Oral Answers to Questions

Patrick Mercer Excerpts

Tuesday 16th April 2013 Commons Chamber

[Mr Hunt]

Professor Malcolm Grant did not say that. What he actually said was that if the NHS considered charging, he would oppose it. I agree with him; I would oppose it, too.

[Patrick Mercer (Newark) (Con)]

I should like to thank the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), for his visit to Newark, which was a huge success. However, it has been pointed out that there is a distinct feeling in Newark that dementia patients are not being treated quite so quickly there as they are in other parts of Nottinghamshire. Will the Secretary of State please give that matter his attention?

[Mr Hunt]

I entirely agree with my hon. Friend the Member for Newark (Patrick Mercer). We must urgently tackle the variation in dementia diagnosis rates. In the end, the litmus test of whether we are able to cope with an ageing population in the NHS will be how we deal with dementia, which now affects one in three people over the age of 65. There is still a lot of misunderstanding about the impact that a good diagnosis and care plan can have, and for the sake of my hon. Friend’s constituents and everyone else, this is an area in which we need to make urgent change.

Oral Answers to Questions

Patrick Mercer Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Hunt]

Thank you, Mr Speaker.

Sir Bruce Keogh accepts the calculations that were made in the proposals put forward by the trust special administrator that the plans would be likely to save about 100 lives a year, because they would allow the hospitals in south-east London to move towards the London quality standard, which would mean reducing excess mortality at weekends. Sir Bruce Keogh accepted that, and I accepted his view of it.

[Patrick Mercer (Newark) (Con)]

rose—

[Mr Speaker]

Order. Many London hospitals and the representatives thereof have an interest in the question. Newark is some distance away, but I feel sure that the hon. Gentleman’s supplementary question will be not about Newark but purely about these London hospitals. On that basis, I am delighted to hear from him.

[Patrick Mercer]

indicated dissent.

[Mr Speaker]

I am disappointed, but never mind. We will hear from the hon. Gentleman ere long on another matter, I feel sure.

--- Later in debate ---

[Norman Lamb]

The Government inherited an institutional bias against mental health in the NHS. [Interruption.] It is absolutely true; when the 18-week target was introduced, nothing was available for those suffering with mental health problems. Mental health patients did not benefit from choice that was introduced elsewhere in the NHS. I completely agree with the hon. Gentleman about the importance of crisis services, and the first NHS mandate has required the Commissioning Board to do work on the availability of mental health services and to ensure that we can introduce access standards so that mental health service users and patients benefit from the same rights as those with physical health problems.

[Patrick Mercer (Newark) (Con)]

First, may I thank you for your earlier guidance, Mr Speaker?

May I thank the Department for its approach to the ravages to which Newark health care has been subjected, principally by the last Government, and thank the Minister for his forthcoming visit to Newark and assure him that mental health care services, which have been diminished in Newark, will certainly be top of the agenda?

[Norman Lamb]

The Minister who will visit Newark is, in fact, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), but I am grateful to my hon. Friend the Member for Newark (Patrick Mercer) for raising this issue and for highlighting the importance of mental health care. The mandate makes it very clear that the Commissioning Board and the NHS must make measurable progress towards achieving parity of esteem by 2015.

Accident and Emergency Departments

Patrick Mercer Excerpts

Thursday 7th February 2013 Commons Chamber

[Patrick Mercer (Newark) (Con)]

I followed with interest the excellent speech of the hon. Member for Barrow and Furness (John Woodcock), and I thank the hon. Member for Ealing, Southall (Mr Sharma) for, along with a number of us, securing this debate.

I hope we can step above the confines of party politics in talking about this crucial matter, which terrifies people, especially the elderly and frail. I shall talk about Newark, of course, but I also want to talk about this matter nationally. The A and E in Newark was closed under the last Labour Government. The difficulties with Newark hospital have continued from that party’s regime into my party’s regime. I do not care about that, however. What I care about most is delivering the right service to my constituents, in particular the elderly, the frail and the vulnerable, who depend much more than other groups of people on A and Es and their substitutes.

[David Morris]

Does my hon. Friend agree that this issue is above party politics?

[Patrick Mercer]

I totally agree. I would never dream of being critical of my hon. Friend, but I do think that this is such an emotive subject that we can be distracted from the realities by the fears these proposals raise.

I hope that I will speak for everybody who lives in semi-rural and remote areas—as I do, living north of Newark—and who depends on hospitals such as Newark. Newark no longer has an A and E. We, like many other parts of the country, are now at least 20 miles away from our nearest A and Es. Our nearest ones are at Lincoln County, Grantham or—extraordinarily and disgracefully—King’s Mill, which is part of the same private finance initiative with which Newark finds itself lumbered.

Newark sits on the A1 and is adjacent to the M1, and it also sits on the crucial and very busy east coast main line railway. The sorts of incidents the hon. Member for Barrow and Furness described in the nuclear industry could also arise on the road and rail networks in and around Newark, yet Newark has no A and E, in common with many towns of the same size in similar areas.

I do not understand why there has been such confusion over my A and E, and I ask the Minister to explain. If this has happened in Newark, I have no doubt that it happens elsewhere, and that it will continue to do so. Let me explain. When I returned to my home town of Newark in 1999, we had a department called “A and E.” Only subsequently did I find out that it was not an A and E at all; it was a sort of minor injuries unit with a big notice above the door saying “A and E.” Nobody had had the political courage to say, “Take that notice down.” That was nothing to do with the Labour Government or the coalition that subsequently came to power; it was to do with the staff in charge of the local NHS, who eventually grasped the nettle and said, “No, this is no longer an A and E.” The fuss caused was disproportionate.

For 10 years, nobody had had the courage to say, “This is not right; we are lying to the people of Newark.” Why was this allowed to happen? The Minister is a fellow Nottinghamshire Member of Parliament, so she knows about what happened at Newark, but I do not understand how A and Es can continue to function like this, and how the protocols of the ambulance crews that service A and Es can cope.

[Jeremy Lefroy (Stafford) (Con)]

Does my hon. Friend agree that we need clear national definitions of what emergency departments do? We currently have many different types of departments that are called A and Es. Some may have major trauma, others may not. Some may do acute stroke and heart attack; others may not. The Government must put in place a classification that is recognised across the country and, as my hon. Friend says, by the ambulance services.

[Patrick Mercer]

My hon. Friend has clearly been reading my notes, as that is exactly the point I am going to make. If we look at the composition of the anti-tank platoon of the 1st Battalion, The Royal Anglian Regiment and the composition of the anti-tank platoon of the 3rd Battalion, The Parachute Regiment—I know that you, too, think a lot about these matters, Mr Deputy Speaker —we will see that they are identical; they have the same weapons, the same troops, the same kit and so forth. There is no difference between them. Why, therefore, do we have this byzantine set of organisations in our NHS, so that an A and E can be a sort of an A and E, perhaps, or not an A and E at all, or an MIU-plus—or have a notice outside its door that is wholly misleading?

Why do ambulance services not have a standard set of operating procedures? Why do they call them protocols? Why do protocols vary? Why are not the staff correctly, and centrally, trained to understand what an A and E delivers, so they can know when they arrive at a hospital that the casualty they are carrying will receive the sort of treatment an A and E should deliver? More to the point, why are those ambulance crews not in a position to understand that, perhaps, town X’s A and E—or MIU, or whatever—cannot cope with a certain sort of injury? As a result of all this confusion, we waste time, resources and lives. This is not the province of party politics. Party politics is not worth a damn when it comes to the lives of our constituents.

I recognise, and most people recognise—even the nay-sayers, the negatives, the people who still want a policeman in every village and the return of the home guard, and even those in Newark who do not understand that we are not going to have a general hospital there—that we are never going to have A and Es, in all their glory, returned to towns the size of Newark. However, despite asking for commonality, I ask the Minister to recognise that there has to be flexibility, although I appreciate that that sits uncomfortably with my last point. The Minister understands the country and its dreadful road systems. May we please take a flexible view of these things? Could clinical cases be assisted in places such as Newark, so that minor injury units can indeed provide other critical services than those they currently provide? We do not need to be hidebound by these things, but we do need to be regulated. We do not need to be narrow-minded, but we do need to understand that different communities have different needs, and that roads in particular impose different travelling times and different strains on ambulance services across the country.

A great deal of noise and fuss is made all the time about the A and E, the critical services and the minor injuries unit in Newark, but that is only a fraction of what our hospitals do. It was widely bruited about in Newark until recently that the hospital was going to close, and yet on Monday I helped to open a new ward there. It is not a critical ward, and it has nothing to do with the minor injuries unit or the A and E; none the less, it is an exceedingly important part of the hospital, nine-tenths of which does not deal with critical matters.

[David Morris]

Does my hon. Friend agree with me that the NHS is actually getting better under this Government?

[Patrick Mercer]

Yes, I do. In my own town, things have improved but, by golly, there is a long way to go before we get to where we need to be. There is one thing that I do not agree with my hon. Friend about. The East Midlands Ambulance Service NHS Trust has had the courage to say that it is not performing properly. I appreciate that it is not part of the NHS trust which forms part of Newark hospital. But patently, A and Es, minor injury units—whatever we are going to call them— cannot work effectively unless the communications between each are properly formulated, properly regulated and properly led.

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.

Children’s Cardiac Surgery (Glenfield)

Patrick Mercer Excerpts

Monday 22nd October 2012 Westminster Hall

[Sir Edward Garnier (Harborough) (Con)]

I beg to move,

That this House has considered the e-petition from Adam Tansey relating to children’s cardiac surgery at the East Midlands Congenital Heart Centre at Glenfield, Leicester.

Mr Hollobone, I welcome you to our proceedings and thank the Backbench Business Committee for agreeing to the debate this afternoon. Parliament can respond to issues of public concern quickly. More than 100,000 names —I think that the total is about 103,000 at the last count—appear on the e-petition that I have referred to.

The new Secretary of State for Health has responded in short order to the facts presented to him, and I thank him for that. In a letter sent by him today to the various councils that referred the Glenfield decision to him, he says that the Independent Reconfiguration Panel will now conduct a full review of the decision by the Safe and Sustainable review. That is most certainly to be welcomed. However, he also says that the IRP will not consider the decision taken by his predecessor, my right hon. Friend the Member for South Cambridgeshire (Mr Lansley), to remove ECMO from Glenfield, as that decision was not taken by the joint committee of primary care trusts; I will say what ECMO means in a moment.

That last statement is illogical and certainly difficult to understand; we are surely entitled to assume that the previous Secretary of State made his decision on the basis of the recommendations from the Safe and Sustainable review. We need to find out, as an urgent priority, whether the new Secretary of State can reverse the decision on ECMO. As I am sure contributors to this debate will demonstrate, it would be sensible for him to do that and I look forward to receiving confirmation from my hon. Friend the Minister that that is going to happen. Cardiac services and an ECMO facility go hand in hand. We know that; I am sure that the Department for Health knows it, and I look forward to hearing in due course from my hon. Friend that she knows it, too.

I have had some intermittent contact over the years with the campaigners supporting the case for Glenfield’s ECMO and children’s cardiac units and I have visited the hospital on many occasions as the MP for Harborough, which is in south-east Leicestershire—most recently, when the additional facilities funded by the Thomas Cook travel company’s charitable foundation were formally opened in May this year. However, owing to the time and other constraints imposed on me as Her Majesty’s Solicitor-General, a post I held until last month, I have not been able to follow the development of the issues surrounding the Government’s reconfiguration of children’s heart services with as much attention to detail as I might have wished.

Now, what does ECMO mean? It stands for “extracorporeal membrane oxygenation”, and it is a highly technical, very clever and hugely successful medical means of recovering people who have both severe heart problems and severe respiratory problems. It might interest you to know, Mr Hollobone, that the only survivor of the house fire in Prestatyn at the weekend—the father of the household—is alive today only as a consequence of his being transported to the Glenfield ECMO unit, where he is under the treatment of Mr Giles Peek, one of the consultants there.

I am happy to report that, despite my absence from the battlefield, two other hon. Members from Leicestershire, my hon. Friend the Member for Loughborough (Nicky Morgan) and the hon. Member for Leicester West (Liz Kendall), have been at the forefront of the campaign to bring this matter to the attention of the Government and the wider public. That is not to say that my hon. Friends the Members for North West Leicestershire (Andrew Bridgen) and for Bosworth (David Tredinnick) have not played their part, nor that the Minister for the Armed Forces, my right hon. Friend the Member for South Leicestershire (Mr Robathan), and the Minister at the Department for International Development, my right hon. Friend the Member for Rutland and Melton (Mr Duncan)—colleagues who, unlike me, continue in Government—have not been working below the radar. Nor do I mean to suggest that my right hon. Friend the Member for Charnwood (Mr Dorrell), the Chairman of the Health Committee, has been a mere spectator—of course, he has not. All of us have been doing our best to ensure that the case for Glenfield is heard in the right quarters. That is also true of the right hon. Member for Leicester East (Keith Vaz) and the hon. Member for Leicester South (Jonathan Ashworth); despite their being respectively the Chairman of the Home Affairs Committee and an Opposition Whip, they have played their part in this campaign.

We have an abundance of parliamentary talent in Leicestershire, but if any praise is due, it is due to my hon. Friend the Member for Loughborough and the hon. Member for Leicester West, who have led the cross-party campaign—I stress that it is cross-party—to ensure that the case we are here to make has been, and continues to be, waged so effectively. The hon. Member for Leicester West is the constituency MP for Glenfield, but she is also the shadow Minister for Health, so she has a double reason for taking an interest in today’s proceedings. It goes without saying that she has been working very hard for her constituents, both human and institutional, in this regard, but she has been doing so in co-operation with my hon. Friend the Member for Loughborough, who is now a Government Whip; my departure from the Government has been more than compensated for by my hon. Friend’s promotion.

However, by convention and practice that means that my hon. Friend is no longer able to speak in Parliament, either here in Westminster Hall or in the main Chamber of the House of Commons. Nevertheless, she is in her place this afternoon and I know that she will continue, as we all will, to support vigorously the medical and ancillary staff at the Glenfield hospital and the patients and their families who benefit from the services provided by those doctors, nurses, technicians, administrators and the many others connected to that great hospital, some of whom are with us in Westminster Hall today.

My constituents Dr Sanjiv Nichani, the senior consultant paediatrician at the Glenfield hospital, who specialises in children’s heart care, and Mr Giles Peek, the director of the paediatric and adult ECMO programme and a cardiothoracic consultant surgeon, have travelled here today to hear the debate and to speak to the Minister afterwards, all being well.

[Patrick Mercer (Newark) (Con)]

May I express my support for the comments of my hon. and learned Friend? As you, Mr Hollobone, and he both know, Newark has all sorts of problems with health care at the moment. Glenfield hospital is crucial to my constituency. I particularly draw the attention of my hon. and learned Friend to the comments by Mrs Pamela Durney, who owes so much to this crucial hospital for her children’s health.

[Sir Edward Garnier]

I am grateful to my hon. Friend for that intervention. His support demonstrates that the issue is not only for Leicestershire, but one that affects patients from right across the east midlands and, I would suggest, from well beyond the east midlands.

Before my hon. Friend the Minister feels a little surrounded, may I thank her for being here to respond to the debate? I also congratulate her, although she must be bored of hearing congratulations, on this first step in what will be a long and successful ministerial career; I say that not as a question but as a statement of fact, and on that basis I am sure that we have won the case. I have no doubt that her response to this debate will act as an accelerant to her progress and provide great hope to those of us who want to see the Glenfield hospital’s ability to save lives continue.

Let me read out part of a letter from some members of staff at the Glenfield hospital:

“As members of the East Midlands Congenital Heart Centre team, we feel that we have a responsibility to our patients to ensure that we make clear our intentions with regards to the implementation of the recommendation of the safe and sustainable review. We are not in a position to leave our homes and families, to move to Birmingham to work. As a team of (predominantly) women, we are (predominantly) second wage earners, with husbands, children and homes. The toll of this review on both our work and home lives has been immense. It has created uncertainty and confusion, as well as intense anxiety. The repeated mantra of the review team that it will all be ok ‘with the help of the EMCHC team’ is meaningless in that we have not even been consulted. Unfortunately, we have been placed in a position where to refuse to relocate is openly criticized as being obstructive by the review. This is not the case. Our patients remain our priority within our working life, yet we have a responsibility to our families which, when push comes to shove, will over ride this.”

They go on:

“This letter is in no way representing a threat. It is an open expression of our concerns, over another assumption made by the review team, and which places us in a position where we are forced to choose between our patients and our families. We are a group of dedicated professionals, who have worked hard to achieve the excellence that we have done. Our patients deserve the best, and we fear that the recommendations will not give them that, and we will be unable to be there to support them.”

In my view, that letter speaks for them all—from doctors through to cleaners—and I hope that the Secretary of State will not forget the work that employees of the national health service do at the Glenfield unit when he comes to decide how best to proceed.

It is proposed that the number of cardiac centres in England be reduced from 11 to seven, and thus they will all be working at full capacity. Can the Minister ensure that in the event of a superbug outbreak, for example, as happened at the Belfast neonatal unit this year, or of a fire, as happened at Birmingham hospital in 2010 and in Leicester in 2011, or of any other catastrophic event in one of the cardiac units under consideration, that the remaining six will be able to cope with the pressure without endangering the lives of the critically ill children and babies in their care?

Glenfield already takes patients not just from Leicestershire, but from across the east midlands, as my hon. Friend the Member for Newark (Patrick Mercer) said. It also receives patients from Birmingham, Southampton, Northern Ireland and elsewhere in the United Kingdom—and even from Scandinavia and mainland Europe.

The Safe and Sustainable cardiac review for children in England has been under way for more than three and a half years. It proposes that the Glenfield unit be closed and its patients and neonatal and paediatric ECMO services be transferred to Birmingham. The Minister and the Secretary of State are, we now know, to revisit the medical and economic evidence that the review board has considered, but I look to them to make a different, better and more logical decision, based on the evidence that is there for all to see.

Four available options emerged from the review, and they were predicated not so much on the cost of providing children’s cardiac services—albeit that cost must play a significant part—as on their sustainability. I will not, for reasons of time, list the options or their components, but option A suggested that there should be seven surgical centres: at Glenfield, at Freeman hospital in Newcastle, at Alder Hey children’s hospital in Liverpool, at Birmingham children’s hospital, at Bristol royal hospital and at the two centres in London, each with four surgeons looking after a minimum of 400 children every year.

Following the public consultation between 1 March and 1 July this year, option A received the greatest support. The consultation was the largest ever public consultation within the national health service, with more than 75,000 respondents; nevertheless, that number is much smaller than the number of people who signed the e-petition that provoked this debate. Option A was supported by six of the 10 health regions in England. It is, at £22 million, the least expensive option—the next cheapest costs £44 million—and it has the added advantage of ensuring shorter travelling distances for families.

None of the four options is perfect or ideal, but the option that includes Glenfield satisfies many of the objective criteria that one would expect of a good solution—not least in respect of Glenfield’s nationally commissioned ECMO services. Given today’s letter from the Secretary of State, it is in that regard that our attention now needs to focus. Glenfield provides both cardiac and respiratory ECMO. Its national ECMO centre has been in operation since 1991, and it treats babies, children and adults from across the country and abroad.

ECMO is an invasive life-support system, which can be used on patients with severe respiratory or cardiac failure. It consists of removing blood from a patient, taking steps to prevent clots from forming in the blood, adding oxygen to the blood and pumping it artificially to support the lungs. There is an increased chance of survival of half as much again when a patient is treated in an ECMO centre rather than in a conventional intensive care unit. The Glenfield ECMO unit has the best results in the world, has more expertise and success than any other ECMO unit in the country and is the only such unit in the country to provide mobile ECMO. We have four national centres for ECMO, and the ideal scenario would be to maintain ECMO services in their current locations.

There is the fact that Glenfield’s ECMO unit was applauded by the national health service during the H1N1 crisis and that Glenfield’s ECMO survival rates are 20% higher than the United Kingdom average. Kenneth Palmer, director of the ECMO unit of the Karolinska university hospital in Stockholm and an international expert on ECMO treatment, wrote to my right hon. Friend the Member for South Cambridgeshire, the former Health Secretary, on 7 July, on learning about the proposal to shut the Glenfield unit:

“You will take over 20 years of experience from one of the world’s...best ECMO units and throw it away...to rebuild it in another place...You cannot move a unit, you can just destroy it and rebuild it with many years of decreasing survival rates and increasing morbidity”.

Mr Jim Fortenberry, paediatrician-in-chief of children’s health care in Atlanta, Georgia, also wrote to my right hon. Friend on 6 July:

“Glenfield has one of the finest ECMO programmes in the world and was the source of the recent CESAR trial, a landmark study that helped sort out the benefits of adult ECMO...The impact on care of attempting to move out this program in toto to another location would be devastating. ECMO is not merely the equipment, but the incredible collective expertise and institutional memory of its entire team”.

Glenfield has, over the years, built up a team of more than 80 ECMO specialists.

Dr Thomas Müller, ECMO co-ordinator at the university medical centre in Regensburg, Germany, wrote to my right hon. Friend on 9 July:

“Glenfield Hospital has won an excellent reputation for their expertise in paediatric and adult ECMO treatment and is deemed to be one of the world’s leading centres. The knowledge and experience of the staff in Glenfield probably is unmirrored in Europe and the US. To my knowledge, Glenfield treats the largest number of patients with severe cardiac and respiratory failure with ECMO worldwide...centres with less expertise certainly will experience a higher mortality. Therefore, in the interest of best patient care the decision to close down the most experienced centre of the UK is difficult to comprehend for somebody from abroad.”

Dr Leslie Hamilton, a cardiothoracic surgeon at the Freeman hospital in Newcastle, has also acknowledged that there is a risk in moving ECMO services from Glenfield.

Glenfield performs about 100 ECMO procedures a year, which accounts for 80% of the neonatal and paediatric activity in England and Wales. As I have mentioned, Glenfield also takes patients from other countries, including Scotland, Sweden, Finland and Ireland. The mortality rate at Glenfield is 20%, compared with 34% in the rest of the United Kingdom. Two additional surgeons have expressed an interest in going to work there. The centre is a popular place to work and can be made more “sustainable”—to use the jargon—with more surgeons and space.

In advancing the case for Glenfield, I do not need to denigrate the facilities and expertise of other hospitals. I see the right hon. Member for Newcastle upon Tyne East (Mr Brown) in the Chamber along with my hon. Friend the Member for Solihull (Lorely Burt), who no doubt represents the interests of the Birmingham children’s hospital. In advancing the case for the retention of the internationally acclaimed ECMO centre in Glenfield, I do not need to undermine the good work and dedication of cardiac and thoracic specialists elsewhere. I do not want to do that, and I would not have the time, even if I thought it a proper or sensible thing to do. It just so happens that Birmingham children’s hospital regularly refers patients to Glenfield. Why? Because unlike Birmingham, which conducts only cardiac ECMO, Glenfield does both cardiac and respiratory ECMO.

Oral Answers to Questions

Patrick Mercer Excerpts

Tuesday 12th June 2012 Commons Chamber

[Anne Milton]

We are doing a number of things, and the most important is devolving responsibility for public health to local areas. It is clear that delivering improvements in diagnosis, outcomes and so on for people with pancreatic cancer relies on different actions in different areas. The important thing is to give local people the power and money to do what they know is right.

[Patrick Mercer (Newark) (Con)]

I am sure the Minister would agree that Newark hospital is performing outstandingly in stamping out inequalities. However, given the expansion of population in Newark that is expected by the end of the decade, will the Minister allow me and some of my constituents to meet her to discuss the inequalities we anticipate?

[Anne Milton]

I am always delighted to meet any hon. Member or hon. Friend and their constituents, particularly if they face inequality concerns.

Oral Answers to Questions

Patrick Mercer Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Burns]

The right hon. Gentleman is absolutely right. There was a significant increase in managers in the NHS in the last two or three years of his Government. Since we came to power, there are just under 15,000 fewer managers and administrators, and 3,700 extra doctors.

[Patrick Mercer (Newark) (Con)]

The Minister is well aware of the reforms to the NHS in my English constituency, but many of my constituents question whether they are getting value for money in view of the expansion of population in Newark over the next couple of years. Will he look again, please, at the Newark health care review?

[Mr Burns]

If my hon. Friend would be kind enough to write to me with specifics on the situation in Newark, I would be more than happy to look into it in detail and respond to him.

Oral Answers to Questions

Patrick Mercer Excerpts

Tuesday 25th January 2011 Commons Chamber

[Mr Burns]

Because I am afraid that the hon. Lady has not read the whole document, in this case from the BMA, or those from other organisations. What many say, including the BMA, on many of the proposals is that they are supportive of them, but naturally the hon. Lady and others cherry-pick those parts that suit their arguments.

[Patrick Mercer (Newark) (Con)]

The Minister will be only too aware of the worries of my constituents in Newark about the future of the hospital. Will he assure me that the internal reorganisation of the NHS will run in parallel with and improve the delivery of the Newark health care review, rather than the contrary?

[Mr Burns]

Yes, and let me reassure my hon. Friend—because last summer I had the pleasure of joining him to visit what is an excellent hospital for the people of Newark—that under our reforms, given the commissioning powers of the GP consortia in the area, they will be able to help strengthen and tailor the health care that the hospital delivers, ensuring that it meets the needs of the people of Newark.

Newark Hospital

Patrick Mercer Excerpts

Tuesday 6th July 2010 Westminster Hall

[Patrick Mercer (Newark) (Con)]

I am most grateful that you are chairing this important debate, Mr Amess. Nottinghamshire is getting a good outing this morning. I hope that the local press appreciate it; it is not at all laid on for their benefit. I thank the Minister for being here. It shows a degree of commitment from his Department as well as from him personally. Not only did he give up his time to make his first ministerial visit to Newark hospital when I asked him, he is also here today. I thank him personally for the great interest and acumen that he is showing. I also thank the hon. Members who are here in support. My local paper, the Newark Advertiser, is interested in the issue and has been supportive, and the “Save Newark Hospital” campaign has been immensely helpful.

This subject is extremely important in my constituency. I will not say that it divides public opinion, because it does not. It is quite simple: I cannot find a single person in Newark who does not support the development and further expansion of the services of a vibrant and successful hospital in a town due to grow by many thousands over the next five to 10 years. The issue does not divide the town; everybody agrees that we need a proper, developing and expanding hospital.

A health care review began 18 months ago, entitled “Help to shape the future of Newark’s NHS”. As a sitting Member, I realised that the three elements involved—Nottinghamshire County primary care trust, Sherwood Forest Hospitals NHS Foundation Trust and the East Midlands ambulance service—needed my responsible and sensible support if we were to improve health service in a town that is growing exponentially.

The process made good progress, but recently we have run into trouble. The subject, quite rightly, became extremely contentious and difficult during the election campaign, and is now attracting more and more energy as people become more concerned about what is going on. One or two mendacious suggestions that the hospital would close were made during the campaign. I do not believe that the hospital will close under this Administration or any other, nor should it, so we can put that suggestion to one side. Those in the town of Newark who hope to frighten individuals with it are both irresponsible and mendacious, but things become difficult when one sees the health care review document—it also says that Newark hospital will not close, which is fine—which says:

“Some services will change, some will be added.”

If we pitch against that the changes that have occurred, we can understand the perception in my constituency. First, we are going to lose our accident and emergency ward. I know that and accept it, but it is alarming to the people of Newark. I will return to that issue in a moment. We have already lost the Friary ward; I will return to that in a moment as well. The blood classification service has been alienated. Pharmacy services have been closed. All sorts of dilemmas exist about the protocols under which ambulances work: for instance, if a child is knocked over within sight of Newark hospital, the ambulance that picks up that child will not take the child to Newark hospital. Nor should it—Newark hospital cannot cope with injured children—but it is hard for a parent who can see the hospital not to wonder why his or her child is being taken to Lincoln, King’s Mill or Mansfield hospitals or to Sutton in Ashfield, for instance. It is a difficult matter of perception. Furthermore, we were recently told that another ward would be closed. I think that my constituents feel that they have been misled rather than informed by the process.

We have had a healthy debate among the three different factions and various town campaigns, but if the Minister will bear with me for a few moments, I would like to apply to what is happening in Newark the four crucial tests laid down by the Health Secretary for the improvement of health services throughout the country. I repeat that a lot of it is a matter of perception. Ambulances were never going to take children to Newark hospital. However, why that has not been properly explained to my constituents, who continue to think that ambulances could do so, is a wholly different matter. I have no doubt that the Minister, who is nodding in agreement, understands that as well as I.

The first of the four crucial tests is that changes should have the support of GP commissioners. Let us test the closure of the accident and emergency ward at Newark hospital. Anybody who bothers to lift the stone and look underneath will understand that Newark has not had an A and E ward for as long as I can remember. There is no debate about whether it should; it meets none of the criteria. Therefore, the sign is clearly misleading and unhelpful, and it must go. However, Newark sits at an extremely important point on the A1, near the dualling of the A46 and the east coast railway line, where there is massive potential for large-scale injuries. If the Potters Bar crash happened in Newark, as it might, Newark hospital could not cope with that many accident and emergency cases.

However, we need something better than what is proposed. I am told—although I treat this with a certain amount of scepticism—that GPs are strongly behind the idea of having a minor injuries unit-plus rather than an A and E ward. I cannot describe how irritating that is, not only to me but to the people of Newark. Most will accept that A and E has no place at Newark hospital, but most believe, and indicated during the consultation process, that we need an urgent care centre, ward or similar at Newark hospital where people can go to receive the care that they need. I believe that that will be provided, so it does not matter much; we are really arguing about what the notice should say. However, I say to the Minister that if we do not get an urgent care ward, centre or whatever, it will spread unnecessary alarm and despondency in Newark. The title “minor injuries unit” suggests cuts and bruises or coughs and sneezes, which is unacceptable and similarly misleading to the public.

Sherwood Forest Hospitals NHS Foundation Trust says that it supports

“the provision of an ‘urgent care, minor illnesses and minor injuries service’ at Newark Hospital, as agreed by local clinicians and supported by the majority of local people during the formal consultation process”

and wishes

“to ensure that the name of the new unit clearly describes the breadth of services provided and ensures that patients access services in the right place, at the right time, first time.”

The next test, however, is that proposed changes must strengthen public and patient engagement. I seek an assurance from the Minister about patients, members of the public, all local GPs and particularly the staff of Newark hospital, who have been enormously supportive, helpful and loyal to their organisation. A horrible rumour circulated in town that staff had been gagged from talking to the press or the Minister. I am sure that the Minister would agree that during his visit last Thursday, not only did we hear some extremely articulate individuals but members of staff were not restricted at all. They and their opinions are terribly important. Will staff at Newark hospital be included in all decisions on the future of the hospital? I ask the Minister how we can achieve that, because clearly we are anxious to help with the process.

The next question I ask the Minister comes under the same heading of strengthening public and patient engagement. I absolutely accept his point that the process has to be led from the bottom up—it must be led from the grass roots and must not be top down and dictated from the top. I know that the Government are committed to maintaining front-line services, but will the Minister assure me that services at my local hospital will not be reduced or diminished for acute and sub-acute patients? I understand that change has to occur—I am not being a stick-in-the-mud about this; I am trying to be as helpful as I can—but that question is crucial. As I have said, not only has the Friary ward been closed, but there is word that another 30 beds will be taken away. That is the equivalent of another ward. If we lose that number of beds, my worry is that very shortly Newark hospital will become nothing more than a cottage hospital. That is the last thing I want, so I ask the Minister to deal with that question.

[Mr Mark Spencer (Sherwood) (Con)]

Does my hon. Friend recognise that Newark hospital is important to not only his constituents, but the constituents of Sherwood and Bassetlaw? It is particularly important to people who live in villages to the east of the A614, many of whom prefer to use the services at Newark rather than travel to the Queen’s medical centre or to King’s Mill hospital.

[Patrick Mercer]

I am grateful to my hon. Friend for that intervention and I congratulate him on his tremendous success at the election, although I regret the departure of his predecessor, who was a close friend of mine. I completely agree: the hospital’s influence extends far beyond Newark. Once the A46 is dualled—heaven help us if that is cancelled—it becomes even more important that the hospital can provide a quick and urgent service to people in the Sherwood constituency. I absolutely accept his point.

The third crucial test is that of greater local clarity and the need to have a clinical evidence base for any proposals that will be made. In the light of that, it is proposed that patients are treated at Lincoln hospital’s accident and emergency department instead of Newark’s. The patient safety record at Lincoln hospital is worse than at Sherwood Forest Hospitals NHS Foundation Trust. Can the Minister shed some light on the matter of patient safety, because I want my constituents, or anyone who is injured, to go to the best possible place? If such a situation exists, can we have some explanation for that proposal?

The last test is that proposals should take account of patient choice. Many in the town of Newark would say that the consultation process was faulty and was not properly delivered. A number of proposals were clearly supported by everybody who responded to the process and therefore my fourth, and almost my last, question to the Minister—I am sorry if I am burdening him with tedious matters—is whether he will investigate the closure of the Friary ward, which is our local psycho-geriatric ward, and consider whether it might be reopened in the future. We have been told that the Friary ward has only been closed temporarily and that we will get psycho-geriatric services back in the near future. It is crucial that that happens.

I respect and understand those four points. The difficulty is that Newark lies right on the edge of Nottinghamshire and Lincolnshire. In theory, we have excellent communications in all four directions, but if we have a national health service based on centres of excellence in places such as Lincoln, Sutton-in-Ashfield and Nottingham, we obviously need communication from Newark to those centres of excellence. I understand that we cannot have one of the several hospitals in Nottingham inside Newark, but we must have an ambulance service that is capable of getting our injured or routinely sick to centres of excellence quickly, efficiently and calmly. I have received a number of reassurances from the ambulance service that those improvements are in hand, but I would be grateful to the Minister if he could dilate upon that a little more. Can he reassure me that we will have an ambulance service that is fit for the 21st century, which can deal with the increasing number of people who live inside the town?

You will be relieved to hear that I have almost finished, Mr Amess. I understand that we must have demonstrably better outcomes for patients and that we must ensure they receive the highest-quality specialist care in specialist centres. I understand that, in many cases, it is better to treat people at home rather than in hospitals. I am not being narrow minded or reactionary about this, but so much of the process has been badly presented to the public, to health care professionals and to patients. If only we could have some clarity on the matter and I could see clearly that the four tests set by the Secretary of State were being met, I would be a lot happier. The matter is crucial to Newark, which sits on the edge of two different local authority areas, and I am extremely grateful to the Minister for the time he has taken to visit the town. However, a strong and vibrant outcome from this process would assure Newark that it does not just sit on the edge of everything; it lies in the heart of the east midlands, which is exactly where it ought to lie.

[The Minister of State, Department of Health (Mr Simon Burns)]

I congratulate my hon. Friend the Member for Newark (Patrick Mercer) on securing this important debate on the future of Newark hospital. As he said, I was fortunate enough to visit the hospital last week. I was extremely grateful to have the opportunity to do so and I was particularly struck by the enthusiasm and dedication of all the staff and management I had the privilege of meeting during that visit. I fully understand my hon. Friend’s desire to ensure his constituents have the best possible health services. My visit last week proved extremely useful in understanding the issues there.

I would like to take this opportunity to outline briefly the Government’s approach to service reconfiguration. We believe that the best decisions are local decisions, and that change should be driven by local clinicians, not imposed by politicians or decided by managers behind closed doors. The Secretary of State has identified four crucial tests that all reconfigurations must now pass. First, they should have the support of GP commissioners; secondly, arrangements for public and patient engagement, including local authorities, should be strengthened; thirdly, there should be greater clarity about the clinical evidence base underpinning any proposals; and fourthly, any proposals should take into account the need to develop and support patient choice.

To ensure the long-term future and sustainability of health service provision in Newark, a range of NHS services in the area have been reviewed. Those include unplanned and emergency care as well as in-patient dementia care. I understand that clinicians from primary and secondary care are in unanimous agreement that Newark hospital cannot provide a full accident and emergency service—I am grateful to see my hon. Friend nodding in agreement to that. They have concluded that, for the sake of patient safety, the hospital should no longer care for patients with acute medical conditions. The hospital should also be named more accurately to avoid public confusion, ensuring that patients go to the right place first time and are not put at additional and unnecessary risk by going as a first destination to a unit that is not able to look after their degree of injury.

The main reasons for that are as follows. First, every tier 1 accident and emergency department needs an intensive care unit, emergency operating theatres and 24/7 anaesthetics to provide back up for the A&E and acute medical conditions. Unfortunately, Newark does not have those and has not had them. Secondly, acute emergencies require specialist skills, which are not and have not been available in Newark. Thirdly, doctors agree that avoidable transfers are associated with poorer health outcomes and worse patient experiences. In 2009/10, the PCT reports, a significant number of patients had to be transferred, many due to a deterioration in their condition.

The local NHS ran a consultation exercise earlier this year to garner the views of local people. The majority were in favour of changes to urgent and emergency services at Newark hospital. I know that there is a view, expressed by some campaigners, that the consultation was rushed, too small to be properly representative of the local community’s views and that the full implications of the review have not been sufficiently drawn out. The NHS must not take local support for granted and must continue to engage fully with clinicians, the public and the council’s overview and scrutiny committee. If a consultation is inadequate, it must be improved and should provide as much relevant information as possible. The overview and scrutiny committee continues to review the implementation of planned changes, which is essential to help to ensure democratic scrutiny.

The strategic health authority has told me that Nottinghamshire County PCT engaged with the overview and scrutiny committee throughout the Newark review and that evidence of that engagement was presented at the PCT board meeting on 17 June. Yesterday, the PCT met with the overview and scrutiny committee to decide the next steps. I understand that it does not intend to refer the proposals to the Secretary of State.

I will turn now to one of the problems with the reconfiguration: the naming of the unit that will deal with injuries, which my hon. Friend mentioned. It is of course important that the facility at Newark hospital is appropriately named. I know that some people would prefer it to be known as a minor injuries-plus unit, while others would prefer to call it an urgent care centre. As he will appreciate, it is not for me to intervene in that issue in a top-down manner. The choice of a name must be agreed locally and should clearly reflect the nature of the facility, so I hope that the matter can be resolved locally through ongoing discussions.

On A and E services, I understand that Newark hospital has never had a full A and E department. Confusion has arisen in part because there is an A and E sign outside the building, but that does not reflect the nature of the services provided inside. Having a local A and E department on one’s doorstep can feel reassuring, but the reality is that receiving the best care does not always mean being taken to the nearest hospital. Some patients might be treated at the scene and others might be taken to Newark for treatment, but those who have suffered major trauma will be best served by being taken directly to specialist units, receiving care en route to the hospital that has the most suitable facilities.

The proposed changes aim to solidify the existing protocols on diverting acute patients to more appropriate hospitals, ensuring that patients go to the right place the first time and are not put at additional and unnecessary risk. I understand that the parents of a young child recently turned up at Newark hospital A and E, incorrectly assuming—understandably—that it was a full A and E department, and the child’s care was delayed as a result. I stress my earlier point about the importance of naming the unit correctly so that local people can understand easily what it does and does not do. I am pleased that during October and November there will be a public education process in Newark to explain exactly what the unit does and where patients should go in the first instance, either to Newark or to another hospital, for appropriate treatment when injured.

[Patrick Mercer]

Would the Minister be kind enough to inform the relevant authorities that I would very much like to be involved in that work? The whole process has been marred by poor communication and bad consultation, so I would be happy to help in any way I can.

[Mr Burns]

I am extremely grateful to my hon. Friend and am sure that there is a role for him to play in helping his constituents in the education process and explaining fully the role of the unit so that it receives appropriate admissions in future.

On the running down of services at Newark, we must be careful not to do the local NHS a disservice through idle talk about the future of the hospital. The proposals focus on giving patients access to safe care for urgent conditions. The people of Newark will continue to access Newark hospital if that is the most clinically appropriate place for their treatment. There will be an increased availability of same-day or next-day outpatient appointments for patients who GPs believe require urgent assessment. If a diagnostic test such as an X-ray is required, that will be done at the same time.

There is also scope for Newark hospital to undertake more planned surgery, such as hip and knee replacements. I know that that is being explored by the Sherwood Forest Hospitals NHS Foundation Trust and the PCT. It is also important to note the important role that Newark hospital plays in rehabilitating patients who are well enough to leave the facilities at Lincoln and Nottingham and can continue their care closer to home. Those proposals would also see an out-of-hours GP service available on site, which I hope my hon. Friend will welcome, as patients who wish to see a GP after midnight currently have to travel up to 20 miles to see one in Mansfield.

I am aware that the local press have reported that Newark hospital is being downgraded. The trust has made it clear that there are no plans whatever to downgrade the hospital. Rather, the plan is to make it fit for purpose and safe for patients. The trust also assures me that it is fully committed to Newark hospital and has no plans to close it. Rather, it sees the hospital as an integral part of local health services. I hope that that goes some way towards reassuring my hon. Friend and his constituents.

He also mentioned Friary ward, which was temporarily closed by Nottinghamshire Health Care Trust to assess how it can best be used in future. I gather that demand for the ward, which has 15 beds, had dwindled to two patients. More people need to be cared for in their own homes, as I suspect many patients would prefer, if that is medically and clinically feasible. I will certainly write to him with more details on what is happening at Friary ward and what will happen as a result of the trust’s assessment of the future of that part of the hospital’s activities.

On the concerns about the public consultation, the evidence I have been given indicates that there was a full engagement with the local community about the proposals that were put out to consultation prior to decisions being reached, although there will always be differences of opinion. I have no evidence to show that that was not a satisfactory and wholehearted consultation, even though I accept that some people remain unconvinced by the proposals before the trust.

In conclusion, local health services will need to evolve and become more efficient, in line with current Government policy. If we want to take people with us, we must ensure that they have full confidence in the decisions being taken and feel that their voices are properly heard. That is what the new arrangements are about. That will not always be easy, but if it is clear, transparent and led locally by clinicians, and if it listens and responds to the voices of local people, it will help to reduce the anxiety my hon. Friend has spoken about today and on which he has so eloquently campaigned over the past few months for the people of Newark. The commitment and tenacity he has shown in fighting for local health services is commendable, and I know that he will continue to engage constructively with the local NHS to ensure that his constituents’ concerns are properly heard.

I trust that something can be done through continued dialogue between all parties, including my hon. Friend, to resolve satisfactorily the differences of opinion on the name of the unit so that there is no confusion about where his constituents should go if they or their family members are involved in an accident and that they get the quickest and finest health care possible in the most appropriate setting.