NHS Winter Crisis

Debate between Liz Kendall and Philip Dunne

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I do not think my hon. Friend will be surprised if I say no, I do not agree that the system is broken. I do accept that it requires more funding, and that is why more funding was provided. It also requires local authorities to work more closely alongside the NHS to try to share these problems and find solutions together.

[Liz Kendall (Leicester West) (Lab)]

The Minister said earlier that he did not know how many operations had been cancelled—maybe a few. Let me tell him that in one week alone 300 operations were cancelled in Leicester. I find myself unusually agreeing with the hon. Member for Wellingborough (Mr Bone)—social care is broken. Will the new Cabinet Office Minister be leading on the social care Green Paper, as the previous one did, and if not him, who?

[Mr Dunne]

I am glad that the hon. Lady has referred to the social care Green Paper, because that will be published this year, providing an opportunity for all Members to participate in it. It does not sit within my set of responsibilities, so I will come back to the hon. Lady on exactly who will be leading on it.

Glenfield Hospital Children’s Heart Surgery Unit

Debate between Liz Kendall and Philip Dunne

Wednesday 19th October 2016 Westminster Hall

[The Minister of State, Department of Health (Mr Philip Dunne)]

It is a great pleasure to serve under your chairmanship, Mrs Gillan. I congratulate the hon. Member for Leicester West (Liz Kendall) on securing the debate and on speaking with such evident passion and knowledge on the subject. I think she has impressed us all with her grasp of the issues. I also congratulate all other hon. Members, from both sides of the House, who managed to secure an intervention during her speech. They made their points clear, with some personal testimony from constituents who have used these facilities, and also made clear how important it is to the region of the whole, in their eyes, that the facility continues.

The future of congenital heart disease services at Glenfield hospital is an important subject, not just regionally but as part of the national plan to ensure that we have world-class heart facilities for infants and children in this country. It is a matter that has been around for some time, and I understand the point the hon. Lady and others made about how unsettling the uncertainty around the future of services is for the dedicated staff who work in those units. It is appropriate that we try to bring these discussions to a head in an orderly, thoughtful and timely way, so that that is not prolonged.

It is worth emphasising that NHS England’s review is about ensuring that CHD services are delivered with high quality and that they are consistent and sustainable for the future. The common standards, which have been agreed by clinicians, other experts and patients, are the driving force to make sure every patient benefits from the same excellent care. It is worth reminding hon. Members present that the proposals for changes to adult and children’s congenital heart services at Glenfield and the other centres across the country are at present just that: proposals. They are not final decisions. NHS England will be consulting on the proposals in the coming months, so it is not appropriate for me to respond in detail to all the concerns raised here today.

The hon. Member for Leicester West asked some specific questions, some of which I will be able to address but most of which, I regret to say, I will not. Those will be drawn out when we come to the consultation, so that the points she made about the current performance of the hospital can be brought to attention through the consultation process.

[Liz Kendall]

I am soon to meet the Minister at the Department of Health. If he is not able to answer the specific questions I have raised, perhaps he can come back to me on those issues at that meeting next month.

[Mr Dunne]

The hon. Lady has put her points on the record. I will be able to respond to some next month, but some will be part of the consultation, which we anticipate will get under way in the new year.

I am trying to put this in context, particularly in relation to the amount of time that we have been considering how to create excellent centres of congenital heart surgery for children across the country, which has been the subject of concern for more than 20 years. Clinical experts and national parent groups have repeatedly called for change, and there has long been an overwhelming feeling that change is needed. Added to that is the fact that children’s heart surgery has become ever more complex and technically demanding. Surgeons now operate on babies who may be only hours old, which demands a highly-skilled and technical team of doctors and nurses who maintain those skills through regular practice. That is why standards are being progressively raised for each surgeon over time, as the hon. Lady referred to.

As I am sure everyone involved in the Glenfield debate is aware, the process of consultation began quite a long time ago. A Safe and Sustainable review was launched in 2008 by the Department of Health under the previous Labour Administration—of which the hon. Lady was a member—to start addressing these issues. The decisions that came out of that review were challenged in court, via referral to the Secretary of State and subsequently to the independent reconfiguration panel. As a result of those challenges, the Safe and Sustainable review was halted. Responsibility for reviewing children’s CHD services was then handed to NHS England, which decided that its new review of those services would also encompass services for adults.

NHS England’s review team consulted extensively with patients and their families, clinicians and other experts before publishing the new standards for CHD services, which only came into effect in April this year. Hospital trusts providing CHD services were then asked to assess themselves against those standards and report back on their plans to meet the standards within the set timeframes. In July this year, following those assessments and further verification with providers, NHS England announced its proposals for change.

In the case of Glenfield, NHS England is minded to work with University Hospitals of Leicester to safely transfer CHD surgical and interventional cardiology services from there to appropriate alternative hospitals. The rationale for that is that NHS England is currently of the view that Glenfield does not meet the standards to be a centre for surgery and interventional cardiology, and is unlikely to do so in the future. The hon. Lady eloquently expressed her belief, presumably based on conversations with the hospitals and with clinicians, that they are on track to meet those standards. That will be important evidence to make available to the consultation, and I am sure that she and other hon. and right hon. Members will do so over the months of the consultation. NHS England’s assessment is based on information provided by the trust itself about surgical numbers, surgeons and their expertise, and which specialist services are located together. It has not come from the centre; it has come from the trust itself.

There is no plan to close Glenfield as a provider of CHD services, other than in relation to surgery. NHS England is instead proposing to continue to commission specialist medical services that make up much of the pre and post-surgical care required by people with congenital heart disease. Closing the medical services for CHD at the hospital is not mentioned under any of the proposals. That has understandably prompted much concern, including about the impact that such a transfer might have on issues such as children’s extracorporeal membrane oxygenation—ECMO—services and paediatric intensive care services, as the hon. Member for Leicester West identified. As I understand it, when the review was undertaken in 2008, Glenfield was not only the first hospital in the country providing ECMO services but was the leading hospital. There were not many others. Today there are five centres offering ECMO services, so Glenfield is not in quite as strong a position as it was a few years ago.

The hon. Lady referred to the petition on Glenfield and the many hundreds of thousands of people who have signed it, which demonstrates the strength of public support for maintaining the service. It shows how passionately people feel about these issues and their strong desire to defend their local services. At this stage I reiterate to those people that no final decisions have been made. We need to wait and see what comes from the next stage of the process, and I am sure the petitioners will make their views known during that. I appreciate that hon. Members may be frustrated that I cannot answer all their questions at this stage. The hon. Member for Leicester West has referred to the meeting we will have in the coming weeks. I look forward to that and to attempting to answer some of her questions.

I remind hon. Members that this is not about cutting costs—that allegation has not been made by anyone during the debate, which I appreciate. It is about trying to improve the standard of service for some of the most sick infants and children in the country, and to ensure that we have a robust, sustainable pattern of expertise in a slightly smaller number of hospitals. Precisely where we get to in deciding which hospitals should provide those services in future will come through the consultation that will take place. The intent is for a formal, three-month public consultation that will conclude in the spring, with decisions being made next summer. I am sure all hon. and right hon. Members present will participate in that debate and I look forward to hearing their contributions.

Question put and agreed to.