Worcestershire Acute Hospitals NHS Trust

Rachel Maclean Excerpts

Tuesday 11th July 2017 Westminster Hall

[Rachel Maclean (Redditch) (Con)]

I beg to move,

That this House has considered the future of the Worcester Acute NHS Trust.

It is a great pleasure to be here under your chairmanship, Mr Hollobone. I am grateful for the opportunity to raise this matter, a cause of deep concern and worry for the people of Redditch and the surrounding area.

As this is a day on which health is being discussed in this place, I take the opportunity to pay tribute to the hon. Member for Kingston upon Hull North (Diana Johnson) for her tireless work on behalf of the victims of the contaminated blood scandal. I have a constituent in Redditch who has contacted me, even in my first few weeks of serving as a Member of Parliament, and I know that they and other victims will welcome the inquiry announced today.

The Worcestershire Acute Hospitals NHS Trust caters for a population of between 420,000 and 800,000 people. Referrals from GP practices outside of Worcestershire currently make up 13% of the trust’s market share. That clearly shows that the trust is under immense pressure to provide care to a huge number of widely dispersed people.

I will focus on the Alexandra Hospital in my constituency of Redditch. It serves approximately 200,000 people, is the county’s centre for urology services, and has eight operating theatres, MRI and CT scanners and cancer unit status. It may appear on paper that the hospital is well resourced. However, the Care Quality Commission’s most recent report, published in June this year, rated the Alex and the trust overall as inadequate, which is clearly a highly distressing situation. As a result, the trust is in special measures until further review, a status it has remained in since its initial inspection in November 2015.

Despite that status, I welcome that the trust is rated as good overall for its care. Feedback from patients, their families and friends is exceptionally positive in terms of their being treated with kindness, dignity and respect. My constituents in Redditch have often told me of their great personal experiences at the Alex.

[Nigel Huddleston (Mid Worcestershire) (Con)]

I congratulate my hon. Friend on securing the debate. As a fellow Worcestershire MP, I agree wholeheartedly with her comments. While there are many concerns about our local hospitals, not a week goes by in which I do not get letters and calls from people saying how positive their experiences at them were. While a lot of things need to change, we should also recognise the hard work and dedication of many of the staff, who provide excellent service much of the time.

[Rachel Maclean]

I wholeheartedly agree with my hon. Friend’s remarks. I am grateful to the Minister for his generosity in giving up his time to attend today, but I have some key questions for him. While a number of factors led to the trust being in this situation—the debate does not have the scope to allow me to describe them all—what is important to my constituents is what the Department and other responsible bodies are doing to plan for the future. We want the trust to come out of special measures as quickly as possible.

A related but somewhat separate issue is the consultation on the future of acute hospital services in Worcestershire. The review of services in the trust began in January 2012 when clinicians across Worcestershire raised concerns about whether they could safely deliver services due staff shortages. Those shortages meant that services had to be concentrated and centralised, owing to the provision being too small at each of the Worcestershire hospitals. Initial temporary emergency changes—births, complex emergency surgery, in-patient children’s services, emergency surgery on children and emergency gynaecology moved from the Alex to the Worcestershire Royal Hospital—have now become permanent. Those changes will be the subject of the consultation proposals put to the board of the three Worcestershire clinical commissioning groups for approval tomorrow.

As hon. Members will understand, those two wide-ranging issues when taken together have been highly emotive for my constituents, as well as for Members for the rest of Worcestershire. The “Save the Alex” campaign in my constituency has gained huge community support, and I have nothing but respect for the dedication and commitment of those campaigners, led by Neal Stote and many others, who have campaigned extremely hard for more than 11 years. They have kept the Alex at the forefront of public debate in our area, and I look forward to working closely with them in future in the best interests of the people of Redditch and the whole community.

In their proposals, the CCGs told us that there are not enough staff or local demand to maintain services at the Alex. I understand that the Worcestershire Royal is a busy, modern hospital with an interesting caseload that is attractive to consultants and specialist neonatal nurses who want to develop their skills. I have also learned that the Meadow Birth Centre at Worcestershire Royal is fantastic. Since the transfer of maternity services, emergency C-section rates have dropped from 32.6% to less than 25%, meaning fewer expectant mums being rushed down corridors and more relaxed births. Having given birth four times myself, and having been a National Childbirth Trust worker, I am somewhat of an expert on birth, and I know that local women are fortunate to have access to that wonderful care.

I accept that the Worcestershire Royal provides the safest and best care for the women of Redditch and their babies, but we cannot ignore the fact that Worcestershire is a rural county and that Redditch has a very low level of car ownership. In fact, it is one of the lowest in the country, with one in five Redditch households having no access to a vehicle. Not owning a car or driving will be a cause of great stress in times of emergency, and for those who want to visit loved ones who have just given birth in Worcester, it will present difficulties if travelling with young children in tow. Additionally, I have heard from my constituents that, when they arrive at Worcestershire Royal, the facilities are sometimes not quite set up for their needs.

During the general election campaign, and now as a newly elected MP, I have talked to thousands of local people who have brought up the Alex time and again—I have received numerous messages, emails, phone calls and comments on my Facebook and Twitter channels on this topic. Hon. Members will be able to imagine that, at every door I knocked on, the constituent said, “Let me tell you what the number one issue in Redditch is.” I already knew the answer: the Alex.

One young mum broke down in tears during my visit. She said that she had moved to Redditch specifically for the Alex, and had given birth to her first son there—a young lad who was now four. She suffers from a condition that means she is at high risk when in labour, needing almost immediate access to maternity services or her life would be at risk. She is therefore unwilling to fall pregnant again, even though she would like a second child. I find that situation tragic. While I have reassured her that our West Midlands Ambulance Service is the best in the country and would be able to transport her safely if needed, I would be grateful for confirmation from my hon. Friend the Minister that conditions such as hers have been taken into account in the clinical decision-making process.

Another problem that people raise with me is the rate of growth of Redditch as a town—it grew by more than 7% between 2001 and 2011. There must be something in the water in Redditch, because in 2012 there were 18,800 children, which is more than 22% of Redditch’s total population. It is a young and growing town with a lot of young people and children. On top of that, there are plans for new houses in areas such as Webheath. People are naturally worried that services at both the Alex and the Worcestershire Royal will not be able to cope in future, so I would be grateful if my hon. Friend the Minister confirms that he has considered the projected rise in the population when making decisions on commissioning services in Redditch, which serve the populations of both Redditch and Worcester.

Specifically, will the Minister tell me at what level of population, and births-per-head in the population, he would review maternity service provision in an area? I have also questioned the Secretary of State on that point. Will the Minister commit to call for a review when the population reaches that level? Can he also give examples of comparable areas in the country that have successfully transferred maternity services to a neighbouring town or area, so that the people of Redditch do not get the sense that they are being unfairly singled out? My constituents would particularly like to know why services were centralised in Worcester instead of Redditch, and whether that process was carried out fairly and with all due process.

Another extremely worrying fact is the winter pressures faced in Worcester. The BBC reported in January 2017 that three patients died at Worcestershire Royal over the winter period after waiting on trollies for lengthy periods, which has been quoted back to me many times by residents. I heard, and continue to hear, many stories of people waiting on trollies in corridors for lengthy periods and in dirty conditions. I join my hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) in recognising the dedication of our NHS staff—the hard-working doctors and nurses doing their absolute best in such conditions—but the root cause of this problem lies not with them, but with a failure of leadership that goes back some time. That is not good enough. I call on my hon. Friend the Minister to provide much-needed assurances that robust and effective plans are in place to provide much better care for next winter.

As I previously alluded to, transport to Worcester is of huge concern to my constituents—my hon. Friend the Minister will find it challenging to drive between Worcester and Redditch on the M5 if he is unlucky enough to be stuck in traffic. What assurances can he give me that, if an ambulance providing transport in the event of an emergency transfer from Redditch to Worcester is unlucky enough to be held up in traffic, it will be able to care for a critically ill patient, baby, child or mum in labour? That is a priority for me and my constituents.

Although I am delighted that there is a free shuttle bus from the Alex to the Worcester Royal, I would like the Minister to join me in calling on the responsible authorities to ensure the sustainability and extension of that service. It could then serve more areas by making more stops over the diverse area that our county covers, as well as being more flexible and publishing its services more effectively. A lot of people in Redditch do not know about that valuable service, as I saw for myself when I knocked on doors in the election campaign.

The Minister will understand that one of the most difficult and emotive subjects is the treatment of critically ill children. Given the removal of accident and emergency care services for under-16s at Redditch, can he confirm that the new urgent care centre proposed for Redditch will be staffed 24 hours a day? What type of conditions will be treated there, and which cases will need to be transferred to Worcester? Can he confirm that, if children need to be treated in the urgent care centre, there will be enough fully trained staff to treat children, given that they are mainly serving an adult A&E population? Can he give any idea of the timescale for opening that urgent care centre?

One key problem identified by the CQC was leadership. I am very pleased that the trust has a new permanent leadership team, including a new chairman and a new chief executive. My Worcestershire colleagues—my hon. Friends the Members for Mid Worcestershire, for West Worcestershire (Harriett Baldwin), for Wyre Forest (Mark Garnier) and for Worcester (Mr Walker), and my right hon. Friend the Member for Bromsgrove (Sajid Javid)—and I will meet regularly with the trust’s new chief executive, Michelle McKay, whom I have already met.

I welcome the reaffirmed commitments that the Minister of State, Department of Health, my hon. Friend the Member for Ludlow (Mr Dunne) and the Secretary of State made to me of a £29 million investment in the Worcester and Alex Hospital sites, if the business case is approved this week by the CCG board. I would be most grateful to have more detail on what that will involve, when we will see it and what benefits it will deliver to Redditch.

What conversations has the Minister had with, and what support has he given to, the trust’s leadership team to ensure that the new chief executive can swiftly transition the trust out of special measures? Specifically, can he confirm what conversations his Department has had on the critical issue of staff morale? Low staff morale has in the past led to high staff attrition at the Alex, as I heard at first hand during the election campaign from a number of former and current staff members at the Alex. That has a knock-on effect on service delivery. I know from my experience of running a business that if staff are not happy and do not feel valued, it is impossible to achieve a good outcome in an organisation, no matter how much investment and resources are put into it.

[Nigel Huddleston]

I thank my hon. Friend for giving way again. Does she agree that low morale and any hospital being in special measures has a knock-on effect on recruitment, because people are a bit more reluctant to start or pursue their careers in those hospitals? The challenges that that brings need to be addressed.

[Rachel Maclean]

My hon. Friend touches on the key point of recruitment, which my colleagues and I, and himself, have raised with the new trust leadership. The trust has brought forward some interesting and exciting measures to address that, such as a new Facebook recruitment video. We look forward to seeing how that progresses and delivers more staff into this much-needed trust.

I am extremely grateful for the Minister’s interest in this matter and for being granted the time to discuss it. I am especially grateful for the commitment shown during the general election campaign by his colleague the Minister of State, who visited me in Redditch. I call on him to lay to rest the pernicious rumour circulating in Redditch that our hospital is at risk of further downgrades or even closure. I am aware, as are some of my constituents, of the Naylor report, which contains in its numerous pages—they are too numerous to mention—proposals for selling unused NHS land to build affordable housing for NHS workers. That seems to me to be an eminently sensible suggestion, given the shortage of affordable housing in our country and the need for affordable homes for our public sector workers.

Some of my constituents have found suggestions in the report’s pages—suggestions that I have not personally been able to find, despite assiduous reading over a number of hours, which I can confirm is a great insomnia cure, should the Minister be interested—that the Alex Hospital might be sold off for building land. I would be grateful for his confirmation that no suggestion is hidden in the small print of the report or elsewhere in any Government document that the Alex Hospital faces that fate.

As the Minister has been so generous in attending this debate, I would like him to go further by guaranteeing my constituents that Redditch will have a hospital that serves its population and is fit for the size of the town both now and in the future. Thank you, Mr Hollobone, for allowing me time to make my points. I look forward to hearing from the Minister.

[Mr Philip Hollobone (in the Chair)]

It was a pleasure, and I congratulate the hon. Lady on her address. I call the Minister.