The National Health Service

Lucy Allan Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Matt Hancock]

I will give way to my hon. Friend the Member for Telford (Lucy Allan), who has already intervened on the Prime Minister today. I hope that I can help out.

[Lucy Allan (Telford) (Con)]

I am grateful to my right hon. Friend for giving way, and for coming to Telford to have a look at the women and children’s unit. However, six months later, he signed off an approval to have it closed. It is galling to hear about all the “goodies for all” that are being distributed, but unfortunately not for Telford. I would like to invite him to come back and listen to the people of Telford and to hear why they value their women and children’s unit.

[Matt Hancock]

My hon. Friend has campaigned incredibly hard. As she knows, the local NHS brought forward the plan, which we are proposing to amend. I am working on that with her. However, I am delighted to announce that the Princess Royal in Telford will be benefiting from £4 million of winter capital funding that will come on stream for this winter, partly as a result of my hon. Friend’s campaigning.

The National Health Service

Lucy Allan Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Dr Sarah Wollaston (Totnes) (LD)]

It is a pleasure to follow the right hon. Member for Old Bexley and Sidcup (James Brokenshire), who spoke so powerfully about his experience of the NHS and the importance of early diagnosis of cancer. He said in his opening remarks that we should have been discussing Brexit. I say to him and his colleagues that there is no version of Brexit that would benefit the NHS, social care, science and research or public health, so I urge him to look again at the way he has voted over recent days. That is something we heard compellingly and repeatedly—

[Lucy Allan]

Will the hon. Lady give way?

[Dr Wollaston]

I will not give way, simply because of Madam Deputy Speaker’s comments about time pressures.

We heard those views on Brexit powerfully and consistently from all those who gave evidence to the Health and Social Care Committee, so I again urge the right hon. Gentleman to reconsider.

No debate about the NHS can take place without considering alongside it social care and public health. I start by thanking all those who work in all those sectors, who are working under pressure as never before. I reiterate the powerful points raised by the shadow Secretary of State for Health and Social Care. I will not repeat his points about the pressures, including the financial pressures, because I agree with him. However, as parties write, structure and frame their manifestos, I urge all colleagues to look at the evidence and at the asks of the NHS’s workforce and leaders.

I welcome an NHS Bill in the Queen’s Speech—I was going to ask the Secretary of State this, but unfortunately he has left his place, so I hope it will be addressed in the summing up—but have the Government looked carefully at the work that was done by the NHS, alongside the Select Committee, to frame those asks? People in the NHS were clear that they did not want another top-down administrative disorganisation of the NHS; they wanted something targeted. As was set out by my former colleague on the Select Committee, the hon. Member for Central Ayrshire (Dr Whitford), they want the scrapping of section 75. They want a common-sense approach to getting rid of the endless and wasteful procurement rounds. They want an approach that allows all parts of the NHS and partner organisations to work together more closely. I want to hear from the Minister in his summing up that the Government have heard that loud and clear, and that it will all be adopted, because it has cross-party support in the Select Committee and a very clear evidence base. That would help us to implement the long-term plan much more quickly.

I would also like the Minister to say more about when we will hear the Government’s proposals for social care, because the knock-on pressures from social care on the NHS are enormous. Far too many people end up in far more expensive settings, where they do not want to be and where they are put at greater risk, for the want of good social care in our communities. This is a political failure. Two Select Committees—the Health and Social Care Committee and the Housing, Communities and Local Government Committee—worked alongside a citizens’ assembly to come up with a consensus approach. We have to get away from the back and forth of, “Is it a death tax?”, “Is it a dementia tax?” The fact is that we already have a dementia tax in the NHS and social care. The result of the failure to grasp this issue and come up with a long-term solution is that 1.4 million people are going without the care they need. It is a failure on the part of all of us to grasp this problem and come up with something long term and sustainable.

We need to take a far more evidence-based approach to public health and prevention. To give an example of that, today the Health and Social Care Committee published our “Drugs policy” report. Last year, 2,670 people died as a direct result of drug use. That is an increase of 16% on the year before. That figure can be doubled if we include all the causes of preventable early death among people who use drugs. Again, we know what works. I urge the Government to look at the international evidence, to be bold and to consider making this a health responsibility—to say that we will help addicts and that we will radically improve treatment facilities.

There has been a 27% cut in resources for drug treatments, and as a result people are dying unnecessarily. I am afraid that we are not being bold enough in saying that we can save these lives and benefit people’s wider communities if we are just prepared to take the step of destigmatising drugs and seeing drug use as an illness rather than something for which, for personal possession, people should be banged up in jail. We should allow our police forces to continue to go after the dealers—the Mr Bigs—rather than criminalise people, especially given that, frankly, we saw competitive drug-taking stories during the Conservative leadership election. I would ask whether any of those people would have been in the position they were had they had a criminal record.

The point is that people are dying completely unnecessarily because of our current policies. Our drug policies are failing, and they are particularly failing those who are dying, their families and all the wider communities that are being subjected to the harms of unnecessary acquisitive crime, discarded dirty needles and so forth. Let us look at the evidence, and let us be bold—not just on drugs policy, but on so many of the other things that are leading to serious health inequalities, such as childhood obesity. Let us be evidence-led in our policy and let us try to get away from the party divisions.

In closing, I would just like to express again my sincere thanks to all those who are helping us out there in our emergency services.

--- Later in debate ---

[Lucy Allan (Telford) (Con)]

It is a privilege to speak in this debate. I particularly want to pay tribute to the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), because if we could all speak about this issue in the way that she did, we would have a much more constructive and productive debate.

We have spent so long in this place listening to the same people talking about Brexit, dominating the agenda and crowding out those of us who want to speak for our constituents on other issues, so I am delighted that today we are discussing the Queen’s Speech and the NHS.

Unlike the hon. Member for Wimbledon (Stephen Hammond), who forgot that he had put in to speak in today’s debate, I have long been anticipating this opportunity and writing long speeches that will not get heard today, but I know I will have an opportunity on other occasions. I want to speak about the fears and concerns of the people of Telford. For the last six years there has been an ongoing debate about the future of our A&E and our women and children’s unit. I accept that this issue is not of the Secretary of State’s making and that a revolving door of senior executives has set the agenda. I am glad to see that the Secretary of State is trying to help out on this issue and that discussions are ongoing about keeping our A&E in Telford. I am grateful for his efforts.

In the blizzard that is Brexit, it has inevitably been impossible for senior Cabinet Ministers to properly focus on the day job. Mistakes will happen, and I think that this is one such case. This summer, we watched with mounting excitement as the new Prime Minister set out an energising domestic agenda with the NHS at its heart. We heard about his genuine desire to tackle the concerns of leave-voting, left-behind communities and their sense of being ignored. In August, as plans were unveiled for 20 hospital upgrades and 40 hospital new builds, we saw genuinely touching videos of the Prime Minister visiting hospitals across the country, from Boston to Harlow. There was something moving about the way he acknowledged the sense of identity that people have when talking about the NHS—the sacred promise between the people and the state—and talked about levelling up.

As summer rolled into autumn, on 2 October, just 70 days into the new Prime Minister’s premiership, he stood on the stage at our conference in Manchester and made a brilliant and inspiring speech. I heard him speak of his clear understanding that opportunity is not being evenly distributed and that it is the job of Government to unlock potential, level up, narrow inequality and deliver on the priorities of the people. He spoke about his mother, who taught him about the equal dignity and equal worth of every human being, and said that the NHS sums up that idea, because it does not matter who we are or where we come from; the NHS is there for us. My spirits were lifted by that vision, which my constituents would inherit under the new Conservative Government.

The Health Secretary was sitting in the front row watching that speech, and he too was surely moved by what he heard. But within hours, he was back in his office in London and, with a stroke of his pen, he was signing his approval for a scheme that we in Telford have been fighting for the last six years. As is the way with these things, it was the outpouring of rage on social media that reached me first. It seemed that the Secretary of State had approved a decision that would see Telford lose its A&E and women and children’s centre.

I know that the Secretary of State wanted to get this right for Telford; he told me so. He knew how important that centre was for our community, because he had visited, yet when that decision was made, there was no press release, no announcement and no briefing for MPs. There was no attempt to justify to my community why this was good for them. What member of Government makes a difficult decision that undermines the credibility of the central plank of the Government’s domestic agenda on the very same day that the Prime Minister sets it out?

I understand that, in this crazy environment, mistakes are made, and it takes a little humility and bravery to admit when they have been made. It is not enough to wear the badge, echo the platitudes, stand on a stage and say, “I love the NHS”. The Secretary of State needs to show that he cares about the people who use the NHS, no matter where they come from. In this case, it seems that the people of Telford were forgotten. This is a great Queen’s Speech, but it must not just be words. We have to mean it if we are to be the party of the NHS, and there is work to do in Telford to demonstrate that that is the case.

Interim NHS People Plan

Lucy Allan Excerpts

Wednesday 5th June 2019 Commons Chamber

[Stephen Hammond]

I am sure they will also have said that one of the things Health Education England has explicitly set out is that one of the biggest barriers to more nurses was that there was not the placement capacity. I am sure Sir David Behan will also have set out that he therefore welcomes entirely the 5,000 extra clinical placements that are being made available, which is a 25% increase on last year.

The right hon. Gentleman will also know, as I have set out, that there are more EU nationals working in the NHS now than there were at the time of the referendum. However, one of the reasons why we are having an interim people plan is that we are not complacent. There are huge challenges, as I set out not only in my written ministerial statement, but in my opening remarks. That is why this plan is addressing the shortages in nursing, and it is right that we do so.

[Lucy Allan (Telford) (Con)]

I welcome very much this initiative, and I am delighted by all that has been said. The chief executive officer of Shrewsbury and Telford Hospital announced his departure on Monday, following a catalogue of failings. Despite these failings, formal complaints to Dido Harding and others and a series of calls for his dismissal, the CEO has apparently resigned of his own volition to take up another highly paid job within the NHS and is not going to work his notice because he has too much holiday to take. Does the Minister agree that senior management in any organisation, including the NHS, must be held to account for their performance, and will the people plan deliver this?

[Stephen Hammond]

My hon. Friend makes a very powerful statement on behalf of her constituents about the change of leadership. I am obviously aware of the change of leadership, including the departure of the chief executive, and I am aware that it raises a number of issues, which she and I may wish to have a meeting to discuss. She is right to ask whether we are tackling the culture to make sure that we have the best leaders in the NHS, whether we are ensuring that they are properly trained for the challenges of the 21st century and whether we are making sure that they are not only held accountable but supported to make sure they are doing the best they can. That is why Sir David Behan led a chapter in the whole draft people plan, which will lead into the final people plan, on leadership. The right leadership for the NHS will make sure that our constituents get better care.

Health Inequalities

Lucy Allan Excerpts

Wednesday 20th March 2019 Westminster Hall

[Lucy Allan (Telford) (Con)]

I beg to move,

That this House has considered legal duties on the Secretary of State to reduce health inequalities.

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I am delighted to have secured this debate and to raise this important issue.

In 2016, the Health Committee Chair, the hon. Member for Totnes (Dr Wollaston), led a thoughtful and important debate on this issue, noting that in the Prime Minister’s first speech in No. 10 Downing Street she had put reducing health inequalities at the top of her list of priorities. But July 2016 is now a very long time ago, and since that date we have heard a great deal less about that injustice. During that time, inequality of health outcomes between those in affluent areas and those in areas of deprivation has persisted.

That injustice has been obscured by improvements in overall health outcomes—and, of course, by all the other business that has been going on in this place and distracting us from the reasons that so many of us came to Parliament. As the Government unveil the NHS 10-year plan, it is right that we make a conscious effort to revisit the question of health inequalities. I want to do so in particular because I can see unequal health spending by local clinical commissioners in my area. While decision-makers may pay lip service to tackling health inequalities, it is not the driver that it is meant to be under the law.

Of course, the primary causes of health inequalities are complex and varied, from unemployment to poor housing. While no one would suggest that healthcare spending is the answer, we must ensure that all healthcare decision-makers understand their duties and the importance of their obligation to provide access for, and direct spending toward, those most in need. Healthcare spending is the one part of the mix that Government can control, and it is right to expect healthcare spending to be focused on tackling both unequal health outcomes and unequal access to healthcare.

The allocation of funding to local commissioners, which the Minister will probably touch on, rightly includes an adjustment for health inequalities based on the mortality rate. An area with a higher mortality rate, such as my borough of Telford and Wrekin, will get more funding per head than an area with a lower mortality rate, such as neighbouring Shropshire, but that is not the end of the matter, particularly when it comes to major hospital reconfigurations, which are happening in so many places across the country.

While funding may be allocated to separate clinical commissioning groups on the basis of need, when it comes to a major reconfiguration, CCGs will group together to form a joint CCG, bringing widely disparate areas under their umbrella. The funding and resource decisions are then made by the joint CCG, without considering health inequalities between those disparate areas. That is exactly what is happening in my area.

Telford is a post-war new town, created on the east Shropshire coalfield, and it has areas that are among the most deprived in the country. It has, by every measure, significantly worse health outcomes than Shropshire, a county that has better health outcomes than the national average, and significantly better outcomes than Telford, by almost every indicator.

We are experiencing just such a hospital reconfiguration. Telford and Shropshire have combined, and funding for hospital care is allocated to the area as a whole. What we have seen is a joint CCG, representing those disparate areas, deciding to direct the bulk of its funding to the more affluent area, and to move existing resources there from an area of deprivation. That is a clear failure of the duty to narrow health inequalities.

The national health service database has the figures there for all to see. When it comes to health outcomes, Telford and Shropshire are at different ends of the spectrum. For someone living in Telford, the premature mortality rate is 25% higher than for a person living in Shropshire. Children in Telford are far more likely to suffer from obesity or to be hospitalised for dental decay. Tragically, rates of suicide and cancer in Telford are significantly higher than in Shropshire. Smoking rates, inactivity in adults and other such indicators show the very same disparity. The truth is that a shire town in rural England is healthier than a new town built in a former mining area on the east Shropshire coalfield, and NHS spending allocations are required to recognise that greater need. It is that simple—yet in practice, that is not what is happening.

The Health and Social Care Act 2012 makes it clear that there is a requirement to move towards greater investment where levels of deprivation are higher. Under the Act, that is a legal duty on the Secretary of State, NHS England and CCGs. The guidance makes it clear that inequalities

“must be properly and seriously taken into account when making decisions”.

As a former non-executive director of an NHS trust, I know that the NHS constitution requires the NHS to pay attention to sections of society where improvement in health and life expectancy do not keep pace with that in the rest of the population.

It is not enough for the Government or NHS England to hand over the cash to a joint CCG and then say, “Job done,” as far the health inequality duty is concerned. CCGs also have a duty to narrow health inequalities and, if they are not complying—as in my area they are not—I ask the Minister how we can hold them to account. What steps can be taken to enforce that requirement?

This is happening not only in Telford. Across the country, from Lewisham to Huddersfield, the NHS is carrying out controversial restructurings of hospital care similar to the one in Telford, where funding and resources are being targeted toward a single area. If what is happening in Telford is happening elsewhere, decision-makers are ignoring their duties to address inequalities—or maybe they are merely paying lip service to them. It is all very well to commit to narrowing health inequalities, but that commitment is manifested only on a spreadsheet when we do our allocations to CCGs; it is not happening in practice when it comes to spending that allocation of funding.

[Stephen McPartland (Stevenage) (Con)]

I am grateful to my hon. Friend for securing this important debate. In my area, East and North Hertfordshire CCG is being forced to merge its management and executive teams, but so that it does not have to consult with local people, it is going to keep three separate boards. As a result, we are concerned about how decisions will be taken going forward and, although the spending will be going to the three separate CCGs on paper, in reality one committee will be making those decisions and getting the boards to ratify them. The concerns she is raising in her area are repeated around the country.

[Lucy Allan]

I thank my hon. Friend for his intervention, and I am aware of the position he sets out. He is absolutely right; these problems are happening elsewhere with the combination of CCGs coming together and not being able to meet the needs of the individual areas that are receiving the funding.

In Telford, the local hospital trust serving both Telford and Shropshire announced in January, after five years of bizarrely convoluted and contorted deliberation, that it was pleased to announce its investment of a total pot of £312 million in a state-of-the-art critical care unit in the leafy, affluent shire town of Shrewsbury in Shropshire, 19 miles from Telford. In addition, the trust announced that it was pleased to say it would transfer Telford’s women and children’s unit and emergency care from Telford to Shropshire.

I have repeatedly asked the revolving door of hospital management over the past five years to explain how that proposal narrows health inequalities, how that decision improves the health outcomes of the most disadvantaged groups in the area they serve and how it improves health access for the most disadvantaged group if it is moving their provision 19 miles from its current location.

The response to my questions over a significant period has been to take no notice whatever. As an MP I have found, and I know from talking to them that many colleagues have also found, that local hospital trusts and CCGs feel no obligation whatever to respond to or even take notice of elected representatives. Indeed, my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning) noted in this place just last week, in an excellent debate on his local trust, that he had “absolutely no influence” on any decisions made by the CCG in his area.

As the Shrewsbury and Telford trust felt no obligation to respond to questions on this incredibly important issue, I asked the then Secretary of State if he could seek a response on my behalf. However, even that did not bring so much as an acknowledgement that reducing health inequalities is an important issue for the hospital trust or the CCG when making spending decisions.

The trust seems to feel entirely unaccountable to anyone. The Department of Health and Social Care says that it is accountable to NHS England, and NHS England says that the trust board is accountable to the trust chairman. In reality, there is no accountability. This subject has been raised with me over and over again by local residents who strongly oppose this reallocation of funding from a disadvantaged area to a more advantaged area.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

My hon. Friend will be aware that there are health and wellbeing boards at play in local authorities. How effective has her local health and wellbeing board been at holding the CCG and other parts of the NHS to account, not only for their spending decisions but for how those decisions impact on frontline patient care?

[Lucy Allan]

I thank my hon. Friend for sharing his expertise in this area. My local council and health and wellbeing board have equally not been listened to on this issue. It is a Labour council, but it has tried extremely hard; if there was an opportunity to suggest otherwise, I would perhaps take it, but that is not the case. Both tried hard and have not been listened to. Most frustrating has been that the voice of local people has not been heard. Who do we expect to enforce this statutory duty? We cannot expect constituents to crowdfund a legal process because we want to hold CCGs to account.

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

Does the hon. Lady share my concerns on integrated care providers? Those should be statutory bodies and not in any way open to being private companies, which can hide behind commercial sensitivity, for exactly the reasons she says.

[Lucy Allan]

I thank the hon. Lady for her comment. There was an interesting debate on that issue on Monday night in the Chamber. This is an important issue, and I have a lot of sympathy with what she says.

On the injustice of unequal health outcomes, I said at the outset that that is of course not about spending more, and that poor health is not only about healthcare but is a much wider issue. However, if the NHS overlooks its statutory, constitutional and moral duty to properly consider health inequalities when making major spending decisions, the Secretary of State has a legal duty to act; he cannot just sit on his hands and say it is down to local clinicians. That response is all the more frustrating in my case because all six voting members of the Telford CCG voted against the transfer of resource from an area of deprivation and to an area of relative affluence, whereas all six voting members of the CCG in the more affluent Shrewsbury naturally voted for the funding resource to be transferred to their area.

In our case, Telford CCG was made to vote again until it came up with the right answer and allowed that transfer of funding. [Interruption.] That is very topical, yes. This whole issue reminds me exactly of Brexit. I wish I had not come on to that point; this should be a Brexit-free zone, for a change, so that we can all maintain our sanity. However, it is similar in the way that those in power have not been listening to the people. It is extremely important to note that, if we give that sort of funding to relatively affluent areas and take resource away from the most disadvantaged, we are doing something wrong. No Government could think that that was a good idea. I am grateful to the new Health Secretary, who came to Telford to visit our Princess Royal Hospital earlier this month and took the time to see for himself the fantastic work being done in the very areas that the management is seeking to close and to transfer 19 miles away to Shrewsbury hospital.

I would like to get something else off my chest, to further illustrate the problem of unequal health spending. Six months ago the Government gave the Shrewsbury and Telford Hospital Trust £3 million for winter pressures. The trust decided to spend all of it in Shrewsbury—all of it—despite there being no evidence that the decision reduced health inequalities between the areas that it serves and not even an indication that it had considered health inequalities when making that decision.

No Government could possibly condone transferring resources from an area of need to an area of greater affluence and better health outcomes. The Government have a legal responsibility to ensure that that does not happen. Everyone in this room will agree that NHS funding decisions must focus on the areas of greatest need, and where that is not happening, we cannot ignore it. The trust has been able to forge ahead with a plan that has never made sense to local people, that was roundly opposed by a consultation that took place, bizarrely, two years after the original decision was made, and despite MPs and councillors vocally pointing out the plan’s shortcomings and its failure to address health inequalities. The hospital trust and CCGs carried on regardless. It cannot be down to local people to enforce the Act. I can only conclude that decision-makers perhaps do not understand their duty to narrow health inequalities or—of more concern—that they do not understand the extent of the need, disadvantage and health inequality in the area they serve.

The flat-out refusal to even discuss the reconfiguration’s impact on health benefits and outcomes for the most disadvantaged has been extraordinary. I have written letter after letter for a considerably longer period than the consultation lasted and I have not received any answers. My trust treats the issue as if it was entirely irrelevant to its reconfiguration plan. If it is not able to show how its plans narrow health inequalities, it must think again.

I know that once the Secretary of State receives the relevant documentation from my local council, he will carefully consider whether to call in the Telford proposal for review by an independent reconfiguration panel. For that, I am most grateful. I hope the panel will look closely at the failure to address need and disadvantage and, on those grounds alone—there are many others—throw out the scheme. If the Government are committed to reducing health inequalities and not only focusing on better health for all, they need more than just warm words. I ask the Minister to remind hospital trusts and commissioners generally, and the Shrewsbury and Telford Hospital Trust and its commissioners specifically, to give due regard to their duty to demonstrate how their spending decisions narrow health inequalities.

In conclusion, I ask the Minister to keep focusing on this issue. It is so easy to lose sight of the reason we all came to this place, and it is too easy for the Department or the Minister to believe that health spending is allocated and targeted towards need, and that we do not have to look beyond the spreadsheet. We have to ensure that it is happening in practice on the ground. We cannot simply say that we have done our bit and that there is no need to look any further. Health inequalities are a shameful injustice of unequal lives and unequal life chances. I know that the Secretary State wants to ensure that no NHS decision-maker allocates funding in a way that exacerbates this injustice, whether in Telford or any other area.

[Mr Philip Hollobone (in the Chair)]

The debate can last until 5.30 pm. I am obliged to call the Front-Bench spokespeople no later than 5.07 pm. The guideline time limits are five minutes for the Scottish National party spokesperson, five minutes for Her Majesty’s Opposition’s spokesperson and 10 minutes for the Minister, with the mover of the motion having two minutes at the end to sum up the debate. The next 18 minutes will be for Back- Bench Members. You can all contribute if you speak for no more than four and a half minutes each.

--- Later in debate ---

[Lucy Allan]

I thank all Members for participating in the debate this afternoon. I am grateful to have heard not only their contributions but their passion for the subject, which I share. The Minister has been very kind in making a commitment to transparency and better communication by decision makers when it comes to major changes in local areas, and I will hold her to that commitment.

Health inequality is such an important issue, which we do not talk about enough in this place. We must do better, as the hon. Member for Strangford (Jim Shannon) said. I loved that the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) mentioned that there is hope for improving life chances and opportunities for those most in need. We all have to keep focusing on this issue and keep it on the agenda, despite the whirlwind of everything else that is going on around us. It has been refreshing to talk about something that we are all passionate about and will change lives. I again thank the Minister. I will gladly continue to work with her to ensure that the issues in Telford are addressed.

Question put and agreed to.

Resolved,

That this House has considered legal duties on the Secretary of State to reduce health inequalities.

NHS 10-Year Plan

Lucy Allan Excerpts

Tuesday 19th February 2019 Commons Chamber

[Lucy Allan (Telford) (Con)]

Thank you, Madam Deputy Speaker, for calling me to speak in this important debate. I welcome the 10-year plan, especially the emphasis on delivering care closer to home.

The future of the NHS is the greatest concern to my constituents in Telford because local health bosses have been deliberating for the past five years on whether to move our A&E and our women and children’s services out of the borough, in a project that they have named NHS Future Fit. On 29 January 2019, local health bosses announced that they will indeed remove those services and transfer them 19 miles away, to the other side of Shrewsbury, and that they plan to create in addition a new “super-hospital” on the same site. The project will cost a record £312 million.

My opposition to that project has been long-standing, because it does not meet local people’s needs. It does not improve health outcomes and it does not focus on narrowing health inequalities. I believe that if local hospital management understood the people of Telford better, they would not have come up with this plan. Telford is a rapidly growing new town—people are coming to live there all the time—and it has pockets of significant deprivation. By any measure, it fares significantly worse when it comes to health outcomes, life expectancy and the number of children living in low-income families than does Shropshire, which fares better than England’s average on measures of deprivation.

There are some very important points that we must consider when making a transfer of assets from an area of need to an area of affluence, because such an action is wholly inconsistent with the ethos and obligations of the NHS. Some have called my opposition parochial and territorial, and said that if I understood the plans, I might view them in a different light. But as a former non-executive director of a hospital trust, and as someone who has been working with constantly changing senior executives in the local hospital trust and engaging in the details of this plan since its inception in 2013, my opposition is based on an understanding of the healthcare landscape and local need.

We must ask these questions. Does this scheme meet the needs of local people? Is there any evidence that health outcomes will be improved? Is there any evidence that we will narrow health inequalities? Will out-of-hospital care make up for a reduction in planned medical beds and hospital staff? Put simply, the scheme may look good on paper, but will it work in Shropshire?

I have asked the Minister to call in the scheme for review, and I very much hope that he does.

Oral Answers to Questions

Lucy Allan Excerpts

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

We are supporting Leighton Hospital through the delivery of the long-term plan and the extra £20 billion—£33 billion in cash terms—the first £6 billion of which comes on stream in April, in two months’ time. It is true that a record number of people are going to A&E. We have to make sure that the record numbers being treated within the four-hour target are supported, but that we also support hospitals to do yet more.

[Lucy Allan (Telford) (Con)]

In Telford, we have been waiting five years for the chance to ask the Secretary of State to call in for review a highly controversial plan called Future Fit. We now have that chance, and the Secretary of State has been really generous with his time in listening to MPs’ concerns. The local council, however, has still not yet made any submission to the Secretary of State. Can he confirm that without that submission he cannot call in that scheme for review?

[Matt Hancock]

My hon. Friend has made the case very powerfully for the future of Telford Hospital, and I have enjoyed working with her, but it is true that the call-in powers that I have as Secretary of State can be exercised only when a scheme is referred to me by a local council. Should that happen, I will consider it very carefully.

Oral Answers to Questions

Lucy Allan Excerpts

Tuesday 23rd October 2018 Commons Chamber

[Stephen Barclay]

The current modelling suggests that about 11 ambulances will be diverted from the Shrewsbury and Telford Hospital NHS Trust between the hours of 10 pm and 8 am during closure. Of the patients who go to Wolverhampton, any admitted as in-patients will return to Shrewsbury and Telford and any who are discharged will be discharged from Wolverhampton.

[Lucy Allan (Telford) (Con)]

The chief executive of Royal Wolverhampton NHS Trust says that the closure at Telford is the result of bad planning and could have been prevented. Does the Minister agree it is wholly unacceptable that my constituents’ safety should be put at risk by a preventable closure that is the result of bad planning by management, and will he do all he can to ensure that the hospital management have the help they need to properly run our hospital and properly plan for the needs of our community?

[Stephen Barclay]

First, may I pay tribute to my hon. Friend, who has campaigned assiduously on behalf of her constituents? She has lobbied me and the Secretary of State and made her case very powerfully to NHS leaders. There has been progress: three additional consultants have been hired and attempts made to recruit middle-ranking doctors to the trust, including from neighbouring trusts. We are making a significant capital investment in the Shrewsbury and Telford Hospital NHS Trust, and these changes must be seen in the light of that.

Oral Answers to Questions

Lucy Allan Excerpts

Tuesday 6th February 2018 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jackie Doyle-Price)]

The hon. Lady will know that we are currently implementing the findings of the expert working group, and we are continuing our discussions with the all-party group to see how much further we can go in answering people’s questions and in responding to these moving cases, one of which she has just explained to the House. Obviously I would be happy to have further discussions with any hon. Member who wants to discuss it with me further.

[Lucy Allan (Telford) (Con)]

In Shropshire, we have had four years of confusion on the future of our two hospitals. Will the Secretary of State tell the people of Shropshire whether there is Government funding for the proposed reconfiguration of the county’s hospitals?

[Stephen Barclay]

As my hon. Friend will be aware, we announced further funding in the Budget and the autumn statement. On the specifics of Telford, which she has raised on a number of occasions, I am very happy to have further discussions with her.

Hospital Car Parking Charges

Lucy Allan Excerpts

Thursday 1st February 2018 Commons Chamber

[Lucy Allan (Telford) (Con)]

It is a great pleasure to follow the hon. Member for Great Grimsby (Melanie Onn), who made a very thoughtful and engaging speech on this important issue. I am very glad that so many Members are in the Chamber to take part in the debate.

I particularly congratulate my right hon. Friend the Member for Harlow (Robert Halfon) on steadfastly championing this issue in Parliament for many years. He is much admired across the House for taking up issues that not everybody chooses to champion, but his work on such issues so often makes the lives of the people he and I represent much better, so I thank him for it. Indeed, I was inspired by his efforts in this area when, before I became an MP, I campaigned in my constituency of Telford on the whole issue of parking charges after they went up by 75% at our Princess Royal Hospital, creating a great deal of local upset.

My constituents, like my right hon. Friend’s, raise their concerns about this issue frequently. During the time I have campaigned on it, I have received over 5,000 letters —letters, not emails—on this specific issue. In Telford, we really care about this, and that is why I am here today. I was supposed to giving a speech at Thomas Telford School’s ethical debating society but, unfortunately, I have had to cancel at short notice so that I can be here, because this matters so much. I apologise to the students at Thomas Telford School.

I was told by my hospital trust in 2014 that it was not possible to change the existing arrangement because of the long-term nature of the trust’s legally binding contract with CP Plus, a parking contractor. Even poorly negotiated long-term contracts eventually expire, so we must look forward to what we will put in place when they do. It is not acceptable for those who can effect change simply to stand back and wait for onerous contracts with parking contractors to be renewed.

[Mike Wood (Dudley South) (Con)]

As my hon. Friend says, part of the problem is that so many hospital trusts are locked into long-term PFI contracts. Many of them were negotiated in the late 1990s or early 2000s and will shortly be coming up for renewal or expiry. Does she agree that now is the time to look at what provisions we can put in place to ensure that, as the contracts are renewed, they do not contain exploitative provisions that allow hospital trusts to take patients, as well as their families and visitors, for mugs by overcharging them for parking?

[Lucy Allan]

My hon. Friend eloquently makes a very important point, and I am very glad that he has raised it. The debate is timely, and it is important for us to be here to make this case.

Sadly, my local hospital trust has continued to increase hospital parking charges in a way that some feel thoughtless and has been described to me as cavalier. Following the rises in 2017, it is cheaper to park in Southwater shopping centre in Telford than to go to hospital to visit a sick relative. There is clearly something wrong with a model that operates in that way, because, as many hon. Members have said, no one chooses to go to hospital.

Telford is a new town, much like the constituency of my right hon. Friend the Member for Harlow. There are problems to do with the way in which many new towns were designed because, rightly or wrongly, they are all about road users. Major roads and roundabout systems are much loved in Telford. Everything is focused on the car, and it was never intended that the pedestrian should be able to walk from A to B. That is one of the problems that makes this such an important issue locally.

We do not have good public transport. We cannot just hop on a bus, jump on a tube or walk to the local hospital, as people might in other areas; instead, we have to take buses, changing a few times. Many people are therefore driven, or drive, to hospital, and they have to pay. My trust gave several reasons why its charges increased, one of which was that they were lower than those elsewhere in the country. That argument does not have a lot of teeth to it, because London is very different from Telford, in terms of income and accessibility of transport. Trusts need to consider local factors when setting charges.

It is good if concessions are offered, and there are concessions at the Princess Royal in Telford, but they are complicated to administer and operate. People have to prove that they are on benefits, that they have had an appointment and that they have paid their charges. Healthcare staff have to administer that system. They have to cancel charges and give out refunds and concessions, but that is not what they are there for. It is no good saying that if there was more money for hospitals, they would not need to charge for parking, because we all know what happens in many cases. In my local hospital, 50% of the revenue goes to CP Plus, the parking contractor, which has to be wrong.

Another argument that we have heard today is that if there were no parking charges, there would be nowhere for people to park, because anyone who wished to could use the hospital car park. It is argued that charges are a disincentive to parking. My local hospital trust says that without charges, people might stay all day in the hospital cafés, having refreshments, rather than leaving the site. Clearly that is complete nonsense, because even with incredibly high charges, there is nowhere to park. All the spaces—and the grass and concrete—are filled. The argument that everyone is sitting in a café is simply beyond my comprehension. This issue needs to be addressed with careful thought, rather than charges being seen as an instant panacea to a problem, when they clearly are not.

Bizarrely, my hospital trust tried to justify the increase by talking to residents about the number of nurses whom the parking revenue has paid for. I do not like that argument, because nurses are paid for by taxpayers through Government funding, not by parking charges. The increase that it implemented was in the contractual agreement, and nothing whatever to do with the number of nurses whom it employed.

I worry when hospital managers think that the charge is not that big a deal because parking is cheaper than somewhere else; that transport is not really their problem; and that if people are spending too long in cafés, managers need to move them on by putting up the charges. That shows that they probably do not understand the people whom they serve as well as they should.

If we dig a little deeper, we see the reason why it is not possible to park at the Princess Royal is that there has been a huge increase in the number of staff working on the site and therefore parking in the car park. We need to look at ways of helping staff to reduce car park use, as that would free up many spaces for patients to use throughout the day. We need to think imaginatively about how that might be done. Perhaps park and ride schemes specifically tailored to shift times might help. It is a surprise to find that hospitals are not looking at that.

We have heard today that this is a tax on the sick. Most taxes take account of people’s ability to pay, as is absolutely right, yet hospital managers and porters pay the same to park at work. It is always the least well-off who are hit the hardest. If the aim is to tax people and then give half the tax revenue to a car parking company—that is a bit senseless in any event—do it through pay-as-you-earn, and do not get nurses and other healthcare staff involved in the enforcement. It is completely inefficient to operate the system in this way.

Others have touched on the rigmarole that goes with paying for parking. Whether that means people paying with coins, typing in their number plate, or being videoed as they go in or come out, there is a punitive element. When a person is rushing to see someone who is extremely ill, or if they are waiting for an appointment and the consultant is running over time, it all adds to the anxiety, and in this context, it is completely inappropriate.

No one really wants to own this issue, so we all end up accepting it rather than solving it. Too many people say, “It is not our problem, it is too difficult to fix and actually, it is not really that important, because it is only £8 a day.” Too often, people in power look at the world through their own eyes and not through the eyes of those whom they serve.

There is little appetite among hospital management to deal with this. It is not a big-ticket issue. It is not exciting. It is not a shiny new hospital. It does not cost £300 million—in Telford, we spend a lot of time talking about our new emergency unit—so that is why I am here today. I want the Government and hospital managers to sit up and take notice. Do not brush this off as a non-issue—it is not. Try to see it through the eyes of others and tackle the issue that is facing everyday users of our hospitals. It can be fixed and it will make a difference to the lives of those who most need hospital services. For that reason, we should all care about it.

My right hon. Friend the Member for Harlow does a great service to his constituents. I thank him for securing this debate and I support him entirely.

Capital Funding: New Hospital in Harlow

Lucy Allan Excerpts

Wednesday 18th October 2017 Westminster Hall

[Lucy Allan (Telford) (Con)]

My right hon. Friend is making an excellent and passionate speech about the needs of his community—a new town, just like mine. He is setting out the problems of decaying infrastructure against a backdrop of increasing population. Does he agree that, as new town MPs, we should be championing our hospitals at all times? They are the centre of our communities and cement our identity. Hospitals are something people are deeply attached to and they form so much of what the town is, whether it is the Princess Alexandra or the Princess Royal in Telford.

[Robert Halfon]

My hon. Friend has set up the all-party parliamentary group on new towns, of which she is the chair and I am pleased to be vice-chairman. We set it up because we have many of the same problems. Our towns were built at the same time and we have the same issues, whether it is to do with our hospitals or regenerating housing and our high streets. I thank her for the work she does on this and the way she represents her new town and her constituents in Telford.

As I was about to say, the hospital secured £1.95 million of emergency department capital funding in April this year, allowing significant building works to support the department’s work, including the expansion of the medical assessments base. That is coupled with an A&E-focused recruitment drive to take advantage of the new facilities.

That leads me on to staff recruitment and retention. While Harlow hospital now has 27 more doctors and 35 more nurses than in 2010, the vacancy rate in recruitment is a perpetual worry. The nurse vacancy rate for September stood at 25%. Staff vacancy rates were picked up in the CQC report in 2016, in which inspectors found that

“staff shortages meant that wards were struggling to cope with the numbers of patients and that staff were moved from one ward to cover staff shortages on others.”

The proximity of Princess Alexandra Hospital to London plays a major role and, although pay weighting is a factor, I have been told by the hospital leadership and Harlow Council’s chief executive, Malcolm Morley, who is in Parliament today, that career development is significant. Princess Alexandra Hospital must compete with Barts and University College Hospital in specialist training and career development. The retention support programme established career clinics and clear career pathways, but there is only so much that the hospital can do to compete with the huge investment and facilities at London hospitals. Harlow needs to be able recruit and retain staff. Recruitment is related partly to the future of the hospital itself and partly to the staff’s ability to develop their careers in Harlow. Of course, both factors relate to the hospital’s infrastructure.

I have tried to make sure that our NHS in Harlow is a top priority for the Government, and I have had many meetings with the Health Secretary and the hospitals Minister. I am pleased to say that they have visited our hospital a number of times, most recently in May, when the Health Secretary visited the Princess Alexandra Hospital to speak to the hospital leadership team about Harlow’s case for a new hospital. He spoke of

“the exciting proposals which are coming together to invest capital in upgrading these facilities, including the option of a brand new hospital.”

He also stated:

“These proposals are at an early stage but upgrading services on this important site will be a priority for a Conservative government”.

Following capital funding announcements for sustainability and transformation partnerships in July, I was informed that

“Princess Alexandra Hospital is still a real priority”

for the Department of Health

“and work is ongoing to take it forward”,

and that the Government are “on hand” to carry on helping to get the Princess Alexandra bid together. Given that the Health Secretary said that Princess Alexandra Hospital is a priority case, will the Minister say what the current budget is for capital funding and how it will be allocated to new hospitals, such as Harlow?

In autumn 2016, the Secretary of State requested that the PAH board, the local clinical commissioning group and local authority partners progress a strategic outline case. After considering a number of options,

“the SOC concluded that a new hospital on a green field site, potentially as part of a broader health campus, to be the most affordable solution for the local system”—

note the expression “most affordable”—

“and the solution that would deliver most benefit to our population.”

The health campus would bring together all the services required to ensure that healthcare in Harlow is fit for the 21st century: emergency and GP services, physio, social care, a new ambulance hub, a centre for nursing and healthcare training.

Having recently met the chief executive of the East of England Ambulance Service, I know that there has been a significant increase in the number of calls from critical patients who need a fast response. Harlow has four new ambulances but the development of a top-class ambulance hub would allow huge improvements in that area. The health campus could also act as a centre for degree apprenticeships in nursing and healthcare, bringing specialist training to the eastern region. It could build on strong links between the Princess Alexandra Hospital and Harlow College and capitalise on the new Anglia Ruskin MedTech innovation centre at the Harlow enterprise zone.

The health campus proposal has been supported by West Essex CCG, the East and North Hertfordshire CCG and the Hertfordshire and West Essex STP, which brings together 13 local bodies and hospital trusts. A joint letter has been signed by more than 10 councils, including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority.

Despite recognition from local authorities and Ministers alike, some NHS England officials—I stress the word “some”—suggest that a refurbishment would be more fitting than the development of a brand-new hospital, due to capital funding constraints. That solution is the equivalent of an Elastoplast—a short-term option that will do nothing to solve real, long-term problems.

Given the support from the Government and key organisations, we need to be sure that plans for a new hospital are not obstructed. Will the Minister give an assurance that NHS England and NHS Improvement will work positively with public, private and voluntary sector partners to progress the plans? A rapid strategic solution is needed, rather than a short-term fix.

The cost of the new campus model would be between £280 million and £490 million, depending on the type and preferred method of funding. The hospital leadership is looking at all the options to maximise public sector investment and bring together the public, private and voluntary sectors. Private investment will not involve any kind of private finance initiative contract. Instead, the leadership will focus on how the private sector works with the NHS and how the development can generate revenue flows through social care, for example. The development also raises the potential development of housing as a source of income and private investment. These are decisions for the future. When the PAH leadership looks at private investment, it will consider supported housing and similar options.

Moreover, Public Health England’s move to Harlow will create a world-class health science hub. Without exaggeration, once Public Health England has completed its move, Harlow will be the health science capital of the world, Atlanta aside. We must ensure that the Princess Alexandra Hospital is an important partner that benefits from and adds to that success. The creation of a health campus is vital not only for Harlow but for the surrounding area. The infrastructure of the campus would be fundamental to the vitality of the community and the economy of the entire region that the Princess Alexandra serves.

I have visited the Princess Alexandra Hospital many times. I defy the Minister to find more professional and dedicated staff, doctors and nurses. They work day and night to look after the people of Harlow and the surrounding area. I have seen the incredible work in A&E, intensive care and the maternity and children’s units. That is why I know that PAH staff are second to none. However, their professionalism and hard work will go to waste unless our hospital is fit for purpose. I know that the Secretary of State recognises that, given his numerous visits to the hospital and what he has said since. I know that the Minister himself recognises that, given his visit to the hospital this time last year. I know that all the key local authorities, neighbouring MPs and trusts are supportive. I urge the Minister to do everything possible to ensure that Harlow has a hospital that is fit for the 21st century.