Health Services (Lewes)

Norman Baker Excerpts

Friday 9th January 2015 Commons Chamber

[Norman Baker (Lewes) (LD)]

I welcome the opportunity to discuss the local health issues affecting my constituency. Of course, the debate comes at an opportune time given the attention that has been given to the NHS locally.

I welcome the funding the coalition has given to the NHS, which is of course more than the Labour party gave or would have given had it been elected to office. I also welcome the £1 billion reduction in management costs that we have secured as a coalition and the investment in extra doctors and nurses. There are elements of the Health and Social Care Act 2012 that I strongly welcome, too, including the decision to make public health once again a local authority responsibility, to integrate better health and social care and to give more say to our local GPs in decision making. They will be in a far better place to make sensible decisions than the alphabet soup of various bodies that they replaced. I also welcome steps that the coalition has taken to end the preferential treatment for the private sector in terms of financial arrangements that the previous Government introduced.

As everybody in this House will recognise, we have a serious challenge with the ongoing costs of the NHS, including the fact that NHS inflation is always greater than normal inflation and, most recently, with the pressure on accident and emergency places, and consequently funding. The chief executive of the NHS, Simon Stevens, has called for a real-terms funding boost of £8 billion per year by 2020-21, on top of efficiency savings and further reforms to the NHS. I believe—I support my Lib Dem colleagues in this—that we should maintain the additional £2 billion that was secured in the autumn statement. In addition, as we said at our conference, we should invest a further £1 billion in real terms in 2016-17. That would be maintained in future budgets, paid for by capping pensions tax relief for the very wealthiest, aligning dividend tax with income tax for those earning over £150,000, and scrapping the shares-for-rights scheme. Of course, once we had finished the job of tackling the deficit, we would increase health spending in line with the growth in the economy.

So there are steps we can take, but we need to look at this in a more fundamental way as well. I suggest that we should prioritise, more than we have so far, the provision of primary health care in our local communities. That not only helps the people within those communities but takes the pressure off accident and emergency departments. I am particularly concerned about the pressure exerted on Brighton general hospital and Eastbourne district general hospital, which serve my constituency. My hon. Friend the Member for Eastbourne (Stephen Lloyd) has written to the chief executive of Eastbourne DGH seeking urgent assurances that it is able to cope with the demands currently placed on it. Both hospitals are failing to meet the Department of Health’s target of 95% of patients being dealt with within four hours, which is a matter of concern. One of the ways to deal with this is to have better local services and investment in primary care.

I am going to raise a number of issues with the Minister; I am not sure whether he will be able to respond to them all today. If there are outstanding matters on which time does not allow for a response or on which he is insufficiently briefed, I ask him or his officials to write to me subsequently with answers.

I am particularly concerned about the situation in Seaford, the largest town in my constituency, with a population of some 25,000, where we have had broken promise after broken promise from NHS bodies over very many years. They have always promised to improve services, to provide more local services, to introduce diagnostic testing and the like, and one after another of those promises have been broken by successive primary care trusts, strategic health authorities and the rest. I welcome the fact that we now have local GPs involved who live in Seaford and therefore have some chance, through the clinical commissioning groups that the coalition introduced, of bringing some services to the town that are not currently there.

Specifically, it is shocking that a town the size of Seaford with its population spread—there are many elderly people—has no minor injuries facility. Lewes, where I live in the constituency, does have such a facility at Lewes Victoria hospital, but Seaford, which is much larger, does not. I have been in discussions about this with the CCG and with the local ambulance trust. In my view, the local ambulance trust ought to provide paramedics to help with the provision of minor injuries facilities in Seaford, if only by stationing ambulances that are not required on urgent calls, thereby diverting people away from accident and emergency services and enabling them to stay in their own town rather than having to travel a very long way to Eastbourne or Brighton to secure treatment. My first request to the Minister is that he should have discussions with the ambulance trust to make progress on ensuring that a facility of some sort, even a mobile one, can be put in place for my constituents in Seaford so that they are able to have their minor injuries dealt with, sensibly, in the town rather than clogging up the accident and emergency unit at Eastbourne, which, as I say, is not meeting its target of delivering treatment to 95% of people within four hours.

We have a new facility in Seaford—the Horder centre, which I argued for and which is now delivering some services. It has taken over from Seaford Day hospital, which was a mental health facility. However, its range of services is inadequate, and I would like more NHS business to be put through it, given that there is capacity in the building. My second request to the Minister is to engage with the Horder centre to find out whether we can extend the range of services in that building to ensure, again, that pressure is taken off A and E departments.

Another issue relates to the Newhaven Downs facility, which is just to the west of Newhaven and not very far from Seaford. This is a relatively new facility and is of quite a good standard, but it is chronically underused. I want to know why, when we are short of money, we have a good facility that is not being used to anything like its maximum potential. It could be used to deal with people from Newhaven and Seaford in my constituency and from Peacehaven in the constituency of the hon. Member for Brighton, Kemptown (Simon Kirby). What is the forward plan for improving and increasing the use of the Newhaven Downs facility?

I am conscious that one of the problems is that if we are to invest locally in primary care, we have to keep the A and E facilities and the acute hospital money there while the improvements are made. There is therefore a need for a one-year investment programme to ensure that both angles are covered until the primary care facilities take over. I imagine that this is a problem not only in my constituency, but elsewhere, so is there a plan to implement the Government’s aim, which I very much welcome, for far more people to be treated locally in their own communities? That is the right policy, but it needs pump-priming to ensure that it can occur. The question is how that happens when A and E departments and acute hospital trusts are still being funded as they have been.

The problems of the need to travel to acute hospitals have been exacerbated by the transfer of services from the Eastbourne district general hospital to the Conquest hospital in Hastings. The East Sussex Hospitals NHS Trust runs those two facilities, which are some way away. The sad fact is that we are now seeing a two-tier acute hospital service in East Sussex, with Brighton and Hastings having pretty much the full range of services, and Eastbourne being downgraded. That is a matter which my hon. Friend the Member for Eastbourne is very worried about, as is the local population.

My constituents in Seaford and Polegate are sometimes asked to make extraordinarily long journeys to Hastings, which is a very long way away. The hospital in Hastings is nowhere near the train station and is very difficult to get to. We have already seen maternity services transferred there—by sleight of hand, I might say— with a so-called temporary transfer which then became permanent, bypassing the normal consultation arrangements, not to mention bypassing public opinion. I have to say to the Minister—I do not say this lightly and I have not said it before in 18 years—that I do not have confidence in the management of that NHS trust to deliver the right thing for the people of my constituency or even to play straight with them. That is a matter of great regret to me.

If, at least for the short term, my constituents are required to travel a very long way for very basic services, which I hope will change, the NHS trust in Eastbourne and Hastings which has been responsible for that situation needs to take some responsibility for the transport implications. Will the Minister set out what he believes are the responsibilities of the NHS trusts that generate extra transport requirements, but then wash their hands of the consequences and say it is a matter for the county council as the transport authority, the commercial bus company, the rail company or somebody else—anybody apart from them—to pick up the pieces?

The hospital in Brighton, the Royal Sussex County hospital, which also runs the Princess Royal hospital in Haywards Heath has accepted that there is a need to do something about that. It has organised a bus running between Brighton and Haywards Heath, which is a good service used by patients and by those who work in the health service as well. No such arrangement has been put in place between Eastbourne and Hastings and I want to know why not. It is not sufficient to say that people can get the bus, because my constituents sometimes have to pay extraordinary amounts of money to get taxis from where they live to Hastings, and no money is paid back. Some of these are poor people who cannot afford to pay for taxis. That is an outrageous situation for them to be in. I ask for the Minister’s help in dealing with that important transport issue. I hope he will accept the principle that if an NHS trust causes a transport problem, it has a responsibility to deal with it, rather than washing its hands and pushing it on to somebody else.

I draw the Minister’s attention to another problem on which I would welcome some help. It relates to a retirement development called St George’s Retreat at the far north-western corner of my constituency. Hundreds of retired people are living there in a pleasant community, but it is right on the border. Those people naturally look across the border to West Sussex for their health services, but West Sussex does not want to know about them because they are technically in East Sussex, and East Sussex says that they are so near the West Sussex border that they should be accessing West Sussex services.

How can that particular conundrum be solved? People are in limbo without proper services. One approach—this is a bit like the solution for minor injuries—would be for a district nurse and other health visitors to pick up some of the casework at that large facility once a week, rather than expect people to travel very long distances because of where they happen to live.

I am also concerned that pressure on A and E in Eastbourne is being caused by the lack of facilities in Polegate, which is a long-running issue. Polegate is in my constituency to the north of Eastbourne. It has two doctors’ surgeries in Manor Park and Downlands, and they are chronically short of space. The doctors are ready, willing and able to deliver more services locally, which, quite rightly, is what the Government wants, but they are unable to do so because they simply have no space. When I visited those surgeries I was horrified by the lack of space.

There have been plans for a very long time—we have been let down by successive primary care trusts—to improve the facilities and have a new medical centre in Polegate by combining the two surgeries. That is a sensible suggestion and the Minister’s colleague, the Minister of State, Department of Health, my right hon. Friend the Member for North Norfolk (Norman Lamb), came to look at the situation. The reality is that my constituents and, indeed, the doctors are being held back and asked to deal with an inadequate situation in inadequate conditions because of the lack of a medical centre. What pressure can the Minister bring to bear on the clinical commissioning group to ensure that the problem is dealt with?

The Lewes Victoria hospital, which is in my constituency, is in the county town of East Sussex and has a minor injuries facility. It is much loved, very well respected and hugely supported by the friends of the hospital, who have done so much over the years to make sure that it is a lovely place to be. I had a minor op there myself recently and I was extraordinarily impressed by the level of care and compassion shown by all the staff, to whom I am very grateful. I want to put that on the record.

Unfortunately, the hospital is also technically run by the East Sussex Hospitals NHS Trust, which has no particular interest in the place. It is outside its catchment area. It was left standing when the music stopped and it should not be in the trust’s purview. I want the arrangements to be changed and for the Victoria hospital to be transferred to somewhere that has more interest in it than the trust. Will the Minister consider that? My view is that there should be a community trust across Sussex. Failing that, the hospital should be handled by Brighton, which is more local to it.

The hospital is losing facilities, such as the pacemaker clinic, which is shocking. At a time when we want to get more, not fewer, facilities in towns, they are disappearing. That simply clogs up A and E and other hospitals, where parking is particularly difficult.

My last point, which was raised with me by the chief executive of the South East Coast ambulance service, relates to a curiosity to do with ambulance waiting times. I would be grateful if the Minister looked at it and came back to me. Ambulances are being left waiting outside the A and E section of the hospital in Brighton. Why is that happening? The hospital does not want to accept the cases because they worsen its figures for the time people wait in A and E. Therefore, in order to, in effect, fiddle the figures, ambulances are wasting their time and patients are kept there until the hospital is confident it can see them within the four-hour limit. That is not sensible, and nor is it what the Government and Health Ministers want. Will the Minister look at that? In my view, the clock should start ticking as soon as the ambulance arrives on the forecourt or on the premises of the acute hospital. If he could give me an assurance that that will be the case in the future, I would be grateful.