Debates between Peter Bone and Philip Hollobone during the 2019 Parliament

Fri 10th Sep 2021
Tue 8th Jun 2021

Kettering General Hospital

Debate between Peter Bone and Philip Hollobone
Friday 10th September 2021

(2 years, 6 months ago)

Commons Chamber
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Philip Hollobone Portrait Mr Philip Hollobone (Kettering) (Con)
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It is a delight to see you in the Chair, Madam Deputy Speaker. I thank Mr Speaker for granting me this debate, and I welcome the hospitals Minister and my hon. Friend the Member for Wellingborough (Mr Bone) to their places. My hon. Friend the Member for Corby (Tom Pursglove) would be here, but other engagements sadly prevent him from being here. I thank all staff at Kettering General Hospital, who always perform magnificently but have done so especially over the pandemic period, and in particular Simon Weldon, the magnificent group chief executive.

I commend and thank the Minister for his personal interest over a number of years in this important issue. He visited the hospital on 7 October 2019. He responded to an Adjournment debate that same month, when he outlined plans for a £46 million investment in the new urgent care hub. He also responded to the last Adjournment debate, on 8 June earlier this year, and met the hospital and the three local MPs in February. May I also thank the Prime Minister, who undertook a five-hour nightshift visit to the hospital in February last year?

I welcome the Government’s unprecedented investment in the NHS and their commitment to the national hospital building programme. This has resulted in promised commitments to Kettering hospital of £46 million for an on-site urgent care hub, £350 million in health infrastructure plan 2 funding for 2025 to 2030, and a write-off last year of £167 million of trust debt at the hospital. That is a total investment of a staggering £563 million in Kettering hospital, which is a record-breaking figure. However, the Minister will appreciate that promises are one thing but delivery is another. The problem that the hospital faces is that these two funding streams from the Government—£46 million for the urgent care hub and £350 million for the phased rebuild—are not being meshed together by the Health Department and Her Majesty’s Treasury.

In a way, the problem is a nice one to have. Kettering hospital has successfully won access to these separate funding streams. To explain in a bit more detail, this is £46 million of STP—sustainability and transformation partnership—wave 4 capital, to be spent by 2024, to build a new on-site urgent care hub to replace and enhance one of the most overcrowded accident and emergencies in the country, and £350 million of HIP2 funding, for the period 2025 to 2030, for a phased rebuild of the hospital on the existing site, as one of the 40 designated hospitals in the national hospital programme.

Peter Bone Portrait Mr Peter Bone (Wellingborough) (Con)
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I am grateful for my hon. Friend’s persistence on the issue of Kettering General Hospital, which serves my constituency as well. I had to go to Kettering General Hospital A&E with my son last week, and I can only confirm exactly what my hon. Friend says. It needs to be completely—well, knocked down, really, and a new A&E built. Because we had the Corby urgent care centre, I could go there and then to Kettering hospital, which helped. He will have an urgent care centre at Kettering, and I hope in due course that we will have the same thing in Wellingborough.

Philip Hollobone Portrait Mr Hollobone
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I am sorry to hear about my hon. Friend’s recent visit to the hospital, but I hope he is better now—he certainly looks fighting fit.

The problem that we face at the hospital is twofold. If the hospital goes ahead and builds the £46 million urgent care hub as a stand-alone project, there will not be enough room on site for the future HIP2 works and the hospital will effectively be ruling itself out of the much-heralded national hospital rebuild programme. On the other hand, if the hospital delays the £46 million urgent care hub development until the start of the HIP2 programme in 2025, it will lose the £46 million funding allocation, which expires in 2024, and the urgent care hub will not be built.

If there is a delay to the funding, the biggest headache may well be the failure of the existing, very high-risk, old steam boilers at the hospital site. This is the main thing that keeps the hospital chief executive awake at night. Part of the extra money that is being requested as part of the advance from the HIP2 funding is for a new net zero on-site power plant, so that the old boilers can be replaced and the power systems needed for the HIP2 programme installed. The value-for-money solution is to dovetail the two funding streams by advancing 15%, or £53 million, of the hospital’s already allocated £350 million funding over three years—£6 million in 2021-22, £29 million in 2022-23 and £18 million in 2023-24—and blending it with the £46 million urgent care hub funding.

I wish to make it clear to the Minister that we are not asking for more money; we are asking for an advance of just 15%—£53 million—of the £350 million of HIP2 funding already allocated to the hospital, so as to facilitate a value-for-money start to the hospital’s promised redevelopment.

I have five main asks of the Minister. First, will he confirm that the £46 million STP allocation for the urgent care hub can be combined with the new hospital programme funding scheme to create a single development scheme that can proceed to an outline business case on that basis?

Secondly, will the Minister confirm that the £46 million allocated to the hospital can be used to progress early enabling works that are essential to meeting its delivery timescales?

Thirdly, may we have an early advance of £53 million, spread over the next three years, from the £350 million HIP2 commitment, so that the urgent care hub can be built not as a stand-alone project but as the initial part of the phased hospital redevelopment?

Fourthly, will the Minister confirm that, when delays occur in other larger hospital-rebuilding programmes throughout the country, he will look to create an opportunity for Kettering to receive some of the money to move beyond enabling works before 2025?

Fifthly, will the Minister be kind enough to visit the hospital again? It is two years since his last visit. Kettering General Hospital is only 30 miles from Charnwood, straight down the A6. If he is kind enough to visit, I would be keen to show him the boilers in the power plant, which is a critical part of the required new infrastructure.

Those five asks are not about asking for extra money over and above that which has already been promised; instead, they outline a sensible, flexible, dovetailed approach to funding commitments already given so as to maximise value for money for the taxpayer and ensure that local people get to see as soon as possible the badly needed improvements to our local hospital that we have already been promised. Simply put, the problem is that building the promised urgent care hub is no longer an option on a stand-alone basis, because if it is built as stand-alone project, there will not be enough room on the site for the subsequent HIP2-funding works. The value-for-money solution is to integrate the two funding schemes.

The Minister will know, but I will repeat, that the hospital is ready to go on this work. It owns all the land, so no land deals are required and no extra public consultation is needed. It has written, confirmed support from local planners and the regional NHS. The phased approach would deliver visible and real benefits. It is shovel-ready and has far lower risks than many other hospital-build projects. In developing a whole-site plan that integrates the two funding streams, the hospital has identified the best way of delivering value for money and getting the buildings up, operating and serving local people as quickly as possible.

Kettering General Hospital is unique among the 40 designated hospital rebuilds scheduled to be completed by 2030. First, it already has the Government commitment for a new £46 million urgent care hub, so its future funding is complicated as it comes from two separate funding pipelines; secondly, it is ready to go with an innovative, phased, value-for-money rebuild on land that it already owns, with no planning or consultative hold-ups; thirdly, it serves one of the fastest-growing areas in the whole country; and fourthly, it has one of the most congested A&Es of any hospital—as my hon. Friend the Member for Wellingborough recently experienced—and this needs to be addressed as a matter of urgency. I do not believe that any other hospital in the whole country has such a unique set of circumstances.

Why are improvements at the hospital needed? Kettering General Hospital is a much-loved local hospital. With 500 beds, it has been on its current site, in the heart of the town of Kettering, since 1897—that is 124 years. Most of the residents in the parliamentary seats of Kettering, Corby and Wellingborough were either born there, have been repaired there or, very sadly, have passed away there. There can be few local residents who have not accessed the hospital at some point in their lives. It also has a superb, dedicated, talented and loyal workforce.

The pressure on the hospital is primarily being driven by the very fast population growth locally. The Office for National Statistics shows that we are one of the fastest growing areas in the whole country, at almost double the national average. Kettering ranks sixth for growth in the number of households and 31st for population increase, Corby has the country’s highest birth rate and Kettering Hospital expects a 21% increase in over 80s in the next five years alone.

The area has committed to at least 35,000 new houses over the next 10 years, which is a local population rise of some 84,000 to almost 400,000 people. The A&E now sees up to 300 patients every single day, in a department that is sized to see just 110 safely. Over the next 10 years, the hospital expects the number of A&E attendances to increase by 30,000, equivalent to almost 80 extra patients every day. That is why the improvements are so desperately needed.

The big problem at Kettering Hospital is that the A&E is full. It was constructed in 1994 to cope with 45,000 attendances each year. Now, it is already at about 100,000 attendances a year, which is well over 150% of its capacity. By 2045, 170,000 attendances are expected.

The solution, which everyone agrees, including the Government, is for a new urgent care hub facility, costing £46 million. It would be a two-storey, one-stop shop, with GP services, out-of-hours care, an on-site pharmacy, minor injuries unit, social services, mental healthcare, access to community care services for the frail elderly and a replacement for the A&E. All the NHS organisations locally, as well as NHS Improvement nationally, agree that this is the No. 1 clinical priority for Northamptonshire.

I am glad that the Government have recognised the hospital’s superb business case for this fit-for-purpose emergency care facility, and that it will meet local population growth for the next 30 years. All the local health and social care partners have been involved in its design, and local people need it to get the local urgent care service that meets Government guidance on good practice. When built, the facility will ensure that people who come to the hospital are seen by the right clinician at the right time, first time.

I also warmly welcome the Government’s inclusion of the hospital on the list of 40 hospitals in the national hospital rebuilding programme, and the funding kicks in from 2025. That is important for Kettering Hospital because 70% of the buildings on the main site are more than 30 years old, there is a maintenance backlog of £42 million and 60% of the hospital estate is rated as either poor or bad.

The hospital plan for the redevelopment of the site, as part of the HIP2 programme, offers a phased approach over a number of years, with the extra ward space provided by the funding to be built on top of the urgent care hub. This is in contrast to a number of other hospitals in the HIP2 programme that are seeking an all-in-one-go funding package.

Kettering Hospital is not asking for its HIP2 allocation in an up-front £350 million, all-in-one-go lump sum; instead, it is seeking a modular, annual funding requirement for what would be a phased and, crucially, value-for-money rebuild up to 2030. Out of the £3.7 billion national hospital rebuild programme, just £6 million would be needed this year for Kettering Hospital to get the project started, and just £29 million would be needed next year.

I know Her Majesty’s Treasury is currently completing a commercial strategy for all the hospital rebuilds, so as to standardise hospital redesign, to secure key commercial efficiencies in procurement and to address digital and sustainability requirements. Kettering Hospital is 100% committed to these Treasury objectives. Value for money is extremely important in delivering the hospital rebuild programme across the country, and if Kettering Hospital’s innovative and sensible approach could be matched with sufficient flexibility from the Government in applying the relevant funding streams from the Department of Health and Social Care and Her Majesty’s Treasury, it would be an exemplar hospital redevelopment that others could follow.

I urge the Government, both the Department of Health and Social Care and Her Majesty’s Treasury, to do the sensible thing and dovetail together the two presently separate funding streams for Kettering Hospital not only to optimise value for money for the taxpayer but to deliver sooner, rather than later, the urgent improvement of Kettering General Hospital that all local residents need, wish and deserve to see.

Kettering General Hospital

Debate between Peter Bone and Philip Hollobone
Tuesday 8th June 2021

(2 years, 9 months ago)

Commons Chamber
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Philip Hollobone Portrait Mr Philip Hollobone (Kettering) (Con)
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What a joy it is to see you in the Chair, Madam Deputy Speaker; thank you for staying for the Adjournment. I thank Mr Speaker for granting me this debate and welcome the Minister to his place. I also welcome my hon. Friend the Member for Corby (Tom Pursglove), who is a superb representative for his constituents, but who unfortunately, as he holds the high office of the Government Whip, is not allowed to speak in this place. I also thank all the staff at Kettering General Hospital, in particular Simon Weldon, the superb group chief executive, and Polly Grimmett, the director of strategy.

I thank the Minister for the personal interest that he has shown over a long period in Kettering General Hospital. He visited the hospital on 7 October 2019. He responded to an Adjournment debate on the hospital on 23 October 2019, when he announced £46 million of new funding for the proposed urgent care hub, and on 3 February this year he met with the hospital and my hon. Friends the Members for Wellingborough (Mr Bone) —who I welcome to his place—and for Corby. I would also like to thank the Prime Minister, who spent five hours on a night shift at Kettering General Hospital in February 2020.

I welcome the Government’s unprecedented investment in the NHS and their commitment to the hospital building programme, which has resulted in promised commitments to the hospital of £46 million for a new on-site urgent care hub, £350 million in health infrastructure plan 2 funding for 2025 to 2030, and a write-off last year of £167 million of trust debt at the hospital. However, promises are one thing and delivery is another. The problem that the hospital faces is that these two funding streams from the Government—£46 million for the urgent care hub and £350 million for the phased rebuild—are not being meshed together by the Health Department and HM Treasury. The danger is that, as a result, the promised investment in the hospital faces potentially serious delays.

The dilemma is this: if the hospital proceeds with the £46 million urgent care hub build as a stand-alone project, there will not be room on the site for the HIP2—health infrastructure plan 2—development post 2025. On the other hand, if the hospital waits for the HIP2 funding, it will lose its £46 million urgent care hub funding commitment, and the urgent replacement for the hospital’s overcrowded A&E may never happen.

I have four main asks of the Health Department and HM Treasury: first, permission for the hospital to draw down on the £46 million urgent care hub funding commitment so that work can start on the initial works required for the project; secondly, permission for the hospital to proceed with the preparation of its outline business case for the HIP2 investment expected after 2025; thirdly, an early advance of £52 million, spread over the next three years, from the £350m HIP2 commitment, so that the urgent care hub can be built not as a stand-alone project, but as the initial part of the phased hospital redevelopment; and, fourthly, that the Secretary of State for Health honours his welcome commitment made on the Floor of the House earlier today, in response to a question of my hon. Friend the Member for Wellingborough (Mr Bone), to meet the three hon. Members for north Northamptonshire to get the issues sorted out. The Secretary of State said: “Nothing gives me greater pleasure than making stuff happen, so I would be very happy to meet…to make sure we can get this project moving as soon as we can.”

Those four asks are not about asking for extra money over and above that which has already been promised. Instead, they outline a sensible, flexible and dovetailed approach to already given funding commitments, so as to maximise value for money for the taxpayer while also ensuring that local people get to see as soon as possible the badly needed improvements to our local hospital, which we have already been promised. Simply put, the problem is this: building the promised urgent care hub is no longer an option on a stand-alone basis. If it is built as a stand-alone project, there would not be enough room on the site for the subsequent HIP2 funding, so the value-for-money solution is to integrate the two funding streams.

Kettering General Hospital is ready to go. It owns the land, so no land deals are required, and no extra public consultation is needed. It has written support from local planners and the regional NHS. It is a phased approach that would deliver visible and real benefits. It is shovel ready and has far lower risks than other hospital build projects. In developing this whole-site plan—integrating the urgent care hub and HIP2 funding streams—the hospital has identified the best way of delivering value for money to get the buildings up and operating, serving local people.

Kettering hospital is unique among the 40 designated hospital rebuilds scheduled to be completed by 2030. First, it already has a Government commitment for a new £46 million urgent care hub. Therefore, its future funding is complicated as it comes from two separate funding pipelines. Secondly, it is ready to go, with an innovative, phased and value-for-money rebuild on land that it already owns, with no planning or consultative hold-ups. Thirdly, it serves one of the fastest growing areas in the whole country. Fourthly, it has one of the most congested A&Es of any hospital in the land, which needs addressing as a matter of urgency. I do not believe that any other hospital in the country has that unique set of circumstances.

Peter Bone Portrait Mr Peter Bone (Wellingborough) (Con)
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Does my hon. Friend recall that this project in effect started before my hon. Friend the Member for Corby (Tom Pursglove) was elected in 2015? It has widespread cross-party support. If this were a business, without doubt a pre-payment would be made, because it would save money in the end and get things done. Are we just caught in a silo, with the Treasury here and the health service there? They must somehow mesh together.

Philip Hollobone Portrait Mr Hollobone
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My hon. Friend is quite right. This is not a difficult problem to solve. It requires a political solution and it requires a decision by Health and Treasury Ministers acting together.

Kettering General Hospital is a much loved local hospital. With 500 beds, it has been on its present site in the heart of the town of Kettering since 1897—that is 124 years. There cannot be many hospitals that have such a record. Most of the residents in the parliamentary constituencies of Kettering, Corby and Wellingborough were born there—as my hon. Friend the Member for Corby was—have been repaired there or, sadly, passed away there. There can be very few local residents who have not accessed the hospital at some point during their lives. It also has a fantastically dedicated, talented and loyal workforce.

The pressure on the hospital is being driven primarily by very fast local population growth. The Office for National Statistics has shown that we are one of the fastest growing areas in the whole country, at almost double the national average. The borough of Corby is the fastest growing borough outside London. In the last census, out of 348 districts across the country, Kettering was No. 6 for growth in the number of households and 31st for population increase, while Corby has the country’s highest birth rate.

Kettering General Hospital expects a 21% increase in over-80s in the next five years alone. The area is committed to at least 35,000 new houses over the next 10 years. That means a local population rise of some 84,000 to almost 400,000 people. The A&E department, which is sized to see 110 people a day safely, now sees up to 300 patients every single day. Every day, 90 patients are admitted to the in-patient wards from A&E, and the hospital expects the number of A&E attendances to increase by 30,000 over the next 10 years, which is equivalent to almost 80 extra patients every day. That is why the promised improvements are desperately needed.

The big problem at Kettering General Hospital is that the A&E department is full. It was constructed in 1994 to cope with 45,000 attendances each year. It now has around 100,000 attendances a year, which is well over 150% of the department’s capacity, and by 2045, 170,000 attendances are expected at the same site. The solution to that pressure is for an urgent care hub facility, costing £46 million, to be constructed on the site. It would be a two-storey, one-stop shop with GP services, out-of-hours care, an on-site pharmacy, a minor injuries unit, facilities for social services and mental health care, access to community care services for the frail elderly, and a replacement for our A&E department. All the NHS organisations in Northamptonshire, as well as NHS Improvement regionally, agree that that is the No. 1 clinical priority for Northamptonshire.

The A&E department at the hospital was visited five years ago by Dr Kevin Reynard of the national NHS emergency care improvement programme. He said:

“The current emergency department is the most cramped and limited emergency department I have ever come across in the UK, USA, Australia or India. I cannot see how the team, irrespective of crowding, can deliver a safe, modern emergency medicine service within the current footprint.”

I am glad that the Government have recognised the hospital’s superb business case for this fit-for-purpose emergency care facility that will meet local population growth for the next 30 years. It has been developed with all the health and social care partners across the county so that patients can get a local urgent care service that meets all the Government guidance on good practice, ensuring both that they can get the care that they need to keep them safely outside hospital if necessary, and that if they come into hospital, they are seen by the right clinician at the right time and first time.

In announcing the award of £46 million for the new urgent care hub in the debate on 23 October 2019, the Minister said:

“My officials and NHS England will be in touch with the trust to discuss further details, in order to ensure that funds are released and that work starts on the project as swiftly as possible. I am conscious of the urgency that my hon. Friend the Member for Kettering highlighted.”—[Official Report, 23 October 2019; Vol. 666, c. 31WH.]

That announcement was 20 months ago, and the hospital has still not had permission to draw down that funding. That is why my first ask of the Government is to grant permission for the funding to be drawn down so that the project can start.

I warmly welcome the Government’s inclusion of Kettering General Hospital on the list of 40 hospitals for health infrastructure plan 2—HIP2—funding from 2025. That is important for Kettering, because 70% of the buildings on the main hospital site are more than 30 years old, and there is a maintenance backlog of £42 million. Some 60% of the hospital estate is rated as either poor or bad.

The hospital plan for the redevelopment of the hospital site as part of the HIP2 programme offers a phased approach over a number of years, with the extra ward space provided by this funding to be built on top of the urgent care hub. That is in contrast with a number of other hospitals in the HIP2 programme that are seeking all-in-one-go funding packages. The hospital is not asking for its HIP2 allocation in an up-front £350 million all-in-one-go lump sum. Instead, it is seeking a modular annual funding requirement for what would be a phased and value-for-money rebuild up to 2030. Surely, out of a £3.7 billion national hospital rebuild programme, providing just £6 million to the hospital this year to get the project started and £29 million next year is not beyond the wit of man.

I know that the Treasury is currently completing a commercial strategy for all the hospital rebuilds so as to standardise hospital redesign, secure key commercial efficiencies in procurement across the country and address digital and sustainability requirements. Kettering General Hospital is fully committed to those Treasury objectives. Value for money is extremely important in delivering the hospital rebuild programme across the country, and if Kettering General Hospital’s innovative and sensible approach was matched with sufficient flexibility in applying the relevant funding streams from the Department of Health and Social Care and the Treasury, Kettering General Hospital could be an exemplar hospital redevelopment that others could follow.

I am using this debate to urge the Government—both the Department of Health and Social Care and HM Treasury—to do the sensible thing: dovetail the two presently separate funding streams for Kettering General Hospital so as to not only optimise value for money for the taxpayer but deliver sooner rather than later the urgent improvements at the hospital that all local residents need and wish to see.