Leeds Children’s Heart Surgery Unit

Julian Sturdy Excerpts

Tuesday 30th October 2012 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Mr Hollobone. I congratulate my hon. Friend the Member for Pudsey (Stuart Andrew) on securing this important debate. He has been a champion of the children’s heart unit in Leeds, and I know that the staff, and, most importantly, the young patients, appreciate all that he does to lead the campaign in Westminster to save it from closure. It is a testament to the campaign that so many hon. Members from across the House are here to support it.

The debate over the Safe and Sustainable review has been going on for months. At each stage I have openly supported the need for the review. We must always strive to improve clinical standards in the health service. That is right; and it is right that the responsibility for treating children’s heart problems should be transferred to units that can offer the outstanding treatment that all affected children and their families deserve. The families of those children would not want anything else. I am a parent and understand it completely. Indeed, my support for the Leeds children’s heart unit is based not simply on close geographical links to my constituency or the wider region that it serves; it is based on the fact that the unit offers superb clinical outcomes for young patients. Indeed, as other hon. Members have mentioned, it scores higher on the JCPCT’s core clinical standards than the preferred option for the north-east. Core clinical standards should be combined with core statistics from the local area, too. More than 600,000 people have signed a local petition demanding that the Leeds unit should remain open. Leeds serves a population of 5.5 million, and 14 million are within two hours of the city. That is a catchment area far larger than those of other units.

Throughout the saga, I have been reluctant to compare the Leeds unit directly with others, particularly Newcastle.

--- Later in debate ---

[Mr Philip Hollobone (in the Chair)]

Order. Mr Sturdy has about three minutes remaining.

[Julian Sturdy]

Thank you, Mr Hollobone. As I was saying, throughout this saga I have been reluctant to compare the Leeds unit directly with others, in particular Newcastle’s. My intention is not to criticise the Newcastle unit, which has also carried out great work, saving many young lives over a number of years. Rather, my belief continues to be that the Leeds unit has always had the strengths to merit its survival without such comparisons. Put simply, its own case is strong enough. That is my message to the Minister today, and it was also put eloquently by my hon. Friend the Member for Pudsey.

The single biggest failing in the consultation has been the flawed decision-making process of the Joint Committee of Primary Care Trusts, from the lack of weight given to transport and travel times, and the population that centres such as Leeds serve, to the true co-location of services. There has also been a lack of clarity over the terms of the review, and the failure of the JCPCT to release the information and evidence behind its decision is only adding to the controversy and suspicion. Without being able to break down the scores awarded to each children’s heart surgery unit by Professor Sir Ian Kennedy’s assessment panel, the decision-making process lacks basic transparency and scrutiny.

Throughout York there exists huge public interest in this ongoing and disruptive issue. I am particularly concerned for the families of affected children in York who now face the problem of having to travel to other areas for treatment—I stress “other areas”. The Minister must be under no illusion that the families and children displaced to Newcastle if Leeds closes will not automatically head north. They will disperse to centres throughout the country, and we must not lose sight of that.

In conclusion, the Save our Surgery campaign has suggested a balanced solution to the current dispute, as set out by my hon. Friend the Member for Pudsey. It suggests that the decision should be implemented in full throughout the country, but delayed in the north-east until April 2014. That window of opportunity could then be used to clarify the figures and findings of the JCPCT, allowing both affected units to demonstrate their capacity and capability on a level playing field.

I am delighted that since the election, the Government have worked to make health services more representative and more responsive to local people. I urge the Minister to continue that fine work by listening to the concerns of patients and residents in Yorkshire and taking on board and responding positively to the Save our Surgery campaign to save the children’s heart surgery unit in Leeds from an unjust and ill-informed closure.

Veterans (Mental Health)

Julian Sturdy Excerpts

Wednesday 7th March 2012 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

Given the nature of this afternoon’s debate, I should like to pay tribute to the soldiers missing and believed killed in Afghanistan. Our thoughts and prayers are with their families at what must be an incredibly difficult time.

It is always a privilege to serve under your chairmanship, Mr Dobbin, and indeed to initiate a debate in this Chamber. I feel, however, an even greater sense of privilege due to the special nature of this debate. Like many Members on both sides of the House, I am a great supporter of our armed forces family. From serving personnel to veterans, those brave men and women have served our country with dedication, and they deserve admiration, respect and parliamentary attention.

I should like to discuss veterans’ mental health, which is one of the few subjects that quite rightly commands political unity on both sides. The work of successive Governments over recent years has given the issue great momentum, and early in the debate I should like to commend the previous Government on the work that they did on behalf of veterans. I also congratulate the Minister on the way that the current Government have championed this worthy issue.

My interest in the mental health of veterans comes from my frequent correspondence and discussions with one of my constituents who is the mother of a veteran. Her dedication to improving the provision and information provided to veterans is inspiring, and I hope that she will take heart from today’s debate.

In recent years, efforts to tackle the cruel stigma that is related to mental health issues more generally across society have begun to make a difference to many of those who suffer from what is often an invisible illness. Indeed, it has been estimated that one in four people in the country suffer from some form of mental health issue each year. The Mental Health Network, which is part of the NHS Confederation, has carried out excellent work, and over the past few years, it has been heartening to see the Ministry of Defence and the Department of Health working closely with the Royal British Legion, Combat Stress and others in the voluntary sector to provide a range of improved services for veterans who suffer from mental health problems.

Let me take the opportunity to praise the work of all charities up and down the country that work day in, day out with members of our armed forces family. In particular, I should like to champion the Royal British Legion and Combat Stress—two charities that play a vital role in delivering key services to veterans and serving armed forces personnel. Together, those charities offer vast experience, unquestionable compassion and unwavering dedication. With approximately 22,000 armed forces personnel leaving the service and returning to civilian life each year, we must appreciate the wide-ranging mental health issues that can be provoked by experiences in war-torn countries and dangerous conflicts around the world.

Over the past 10 years, British troops have been involved in a range of conflicts from Iraq and Afghanistan to Bosnia and Sierra Leone, and the bloody experiences of those wars cannot fail to leave a mark on those who confront them. When we think of the sacrifices made by armed forces personnel, it is right to consider not only the often terrifying physical risks undertaken, but the mental strains that are placed on our brave servicemen and women.

It has been estimated that more than 27% of veterans suffer from a common mental disorder. For those armed forces personnel who leave the service each year having experienced direct action in recent operations, the transition from service life to civilian life is often traumatic. For many, the future is uncertain, and owing to the stigma that surrounds mental health issues, many sufferers fail to seek help on leaving the services. If they do seek help, it is often at a dangerously late stage. A Mental Health Network briefing last year suggested that, on average, veterans do not come forward for mental health support until 14 years after their discharge. Sadly, homelessness and alcohol or substance abuse is more prevalent among veterans when compared with others of similar age or social background.

I have three main objectives in this debate: first, to commend the superb work that has been carried out on behalf of veterans who have suffered from mental health problems in recent years; secondly, to seek assurances about the continuation of parliamentary support for such work to be maintained on a more permanent basis; and thirdly, to ensure that our provision for veterans is coherently delivered in the best possible manner.

The previous Government’s “New Horizons” strategy document bound the NHS and the MOD to improve access and support for the early treatment and prevention of mental health illness among servicemen and veterans. The current Government, led admirably by the Prime Minister, launched the military covenant, which enshrines into law the Government’s duty to support the entire armed forces family. The covenant makes a new commitment to provide

“extra support for veteran mental health needs.”

Soon after taking office in 2010, the coalition Government asked my hon. Friend the Member for South West Wiltshire (Dr Murrison) to produce a report on veterans’ mental health. He should be congratulated on his truly outstanding work and recommendations, and I encourage any hon. Member who has not yet read the report to request a copy from the Library.

My hon. Friend’s “Fighting Fit” report received favourable backing from the Government, and rightly so because it includes a raft of measures to ensure better provision for veterans and their families. Among 13 action points and four principal recommendations, the report specifically calls for

“An uplift in the number of mental health professionals conducting veterans outreach work… A Veterans Information Service (VIS) to be deployed 12 months after a person leaves the Armed Forces… trial of an online early intervention service for serving personnel and veterans.”

As part of the Government’s initial response, a dedicated 24-hour mental health support line for veterans was launched in March 2011, operated by the charity Rethink on behalf of Combat Stress and funded by the Department of Health. In addition, the number of mental health professionals was doubled from 15 to 30.

With the “Fighting Fit” report, the Government’s military covenant and the previous Government’s valuable work, much effort has been made to deal with this issue. The objective now, however, is to ensure that that wide-ranging support, financial assistance, e-learning provision and information literature continues and is focused in the most effective way possible.

I have a number of questions for the Minister to which I hope he will respond, although I accept that some information might require communication with his colleagues in the Ministry of Defence. First, will funding for the dedicated 24-hour support telephone line continue after the one-year trial, which I believe is soon coming to an end? I believe that having someone on the end of a telephone at any hour of any day who is willing to listen, able to support and trained to understand must be of tremendous reassurance and assistance to affected veterans. The continuation of funding for that telephone service would indicate a clear commitment to veterans, and I urge the Minister to push for that support to continue.

With an eye on the future, I ask the Minister to outline the time scales involved in implementing the new veterans service to which the Government have made a commitment. A key issue as we discuss the future of such support is the difficulty of keeping in touch with veterans. As discussed earlier, many leave the service and move on to temporary accommodation or work. It is impossible to provide meaningful support if we do not know where veterans now live or work. Will the Government do more to track and store information about veterans, and will that information be shared with key partners?

[Mr James Gray (North Wiltshire) (Con)]

I congratulate my hon. Friend on securing the debate. Does he agree that there is a particular problem with regard to the Territorial Army and reserve forces? Many of them are spread out across the nation, and we do not know where they are. At least, regulars have the regimental family around them, even after they become veterans. People from the TA are often out in the wide world without anyone to provide such support.

[Julian Sturdy]

I agree. It is also worth noting that reservists tend to suffer more from mental illness, if they have experienced conflict, than regular soldiers, so it is probably even more important that we understand where the reservists are and can monitor that and target help towards them.

[Guy Opperman (Hexham) (Con)]

I congratulate my hon. Friend on securing the debate and I support the laudable aims that he is describing. Given the established difficulties with keeping track of individual soldiers and the difficulties with giving the necessary support post discharge to all manner of servicemen and women, is it not time that we started to consider the possibility of a veterans agency that brings together all these things and provides a co-ordinating review and a hub point for all these services?

[Julian Sturdy]

I agree. As I said, there is a real problem about the joined-up thinking that needs to be done. A tremendous amount of work and services are out there, but we need to bring that all together, under one roof. I will come on to that later if I can.

There remains a real danger that too many veterans will slip through the net because they fail to be registered for initial support on leaving the service and get lost in the system thereafter. The best way to ensure that support gets through to veterans is to keep up to date with veterans, as has been said.

Having touched on the increase in mental health nurses across the strategic health authorities covered by an armed forces network, I ask the Minister to outline the initial effect that the Government believe those nurses are having. Is there sufficient demand for the increased services? Do we need to consider increasing the numbers further? Ensuring that Government provision is frequently reviewed in such a manner will help to keep the ball rolling on this very important subject.

Without wishing to ask too many questions, I should be grateful to the Minister if he confirmed how many of the 10 health networks have now developed integrated services for veterans with specific mental health problems. As I said, ensuring that our provision is targeted correctly and effectively in supporting veterans is key.

I should now like to deal with the online package of interventions for veterans. In response to a recent written question tabled by my hon. and learned Friend the Member for Sleaford and North Hykeham (Stephen Phillips), the Minister, who I am delighted to see will respond to this debate, stated that the uptake of membership of the Big White Wall among the armed forces family is exceeding expectations. It would be interesting to know whether uptake among veterans is also high. Although I am a great supporter of online interventions, my slight fear is that information, assistance and forms of community engagement are all present and accessible online, but only if someone actively searches for them. With respect to veterans who suffer from mental health problems, we cannot expect all of them to be able or even willing to carry out such research. Are those leaving the service provided with the relevant links and information before they leave?

[James Morris (Halesowen and Rowley Regis) (Con)]

I, too, commend my hon. Friend for initiating the debate. Does he agree that there is a key role to be played by local authorities in providing the information for veterans that he is describing? David Herbert, a constituent of mine in Halesowen, was instrumental in bringing together a veterans charter in the Dudley borough, precisely to signpost veterans towards key information in the local area, including information on provision of mental health services.

[Julian Sturdy]

I thank my hon. Friend for that timely intervention. I agree that local authorities have a key role to play, and I agree with the point about the veterans charter, which could go a long way towards delivering what we need, because ultimately we must signpost services correctly. That is the real point. As I said, there are great services out there, but I fear that if we do not signpost them to veterans effectively, we might be missing a trick.

[Nic Dakin (Scunthorpe) (Lab)]

The hon. Gentleman has done a service to the House and to people outside it, particularly veterans, by initiating this debate today. One of my constituents, Charlie Brindley, is a veteran and a champion of veterans’ causes. Does the hon. Gentleman agree that we should look for the best way of using such people as champions to assist us in reaching veterans and dealing with the difficulties in relation to mental health even more effectively?

[Julian Sturdy]

I agree. We must use the experience of such people to help us in this process. Signposting is the key. We have the strategy, but we need to bring things together in a coherent manner that best serves veterans such as those whom hon. Members have mentioned in their constituencies.

As I have said repeatedly, the work carried out in this field recently has been outstanding, yet we cannot rest on our laurels. We need to engage more public interest. We must continue to provide direct funding and support and to monitor each initiative to ensure that it is proving effective. There are so many different strands of support. My final plea is that all the excellent provision be kept together in a specific and coherent strategy. We have already in the debate heard about a number of different ways in which that might be done. If the provision is too loose, too disjointed or too sporadic in its implementation, we run the risk of undermining the general force of the positive work in this area.

I appreciate that a number of hon. Members would like to contribute to the debate, so I shall briefly conclude my thoughts. The work carried out by charities such as Help for Heroes, the Royal British Legion, Combat Stress and so many others literally saves lives. I applaud every one of them. Likewise, hon. Members on both sides of the House who have championed our armed forces should be proud of the work achieved in recent years to assist veterans who suffer from mental health problems. However, our work in scrutinising the present Government and future Governments must never cease. We have a duty to monitor and assess and to push those at the very top to ensure that veterans are at the top of our leaders’ agendas.

I save my last words for both serving and retired servicemen and women. I have never served in the armed forces family, and I expect that only those who do will truly understand the pressure, sacrifice and honour that such service entails. I do not pretend to understand what it must be like to face danger and even death on foreign shores on behalf of Queen and country. However, I can assure all veterans that I shall continuously do my best to ensure that they are never forgotten once their service is completed, that their needs are met by the country to which they gave so much and that their dedication and commitment are rewarded, acknowledged and, indeed, celebrated.

Health and Social Care (Re-committed) Bill

Julian Sturdy Excerpts

Tuesday 6th September 2011 Commons Chamber

[Grahame M. Morris]

That is a good point. Like the curate’s egg, the Bill is good in parts—and bad in parts. I am prepared to acknowledge the commitment on health inequalities but, as I have mentioned, there are contradictions in the Bill, and that is what I seek to highlight. My concern is that the new structures proposed in the Bill move us away from a co-ordinated health service and towards a competition-based health service. Failure has been touted by Ministers as a driver of improvement, but following the latest U-turn, that commitment seems to have been dropped. I would welcome Ministers’ views on that.

Our concern is that the health service will be left to the worst elements of privatisation, without the supposed benefits of market competition. Members have referred to the British Medical Association and its calls for a co-operative and co-ordinated environment, which an open market would make impossible. When Dr Clare Gerada, the chair of the Royal College of General Practitioners, gave evidence to the Bill Committee, she raised a number of concerns about the clauses that we are discussing—concerns

“about the duplication of care and fragmentation…the under-provision of care once competition starts kicking in, the pace and extent of change, and the capability capacity and competence of GPs”

to deal with the extent of health needs. Most importantly, she said that

“the Bill risks widening health inequalities and could lead to worse patient care”.––[Official Report, Health and Social Care Public Bill Committee, 8 February 2011; c. 43, Q94.]

[Julian Sturdy (York Outer) (Con)]

The hon. Gentleman talks about health inequalities, but does he accept that under the current system primary care trusts have brought about a number of health inequalities? Certainly in my area of north Yorkshire, the PCT has brought about a number of health inequalities, and I think that that is the case in other areas, too. The system is already delivering that; that is why we need the change.

[Grahame M. Morris]

The picture is incredibly variable. We should consider many of the policies that the Government are pursuing, not least that on public health observatories, which collect the evidence on which many public health interventions are based. The sustained cuts to their budgets—there is a cut of 30% this year, and 30% next year—are exacerbating the situation. Some PCTs are performing well in this regard, and some are not performing as well. If there are measures that can strengthen our performance, they ought to be welcomed.

We have in the past mentioned some of the public health issues. As far back as 1977, the Department of Health and Social Security’s chief scientific adviser, Sir Douglas Black, commissioned a report on the extent of health inequalities in the UK. The Black report, published in 1980, brought about a sea change in how Governments would respond to health inequalities and reduce their worst effects, particularly for the lower social classes. It is generally acknowledged in more recent reports by Professor Sir Michael Marmot that the NHS can only do so much to address the situation. There are general issues that must be addressed through a whole plethora of Government policies—child benefit, improvements in maternity allowances, more pre-school education, an expansion of child care, and better housing. I mention that in relation to the amendments that we are discussing to highlight the stark danger of a reversal in relation to health inequalities, which are not only influenced by decisions of the Health Secretary, but greatly influenced by decisions taken across Government.

I shall draw my remarks to a conclusion. I am sure that Government Members will be relieved to hear that. [Interruption.] Well, I could go on for longer if they want; I have another six pages. I draw the House’s attention to the real concerns that the general public, the medical profession, staff who work in the service and patients have about particular details—about the new and expanded role of Monitor, and about the implications for the new NHS. It will not necessarily be Monitor that decides the future of failing services; in the end, that will be decided in the courts. Finally, in parts 3 and 4, we are dealing with some of the most contentious issues in the Bill, and I urge Members to consider the issues very carefully and to think about what is at stake, before deciding how to vote on the amendments.

Reform of Social Care

Julian Sturdy Excerpts

Monday 4th July 2011 Commons Chamber

[Mr Lansley]

Many people would therefore be wrong in that respect, because we are clear about taking this report forward as the basis for engagement in the autumn, publishing a response and carrying out other related work on palliative care in the spring, publishing a White Paper and a progress report on funding reform and legislating at the first available opportunity thereafter.

[Julian Sturdy (York Outer) (Con)]

Through the broad principles of the Dilnot report and the work already carried out by the Government, we at last have a framework that we can work towards to bring security, dignity and fairness back to elderly care, which I believe is really important. Will my right hon. Friend assure us, however, that we have a sensible and workable time frame within which to deliver?

[Mr Lansley]

My hon. Friend is absolutely right. At the heart of this, we know that additional resources have to be brought to bear and that given the financial circumstances we face, we also know that this will have to be a partnership between taxpayers, families and individuals—it cannot simply be handing costs over to the state. Although Andrew Dilnot makes no specific recommendations about how to pay for his proposals, he is very clear that even if it were to be through a tax mechanism, he believes it should come from an existing tax and should bear particularly on the same groups of older people rather than be a further intergenerational transfer from working age adults. What that immediately points to is the necessity of engaging fully with some of the stakeholder groups such as Age UK and others and of engaging properly with the public so that before we embark on this major reform, they can feel confident that they understand those trade-offs and precisely how these costs are to be met.

Congenital Cardiac Services for Children

Julian Sturdy Excerpts

Thursday 23rd June 2011 Commons Chamber

[Julian Sturdy (York Outer) (Con)]

Like many Members, I have a local heart unit that I shall seek to defend. However, before discussing the merits of retaining the Leeds unit, it is important to acknowledge the wider context of the debate.

I strongly believe that the Safe and Sustainable review is a necessary and genuine exercise. Its aim is to ensure that the highest possible level of surgical care is provided to each and every affected child, regardless of where they live. There is no doubt that the case for change is medically accepted. Nevertheless, I believe that decisions over the potential closure of local health services cannot and should not be taken lightly. In the light of the huge amount of evidence behind the motion, I urge the review’s steering group to take as much time as possible in considering the performance, locality, capacity and strength of each unit, among other factors.

On the basis of those four criteria, I strongly believe that closing the Leeds unit would be a huge mistake. The first and most important factor is performance. Leeds General infirmary is at the forefront of work on cardiac conditions. All the relevant reviews and statistics highlight its record of excellence in providing safe and high-quality children’s heart surgery. An important contributing factor in that excellence is the centralisation of the whole children’s services operation at the site in Leeds. However, the review document contains discrepancies when it comes to the definition of co-location of services. To me, co-location means all children’s services operating on a single site, and Leeds is one of only two hospitals cited in the review that offer that gold standard.

The second principle is locality. The unit is within two hours’ travel time for nearly 14 million people, including 5.5 million in the Yorkshire and the Humber area. In such highly populated areas, surely the focus should be on delivering services to the people and delivering them to the greatest area of need, not vice versa. In my view, the location of the unit and the huge number of children whom it serves make its continued existence imperative.

The review document states that parents need not accompany their children. I have two young children myself. What parents would not want to accompany their children in such difficult circumstances? Sadly, however, that is not always possible. There are child care arrangements to be made, and work issues and transport links to be considered. The stress of all that is extremely disturbing for all families in such circumstances. I realise that that applies to all the centres, not just Leeds, but I believe that we must take account of the core principles: the need to deliver services to the people, and the need to provide easy access for as many as possible. That means locating services in highly populated areas with good transport links and travel times. Birmingham and Liverpool have been included in every option in the review, and rightly so, but why has Leeds not been identified in the same way on the basis of those core principles?

Children's Heart Surgery (Leeds)

Julian Sturdy Excerpts

Thursday 3rd March 2011 Commons Chamber

[Stuart Andrew]

I completely agree. When I worked at Martin house, we found that one of the big problems was the travelling distances—some people lived on the coast in Scarborough, for instance. It is very important that families are able to get to a centre quickly, because when a child is sick they want their mum and dad there—and we want that when we are a bit more than a child too. These facilities must be accessible, therefore.

[Julian Sturdy (York Outer) (Con)]

I too congratulate my hon. Friend on securing this important debate for our region. Many of my constituents in York are very concerned about the potential closure, which would mean that they would go to Newcastle, so my hon. Friend makes a good point when he says this is about the whole region. Because of the lack of transport links on the eastern coast of our region, it could be greatly affected by the closure, and I do not think sufficient account has been taken of that.

[Stuart Andrew]

Given the location of Leeds and the extent of the population all around it, it seems very odd that Leeds is not being considered.

Health and Social Care Bill

Julian Sturdy Excerpts

Monday 31st January 2011 Commons Chamber

[Julian Sturdy (York Outer) (Con)]

It is a privilege to be called to speak in today’s debate at such a late hour. I shall try and keep my comments as brief as possible to allow other Members to get in.

Alongside the economy, crime and employment, the performance of the NHS and the provision of local health care is of the utmost importance to most, if not all, people. Health care is rightly viewed as an indicator of a community’s well-being, prosperity and happiness. I know that some hon. Members may disagree, but I firmly believe that all elected Members, on both sides of the House, share a genuine desire to protect and enhance our NHS. Unfortunately, party politics too often comes into health debates. I fear that some Opposition Members have proved that again today.

We all want to improve our NHS services, cut waiting lists, increase cancer survival rates and improve patient experience. Those are certainly the desired outcomes that my constituents want to see.

I truly believe that doctors, nurses and paramedics carry out tremendous work, often in the most testing conditions. We must get away from the idea that a desire to reform the NHS radically equates to some sort of insult to the commitment, ability and performance of NHS staff, because it does not. I am interested in the Bill’s reforming potential because of the conversations that I have had with concerned, exhausted and demoralised NHS professionals.

The NHS is indeed a national treasure, and I can safely say that I will always support it having a place in our society. Such sentiments echo what has already been said by the coalition Government, who from day one pledged to increase spending on health services and shall now do so by no less than £10.7 billion over the course of this Parliament. However, as my right hon. Friend the Member for Charnwood (Mr Dorrell) noted, future demands on the NHS will be unprecedented. Despite the best efforts of NHS staff, our performance has fallen, compared with other countries in the OECD, on respiratory diseases, heart attacks and cancer survival rates. Too much top-down control, too little patient consultation and too many Government-driven targets have brought unsustainable pressures to those on the NHS front line.

Reform is necessary, and it is clear that this broad piece of legislation contains a host of reforming measures. One of the most discussed aspects of the debate is the abolition of the PCTs and the devolving of commissioning to GPs, which I wholeheartedly support. In North Yorkshire, the local primary care trust has been an issue of concern for some time, and in December I secured a Westminster Hall debate on the matter. Concerns from constituents, the voluntary sector and local practitioners were all raised. In essence, the local PCT has in part inherited and in part created a substantial budget deficit running into millions of pounds. As a result, local services such as the provision of back pain relief injections have been withdrawn, impacting severely on the lives of thousands of residents across the region. The local primary care trust’s bureaucratic approach highlights the overall failures of PCTs. I could go on, but time is pressing.

I will mention one further concern. Although I welcome the specific reform, I believe that what happens during the transitional period from PCTs to GP consortia is vital. Services, patients and performance levels cannot be allowed to slip during that important period. I urge Ministers to ensure that all the preparations are in place so that that does not happen.

In conclusion, I very much welcome this truly reforming Bill and pay tribute to the Secretary of State for the work he has done on it. I care passionately about the NHS and its future ability to provide world-class health services for the whole country. I do not believe that it would be morally right to allow the NHS to continue to suffer from top-down, bureaucratic, state-led management. We should and can put patients first, with a flexible health care service that is able to respond to local needs. The Bill will not endanger the NHS, as some Opposition Members might claim, but it will enhance it through the empowerment of patients and local health professionals.

Health Care (North Yorkshire and York)

Julian Sturdy Excerpts

Wednesday 1st December 2010 Westminster Hall

[Julian Sturdy (York Outer) (Con)]

It is a pleasure, Mr Leigh, to serve under your chairmanship. Naturally, I am grateful to those hon. Members attending this debate and to the Minister.

More than 800,000 people are fortunate enough to live in our beautiful part of the country, the North Yorkshire and York region. It is part of God’s own county, as some would say. Quality of local health care is of the utmost importance to many, if not all. Local health care provision is often viewed alongside other criteria such as employment and crime. It is a measure of the local community’s economic well-being and happiness—a word that seems to be floating around in many debates at the moment.

It is in our moral and economic interests to ensure the widest availability of health services, the shortest waiting lists and the most impressive health outcomes, and they should be implemented in each and every region. Ensuring such health care standards for all is truly one of the most essential roles of Government. Indeed, I am sure that all those Members here today will agree that health-related concerns crop up frequently in our constituency mail. That is certainly so in my constituency of York Outer.

When it comes to health, I often have nothing but sympathy with the majority of my constituents who are affected. Many of them feel betrayed by the system, weighed down by the bureaucracy, frustrated by the delays and ultimately let down by those supposedly in charge. In my experience, it is easy to comprehend such frustration. After all, our national health service is a national treasure. We champion it, and rightly so. However, when patients report negative experiences and local health funding concerns, our national treasure is in danger of being tarnished, to the detriment of health care users and service deliverers. That, in my view, should not be allowed to happen.

The health service has some of the most caring, compassionate and hard-working nurses and doctors in the world. That is certainly true in North Yorkshire and York. Our health care personnel carry out tremendous work, often in tough circumstances, and they do so out of a sense of public duty, kindness and compassion. I cannot commend these individuals highly enough. However, I am concerned about health care provision in North Yorkshire and York because of the representations that I have received from NHS employees and local patients.

The region faces some real health care difficulties. In truth, extremely serious concerns are growing about the capability and performance of the region’s primary care trust and related bodies. Local residents have good reason to believe that a huge range of treatments will be withdrawn, if they have not been withdrawn already. For example, I have received letters regarding the future of IVF treatments, counselling services, broken voluntary sector contracts and the withdrawal of pain relief injections. It also appears that about £2 million will be cut from GPs’ budgets for prescribing medications, and that some physio services are at risk.

[Julian Smith (Skipton and Ripon) (Con)]

I congratulate my hon. Friend on securing this debate. He might be about to discuss this, but my experience from my constituency is that North Yorkshire and York PCT’s way of dealing with voluntary organisations in the past few months has been a disgrace, breaching the voluntary compact between those organisations and the PCT. It has caused problems for those important parts of the big society that have been operating in North Yorkshire for so long.

[Julian Sturdy]

Absolutely. I agree entirely with my hon. Friend. The time limit given by the PCT to those voluntary organisations is despicable, and it has caused fear and concern in the sector. Not only that, if the organisations lose funding for six months, which might be seen as only a short period, the problem is that they might not start up again. That is my concern, and I will go on to discuss it in more detail.

Local residents have good reasons to believe that a huge range of treatments will be withdrawn, as I said. If the truth be told, the status quo is not only unacceptable but frightening, particularly for the most vulnerable members of our communities. Even describing the current situation as a postcode lottery is too generous. I fear that our patch is in danger of becoming an area of health deprivation.

Several different factors require deep consideration as we piece together this somewhat depressing picture. First, we must accept that the region has to some extent been underfunded in the past. Before 2008, the North Yorkshire and York PCT did not exist. Instead, four separate PCTs covered the area. Nevertheless, for the purposes of this debate, I have amalgamated funding data to show the PCT’s current funding allocation and the annual figures stretching back to 2003-04. For 2010-11, our region’s PCT received just over £1.1 billion, an allocation that places it in the lowly position of 140th out of 152 PCTs. From a starting point of 127th in 2003-04, it has dropped down the funding table each year. The current funding level is the lowest allocation per head of all Yorkshire and Humber PCTs.

PCT funding is currently allocated according to a complex funding formula, often referred to as the weighted capitation formula. In essence, the formula determines the target share of resources to which PCTs should theoretically be entitled, based on a broad range of criteria including population, the local cost of health care provision and the level of need and health inequality in the area. Unfortunately, most PCTs never receive an allocation equal to their deemed target share according to the formula. Rather, they move towards it over time, some faster than others.

Personally, I am slightly critical of the current formula. It often results in greater funding disparities between different regions, which provoke a profound sense of unfairness. Less deprived areas often seem to get a certain tag as well. For example, according to the formula, North Yorkshire and York does not have adequate need for additional resources, particularly compared to the needs of more urban areas such as Hull. I am not convinced that approaching regional health funding consideration with that mentality—judging whether areas are deprived enough—is a sufficiently robust methodology in current circumstances. We must look more deeply at the funding stream.

I agree that the funding shortfall has increased the strain on our local PCT and its ability to deliver the best possible health outcomes and equity access for local residents. I would appreciate the Minister’s comments on whether the coalition Government will review the funding formula at some future date. However, I also suggest that excusing our health care failings in our region on past funding alone would be somewhat naive. Over the past few years, North Yorkshire and York PCT has accumulated an overspend of some £17.9 million. Thus, despite the coalition’s welcome commitment to protect the wider health budget, services are being cut in our region to pay for the fiscal irresponsibility of the PCT. Moreover, the PCT seems to be intent on resolving this deficit immediately because the previous Government imposed a statutory obligation on all primary care trusts to break even by the beginning of 2011. Such a target-focused piece of bureaucracy has now resulted in the PCT cutting too many services too quickly, possibly leading to a diminished health care package for our local residents.

I have already listed some of the services that are under threat of withdrawal. My hon. Friend the Member for Skipton and Ripon (Julian Smith) has named the services in the voluntary sector as well. I shall expand on a few examples. First, there is the withdrawal of the pain relief injections. As Members from neighbouring constituencies know—my hon. Friend the Member for Selby and Ainsty (Nigel Adams) has campaigned with me on this—the PCT’s decision to restrict the provision of back pain relief injections has provoked a huge reaction from both patients and health care professionals alike.

[Nigel Adams (Selby and Ainsty) (Con)]

I, too, congratulate my hon. Friend on securing this debate. I am not sure whether I should declare an interest, having received several back pain relief injections in the past. The injections are a big issue in the north Yorkshire area, as evidenced by the huge postbags that my hon. Friend and I receive, and we have spoken to the Secretary of State on the matter. Can my hon. Friend recall a discussion with the Secretary of State in which he said that one of his officials would look into the York PCT’s interpretation of the NICE guidelines on back pain relief injections? Has he received any notification of those discussions or heard from the Secretary of State’s office?

[Julian Sturdy]

My hon. Friend makes a valid point. We did indeed meet, and I have not yet received a response from the Secretary of State. I hope that the Minister will hear our message here and chase up that response, because it is important that we get an answer to our question.

My hon. Friend mentioned the back pain relief injections, and the issue is causing real concern among our constituents. Members of the public came to my last surgery to discuss the matter. The PCT, as my hon. Friend said, based its decision to cut back pain injections on its interpretation of the NICE guidelines. Unfortunately, almost every other PCT interprets the same guidelines in a different way. As such, countless local people are being forced to suffer enormous and unnecessary pain.

Alongside other hon. Members from the region, I have lobbied the Secretary of State. Campaign groups such as York and District Pain Management Support Group have been leading the way on this as well. I have also received representations from concerned health professionals. Only last week, Dr Peter Toomey, a consultant anaesthetist at York hospital wrote to me, stating:

“I consider that the PCT have made serious errors of judgement in coming to their decision to restrict access to spinal injections for the relief of pain. The PCT will not reimburse York Hospital for any injection into any part of the spine for any diagnosis unless it has been approved by the PCT’s Funding Request Panel.”

We know—my hon. Friend the Member for Selby and Ainsty will back me up on this—that many people are being refused by that request panel. Dr Toomey and a number of his colleagues have fought hard to challenge the PCT’s policy, but—alas—their medical expertise seems to have fallen upon deaf ears.

Patients and medical professionals are united in the view that this pain relief service should not have been withdrawn. It has been taken away for the wrong reasons and should be reinstated without delay. The withdrawal of such vital services is causing me great concern, as is the withdrawal of funding for numerous voluntary services. My hon. Friend the Member for Skipton and Ripon touched on that matter earlier. The York Council for Voluntary Service has been informed of a 37% in-year cut, which has been issued by the PCT with just one month’s notice. Angela Harrison, the chief executive of the YCVS, summed up the whole situation quite aptly when she said:

“These cuts have already had a disastrous effect on front-line voluntary groups who serve some of the most vulnerable members of society. At the same time, the infrastructure groups who support them have had their funds withdrawn at very short notice, reducing their capacity at a time when it is most needed.”

One specific voluntary case vividly highlights the poor management of the way the PCT has handled this situation. On 19 October, Yorkshire MESMAC received a letter from the PCT, informing the organisation that its contracted health care funding was to be withdrawn within one month. Such blunt and definitive notice is absolutely outrageous. Not only has an agreement been broken, but no consultation took place with the organisation, which—knowing the PCT’s overspend—would have been happy to sit down and reach a more amicable agreement. As Tom Doyle, the director of Yorkshire MESMAC, said:

“I want to express my deep frustration at how the process has been handled, which was, in my opinion, unlawful, disrespectful and showing an arrogant disregard for the PCT’s own agreements and processes.”

It is now feared that Yorkshire MESMAC will be forced to close.

On a wider note, the voluntary services budgets are expected to lead to a saving of some £150,000 for the PCT this year. Given that that is a small drop in the £17 million overspend, I would urge the PCT to look internally for structural and efficiency savings, rather than merely reducing the funding of voluntary groups, whose work often plays such as vital role in our health service. If our voluntary health services are forced to close, I predict that far greater numbers of patients will actually require more hospitalised, long-term and expensive treatments through the NHS, thus undermining the PCT’s initial savings.

Due to the overspend and service reductions, there now exists a lack of trust in the PCT and a complete absence of confidence over its future intentions, and I fear that local people are simply paying too high a price for that. In the long term, I am more optimistic about health care provision in north Yorkshire and York, largely due to the contents of the health White Paper. The localised drive to ensure that PCTs are, at some point, abolished altogether and replaced by GP-led commissioning bodies, which are influenced by local patients, is a measure that I wholeheartedly welcome.

At long last, local patients will have a say in their local services, holding the decision makers to account and freeing up our nurses, doctors and health providers from the red-tape that so often binds them and takes them away from the front line. I hope that the Minister can reassure me that the transition from PCTs to GP-led commissioning will be carried out swiftly to ensure that the interim transitional period will not see a lack of leadership or direction for local health care services—especially in our area.

I believe that the PCT will continue to operate until 2013, and I plead with the Minister to review to the situation in north Yorkshire and York in the meantime. Our constituents simply cannot afford to wait three years for the situation to be remedied. Most specifically, I would welcome any comments from the Minister on the previous Government’s imposition of a statutory obligation on PCTs to break even by the end of this year. Could that deadline be extended to soften the blow of the cuts over a greater time period?

The people of north Yorkshire and York depend upon their health care services, and many are extremely worried at present. I hope that hon. Members from the region—I was going to say “regardless of political allegiances”, but as we only have coalition Members here I will not say that. To give the hon. Member for York Central (Hugh Bayley) credit, he did say that he would try to be at the debate today.

We must protect the essential health care services and funding that our region deserves. I ask and urge hon. Members to fight and to campaign for that. We must ensure that, before GP-led commissioning starts, the PCT delivers the best service that it can within its budget. It must focus on service delivery and the outlying services to our communities, rather than cutting.

I hope that the Minister will give serious consideration to the issues that I have raised. I am grateful for his time. I know that it has been a hectic day thanks to the Divisions, but I am grateful to him for giving us the time, and I hope that he will give the matter serious consideration.

Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 2nd November 2010 Commons Chamber

[Mr Lansley]

I am afraid the right hon. Gentleman is wrong about that. Even if we did not treat up to £1 billion to support social care through the NHS as NHS money—we should treat it as NHS money, but even if we did not—there would still be an increase in the resources available to the NHS in real terms each year. It is NHS money. The right hon. Gentleman must accept that this year we are spending £70 million on reablement, which has the effect of mitigating need in social care and reducing emergency readmissions to hospital. We will provide NHS money, which in itself supports health gain and social care support.

[Julian Sturdy (York Outer) (Con)]

6. What assessment he has made of the likely effect on cancer survival rates of the implementation of his proposed reforms of the NHS.

[The Minister of State, Department of Health (Paul Burstow)]

Our health spending now matches European levels, but our cancer survival rates do not match European levels. If we brought survival rates up to the best in Europe, we could save up to 10,000 lives a year. Our updated cancer strategy will set out how our NHS reforms will improve cancer survival rates.

[Julian Sturdy]

Does my hon. Friend agree that local charity groups, such as York Against Cancer in my constituency, play a vital role in the fight against that disease? Can he assure me that the Government will continue to support and work with the voluntary sector to provide the very best cancer care?

[Paul Burstow]

The Government certainly work closely with the voluntary sector in many ways to promote and develop our approach to cancer services. We value the work of organisations such as York Against Cancer because of the support that they provide through information and support for people diagnosed with cancer and their families. It is very important that we continue to support such activities.

Oral Answers to Questions

Julian Sturdy Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Lansley]

We have been very clear that it is a scandal that we have some of the finest cancer research anywhere in the world and some of the best cancer medicines have been developed in this country, yet in the past in this country NHS patients have often been the last to have access to those drugs. That is why at the election we made it clear that we will introduce from April next year a cancer drugs fund, the purpose of which will be to ensure that patients get access through the NHS to the cancer medicines that they need, on clinical recommendation and advice, and that they are not unduly delayed in getting that access.

[Julian Sturdy (York Outer) (Con)]

T9. I am sure that the Secretary of State will remember visiting my constituency earlier in the year and listening to constituents’ concerns about the withdrawal of spinal injections on the NHS. Given that the PCT’s decision is set to become another example of the postcode lottery in the health service, will his Department consider the ongoing debate about spinal injections in York and support the attempts of my constituents as they seek to shape local health services around their specific needs?

[Mr Burns]

I am a bit confused as to where to look. [Interruption.] Right, I will look forward.

My right hon. Friend the Secretary of State well remembers his visit in April to meet the York and District pain management support group. He made it plain at the time that it should be for GPs and their patients to decide what treatment should be given, as opposed to a decision by the PCT to veto spinal injections for all sufferers of long-term chronic back pain. We will, in due course, set out our proposals to put more power in the hands of patients and GPs.