Adult Social Care in Shropshire: Government Funding

Owen Paterson Excerpts

Wednesday 22nd January 2020 Westminster Hall

[Daniel Kawczynski]

Shropshire Lad. The clear message from Peter Nutting, the leader of our council, from the chief executive, and from the other senior councillors is that social care is their top concern. The Minister will know—she played a part in it as well—that in the last Parliament, MPs from rural shire counties worked constructively together to get a change to the funding mechanisms for our schools. Rural shire counties were unfairly discriminated against in comparison with inner-city, metropolitan areas. In this Parliament it is my intention, and that of many other Members, to make social care the No. 1 issue, because we have to listen to what our councillors are telling us.

There is no doubt in my mind that the black hole of approximately £20 million a year that the council faces is affecting not only adult social care costs but many other services in our county. The leader of the council has to take money away from repairing potholes, and all the other things for which the council is responsible, in order to manage the black hole that is staring them in the face.

[Mr Owen Paterson (North Shropshire) (Con)]

I congratulate my hon. Friend on landing the debate and on the powerful case that he is making. As he said, we have all been working very closely on the matter for some time. I think he would agree that the situation is going to get worse. Currently, 23% of Shropshire’s population are aged over 65. That will increase by 50%, to 33% of the population, by 2036, compared with the projection for England of 24%. That is an increase from 74,029 to 110,926.

I am sure that, like me, my hon. Friend is an avid reader of the Shropshire Star. On Monday there was a story titled, “Dramatic rise in dementia cases”, which reported that dementia cases have gone up by 57%. Dr Karen Harrison Dening of Dementia UK said:

“We are going to have a huge increase in population of older people, and one of the main risk factors of dementia is age. There is also going to be a reduction in the number of younger people who will be able to care for them.”

Would my hon. Friend like to comment on the inevitability of this getting worse?

[Daniel Kawczynski]

I would, but I will first give way to my right hon. Friend.

Ockenden Review of Maternity Care: Shrewsbury and Telford

Owen Paterson Excerpts

Wednesday 15th January 2020 Commons Chamber

[Lucy Allan]

I very much appreciate the hon. Gentleman’s intervention. As always, he makes an excellent point, and I am grateful to him for his many interventions in many debates I have secured.

I am concerned that the NHS can choose to sit on this information, and that Ministers can say, “Well, we don’t comment on leaks”. This is about the safety of women and babies, and the adequacy of the maternity care they receive in our hospitals today. Women were repeatedly told that their case was a one-off tragedy, that there will always be risks to childbirth, and that such risks cannot be completely mitigated. Failings seem somehow to have been normalised, and at the time many women accepted that, rather than question or challenge the care they received. People trust the medical profession, which is why openness and transparency are so crucial.

When people raised concerns they were dismissed as being difficult—no one listened. There was a “we know best” attitude, and complaints about poor practice were treated as women making a fuss about a perfectly natural event that occasionally would have a negative outcome. As Health Secretary, my right hon. Friend spoke about “never events”, and I suggest that those must include an avoidable death. A baby dying in childbirth should therefore be a “never event”, yet it seems that that is not the way the deaths in this case were treated—they were treated as something that could be a result of childbirth. The trust even boasted of having the lowest number of caesarean deliveries in the country, so there seems to have been an unwillingness to intervene when there were complications in a delivery. In my view, an intervention during a difficult birth must be a good thing: that is what the clinicians and medical professionals are there to do. I am concerned about the way this trust appears to have treated women and about its attitude towards women, which seems to have been dismissive. And that is something we have seen from the top.

What adds insult to injury in this particular case is that the trust commissioned a report in 2013 that appeared to find that all was well. We now know, because of the leaked report, that that was in fact a whitewash. The trust was exonerated by what was a perfunctory bare minimum desk-top review. This allowed poor practice to continue unchecked. If it had been identified at the time, the more recent cases of malpractice, which are still coming forward and include death and injury, could have been avoided. We still do not know how many women and babies have been affected, but we do know that £50 million in compensation has been paid out already. However, with hundreds more women coming forward, the cases in which a financial settlement has already been reached are clearly the tip of the iceberg.

The question we have to ask, and must go on asking, is whether that poor care, and the normalisation and denial of it, is a systemic problem within the complex bureaucracy that is the NHS.

[Mr Owen Paterson (North Shropshire) (Con)]

Will my hon. Friend give way?

[Lucy Allan]

I shall be delighted to give way to my right hon. Friend and constituency neighbour.

[Mr Paterson]

I congratulate my hon. Friend on bringing this very, very difficult subject forward. I also thank my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for launching the Ockenden review. It is very easy to talk about numbers, but every one of these cases is unutterably terrible and ghastly for the family concerned, and obviously a total tragedy. We all know dreadful stories from the past. The latest figures show that the infant mortality rate at Shrewsbury and Telford Hospital Trust is 3.7 per 1,000, against a national average of 3.9 and a national target, which I would like the Minister to comment on, of 2.6 by 2025. My hon. Friend has rightly raised the absolute horrors and the dreadful culture—we all know terrible stories—but does she derive any satisfaction from the fact that we are marginally better than the national average at the moment and possibly heading towards the national target by 2025?

[Lucy Allan]

My right hon. Friend makes a very important point. Clearly, the majority of women using these services have an excellent and safe experience. It is good news that there is progress and improvement, but we should not gloss over any of these cases. Regrettably, there have been new, recent cases in my constituency where women have come forward, having been made aware of the review, saying, “This happened to me a couple of years ago.” It is good that the numbers are improving, but we must make sure that every one of those deaths is treated as another event.

A&E Provision: Shropshire and Mid-Wales

Owen Paterson Excerpts

Wednesday 11th January 2017 Commons Chamber

[Daniel Kawczynski]

As I said earlier, of course they have the right to do so. Let me take this opportunity to acknowledge the work my hon. Friend has done since she became a Member of Parliament to campaign for Telford, and to campaign very strongly and effectively on this issue without being overtly political or personal, unlike some other people. I will come on to talk about the CCG a little later.

I reiterate that my concern is for us all to put our cards on the table. We all went along with the Future Fit process. The decision could have gone against Shrewsbury. Ultimately, the decision has been made to have the urgent care centre in Telford and that the main A&E service should be provided by Shrewsbury. That decision could have gone the other way. It could have gone to Telford, and we would have lost out. At the end of the day, it should not be about winning or losing—that is the biggest problem.

My right hon. Friend the Member for North Shropshire (Mr Paterson) has talked about the pillow fight that has gone on between Shrewsbury and Telford ever since he became an MP. Over the past 11 years, I have lost more sleepless nights over the constant fighting between Shrewsbury and Telford about hospital services than over anything else. At the end of the day, we are one county and we must fight collectively as one county for all the people of Shropshire, and of course for our friends across the border in Wales.

[Mr Owen Paterson (North Shropshire) (Con)]

I congratulate my hon. Friend on landing this debate. He is absolutely right. This bickering between Shrewsbury and Telford has dogged my nearly 20 years in Parliament. I thoroughly back Future Fit because it provides a solution that benefits everybody. I like the idea that the two existing A&Es carry on doing 80% of their current work, albeit—possibly—having been renamed as urgent care centres, while we get a £300 million emergency care centre. Some of my rural areas look to Shrewsbury, some look to Telford, but we will also gain from urgent care centres being built in the rural areas. What is utterly exasperating for my constituents is this indecision. We have had three years and £3 million spent, and still no decision. I am delighted that the Minister is listening so carefully and I very much hope that at the end of the debate we will have a clear recommendation for a decisive mechanism to deliver the will of the local commissions.

[Daniel Kawczynski]

I could not agree with my right hon. Friend more, and I pay tribute to him for the work he has done on this over the last few years.

I would like the Minister to intervene to ensure that the process allows for a decision. In our case, all six members of the Shropshire CCG voted for the proposals and all six members in Telford voted against. I am very concerned—I want him to take this away—about this. What sort of a process is it when we can get a tie? There needs to be a casting vote or perhaps some independent third party who can arbitrate in such a hotly contested issue where the two local CCGs cannot come to an agreement. So I would like to hear from him on that.

I appeal to constituents from the whole of Shropshire and mid Wales to lobby Telford Council, to get behind the concept of us all working together, as my right hon. Friend said, and to lobby the Government more effectively for more resources, rather than fighting one another in a rather parochial way over where these services are going to be. Let us not forget how close these two hospitals are to one another. We are not talking about 50 miles, 30 miles or 20 miles. Somebody might correct me if I am wrong, but I think they are only 13 miles apart. We ought to be thinking about how to improve and modernise the provision of healthcare for all the people of Shropshire and mid-Wales and listening to the proposals of the medical experts, who have done so much work to put these proposals together.

--- Later in debate ---

[David Mowat]

Sorry, an editorial in the Shropshire Star—it is not a newspaper I read—made the point that we now need to get this right; we need to make a decision and to stick by it. I think everybody in the Chamber would agree with that, with the caveat that in the end it has to be a local decision. There are very real battle lines here; I think my hon. Friend the Member for Telford met the Secretary of State yesterday on this with other Members and council leaders.

What is the proposed way forward? My briefing from the CCGs is that a week today there will be a meeting at which the intention is that two things happen. The joint committee will be reconstituted and an independent chair appointed who will have a casting vote. In parallel with that, there will be an appraisal, or review of the appraisal process, that Future Fit takes, with the intent to address the concerns raised by Telford about whether it was robust. At the end of the review—depending on the outcome, I guess—there will be a new vote with a view to potentially having a majority on one side or the other and therefore there will be a local direction. That is my understanding of the way forward.

[Mr Paterson]

It is tremendous news that there will be a mechanism that will give us the ability to come up with a clear answer. Does the Minister have any idea of the timescale for this new process?

[David Mowat]

I have been advised that the timescale is in the order of eight to 12 weeks, but it remains a local decision. That is what we hope and expect to be the case.

In finalising my comments, I want to make a couple of observations.