathy with what my right hon. Friend says, and he is right that the recruitment and retention of GPs is a big issue. I have a constituency interest, in that I have a university that is also very keen to host more medical school places, so I am recusing myself from the decision. However, I wish all universities good luck, because this is a historic expansion of medical school places for the NHS.
Community Hospitals
John Whittingdale Excerpts(10 years, 2 months ago)
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Mr John Whittingdale (Maldon) (Con)
It is a pleasure to serve under your chairmanship, Mr Owen. I too congratulate my hon. Friend the Member for Dover (Charlie Elphicke) on obtaining this debate, and add my congratulations to the Minister on his appointment.
Every speaker so far has talked about the value of community hospitals. I do not want to repeat what has been said, but I utterly endorse the tributes that have been paid to the dedicated staff who work in those hospitals, the intimate care that they are able to provide to patients—sometimes lacking in very large, more general hospitals—the proximity they have to communities and the fact that patients can be visited by relatives and friends much more easily. All those factors are real strengths that contribute to faster recovery times.
I am afraid that, like every Member, I will talk about my own experience of my local community hospital in Maldon, St Peter’s community hospital, which is greatly loved. Like many, it offers out-patient treatments, has rehabilitation beds and offers therapies. It also has a maternity unit. In my early days as a Member of Parliament I marched down Whitehall with the local protest group in defence of that unit when it was suggested that it might close. I am pleased to say that it did not and is still there; although I cannot personally say that I have contributed to its work, my hon. Friend the Member for Witham (Priti Patel), who I am sure would be here had she not become a Minister, had her first child in the Maldon hospital maternity unit.
Like many community hospitals, however, it is an old building. It was built in 1874 as a workhouse for 450 inmates. Although it has had various refurbishments over the years, it is not really fit for purpose. It is in poor condition, with leaks in the roof, and there is a possibility that it could be declared unsafe. Everybody realises that services cannot continue there for much longer.
For almost all the time that I have been in Parliament, therefore, we have been discussing how best to replace the hospital—whether to rebuild on the existing site or to build a brand new community hospital. Various options have been put forward. At one point we thought we had an agreement, but then it was discovered that nobody could quite work out who owned the land on which the new hospital was to be built, so that agreement fell through.
We now face a serious problem: as the Minister may know, mid-Essex has one of the most severe financial problems of any area in the country. It is largely an historical problem that has come about through the formula for funding allocation and has been compounded by a private finance initiative scheme that is draining money out of the local health budget at our main general hospital in Broomfield. We have to look at more imaginative solutions: it is clear that it is unlikely that the local health service will be able to afford the capital cost of a new hospital and we have had our fingers burnt by PFI once before.
We are looking for a new solution, and one has appeared; I will describe it briefly and invite the Minister to endorse at least the principle behind it. The Maldon district, like many, has a severe housing need—we need a lot of new houses. The district council is preparing a development plan, which is now before the planning inspectorate. The development of new housing offers opportunities and a scheme has been suggested for a housing development that will bring with it a new hospital for the NHS, built by the developers at zero capital cost. Indeed, the scheme offers an even greater potential benefit, as not only will a new hospital probably be cheaper to run than the very old existing hospital, meaning that the revenue costs may be reduced, but it will free up the site of the existing hospital, which will be available to the NHS for potential sale for development and could therefore raise some money. It is potentially a win-win situation: Maldon will get a brand new hospital and the houses that, although they are controversial, there is no doubt we need, and the NHS will have additional resources and a hospital that is more up to date and cheaper to run.
Obviously the scheme still needs a lot of work. There are questions over who will own the new hospital building—whether it ought to remain in the developer’s ownership and be leased to the NHS or be passed to the district council—and it has to go through the planning process. At the moment, we are also wading through the treacle of NHS bureaucracy: dealing with the NHS Property Service, with the CCG, with the Mid Essex hospital trust and with Provide, which used to be called Central Essex Community Services. But everybody who looks at the scheme can see the potential to provide, at zero cost, the new hospital that my constituents so desperately need.
Although the Minister cannot get involved in the detail of the scheme, I hope that he can at least express general support for that kind of imaginative thinking, which will ensure that we have a new community hospital for the future. I also invite him to think about that model, which could well be applicable in many other areas.
Several hon. Members
I congratulate my hon. Friend the Member for Dover (Charlie Elphicke) on securing this debate and on his tireless work on this matter and the wider subject of social engagement and community ownership of public resources. I pay tribute to his work in his constituency, particularly on securing the future of the Victoria hospital in Deal.
Several hon. Members who are not here at this well attended debate, such as my hon. Friend the Member for Thirsk and Malton (Miss McIntosh) and my right hon. Friend the Member for Berwick-upon-Tweed (Sir Alan Beith), continue to support their local community hospitals through their constituency and parliamentary work. I extend my thanks to all hon. Members. It is wonderful to see so many of them here today representing their own community hospitals and the wider cause.
We have heard a range of excellent contributions from a distinguished and committed group of hon. Members, including two doctors—the Chairman of the Select Committee on Health, my hon. Friend the Member for Totnes (Dr Wollaston), and my right hon. Friend the Member for North Somerset (Dr Fox)—and my right hon. Friend the Member for North West Hampshire (Sir George Young), my hon. Friends the Members for Stroud (Neil Carmichael), for Congleton (Fiona Bruce) and for Maldon (Mr Whittingdale), and the hon. Members for Upper Bann (David Simpson) and for Strangford (Jim Shannon).
We have heard some important reasons why community hospitals and local health care facilities matter so much, and I will highlight and reinforce them. We have heard strong views about the invaluable role of community hospitals, clinics and local health centres in our communities; about the benefits of community engagement and patient voices in health care that flow from them; about the potential for community hospitals to be hubs of social care, intermediate care and recovery beds; and about the role of community hospitals in easing pressure on expensive clinical and bed space in our acute hospitals. Some colleagues have made the point that big is not always best in health care. We have also heard about the importance of integrating social care and health care, which is a Government priority, as is the role of local centres in facilitating that; the impact of reconfiguration on recruitment; the important role of community hospitals in providing respite care beds; and the strength of patient support and community voice in support of hospitals.
We have heard some important examples of imaginative new thinking in Dover, Maldon, Andover, Congleton and elsewhere, and of the risk of fundraising being channelled to the big, the professional and the remote by excessive bureaucracy and complexity. We also heard an important point about transparency and evidence-based, jargon-free language in consultations, the absence of which militates against the small, voluntary and local community.
I want to start by signalling that all Ministers in the Department of Health acknowledge absolutely the great benefits that community health care, hospitals and health centres provide to our communities. I will speak about the role we foresee them playing and highlight how our NHS reforms are changing the NHS in a way that should help to support more local and community facilities, putting in place specific protection for community hospitals. I will try to address some of the specific points that have been raised, and if time prevents me from doing so, I will write to colleagues to deal with points that they have raised.
We should remind ourselves about what community hospitals are and why they matter so much. They are local hospitals, units or centres providing an appropriate range and format of accessible health care facilities and resources. There are around 300 in England and they are overwhelmingly owned by NHS trusts, foundation trusts and NHS Property Services Ltd. Where they are wholly owned by the NHS and are needed for service delivery, they will remain in NHS ownership and will not be sold for profit. The sustainability of a community hospital is down to the decision making of local NHS commissioners, regardless of who owns the hospital.
Community hospitals can be invaluable assets that make it easier for people to get care and treatment in their community, as we have heard, closer to where they live. They allow large hospitals to discharge patients safely into more appropriate care, freeing up hospital beds for people who need them urgently, and they allow many patients to avoid travelling to large hospitals altogether, providing a wide range of vital services, from minor injury clinics and diagnostic services to intensive rehabilitation.
Therefore, people are often very protective of their local hospital, and with good reason. In many cases, they deliver a range of essential services, as well as providing employment for local people and often space for community groups and associated members of what one might call “the health big society”. It is understandable that community hospitals are fiercely defended and inspire such loyalty, and that support for local facilities is a sign of the growing appetite for the quiet revolution of patient empowerment and health citizenship at the heart of our vision of a 21st-century health service. That is why everything we are doing in central Government is designed to support local clinicians and patients to change and shape their local NHS for the better, making improvements to primary and community services to suit local needs.
As a result of the Health and Social Care Act 2012, PCTs have been abolished and responsibility for commissioning services has, as we know, moved to clinical commissioning groups and local clinicians are now in control. CCGs are free to commission services that they judge provide the best care and outcomes for their patients and free to work out which services are needed and where they should be located to best meet local needs. With strong local patient and clinician input, the CCGs will also be able to decide which providers are in the best position to offer those services. They—and, I am delighted to say, not the Ministers at the Department of Health or officials at NHS England—will determine whether a community hospital remains open and what services it should provide.
With the abolition of PCTs in April 2013, ownership of a significant number of community hospitals changed. Some were transferred to local NHS trusts and NHS foundation trusts. Other hospitals went to NHS Property Services, the Department of Health-owned property management company. I know some hon. Members—some not here today—have concerns about some of those transfers, which I want to touch on. I want to make it clear that the conditions applying to those transfers mean the hospitals will not be closed unless commissioners determine that they are no longer fit for purpose. As with all decisions about local patient services, it is absolutely right that those decisions are taken locally, taking account of local views.
Sometimes tough decisions need to be taken. Buildings become tired and inefficient. New and better treatment, diagnostics and technological innovations are transforming the way in which health care is delivered, and, of course, communities grow and evolve. It is understandable that sometimes old infrastructure, though much loved by the community, cannot always keep up with the community’s needs. It is right then that commissioners explore how services can continue to be delivered efficiently and accessibly to patients.
That could mean decommissioning a hospital, in part or wholly, and moving some services even closer to the community. It could mean extra investment to modernise and develop existing community hospital centres, such as the development of the new Buckland hospital in the constituency of my hon. Friend the Member for Dover. These are tough decisions about meeting the changing health needs of the local community in the decades to come and it is absolutely right that they should be taken locally, driven by what is best for local people.
I am well aware that some hon. Members have been asked by their constituents about promoting community ownership of hospital assets in order to save at-risk or surplus hospital and clinical space, and I emphasise that all NHS property decisions are driven by clinical decision making by the CCG, and not the other way round.
First, under statutory provisions, while a building is needed to deliver NHS services, no NHS organisation will be allowed to sell it off, so there is no question of useful NHS property being transferred outside the NHS. The commissioners decide that, not the providers. At the same time, that means that a community-owned company is unable to own the freehold of operational NHS property.
Secondly, current Government policy is that property that is surplus to the NHS and the wider public sector should normally be sold by auction or competitive tender. In such cases, a community-owned company would have the opportunity to bid for the property along with other interested parties, but there is no guarantee that the community-owned company’s bid would be successful. However, if they were successful, we need to be clear that it would be in circumstances where NHS commissioners would have already decided that the site is no longer required for health service delivery. It would therefore no longer be operated as an NHS community hospital, but that is not to say an alternative community use could be found for the site. I think that is a key point. We will not necessarily be helping our constituents in advocating community ownership where commissioners have taken a decision to decommission services at particular site.
In conclusion, I want to highlight that the Government and Ministers are absolutely committed to greater diversity, choice and local community influence in our modern NHS. We have taken steps to secure the sites of community hospitals and make sure they are used for the benefit of their community where there is an ongoing use for them. However, the lifespan of those hospitals is solely down to the decisions made locally by clinicians and service providers—the people qualified to make those decisions. That is the best thing for the hospitals themselves, and it is certainly the best thing for the communities we serve.
If my hon. Friends or any other hon. Members have raised specific concerns that I have not addressed or highlighted in my earlier comments, please—
Mr Whittingdale
Just before the Minister sits down, I accept that decisions will be made locally, but I raise again the specific proposal that I suggested was under consideration, of obtaining a new hospital as a benefit of the development scheme. Although that is to be locally determined, it would help enormously if the Minister could at least smile on it and encourage that kind of thinking. If he would like to write to me once he knows a little more about it, I would be very grateful to him.
George Freeman
I am very grateful to my hon. Friend for flagging that point up. It was concealed within my list of exciting and imaginative bold thinking, but I did hear him and I would be very interested to pick that up. I invite him to write to me with the details.
The vision at the heart of our NHS reforms is of an NHS freed from the 20th-century model of health care in which health has been something done to the people we serve when government deems it appropriate, with the shape of health driven from the top down, to a model of 21st-century health care in which services are shaped by local priorities and greater freedoms to innovate and differentiate, combining the local, the personal and the voluntary with the general, the central, the specialist and the world-class. Exciting breakthroughs in diagnostics, remote sensing, e-health and telehealth, and in non-invasive new surgical and informatics technologies are driving new models of integrated health and social care. I believe that it is one in which local community-based hospitals, clinics and health centres will play a key role in the next century.