Huddersfield Royal Infirmary

Justin Madders Excerpts

Tuesday 2nd February 2016 Westminster Hall

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate the hon. Member for Colne Valley (Jason McCartney) on securing this extremely important debate, and on the eloquent and powerful way in which he set out the issues in his opening speech. We heard quite a remarkable volley of NHS-related slogans at the start. I aim to keep a copy of that Hansard extract in my pocket for future use at rallies and so on, such was the power and breadth of his comments. He deserves praise for the non-partisan way in which he presented the issues, and his passion for the local hospital, which he and his family have clearly used on a number of occasions, shone through. He spoke with great personal knowledge about the geography of the area and how it does not lend itself to the proposals, and he pointed out, quite rightly, a need for a wider, sub-regional focus on services.

I pay tribute to the contribution of my hon. Friend the Member for Dewsbury (Paula Sherriff), who spoke with typical passion and sincerity, and brought with her a wealth of experience from the health sector. She rightly questioned whether Halifax will be able to cope with the extra A&E visits, and we all ought to take note of her revelation that the ambulance service has not yet worked out the implications for its service.

My hon. Friend the Member for Huddersfield (Mr Sheerman) spoke with typical authority about how his constituents will be affected. His recounting of the history of healthcare in his area was highly informative. He rightly pointed out that the financial pressures that this trust faces are not unique and he was characteristically forthright about what he considered to be the failings of the local CCG.

I congratulate my hon. Friend the Member for Batley and Spen (Jo Cox) on her intervention. She spoke eloquently and clearly about how significant the issue is when she pointed out that an entire Kirklees Council area will be without its own A&E unit. She also astutely pointed out that the issue has ramifications far beyond the immediate CCG area.

All hon. Members who have contributed to the debate have clearly set out their constituents’ concerns about the proposals, which will fundamentally change how NHS services are delivered in Huddersfield, Calderdale and the surrounding areas. The question of how services are configured in the area has been the subject of discussion for some time, but found a new impetus on 15 January when Calderdale CCG and Greater Huddersfield CCG released the pre-consultation business case on a reconfiguration of hospital services across Calderdale and Kirklees. As we know, the proposal is to treat emergency cases at Calderdale Royal hospital in Halifax, while a newly built Huddersfield Royal infirmary will tackle planned cases. That will involve the closure of the A&E department at Huddersfield, which has understandably caused a great deal of anxiety locally and has been much of the focus of today’s debate.

It is not just hon. Members who have expressed concern. Stellar characters such as Patrick Stewart have joined in, and there has been a considerable reaction in the community. On 25 January, a paramedic was quoted in the Huddersfield Examiner expressing concerns that the proposals had the potential to create delays of up to an hour in taking a 999 patient to casualty. As we heard, a local statistician has warned that there could be an additional 157 deaths a year if the changes go ahead. It is hugely important that the CCG responds to those claims as part of the consultation process, as patient safety must be the primary consideration when any changes to health services are proposed.

It is clear from the pre-consultation business case that the changes are significant. As the risk assessment states,

“the most likely areas for negative impact is to those groups who are high users of accident and emergency services, such as younger, older people, and some ethnic groups.”

As the hon. Member for Colne Valley mentioned, the risk assessment also states:

“We understand that the population of Calderdale and Greater Huddersfield is ageing slightly faster in the rural areas than in urban areas. This means that new service models could place older residents at a slight disadvantage if the services they need to access are located further away than the services they are currently using.”

We know before we start that older people are more likely to be particularly affected by the proposal to close Huddersfield A&E, as they are more likely to live in rural areas that are further away from Calderdale Royal and, of course, they are far more likely to use emergency services. It is therefore vital that there is the widest possible consultation on these proposals and that the consultation is meaningful. I note from the business case that seven separate engagement exercises have so far been undertaken. However, not one of them has asked this simple question: “Do you want the A&E at Huddersfield Royal infirmary to close?” It is vital that residents are now given the opportunity to engage with those core issues through accessible methods.

Residents of Calderdale and Huddersfield may well be a little disappointed that we are even discussing this issue today. As my hon. Friend the Member for Dewsbury said earlier, residents will remember that in 2007, when in opposition, the Prime Minister visited, posed for photographs and spoke about having a bare-knuckle fight with the then Government to safeguard A&E services at Huddersfield Royal and many other hospitals. The Prime Minister’s attention has been elsewhere recently, so perhaps he needs to be reminded of those comments now. The Minister will know that when the Prime Minister visited Halifax last year, he promised to

“sort out the PFI mess and financial mess that they’re in.”

My hon. Friend the Member for Halifax (Holly Lynch) had hoped to be here today, but she has whipping responsibilities on the Energy Bill. She has been persistent in trying to hold the Prime Minister to account for that promise. I trust that the Minister will be able to set out what is being done to sort it out.

I am sure the Minister will also be gracious enough to acknowledge, as the hon. Member for Colne Valley did, that although the PFI deal was signed when Tony Blair was Prime Minister, much of the work and negotiating was done when John Major was in charge. I am sure the Minister will also agree that the residents of Huddersfield would be right to say that arguing about who is responsible takes us no nearer to finding a solution.

It would also be fair to say that the financial problems faced by the trusts are not solely down to the PFI deal, nor are they alone in facing such challenges. Despite the warm words on funding, a number of challenged trusts are now being asked to consider headcount reductions additional to the current plan. The truth is that the Government have lost control of NHS finances. By slashing social care budgets, they have created a crisis in the sector that is adding pressure to every part of the NHS. By completely mismanaging staff issues, they have created a crisis in recruitment and retention, leading to a surge in spending on agency staff. The report makes it clear that workforce issues are a factor in driving the need for reconfiguration. In 2010-11, the spend on agency staff at Huddersfield and Calderdale was £7.2 million; according to page 29 of the business case, this year the figure is forecast to be £21.2 million, an increase of 194% in just five years.

That issue is not unique to Huddersfield and Calderdale; it is a deeply worrying trend that we see replicated across the country. One of the key reasons for that increase, which again is set out in the business case, is recruitment, retention and vacancy challenges. An example of that is the Government’s decision, after taking office, to slash the number of nurse training places, which led to far fewer nurses qualifying than in previous years. The upshot of that, as the Royal College of Nursing and the Labour party warned at the time, is that trusts across the country are simply unable to fill all their vacancies and are left to rely on expensive agency staff. I ask the Minister, as I have asked him before, whether he will now accept that cutting the number of nurse training places was the wrong thing to do and is a fundamental cause of the increase in spending on agency staff.

The business case also refers to sickness rates being a worrying 5.3% in the clinical directorate, with by far the main causes being anxiety, stress and depression. Sickness rates are high and retention rates are low because the NHS workforce are, frankly, demoralised. I look forward to hearing what the Minister intends to do to improve the position, as many of the challenges facing this trust pervade throughout the NHS.