Barts Health NHS Trust

Rehman Chishti Excerpts

Thursday 19th March 2015 Commons Chamber

[Jane Ellison]

The hon. Gentleman and I have debated these issues in Adjournment debates in this House, so I know that they are of great concern to him. All these issues in that part of London’s health economy need to be considered.

[Rehman Chishti (Gillingham and Rainham) (Con)]

Will Barts be given the same excellent support from the Government as Medway hospital in my constituency, which is in special measures? It has received extra resources and been paired with excellent hospitals such as Guy’s and St Thomas’s. Will the Minister join me in paying tribute to the excellent staff who work day in, day out caring for patients at Medway? Will she also note that in 2006 Medway hospital had the seventh highest mortality rate in the country, yet nothing was done? Will the shadow Health Secretary apologise for that? I welcome the support that the Government have given Medway hospital to turn it around.

[Jane Ellison]

I thank my hon. Friend for that question. He illustrates the fact that these problems can be addressed through this regime of extra support. I pay tribute to the staff at his local hospital, who have worked so hard to address the failings and to provide much safer care for their patients. He illustrates exactly why this regime of being transparent about issues and ensuring additional support can be given to trusts to address their problems can be successful and can benefit patients.

National Health Service

Rehman Chishti Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr Hepburn]

I can assure the hon. Gentleman that after that pledge I will certainly be watching the shadow Secretary of State when he gets in, to make sure our walk-in centre is still going.

Who gains from the present situation? Only two lots of people—the Tories, many of whom are up to their necks in involvement with private health care providers, and the profiteers, the health care providers, who are going to come in and cherry-pick the best services so that they can make profits. I welcome the shadow Secretary of State’s statement and commitment today. It will boost the morale of the people of the north-east who are so desperate to keep the service.

[Rehman Chishti (Gillingham and Rainham) (Con)]

The hon. Gentleman just asked the shadow Secretary of State whether his walk-in centre would be kept open and the answer was yes. However, we should not look at future promises. We should look at the past and what was done under the previous Administration. In 2006, Medway hospital in my constituency had the seventh worst mortality rate, yet nothing was done. We must judge Labour by what it did, not by future promises.

[Mr Hepburn]

We must remember that it was the Labour party that created the NHS, that saved the NHS in 1997 and that tripled spending on the NHS in our last period in government. It is the Labour party, when we get in, that will return the NHS to the people—unlike the Tories, who would return the NHS to the profiteers who fund them and their organisation. The only way to get rid of the crisis in the NHS is to get rid of the Tories.

--- Later in debate ---

[Stephen McPartland]

My hon. and learned Friend is correct, and he supported me all the way as I fought with the Treasury, the Department of Health and every single system to ensure that we got the deals signed, sealed and delivered and the buildings constructed on time. I am proud of the investment and the staff who work in the hospital, but I am concerned about the way that Members talk down the NHS. Thousands of NHS workers in my constituency feel very depressed about the situation. They put in a huge amount of hours and a great deal of effort, and what happens at the end of the day? People say that their A and E is in crisis. That is completely unacceptable. Last week, the A and E department in my constituency saw 93.7% of people within the four-hour target. This week, it is on target, with nearly 95% of people, which is down to those doctors and nurses working their backsides off on a daily basis to ensure that they save lives.

[Rehman Chishti]

I pay tribute to the work my hon. Friend does in his constituency. I often see it on Facebook and read about it on the internet. He is a tireless campaigner for the health service in his constituency. He mentioned the A and E in his constituency. A linked issue is that of resources. In my constituency, £13.4 million has just been invested in resources for the A and E department—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I do not want such long interventions. If the hon. Gentleman wishes to speak, we can always put him on the list. If he wants, he can save something for later.

--- Later in debate ---

[Mark Reckless]

Yes, I can give the hon. Gentleman that assurance. It is the view of my party, it is the view of the whole party, and it is my own personal view, which is core to my politics and what I came to the House to represent.

The Prime Minister said earlier that I came to the House week after week to discuss the NHS in Kent. Following what could perhaps be described as an endorsement of my approach from the Prime Minister, I now wish to raise some of the issues that have arisen in Medway. One of the problems with the motion is that it makes no mention of introduction of the new GP contract in 2004, which I believe has been a significant driver of increased demand for A and E services.

In Medway, where the proportion of single-handed general practices is significantly higher than the national average, the burden of out-of-hours care falls largely on an organisation called MedOCC. While I would encourage constituents to use MedOCC rather than A and E when that is appropriate, I have one or two concerns about the way in which it operates.

Like the hon. Member for Wirral South (Alison McGovern), we had a young child who was ill, and we sought an appointment. My wife telephoned MedOCC and we were offered an appointment at a particular time, but were then told that the wait would be an hour and a half. We said “If the wait will be an hour and a half, why do you not give us an appointment an hour and a half later than the one that you have just given us?” However, that was not allowed. We had to wait for an hour and a half, because that was the procedure, and that was the way it had to be. Although we went to the MedOCC clinic because we thought that that was the appropriate service, I would understand it if a constituent in the same circumstances decided to take his or her chances at A and E, where it might even be possible to be seen more quickly.

It is important for an out-of-hours service—in our case, MedOCC—to be flexible and responsive, and to be operated in a way that makes it an attractive and appropriate alternative to A and E, and I shall develop that point further when I meet members of the clinical commissioning group on Friday.

[Rehman Chishti]

The hon. Gentleman and I share the same hospital in Medway. Will he join me in welcoming the extra £13.4 million that has been given to its A and E department, the extra £6 million of winter funding, and the additional £10 million that has been given to the CCG to help to improve local health services?

[Mark Reckless]

I do indeed welcome those sums; I pressed for them strongly. I was particularly delighted by the provision of that £13.4 million for the rebuilding of the A and E department, which I think is essential. I am now campaigning for the provision of a further sum of approximately £20 million so that the hospital can build what it describes as an “emergency village”, consisting of short-stay medical wards around the A and E to improve the throughput of patients and the quality of care.

I have also helped the hospital with its efforts to ensure that patients are referred more appropriately, and are not necessarily sent to A and E. If a GP refers a patient to hospital and that patient has a known condition, surely it is better for the patient to go to the relevant ward than to be pushed through A and E, which is not an appropriate environment for someone who has already been assessed by a GP. Similarly, A and E is rarely the right environment for people suffering from dementia. It is best for action to be taken at the nursing home or by GPs, possibly based alongside A and E, who can make a speedy assessment and transfer the person to an appropriate treatment area. I am also pleased by the decision to end the so-called Star system in Medway A and E. The idea was that someone would be assessed by a senior clinician before it was decided what should be done, but that was not happening within a sensible time scale. That system has now been replaced by nurse-led triage, which I think will work better.

I am also grateful for the support we have received from other hospitals, notably the Homerton, which has an excellent A and E department. Medway has benefited from secondments there. It is important that those secondments and that support are integrated with the permanent staff in Medway hospital and the clinical director lead for emergency medicine is key.

We have had extra consultants appointed in emergency medicine at Medway hospital, which I strongly welcome, but I must mention the terms and conditions of emergency doctors. It is an extraordinarily demanding specialty and doctors working in it rarely have the opportunity to take on private work, which is a consideration for some but not all doctors when they make their choice of specialty. To encourage more doctors to come in to this field, should we consider changes to the lockstep consultant contract so that doctors in the extraordinarily demanding area of emergency medicine can perhaps receive more pay than others who are in specialties that are not as extraordinarily demanding, to which some might have been attracted by the potential for private earnings that they could not make in emergency medicine?

The Secretary of State tells me that what is actually required is more holidays for A and E doctors. That might be the case, but it would require pulling more doctors in to emergency medicine to cover for colleagues on holiday. I question a system in which high numbers of agency staff are used for a day or a week. Hospitals with problems in A and E and that have problems attracting people can fill places with those staff by paying very high rates, but they do not necessarily gel as a team or provide support in anything but the short term. We need to make emergency medicine attractive for doctors.

Finally, on the question of Monitor and the CQC, Medway hospital is a foundation trust. That happened in a largely box-ticking and financial exercise under the previous Government that ignored the death rate being one in 10 higher than it should have been, as mentioned by the hon. Member for Gillingham and Rainham (Rehman Chishti). Although Monitor has been reasonably sensible in its approach to Medway, it cannot come and run the hospital. We had to look to the board to do that. Similarly, the CQC has made some sensible interventions, for example on A and E, but in 2012 it said that Medway was a good hospital that was meeting all its standards. I believe that many of the problems we are seeing were in place then but were not identified by the CQC. My party wants to replace some of the alphabet soup of bureaucracies and regulators, such as Monitor and the CQC, with directly elected health boards that could, we believe, oversee these things better.

A and E (Major Incidents)

Rehman Chishti Excerpts

Wednesday 7th January 2015 Commons Chamber

[Mr Hunt]

It is interesting that the hon. Gentleman did not want to talk to the House about his own local hospital, which is performing extremely well for A and E. It would be good if more of those on the Opposition Benches talked about the good things that are happening in the NHS, including nine out of 10 people who go to A and E being seen within four hours.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I thank the Secretary of State for the £13.4 million given to Medway Maritime hospital’s A and E department. Will he assure me that everything that can be done is being done to turn around hospitals in special measures such as Medway, which had the seventh highest mortality rate in 2006 yet nothing was done? Will he also join me in paying tribute to all the front-line staff who do a fantastic job at Medway?

[Mr Hunt]

I am happy to do that. One of the things that this Government are most proud of is what we have done to turn around hospitals with entrenched low standards of care following the terrible tragedy at Mid Staffs, with 18 hospitals put into special measures and six of them turned around. Despite all the pressure on me and on this Government to hit targets, we are sending out signals to the system, loud and clear, that targets matter, but not at any cost, and that we do not want corners cut when it comes to patient safety.

A and E and Ambulance Services

Rehman Chishti Excerpts

Thursday 18th December 2014 Commons Chamber

[Mr Hunt]

I do agree. The first thing we could do as a step towards that is properly integrate out-of-hours care, linking out-of-hours GP services, A and E departments and 111 departments. Obviously, that needs to be linked into the in-hours GP care that people will give. I wish to commend the efforts being made in Cornwall to improve A and E performance, which has been getting better in recent weeks. We are all very encouraged by that, because there have been a lot of challenges in that area.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I thank the Secretary of State for the personal support he has given to Medway Maritime hospital, particularly the extra £5.5 million given to the hospital to improve its A and E services. Will he confirm that hospitals in special measures and in challenging circumstances will receive any additional resources they need over the coming winter months?

[Mr Hunt]

We absolutely will make sure that we give Medway what it needs. I wish to thank my hon. Friend for his tireless campaigning to improve the situation, as it is very challenging there at the moment and he has taken a responsible attitude towards it. It is really important to praise the staff at the hospital, who are working very hard, and to reassure his constituents that although there are many improvement to be made, there is a lot of excellent care in that hospital and we all want to get there as quickly as we can.

NHS (Five Year Forward View)

Rehman Chishti Excerpts

Monday 1st December 2014 Commons Chamber

[Mr Hunt]

I warmly congratulate the hon. Gentleman on being the first Labour Member to say in this House that a strong NHS needs a strong economy. May I encourage him to transmit that message to those on his Front Bench, and perhaps to the shadow Chancellor, who might then understand why people in the NHS are backing this Government because they know that we will deliver a strong economy? I do not know whether we can do all the things the hon. Gentleman talked about, but we will have a better chance with the fastest-growing economy in the G7.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I thank the Secretary of State for his statement and for the support that he has personally given to Medway Maritime hospital in my constituency, including, at a meeting last week, a commitment of £5.5 million to increase its A and E capacity. Can he assure me that hospitals in special measures that have problems going back to 2006 with high death rates will be given extra resources from the funding announced today to ensure that they are turned around as quickly as possible?

[Mr Hunt]

I assure my hon. Friend, who has campaigned very hard to improve standards at Medway hospital, that, first, we want to support its doctors and nurses, who are more passionate than anyone about putting this difficult period behind them; and that secondly, I have no greater focus than on making sure that we do turn around these hospitals in difficulty. It is a challenging process, but the extra funds that I have announced today will benefit all hospitals, including Medway.

Five Year Forward View

Rehman Chishti Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

The hon. Lady has made an important point. We would like more NHS land to be sold off for precisely those purposes.

There is a broader point to be made about housing, which is also important, and which I thought the hon. Lady was going to make. If we are to think about care in a more integrated way, we shall need to reform the NHS so that we look at people’s problems holistically, and that will include looking at their housing, which has a direct impact on their health. I think the structures that feature in the five-year plan begin to make such an approach possible for the first time, and I find that very exciting.

[Rehman Chishti (Gillingham and Rainham) (Con)]

Does the Secretary of State agree that the key aim of our reforms is to support hospitals which have not been fully supported before? Medway Maritime hospital, which is in my constituency, had one of the highest mortality rates in 2005-06, but nothing was being done. I thank the Secretary of State for putting the hospital into special measures, so that it can secure the support that it needs to turn things around and my constituents can have an excellent hospital that delivers for them. I also thank him for visiting the hospital recently and meeting its excellent front-line staff, who do a great job.

[Mr Hunt]

I thank my hon. Friend for what he has done for Medway Maritime. That was a very good visit: I met both management and staff, and gained a better idea of the challenges faced by the hospital.

The report makes it clear that we must become much better at tackling variations in care. Never again must we have a system in which hospitals are struggling and delivering poor care, and that poor care is swept under the carpet and nothing is done about it. The Government have put 18 hospitals into special measures—more than 10% of all the hospitals in the NHS—and that has been very challenging. We have been accused by Opposition Front Benchers of running down the NHS when we have done it, but do you know what has happened? Six of those hospitals have now come out of special measures, and nearly all the others have improved dramatically. It is time that the Labour party got behind what is a really good inspection programme, based on openness, honesty and transparency about problems.

Patient Safety

Rehman Chishti Excerpts

Tuesday 24th June 2014 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for raising that very harrowing issue. I hope I can reassure him by saying that we are progressively extending the changes we introduced to hospital inspections to inspections of general practice and adult social care settings. The new inspection regime is designed to be much tougher when it comes to identifying problems. It is never possible to identify all abuse in an inspection, which is why what I have announced today is so important: it is about the creation of a culture that tries to prevent such problems from arising in the first place.

[Rehman Chishti (Gillingham and Rainham) (Con)]

I welcome the statement and the work that the Secretary of State is doing. Mr Mufti, who was the medical director of Medway hospital under the last Government, raised serious concerns about the bullying of staff, which he feared was affecting the quality of care and patient safety. Will the new provisions address that problem?

[Mr Hunt]

That is exactly the intention. Following my conversation last week with Nigel Beverley, the chief executive of Medway, I think that the hospital is making good progress after going into special measures. However, it is important to recognise that while it is possible to change things externally, real culture change must come from inside. This is not a day on which we are announcing new targets or top-down initiatives. The Sign up to Safety campaign to be led by Sir David Dalton will be voluntary: hospitals must choose whether to sign up to it. I think that that will enable us to make more progress than we would make if we tried to do things in the old way.

Mid Staffordshire NHS Foundation Trust

Rehman Chishti Excerpts

Tuesday 19th November 2013 Commons Chamber

[Mr Hunt]

We have based our recommendation today precisely on what Salford Royal does. It uses the kind of model to ensure minimum recommended staffing levels on every ward that we want every hospital to use. We say that we want those data published monthly, but that is a minimum. Salford Royal publishes them every day, which is very impressive. Given that most hospitals are not using tools anything like as sophisticated as that, it will be a big step up for most hospitals to do that. We want to do it. What is significant about our announcement is that we want to assemble those data for every trust in the country so that they can be compared on a monthly basis and so that people can know how many wards and how many shifts are being safely staffed at their local hospital compared with neighbouring hospitals.

[Rehman Chishti (Gillingham and Rainham) (Con)]

The Secretary of State will know that Medway Maritime hospital in my constituency had the seventh worst mortality rate in 2005 and 2006, yet nothing was done until he put the hospital into special measures. It is now linked with the outstanding Frimley Park hospital, sharing good practice and turning things around, so that my constituents can get good care, while inspections are also on their way. He said that if hospitals do not turn things around in the short term, they will be put into administration, but what does “short term” mean—is it a year or six months?

[Mr Hunt]

Our intention is that the maximum period when a hospital is put into special measures should never be longer than a year. After that, if it is not making significant progress, there is the possibility of it being put into administration. The reason for that, precisely as my hon. Friend said, is that we cannot let poor standards and poor care persist over a long period. I am pleased about the progress made at Medway Maritime in recent months; Frimley Park, which is my local hospital, delivers truly outstanding care. He is absolutely right to say that it should never have taken so long to get to the heart of the problem.

Tobacco Packaging

Rehman Chishti Excerpts

Thursday 7th November 2013 Commons Chamber

[Bob Blackman]

The hon. Lady comes on to a particular issue. The vast majority of smokers begin smoking in childhood. Two thirds of current smokers began under the age of 18 and we know that 200,000 young people under the age of 15 begin to smoke every year. When you add in the people that begin to smoke between 15 and 18, it becomes 300,000 smokers per year. Once someone is hooked, it is very difficult to give up. Most people say that after the direct sale of cigarettes to minors was made unlawful, many young people still continued to start smoking. Cancer Research stated in 2011 that more than 200,000 young people under the age of 16 had started to smoke. We must make sure that we reduce that number quite drastically.

[Rehman Chishti (Gillingham and Rainham) (Con)]

My hon. Friend talks about the accessibility of cigarettes for people who take up smoking. Gillingham has the largest amount of illegal cigarettes smoked in the country, which has an effect on health, the economy and crime. Does he agree that more needs to be done nationally to ensure that we stop these illegal cigarettes coming in to our country?

[Bob Blackman]

I agree completely. That demonstrates the failure of the tobacco industry to stop the illicit trade, even under the current advertising arrangements for packaging.

Hospital Mortality Rates

Rehman Chishti Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

I struggle to find the link between that question and Sir Bruce Keogh’s report on the 14 hospitals, but as the hon. Gentleman has asked about A and E, and as he is trying to take the moral high ground, perhaps he would explain why he has not been standing up in this House campaigning against Labour’s abysmal record, as it has missed its A and E targets in Wales since 2009.

[Rehman Chishti (Gillingham and Rainham) (Con)]

In 2005 and 2006 Medway Maritime hospital had the seventh worst mortality rate in the country, yet nothing was done. May I thank the Secretary of State for the actions he has put forward today, which will help improve the quality of care for my constituents and people from further afield?

[Mr Hunt]

My hon. Friend is right. There were high mortality rates in his hospital in six of the nine years they were measured under the last Labour Government, and there were problems with A and E and with inappropriate medical interventions. He can say to his constituents today that the Government have identified the problem and have been transparent about it, and we will be accountable for sorting it out.