Covid-19

Mark Fletcher Excerpts

Monday 14th December 2020 Commons Chamber

[Mark Fletcher (Bolsover) (Con)]

I am one of a number of colleagues speaking from the Government Benches this evening who was elected for the first time a year ago. On that joyous night, I do not think any of us foresaw quite what we were about to face over the past year. I hope that we have done our best and served our constituencies to the best of our abilities, but it has been a sharp learning curve, and I certainly did not expect to have to start a speech a year on saying that I send my sincerest condolences to those who have lost their lives in my constituency and elsewhere over the past year. It has been a time of tremendous challenge and one that I hope I never have to live through again.

There have been a number of covid debates over the past few months and I have not always been able to get on to the call list, so Members should forgive me as I add my general thank yous to so many people who have stepped up and done amazing things over the past few months. I include, of course, our NHS workers. My constituency is blessed to be served by three fantastic hospitals: Chesterfield Royal Hospital; King’s Mill Hospital; and Bassetlaw Hospital. The overwhelming consensus is that those three hospitals have been absolutely superb and have served my constituents and others with tremendous distinction. The care home staff, many of whom I have spoken to, have done such wonderful things. Let me mention in particular the care home managers who were so forthright and so determined to keep their homes safe. Some of the most emotional phone calls that I have had over the past few months have been with those care home managers who have taken on this project so passionately and so personally.

I pay tribute to the community groups and volunteers who have stepped up and served so selflessly. They have made sure that people have had food to eat and people to talk to and have done such amazing work. I also pay tribute to all those who have shielded and who have sacrificed themselves to keep safe. Then, of course, there are all those who have kept working as well. We so often forget those who have kept going, so I pay tribute to those in manufacturing jobs; to the shopkeepers who have served their communities; to the supermarket staff; to our rubbish collectors; to our council staff; to our postal workers; and to so many others. There are too many to mention and to list, but it has been a profoundly moving experience to hear so many wonderful stories.

This has been a challenge for our nation, the like of which I have not known in my lifetime. It was back in February and March when what was happening with this virus really dawned on us. The news was filled with so many stories about having to start testing, and then having to secure PPE. It is quite amazing how far we have come in that time. The fact is that we now have national producers and manufacturers of PPE, which effectively means that we can be self-sufficient. We have warehouses full of the stuff to protect our NHS workers and it all happened in such a short space of time. Then there is the fact that we can now carry out more than 500,000 tests every single day. I remember when we were carrying out about 1,000 tests and when 100,000 tests seemed a mile away. There are so many people who have been involved in making that happen. Again, the list is too long to mention, but we must not lose sight of how far we have come.

Then, of course, we have the vaccine: to think that we have so many vaccines ready to come down the track, as long as we get the approval; to think that we were the first country in the world to approve a vaccine; and to think that, last week, we started getting that vaccine out to people across this country. What a moment of hope and pride that was for this country.

So much nonsense has been written on social media and allowed to circulate about this vaccine and about its so-called evil effects. I am sure that Bill Gates is over the moon that he controls us all, day in, day out, but we must not let that nonsense put people off from having this vaccine, because it will save lives. Everybody who can have it, should have it. It is incumbent on every Member of this House and every right-minded person to say, “That is absolute nonsense. This vaccine is safe.” It has been tested to the highest possible standards, and we should not circulate anything other than that—sorry, Mr Gates.

We should also remember our economic support and quite how much has been pumped into our economy. The level of Government action and support that we have seen over the past few months is unprecedented. I appreciate that there are Members in every part of this House who will say, “What about x sector, what about y sector?” I have tremendous sympathy with some of those arguments, but we must not lose sight of that bigger picture.

I share many of the concerns raised by my hon. Friend the Member for Gravesham (Adam Holloway), because there are two particular sectors that need highlighting. One is the events industry and the other is pubs and hospitality. I agreed with the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) when she said that pubs are at the heart of northern and midlands communities, and that they play a special role. We are asking certain industries that are reliant on people coming together to suspend that for the moment, which is a tremendous challenge. We need to look at those particular industries again and question whether we are doing all that we can for them.

We had a wonderful moment in Derbyshire on Saturday, when the Government announced the local authorities that will begin community testing. I am incredibly grateful to the Minister. I have spoken to her and several of her colleagues at the Department of Health and Social Care to ensure that we get community testing in Derbyshire. The plan at the moment is that Derbyshire County Council will roll out five testing sites across Bolsover. This is a vital step in making sure that we eradicate the virus locally. Lateral flow tests have an important role in that.

I cannot thank the Department enough for its proactive engagement. I place on the record my thanks to Derbyshire County Council and my fellow Conservative Derbyshire MPs, who worked together consistently and for very many hours over the past few weeks to ensure that our bid was as tight as it could be. The fact that testing is being rolled out in the next couple of weeks says an awful lot about the quality of the bid that was put together. It is a hugely important step for my constituency.

It is hard to overstate how difficult this period has been or the sacrifices my constituents have made to help us get the numbers back down and to help us in our bid to get into tier 2. I doubt there is an MP in the House who does not want to get out of tier 3 if they are in it. I understand that the Government will look at a wide range of data. I spoke to the Minister last week about my hope that the data will be made publicly available and that the decision will be made as transparently as possible. I also understand that the Department is rightly filled with a cautious bias: it understands that Christmas is coming and that that might have a certain impact, so it wants to take the safest possible course of action. However, I am sure I speak for all Derbyshire MPs when I say that we are desperate to get out of tier 3. I imagine that will be heard from other Members.

Finally, I want to touch on the impact this period has had on people’s mental health. It is hard to overstate the impact that taking away people’s daily routine and normal social contact has had. Those intimate moments that people have with their friends and family have been replaced with a climate of fear and uncertainty—fear of catching the disease and becoming ill; fear of what might happen if one of their relatives or friends catches the disease.

It is striking to find how many people I have talked to seem to have been impacted by this period. We are very lucky in that we get to come to this place of work. Many people have not had that and have spent many months being incredibly scared. I spoke to one young lady in my surgery on Friday called Cara, who spoke passionately about her love of ice skating. Not having ice skating in her life had taken away her entire routine, her social group and the structure that she is used to and loves. That is just one example of many conversations of that nature.

Yes, the Government have done remarkably well given all the circumstances; yes, I would like pubs to get more support; yes, the vaccine offers a source of hope that we all need, but I think we will be living with the mental after-effects of this disease for some time to come.

Health and Social Care Workers: Recognition and Reward

Mark Fletcher Excerpts

Thursday 25th June 2020 Commons Chamber

[Mark Fletcher (Bolsover) (Con)]

It is always a pleasure to follow the hon. Member for Strangford (Jim Shannon). I am very grateful for the opportunity, on behalf of all the residents of Bolsover, to say thank you so much to all our care workers and all our NHS staff, who have done so much during these incredibly difficult months. We thank them unreservedly for everything they have done for our communities and our country.

A few weeks ago I suggested in oral questions that we should have a special honours list to recognise those who have done so much and sacrificed so much during this period. I say again to the Minister that I feel that is something we should pursue. I suspect that many, many people from Bolsover would be suggested for inclusion on such a list.

One of the most humbling and difficult things that I have done during this period has been to speak to every single one of the care home managers in my constituency. One in particular stands out. She said that this had been the most difficult period of her life. In tears, she said, “But I’m also incredibly proud of what we’ve done—of the leadership we’ve shown and how well my team have coped.” That just goes to demonstrate the amazing spirit that we have seen in this period. In my conversations with my local hospitals—the Chesterfield Royal, the King’s Mill Hospital and the hospital in Bassetlaw—I have heard only good things about the efforts that the staff have put in.

Our manifesto committed us to seeking a cross-party consensus on the future of social care. Now more than ever, we should continue to seek to do so. We can talk about pay and conditions—we can talk about all sorts of aspects of social care—but ultimately we need a vision for that sector that is sustainable and that is suitable for those who live long lives. I have a background in the care sector, and I know that there is so often a stigma attached to it. There is a fear of care homes and a fear of older age that should not be there. Based on the contributions today, I think there are many things on which we agree and many things that we should look to solve together.

GP Provision: Pilsley

Mark Fletcher Excerpts

Monday 10th February 2020 Commons Chamber

[Mark Fletcher (Bolsover) (Con)]

Once again, Madam Deputy Speaker, it is an honour to speak under your chairmanship; fate seems to keep bringing us together. I am delighted to have the opportunity to raise this important constituency matter in this House.

During my maiden speech, Madam Deputy Speaker, you may recall that I invited you to visit many wonderful parts of my constituency. Pilsley was one of the places I mentioned, and of course I extend that invitation once again. Pilsley is a delightful village—or perhaps two villages, depending on who you speak to—with great charm and character. But the village is currently in a state of great anxiety due to the proposal to close the incredibly popular local surgery. This potential loss is what I wish to discuss tonight.

The future of the Pilsley surgery has been something of an ongoing affair for nearly three years. The surgery is run by Staffa Health. It is one of four that it runs in the region, and they are generally considered to be very good. I wish to say early on that I do not doubt the commitment of the staff of Staffa Health to deliver the best possible service, nor do I doubt their sincerity in their belief that this closure is a good move. That is not to say that I agree with them.

As I understand it, an initial proposal was put forward in 2017 by Staffa Health to close three surgeries, but that got dropped along the way. I will recap some of the events over the past year. On 1 May 2019, the practice identified the various stakeholders that it needed to discuss the planned closure with. On Monday 24 June 2019, Staffa Health wrote to patients, commencing a consultation to propose the permanent closure of Pilsley Surgery. The consultation ran for 60 days, until 23 August 2019.

As you will appreciate, Madam Deputy Speaker, I was elected in the early hours—around 5 am—of 13 December, some months after the consultation had closed. I feel a bit like I have won an FA cup final ticket, only to discover that I have turned up in injury time, because my involvement started last month. I received a letter via email on 14 January from Staffa Health informing me of its decision to close the surgery. I was given eight days’ notice before it was taken for a final decision to the NHS Derby and Derbyshire clinical commissioning group. I immediately wrote to Staffa Health, offering a meeting with the Secretary of State to explore other options. Similarly, I wrote to the clinical commissioning group, asking for a delay to any decision, and I met the amazing Sheila Baldwin, who I will mention more later on.

I think it would be helpful to set out the reasons given for this proposed closure. In the letter to patients dated 24 June 2019, Staffa Health said:

“Staffa Health provides a high degree of choice to our patients in terms of appointment type, location, time of day, day of the week and the ability to book ahead and on the day. Operating in this way over our four sites and providing effective GP cover is challenging. For some time the Practice has been experiencing increasing difficulty in sustaining clinical GP cover over four sites.”

On the face of it, this is about difficulties in recruiting and retaining GPs—a problem that many surgeries face.

[Jim Shannon (Strangford) (DUP)]

The hon. Gentleman is illustrating an issue that is apparent in not only his constituency but across the United Kingdom, including in my constituency. The availability of GP appointments is fast becoming a nationwide crisis, which is adding to pressure on minor injuries units and A&E departments. Does he agree that there must be direct funding to encourage medical students to commit to a five-year placement in a GP practice, in exchange for student loans, Province-wide and UK-wide? That may be a possibility.

[Mark Fletcher]

It is a delight to receive an intervention from the hon. Gentleman. As I understand it, he is slightly notorious for doing so. He strayed slightly from what I wish to speak about this evening, but I thank him for his support, as do the people of Pilsley.

As I was saying, on the face of it, this is about difficulties in recruiting and retaining GPs. That is why this Government have committed to recruiting 6,000 more GPs and 26,000 primary care staff other than GPs. We know that there is a particular issue with meeting increased demand at GP surgeries, and we are addressing that challenge head-on with a three-pronged approach: recruiting more GPs; recruiting other staff such as nurses and pharmacists, who can often deal with more routine appointments; and finding new ways of working, such as telephone appointments. That is why I wrote to the Secretary of State asking for a meeting with myself and Staffa Health, to discuss alternative ways of working—a meeting that I believe he is happy to arrange.

But if I were being a cynical man, I would suggest that the top line about GP recruitment is a cover for other reasons why Staffa Health wishes to go ahead with this closure. In the frequently asked questions section of the consultation letter, there was a section headed,

“How would it help Staffa Health by closing the Pilsley surgery?”

Five reasons are given. The first is, as previously covered:

“Enabling us to review and improve access to GP appointments without having to spread staff thinly over four sites”.

The second is:

“Allowing us to redesign the way we provide some aspects of the service. We plan to improve access to same day urgent care, telephone and online consultations”.

I am at a bit of a loss as to why the closure of a surgery is required for that to happen. The third reason stated is:

“Reducing some of the activities that are duplicated across multiple sites, providing greater efficiency”.

I suspect that that might be the most important reason. I think that the finances of the closure may be a considerable factor in this proposal, and if I am right, I wish that Staffa Health would come out and say so, rather than hiding behind other factors.

The fourth and fifth reasons given are:

“Giving the Practice a greater ability to support doctors, nurses and pharmacists in training by supervising them on fewer sites”

and

“Making the practice a more attractive place to work due to a more supportive, less stressful and less isolated working environment”.

What both those points skirt over is the impact that this will have on residents in Pilsley, who are unanimously against this closure. Of course it is important to think about the morale of staff and the quality of their training, but if doing so results in the plummeting morale of patients, is that a good decision? There are serious concerns about the impact the closure will have on the residents of Pilsley, especially those who cannot drive or suffer mobility issues. The village has a higher proportion of elderly residents than most of my constituency, and there are three major issues that I want to raise today.

The first is public transport. The consultation document points out that the other Staffa Health surgeries are only a couple of miles away from the Pilsley surgery, and that there are two public transport routes to them. My inbox and postbags are full of residents’ communications presenting a very different picture. As one email from a Pilsley resident stated:

“Our village has lost one bus service and what is left is erratic and unreliable. I am 72 and currently drive but wonder what will happen in the years to come.”

Do we really want our elderly patients who cannot drive waiting in the freezing cold in bus shelters for a once-an-hour service that is far from reliable? Will this improve their health, or would we prefer them to shell out for a return taxi that will cost about £20, or are we to rely on a commitment to home visits that will surely put considerably more strain on the workforce?

The consultation document says that the practice

“recognises that not all patients would be able or willing to travel to one of the other surgeries. Any patients who may choose not to remain registered with Staffa Health would be fully supported and offered advice on how to re-register with a different Practice.”

However, this is far from adequate. It knows that it is the only surgery available, and those wanting a local doctor will have no alternative. That was the one part of the consultation I was somewhat offended by.

The second issue is the new housing being built in the village. Because it is a fantastic place to live, Pilsley is popular for new housing developments. The Pilsley surgery has 2,800 patients registered at the practice, which has increased by 500 patients since 2017 due to new housing in the area. Other developments, such as the Rockliffe housing development on Green Lane and a site on Gladstone Lane, have been identified for more housing. It is perverse to build new housing in a village while at the same time losing vital infrastructure. We need to have a much more joined-up approach between the local authority, the CCG and Staffa Health, and I suggest that some of the developers building in Pilsley should be contributing financially to local services such as the GP practice.

The new houses will create more demand, and we are going to end up in a position in a few years’ time where we will need to reopen this practice, so let us just cut out this closure. I was particularly amused to read that, because of concerns over parking at one of the other surgeries—in Tibshelf—the plan was to close the Pilsley surgery to patients, who will then have to travel to Tibshelf, but to move administrative staff from Tibshelf to the now closed Pilsley service so as to free up car parking space in the short term at Pilsley. It brought to mind the episode of “Yes Minister” when Jim Hacker visits a new hospital that has no patients, and Sir Humphrey proudly tells him that it is one of the best performing hospitals in the country on many measures.

The third concern I want to raise is the consultation, a lot of which was done online. Not all residents are online and not all residents in Pilsley feel they have been kept up to date on the process. Two brilliant ladies, Sheila Baldwin and Wendy Hardwick, took matters into their own hands and organised a petition against the closure, collecting 600 signatures in three weeks. I applaud their efforts, particularly as Sheila is not online, yet she has galvanised Pilsley into action. She is one of a number of people who have tried calling the surgery in recent weeks only to discover that the options system for the practice automatically transfers them to the test results option. This has added to the confusion and Chinese whispers that are inevitable in a situation of high anxiety.

I brought the consultation up in business questions a few weeks ago, and I know that the CCG is of the opinion that the consultation process for the proposed closure was satisfactory, but I question whether it has explored more than the papers put in front of it. It is clear from speaking to residents in Pilsley that they feel very unsure about who is making decisions, when they are coming, and what impact they will have. We are far too reliant on websites for this sort of thing, and it annoys me that those of us who are tech-savvy gloss over the discrimination this presents to those who are not computer-literate. On behalf of all residents in Pilsley, I thank Sheila and Wendy for all that they have done.

I appreciate that the Government do not have control over this decision: responsibility lies with the CCG. Reportedly—this has not been confirmed to me in writing—a decision will be made at its next meeting on 26 February, although no time or location has yet been provided to me. Equally, I appreciate that a lot of this happened before I was elected. I also wish to state again that I have no ill will towards those who work for Staffa Health, who I am sure wish to do their very best to make their patients’ lives better; I disagree with them on this matter, but I do not question their passion for what they do. But it seems to me that the rationale for this proposed closure is short-sighted. It will adversely impact many vulnerable and elderly patients. It is deeply unpopular, and the best approach would be for us to find a way of keeping this surgery, such a vital part of the Pilsley community, open.

I also fear that the closure of the surgery could see a reduction in services or a potential closure of the local pharmacy, creating a real health blackspot in one of the finest parts of Derbyshire. I know the Minister is particularly passionate about pharmacies, and she knows how vital to communities these local businesses are.

I hope Staffa Health and the Derbyshire CCG will pause this proposal, meet me and the Secretary of State to discuss their issues and reassess what can be done. If any confirmation of the importance of this issue were needed, I might add that when I spoke to Sheila earlier today she told me that a last minute notice had gone out in the community because ITV’s “Calendar”—I am sure you are a big fan, Madam Deputy Speaker—was filming in the local area and wanted people to come out; at incredibly short notice 30 people made themselves available. This is a vitally important issue for the residents of Pilsley and I look forward to the Minister’s response.