Wednesday 24th February 2016

(8 years, 9 months ago)

Commons Chamber
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Steve McCabe Portrait Steve McCabe
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I might agree with that, but one of the problems in my area is that GP surgeries have been cut as well, so that is not the answer.

As I said, more than 72% of the people I consulted had experience of using the centre and were firmly opposed to any plans to close it. I also found that 56% of people had used the centre for out-of-hours emergency treatment, and 55% expressed serious concern about any plans to move the service to or near the A&E unit. My findings are consistent with that of the survey conducted on behalf of the NHS central midlands commissioning support unit in 2012, which found that more than two thirds of patients surveyed at eight walk-in centres and urgent care centres across Birmingham and Solihull indicated that they had attended because of an access-related issue—for example, they could not get an appointment with their GP or had to wait a considerable time to be seen.

There were major objections from my constituents to relocating their walk-in centre to the main hospital. They referred, for example, to the distance, waiting times, parking and accessibility. During a visit to Katie Road, I witnessed an ambulance crew bring into the walk-in centre an elderly lady in need of stitches to a leg injury. They did that rather than take her to the A&E unit because of their concerns over the likely delays. The CCG’s own figures suggest that an average visit to the walk-in centre costs around £45, as opposed to £75 to £100 for an A&E visit.

I am aware that there are many examples of walk-in centres being co-located with other health or social care services, and that some have a pharmacy on site or are co-located with diagnostic services such as X-ray services, dental facilities or family planning, but I should like to ask the Minister whether there is any evidence that shows an obvious advantage in co-locating an urgent care or walk-in centre alongside an A&E unit, especially evidence that would outweigh such negatives as distance, waiting times, parking and accessibility. In fact, is it not the case that most walk-in centres have a limited ability to refer patients on to secondary care services, as patients needing a referral to secondary care are normally referred by GPs, who are the traditional gatekeepers—a role that has, if anything, been strengthened as a result of the reorganisation of the NHS?

In autumn 2013 the CCG commenced its pre-consultation. The chair of the CCG met with a number of my constituents in February 2014, when he heard clearly their desire to retain Katie Road and their objections to a plan being pushed by the CCG to relocate the walk-in centre to a site at the University Hospitals Birmingham NHS Trust site, adjacent to the hospital’s A&E unit. In July 2014 I invited the chair of the CCG and a number of his staff to take part in a second meeting attended by more than 80 constituents—we were limited by the size of the room, or it would have been many more. At that meeting they heard clearly once again that there was total opposition to the closure of the walk-in centre and the plans to relocate to the hospital. That review or consultation eventually fizzled out, with the promise of a bigger and better consultation later in 2014.

Khalid Mahmood Portrait Mr Khalid Mahmood (Birmingham, Perry Barr) (Lab)
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The issue of such walk-in centres closing down is difficult for all of us in our constituencies. It is no good Conservative Members saying that we will have a seven-day a week GP service, because what they have done already with regard to the junior doctors dispute shows that they are not capable of doing that. That means that our constituents will continue to suffer. In particular, those at work cannot access services and are therefore put at greater risk through further misdiagnosis or non-diagnosis.

Steve McCabe Portrait Steve McCabe
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My hon. Friend will know very well that there is a problem with GP provision in his part of Birmingham as well as my own, so it is difficult to see how it could be stretched further.

As I said, we were promised a bigger and better consultation for later in 2014, but that was abandoned in light of the impending general election, the date of which had, obviously, been known since the Fixed-term Parliaments Act 2011.

No satisfactory explanation for the proposed change has ever been provided, but now, once again, the CCG wants to consult on the future of the walk-in service. This time it apparently wants to consult on a new model of service, the details of which are known only to itself but which has apparently not been clinically tested. It appears that, once again, it involves plans to relocate the walk-in centre to a site adjacent to the A&E unit.

As the Minister will know, sections 75 to 77 of the Health and Social Care Act 2012 specifically state that commissioners are required to act in a transparent way when procuring services:

“Transparency is important in ensuring that commissioners are accountable for their decisions. As noted, commissioners also have a duty to involve the public in commissioning decisions.”

It is not clear to me where in that part of the Act there is support for a series of bungled and inadequate on-off reviews and a constant determination to impose one outcome irrespective of the arguments to the contrary. I would welcome the Minister’s view on that. I am deeply concerned at the continuing threats to the service, which plays such a vital part in the delivery of healthcare for my constituents. I cannot see how the loss of a provision such as Katie Road is consistent with the Government’s ambitions for a seven-day NHS—perhaps the Minister can advise me on that.

Ironically, I have recently discovered that the opening hours of the Katie Road centre are to be extended to help cope with winter pressures. Dr Lumley, who works with the neighbouring CCG, which also serves south Birmingham, is quoted in the press as saying, in response to that announcement, that

‘this is great news for patients in Birmingham and means they can access the Walk in Centre until late, seven days a week.”

Such a pity her views are not shared by her colleagues in CrossCity CCG, who assumed responsibility for Katie Road in the carve-up following the introduction of the Lansley reforms.

It seems to me that the CCG is clearly out of its depth in handling a public consultation, or certainly one that can command any public confidence. What advice and support, if any, do the Government offer to CCGs on conducting consultations with the public? I am curious to know how much public money—money that could obviously have been spent on patient care—the CCG has spent on its on-off reviews and consultations so far. Is there any limit to how much public money a CCG is entitled to spend on a review or consultation on a single issue? If so, how much is it? Who is ultimately responsible for making a decision on the future of urgent care provision in south Birmingham? Do the Government accept any responsibility for this unsatisfactory state of affairs, and is there anything the Minister can do to help me and my constituents secure the future of this popular and well used health resource in south Birmingham, which is clearly needed and highly valued?

At the very least, I urge the Minister to write to the chair of the CCG following this Adjournment debate, urging him to communicate properly with my constituents and their elected representatives, to stop repeatedly trying to impose plans that have already been rejected and to bring this whole sorry state of affairs to a satisfactory conclusion.