Healthcare: East Midlands

Karen Lee Excerpts

Tuesday 30th April 2019 Westminster Hall

[Karen Lee (Lincoln) (Lab)]

I beg to move,

That this House has considered provision of local healthcare in the East Midlands.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am glad to have secured this crucial debate, which gives me and my east midlands colleagues a great opportunity to highlight the healthcare crisis in our constituencies, our region and across the country. I must stress in everything I say that I do not blame the hard-working and dedicated staff for any of it; the fault lies fairly and squarely with Government cuts. Our constituents deserve better than the past decade of under- funding, which has created a postcode lottery in local healthcare. It has had particularly detrimental implications for my constituency of Lincoln: local healthcare centres have been forced to shut, more general practitioners’ services are at risk of closure in the coming months, and local hospitals are in need of considerable funding and support.

Our healthcare infrastructure in the surrounding region of Lincolnshire has also been put under considerable pressure over the past nine years. In July last year, the chief inspector of hospitals recommended that United Lincolnshire Hospitals NHS Trust, which has a deficit estimated at £80 million, should remain in special measures. The latest figures show that the trust missed its A&E waiting time target by 32% and has not met the national standard since September 2014.

The east midlands reflects the national picture of a health service in crisis. The Government have spent nine years running down the NHS by imposing the biggest funding squeeze in its history, with massive cuts to public health services. Social care has been slashed by £7 billion since 2010. Our NHS is short of 100,000 staff, including 41,000 nurses and nearly 10,000 doctors. That has had a detrimental knock-on effect on performance: waiting lists are at 4.3 million, more than 500,000 patients are waiting more than 18 weeks for treatment, and 2.5 million people are waiting for more than four hours in A&E. That is a crisis.

It is clear that the underfunding, privatisation and inadequate staffing of our health service has had a devastating effect on healthcare provision in Lincoln and the east midlands. Government decisions have had terrible consequences for people who need care in the areas that I and many of my colleagues represent. That is typified by the recent announcement that the highly relied-on Skellingthorpe surgery may close.

For those who do not know it, Skellingthorpe is a beautiful village in my constituency. Its doctors surgery provides healthcare to more than 8,000 patients, many of whom are local residents. The national patient survey found that 81.9% of the surgery’s patients felt that their overall experience was good or very good. The Glebe Practice, which runs the surgery, is in the process of proposing its closure to the clinical commissioning group, and the practice’s patients are centralised in its Saxilby surgery. I acknowledge that there are pressures on the service—there could not fail to be, given the Government’s cuts—and that the practice is struggling to recruit clinicians, so centralising its service in Saxilby allows it to maintain quality in one surgery. However, centralising the service restricts my constituents’ access to care. They have told me that it is already very difficult to book a timely GP appointment there.

As many other hon. Members will know from their own constituencies, rural areas are often inaccessible because of limited transport links. If the Glebe Practice’s plan to transfer patients to its Saxilby practice is agreed to, it will mean patients having to travel on public transport—remember, not everybody can drive or has a car—or walk for 90 minutes from the Skellingthorpe surgery. Even the closest surgery is about a 40-minute walk away. Imagine elderly people having to walk for 40 minutes!

This is a shocking downgrade of my Skellingthorpe constituents’ access to care. The proposed alternatives do not offer an acceptable journey length to patients who are in need of health services. Many patients may struggle with mobility issues because of age or illness, while others may not be able to afford to travel other than by public transport.

[Ruth George (High Peak) (Lab)]

My hon. Friend is making an excellent speech that sets out the challenges to healthcare in rural areas such as Lincolnshire. Just this week, the wound service in one of our local clinics in High Peak has shut. Elderly patients with open wounds are having to travel for four hours each way, on three buses, to access the clinic that they are supposed to go to. Does my hon. Friend agree that that is absolutely unacceptable?

[Karen Lee]

Yes, I do. I hope that everybody in this Chamber would agree that that is really unacceptable.

Rather than reducing access to one-to-one healthcare, we should be outlining how we can help groups such as the Glebe Practice by implementing effective national programmes that incentivise recruitment in rural areas. There is a major workforce crisis: as a report co-authored by the Nuffield Trust, the King’s Fund and the Health Foundation has found, the NHS could be short of 7,000 GPs within five years. Rural areas will be the first to be hit. As access to GP services in the east midlands is reduced, I urge the Minister to take action to address the staffing crisis.

Before the surgery closes, Lincolnshire West CCG intends to hold a public consultation—but the people of Lincoln have been there before, very recently. Lincoln’s walk-in centre on Monks Road closed last year after an allegedly meaningful public consultation, 94% of respondents to which were opposed to the closure. Protests were held outside Lincoln County Hospital and along the high street. Both Conservative-led Lincolnshire County Council and Labour-controlled City of Lincoln Council formally objected to the closure, as did I, but not a bit of notice was taken—the centre was still closed. The justification was similar to the one being given now for the Skellingthorpe closure: we were told that there would be sufficient alternative provision to ensure the same level of care. After researching that claim, we found that no substitution would come anywhere near the accessibility of the walk-in centre, so I am afraid that my constituents’ faith in any local consultation is pretty limited.

Appointment-only slots will not meet the needs of my constituents who rely on short-notice, timely access to care. Inevitably, they will only add to the pressure on the overworked A&E department at Lincoln County Hospital and East Midlands ambulance service.

I am very concerned that a trend is emerging: the implementation of cuts to healthcare services, in direct opposition to local people’s wishes and needs. It is deeply worrying that CCGs are not listening to residents’ concerns before closing local health services. I completely acknowledge that there have been sustained budgetary pressures on the healthcare system over the past nine years, and that it is the CCGs that are expected to deliver large-scale cuts, but in a transparent health governance system we cannot allow cuts to be rubber-stamped against such clear local opposition.

I ask the Minister to consider these cases and contact me to provide substantial reasoning to explain why another closure in my constituency is considered acceptable. The information that I and my constituents have been afforded has led us to the opinion that neither the walk-in centre nor the Skellingthorpe surgery should have been considered for closure. I am sorry, Minister, but passing the buck to the CCG is not good enough for my constituents.

It is not just local GP practices and health centres that have been put under debilitating pressure over the past decade. In my constituency, Lincoln County Hospital serves the city of Lincoln and the north Lincolnshire area. Due to funding and staffing pressures, the latest Care Quality Commission inspection has found that Lincoln County Hospital is below the national standard and requires improvement. It is important to stress that, as is the case in hospitals throughout the UK, this substandard performance is in no way the fault of the dedicated and hard-working staff. I speak from experience: when I was a nurse there, we often used to stay up to an hour late. In theory we got our time back, but in practice we did not.

The staff give a lot—it is not their fault. I worked as a nurse at Lincoln County Hospital for 14 years and I know how much energy and care all the staff, from porters to doctors, put into their challenging work. That is supported by the CQC report, which concluded that the hospital requires improvement in four out of five areas: safety, effectiveness, responsiveness and management. The only area rated as good was the caring nature of the hospital. As the report states repeatedly:

“Patients were treated with compassion, dignity and respect.”

I pay credit to the hard-working staff for that, but they are being let down by a Government who have consistently neglected our health services. I have been through their cuts myself.

The inspection found that nurse staffing numbers were often insufficient to keep people protected from avoidable harm and that the hospital relied heavily on agency and locum staff. I know that at first hand: my friends who are still nurses there tell me that that is true even now. Most worrying was the fact that adequate levels of nurses were observed on only four of the 28 days that the CQC reviewed. It is hardly surprising that there are such drastic staffing shortages. Since 2010, there has been a 19% real-terms fall in weekly earnings for full-time nurses. Nursing degree applications have dropped by one third since the Government scrapped nursing bursaries, without which I would not have been able to train. I go on and on about the nursing bursary, and I will not stop. We need to bring it back; we will not have enough nurses until we do.

The Health Foundation has also found that the number of nurses quitting because of a poor work-life balance almost tripled between 2011 and 2018. Our NHS staff should be celebrated and supported. Their kindness and commitment should not be taken advantage of by a Government who strip away the security of their profession. Lincoln County Hospital demonstrates the devastating way in which avoidable staffing shortages affect vulnerable patients in our communities.

The CQC report also found that patients could not always access care and treatment in a timely way. Waiting times were worse than the England average and did not meet the national standard. Some 60% of ambulance handovers were delayed by 30 minutes or more, and 47% of patients in A&E waited longer than the recommended 15 minutes to be triaged. I went out with an ambulance crew about a year ago, and I saw that at first hand.

That shows how hard-working, committed NHS staff in Lincoln are being put under intolerable pressure by decisions made in Whitehall. That is not unique to Lincoln. In July last year, England’s chief inspector of hospitals recommended that United Hospitals Lincolnshire NHS Trust should remain in special measures after visits to Lincoln County Hospital, Pilgrim Hospital, County Hospital Louth and Grantham and District Hospital. Pilgrim Hospital in Boston, which serves my constituents, is a particularly worrying case. It received an overall rating of “inadequate” in this year’s CQC inspection. The report found that there was no allocated corridor nurse. Corridor nurse—really? Should people be in corridors on trolleys? One nurse was caring for up to 21 patients at one time. When I was a nurse, the average was about six or eight. On a bad day, if someone did not come in, it could be 10 or 12, but 21—really?

It is clear that at the local, regional and national level, healthcare provision is not working. Vulnerable people who need care in Lincoln, the east midlands and across the UK have a right to access the health provision that they need. That requires a properly funded and staffed NHS service, from local GPs to county hospitals. Although I welcome the Government’s planned funding increase for the NHS, most health experts agree that it is barely enough to keep the NHS afloat, let alone reverse nine years of severe funding cuts. Areas such as Lincoln and the east midlands need and deserve much more than a plan that will barely keep afloat a system operating on a shoestring budget.

As someone whose job used to be to provide local healthcare, I am lifted by the fact that everyone can access healthcare as a human right in this country, but that universal right is threatened by policies that do not enable an effective health service in which everyone can access care based on their need, not on the austere policy decisions of the Government of the day.

[Several hon. Members rose—]

--- Later in debate ---

[Karen Lee]

I thank all those who have contributed to this excellent debate. Some comments have reflected the fact that healthcare remains something of a postcode lottery. In some areas we hear that everything is positive and good, but that is not always the case where I live. Travelling long distances to access a GP is not positive for someone who is ill, and that is not what my Skellingthorpe constituents want. That is not about an emotional attachment; it is a practical consideration. The concern in Lincoln is that nothing is opening, it is all closing.

The hon. Member for Strangford (Jim Shannon) spoke about suicide and mental health and I agree that we need ring-fenced funding for mental health care. My hon. Friend the Member for High Peak (Ruth George) spoke about problems delivering healthcare in rural settings, and people travelling long distances to access care. My Skellingthorpe constituents are not looking forward to that, should they lose their GP services.

Motion lapsed (Standing Order No. 10(6)).