Healthcare (Devon)

Debate between Lord Swire and Kevin Foster

Tuesday 18th October 2016 Westminster Hall

[Kevin Foster]

I am reminded that it is seven minutes. [Interruption.] The more heckling there is, the longer I might get.

For me, this debate is prompted by what is one of the greatest successes of the NHS: the fact that life expectancies are rising. In parts of my constituency, life expectancy has reached 90, and in one ward that I represent, Wellswood, 9% of the entire population are aged over 85. That brings challenges not only in health and social care, but in relation to the wider selection of services that those who have reached that age will need in order to have a whole life and not just have their healthcare needs taken into account.

Today, however, the focus is on the health service. Clearly, the proposals announced by South Devon and Torbay clinical commissioning group have created a lot of concern across Torquay, Paignton and the rest of the bay and south Devon. In fact, public concern was so great that the first three consultation meetings that it arranged in Paignton did not go particularly well. It arranged what were obviously going to be very large meetings in rather small venues, so when I attended the first one, at 9 am, I found myself, with about 40 residents, my predecessor, the former mayor and a number of councillors, plus trade union representatives, being told that the room was full and we could not go in. Things got worse at the 4 o’clock meeting. I ended up addressing more people at an impromptu meeting on the steps of the venue than had actually got into the official meeting. Then finally, in the evening, although there was a reserved seat for me, that meant that another resident was turned away because I was there speaking. It was a shambolic start to a serious consultation, but thankfully I notice the trust has now arranged further meetings.

Local concern about Paignton hospital is so great because of the breadth and importance of the services that it provides, not least the beds that many people are discharged to from Torbay hospital. When the Public Accounts Committee did its recent report on delayed discharges, Torbay had one of the best records. I am sure that my right hon. Friend the Member for East Devon would reflect that, sadly, the Royal Devon and Exeter did not. That is not so much about the hospital’s own services as about its ability to discharge to a social care setting.

We have already seen the impact that the consultation has had in terms of beds. Qualified staff have decided to seek jobs elsewhere, seeing the numbers of beds already reduced. During the consultation, the fact that there are hundreds of beds in residential and nursing care homes in Paignton was cited. I took the time to ask the obvious question: how many of those are actually vacant at the moment? The answer that I got back—this was a snapshot taken two weeks ago—was that 12 of the beds are vacant, yet two are in places that are accepting no new placements at the moment and four are in a place that specialises in caring for children. That causes real concern that we will see more delayed discharges at our local hospital if the proposals for Paignton go ahead.

Many residents of Paignton are concerned about the wider clinical services provided there, not least the minor injuries unit. The suggestion made in the consultation is that if a minor injuries unit closes at Paignton, residents will travel to either Totnes or Newton Abbot. I am sure that we will hear from my hon. Friend the Member for Newton Abbot (Anne Marie Morris) that the facility there is in excellent condition, but the reality is that that involves travelling past the acute hospital at Torbay, with its A&E department. I think it is far more likely that there will be more pressure as a result of people who would have been at the minor injuries unit in Paignton ending up at A&E in Torbay—the very place that we want to discourage people from going to unless they need to be there. There are also services such as X-rays and other clinics that many local residents find convenient and that support local GPs in delivering excellent healthcare.

My other concern about the consultation document is that although it is very detailed about what will be taken away from the south Devon area, it is not detailed at all about what will replace it. For example, there is talk of a clinical hub in Paignton, but no location. There is talk of doing more through GP surgeries, yet many of the practices are in buildings that predate 1948 and are in effect converted houses—not places that would be able to provide extended facilities for healthcare.

I find it very concerning when I speak with local people about what engagement there will genuinely be as part of the consultation, not least given the meetings arranged for small venues and the way that much of the questioning really produces only one logical answer. No one is going to say, “Yes, I’d like to spend the night in hospital,” but we would spend the night in hospital if we felt that we needed to be there. This is about ensuring that people have genuinely been able to express their views. That is why I hope that my hon. Friend the Minister will take a close look at the consultation being undertaken.

In closing, I emphasise the point that has been made about recruitment. The movement of qualified staff out of Paignton the moment the proposals to close the hospital were mooted speaks to a wider problem of recruitment across health and social care in south Devon. Although seeing the Torbay and South Devon trust receive Fair Train’s gold standard work experience accreditation last Friday was welcome, more still needs to be done to convince people that careers in health and social care are just that: careers. Many male jobseekers in particular see a job in that field as an entry-level job that they would not progress from, yet there are so many opportunities there. This is another concern for me, as it is for colleagues. We can put things down on paper, but if, in the social care market locally, there are not the providers, there is not the quality of provider and, bluntly, the vacancies that we already have for GPs are spreading across other health professions, then whatever position we come up with in the consultation will not be able to be implemented unless we address those long-term challenges in our economy.

[Sir Hugo Swire]

Does my hon. Friend share my concern about recruitment in social care and care homes: that a lot of staff are, of course, from the Philippines and other countries around the world? We must all hope that that is taken into account when the UK comes up with a new immigration policy.

[Kevin Foster]

I thank my right hon. Friend for his intervention. It is worth saying that the outcome of the EU referendum and Brexit is probably not going to affect those from the Philippines, given that the Philippines is not a member, but I fully accept the point that we have for too long relied on importing healthcare professionals—doctors and others. We have to have a debate about whether it is ethical for us basically to be depopulating parts of the third world of much-needed doctors, nurses and other trained medical professionals and to be relying on other countries’ training schemes to provide the numbers of healthcare professionals we need. The key point is that we want our own young people to be taking up those opportunities, as well as having the services provided.

I can see you indicating that my time is coming to an end, Mrs Main, or has come to an end. I will finish with one plea: I want to see Paignton hospital and Paignton people’s services continuing into the future.