Healthcare (Devon)

Neil Parish Excerpts

Tuesday 18th October 2016 Westminster Hall

[Neil Parish (Tiverton and Honiton) (Con)]

It is great to serve under your chairmanship, Mrs Main. I thank my right hon. Friend the Member for East Devon (Sir Hugo Swire) for obtaining this debate, which is very timely.

Consultation should be about consultation. The CCG has presented four options: in option A Tiverton has 32 beds, Seaton 24 and Exmouth 16; in option B Tiverton has 32, Sidmouth 24 and Exmouth 16; in option C Tiverton has 32, Seaton 24 and Exeter 16; and in option D Tiverton has 32, Sidmouth 24 and Exeter 16. There is no sign of Okehampton or Honiton hospitals on the consultation. Beds there are simply said to be closed. Is that consultation? In our original reforms of the health service we said that local people must be consulted. Angela Pedder did exactly the same in Axminster, two years ago, as is being done now; she just came and said the beds were to be closed. There were no alternatives or consultation—just “We have made the decision, we know best, and we will overrule anybody who says any different.”

I tell the Minister that that is not consultation; we must make sure that consultation happens. Honiton is a great hospital. It currently has 18 beds and offers midwife-led births, a minor injuries unit, therapies, outpatients, X-ray and GP-allocated primary care services. It has an outstanding reputation and is often referred to locally as the Honiton Hilton, because it provides such great services. People in Honiton have supported it for generations, and that is what is so essential. We have an ageing population in Devon. My constituency starts in Uplyme. My hon. and learned Friend the Member for Torridge and West Devon (Mr Cox) has Great Torrington in his constituency up in the north-west. Lifton is down in one corner of the county, and it goes right up to beyond Ilfracombe. The county is massive, and it is being suggested that community hospitals should be closed. The Royal Devon and Exeter hospital will be under great pressure to keep its acute beds free. Yet we are closing down community hospitals that could ease the pressure on acute hospitals. That seems to be taking things in totally the wrong direction.

I welcomed the Minister’s intervention on my hon. Friend the Member for North Devon (Peter Heaton-Jones) about the reallocation of funds. Are not the consultations therefore premature? Do they not exclude whole hospitals from being considered at all, and should not that be reviewed? Can the Minister ask for that? The independent health service review looked at the case of Torrington and said that it should not have been closed. As to Axminster, we still do not have a proper facility and we do not know how it will be engaged. Not only are the CCGs taking beds away from community hospitals; they are not putting anything in their place.

I make a plea to the Minister: what are we to do? We have an ageing population; the age profile of Axminster is probably what the whole country’s will be in 2035. Our population is healthy but growing older. We want to help people in their own homes. I am pleased for that to happen, and I think it is right, but we also need community hospitals. Honiton has excellent communications so it is easy to bring people in and out of the hospital, and it is a quick journey from the Royal Devon and Exeter to Honiton hospital if people need to be brought back to relieve the pressure on beds. I cannot see how it is possible to go forward with a consultation when a hospital is completely taken out. I am sure that the Minister will say that it is up to local people and organisations to decide; but there is a problem if, when local consultation comes along, a hospital is removed from the list. Also, when it comes to staffing, it does not help in getting staff for a local hospital if that hospital is threatened with closure.

I really feel that all our MPs across the whole of Devon need to unite, because over the last two years the number of beds in our community hospitals has been halved. I rather fear that we will be standing here in two years’ time saying that they have been halved again. Rather than fighting between each other over which hospitals are kept open and which are closed, let us fight all the closures across Devon. Otherwise we are just being picked off one by one, Minister, and this is not the way to run a health service in Devon.

--- Later in debate ---

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

I am grateful to you for taking the Chair this afternoon, Mrs Main, and for encouraging me to leave some time for my right hon. Friend the Member for East Devon (Sir Hugo Swire) to respond, which I will endeavour to do. I congratulate him not only on securing this debate, which has been very well supported by his colleagues from across the county, but if I may—this is the first opportunity for me to do so publicly—on the recognition that he received of his time in Government from the previous Prime Minister.

I start by highlighting some of the excellent work carried out every day by all those who work in the NHS, not only in my right hon. Friend’s constituency but in mine and those of all the others who have spoken today. I will attempt to address some of the specific points that have been raised, particularly by my right hon. Friend, but I shall first provide the House with a little context and background regarding health services in Devon.

Devon is a leader in many areas of the health service—perhaps to the surprise of some hon. Members who have spoken—relative to other parts of the country. Not least, the Torbay and South Devon NHS Foundation Trust was the first trust in England to join up hospital and community care with social care. A plea to do that was made by my right hon. Friend and it is already happening in South Devon. The trust operates as a single organisation, working with partners to improve the way it delivers safe, high-quality health and social care. The trust is showcasing exactly the kind of joined-up, patient-centred care that we want the NHS to provide to meet the needs of the ageing population.

I also pay tribute to the staff at the Royal Devon and Exeter NHS Foundation Trust, who last month celebrated their fifth anniversary since the last incident of hospital- acquired MRSA. That remarkable accomplishment comes as the result of continuous improvements at the trust over the last 10 years. The trust is now considered a national leader in infection control, being the only general hospital in the whole of England to have avoided any MRSA infections in the last five years.

However, I absolutely recognise that the region is facing difficulties. NHS staff across the region are working hard to provide good care to patients, but services are not keeping pace with the changing needs of local people. It is becoming increasingly difficult to make sure that local people have access to consistently high-quality care that is affordable and sustainable.

As my right hon. Friend said, in June 2015, NHS England announced that north, east and west Devon would be one of the three areas in the country to take part in a success regime. That is designed to improve health and care services for patients in local health and care systems that are struggling with financial or quality problems. Following intense diagnostic work, the north, east and west Devon success regime published, in February this year, the “Case for Change” report, which was referred to earlier. The report sets out the underlying challenges facing the area and the opportunities to improve access to services and ensure clinical and financial stability. The work concluded that if nothing was done, Northern, Eastern and Western Devon would have a system deficit of £398 million by 2020/21, as has been referenced by a couple of hon. Members, including the hon. Member for Burnley (Julie Cooper).

As well as the financial challenge, the work identified significant health inequalities and some clinical services that will be unsustainable in their current form. There are good reasons for that. As we have heard from hon. Members, people in north, east and west Devon are living longer successfully, particularly in areas of the constituency of my right hon. Friend the Member for East Devon and in Torbay.

People are living with increasingly complex care needs and require more support from health and social care services. More than one in five people in north, east and west Devon are over the age of 65, and that figure will be almost one in four by 2021. Some 40% of local people use almost 80% of health and social care services. There are 280,000 local people, including 13,000 children, living with one or more long-term conditions such as asthma, diabetes, hypertension, cancer and mental illness.

Although Devon is regarded from the outside as generally affluent, we are all aware—hon. Members have explained this—that there are areas of significant deprivation. There are big differences in health outcomes between some areas, particularly in Plymouth. There are also spending disparities between different parts of the county.

More than 10% less for each person is spent on healthcare in west Devon compared with north and east Devon, even when age and deprivation is taken into account, as my hon. Friend the Member for North Devon (Peter Heaton-Jones) emphasised. Somebody living in Ilfracombe Central is statistically likely to die almost 15 years earlier than a person living a two-hour drive away in Newton Poppleford.

Inequalities need to be reduced, and the spread of health and social care across north, east and west Devon needs to be made more equal. I am sure that my right hon. Friend the Member for East Devon agrees that his constituents should have access to the same high-quality healthcare services as those in the rest of Devon, let alone the rest of the country. He referred to the success regime consultation as being at fault. I gently remind him that it was only published on 7 October. I am sure that comments made today about the lack of available paper copies of the consultation will be taken into account by the organisers, and that we can respond to that.

[Neil Parish]

I want to press the Minister on the success regime’s consultation. Is it right for a hospital to have its beds taken away as part of that consultation? Surely a consultation should be for people to have a say on a public decision.

[Mr Dunne]

I heard my hon. Friend mention the lack of reference to Okehampton and Honiton. I gently draw attention to the fact that the option to retain community beds in both those hospitals was considered as part of the 15 options in the document. The option was rejected as one of the four recommended for consultation, but that does not prevent him, his constituents or local representatives in those areas from putting those alternative options forward.

My right hon. Friend the Member for East Devon asked whether there was a “none of the above” option. I think he may have been referring to page 42 of the consultation document, on which the organisers say that they

“welcome all views and will carefully consider all responses and analyse these against the decision making criteria. That will include options which are not currently in the consultation document”.

They are open for proposals to be made by others, but those need to be looked at in the context of the criteria.