Community Hospitals

Liam Fox Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Dr Liam Fox (North Somerset) (Con)]

I add my congratulations to my hon. Friend the Member for Dover (Charlie Elphicke). Having visited his constituency, I know how important community hospitals are for the well-being of his constituents. His commitment is greatly appreciated. I also warmly welcome the Minister to his place. It is wonderful to have a Minister in a Department who has a genuine passion for his subject, and a level of expertise that will be hugely welcomed—no doubt that will be a great threat to the civil service.

Like my hon. Friend the Member for Totnes (Dr Wollaston), I have served on both sides—as a Member of Parliament with a local community hospital, and as a doctor working in community hospitals. Clevedon hospital has been at the heart of our community in North Somerset for many years. Like many of those who have spoken, we have a league of friends, which over many years has performed heroically raising community funding to support the hospital. Despite that, our hospital is still under threat. We had a perfectly sound plan for a replacement, which we approved and then dropped. It was the subject of an Adjournment debate in the House. I will not repeat what I said then. Our CCG is under pressure from legacy funding issues, and from a funding formula that does not properly reflect issues of rurality or take into account our demographic patterns. The Department needs to look at that but, none the less, we have very good services in our community hospital. We have recently improved and replaced ultrasound facilities, we have increased facilities for ambulatory care and we retained our in-patient beds. I agree with my hon. Friend that that is one of the most crucial issues.

In-patient beds in community hospitals are good for several reasons. They are good for patients. As my hon. Friend the Member for Maldon (Mr Whittingdale) said, one of the most important things is that families are close by. With increased centralisation of acute hospitals in cities and away from many communities, community hospital beds are valued for enabling people to get close. They can make frequent visits to their relatives, who often are elderly or disabled. We cannot put a price on that social element. Community beds also allow preparation time for patients with complex support needs. All too often, patients leave an acute hospital with nursing or social care needs, and there is not sufficient preparation time before their discharge. As my hon. Friend the Member for Totnes said, community hospital beds used on a step-down basis allow proper preparation time, so that that patient gets proper support.

In addition, I believe that community hospital beds are good health economics. There is too big a gap between our increasingly specialised acute services in hospitals and patients’ homes. Because acute beds are expensive, there is often pressure on hospital staff to discharge patients early. We have all come across far too many constituency cases in which patients have been discharged inappropriately early from an acute hospital. The trouble with that in terms of health economics is that it leads to rebound admissions. Patients are sent home too early and it is not possible to prepare appropriate care, or they cannot recover sufficiently, and they end up back in an acute hospital, blocking another acute bed. The system is less efficient than it would be if patient care were put at the centre.

The value of respite care beds has not been raised in the debate. Society depends hugely on carers, who are often the unsung heroes of the health care system. Respite care beds can be invaluable in giving carers a break, so that they can be strong enough to give the care they want to give. We have lost far too many respite care beds. In my constituency, we lost the planned Portishead cottage hospital, which meant fewer beds, and we lost a range of respite care beds at Orchard View. We were always promised that alternatives would be found, and they never materialised. We must understand that if we do not care for the carers and if they become unable voluntarily to carry out those functions, for which they should be given more thanks by the nation, it will cost the NHS a great deal of money.

The issue is not a party one, although I am rather surprised that not a single Labour Back Bencher seems to have a community hospital problem to talk about today. However, there is no doubt that people believe that community hospitals are good for them and their local identity. They are good value for money and good health economics and, above all, good for patients. My hon. Friend the Minister is new to his post, and I want to tell him that community hospitals are what the public undoubtedly want from health care. It is up to the Government to ensure that that is what the public get.