Woodhaven Hospital

Debate between Julian Lewis and Charles Walker

Thursday 10th November 2011 Commons Chamber

[Dr Julian Lewis (New Forest East) (Con)]

I am particularly pleased to see the Minister on the Front Bench tonight. I know of his care and compassion on the topic of mental health.

Woodhaven hospital is a state-of-the-art mental health unit set in a therapeutic, semi-rural but easily accessible location in my constituency. Its acute Winsor ward has, unusually, en suite facilities for all 24 in-patients and other top-of-the-range features. It was a proud and happy moment for me when I cut the ribbon to open the new hospital just eight short years ago. Now, to the immense distress of service users and their carers, Woodhaven is threatened with closure.

Currently, 165 acute in-patient mental health beds are available to the Southern Health NHS Foundation Trust. They are in six units throughout Hampshire, as follows: 50 beds at Antelope House in Southampton, 25 each for men and for women; 20 beds at Elmleigh in East Hampshire, 10 each for men and for women; 24 beds at The Meadows in Fareham, 10 each for men and for women and four more, known as flexible beds, which can be used for either; 23 beds at Melbury Lodge in Winchester, 13 for men and 10 for women; 24 beds at Parklands in Basingstoke, seven for men and 16 for women, plus one flexible bed; and finally, the 24 beds at Woodhaven in my New Forest East constituency, 10 each for men and for women, plus four flexible beds.

The foundation trust proposes to close Woodhaven, which is virtually brand new, and The Meadows, which is also quite modern. That would reduce the total available beds in the region from 165 to 117. However, of the 50 beds at Antelope House that have been available for acute cases up to the present, 10 are to be allocated to long-term, challenging in-patients, effectively reducing the total number of acute in-patient beds that will be available in future to only 107. The foundation trust has suggested that some of the future occupants of the 10 beds might come from other acute beds out of the 165 total, but it seems much more likely that the 10 beds at Antelope House will be allocated to residents from Abbotts Lodge, a different kind of unit that is not included in the 165-bed total and will be shut. For that reason, the real reduction in available acute in-patient beds will be from 165 to only 107.

Those 107 acute beds will contain two distinct categories of in-patient: those who are voluntary and those who have been detained. On what I believe to have been a typical day in mid-October, and on a similar day this month, when 153 beds were in use across the whole trust area, no fewer than 88 were occupied by in-patients detained under the Mental Health Act. That constitutes 53%—just over half—of the existing 165 available acute beds. With only 107 beds available in future, that 53% figure will rise to approximately 82%. Conversely, the proportion for voluntary in-patients who are acutely mentally ill will fall from about 47% to just 18%. In practice, there will be only about 19 beds left for the whole of the trust area in Hampshire for acutely mentally ill people who voluntarily go into hospital.

That will have a huge and negative effect on patient choice. There will be little chance of choosing or obtaining an acute in-patient bed, as four fifths of them will be occupied by people who have had to be detained because they will not voluntarily agree to admission. Indeed, someone who desperately wants an in-patient bed would be well advised to create sufficient mayhem in order to be sectioned, if they are to have a reasonable chance of gaining admission. Once admitted, the voluntary in-patients will find that the effect of the greatly increased preponderance of detained in-patients in each of the four remaining units in Hampshire will be to make their wards significantly less therapeutic. Should the trust be thinking of such a huge reduction in bed totals at all?

I should say at this point that there is no fundamental philosophical disagreement between me and the representatives of the district and county councils on the one hand, and the management of the trust on the other. The trust’s spokesmen consistently agree that some acute in-patient beds will always be needed. For our part, my colleagues and I have no doubt of the value of strong community, assertive outreach, crisis resolution and early intervention services at home.

The key question that must be resolved—I hope that it will be resolved as a result of this debate—is simply what is the correct number of acute in-patient beds in Hampshire. Naturally, the trust maintains that by investing in extra services at home some people will be prevented from deteriorating to the point where they need to occupy acute in-patient beds, but I believe that stripping out more than one third of the existing beds, as the trust proposes, cannot possibly be justified.

Of course, the trust ought to make efficiency savings. It states that closing two out of six acute in-patient units in the area will save £4.4 million, £1.5 million of which is intended to be invested in what was previously described as a “virtual ward” but is now more sensibly described as a “hospital-at-home” service. The remaining £2.9 million is, of course, an easy way to make a significant annual saving, but it is not an efficient way, especially when one considers that, according to an Audit Commission survey, Hampshire already has the highest number of staff per 1,000 of the population in community mental health teams out of 46 trusts examined. Cutting front-line services and making efficiency savings are two very different things.

Twenty-six acute beds per 100,000 people is the current average among the 46 mental health trusts surveyed. The Southern Health NHS Foundation Trust has 28 beds per 100,000 and expects that figure to go down to 21 if the two units, including Woodhaven hospital, are closed. I believe that the actual total would be just under 20 beds per 100,000 people. At the moment, with 28 beds, we are in the top 19 of the 46 trusts. Whether we go down to 21 acute beds per 100,000 or to just 20, we shall be in the bottom six, and that is an immense gamble to take with the welfare of people who, almost by definition, are at risk of losing their lives.

Every day, the trust files a record of how many beds were vacant out of the total of 165, and at my request it has provided a print-out for the past three months. This shows, beyond any doubt, that bed occupancy levels are consistently high. Let us remember that we are considering 165 beds, spread over almost all of Hampshire and serving hundreds of thousands of people. The trust’s tables give a breakdown of the numbers of male and female beds vacant each day, and the numbers of so-called “leave” beds temporarily empty. Leave beds are those that have already been allocated to in-patients, but that are not being used for short periods, because their occupants are spending typically one, two or three nights at home. Even when leave beds are counted together with genuinely vacant beds, the total number of empty beds throughout the area is low—often, indeed, in single figures. Thus, from 21 September to 6 October this year, the overall daily totals were respectively nine, seven, five, five, seven, three, three, three, four, 11, nine, nine, eight, nine, seven and six empty beds out of 165. When one excludes the leave beds, however, as one should because they have not been genuinely vacated, one is left with numerous instances of 100% acute bed occupancy for the whole region. For example, there were no vacant male beds at all on 2, 7, 10, 11, 17, 18, 20 to 24 and 26 September; in the same month, there were no vacant female beds on 7, 10, 11, 16 to 18, 20, 23, 24, and 26 to 29; and on September 3, 4 and 25, gender information not being available for those three dates, there was either only one male and no female acute beds available, or only one female and no male beds available in the entire trust area in Hampshire.

Of course, one can debate how much use can safely and regularly be made of at least some of the leave beds that are temporarily vacant.

[Mr Charles Walker (Broxbourne) (Con)]

My hon. Friend will know from previous debates that one can have occupancy rates above 100% because sometimes, in emergencies, leave beds are drafted into use.

[Dr Lewis]

I am extremely grateful to my hon. Friend for making that important point, as I am for him being here to support me tonight. I know of his great interest in the subject.

Using the trust’s own figures, I have calculated the average acute in-patient bed occupancy over the three months from August to October. Even if all the leave beds are counted as available, which they are not, bed occupancy was 91.9%, and the figure would be higher if weekends were excluded, given the number of people who go home for short periods at those times. When only the genuinely vacant beds are considered, the average occupancy rate is seen to have been a remarkable 96.7%.

One of the most extraordinary assertions in the consultation document on the proposed changes is to be found on page 11, where it declares:

“The time that people are spending in our…hospitals is longer than the national average (our average length of stay is 51 days (including leave) compared to below 30 days (excluding leave) in other Trusts).”

That is an extraordinary manipulation of the data, as it contrasts the total of days spent on and off the wards in our trust area with the total of days spent only on the wards in other trust areas. A glimpse of the true situation is again to be found in the tables drawn up by the Audit Commission. In referring to all mental health admissions in the Hampshire PCT area, which is not quite the same as the foundation trust area but is a reasonable general guide, the Audit Commission states:

“Hampshire PCT is below the national average”

for length of stay. I do not know whether the trust’s blatant and gross failure to compare like with like was deliberate, but the public, their local representatives and Ministers are surely entitled to ask what the average length of stay excluding leave is in Hampshire’s acute beds, and what the average length of stay including leave is in the acute beds of other trusts, so that real rather than bogus comparisons can be made.

Time prevents a more detailed dissection of other dubious claims made by the trust. Its spokesmen refer to the acutely mentally ill suffering “disempowerment” as a result of spending what is usually a relatively short time on an in-patient ward. Most frequently, it insists that

“people have consistently told us they want to be at home”.

Such claims fly in the face of what we hear from service users and especially from carers, who want the assurance that an acute bed will be available when it is needed. I have yet to discover what, if any, systematic survey was undertaken to arrive at that conclusion. Who carried it out? How many people were surveyed? What questions were asked? The trust says that its soundings showed a desire for:

“Care within a community setting where possible, and avoiding going into hospital unless it is necessary.”

Well amen to that; we can all sign up to that, but that is a very different proposition from wishing to see a more than one-third cut in available beds that have an average occupancy rate of between at least 91.9% and 96.7%.

Only five out of the 46 trusts listed by the Audit Commission have 20 beds or fewer per 100,000 of the population. Southern Health NHS Foundation Trust wishes us to follow that example. Its consultation says that that small minority of trusts

“deliver good or excellent standards of care”,

and it recently identified four of those five trusts in a presentation to me and others. Although the overall ratings for those four trusts are, indeed, good or excellent, the picture is different where in-patient services are concerned: none of the four is rated as excellent, two are rated as good, a third is rated only as fair, and the fourth is rated as weak.

At meetings with the trust, I and my colleague, County Councillor Keith Mans—a former and distinguished Member of this House—have stressed the need for the new hospital-at-home model to be piloted before any of the six in-patient units is closed. If this exercise is really about “Improving Outcomes for Hampshire’s Adult Mental Health Services”—as the consultation document is entitled—rather than about saving £2.9 million a year, then acute in-patient beds should not be discarded until pilot projects clearly show significant reductions in the current very high levels of acute bed occupancy.

We need a step-by-step approach that clearly rules out the present plan to remove not just one but two modern mental health units, including Woodhaven hospital, right at the start. It is distinctly probable that the overview and scrutiny committee of Hampshire county council may decide to refer this matter to the Secretary of State. This evening, I look to the Minister for two assurances.

First, I want an assurance that Woodhaven hospital, which is so valued by our community, will not be closed until objective and independent surveys have been carried out assessing whether there really are dozens of people in beds for the acutely ill in Hampshire who do not need to be there. Secondly, I want an assurance that Woodhaven will remain open until a pilot scheme has demonstrated that the proposed hospital-at-home scheme is starting to reduce the current high levels of acute bed occupancy. It cannot be right that in-patient beds should be cut to 107 for the whole trust area in Hampshire, so that we are left with a woefully inadequate total of about 19 for voluntary in-patients once all those detained under the Mental Health Act have been accommodated. People’s lives are at stake.

Debate on the Address

Debate between Julian Lewis and Charles Walker

Tuesday 25th May 2010 Commons Chamber

[Mr Charles Walker (Broxbourne) (Con)]

Mr Deputy Speaker, thank you for calling me to speak on this first day of the Queen’s Speech. It is fantastic to see you in the Chair.

There are so many new things going on: this is the first time that I have been on the Government side of the House and I am getting a new perspective on the Chamber; and it is the first time that I have been in the House with a Conservative Prime Minister, and I would like to pay tribute to my right hon. Friend the Member for Witney (Mr Cameron). He spent four long, hard years getting us to this position. He made huge personal sacrifices in his life, and I wish him the very best as he leads this country through some difficult times. He has it in him to be an outstanding young Prime Minister. I also welcome the Liberal Democrats to this side of the House. I have many friends among the party—I like them very much—but it will take me some time to get used to them being in government with us. I will get used to it, I promise, but it will not happen over night. However, I have a great deal of time, particularly for the hon. Member for Somerton and Frome (Mr Heath), the Deputy Leader of the House, whom I know has a great love and passion for this Chamber.

I have been very disturbed by today’s maiden speeches, because they have been awfully good. My hon. Friends the Members for Sherwood (Mr Spencer), for Morecambe and Lunesdale (David Morris) and for Watford (Richard Harrington) have been dangerously erudite. They are either geniuses or total creeps, but I think that they are geniuses, because I have never heard such good speeches in this Chamber from new Members—I certainly did not hear them in my first six months, and I doubt that we will hear much better in the months ahead. They were fabulous speeches, and I am sure that their families are extremely proud of them. I bet that their constituents are very grateful that they have them as their Members of Parliament.

I am enormously excited by the number of new colleagues on the Government and Opposition Benches. They are a very self-confident and vibrant bunch, but what excites me most is that they are independent-minded. I am sure that that does not excite the Whips on the Front Bench so much, but I think it is a great asset to this place to have independent-minded Members of Parliament who will go on to be brave and courageous, because if our constituents want anything, they want people who say something in their constituency and then go down and do it in the House of Commons. They want consistency. They want their Members of Parliament to deliver on their promises.

We in this House will be faced with an enormous number of challenges in the weeks, months and years ahead. We will have to make some enormously difficult decisions—decisions that will cause us personal pain and, I am sure, personal pain for our constituents, but decisions that need to be made. They need to be made for the sake of our children and grandchildren. We need to rebuild our economy. We need to have a strong and vibrant economy that can support high levels of employment. It does not matter if we represent a Labour seat, a Conservative seat, a Lib Dem seat or, now, even a Green seat; the most important thing to the majority of our constituents is having a job, because with a job comes self-respect and the ability to put a roof over their families’ heads and food on the table. We in this House have a duty to ensure that we have a vibrant economy that can continue to generate high levels of wealth. I and others will be working to achieve that.

We also have to deliver on our promises. All of us—or almost all of us—said that immigration was a concern that needed to be addressed. My constituents in Broxbourne are fair-minded, decent and compassionate people. They want skilled workers coming to this country who can add to the wealth of this country and pay taxes that help to support hospitals, schools and infrastructure. My constituents also want to provide genuine sanctuary to those who are in genuine fear for their lives. However, we have to recognise in this place that uncontrolled immigration is not an unalloyed good for everyone.

Immigration tends to work very well for the middle and upper classes, but many of my constituents are competing for scarce public resources, such as education, health, transport and housing. That has created a level of concern and bad feeling which has caused me a great deal of concern, because in my constituency and others we still see the British National party getting a foothold and gaining traction. I am delighted that the hon. Member for Dagenham and Rainham (Jon Cruddas) and the right hon. Member for Barking (Margaret Hodge) had such fantastic results against the British National party, not only turning back Nick Griffin, the leader of that party, but ensuring that night that many BNP councillors lost their seats. We need to continue that progress, but if we are to do so, our constituents need to know that we are serious about addressing their concerns.

[Dr Julian Lewis (New Forest East) (Con)]

I am sorry to interrupt my hon. Friend when he is in full flow, but may I just point out two things? First, I come from an immigrant family—I am third generation—and the thing that made it work was that my ancestors came to this country because they admired it and wanted to be part of it, to learn the language and to integrate. That is an essential component to which he might give some attention. The second thing is that if we were unwise enough to have changed the voting system, we might have BNP MPs in this place right now.

[Mr Walker]

My hon. Friend makes two powerful points. Of course we want to enable people to integrate into our wonderful society. It has many benefits—freedom of association; freedom to hang out with who we want to hang out with; freedom to marry who we want to marry; freedom to go to a polling station and vote for the person who we want to represent us, for better or for worse—so I agree with him: there are many, many things that need to be done.

While I have the attention of the House, let me say that it is so nice to speak to such a packed House. Many new Members will smile at that, but let me tell them that there will be evenings when they are speaking to no more than three or four people, so this is a good outcome for those who have made their maiden speeches today.

Within the Government’s priorities, of which there are many, they have paid great attention to the issue of health and the provision of health care to our constituents. I would make one plea to them. I see my hon. Friend the Member for New Forest East (Dr Lewis) in the Chamber; he has played a great part in raising in this place the profile and status of mental health. Nevertheless, mental health remains a very unfashionable subject, and that is a great shame. Many of our constituents live daily with terrible conditions that impact on their lives, on their happiness and that of their families, and, collectively, on their families’ prospects.

I know that tough decisions will need to be taken on the allocation of scarce resources, but, for too many decades, mental health has been left behind. It has been at the back of the queue. It would be churlish if I were not to pay tribute to the previous Government, because they did start to address the shortcomings in funding and to ensure that the mentally ill got the care that they deserved. I have every confidence that my Government—this Conservative Government supported by my Liberal Democrat friends—will pay the same attention to mental health and elevate it further up the list of priorities in the NHS.

There is nothing more rewarding, having made a speech in this place raising an issue of great concern, than to have someone come up to you very quietly in your constituency, take you by the arm and thank you in a private, understated way. That is when you know that you are making a difference and giving people a voice who would otherwise not have one.

--- Later in debate ---

[Mr Walker]

Again, my hon. Friend makes a good point.

In concluding my remarks on mental health, I must point out that there are far too many initiatives. There are also far too many different groups and professional set-ups providing support services to people with mental health problems. We need to streamline all that. People with mental health problems do not want to have to relate to seven, eight, nine or 10 teams; they want to relate to one team that can give them the support that they need in order to manage their illness, recover from it—if that is possible; it is not always so—and get back into work to lead a fulfilling professional life.

So, Mr Deputy Speaker—Mr Speaker! I see that you are back in your Chair! How exciting! I have waffled on for far too long, but I should like to conclude with these few slightly rebellious remarks. There is a great tension in this place between Parliament and the Executive. For 100 years, the Executive have cleverly taken powers out of the hands of Parliament, taken them on board and used them for themselves. I hope that in the years ahead we will start to take some powers back from the Executive, find our collective voice on behalf of this nation and restore people’s confidence in us.

I say to new Members, “Do not look towards any Government to raise the status of the House of Commons.” That is not the responsibility of the Government and I assure new Members that if the Government try to do it they will not do a particularly good job. It is our responsibility to raise the status of the House of Commons, and I am very much up for the challenge, just as I am sure my hon. Friend the Member for New Forest East, who wants to intervene, is up for it.

[Dr Julian Lewis]

I intend this to be an intervention rather than a subsequent speech. Before my hon. Friend sits down, may I say that should he be successful in becoming a vice-chairman of the 1922 Committee—a matter that I know he is far too modest to raise himself on the Floor of the House; it is being voted on tomorrow—I am sure that he will put into practice the very message that he is preaching to us tonight.

[Mr Walker]

I thank my hon. Friend for doing that advertisement for me.

Let me conclude by saying that a self-confident Government and a self-confident Opposition will tolerate and encourage independent-minded Members of Parliament. They will actually derive great strength from such independence of mind. I am delighted that there are so many new and able colleagues on both sides of the House. We have said goodbye to some very talented individuals who until six weeks ago were respected Members of Parliament for their constituencies. What I have seen over the last few days quite frightens me, as we have seen some enormously talented people here and the Whips are going to have their job cut out for the next five years—if it is five years. I wish new colleagues every success. This is a great place to be; it is the mother of all Parliaments; new Members have done fantastically well in getting themselves here.

Ordered, That the debate be now adjourned.—(Miss Chloe Smith.)

Debate to be resumed tomorrow.