Newark Hospital

Patrick Mercer Excerpts

Monday 7th January 2013 Commons Chamber

[Patrick Mercer (Newark) (Con)]

I start by thanking the Speaker’s Office for granting this debate, the second debate on Newark hospital in the past couple of years. I thank the Minister for making himself available tonight, I thank colleagues on both sides of the House, and I thank my constituents who have come down here for this evening’s debate. I am most grateful to all of them.

As I said, we have already had one debate on Newark hospital. I do not wish to bore the Minister, but a little bit of history might be useful. I do not know how well he knows Newark, but I hope to enlighten him. We sit right on the border between Lincolnshire and Nottinghamshire, and we are bedevilled by dreadful roads and awful traffic, particularly as we move from east to west and west to east. Newark is a growing town and the population of over-65s is likely to have doubled by 2026. I shall explain later why that is so important.

Newark is a town that I fear suffers from the Nottinghamshire health care model, which has been in place for at least a decade and a half. Centres of excellence have been established in places such as Lincoln, Grantham and the King’s Mill hospital, but not in Newark. I am realistic about that, but it presents huge challenges for a growing town. The hospital delivers superb services, but is diminishing relative to the services offered in the recent past; in addition, with King’s Mill, it is saddled with a private finance initiative that has been in place for two years now but will be in place for 30 years.

The problem is not new. It has been a hot potato in the Newark constituency since at least 2004. We had a helpful visit from a Minister in the previous Government in 2004, and in 2010 the PFI project that I mentioned was put in place. Then, a couple of years ago, the A and E department was closed and replaced with a minor injuries unit.

I have to say that the more I see of the national health service, the more byzantine I find the organisation. I cannot understand how a department that called itself an A and E for the best part of 10 years was not an A and E—it did not qualify to be an A and E. It was always going to be painful when the department’s title was changed—in this case from A and E to minor injuries unit. The fact remains that the goalposts in the national health service seem constantly to change. If, for instance, Mr Speaker, you asked me how an anti-tank platoon was organised, I could tell you how many weapons, how many men and how many vehicles were involved. If you ask what an MIU looks like in one hospital and what an A and E looks like in another hospital, the answers are usually widely different. We definitely suffer from that problem in Newark.

Another point about the growing town is that it has been clear to me for at least the last five years, and was recently confirmed in the Monitor report, that there is no plan for the hospital to increase in size—no matter whether one is critical of the services it currently offers—to take into account the growth and the natural explosion of the population that is likely to occur.

[Mr Mark Spencer (Sherwood) (Con)]

I congratulate my hon. Friend on securing this debate. He makes a compelling case for the importance of the hospital to the people of Newark, but does he recognise that people in my Sherwood constituency also value the services that the hospital provides?

[Patrick Mercer]

As my hon. Friend knows, I live right on the edge of my constituency and almost inside his, and my family and I unquestionably depend on Newark hospital—and, of course, on the East Midlands ambulance service—just as much as those in many parts of the Sherwood constituency.

[Karl MᶜCartney (Lincoln) (Con)]

Might it help the Minister if my hon. Friend told him where the nearest major road and rail routes to Newark are, and where the nearest A and E unit is?

[Patrick Mercer]

The answer to that question is, of course, Lincoln, but it is by no means true that all the serious cases in Newark go there. I shall say more about that shortly.

Let me continue my brief history. Last autumn, Monitor delivered a devastating report on the private finance initiative and on Sherwood Forest Hospitals NHS Foundation Trust, which includes King’s Mill and Newark hospitals, drawing attention to serious financial problems. It pointed out that Newark hospital was underutilised by 55% at times, that it was closed for admissions after 6 pm, and that many members of the board had resigned as a result. There is no doubt that good has come of that, but on top of all those difficulties, East Midlands Ambulance Service NHS Trust has decided to close Newark ambulance station. I shall say more about that shortly as well.

Where does the problem lie at the moment? First, let me nail a couple of misapprehensions. I am sure that the Minister will not be surprised by my raising them. First, in certain malicious quarters in the town, rumours—more than rumours—have been stoked that the hospital will close. I do not believe that it will close; I see no reason for that to happen. Indeed, Chris Mellor, the new acting chief executive of Sherwood Forest Hospitals NHS Foundation Trust, has made it clear that if the hospital does close, it will be a liability for the next 28 years no matter what, because there can be no withdrawal from the PFI in which Newark hospital is engaged with King’s Mill. Secondly, we still hear forlorn and ill-informed voices talking about the reopening of an A and E unit. No one who understands the problem could think for a minute that Newark will have an A and E unit. That really is not the issue at hand, and, given that the subject will no doubt arise during our continuing conversations, I want to reassure the Minister that, in my opinion at least, it will not happen.

Since the new team has taken over—and I appreciate that it is only a temporary team—some refreshing views have been expressed following the hammer blows of last autumn’s Monitor report. For instance, Eric Morton, who is running the administration of the hospital, albeit temporarily, has responded to a request from me and others for Newark’s minor injuries unit to receive further resources, so that it can at least provide level 2 critical care and become a sort of MIU-plus or A and E-minus—the terms are confusing—and we can be seen as comparable with smaller towns and, indeed, towns of similar size, such as Worksop and Grantham. I have suggested that if a clinical case can be made, there is no reason why such a system should not be introduced at Newark—why, in other words, our services should not be improved.

The GPs with whom I have had some interesting friction over the last couple of weeks—constructive friction, I hope; I say that with the greatest respect to those GPs—have a rather different view. They think that the system would be extremely difficult to implement. I do not know; I cannot judge. I am not a doctor, a clinician or a medical man of any sort. I should greatly appreciate it if the Minister gave me his unequivocal but detached view on exactly how realistic the proposal is, bearing in mind all that I have said about the increasing size of the town, the fact that there seem to be no plans to increase the size of the hospital in line with that, and the fact that it sits on major routes, both rail and road, which are always susceptible to the mass casualties which we see frequently during the year.

[Sir Alan Meale (Mansfield) (Lab)]

I congratulate the hon. Member for Newark (Patrick Mercer), whose tenacity on this issue is well worth the effort and appreciated by many of us who reside in the area covered by the Sherwood Forest trust. I have been closely involved with the trust for many years, and his description and analysis are honest and probably mostly correct. I believe that the Newark part of the trust has been let down badly in recent years by the reorganisation, and his description of the situation that led to the resignation of most of the trust’s board some time ago was an exact and correct one. I assure him that I and other colleagues in the north of the county will do whatever we can to support his effort not only to keep Newark hospital open, but to build on the services that are required for the growing population in that part of Nottinghamshire.

[Patrick Mercer]

I am most grateful to my hon. Friend who sits on the Opposition Benches. His view is always valued by me and certainly by the people of Newark. I have tried to keep politics out of this, and my stand has been consistent under the last Government and this Government. I really appreciate his comments, because this issue, more than anything else, stands above party politics.

One of the benefits of having an upgraded minor injuries unit is that more cases could be dealt with in Newark. GPs and others would be more willing to send patients to Newark, rather than hospitals some way away from the town, and this will have a direct effect on availability of the ambulances—their reaction times and their number—needed to cover Newark and the rural areas. For instance, if we ensured that the transfer times for all green 1 to 4 and urgent minor emergencies could be covered locally, the effect would be felt by East Midlands ambulance service right the way across Nottinghamshire.

That brings me neatly on to the point about EMAS and the service it provides, particularly in Newark town and the rural area. As well as all the other difficulties I have mentioned, which the Minister will recognise, we are currently going through a consultation about exactly how the ambulance service in Newark should be reconfigured. The ambulance service’s boss, Mr Phil Milligan, has helpfully admitted that the ambulance service is not performing to the necessary standard and that there are difficulties with EMAS, particularly in the Nottinghamshire area. The details are there to be seen.

I ask the Minister to look carefully at the need, or otherwise, for a hub inside or adjacent to Newark and at the positioning of the two community ambulance points that we are being promised, again either in or adjacent to Newark. We can have the best hospital in the world in Newark, but, unless we have an ambulance service that can take people with whom it cannot deal quickly, effectively and properly to other hospitals, the health care model will not work. That lies at the heart of the two issues here: the upgrading of the MIU and provision of further critical services, and the improvement —not continuation of the status quo—of the ambulance service. Those two major issues, with all their interlocking threats, lie at the heart of the problem of health care across the Newark area.

It is not all doom and gloom. I visit the hospital regularly—I there last on Christmas day and shall be there again on Friday—and am always impressed by the nurses, doctors, support staff, ambulance drivers and clinicians who deal in Newark. Anybody treated in Newark will say that we have an excellent hospital and that the services it provides are second to none, but we must not allow it to dwindle. When I visit, I am always impressed to find people from Lincolnshire and Derbyshire who are electing to be dealt with in that hospital. That raises the question why, when King’s Mill hospital runs out of beds, as it has over the past couple of months, it is not the customary practice for patients to be taken straight to Newark hospital. Surely if the money follows the patient, too many Newark patients are being taken “abroad”, with the money being paid out to different health trusts around and adjacent to ours, including to King’s Mill. Why does the arrangement not work properly in the other direction? That is exactly the point Chris Mellor made to me when he took over in his new job.

There is no doubt that improvements have been made: a bus service now runs between our hospital and King’s Mill; and we have reopened what used to be called the Friary ward, providing extra beds, particularly for the elderly. Those good things have to be celebrated, not sneered at, as certain individuals in the town have done. I look forward to such improvements being replicated throughout the hospital and in the different authority—the different aegis—of the East Midlands ambulance service.

I also look forward to the meeting that the Minister has kindly agreed to have with me on 4 February—it might be on 5 February, but we will tie the date down. I am grateful to him for that, and I have no doubt that we will talk and talk about these issues. However, I hope I can leave him in absolutely no doubt about the isolation that many of my constituents feel in respect of the hospital. The resources of the hospital and its ability to cope with the sick, the halt, the lame, the deaf and the blind have been seriously diminished over the past couple of years and perhaps even longer. To that end, I ask him not only to address these specific points, but, if he has the time, to visit Newark. I would like him to talk to not only the staff of the hospital and the ambulance service, but to the people of Newark, so that he can gauge for himself how strongly we feel about the hospital, how close it is to our hearts and how we hope it will continue to improve in the future.