Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

I recognise the picture that the hon. Lady paints. I did have an excellent visit to the hospitals, and they are doing some fantastic work on patient safety. Collaboration between the partners in the local health economy is much better than it has been, but there are financial pressures. We are going to have a million more over-75s in this country in 10 years’ time, and that is why we have committed to increasing the resources going into both the NHS and the social care system.

[Peter Heaton-Jones (North Devon) (Con)]

The NHS sustainability and transformation plan review in my region recently recommended that all acute services be maintained at North Devon District Hospital. That was a very welcome decision and a victory for the community. Will the Minister work with me and local NHS managers to ensure that the clinical need that has been identified can be fully met?

[Mr Dunne]

I share my hon. Friend’s ambition. I greatly enjoyed visiting his hospital in Barnstaple during the summer, and I have been impressed by the way in which the four trusts in Devon that provide acute services have decided to come together and provide a collaborative pool of, in particular, emergency department staff to ensure that each hospital is adequately covered and there is continuity of service. I think that is a model that we can adopt elsewhere.

Ambulance Services (Devon)

Peter Heaton-Jones Excerpts

Wednesday 12th July 2017 Westminster Hall

[Dr Wollaston]

I thank my hon. Friend for his intervention. Of course, as we know, demand can escalate considerably during the peak summer times, but many of our roads are single-track ones with passing spaces, and it can be very difficult to get an ambulance resource to the scene in a timely manner.

My first point to the Minister is that there are no concessions for rurality; there is no funding premium to allow SWASFT to meet the extra demands that it faces. In fact, overall, its funding has fallen by 2.46% per incident in 2017-18, compared with 2014-15. It has to meet the huge increase in demand with shrinking resource, in what is one of the most challenged areas in England because of rurality. I would like the Minister to acknowledge that key point and the impact of rurality on response times.

My second point to the Minister is that although overall SWASFT is doing a good job in meeting the performance target of 75% of category 1 calls receiving a response within eight minutes, that does rather mask the picture in the most rural parts of the area. Let us take the South Devon and Torbay clinical commissioning group area as a whole, for which we have some data that show that it just meets the target, with the figure of 75.65% of calls. If we look at the breakdown for the Totnes constituency, we see that during the past three months the figure has been 61%, so my point to my hon. Friend is that, when considering a county such as Devon, he should look not just at the overall, top-line figure, but at the impact in the most rural parts of the constituencies. I hope that he will ask for that as an ongoing measure, as a response to this debate.

[Peter Heaton-Jones (North Devon) (Con)]

There is a specific example of exactly what is being described by my hon. Friend in my constituency of North Devon—the situation in Lynton and Lynmouth, the twin villages right on the north coast. At the beginning of last week, the South Western ambulance trust withdrew what was in effect a rapid-response paramedic vehicle that was traditionally stationed in Lynton and Lynmouth, specifically because of the rurality and the distance from anywhere else of those two villages. There is a lot of concern in the community because that service has been withdrawn. I pay tribute to the CCG, which is looking for an alternative arrangement, but the fear is that there is still a gap, and the response time, because of the distance of Lynton and Lynmouth from everywhere else, is key. May I ask my hon. Friend the Minister, through my hon. Friend the Member for Totnes (Dr Wollaston), to consider that particular example?

[Dr Wollaston]

I thank my hon. Friend for that intervention. Likewise, very considerable concerns have been raised in my constituency about the withdrawal this month of rapid-response vehicles from Dartmouth and Kingsbridge and in Totnes. I understand the reasoning that double-crewed ambulances can provide the conveyance that people need to hospital and that utilisation of the single vehicles is less—about 24%. I understand the rationale behind it, but equally I ask the Minister to respond to precisely the concerns that my hon. Friend the Member for North Devon (Peter Heaton-Jones) has raised, because the worry in communities such as mine is that once the double-crewed ambulances are conveying a casualty to an urban centre, they tend not to come back again, whereas the rapid-response vehicles did. There is a genuine concern about how we will ensure that the double-crewed ambulances come back.

As I have said, I welcome the increase in the double-crewed ambulance resource as the rapid-response vehicles come away, and I am aware of the data whereby efforts are being made to provide a reassuring response that actually the number of hours in total will increase. However, that change is just coming in this month, and I would like the Minister to assure the House today that he will look very closely at the data as they emerge over the next few months, to ensure that those vehicles are returning to the rural areas, because I fear that otherwise we will again see that SWASFT is meeting the overall, top-line target for the entire patch, but that will be at the expense of rural constituencies such as my own, where there will simply be a worsening of the response. We need to look at that very closely, and I would like the Minister to assure me that, following this debate, he will specifically ask SWASFT to ensure that there is a response available and it does not worsen in the rural parts of Devon.

I would also like to address the matter of the workforce, which is an issue across the NHS as the Minister knows. Within our paramedic resource there is actually an 11% turnover of paramedic staff, in part because they are such a skilled and valued workforce, which means in many cases they are being attracted into other parts of the NHS, for example to work in casualty departments and minor injuries units. Everyone can understand that, but we need to make sure that we are recruiting and retaining within our blue light response services as well. For example, there are currently about 100 vacancies over the whole of the SWASFT area, and 16 whole time equivalent vacancies in Devon alone. What is the Minister doing to work alongside Health Education England to address the workforce issues? I will again make the point I have done in previous debates about the impact of the pay cap on the recruitment, retention and morale of the workforce. Again, I call on Ministers to consider giving the pay review bodies greater flexibility to be able to increase the rates of pay.

We know that there are pressures on our ambulance services, but we cannot view them in isolation. I would like the Minister to consider the impact that this is having on our other blue light services, particularly the police. They have raised some worrying concerns with me about not only the amount of time that they are having to spend on scene—as they did the other day in the incident that I described—while they wait for an ambulance resource to arrive, but the fact that on occasion they themselves have to take people to hospital who should really be conveyed by an ambulance resource. To clarify, in May this year there were 226 incidents where an ambulance was requested but no ambulances were available to be assigned in the Devon and Cornwall police area, and in June there were 158. These long waits are having a knock-on on the police’s ability to carry out their other duties, and that should concern us all.

Contaminated Blood

Peter Heaton-Jones Excerpts

Tuesday 11th July 2017 Commons Chamber

[Peter Heaton-Jones (North Devon) (Con)]

This is also the first time I have had the pleasure of speaking in this House with you in the Chair, Madam Deputy Speaker, so may I welcome you to your position? I also echo what has been said in thanking the hon. Member for Kingston upon Hull North (Diana Johnson) for being able to secure this important debate. Let me also say that it was a pleasure to be in the Chamber for the maiden speech by the hon. Member for Oxford East (Anneliese Dodds). I congratulate her on taking her seat.

I am not going to take up too much of the House’s time in this debate, but I want to draw the House’s attention to the case of a constituent of mine, one that I have raised in this House before; I have been fortunate to be called to speak on this issue in a number of different debates. My constituent Sue Threakall has been communicating with me for more than two years. She was one of the first people to come to me after my election in 2015 to raise this issue, and this was one of the first cases I decided to take up and follow. Other colleagues have made this point, but I, too, have to feel a sense of shame that I was not aware of the background to this story before I started to hear some of the personal testimony.

I merely intend to read out part of an email that Sue Threakall sent to me yesterday, when it became clear that this emergency debate was going to be held—I have been in constant touch with her. She asked me briefly to share with the House her story, and I am doing so because it says in more powerful words than anyone else could why it is so important that we have this full public inquiry. At the time of this email, we were not aware of the Government’s announcement, which I warmly welcome. I pay tribute to not only my hon. Friend the Minister of State, but the Prime Minister for driving this forward.

Let me share with Members what Sue Threakall wrote to me in her email yesterday:

“My husband, Bob Threakall, died in 1991, aged 47. Despite being a severe haemophiliac, he had lived a relatively normal life until he was given commercial blood products. Following that his health, and his life, followed a deep and dark downhill path.

He contracted Hepatitis B, Hepatitis C and HIV. He died a terrible death, which I believe was wholly avoidable.

He was NEVER informed about the risks known at the time of imported Factor 8.

He was NEVER told he had Hepatitis C, and indeed I only found out myself a few years ago.

His HIV test result was withheld from him for many months, thus leaving me at risk. I was fortunate...many women were not.

From Autumn 1990 until two days before he died, months later, with shadowing on his lungs and despite being at high risk of contracting pneumonia, he was left UNTREATED.

He never had the chance of seeing his eldest son married, nor met his grandchildren.

He didn’t see his middle son graduate from university.

He didn’t see his youngest son pass his 11 plus and go to grammar school.

Following his death our family basically fell apart. Grief sent us in different directions and for many years we were completely broken. The fallout is still there today, bubbling away, just below the surface.”

Sue writes in conclusion:

“It is my firm opinion, following campaigning and researching since 1985, that haemophiliacs were used as guinea pigs. I believe that, had people acted differently at the time, Bob, and so many others, would almost certainly be alive and well today.”

I found Sue’s email extremely moving, and I have repeated her words to the House today because they say better than almost any of the rest of us could why the decision that has been taken by the Government to hold this public inquiry is so welcome. I will be following this process carefully to ensure that the form of the inquiry is the best it can be, so that victims and survivors, such as my constituent, can get the truth, fairness and justice that they deserve.

Health and Social Care Budgets

Peter Heaton-Jones Excerpts

Tuesday 14th March 2017 Westminster Hall

[Peter Heaton-Jones (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate the hon. Member for Hackney South and Shoreditch (Meg Hillier) on securing this important debate. It will not surprise colleagues to hear that I am unashamedly here to speak up for Devon, and North Devon in particular. We are part of the south-west, and it is significant, looking around the Chamber, to see so many Members from the south-west from all sides. It is because we are concerned that rural areas in the south-west are not getting our fair share in the distribution of available funds.

I join my hon. Friend the Member for Totnes (Dr Wollaston) in unequivocally welcoming the extra money that the Government have put into health and social care. The £10 billion extra for the NHS over this Parliament and the £2 billion for social care announced in the Budget are extremely welcome, as are the extra revenue-raising powers that have been given to local authorities for social care, and I thank the Minister and his team for those.

However, we need our fair share in areas such as Devon and the south-west. As has been mentioned by the right hon. Member for Exeter (Mr Bradshaw), we face a sustainability and transformation plan that is causing huge concern among my residents in North Devon and among those of other colleagues here from Devon constituencies. There are particular concerns about the future of some acute services at North Devon district hospital. I have said before and I will say again that any cuts to services at that hospital would be absolutely unacceptable. That is because of what I describe as the three Ds: distances, demographics and deprivation. I will not rehearse the arguments here; the Minister knows them well. He has been kind enough to hear me out on many occasions, as have the Secretary of State and many others. Those three factors in Devon and in North Devon in particular mean that we have to look at a fairer way of funding our health service so that we get the services we need. I repeat that any cuts to services at North Devon District Hospital would be absolutely unacceptable.

The holy grail of social care is the integration of the health and social care systems, which many colleagues have mentioned. I want to pay tribute to the Northern Devon Healthcare NHS Trust, which does better than most in working with its social care partners to ensure that packages of care are in place when people are able to move out of hospital. I welcome the hard work of all the people who work in the North Devon services to achieve that.

[Mims Davies (Eastleigh) (Con)]

Will my hon. Friend give way?

[Peter Heaton-Jones]

I will not. The Chair was clear about the time limits; I apologise to my hon. Friend.

I will end by saying we must remember the three Ds. Let us work together across parties to find a long-term solution for the fairer funding of health and social care.

Health and Social Care

Peter Heaton-Jones Excerpts

Monday 27th February 2017 Commons Chamber

[Helen Goodman (Bishop Auckland) (Lab)]

I am pleased to follow my hon. Friend the Member for Bradford South (Judith Cummins), who spoke with great feeling about her constituents’ needs, as she always does.

If my constituents were here and saw the estimates, they might be a bit disappointed. A few weeks ago, we had an interesting public meeting. They said to me, “Helen, it’s marvellous: because of Brexit, we’re going to get £350 million extra for the NHS every week, and our A&E department can be reopened.” There seems to be no mention of that in the estimates.

Under our local sustainability and transformation plan, there is a proposal to close the A&E department at Darlington hospital, which would be an unutterable disaster for my constituents. We are continually told that the purpose of the STP is to improve services, but I really wish the local NHS managers would stop pretending. They have also told us that by 2020 there is going to be a funding shortfall of £281 million, so nobody believes it is about improving services; everybody believes it is about managing on limited resources.

I appreciate that pressures on the health service are increasing because of the ageing population, but this level of austerity in the health service is unnecessary. The British economy is bigger now than it has ever been; it is 14% bigger than it was in 2010. Other hon. Members have pointed to the disparity between spend in the UK, which is $3,235 per capita per year, and in Germany, which is $4,800 per capita per year. In the UK, there are 2.8 hospital beds per 1,000 people, whereas in Germany, the figure is 8.3. It does not need to be like that.

I wish to focus on the needs of rural communities, which we have not spoken about this evening. Were the A&E department in Darlington to close, it would be an extremely serious problem for the people to the west of Darlington, and at the top of Teesdale. People are already travelling 30 miles to get to hospital. The response times of the North East ambulance service are not what they should be. People often wait 20 or 30 minutes for an ambulance to arrive, which means that it could be an hour before they get into the hospital.

One of my local councillors has done an absolutely brilliant piece of analysis, looking at the journey times that would be needed were people to have to go to the James Cook university hospital in Middlesbrough. At the moment, someone living in Bishop Auckland would take 25 minutes to get to hospital. It would go up to 39 minutes. If they live right up in the top of the dale, the journey time is 39 minutes. That would go up to 64 minutes. The STP managers running the review say that they want to treat cardio-vascular and trauma patients in specialist centres where a critical mass of staff can maintain their skills. That sounds reasonable enough, but my constituent Judy Sutherland asked them, “What proportion of emergency journeys are not cardio-vascular or trauma cases?” The answer was 94%. So, for acute asthma, adrenal crisis, anaphylactic shock, appendicitis, diabetic coma, meningitis and renal failure—the list goes on—there would be no benefit to being in a specialist centre.

The extra mortality from the longer travel time goes up quite dramatically. In Bishop Auckland, it goes up by 2.4%, Barnard Castle by 3%, and in Middleton in Teesdale by 3.2%. That is why the pretence that this is about improving the quality of healthcare is not believed by my constituents. They are tired of being told that services should be nearer to home when, in fact, they are being pushed further and further away. There is a question mark over the Richardson community hospital in Barnard Castle. The A&E and the maternity services have been taken out of the hospital at Bishop Auckland. When that was done, we were told that it would be absolutely fine, because people would be able to go to the Darlington A&E, but now that A&E is under threat. People in rural communities are facing this constant process of attrition.

[Peter Heaton-Jones (North Devon) (Con)]

I have similar challenges in my rural constituency of North Devon. The STP is looking at the same issues that the hon. Lady is raising, and they, too, will lead to long travel distances. As Ministers know, that is something that I have raised with them and brought up in this House on a number of occasions. Does the hon. Lady agree that the challenges that the STP is trying to address have not happened in the past 18 months or the past six years; they have built up over many years and over many different Governments?

[Helen Goodman]

The proposal to close Darlington A&E has come up only under this Government. It was not proposed under the coalition Government or the previous Labour Government. This Government must take responsibility for what is happening now.

On Saturday, I went to Alston in Cumbria. The people there are also running a campaign to stop their local hospital closing, because they will then have to go to Carlisle, which is 34 miles away. That is a long way, especially in Cumbria, where the weather is absolutely terrible and the road is often blocked. Ministers need to take more account of this big rural issue. People in Alston are also worried that there will be a cynical saving—the hospital in Copeland—and that they will face even bigger cuts. Perhaps the Minister will give us an assurance about that. The interaction between health and social care is well understood. We all know that cuts to social care mean a worse quality of care and less time for individuals.

Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 15th November 2016 Commons Chamber

[David Mowat]

To be clear, every single STP will be published by Christmas. About 12 have been published so far, and the Cheshire and Merseyside STP will be published tomorrow. When the hon. Lady has access to it, she will see that some of the statements she is making are just scaremongering. She mentioned the King’s Fund, so let me quote it:

“The King’s Fund continues to believe that STPs offer the best hope of delivering long term improvements to health and care services.”

That is what the King’s Fund says.

[Peter Heaton-Jones (North Devon) (Con)]

20. Will the Minister ensure that NHS managers undertaking the STP process affecting North Devon are fully aware of my constituents’ concerns, especially in relation to our geographical isolation? In particular, will he ensure that they are aware of their concerns in Ilfracombe, which has suffered from decades of health inequality because of its location?

[David Mowat]

It is vital that every STP engages with all stakeholders, and that includes North Devon. The public and, indeed, MPs should engage in the process as critical friends to try to make these plans better.

Care Homes for Older People

Peter Heaton-Jones Excerpts

Thursday 3rd November 2016 Commons Chamber

[Peter Heaton-Jones (North Devon) (Con)]

I am delighted to have secured this debate about the regulation, inspection and complaints process for care homes for elderly people. Let me be clear about something from the start. In half an hour on a Thursday afternoon, it is not my intention to tackle the huge, overarching issue of social care provision in this country.

--- Later in debate ---

Motion made, and Question proposed, That this House do now adjourn.—(Andrew Griffiths.)

[Peter Heaton-Jones]

Members on both sides of the House know that social care provision is one of the biggest challenges that we face, but that debate must be for another day. My debate is about something very specific: the way in which privately run care homes for elderly people are inspected and regulated, and the process that exists to raise complaints when relatives believe that something is going wrong. This is vital for two reasons. First, we are talking about nothing less than the welfare of vulnerable elderly people. Secondly, I believe it is possible to make significant improvements at relatively little cost, and I hope in the next 15 minutes or so to set out why.

Before I do so, I will provide a little background. Why have I taken up this cause? Three years ago, while I was still a mere parliamentary candidate, a local resident in North Devon told me a very moving story. John Barrass’s mother, Vera, a former resident at a private care home, died in 2009. Mr Barrass had serious concerns about the care she received in the final weeks of her life, and believed that a poor system of inspection, regulation and complaint handling was a significant factor. Specifically, he believed that a mechanism did not exist to allow him satisfactorily to raise his concerns about shortcomings in his mother’s care.

I do not seek to reopen that case, and neither does my constituent. In the years since his mother died, Mr Barrass pursued all avenues available to him to have her case fully investigated. He invariably hit a brick wall, so he began to look beyond his individual circumstances to examine instead the more general question of how care homes are inspected and regulated, and how complaints are dealt with. He came to the conclusion that the system was simply not fit for purpose, and he met me to explain why. That was the birth of a long campaign, which reaches another milestone with this debate.

Tomorrow marks the first anniversary of my raising this matter in Westminster Hall on 4 November 2015. Since then, I believe we have made some progress, but much of what I said at the time still stands today. What I have to say is based largely on a report produced by Mr Barrass, which I have here, called “Care means care, Justice in care”. The report was created in memory of his late mother Vera who, in Mr Barrass’s words,

“spent a nightmare in care,”

which led him to spend seven years producing this document.

I have helped Mr Barrass to take this to the very top. The previous Prime Minister, my right hon. Friend the former Member for Witney, received a copy and arranged a meeting with the former Minister, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt). I am delighted to see him in the Chamber and pay tribute to him for the work that he did in this area, and for his sincere engagement with me and this campaign. Recently, the document was sent to the current Prime Minister. I quote Mr Barrass’s letter to her:

“I cannot bring my mother back or stop what I have agonisingly had to witness and go through, but I can try to stop this happening to others”.

I agree. An estimated 300,000 older people currently live in some 15,000 registered care homes in England. The average age of those people is 85, and a significant proportion suffer from dementia. They are largely without a voice, and that needs to change.

[Jeremy Quin (Horsham) (Con)]

I congratulate my hon. Friend on his campaign and his persistence with it. The matter affects many of us in this House; my constituents are still concerned about Orchid View care home and the issues that arose out of that. Does he agree that we have to learn from the mistakes of the past? We should have proper inquiries and proper investigations, and we should learn from those mistakes.

[Peter Heaton-Jones]

I thank my hon. Friend; I am sure that the Minister will have heard his comments. We need to move forward, and when things go wrong, we need to put them right.

The body responsible for the regulation and inspection of care homes is the Care Quality Commission, with which I have worked closely since launching this campaign. I believe that it is listening, but there is still considerable room for improvement. Today, the CQC’s website tells us that of the 448 care homes it has inspected most recently, a staggering 200—45%—have been rated as “requires improvement” or “inadequate”. There is no reason to believe that those figures are unrepresentative of the sector as a whole, which means that more than four in 10 of all establishments are not reaching the required standard. Surely the purpose of any system of inspection and regulation must be to drive up standards. The figures alone suggest that the current system simply is not working.

In June 2013, the CQC issued a consultation called, “A new start”, which proposed a whole new approach to inspection across all sectors, including care homes. That approach was confirmed in October 2013, and the new inspection regime was introduced. I broadly welcome it, but there are still huge question marks over its implementation. The original deadline for carrying out an initial inspection of all care homes was February 2016. However, in July 2015, the National Audit Office found that just 9% of care homes had been assessed because of a shortfall of about 160 inspectors. Not surprisingly, the original February 2016 deadline to complete the work was not going to be met, so it was pushed back to this October—last month. Yesterday, when my office asked the CQC for an update, it told us that it is

“committed to completing the first phase of the comprehensive inspection programme by March 2017”.

In other words, this new deadline—the third—is more than a year later than the original target.

I absolutely recognise that the CQC faces many challenges. The managers and inspectors are working hard, but my point is that we would not accept a delay of more than a year in the inspection of NHS services, so we should not accept it just because we are dealing with private sector care homes. We are still talking about vulnerable people who might well be suffering. We need to get a grip on this problem and to challenge the CQC to undertake its inspection programme in as timely a way as possible. I seek to be helpful when I say, “Let us, as a Government, work with the CQC to ensure that it delivers what seems to me to be such an important inspection programme without further delays.”

That brings me to another major area of concern: the CQC’s role in handling complaints, and indeed the role of myriad organisations and authorities involved in this area. What can someone do if they fear that an elderly relative is being neglected or mistreated, or is not being given the right healthcare? What can they do if they fear that their relative’s life might even be in danger, and the care home provider has dismissed the complaint or will not even listen to it?

When things go wrong, and a member of the public needs to make a complaint against a care home, they are faced with a bewildering labyrinth, and that needs to change. The website of the CQC, the body responsible for the regulation, says that the CQC

“is unable to investigate individual complaints”

against providers. To many people, that will seem odd.

Many people are in care homes commissioned by their local authority, so that offers another route for making a complaint. However, the complaints procedures in many local authorities—I speak as a former councillor in a unitary borough—consist of several layers, shall we say, and such a system does not lend itself to a speedy resolution. Not all people in care homes are in places paid for by local authorities, but even if they were, their complaint may fail to get through those many layers.

Should such an individual go to the Parliamentary and Health Service Ombudsman? Again, no, because that is another brick wall. The ombudsman says:

“By law the Ombudsman cannot look into complaints about privately funded healthcare.”

There is another possibility, which is an organisation called the Independent Healthcare Sector Complaints Adjudication Service. The ombudsman’s website states that people “may”—I stress that word—“have the option” of going to that organisation, which covers some independent healthcare providers, but if the healthcare provider of the person concerned is not one of them, they are stuck.

In a nutshell, the system is bewildering. It lacks accountability and transparency, and would leave most people confused and frustrated. People simply do not know who to turn to when they are worried that something is not right. Given that level of confusion, let us imagine what the situation is like for people whose elderly relative is in a care home. They are worried and in an emotional state, yet still have to deal with an incredibly complex complaints procedure.

I believe we could solve this quickly and cheaply, simply by requiring every care home to display a standard notice clearly setting out the complaints procedure with the relevant contact details. It seems incredible—I use the word in its literal sense—that that is not already mandatory. I ask the Minister to investigate with the CQC the possibility of producing such a notice. Something that simple really could make a huge difference.

As for the longer term, in the document I referred to earlier, my constituent John Barrass is convinced that we need one body only to investigate, regulate and handle complaints about care homes, with that being its one and only purpose. That suggestion deserves serious consideration.

A further problem thrown up by this entire process has been highlighted effectively by an organisation in Devon—not in my constituency, as it happens, but elsewhere in the county—called Your Voice Matters. I pay tribute to its founder and director, Jenny Moore, who has done very good work in this area. I have met her a number of times, most recently yesterday, in preparation for this debate. The issue in question is the growing number of cases where relatives are banned from care homes simply for complaining. This can take the form of a complete ban or of restricted visits; in some cases, it has even been known to lead to the eviction of the elderly person from the home.

Your Voice Matters has launched a good campaign called “Rights 2 Speak Up 4 Care”. It has identified the issue succinctly. In a nutshell, it is that private care homes are defined in law as ultimate landlords. Quite simply, they can decide who goes on the premises and who does not. Families who raise concerns are threatened or banned. As I have said, sometimes residents are evicted, and a private paying resident is not protected under any legislation—not the Health and Social Care Act 2012 nor the Human Rights Act 1998, for example. A private care home also has the power to prevent health professionals from visiting the home. Let us think about that for a moment: a care home has the power to stop doctors and nurses going into it to visit its clients.

Something has to change. Recommendations from Your Voice Matters include legislation to close those loopholes and to give protection to all residents and their families, a review of the relevant legislation and an independent panel to offer a fair hearing should a private care home want to place restrictions on a family member or a resident. Your Voice Matters has been working on this for some time, and literally yesterday—just yesterday—there was something of a breakthrough. In the run-up to this debate, there has been a flurry of media activity, with TV and radio programmes covering the issue. Yesterday, the CQC published new guidelines on its website. Care homes will now be required to keep a register of any occasions when relatives are banned or people are evicted. I am not convinced that that goes far enough, but it is a start, and I will keep working with Your Voice Matters to ensure that we go further.

That campaign group has made a number of other recommendations that I will mention briefly, as they have considerable merit. It suggests there should be better protection for whistleblowers who wish to highlight shortcomings in homes, as well as better training, with a mandatory training course for all those who work in or manage care homes.

I have referred several times to my constituent Mr John Barrass. He has carried out an investigation lasting seven years but, as he says, he is only one of the 65 million little people in the UK—those are his words—who are very rarely listened to but whose experiences, and what they have witnessed and suffered, should not be ignored any more. He says:

“I just wish we had been raising these issues before mum had this serious stroke, and helped to change the care system. Maybe, just maybe, my mother would not have had to go through what she did and my father and I would not have gone through 11 years of suffering.”

I want to leave enough time for us to hear from the Minister, but let me be clear about one further thing before I conclude. Many fantastic caring professionals work in care homes. They do their jobs on low wages and care brilliantly for many people. The owners and managers of many care homes are committed to providing the best possible service. They face all the pressures of running a small business and the costs that that entails. There are good managers, investigators and staff at the CQC. I do not wish to criticise those who are doing well, but I do seek to call out those who need to do better.

I should briefly mention the many organisations and individuals who contacted me in advance of the debate. I am unable to name them all, but I have received good representations from the British Medical Association, Independent Age, Hootvox, which is an organisation looking at ways to measure the success or otherwise of care homes, and many other individuals and constituents.

I end with this thought. The problem is that we have a growing number of cases in which care homes are simply not coming up to scratch. I have spent many days, weeks and months on this, discussing it with my constituent John Barrass and the Your Voice Matters campaign group in Devon. Whenever we discuss it, we keep coming back to one thing. I said exactly this a year ago in Westminster Hall and I say it again now: this is not about processes, systems or organisations, but about people—people who do not have a voice in a system in which, let us remember, four in 10 care homes fail to reach a satisfactory standard on the CQC’s measures. That means that some vulnerable, sick and elderly people are not being properly cared for. That cannot be right. I look forward to hearing from the Minister. We have to do something and we have to act now.

Healthcare (Devon)

Peter Heaton-Jones Excerpts

Tuesday 18th October 2016 Westminster Hall

[Peter Heaton-Jones (North Devon) (Con)]

It is a pleasure to serve under your chairmanship, Mrs Main. May I congratulate my right hon. Friend the Member for East Devon (Sir Hugo Swire) on securing this debate on a topic that is vital for all us, right across Devon?

It will not be a surprise to anyone that I intend to focus mercilessly on North Devon and to fight our corner very hard indeed against the threat to our acute services at the North Devon district hospital in Barnstaple. Before I go into that in any detail, I want to make a couple of points. First, I would like to thank the Minister, who has on a number of occasions met myself and other colleagues in Devon to address this issue. I know he understands the particular significance of the North Devon district hospital, because I have discussed it with him, as I have with a whole slew—I am not sure what the collective noun is—of managers in the Northern Devon Healthcare NHS Trust and other directors and managers within NHS England, who by now are well aware of the strength of feeling in North Devon. I want to put it on record that the Minister has been very proactive in arranging such meetings.

My right hon. Friend the Member for East Devon talked about community hospital beds. I do not want the impression to be given that that is not a serious issue also in North Devon, although I will not be majoring on it. In North Devon, there is a bit of history. We did the heavy lifting with the loss of many of our community hospital beds about 18 months ago under a different process from the one now being undertaken in the rest of the county. I agree with what my right hon. Friend said about the need to look very carefully at the provision of social care before community hospital beds are removed.

I do not think NHS England has done this in the right order. Community hospital beds have been removed in North Devon, specifically from the Tyrrell hospital in Ilfracombe, and there is a great amount of concern among the local community about what is replacing that provision. Is there integrated and fully functioning health and social care provision in North Devon to replace those beds? My view is that the answer is no. That is also the view of the community in Ilfracombe. Last Friday I met the League of Friends of the Tyrrell Hospital, and that is strongly their view. That is not my major point today, but I want it on record that that remains a concern in North Devon, as it will become in other parts of the county.

My focus today is on acute services in North Devon. The community is extremely concerned. Many constituents have contacted me and shown their strength of feeling through protests on the street, campaign marches and letters to me, as the local MP, and to my hon. and learned Friend the Member for Torridge and West Devon (Mr Cox), whose constituents also use the North Devon district hospital in Barnstaple.

My point is absolutely clear and I will make it up front: there must be no cuts to acute services at North Devon district hospital in Barnstaple. I cannot see any clinical argument to justify even consideration of any such a reduction in services, let alone its implementation. Let me provide some background.

Healthcare in Devon is currently subject to not one but two separate review processes. We have the success regime, and the Northern, Eastern and Western Devon clinical commissioning group area was given this special treatment with only two other areas in the country—one in Essex and one in Cumbria. Because of the need to ensure that we do not fall into a future funding black hole, the success regime was implemented. I fully support that because we need this special treatment.

On top of the success regime we have a sustainability and transformation plan, which, as hon. Members will know, is being implemented in all NHS regions in England. We have this two-tier process and my understanding from conversations with NHS England is that the success regime will probably be folded into the sustainability and transformation plan, so North Devon will find itself subject to a target that we are at least more easily able to identify. The difficulty is that the ideas that are starting to emerge from the two, soon to be one, reviews are simply unpalatable for North Devon.

I put it on the record that I am fully aware that these are not firm proposals or ideas and no public consultation has been launched. None the less, what has started to emerge has, reasonably and understandably, created serious concern in the North Devon community because, looking across the piece at the various documents that have emerged from both the success regime and the sustainability and transformation plan, we see a picture that puts under threat some of the services at North Devon district hospital, which my constituents rely on most keenly and have done for generations. They include vital services such as accident and emergency, stroke and one that I want to focus on now, maternity.

I have here one of the latest documents to emerge, which hon. Members may remember. Unfortunately, NHS England decided not to make this series of documents public. I say gently to the Minister that that has not been helpful. I know it was not his direction, but it has given rise to the belief that stuff is being done in private behind closed doors and that leads to suspicions, rightly, among my constituents and the public in general. That latest document, which is about five weeks old, starts by talking about

“a two-site option for maternity”

and states that the

“Royal Devon and Exeter Hospital would most probably be the second site”—

after Derriford in Plymouth—

“rather than North Devon District Hospital”.

That is a clear indication that consideration is being given to closing the maternity unit at North Devon district hospital. That is not acceptable to my constituents and we will fight any such proposals if they come forward. We will do that forcefully for a couple of reasons.

North Devon is a special case, not least because of our geography. I have said many times in this Chamber, in the House and elsewhere that Devon has been historically underfunded, and North Devon even more so. We are and have been for too long the poor relation in public funding. Let me be clear. This is not something that has happened in the last 18 months or the last six and a half years. It has been an issue under Governments of all colours for many years, if not decades. It is something up with which we will no longer put.

Part of the difficulty of singling out North Devon and Barnstaple as a place that can apparently sustain further reductions in services is that we start from a lower base of funding than in many other regions. That feeds perfectly into the point that my right hon. Friend the Member for East Devon raised about rurality. North Devon is a largely rural constituency, and for many years a series of funding formulae have dealt unfairly with North Devon because of its rurality. There seems to have been a belief that, because we are a rural area with a sparse population, we can somehow do with less funding. In fact, the opposite is true, and I am delighted that this Government are starting to recognise that. Across the piece of funding for local government, the police, education and health services, we are starting to right that wrong and equalise that funding gap, but the history is still there and that is why North Devon is the last place where we should be looking for further cuts.

[The Minister of State, Department of Health (Mr Philip Dunne)]

I am grateful to my hon. Friend for allowing me to intervene during his limited time in this debate, but I would like to respond specifically to his point about funding and allocations.

In the 2016-17 funding round, the allocation formulae have been looked at again and we have, for the first time in several years, introduced three differentials that are relevant to rural areas and that I think will affect my hon. Friends here. They include looking at the combination of rurality, remoteness and sparsity of population to improve the ambulance emergency cost adjustment, to reflect the greater distances travelled in rural areas; an adjustment to support continued provision by hospitals with 24/7 A&E services that are remote from the wider hospital network—my hon. Friend’s North Devon district hospital will be one of those’and an adjustment to remove from the formula supply-induced demand in urban areas where people live close to hospitals. Those three measures have led to a change and I gently suggest that my hon. Friend may care to look at the CCG allocations table which sets that out. For Northern, Eastern and Western Devon CCG, the per capita allocation for 2016-17 is £1,250, which is slightly above the average for England of £1,221 per head.

[Peter Heaton-Jones]

I thank the Minister for his intervention and I welcome it, but I say gently to him and NHS England, which I am sure is monitoring this, that all that good work will be entirely undone if we then lose our acute services at North Devon district hospital. This is not about figures on a spreadsheet; it is about the services and healthcare provision that my constituents will receive in Barnstable.

I am aware of the time, Mrs Main, but I want to raise a second issue, which is important and recognisable to us in North Devon, but perhaps not to those beyond: our unique geography and the distances. An Australian historian once referred to the tyranny of distance, and I think we suffer from that in North Devon. If one looks at a map, it is all too easy to think that there is a decent road network between Barnstaple and Exeter. I can give several reasons why that would be a wrong assumption. First, vast numbers of people live in isolated regions far north of Barnstaple. Secondly, the road network is not all it is cracked up to be—although that is a subject for another day and one on which I am fighting heavily.

My main point is that what no map or distance table shows is that in North Devon we have pockets of serious deprivation. In Ilfracombe, I have two of the most deprived wards in the south-west and by some metrics the most deprived in south England. In those areas car ownership is less than 80%. Put another way, one in five households do not have access to their own private transport and, because of the demographics, some of those who do are elderly and perhaps have their own vehicle but simply would not feel comfortable or up to going long distances to Exeter or Plymouth. Those two reasons alone are sufficient to argue strongly that the last place where we should be looking to make cuts to acute services is at North Devon district hospital.

I am aware of the time, Mrs Main, so I will conclude. I welcome the fact that the Government are looking at the funding. I welcome the repeated assurances that local clinicians will make the final decisions. However, I want it to be in no doubt whatever—the community of North Devon are very clear about this—that North Devon is a special case and needs to be treated as such. In that regard, I make no apologies whatever for fighting for North Devon and for appealing for there to be common sense and no cuts at North Devon district hospital.

[Mrs Anne Main (in the Chair)]

We have approximately 35 minutes before the winding-up speeches and there are five speakers. I am sure we can do the maths.

Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 5th July 2016 Commons Chamber

[Mr Hunt]

I am more than happy to do so. In fact, we have a copy of the report right here, which my Minister of State has handily given to me. When I was shadow Minister for disabled people, I had a lot of contact with parents of autistic children and with people on the autistic spectrum themselves. The hon. Gentleman makes a very important point.

[Peter Heaton-Jones (North Devon) (Con)]

The maternity unit at North Devon district hospital in Barnstaple in my constituency is one of the services being reviewed under the current Success Regime. Can the Secretary of State reassure me and my constituents that maternity care, and the safety thereof in what is a geographically huge region, will be the first priority under this review?

[Mr Hunt]

I can absolutely assure my hon. Friend on that. I know there are very big national and global events happening right now, but I want to tell the House that over the next month one of my big priorities will be to do something to improve our record on maternity safety. We have made huge progress in reducing stillbirth rates and so on, but maternity safety is still not as good as it should be and certainly not as good as in other countries in western Europe. This is an absolute priority and I hope to be able to inform the House more on this before recess.

Oral Answers to Questions

Peter Heaton-Jones Excerpts

Tuesday 10th May 2016 Commons Chamber

[Mr Hunt]

We are making sure that neighbouring hospitals have the resources to deal with the temporary closure of Chorley A&E. The more patients that any hospital sees, the more resources it gets. This is none the less a very worrying situation that we are monitoring very closely.

[Peter Heaton-Jones (North Devon) (Con)]

The success regime review in Devon is causing real concern about the future of acute services at North Devon District Hospital. Does the Minister recognise that the unique geographical circumstances of Barnstaple mean that the reduction of any of those services will, for some of my constituents, mean a round journey of more than 120 miles to access them?

[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

I do recognise the unique geographical circumstances in my hon. Friend’s constituency. That is precisely why the success regime is being led by local clinicians. I hope and expect that in formulating plans they take account of all the views and all the clinical needs of his constituents and his own views.