Community Hospitals

Lord Young of Cookham Excerpts

Wednesday 3rd September 2014 Westminster Hall

[Sir George Young (North West Hampshire) (Con)]

May I begin by saying that it is a pleasure to serve under your chairmanship, Mr Owen, and by joining my hon. Friend the Member for Dover (Charlie Elphicke) in his warm welcome to our hon. Friend on the Front Bench, who will make his maiden ministerial speech in Westminster Hall? I also congratulate my hon. Friend the Member for Dover on his choice of subject. As we approach a general election, it is worth remembering that a Member of Parliament actually lost his seat in 2001 because of a perceived lack of commitment to a community hospital, but my hon. Friend’s powerful speech will have consolidated his position in Dover and Deal on health-related matters. Listening to his speech and reading some of the comments made about the NHS, one can understand the concern that district general hospitals and specialist services might sap the life blood out of community hospitals, some of which are fighting to hang on to what they have or even face closure. I want to speak briefly in the debate to show that, so far as North West Hampshire is concerned, the opposite is now happening.

I have no district general hospitals in my constituency—Basingstoke and Winchester are the nearest DGHs and are in next-door constituencies—but I do have the Andover War Memorial hospital in my largest town and what has happened there over the past few years shows what can be done. In 2012, a new trust was formed, amalgamating Basingstoke, Winchester and Andover hospitals and there were fears that Andover, as the smallest, would be squeezed as services were centralised. In fact, the opposite has happened, and I commend what Mary Edwards, the chief executive of the combined trust and Elizabeth Padmore, the chair, have done to bring services to Andover and so reduce the need for people who live in and around the town to drive to the nearest DGH—and most people have to drive as access by public transport is difficult. The process has actually helped the DGHs by reducing pressure on some of their services, not least on car parking, and has made it easier to recruit and retain NHS staff, as not everyone in Andover wants to work in Basingstoke or Winchester.

In Andover, as in other towns, the hospital has always had a strong claim on people’s loyalties, and we have to take note of that. Nowadays, however, one cannot make the case for investment on emotion alone; there has to be a hard-nosed business case to back it up. My hon. Friend drew on some research that underlines the need to invest in community hospitals. The reality is that bigger is better for some procedures, but smaller is better for others, and the position is not static as medical technology develops. A modern health service needs to make intelligent decisions about its assets to get the best value out of them.

After careful analysis of the best way forward by the new trust, we have seen service development in Andover and investment in the fabric, which has capitalised on the skills and commitment of the existing staff, whose energy and professionalism I pay tribute to, and has generated additional investment through, for example, an active league of friends. It has also helped to restore confidence in the NHS decision-making process as local people see the outcomes of the new method of running the NHS. For example, we now have a mobile chemotherapy unit that visits Andover weekly, avoiding a 50-mile round trip to Basingstoke or 30-mile round trip to Winchester, which was done in partnership with Hope for Tomorrow. A new minor injuries unit opened in 2010 and is run by highly skilled nurse practitioners with back-up support from the consultants in emergency medicine at the DGHs. We have a modern out-patients department to replace a building that dates from the era of “Carry on Nurse”. Instead of local folk having to travel to a DGH to see a consultant, consultants from nearly all the specialties now come to Andover. We have a mobile MRI scanner, and operations under local anaesthetic are now also taking place in Andover. The Hampshire hospitals birthing unit has just opened and is run by local midwives and provides ante and post-natal care. More and more local families are choosing a midwife-supported birth, and they can either have the baby at home or in the birthing unit.

The hospital campus is large and has always been used intelligently. The Countess of Brecknock hospice, run independently by a charitable trust, is next to the hospital. More consultants in palliative medicine are now based there and it is developing a hospice-at-home service. Also next to the hospital is a nursing home, funded and run by the county council on land provided by the NHS.

At this point, the cynic might ask what is so remarkable about a large building calling itself a hospital providing services for people who are ill, but that is to miss the point. The NHS must adapt and change if it is to continue to provide a quality service, which means specialisation where necessary and localisation where it is not and investment in both DGHs and community hospitals

I have two requests for the Minister—one general and one specific. First, I endorse the plea made by my hon. Friend the Member for Dover for an assurance that the Government support the continued provision of more services locally, as is happening in North-West Hampshire, and will encourage the trust to continue with its strategy of providing more services in the town, such as transferring patients who have had critical treatment elsewhere for rehabilitation in the hospital. We are pleased with what we have, but our appetite has been whetted and we want more. I was tempted to say, “Dover Andover again,” but I will not.

Secondly, and more specifically—I do not expect an answer this morning—the ugliest building in Andover is the Andover health centre, which houses a GP practice on the hospital campus owned by the trust. Not only is it ugly, it is past its sell-by date as a place where GPs can practise. Indeed, the trust wants to demolish it next year. The site could be sold for housing, for which there is great need, and could generate a capital receipt for reinvestment in health services. The dialogue between the various agencies of the NHS to relocate the practice, which is the largest in Andover with some 15,000 patients, has gone on for at least four years with no end in sight. It started off with the primary care trust, but now involves NHS England, the clinical commissioning group and the trust. The practice wants to be relocated near the hospital, where land is available, and there are advantages in having GPs next door. We need to resolve the matter before the Care Quality Commission looks too hard at the current building. In conclusion, I ask my hon. Friend the Minister to indicate that he will take a personal interest in the matter and use his influence to bring the dialogue to a satisfactory conclusion.