Urgent and Emergency Care Review

Paul Goggins Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

I am sorry, that is a completely ridiculous thing to say. I was using the phrase to talk about people who have to go back to the NHS time and again. The whole purpose of the reforms is to make sure that we give a better service to people who regularly use the NHS, and he should understand perfectly well what I was talking about.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

What discussions has the Secretary of State had with his colleagues across government about the need for urgent additional investment in social care? Surely he appreciates that the savage cuts to local authority social care budgets have only added to the pressure on accident and emergency units.

[Mr Hunt]

I find it a little difficult to take a lesson from the right hon. Gentleman, as his Government cut social care funding per head when they were in power and when the economy was in much better shape than it has been since the financial collapse that they caused. If he looks at what we announced this summer, he will know that the Chancellor announced an extra £2 billion of support for the NHS budget going into social care to deal with precisely the problems that he raised.

Hepatitis C (Haemophiliacs)

Paul Goggins Excerpts

Tuesday 29th October 2013 Westminster Hall

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

I am grateful to have the opportunity once again to draw the attention of the House and of Ministers to the injustice that still faces those who in the 1970s and 1980s became infected as a result of treatment with contaminated blood products.

Let me say at the outset that, although I seek in this debate to highlight the particular issues and concerns of those with haemophilia who were infected with hepatitis C, I recognise, of course, that the issues affect others beyond that group. Many haemophiliacs received other infections, HIV in particular, and some were dual-infected with HIV and hepatitis C. Others were multi-infected by the range of other viruses to which they were exposed. Some haemophiliacs were treated with blood taken from donors who later died from CJD. Others did not have haemophilia, but were none the less infected as a result of their NHS treatment. I am sure that some who contribute to the debate later will refer to the experience of those who have been affected in those other ways, and a number of points I will make will have a broader relevance to those people’s situations.

The reason that I selected financial support for people with haemophilia infected with hepatitis C as a topic for debate is simple: it reflects the specific concerns of three of my constituents with whom I have been campaigning on the issue for 16 years. They are Peter Mossman, Fred Bates and Eleanor Bates, who is Fred’s wife. I pay tribute to their determination and the single-minded way in which they have worked with other members of the haemophilia community in pursuit of justice and truth.

I am delighted that you, Mr Dobbin, will oversee our proceedings this morning, although given your keen interest in the topic, I suspect that a bit of you would like to participate.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate my right hon. Friend on securing the debate, which is one of many over the years. Does he, like me, think and hope that the Minister will give positive answers this morning, given the many debates in the past, so that the people affected can experience justice?

[Paul Goggins]

I am grateful to my hon. Friend for that intervention. He makes precisely the point I was moving on to. I welcome the new Minister, the hon. Member for Battersea (Jane Ellison), to the debate and to her new responsibilities. Whatever else she achieves in her time as a Minister—and I hope she achieves a great deal—nothing would be more important than bringing a measure of justice to those who have suffered from such injustice over so many years. Lord Winston described it as the worst treatment disaster in the history of the NHS.

I am delighted that we are joined this morning by so many hon. Members from both sides of the House—particularly the hon. Member for North East Bedfordshire (Alistair Burt), who raised the issue again with the Prime Minister in a clear and determined way a few days ago. I am also pleased that my right hon. Friend the Member for Leigh (Andy Burnham) is in attendance for the start of the debate. It is unusual for a Secretary of State, or shadow Secretary of State, to attend an Adjournment debate in Westminster Hall. His attendance is appreciated; he is keeping a promise made earlier this year. My constituents have asked me to thank him this morning for his willingness to listen—not only now in opposition, but when he was the Secretary of State.

[Andy Burnham (Leigh) (Lab)]

I apologise, Mr Dobbin, for the fact that I cannot stay for the whole debate. I am here to show solidarity with my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins), who has represented his constituents outstandingly, and with Peter Mossman and Fred and Eleanor Bates, whom I met in my office with my right hon. Friend when I was Health Secretary.

I want my right hon. Friend and his constituents to understand that the commitment I gave to them was not a one-off, convenient commitment, but a permanent one. If I were to find myself back in government, that commitment would remain. Does my right hon. Friend agree that there needs to be a further process of truth and reconciliation, so that those concerned have all the answers for which they are still looking?

[Paul Goggins]

I am grateful to my right hon. Friend and I agree with him entirely. There needs to be not only a review of the current financial arrangements, but a deeper search for the truth, to bring justice, an explanation and a profound apology to those who have suffered. I will make some remarks about that later.

I will not dwell this morning on the long history of the injustice, other than to remind the House that of the 4,670 people with haemophilia who were infected with hepatitis C or HIV, at least 1,757 have died from the effects of the viruses; I say “at least” because the number is almost certainly higher than that. Although it was recognised at the time that the use of imported blood products carried a very high risk, treatment continued and patients were simply kept in the dark. As people tried to get to the truth, they were met with a lack of honesty and deep disrespect. Their dogged persistence is remarkable.

[Mr Tom Clarke (Coatbridge, Chryston and Bellshill) (Lab)]

I congratulate my right hon. Friend on his excellent speech, the work he has been doing and obtaining the debate. I know that the debate and the figures he gave relate mainly to England. His late friend and mine—his predecessor, Alf Morris—would be proud of the work he is doing.

Would my right hon. Friend allow me to introduce one Scottish aspect to the discussion? In Scotland, the Penrose inquiry is taking evidence on a wider range of issues than has so far been possible in this House, including about what steps were taken to protect the public, given the clinical knowledge available at the time. Without delaying the action for which he urgently calls, would he take that on board and would the Minister reflect those views?

[Paul Goggins]

I am grateful for my right hon. Friend’s intervention. He is a fine campaigner on a range of issues, but on none more so than this. He did great work with my predecessor, the late Alf Morris. I referred to my 16 years of campaigning with Fred, Eleanor and Peter, but I was, of course, only picking up the baton; Alf had worked with them tirelessly for many years.

My right hon. Friend raises a pertinent point about Penrose, because when he reports no Government will be able sit back and do nothing. Profound questions will be posed by that report and they will apply every bit as much here as they do in Scotland. I am grateful to my right hon. Friend for his timely reminder.

In January 2011, two years after the independent inquiry led by Lord Archer of Sandwell, the Government concluded a review of the support available to those who had been infected with hepatitis C and HIV. Along with others, at the time I welcomed the additional lump sum and annual payments to those infected with hepatitis C who had reached the so-called stage 2—essentially, where cirrhosis has been diagnosed. Other improvements were made, but it was clear to many of us from the outset that for the vast majority nothing would change; they would continue to suffer without the help they needed and were owed. That suffering is deepened by the confusing arrangement of the funds that are meant to help them.

In April, the Minister’s predecessor attended a meeting of the all-party group on haemophilia and contaminated blood. I see a number of right hon. and hon. Members here who were present at that meeting; they will remember that it was fairly stormy and that a range of views were expressed about the funds. Those present will remember what was said. I made a note of some of the comments: “It is utterly bizarre....so many funds”; “a nightmare of bureaucracy”; “something is badly wrong”; and “it is not acceptable to have to go cap in hand”. Those comments were all made by the Minister’s predecessor, leaving those who attended wondering why she had not come to the meeting with solutions rather than joining in the chorus of criticism.

My constituents want one fund for haemophiliacs with hepatitis C, essentially bringing together those parts of the Skipton Fund and the Caxton Foundation that currently administer the limited financial support available. They believe that that would reduce bureaucracy and, more importantly, enable those who manage the funds to increase focus on their specific needs. Although they acknowledge others’ needs, they want and are entitled to a better response than they currently receive.

Within the new fund, the immediate priority should be a complete overhaul of the stage 2 assessment. Currently, the lump sum and annual payments start only after hepatitis C has caused cirrhosis. Three out of four people registered at stage 1 do not progress to stage 2, even though they, too, experience extreme and severe symptoms, including great fatigue and often painful bleeds.

The discrimination between those at stage 1 and stage 2 has been brought home to me through my constituents’ experience. Over the many years I have known Peter Mossman and Fred Bates, I have seen them on good days and bad. I have seen them in pain and distress, but I am aware that their most painful moments have been at times when I have not seen them, because they have not been able to get out of bed and out of the house. They suffer similarly, but one of them is at stage 1 and one is at stage 2.

The discrimination is as incomprehensible as it is unjust, and it has enormous consequences. Those at stage 1 receive a one-off payment of £20,000; those at stage 2 receive an additional £50,000 lump sum plus an annual payment, which is currently £14,191. The Minister should scrap this crude distinction and urgently consider implementing a wider assessment of the health and well-being of each individual. The payments are intended to help people cope with the difficulties that they face, and more should benefit from them.

[David Simpson (Upper Bann) (DUP)]

Like others, I congratulate the right hon. Gentleman on securing this important debate. This issue started in the 1970s, so the problem has now been with us for 43 years. More than 80% of the individuals with a bleeding disorder did not benefit from any ongoing payments for a long time. That must be rectified. The Government must review immediately how the issue is handled.

[Paul Goggins]

I am grateful for the hon. Gentleman’s support for that argument. Differentiating between stage 1 and stage 2 creates a false and discriminatory division. It is not acceptable, and it does not help the many people registered at stage 1 who are not at stage 2 because they have not been diagnosed with cirrhosis, but who still often live in great pain and distress. It is vital that they get the financial and other help that they absolutely need.

Currently, the Caxton Foundation must try through discretionary payments to address the urgent needs of those at both stage 1 and stage 2. The fund simply does not have enough money, and as decisions are made about whose need is greater, recipients feel as though they must beg even for essentials. Ministers will need to obtain and share more accurate data, particularly to assess how many of those registered at stage 1 have died and what the likely financial costs would be of a revised arrangement between stages 1 and 2. That information is vital, but one fund with the resources to make lump-sum and annual payments to all those who need them is an essential first step.

Other issues must also be addressed. People with or without haemophilia who have been infected with hepatitis C should be exempt from the employment and support allowance work capability assessment and placed automatically in the support group. It heaps indignity on injustice to put them through the Atos back-to-work test when work is simply impossible for the vast majority of them. Will the Minister hold urgent discussions with the Secretary of State for Work and Pensions with a view to creating that exemption? It would be compassionate, relatively inexpensive and a clear indication that she means business.

I also ask the Minister to consider the specific needs of those, such as my constituent Eleanor Bates, who care for their loved ones. The Caxton Foundation is meant to help them, but they frequently feel that they are last in the queue. Their lives have also been affected deeply by their partners’ infection, and their needs as carers must be addressed.

Reforming the funds and providing a fairer, more effective system of financial support would be an important step in the right direction, but no debate about the issue should omit the need for a proper acknowledgement of what took place and why, and a profound and sincere apology for the suffering created by the disaster. Campaigners still want a public inquiry, and I support fully their calls for transparency and accountability.

If the Government continue to set their face against a formal public inquiry, they should, in my view, consider other mechanisms established in the recent past to get at the truth of an historic wrong. Two years ago, the Prime Minister commissioned the highly respected lawyer Sir Desmond de Silva to undertake a full investigation into the circumstances surrounding the death of the Northern Ireland solicitor Pat Finucane in 1989. Although this approach was not welcomed by Mr Finucane’s family, Sir Desmond had access to all the intelligence files, Cabinet papers and earlier reports, and concluded that there had been what the Prime Minister described last December as “shocking” levels of state collusion.

In relation to another tragedy that took place in 1989—I am pleased that my right hon. Friend the Member for Leigh is still here—the Hillsborough independent panel, which was welcomed by the families of the 96 people who died at the FA cup semi-final, also demonstrated a determination to get to the truth. As a result of the report, inquests have now been reopened.

Whatever Ministers decide to do in this case must, of course, be discussed with those whose lives have been directly affected. Continuing to do nothing is simply not acceptable. A serious Government-backed inquiry must be held, with access to all the remaining records and the power finally to get to the truth of what happened and why. In addition to fair financial support, those who have suffered so much are still owed a full explanation and a sincere, profound apology.

Health Services (North-West)

Paul Goggins Excerpts

Thursday 11th July 2013 Commons Chamber

[Mr Hunt]

Yes, and I hope that what we have announced today will give my hon. Friend that reassurance. We have announced a future for Trafford general hospital as a centre of excellence for elective orthopaedic work. We have also announced a significant increase in investment in community services, an extra £3.5 million that will pay for community matrons, community geriatricians, a 72-hour rapid response team and better support in A and Es for people with mental health needs. This is a very big step forward, but it is part of the country that has gone further and faster than many others in delivering integrated care. This announcement will take that further and will mean that it stands out as a beacon of what good care can look like in an ageing society.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

May I echo the comments of right hon. and hon. Friends about the lack of notice? It really is outrageous that Members with a constituency interest were not given adequate notice.

May I ask the Secretary of State specifically about the funds that he says have been earmarked for the expansion of the A and E department at Wythenshawe hospital? That is essential, because at least another 4,500 patients will be coming to the A and E following his decision. Can he confirm absolutely this morning that that funding will be made available in full, in advance of any changes? How will the funding be made available? University Hospital of South Manchester is a foundation trust, which means that it cannot receive NHS capital, and it has already borrowed to the limit.

[Mr Hunt]

First, let me say to the right hon. Gentleman that 25 extra patients a day will have to be absorbed by the three neighbouring hospitals to Trafford, so it is not a large number. We want to make sure that all hospitals, including Wythenshawe, which I have visited—it is a superb hospital—are able to absorb that capacity. It is currently meeting its A and E target. The application that has been made for extra capital grant to help it to expand its A and E department will be treated as a priority.

Oral Answers to Questions

Paul Goggins Excerpts

Tuesday 16th April 2013 Commons Chamber

[Dr Poulter]

My hon. Friend is absolutely right, and it is important that a timely conclusion is reached. It is also right, as the hon. Member for Stretford and Urmston (Kate Green) said, that the need to improve community services and preventive care and to provide better support for people with long-term conditions in the Trafford area should be considered.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

I also welcome the Minister’s agreement to meetings. Will he and the Secretary of State carefully consider the likely impact of downgrading accident and emergency facilities at Trafford general and the implications for nearby Wythenshawe hospital? Does the Minister agree that a failure to provide proper facilities at Wythenshawe for the anticipated additional 4,500 accident and emergency patients, the additional admissions stemming from that and the extra beds required could lead to long delays and a diminution in the service?

[Dr Poulter]

My right hon. Friend the Secretary of State has visited Wythenshawe hospital and can pay testament to the high-quality care available there. All the points that the right hon. Gentleman has raised will, of course, be taken into account when a decision is made.

Suicide Prevention

Paul Goggins Excerpts

Wednesday 6th February 2013 Commons Chamber

[Dr McCrea]

I agree with the point that the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) makes. I was talking to folks at the weekend about how young people isolate and withdraw themselves. If we set our minds back to just a few years ago, we remember that we used to see children playing football on the streets, and little girls out with their prams. If we look at our streets today, we see very few children out there. So where are they? They are in their rooms. They are not with their families. In many cases, the internet has taken over their lives, and that leads to the isolation that the right hon. Gentleman mentioned.

When online discussions or communities emerge around harmful behaviours, there is a risk of what the Samaritans describe as an “echo chamber”, in which users reinforce each others’ behaviour and negative feelings about themselves. In a communication to me, the Samaritans stated that

“there are some aspects of the ways that individuals interact with one another online, through social networking sites or online chat rooms, that can place vulnerable people at risk by exposing them to detail about suicide methods or conversations that encourage suicide ideation. Indeed in recent years there have been several widely reported cases of individuals taking their own lives having used websites that have provided explicit information on suicide methods or have been used to facilitate suicide pacts. Restriction of access to information about suicide methods is an established component of suicide prevention. However, this is particularly difficult to achieve online not least because suicide related websites hosted abroad are legal in most other countries”.

The Samaritans have worked in partnership with major companies to develop practical initiatives to support people at risk from suicide online. In November 2010, an initiative was launched in partnership with Google to display the Samaritans helpline number and a highly visited telephone icon above the normal Google search results when people in the UK use a number of search terms related to suicide. The Samaritans also worked closely with Facebook to allow users to get help for a friend they believe is struggling to cope or feeling suicidal. We must express our appreciation to the Samaritans for doing this excellent work.

These pioneering initiatives are to be commended, but more must be done. The Department of Health suicide prevention strategy in England recognises the need to continue to support the internet industry to remove content that encourages suicide and to provide ready access to suicide prevention services. In Northern Ireland, the refreshed “Protect Life” strategy includes a new objective to develop and implement internet guidelines that seek both to restrict the promotion of suicide and self-harm and to encourage the circulation of positive mental health messages.

Online risks must be managed more effectively, and advertisements with hyperlinks to support services must be displayed whenever users discuss or search for information about harmful behaviour if we are to ensure that people in distress can access useful resources quickly.

I acknowledge that the Byron review calls for a shared culture of resilience with families, industry, Government and others in the public and third sector all playing their part to reduce the availability of potential harmful material, to restrict access to it by children and to increase children’s resilience. There needs to be a greater understanding of how young people use modern technologies and communications if they are to be engaged in respect of suicide awareness and prevention, and mental health and well-being.

In conclusion, the causes of suicide are multiple and complex, and they cannot be addressed by any one Government Department working in isolation. Recent years have seen a commitment by Government to deliver suicide prevention strategies throughout the UK, but these must be adequately resourced on a sustainable basis if the progress already made is to be maintained. While we must acknowledge the good work already taking place, there is, of course, always room for improvement, and I believe that efforts must be concentrated on making the internet a safer place for our young people.

I recognise that this is a particularly complex matter and that the challenges it presents are indeed multiple. None the less, they are challenges that must be overcome, for children have the right to be protected from all forms of abuse, violence and harm. Enhanced internet safety is only part of the solution to the growing problem of suicide and self-harm. Through a co-ordinated approach, we must effectively address the issues impacting on emotional health so that we reach a point where so-called “suicide” sites will no longer be attractive to vulnerable individuals and will be made naturally obsolete or unattractive to view. We need to think innovatively about what more can be done across government and the community to reduce the rate of suicide in the UK.

I trust that my right hon. and hon. Friends will deal not only with the issues I have touched on, but with the families of those who have experienced suicide, because they also need help.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

I congratulate the hon. Gentleman on the speech he is making in leading this debate and on the tremendous work he is doing to highlight the issue in this place. He has mentioned the refreshed “Protect Life” strategy, and it is good to know that that strategy is developing under devolution. He may just about remember that I was the Minister with responsibility for health at the time when that was launched in 2006. On the hon. Gentleman’s point, I emphasise and ask him to emphasise how important it is for the families of those with direct experience to be at the core of that strategy because they better understand the issues at stake and can inform us all about the best way forward.

[Dr McCrea]

rose—

Oral Answers to Questions

Paul Goggins Excerpts

Tuesday 27th November 2012 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I thank my hon. Friend for her question, because it touches on a matter of concern to me, notwithstanding the £15 million radiotherapy innovation fund, which, as she said, was announced by the Prime Minister. Indeed, last night, at my ministerial surgery, the hon. Member for Easington (Grahame M. Morris) came along to discuss this very matter, and he raised several important issues, all of which I have this morning taken up with my officials. I am more than happy to meet my hon. Friend to discuss the matter further, however, as I think there is work to be done.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

My 20-year-old constituent, Martin Solomon, has blood cancer and is currently receiving expert treatment at the Christie in Manchester. He needs a stem cell transplant, but finding a match is difficult, especially as he has mixed heritage, and his best chance is from an umbilical cord donation. Will the Secretary of State do two things to help Martin? First, will he reinvigorate the campaign within the black and ethnic minority communities to increase stem cell donations, and, secondly, will he establish a cord collection centre in Manchester, so that mothers can donate cord after the birth of a baby and give young people such as Martin an extra chance to find a match?

[Anna Soubry]

I thank the right hon. Gentleman for raising an important topic. I send my heartfelt sympathies to his constituent. As he identified, this is a real problem. Yes, is the short answer to his first question. I met officials several weeks ago to discuss exactly this problem, as we need to do more in that area. Of course, this is a national scheme. Whether there is a need for a local scheme in Manchester is a moot point, but his constituent will be able to access the national scheme. I am more than happy to discuss the matter further with him.

Oral Answers to Questions

Paul Goggins Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Dr Poulter]

My hon. Friend is absolutely right to highlight the Government’s success in reducing mixed-sex wards not just in his hospital but throughout the NHS—we inherited a very different situation from the previous Government. Medway has been a pioneer in that area and my hon. Friend is right to commend the hospital and I put on record my thanks for all that it is doing.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

T8. Will the Secretary of State take a close personal interest in the proposed changes to the NHS in Trafford? Given the uncertainty about alternative accident and emergency provision, and indeed the delays in commissioning community services, will he ensure that any final decisions are deferred so that they can be considered as part of the wider review planned for NHS services across Greater Manchester?

[Mr Jeremy Hunt]

I should like to reassure the right hon. Gentleman that I take a close personal interest in all reconfigurations because they tend to end up on my desk. In this case, I encourage him to take part in the consultation for Trafford general, which will go on until the end of the month, but I remind him that the Government have put in place four important tests for any major reconfiguration. We must be satisfied that those tests are passed before we approve any reconfiguration, and those include the support of local doctors.

Oral Answers to Questions

Paul Goggins Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Lansley]

The number of cancelled operations rises at certain times during the winter, and it did so during last winter. We are clear about the necessity of ensuring that patients do not have cancelled operations if we can avoid that, and, in particular, that those whose operations are cancelled have access to treatment rapidly thereafter. The key is to make sure, as we have done, that patients have timely access to treatment under the referral to treatment times guidelines, and as the hon. Gentleman will be aware, the average waiting time for treatment in the NHS has fallen since the election, as has the number of people waiting a long time for treatment. That is the strongest measure for ensuring all patients get timely to access to care.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

8. How many patients attended the accident and emergency department at Wythenshawe hospital in the last 12 months for which figures are available.

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

The Department does not collect data on accident and emergency attendances at hospital level. These data are only available at trust level. In the 12 months up to 8 July 2012, there were 108,393 accident and emergency attendances at University Hospital of South Manchester NHS Foundation Trust.

[Paul Goggins]

I am grateful to the Minister for that reply, and I am sure he will want to join me in thanking the staff at Wythenshawe A and E department, particularly given that that colossal number of 108,000 attendances has taken place in a unit originally designed for 70,000 patients. However, if the A and E department at Trafford general hospital is closed, as is currently proposed, that would lead to a still greater increase in the number of patients at Wythenshawe A and E. Given that, is it not essential that the £11.5 million that will be required for extra facilities at Wythenshawe should be made available?

[Mr Burns]

I hope the right hon. Gentleman is not disappointed, but I cannot add anything to the answer I gave in the debate we had last week when he asked that specific question. I can assure him, however, that local commissioners have assessed the impact of the proposed changes at the Trafford and other hospitals, including Wythenshawe. The plans are still at an early stage and are yet to go to public consultation, and I have been informed that local commissioners will continue to review the impact of these changes on the other hospitals, including Wythenshawe. I urge the right hon. Gentleman, other Members whose constituencies are in the area and their constituents to contribute fully to the consultation process.

NHS Services (Trafford)

Paul Goggins Excerpts

Tuesday 10th July 2012 Westminster Hall

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

I am pleased to be able to hold this debate. I am particularly pleased that my hon. Friend the Member for Stretford and Urmston (Kate Green) is with me. I hope she will have the opportunity to catch your eye later in the debate, Mr Robertson, and make a short contribution. I am also pleased to see the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns) in his place, as I know that he takes a particular interest in the NHS in Greater Manchester. I look forward to hearing what he has to say in response to my comments and my hon. Friend’s.

This is a timely debate. It is expected that in the next few weeks, a major consultation will be launched in Trafford on proposed changes to the provision of hospital services in the borough. That is, rightly and understandably, attracting huge interest in the community in Trafford and elsewhere. Last week, 5 July, was the 64th birthday of the national health service. That has particular resonance in Trafford, as it was at Park hospital, now Trafford General hospital in the constituency of my hon. Friend the Member for Stretford and Urmston, where the story of the NHS began. That was the NHS’s birthplace. Aneurin Bevan went to that hospital on that day in July 1948 to launch the national health service, which remains the best health service anywhere in the world.

Last Saturday, my hon. Friend and I joined hundreds of local people in Trafford on a march and rally organised by the campaign to save Trafford general hospital. Many parts of the community were represented, including the two main political parties in Trafford—they were both represented in good numbers—and it was evident that the affection for and commitment to the national health service in Trafford remains, just like everywhere else in the country, as strong as ever.

I think that Aneurin Bevan would be truly shocked, 64 years on from that historic day when he launched the national health service at Park hospital, to learn that the life expectancy of a man who lives in the poorest part of the Trafford borough is 11 years shorter than that of a man who lives in the wealthiest part of the borough. The gap for a woman is six years. That is a gross inequality in health. Our main objective, irrespective of party, must be to reduce such massive and gross health inequalities in our communities.

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

The right hon. Gentleman makes an extremely valid point, in the light of which I have no doubt that he will welcome the fact that, for the first time—and, ironically, under a Conservative Government—there is enshrined in primary legislation a duty on the Secretary of State for Health to work to minimise health inequalities.

[Paul Goggins]

As I have said, Members of all parties should work together, although the legislation the Minister refers to contains many other elements about which I am a great deal more sceptical. In any event, tackling health inequalities should be at the forefront of our minds. If the national health services in Trafford are to be redesigned, that needs to happen in a way that helps us to tackle inequalities that blight lives and bring them to a premature end. We need a system of integrated care in Trafford that is capable of dealing with those issues and that can help us to tackle, in a meaningful way, the difficult problems of heart disease, diabetes, cancer and stroke that blight so many lives and bring them to a premature end. That has to happen. Frankly, the debate about integrated care in Trafford has gone on for long enough. We are signed up to it and it needs to come to fruition.

This time last year, there was great concern in Trafford about the future of Trafford general hospital. There had been serious financial problems at the trust and there was real fear in the community that those who run the NHS and who make decisions intended to privatise the hospital. I am pleased that, eventually, that did not happen and that Central Manchester University Hospital NHS Foundation Trust acquired the Trafford trust, so that Trafford general hospital, Stretford memorial hospital and Altrincham hospital are all still part of the NHS family. That has been widely welcomed throughout Trafford, but it is clear that further changes are on the way. It is vital that we have a full and frank consultation to inform the process of change that will, no doubt, ensue.

One particular issue—and the main focus of this debate—is the likely impact of changes to hospital services in Trafford on the nearby hospitals in the city of Manchester. If the consultation proposes to replace the accident and emergency department at Trafford general hospital with an urgent care centre, there is concern about the implications for Manchester hospitals, particularly Wythenshawe hospital, which is part of the University Hospital of South Manchester NHS Foundation Trust—UHSM—in my constituency.

Many Trafford residents already use hospitals outside the Trafford borough for their NHS treatment. Indeed, I estimate that about 130,000 of the 230,000 people who live in Trafford consider Manchester Royal infirmary in central Manchester and Wythenshawe hospital in south Manchester to be their local hospitals—the hospitals they have easiest access to. It is also true that, if someone suffers a major trauma, a stroke or a serious heart attack, they would not be taken to the A and E unit at Trafford hospital, even if they were a Trafford resident; they would go instead to one of the local teaching hospitals in either Manchester or, perhaps, Salford.

The end result of the geographical link between Trafford residents and hospitals in Manchester—and, indeed, of the requirements of the complex conditions from which people suffer—is that more than half of Trafford residents who need to attend an A and E unit go outside of Trafford in order to do so. That means 25,000 patients who live in Trafford going to Wythenshawe hospital for their A and E treatment. That is a third of all the Trafford residents who require A and E appointments in any one year.

UHSM estimates that if the A and E unit at Trafford general hospital closed, that would mean 7,600 additional patients at Wythenshawe hospital’s A and E unit in any one year. At present, Wythenshawe hospital treats 88,000 people at an A and E unit that was designed for 70,000 patients, so there is considerable concern at the prospect of patient numbers in excess of 95,000 if the changes are introduced. In addition, half of all unplanned admissions of Trafford residents to hospital are admissions to Wythenshawe hospital. It is estimated that, if the changes are introduced and if the A and E department at Trafford general hospital closes, 1,900 additional patients could be admitted, on an unplanned basis, to Wythenshawe hospital. In total, that means an extra 9,500 patients coming in for either A and E or an unplanned admission.

Even if the integrated care system that we all want is able to divert people from hospital and reduce the number of hospital admissions, there would still be significant additional pressure on Wythenshawe hospital. I have seen some estimates of the number of patients who may be diverted from hospital as a result of the changes. Some of the professionals involved in making the assessments predict that, even if the system is successful, a 20% diversion would be heroic. That means that Wythenshawe hospital’s A and E department would need more beds, more theatre time, more examination cubicles, more resuscitation bays and even a new fracture clinic. Although the tariff arrangements may pay for patients’ treatment, the capacity and the facilities will simply not be there, which brings me to the core of my argument: the facilities have to be there if we are to see the kind of major changes that may be proposed. If we do not have additional capacity at Wythenshawe, the consequence will be growing queues and cancelled operations. Nobody wants that to happen.

The case for additional facilities is being made by the UHSM management, but the silence of the response so far from the Greater Manchester cluster is deafening. We need engagement with those who run the cluster, so that we can start to get some proper answers to the problems. It is not as though this is a new issue. Elsewhere in the north-west in recent years, when Burnley’s A and E unit closed down, additional facilities were made available at Blackburn, and, when Rochdale’s A and E department was downgraded, there was investment in the Pennine acute trust. We are asking for the same process to be applied to Manchester hospitals if the A and E department at Trafford general hospital is replaced by an urgent care unit.

As I said, I hope that my hon. Friend the Member for Stretford and Urmston will catch your eye in a moment, Mr Robertson. My constituency next-door neighbour, the hon. Member for Altrincham and Sale West (Mr Brady), who, sadly, cannot be here today, has asked me to say that he fully supports my argument. He has also asked me to say specifically:

“Wythenshawe is the most important acute hospital for most of my constituents and I share the view that any additional demand at Wythenshawe arising from changes elsewhere will need to be properly resourced.”

We are looking today for a guarantee from the Minister that the necessary funding will be made available for the expansion of facilities at Wythenshawe hospital. UHSM should not be expected to take the financial risk to provide those facilities; the money has to come from elsewhere within the NHS.

The Central Manchester University Hospitals NHS Foundation Trust will face similar issues, although perhaps to a lesser extent, because the numbers are not as great. Of course, the relationship between central Manchester and Trafford general is different, because they are now part of the same organisational arrangement. However, the issue will still be there. If more patients are presenting at central Manchester for A and E and unplanned admission, there will be an additional burden that runs the same risk of longer queues, longer waiting times and cancelled operations. I am sure the Minister does not want to see that.

I look forward to hearing what the Minister has to say. I hope he is able to give a positive reassurance—indeed, a guarantee—that the facilities that will be required at Wythenshawe if the other changes go through will be made available. It would be wrong for my constituents who live in Manchester to discover that, because of changes in Trafford, they will face longer queues at A and E and operations being cancelled—that would be unfair. We have to see investment up front. We all want the integrated care model to work, but those patients will not disappear into thin air. Many more patients will be looking for their treatment outside Trafford if the A and E department becomes an urgent care centre. I hope the Minister will engage with that issue, and that we can have a positive assurance from him today.

--- Later in debate ---

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

It is a pleasure to serve under your chairmanship, Mr Robertson. I congratulate the right hon. Member for Wythenshawe and Sale East (Paul Goggins) on securing the debate and the hon. Member for Stretford and Urmston (Kate Green) on her contribution. Like the right hon. Gentleman, she shows a keen and continuing interest in the provision of health care in her constituency and in Greater Manchester. If I do not respond to all the points that they have made—I will seek to respond to as many as possible—I will definitely write to them as quickly as possible after the debate.

As ever with such issues, it is important to not only recognise, but pay tribute to the NHS staff in the constituencies of the right hon. Gentleman and the hon. Lady, as they do so much to improve the health and the well-being of their community day in, day out.

I would like to provide some context to the right hon. Gentleman’s concerns about health services in Trafford. I am sure that he will appreciate that the local NHS, working with commissioners, clinicians and local authorities, needs to determine for itself how best to meet the needs of local people. I am sure that he will accept that it is not for Ministers to intervene at that level. To ensure that all local NHS bodies can do so, we not only protected NHS funding, but actually increased it in real terms, albeit a modest real-terms increase, and that will continue throughout this Parliament. The extra money means better services for patients and, ultimately, healthier communities in the right hon. Gentleman’s constituency and beyond. In his constituency, Trafford primary care trust will receive more than £389 million in the current financial year, which is an increase of £10 million on last year. Manchester PCT will receive more than £1 billion, which is up by more than £29 million on the previous financial year.

Those increases come with a significant challenge, which was referred to by the right hon. Gentleman and the hon. Lady. The NHS as a whole needs to spend its money better. Nationally, it needs to find £20 billion of efficiency savings in the next few years to meet the rising demand for services. The right hon. Gentleman’s party made that commitment when they were in government, and we recognised it as the right thing to do and have adopted what has become known in some circles as the Nicholson challenge.

The hon. Lady asked whether the savings will be reinvested in front-line services. I can give her that commitment: all the quality, innovation, productivity and prevention Nicholson challenge savings will be reinvested in front-line services, not only in Manchester, but throughout the country.

It is to their immense credit that the NHS organisations, teams and individual members of staff are on track to meet that target. In 2011-12, the NHS made £5.8 billion in efficiency savings, which is testimony to the hard work that was put in by staff, managers and administrators throughout the NHS. However, let me be clear that by efficiency savings I do not mean savings that flow straight back to the Treasury, lost to the NHS. Instead, I am talking about efficiency savings where every penny will be reinvested to make care better. Of course, some parts of the NHS therefore face tough decisions, and that is true for the NHS in Trafford.

The right hon. Gentleman is concerned about how service changes in Trafford might affect the quality of services for his constituents. I am sure that he is aware that the NHS in Trafford and Greater Manchester has developed proposals for service changes affecting Trafford general, which are planned for public consultation later this summer. Following the consultation, a final decision about the changes will be made by the end of the year, with plans put into practice by April 2013.

The board of the Greater Manchester PCT cluster approved the proposals at its meeting in June 2012, and they will now be considered by the board of NHS North of England on 12 July 2012. I hope that the right hon. Gentleman understands that I do not want to—it would be wrong to—pre-empt or bias the local process before the consultation. However, I will try to address, as best I can, some of his concerns within that straitjacket.

The former Trafford Healthcare NHS Trust was acquired by Central Manchester University Hospitals NHS Foundation Trust in April 2012, so that the trust could move to foundation trust status, which it could not do independently. The acquisition also ensured that the trust was sustainable, so it could carry on providing health services to the people of Trafford.

Sustainability—the guarantee that the NHS will carry on providing high-quality safe services—is at the root of the right hon. Gentleman’s concerns. Trafford is the birthplace of the NHS, where Nye Bevan famously launched it just 64 years and four days ago. Unfortunately, history is not enough. Every corner of the NHS needs to be on sound financial footing, so that it is a viable service for years to come. That is what we all want, regardless of which side of the House we sit on.

Clinicians and general practitioners across Greater Manchester have developed proposals for a model of care that maintains high standards and improves value for money. Those proposals are called the new health deal for Trafford. Local people and local NHS organisations have been involved. The right hon. Gentleman might be aware that in 2008 the local NHS started work on a new integrated services model that aimed to deliver more care in the community and reduce admissions to hospitals.

The hon. Lady is concerned and wants the proposals for delivering more care in the community to be put in place properly, so that there is no fragmentation or disruption in the delivery of service. I share her concern and agree that such proposals must be part of driving the NHS to a more integrated programme and a policy of delivery and seamless provision of care. That is a challenge for the NHS, as it always is when moving on a part of the delivery of care, but Manchester is acutely aware of that and is working steadfastly to ensure seamless delivery of care and to meet the new challenges of the most appropriate care for patients in Greater Manchester. The right hon. Gentleman is interested in that model.

At the moment, Trafford provider services, which is part of Bridgewater Community Healthcare NHS Trust, delivers community services across Trafford. I understand that Trafford PCT launched a tender exercise for providing community services in Trafford, which should be completed by August 2012.

Clinical commissioners in Trafford are still keen for integrated care to go ahead. For that to happen, clinical services are being redesigned across Trafford, including the secondary care services provided by Trafford general. At the moment, Trafford general provides a full range of acute services, including A and E, as the right hon. Gentleman mentioned. The local NHS worked on several options for services that the hospital might offer in the future, spoke to clinicians, commissioners and public representatives to identify the right model of care and chose the following model. A and E services will be replaced with an urgent care centre, opening between 8 am and midnight, changing to a minor injuries and illness unit within two to three years; acute surgery will not happen there anymore; some parts of acute medicine provision will be removed but some will remain; and in-patient surgery will no longer be provided at Trafford general. The hospital will still provide elective orthopaedic surgery, including the development of an elective orthopaedic centre of excellence, day-case surgery, out-patient services, diagnostics and rehabilitation.

As I mentioned earlier, these proposals were approved by the Greater Manchester PCT cluster in June 2012. I understand that the PCT intends to submit them to the strategic health authority for approval and for a public consultation in which everyone will be able to have their say. I understand that the national clinical advisory team has reviewed the proposals and supports the clinical case for change. I also understand that a series of public events were included in the whole process, so that people could find out more and voice their concerns. There were regular meetings with local health overview and scrutiny committees, and local Members of Parliament have been briefed on what is and was going on.

[Paul Goggins]

I agree that full and frank public consultation is essential, but people need to have all the information. The Minister promised me earlier that he would write to me with further details that he is not able to cover in his speech. Will he undertake now to look in detail at the case made by UHSM for the additional facilities at the accident and emergency unit and elsewhere, at an estimated cost of £11.5 million, and will he comment on that?

[Mr Burns]

I will try to do better for the right hon. Gentleman by commenting on that in the remaining three minutes. I have an answer.

The consultation process has to be carried on within the setting of my right hon. Friend the Secretary of State’s four tests. The right hon. Member for Wythenshawe and Sale East is concerned about the impact of the proposed changes at Trafford on other hospitals, particularly Wythenshawe hospital. Local commissioners have assessed the potential impact of the changes in developing their proposals. However, the proposals are still at an early stage and have yet to go to public consultation. I am informed that local commissioners will continue to look at this issue. Ultimately, when the consultation is over and the responses have been considered and a final decision is made locally, if the local authority overview and scrutiny committee does not share the analysis and agree with the decisions that have been taken, it is open to it to write to my right hon. Friend the Secretary of State to request that he refer the decisions to the independent reconfiguration panel.

The right hon. Gentleman mentioned the £11.5 million for expansion of A and E at Wythenshawe hospital. I can give no such guarantees on that, for the following reason. Local commissioners have assessed the impact of the proposed changes at Trafford on other hospitals, including Wythenshawe. However, the plans are still at an early stage and are yet to go fully to public consultation, which will happen shortly. I am informed that local commissioners will continue to review the impact of the changes on other hospitals, including Wythenshawe. In that respect, I can give a commitment, but I cannot go the whole hog, as the right hon. Gentleman would like me to, and commit £11.5 million, or whatever other figure might arise, because that is not in my gift. These are local decisions freed from ministerial interference, which I think the right hon. Gentleman would agree is the right way forward.

The right hon. Gentleman, the hon. Lady and other hon. Members met Trafford PCT on 6 July 2012 to discuss the proposals. I hope that they found the meeting useful and helpful, and I hope that the right hon. Gentleman and other hon. Members in the area affected by the consultation continue to speak to the local NHS. I urge the right hon. Gentleman and his colleagues, constituents and everyone else who is interested in strengthening and improving the local NHS provision of service in Trafford and Greater Manchester to contribute to the consultation process, so that all views and opinions can be considered and that the decision can flow as a result of direct involvement by those people.

Health and Social Care Bill

Paul Goggins Excerpts

Tuesday 28th February 2012 Commons Chamber

[Mr Lansley]

My right hon. and noble Friend Baroness Williams is now a member of the Liberal Democrat party, and in that respect I am not aware that she has ever transgressed in government.

[Paul Goggins (Wythenshawe and Sale East) (Lab)]

Last year, when the Bill was in its infancy, the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), gave me an assurance that NHS services in Trafford undergoing changes would not be privatised. In the light of all the amendments, is the Secretary of State able to offer me the same assurance, especially given that the Co-operation and Competition Panel in his Department has instructed the local NHS to devise a contract that is divided into six separate lots, with a warning that competition must be prosecuted, otherwise there will be severe consequences?

[Mr Lansley]

I can give the right hon. Gentleman the same reassurance that the Minister of State gave.