Covid-19 Update

Philip Hollobone Excerpts

Friday 26th November 2021 Commons Chamber

[Sajid Javid]

The answer is that a temporary waiver of intellectual property for such purposes would be a huge step backwards. It would not help developing countries and it certainly would not help if we needed new vaccines, not just for covid-19 but for a future pandemic; the industry and businesses might step back and not bother developing if they believed that the intellectual property would always be waived in such circumstances. What is important, as I think the hon. Gentleman would agree, is that the companies developing these life-saving vaccines have an appropriate pricing and access policy for each country, so that vaccines are priced appropriately and accessibly for developing countries, and rich countries such as the UK, the US and others continue to do all they can through international vaccine donation programmes.

[Mr Philip Hollobone (Kettering) (Con)]

I commend the Secretary of State on the swift actions he has taken in relation to the new variant. He is completely right that the booster programme is more important now than ever, but residents in Rothwell, Desborough, Burton Latimer, Barton Seagrave and Kettering are telling me of the difficulty that they are experiencing in getting a booster in the Kettering constituency. They are being asked to go to Corby or Northampton, which is difficult for many people. Can we have a boost to the booster programme in Kettering, with immediately local walk-in booster centres?

[Sajid Javid]

My hon. Friend is right to talk about ease of access to the booster programme. Of course we want to make it as easy as possible, and we are adding numerous sites day by day. I will absolutely see what we can do with regard to Kettering. The Vaccines Minister, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), has heard what my hon. Friend has said. I suggest that they have a quick meet after this, as I am sure that she is eager to open up more access points in Kettering.

Automated External Defibrillators: Public Access

Philip Hollobone Excerpts

Thursday 18th November 2021 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

Before we begin, I am required to read out some advice from Mr Speaker. I remind Members that they are expected to wear face coverings when they are not speaking in the debate. That is in line with current Government guidance and that of the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test twice a week if coming on to the parliamentary estate. That can be done at the testing centre in the House or at home. Please also give each other and members of staff space when seated and when entering and leaving the room.

[Jim Shannon (Strangford) (DUP)]

I beg to move,

That this House has considered public access to Automatic External Defibrillators.

I am pleased to see many hon. Members from all political parties in the Chamber. I will also say, because I mean it, that I am especially pleased to see the Minister in her place and I look forward to her response. She understands the importance of the debate. Each hon. Member who speaks will illustrate the strength of the need for the Government and—dare I say it—civil servants to understand the importance of the debate. If they understand it, and if the Government press the issue, the general public will be glad to see it happening.

It is a pleasure to have this debate before the Second Reading of the Automated External Defibrillators (Public Access) Bill on 10 December. I thank the Backbench Business Committee for granting my application. The intention is to deliver public access to AEDs across the whole United Kingdom. All MPs will have at least one person in their constituency who has been saved by an AED.

I am grateful to the hon. Member for Sedgefield (Paul Howell) who co-sponsored the debate and supported me in making it happen. I appreciate his co-operation, partnership and friendship. He made representations to the Committee alongside me and shared his own experience, which he will tell us about shortly. He has referred to the dedicated work of his constituent Councillor David Sutton-Lloyd, who advocates and lobbies with him about the importance of awareness and public availability of these lifesaving devices.

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[Jim Shannon]

I certainly do. Living in a rural area as I do, I know the hon. Lady is absolutely right. I would hope and expect that to be the case. I want to give others the opportunity to speak and will make my closing comments now.

Let us remember why we are here today. We are here because there are currently over 30,000 out-of-hospital cardiac arrests in the United Kingdom each year. Of those people, only one out of 10 will survive. I put it to the Minister, the Government and civil servants that I want—indeed, I think we all want—the other nine to survive as well. How can they survive? They can survive if we have access to AEDs in the places where people are, including in rural places. That is why we must push this forward.

What value do we put on a life? A typical defibrillator for the community can cost £800. The Library notes refer to the cost being between £600 and £2,500. However, across Northern Ireland, with the efforts of all the charities and groups I have mentioned, the defibrillators are already in place. I have also mentioned the efforts of organisations such as the Premier League and the Education Ministers here in Westminster and back home in Northern Ireland, and I suspect the same is true in Scotland and Wales as well. That is why, when the legislation is introduced, it will be to encourage those who have not yet gone to that extra stage to make sure that there are defibrillators. That is why this debate is incredibly important. If the cost is £600 or, as it is in Northern Ireland, £800, that is a small price for the Government and the private sector to pay potentially to save lives.

Is it not right that every leisure centre should have a defibrillator? Is it not right that there should be one in the centre of every town? Is it not right that defibrillators should be available and accessible in restaurants, and outside buildings for times when people are out and about, including to visit pubs and restaurants at night time?

There is a campaign called The Circuit, which registers all community AEDs. The sale of AEDs rose significantly after the Euros incident, and when AEDs are registered on a central database, emergency call handlers can direct callers to the nearest AED. The objective of this Bill is to have an AED within three minutes of everyone. That is what the hon. Member for Rutherglen and Hamilton West wants to have; indeed, I think it is what we all want to have.

The Bill does not cost the Government anything. I have said it three times now; forgive me for saying it three times, but I want to emphasise it and say why it is important. Here is a Bill that delivers across the whole of the United Kingdom of Great Britain and Northern Ireland. This Bill will save lives, which is why it is important.

I say to my hon. Friends—all the Members here are my hon. Friends; to be truthful, on this issue all Members are probably hon. Friends whether they are in the Chamber or outside it—that this proposed legislation is neither to the left nor the right of politics. It is about what is right and what is wrong. It is about our whole society and equipping it with the means to save lives. Can there be a more civilised or caring thing to do? If words could make the difference—I will use a quotation, but before I do so I will say one other thing.

Today, this House can support the campaign to deliver AEDs, at no cost to the Government. AEDs save lives. That is the purpose of the Bill—it is to save lives. It is about those nine out of 10 who die every year because the AEDs were not available. It is as simple as that. It is about saving lives. For me, that is the crux of it.

I say that life and death are in the hands of the Minister and her Government, and they would seem to be in the hands of civil servants too. So what action will those hands—the hands of Ministers, the Government and civil servants—take in the coming days when the Bill comes back to the House on 10 December?

I will close with very poignant words. I know that the Minister knows that they refer to wee Oliver King. His dad said, and I have never forgotten it:

“Had the swimming pool had an AED, my son, Oliver, would still be here today.”

That is what we are here for.

[Mr Philip Hollobone (in the Chair)]

The debate can last until 3 o’clock. I am obliged to call the Front Benchers no later than 2.27 pm and the guideline limits are: 10 minutes for the Scottish National party; 10 minutes for Her Majesty’s Opposition; 10 minutes for the Minister; and then Jim Shannon will have three minutes at the end to sum up the debate. So, until 2.27 pm, we are in Back-Bench time. Four distinguished Back Benchers are seeking to catch my eye and we will start with Rob Roberts.

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[Mr Philip Hollobone (in the Chair)]

I call Richard Thomson.

[Richard Thomson (Gordon) (SNP)]

I am the Front-Bench spokesperson, Mr Hollobone.

[Mr Philip Hollobone (in the Chair)]

I do apologise—my mistake. In that case, your able replacement is Stuart C. McDonald.

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[Paul Howell (Sedgefield) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone. It has been an absolute pleasure to support the hon. Member for Strangford (Jim Shannon) in his endeavours. I thank him for his kind comments, and thank all other colleagues who are supporting the debate.

The importance of access to AEDs in a life-threatening medical emergency cannot be disputed. In addition to the high-profile and extremely upsetting events at Euro 2020 when Christian Erikson suffered his cardiac arrest, there was a similar event in Newcastle’s football ground on TV the other week, when an 80-year-old gentleman collapsed. Fortunately, there was an AED to help that situation too.

Is the Minister aware that in the UK, nearly 300 school children die of sudden cardiac arrest every year? The emotional statements of colleagues on the specifics mentioned only further endorse the need for something to happen on these proposals. An obvious start for this is our public buildings, such as schools, libraries, and local government buildings, to have access to AEDs.

Unfortunately, without on-site and urgent access to defibrillation, the vast majority of cardiac arrests will be fatal. At present, there are just not enough AEDs accessible to people. As has already been said, for each minute that passes following a cardiac arrest without CPR, the survival rate drops by 20%.

Given that the average response time for emergency services to a cardiac arrest is just under seven minutes, we cannot rely purely on our emergency services—however good they are—to fill the gap. If we want to save as many lives as possible, we need as many defibrillators in the community as possible. That is particularly true in rural areas, like most of my Sedgefield constituency, where call-out times are naturally longer, simply because of the distances the emergency services will have to travel. Prompt, community access to defibrillators can dramatically help improve the chances of survival. Indeed, it would help to level up between urban and rural communities.

The AED Bill would make an important legislative change, helping to build a better, safer environment for people in the community and increasing the cardiac arrest survival rate. As a nation, we have the opportunity to be world leaders in ensuring that we all have access to defibrillation. We should we pass this legislation into law and be the first country to mandate that new public buildings provide access to a defibrillator.

I am aware that the Department for Education offers reduced-cost defibrillators through NHS Supply Chain’s Defibs4Schools programme, which in itself shows that it values the provision. Could the Minister encourage it to go further, particularly with new school builds, and also push other Departments to follow suit? It is clear that it would be challenging to ensure that all current public buildings have AEDs, but it is something the Minister should look at trying to mandate. I strongly encourage her to push her Department—and indeed other ministerial colleagues—to look for cross-departmental engagement to introduce that compulsion for new public buildings, whether they are for local government, health, education, or other purposes.

As has been mentioned, mandated AEDs on public buildings will work best if they are comprehensively mapped so members of the public could be directed to their nearest location. On that, I do like the earlier proposal for an app-driven solution. The proposed Bill would take an important step towards ensuring that AEDs can be readily located wherever they are needed. In addition to ensuring that AEDs are mapped, we need to ensure that we have a system in which people are clear about whose responsibility it is to maintain them, particularly if they are in the public domain.

We all know—we have heard many representations today—that excellent work has done up and down the country by volunteers who understand the importance of AED access to their communities. As already mentioned, in Newton Aycliffe, for example, David Sutton-Lloyd has worked tirelessly to ensure that 32 AEDs are now available to residents. However, I believe that we, as the legislature and elected representatives, have a duty to ensure that all new buildings are fitted with AEDs, and that the work of volunteers is to complement that, rather than provide the initial provision.

Again, this was mentioned earlier, but I have been educated on the use of defibrillators. Mr Sutton-Lloyd is incredibly active in running training courses. I am not sure “training” is the right word. It is not training, it is education. Unless we know about these pieces of kit, we could get concerned that the electricity could cause problems. As has been mentioned, it cannot do that; the machines are good. The machine makes the decision and it is not possible to use a defibrillator on somebody if it is not the right thing to do. I encourage the Minister to promote campaigns to educate the public around this, so that when defibrillators are necessary people are confident and not worried about using them.

To summarise, the provision of AEDs, in and around our communities, is a real aid to saving lives at minimal cost. The opportunity to make them compulsory in public buildings, at least initially in new-build public buildings, is surely a no-brainer. How could the Minister consider otherwise?

[Mr Philip Hollobone (in the Chair)]

We now come to the Front-Bench speeches. Apologies to the Scottish National party spokesman for being so keen to get him in earlier, but his moment has now come.

NHS England Funding: Announcement to Media

Philip Hollobone Excerpts

Monday 25th October 2021 Commons Chamber

[Edward Argar]

I am grateful to the hon. Gentleman —my hon. Friend—for his question. The Chancellor will set out the detail of Barnett consequentials in due course. The hon. Gentleman knows that I speak to Robin Swann, to whose work I pay tribute, at regular intervals—almost fortnightly—about a number of things. I have not yet discussed the detail of this matter with him, and it will be for him as a devolved Health Minister to make those decisions, but I will of course discuss it with him.

[Mr Philip Hollobone (Kettering) (Con)]

My constituents in Kettering will welcome the extra NHS investment in diagnostics and elective care, but the best way to permanently increase elective capacity in Kettering is for permission to be given for the go-ahead for the redevelopment of Kettering General Hospital. In that regard, will the Minister impress on NHS England and NHS Improvement the urgent need to approve and give permission for the strategic outline case for the hospital redevelopment?

[Edward Argar]

For a brief moment, I thought my hon. Friend was not going to mention the new hospital at Kettering. Yes, I am very happy to have that conversation with NHS England colleagues as I continue to discuss the new hospital in his constituency with them at regular intervals.

Black Maternal Health Week

Philip Hollobone Excerpts

Tuesday 14th September 2021 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

Before we begin, I encourage Members to wear masks when they are not speaking, in line with current Government and House of Commons Commission guidance. Please also give each other and members of staff space when seated and when entering and leaving the room. Members should send their speaking notes by email to [e-mail]. Similarly, officials should communicate electronically with Ministers. I now call Bell Ribeiro-Addy to move the motion.

[Bell Ribeiro-Addy (Streatham) (Lab)]

I beg to move,

That this House has considered Black Maternal Health Week.

It is a pleasure to serve under your chairmanship, Mr Hollobone. I am thankful that we are able to have this debate, which follows from an e-petition debate that was held in April after the petition received over 180,000 signatures. MPs were given the opportunity for the first time to debate a petition calling for improvements to maternal mortality rates and healthcare for black women in the UK.

I would also like to take this opportunity to thank Tinuke and Clo from Five X More, as well as Elsie Gayle, whose tireless campaigning efforts have forced this issue on to the agenda. They have not only provided us with the opportunity to discuss the issue but given a voice to many black women who have experienced a traumatic pregnancy or birth and to those families who have lost loved ones.

For too long the statistics had pointed towards a glaring disparity in black maternal health experiences, and for too long nothing was said. We now have a Black Maternal Health Awareness Week, during which we can highlight the disparities and discuss ways in which we can make pregnancy a safe experience for all, regardless of skin colour.

Members will by now be very familiar with the statistics surrounding black maternal healthcare and mortality, but they bear repeating. In the UK, which is one of the safest countries in the world in which to give birth, black women are still four times more likely to die in pregnancy or childbirth. Black women are up to 83% more likely to suffer a near miss during pregnancy. Black babies have a 121% increased risk of stillbirth and a 50% increased risk of neonatal death. Miscarriage rates are 40% higher in black women, and black ethnicity is regarded as a risk factor for miscarriage. Black mothers are twice as likely to give birth before 37 weeks of pregnancy.

The situation for women and birthing people of mixed heritage and Asian heritage, unfortunately, is not much better, with those of mixed heritage being three times more likely to die in pregnancy and childbirth, and Asian women two times more likely. Asian babies also have a 55% increased risk of stillbirth and a 66% increased risk of neonatal mortality.

However, we all know that racial disparities in health do not begin, and certainly do not end, there. Despite these statistics, despite the number of reports and studies that have been produced in the last year and before, and despite being aware of the glaring disparities in maternal healthcare, we still have no target to end them.

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[Anne McLaughlin]

It is Eastwood in the Scottish Parliament. Forgive me, Mr Hollobone. As my hon. Friend said, studies in America show that even among women who come from fairly well-off backgrounds and who do speak English, black and Asian women are still disproportionately affected.

If I worked in maternity care in the NHS and heard someone like me saying these things, I would naturally feel defensive. Instead, what I ought to do is think about it, read up on it, question myself—and I do regularly—and really listen to what people are saying. I have no doubt that the vast majority of healthcare workers care deeply about the people they work with. The debate is more about the system itself and the inbuilt structural inequalities. For those who may be watching and do not know this, if we say the health service is structurally racist, it does not mean it is populated by racists: it means the way in which it is structured is for white people from certain backgrounds. It takes into consideration their needs, culture and language, with very little flexibility to take into account anyone else’s. Changing the structures makes them more flexible, and that is what the debate is calling for, in addition to addressing the very specific problems that have been talked about. After all, our NHS is not a white person’s NHS, it is an NHS for everybody.

I had decided that I was only going to speak for five minutes, and I think if I had not taken interventions then I would have done, but I think it is worth saying why I had decided that. I wanted to give the hon. Member for Streatham longer—and I know she will want to say a few words at the end—because, even though I have ended up taking 10 minutes, I do believe that part of offering support is saying less and listening more.

[Mr Philip Hollobone (in the Chair)]

We now come to the Health Minister, Nadine Dorries. After the Health Minister has spoken, Bell Ribeiro-Addy will have a few minutes to sum up.

Kettering General Hospital

Philip Hollobone Excerpts

Friday 10th September 2021 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

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.

[Mr Peter Bone (Wellingborough) (Con)]

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.

[Mr Hollobone]

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.

[The Minister for Health (Edward Argar)]

I thank my hon. Friend the Member for Kettering (Mr Hollobone) for his speech. It is almost two years to the hour since I was appointed by the Prime Minister to this job, having just by a few days beaten your record in doing this job, Madam Deputy Speaker. He was one of the first colleagues in this House to raise an issue with me, so it is appropriate that he is raising this with me again today. I join him in paying tribute to all at his local hospital for the work they have done in the past year and a half, and for the work they continue to do and have done before the pandemic for his constituents and many others. Equally, I join him in paying tribute to the work of my hon. Friend the Member for Wellingborough (Mr Bone), whose constituents are also served by this hospital, and of my hon. Friend the Member for Corby (Tom Pursglove), who, sadly, cannot be here today but who has been equally vociferous in campaigning on behalf of his constituents.

Before I turn to the main points that my hon. Friend the Member for Kettering raised, I will answer his fifth question now. He is right to say that I am probably overdue another visit to Kettering. Although in a private capacity I passed through it recently, that is as nothing compared with visiting with him, as the local Member of Parliament. So I am happy to see whether we can find a date to do that, as it would be a pleasure. He is, of course, nothing if not constant and courteously persistent on behalf of his constituents. He rightly highlighted the context of this: the challenges faced by the accident and emergency department at Kettering, with it being congested and facing increasing demand from development in the area, and with the pressures it is feeling. He also highlighted that the solution, or the best way forward for his constituents and for this hospital, is not just the urgent treatment hub that he secured the £46 million-worth of funding for, but for us to look at this hospital in the round to see what needs to be done more broadly in the services and infrastructure available there to meet the changing needs of his constituents and those of my hon. Friends the Members for Wellingborough and for Corby.

I am grateful to my hon. Friend the Member for Kettering for rightly highlighting the track record of investment in Kettering under this Government: the write-off of £167 million-worth of debt; the £350 million allocated, with £25 million to £30 million for HIP2; and the £46 million investment in the urgent treatment centre. He should be proud that his campaigning helped secure that for his constituents. He touched on a key element of this: given the subsequent allocation of the £350 million-worth, there are benefits to be had from understanding the project as a whole, rather than simply looking at one thing as one pot and one as another. This is in no way a criticism of Her Majesty’s Treasury or of any other Department, as I would never dream of doing such a thing, but often in government individual pots of money and individual projects are looked at as exactly that, rather than taking a step back and looking at the synergistic opportunities that could be achieved by looking at things as a whole.

I turn now to my hon. Friend’s specific questions, which I am sure he would wish me to answer. I will do so in order not to run out of time and then I will perhaps say a little more. He asked about the ability to combine the £46 million with the £350 million, and the flexibility to do that. He will know that he and I, and my officials, have had conversations with his hospital trust’s chief executive, Simon Weldon—I join my hon. Friend in paying tribute to him for the work he does. We wrote to him on 16 June to confirm that the urgent care hub and the HIP2 scheme would be able to be brought together as part of the wider development at the Kettering General Hospital site. The urgent care hub and the new hospital that is to be built share, as my hon. Friend said, a common set of enabling works that are being factored into the new hospital development. So I hope that gives some reassurance on his first and second questions as to whether the two could be brought together as a single project. As I said, we wrote to the hospital chief executive on 16 June. There is the opportunity to use that provision, rather than purely for the urgent treatment hub, as the enabling works are part of a broader scheme. I know that conversations continue about the mechanics of that, but in principle it appears a sensible approach.

[Mr Hollobone]

I thank the Minister for those encouraging remarks, May I draw his attention to the good work being done by Natalie Forrest in the national hospital rebuilding programme? She has developed a good relationship with Kettering General Hospital, and has been extremely supportive in getting the hospital rebuild delivered.

[Edward Argar]

I am grateful to my hon. Friend. This is a challenging programme, and each of the 40 hospitals and their respective representative Members of Parliament argue their case hard, as do their chief executives. He is right to highlight the work of Natalie Forrest, the senior responsible officer for this project, in managing expectations and working collaboratively and openly with hospital trusts—including that of my hon. Friend—to try to achieve the right outcome for the taxpayer and the Exchequer, and for his constituents and others around the country.

Support for Carers

Philip Hollobone Excerpts

Thursday 22nd July 2021 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

I remind hon. Members that social distancing is no longer in operation, and that Mr Speaker has encouraged us to wear masks. There have been some changes to normal practice to support the hybrid arrangements. Members participating physically and virtually must arrive for the start of the debate and are expected to remain for the whole debate. I must also remind Members participating virtually that they must leave their camera on for the duration of the debate and that they will be visible at all times, both to each other and those of us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address, which is westminsterhallclerks@ parliament.uk. Members attending physically should clean their spaces before they use them and as they leave the room.

[Ed Davey (Kingston and Surbiton) (LD)]

I beg to move,

That this House has considered support for unpaid carers and Carers Week 2021.

We are a nation of carers. Millions of people every day look after one or more loved ones—a family member or a friend, or someone who is elderly, disabled or sick. I want to thank and celebrate carers and to speak up for them and the many challenges so many carers face. To be clear, when I use the word “carer”, I am not talking about professional, paid carers—amazing though they are—or child carers and the important work of parents and childminders. Instead, I am focused on the millions of people working as unpaid carers in homes across our country, many of whom would not even call themselves carers. Millions of vulnerable adults and children depend on the efforts of our country’s carers, and yet the voice of these unpaid millions is rarely heard and listened to even less.

Covid has made the job of carers even more challenging. A recent survey by Carers UK found that 81% of carers are spending more time on their caring responsibilities during the pandemic, whether due to the needs of the person they are caring for increasing, or because the local care services they used to rely on have been reduced or closed. Despite all that, carers have too often been forgotten or ignored in so many ways. Take money. Right at the start of the pandemic, when the Chancellor put up universal credit by £20 a week, he refused to do the same for carer’s allowance. He is still resisting calls by Carers UK, the Liberal Democrats and others to put that right, despite the evidence that so many carers are in real financial distress made worse thanks to covid.

Take vaccinations. When the Government initially published the list of priority groups for vaccination in December, they left unpaid carers completely off the list, even though the case for including them is obvious, with so many caring for vulnerable people. Only after campaigning by carers organisations, the Liberal Democrats and carers themselves did Ministers finally U-turn. Even then, the effort to get the message out to carers and the vaccination services was, frankly, lamentable.

There are many more examples. The Government’s 80-page health and social care White Paper left out unpaid carers altogether, as did the Queen’s Speech in May. I am glad that the Health and Care Bill does at least include a requirement to involve carers in decisions about the people they care for, but the Bill does not go anywhere near far enough. There should be an explicit duty on the NHS to identify carers and promote their health and wellbeing, yet that it is sadly missing.

Here is the nub of the problem: the Government do not seem to understand that improving care is fundamental to improving health. Yes, there is debate about reforming and investing in social care to support the NHS, but I note that even there we are still waiting for the Government to publish their social reform proposals two years after the Prime Minister told us he had them ready to go. However, the link between health and care goes far wider than the relationship between social care providers and the NHS. It is shocking that that is still not properly recognised.

The reality for every family with an elderly, sick or disabled relative is this: the health and wellbeing of their loved one is not determined primarily by the hospital or the GP. So much of improving the nation’s health comes down to the quality of care that can be provided by family and friends. Yet millions of those unpaid carers do not even register in the core thinking and planning of the Department of Health and Social Care.

That is why this debate is so important. It is a chance for us to stand up for carers and say that they must not forgotten and ignored any longer. That is carers like Gayna, who looks after her two daughters with complex disabilities. Before the pandemic, Gayna got support from social services and her local carers’ centre, as well as a much-needed break when her girls were at college or with a youth worker. However, that all came to a halt when we entered lockdown, and Gayna’s amount of time spent on caring more than doubled.

Elaine had a similar experience as she cared for her husband, Mark, who is suffering with dementia. Throughout lockdown, Elaine struggled to cope without regular visits from Mark’s care workers. She deeply missed her respite time, and worried that Mark was not getting the mental stimulation he needed from the activities that he used to do with his care workers. She felt exhausted, stressed and like she had no one to turn to for advice or support. In Elaine’s own words:

“When you’re caring alone, you just have to keep going.”

That is all taking a huge toll, especially on the mental health of carers. Back before the pandemic, the 2019 health survey for England showed that for those carers undertaking 20 hours or more of care a week, the rate of depressive symptoms was double that of the rest of the population. I shudder to think of the state of mental health of many carers now, nearly 18 months into the pandemic.

Let us not forget Britain’s 800,000 young carers. The combination of lockdown, school closures and extra caring responsibilities has taken a toll on their academic progress and their mental health. Some have not been able to return to school, because they are worried about bringing the virus home with them, and about leaving their loved ones without care.

What should be done for our nation of carers? I have already mentioned the need to raise carer’s allowance by at least £20 a week, or £1,000 a year. So far, the Prime Minister has refused time and again to do that. He must do it now. One of the next most urgent things to do is to give carers a break. The survey by Carers UK found that 64% of carers have not been able to take any breaks from their caring role during the pandemic; 74% said they feel exhausted and worn out as a result of caring during covid; and 44% said they are reaching breaking point. Local authority budgets are already stretched way past breaking point, so the Government must give councils immediate emergency funding to offer every unpaid carer the support services that they need to take a weekly break.

Ministers must also provide more cash to councils to fund the voluntary sector’s work for carers. In my constituency, we have an amazing organisation called Kingston Carers’ Network, which is dedicated to improving the lives of carers in Kingston. From support groups to advice on benefits, from special projects for young carers and young adult carers to carers’ assessments and mentoring, Kingston Carers’ Network helps more than 4,000 carers in our borough. With a professional team of 21 and a volunteer group of 72, KCN provides extraordinary value for money. With a bit more help, it could do so much more, helping the thousands of carers locally it knows it has not yet reached.

KCN has risen to the challenge of covid, providing new services. One example is the telephone befriending service it set up in March last year. It recruited and trained 23 volunteers to provide one-to-one telephone support to carers. KCN believes that that simple, extremely cheap service has helped to reduce the anxiety and stress in many adult carers and prevented serious deterioration in carers’ mental health. I hope other colleagues have similar groups in their areas and I hope that the Minister will work with local authorities so that this critical work for carers can receive far more investment.

There is much more I want to say, but I am keen to let colleagues contribute, so that the Government can hear the huge cross-party support for our carers and realise that they need to do far more. Before I finish, however, I want to declare an interest—perhaps I should have done so earlier.

I am a carer and I have been at many stages of my life. My first time was as a young carer, starting aged 12. My dad died when I was four, so when my mum became terminally ill, when I was 12, the daily care fell largely to my brother and me, and finished when she died when I was 15. Later, I cared for my wonderful Nanna, my mum’s mum, organising her care and trying to make her last few years as comfortable as I could. And now as a father, my wife Emily and I care for our gorgeous disabled son John.

I think my experience as a carer is similar to that of millions of people. Caring for a close family member or friend can be rewarding and full of love, but it is far from glamorous and can be relentless and exhausting. That is why this debate is so important. Political debate in our country needs to reflect far better the experience and needs of our nation of carers. The Government need to do far more, especially because of covid, especially to support the nation’s health and the mental health of carers, and especially because our nation depends on those carers.

[Mr Philip Hollobone (in the Chair)]

The debate can last until 4.45 pm. I am obliged to call the Front-Bench spokespeople no later than 12 minutes past 4. The guideline limits are 10 minutes for the SNP, 10 minutes for Her Majesty’s Opposition and 10 minutes for the Minister. Ed Davey has three minutes at the end of the debate to sum up the proceedings. Until 12 minutes past 4, there are seven extremely distinguished Back Benchers seeking to contribute, and if we impose a limit of six minutes, everybody will be able to get in. I call Wera Hobhouse.

--- Later in debate ---

[Ed Davey]

I thank every Member who has contributed. Members have made some really powerful speeches, and I think that carers in their constituencies are very grateful for the work that they do as parliamentarians.

I will single out, rather unfairly perhaps, two colleagues who have spoken, for different reasons—first, my hon. Friend the Member for Caithness, Sutherland and Easter Ross (Jamie Stone). The story about his constituent needing an extra diaper a day for his mother brought home to us all what we are talking about when we are talking about carers: the stresses, the fact that they are providing very basic care—whether it is dealing with toileting, doing washing, dressing, eating or drinking—to ensure that a loved one can have a quality of life, and how the emotional impact of that can affect people. I am grateful for his contribution, which I think brought us down to earth on what we are talking about.

I also thank the hon. Member for Sheffield Central (Paul Blomfield) for talking about the need to identify young carers. The Minister picked that up, agreeing that we need to talk about that more generally. There is an issue about helping people to identify themselves, because many people do not understand that they are carers. They see it as just looking after their wife or husband, son or daughter, or mother or father, but we need to identify them to ensure that they are getting the support that they need, whether for their own mental health, respite care or whatever it might be.

We also need to ensure, as we plan health services, social services, or whatever it may be, that we have proper information. The census, when it comes out, may refresh the figures of 2011. Many colleagues were involved in the efforts to encourage people, when they took the census, to identify themselves as carers. I would probably multiply whatever figures come from the census because I am not sure that all carers will identify themselves as such. However, if we can do that more effectively I think we can bring home to policymakers how significant the issue is. It has been massively underplayed by Government after Government, so I am grateful to the hon. Member for Sheffield Central. He mentioned young carers. I cannot see, for example, why that cannot be central to the annual school census. That is a pretty easy thing to do. I am very happy to work with him and others to try to work with the Government to bring that about.

If we value carers for the work that they do and properly identify them, I think we can come together and really improve the support that we give them, which is so essential. In so doing, we can dramatically improve the health and wellbeing of the people we are elected to serve, which is utterly crucial. May I end, Mr Hollobone, by thanking everybody—

[Mr Philip Hollobone (in the Chair)]

I am afraid not. The sitting stands adjourned.

Covid-19 Update

Philip Hollobone Excerpts

Thursday 22nd July 2021 Commons Chamber

[Nadhim Zahawi]

I am really grateful to the hon. Member for that excellent question, and I am grateful for her comments about our Friday morning meetings. Her constituents can rest assured that those who are in clinical trials, including the Novavax trial, will have their data on the NHS covid app as being fully vaccinated, whether they are receiving the placebo or the vaccine, across all trials. That is happening. I will take it offline to look at her constituents’ case to make sure that that happens for them, because I am assured that the system already recognises that.

By the end of this month, UK nationals who have been vaccinated overseas will be able to talk to their GP, go through what vaccine they have had, and have it registered with the NHS that they have been vaccinated. The reason for the conversation with the GP is to make sure that whatever vaccine they have had is approved in the United Kingdom. Ultimately, there will be a co-ordination between the World Health Organisation, ourselves, the European regulator, the US regulator and other regulators around the world. Because we are working at speed, at the moment it is UK nationals and citizens who have had UK vaccinations who will be able to travel to amber list countries other than France and come back and not quarantine. We want to offer the same reciprocity as the 33 countries that recognise our app, and that will also happen very soon.

[Mr Philip Hollobone (Kettering) (Con)]

I warmly congratulate the Minister for working his socks off over the last year and doing such a tremendous job in vaccinating the nation. In Northamptonshire, the vaccine roll-out has been a tremendous success, with between 90% and 100% of each of the five-year cohorts above age 50 receiving both jabs, and over 67% of 18 to 24-year-olds already having received their first dose. Will the Minister join me in congratulating all the professionals and volunteers locally who have made possible that tremendous local success?

[Nadhim Zahawi]

I thank my hon. Friend for his work locally and for taking that local leadership, like many colleagues have, to get the message out that vaccines are safe and our way out of this pandemic. Of course I join him in congratulating the whole team—the professionals and the volunteers—on the tremendous effort they have made. The figure I have is 124,042 in the Northamptonshire sustainability and transformation partnership. Its numbers are tremendous; even among 18 to 24-year-olds, it is leading the way, at 67%. We want to get that number even higher as quickly as we can.

Kettering General Hospital

Philip Hollobone Excerpts

Tuesday 8th June 2021 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

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.

[Mr Peter Bone (Wellingborough) (Con)]

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.

[Mr Hollobone]

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.

A Plan for the NHS and Social Care

Philip Hollobone Excerpts

Wednesday 19th May 2021 Commons Chamber

[Mr Philip Hollobone (Kettering) (Con)]

I welcome the Government’s health service proposals in the Queen’s Speech, the unprecedented commitment and support to the NHS during the pandemic, and particularly the Government’s continued commitment to the hospital building programme, which has resulted in promised commitments to Kettering General Hospital of £46 million for a new 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, the Minister will know that promises are one thing and delivery is another. I know that as hospitals Minister he has the words “value for money” imprinted on his mind. In that vein, may I press him on the value for money that the Kettering General Hospital redevelopment offers? The problem is that at the moment the hospital faces two funding streams—£46 million for the urgent care hub and £350 million for the phased rebuild—but they are not yet meshing together. Building the original urgent care hub is no longer an option on a stand-alone basis, because there would not be enough room on the hospital site for the health infrastructure plan funding that follows.

The value-for-money solution is to integrate the two funding streams. The best way to do that, which I commend to the Minister, is to designate Kettering General Hospital as an early progress project in the hospital building programme. Kettering General Hospital is ready to go: it owns the land, so no land deals are required and no extra public consultation is needed, and it already has written support from local planners and the regional NHS. This is a phased approach that would deliver visible and real benefits, is shovel-ready and has far lower risks than other hospital build projects.

In developing the whole site plan, the hospital has identified the best way of delivering value for money to get these buildings up and operating, serving local people. Will the Minister look closely at Kettering General Hospital so that Kettering people can have the long-awaited hospital rebuild that we have long been promised and that will be so valued in the local community? The Department needs to be flexible in its funding streams. Let us have an early advance of the HIP2 funding and permission to mesh it with the £46 million for the urgent care hub. We can then have the hospital that Kettering will be proud of for the future. The decision lies in the Minister’s hands.

Covid-19 and Health Inequalities: West Yorkshire

Philip Hollobone Excerpts

Wednesday 21st April 2021 Westminster Hall

[Mr Philip Hollobone (in the Chair)]

I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid proceedings. Members should clean their spaces before they use them and when they leave. Also, Mr Speaker has stated that masks should be worn when not speaking.

[Jon Trickett (Hemsworth) (Lab)]

I beg to move,

That this House has considered health inequalities and the covid-19 outbreak in West Yorkshire.

Thank you for calling me, Mr Hollobone. I thank everyone who has enabled me to secure this important debate so that a Yorkshire voice can make the case. I will be speaking about covid and the vaccine, so first I should like to place on record our thanks from every part of the House to everyone who helped to develop the vaccine, be they scientists, pharmacologists or all the people who have rolled it out. It has been an incredible journey, which shows humanity in a common endeavour against a disease. I congratulate all those involved.

I need not detain the House for long, but I will make a clear case for my constituency in West Yorkshire, where I have lived all my life, although there are lessons for the rest of the country, too. Let me raise two brief points before I get to the central issue. First, statistics. They talk about lies and statistics. I have confidence in the statistics that I will use, because I have been tracking what has been happening since January. They vary a bit, but I am sure that the trends I will describe are correct.

I will use comparisons between my area and the Minister’s area—not to suggest that somehow she has been neglectful of our area while protecting hers, but because the differences are extraordinary. Not for one second do I think she is anything other than someone who wants to do their best for the whole country. However, there are chronic underlying problems in the way that our country is organised. The Government have said they will begin to level up; hon. Members will see how far we have to go. If I were to draw a map of England—the health service that we are responsible for—and shade the economic-social demography, it would be clear that there continues to be a north-south divide. If I were to draw a map of covid, the same would apply. It is striking.

The averages conceal quite a bit; none the less, there has been a rapid decline in covid infections. The figures that I will quote are per 100,000. In January, there were 406 infections per 100,000; now, it is 28 per 100,000. That is remarkable.

[Mr Philip Hollobone (in the Chair)]

I am really interested in what the hon. Gentleman is saying. Are the figures that he just gave for West Yorkshire?

[Jon Trickett]

The figures were for the UK as a whole. It has gone from 406 in January to 28 now. We often hear that no one is safe unless everybody is safe. There are clear hotspots where the infection is still raging, while in other areas it has almost been eliminated. To make the areas that are already low safe, we have to tackle the hotspots.

The UK average is now 28 infections per 100,000, but in my council area it is three times higher, at 72 per 100,000. In West Suffolk, infections are 8.4 per 100,000. Infections are nine times higher in my area of Wakefield than in the Minister’s constituency. That is a staggering difference.

I represent 23 small former mining villages in my constituency. In one ward, the figure is five times higher than the English average, but 17 times higher than the figure for the Minister’s constituency. It is staggering. Across the whole of West Yorkshire, there are 20 areas with levels of ongoing infection that are at least 12 times higher than those in her area. Mine is not even the highest in West Yorkshire. The figures are stark.

Plotting a graph—clearly I cannot illustrate it here, although I would like to—shows that the rate of infection in my constituency was around the English average back at the beginning of January. Suddenly, the line on the graph takes off relative to the national average. That was within three or four days of the decision that was taken—by scientists, I presume, but with the support of the Government—to reduce the vaccine supply to Yorkshire. They halved the amount of vaccine coming into Yorkshire. The average rate in England has continued on its way, whereas the rate across Yorkshire has accelerated rapidly. On the other hand, Wakefield—my area—is vaccinating more than the Minister’s council is. I assume that it was a short-term reduction in supply of the vaccine, rather than something that is continuing through to this day, but perhaps the Minister could confirm that.

There are four underlying factors. I want to focus on one at the end of my speech, but why is it that some areas of the country have alarming hotspots, such as the ones in my area that I mentioned? The four factors all relate to socioeconomic class, stratification or however one wants to describe it. The first is deprivation. Covid is definitely a disease that feeds off poverty in deprived areas. My constituency is the 111th most deprived; the Minister’s constituency is the 417th. Added to that is the fact that I represent former mining communities, where many older men have serious respiratory problems, which obviously makes them vulnerable to a respiratory disease.

The second factor is the cuts that have happened. About 38% of our expenditure has been cut since 2010, which leaves our communities less resilient to all kinds of things, including covid, than they would otherwise be.

The third factor that I want to briefly highlight is the reduction in the number of bed spaces. There has been a kind of consensus that there were too many beds. I never agreed with that; I fought the cuts in the hospitals in my area, unsuccessfully. Some 21,000 beds—I think I am right in saying critical care beds—have closed since 2010, which is too many. We were not ready for the pandemic.

I will discuss the fourth factor before I come to the main issue that I want to raise. We have low access to car ownership in my community, and more than a quarter of households do not have access to a car. As I have already said, I represent a series of villages. The buses are not very good and there is not a frequent service—I am sure thata many hon. Members could say the same thing about their areas. It is very hard for someone to get to hospital if they do not have a car and the bus service is rubbish.

There is a problem not simply with the aggregate number of beds throughout the country, but in connection with population sparsity. I wonder whether more work has been done on this issue. I do not necessarily expect the Minister to reply to me now, but has the relationship between sparsity and access to hospital services ever been properly considered? It was in my area, because I made sure that the people who were making the decisions fully understood the implications of closing hospitals and reducing the number of beds. There are 10,300 households with no car in my constituency alone, which is a problem.

My final point, in terms of what is causing not only our area but West Yorkshire to be a hotspot, is to do with homeworking. Anyone looking at the data will see how striking it is that the proportion of the population who are homeworking varies considerably across the country. For example, in Yorkshire just over a third of people are working from home; two thirds are still working at their place of work. That compares with nearly 60% of people working from home in London. In the Minister’s region, there are 10% more people working from home than in Yorkshire.

As might be imagined, seven out of 10 people in professional occupations are now working from home, whereas in caring, leisure and other services it is only 15% and among process plant machine operatives it is only 5%. So, 5% compared with 70% shows that there is a stratification issue. Why is that relevant? Because people who are working from home are clearly less prone or susceptible to possible disease transmission at a place of work. As their place of work is their home, they are in their domestic bubble.

It is striking that homeworking or working in the workplace relates precisely to occupational structure and the character of the local economy. With an economy such as the one that we have in my area, lots of people work in small manufacturing, warehousing, care services, retailing and other forms of services. We could say that they are all key workers in one form or another because they have kept the country going, but they are working in the workplace rather than at home, so they are exposed to the possibility of workplace transmission.

I have given a lot of figures already, but it is good to get them on the record. Yorkshire has 9% of the English population, but 36% of all workplace transmissions for the whole of the country occurred there. So, it is clear that workplace transmission, reflecting the occupational structure and economic base, is a factor. So, more than a third of all workplace transmissions were in Yorkshire alone, which is an important point.

There is a second related issue, which is access to cars. If someone lives in a village and their place of work is, say, a large warehouse near the A1, then they have to get to work. There are no buses or trains, so what do they do? They share a vehicle, either a minibus or a car, with someone else who lives in the village. The possibility of transmission related to work is clear.

Another point is about the vaccine roll-out. Rightly, the vaccine roll-out tackled the oldest and most vulnerable people first. We are only now arriving at vaccinating the under-50s, but they are the people who are often working in the workplace rather than at home. The vaccine has not reached many of the people who are working in the workplace and who are obviously the most vulnerable to workplace transmission. I would not suggest that we should have done anything differently, but the Government, and we as a country, need to think clearly about the issue of workplace transmission of the virus.

I have one further point on this matter. Some people might say that we should lock down the hotspots, but that will not work. Why do I say that? Because a lockdown affects people who are not key workers. People who work in key industries, such as retailing, care or warehousing, if they are delivering important services or commodities, are still going to work. A lockdown does not protect the people who are at work, and therefore it does not prevent workplace transmission. That seems to be quite an issue for us. Again, I am not saying that the Government were wrong to do the regional lockdowns—we could clearly see that those had an effect—but at the end of the day, they abandoned them. I do not want anyone to listen to my points and say to themselves, “Well, actually there’s a bit of a problem in Yorkshire. We need to protect other parts of the country; let’s lock down Yorkshire.”

If I am right—I would be interested to know whether the Government have other statistics on this—workplace transmission is a serious issue. I spoke about that with the local GP in the most seriously affected village in my constituency, and he thought that it is now about workplaces, and car and minibus sharing. I spoke to the director of public health, who told me broadly the same thing. She said that the figures are slightly susceptible to small variations at ward level, but she still defended them. I then spoke to the chief executive of our health trust. Obviously, he was most concerned about the number of hospital admissions; although that number is now going down because of the medical treatment that we have developed, the ratio is still far too high in our area. He also thought that workplace transmission was an issue.

What do I think ought to happen? Well, the Government may well have already formed a view about workplace transmission. I read in this morning’s newspaper, which covered some of the issues that I am trying to raise, that the Government had responded by saying, “We’ve made available to employers the possibility for an enhanced test, trace and isolate service.” Although I welcome that, because there needs to be as much emphasis as possible on trying to find out who is infected and ensuring that they isolate, there are two problems. First, some people are on very low wages and will not necessarily volunteer that they have symptoms because they are worried about the financial impact on themselves and their households. Secondly, employers are variable, just like any other part of the population. Some employers are very careful, others less so.

I have been approached by a firm, which I will not name, that has a large warehouse in my constituency. It is a household name that provides goods on the high street—everybody knows the name. The workforce, most of whom live in my area, have repeatedly raised with us a sense of not feeling safe at work. I asked the council to visit the employer, and work has been done to make the warehouse a safer place and to reduce transmission. However, my point about sharing cars to and from work still stands, as people share cars if they are not on large incomes or if they live in rural areas such as mine. Also, at the start and end of shifts large numbers of workers are squashed into a small space to get in and out of the workplace, so there are lots of opportunities for workplace transmission.

The employer said to me, “Well, we have told people that if they don’t feel safe, they can go home, but we won’t pay them and we won’t furlough them.” That is not acceptable behaviour from an employer in 2021. It is simply unacceptable that they leave people feeling exposed and at risk but then say, “It’s up to them, but we won’t pay them. They can stay at home with no money.” I live in a fairly poor area, and that is not an acceptable prospect.

Here is what I hope might happen—that the Government and the public authorities accept that employers and employees have a duty and an obligation to try to eliminate covid at work and elsewhere. I do not think it is good enough simply to leave it to the employers. The public authorities need to intervene in hotspot areas and identify what is going wrong. Although the figures in my area are going down quite rapidly, as a multiple of the average, they are horrific, really. It is unacceptable that we are in this situation.

On Tuesday I spoke to Wakefield Council leader Denise Jeffery. I asked whether it was possible for her public health people to identify hotspots of transmission and move in—almost like a hit squad—to test and trace, and perhaps also accelerate the vaccination programme, although that might undermine the Government’s age-related vaccination priorities.

Will the Minister reflect on the points that I have raised and could we have a further exchange, to see what can be done to tackle this chronic problem? I thank the House for listening so courteously.

[Mr Philip Hollobone (in the Chair)]

The debate can last until 11.30 am.