Covid-19 Update

Richard Fuller Excerpts

Thursday 17th December 2020 Commons Chamber

[Matt Hancock]

Yes, I can. I am very sorry that that meeting has not happened yet and we will get right on to it for early January.

[Richard Fuller (North East Bedfordshire) (Con)]

The changes for Bedfordshire announced by my right hon. Friend will be disappointing to residents and businesses, but it will be helpful for them to understand that, in setting up the tier system, my right hon. Friend established clear criteria, and he is publishing the data and has said that he will be open to regular reviews. On those criteria, when it comes to the issue of hospitals and pressure on the NHS, that is not a data-driven criterion; it comes with statements that the NHS is under considerable pressure, which is very difficult for people to understand, because we always hear, during pre-covid times and now, that the hospitals are under pressure. So will he commit to producing projections of occupancy rates and acute bed occupancy rates across the NHS and, if possible, on a local hospital system basis?

[Matt Hancock]

Yes, we are working exactly on how to demonstrate that in a numerical rather than a narrative form, not least for the reasons that my hon. Friend sets out. We have seen a very sharp rise in cases across Bedfordshire, especially in the more rural areas, including North East Bedfordshire, so it is so important that people across Bedfordshire take that personal responsibility and follow the new tier 3 rules. I hope that we can get the rate to come down as fast as it has gone up.

Coronavirus

Richard Fuller Excerpts

Wednesday 17th June 2020 Commons Chamber

[Matt Hancock]

Nobody wants to see the sort of economic consequences that we have already seen—even if there are more to come—but we have to take these measures in order to tackle this pandemic. We have put extra support into mental health, and more is to come. It is a really important part of the solution.

[Richard Fuller (North East Bedfordshire) (Con)]

This is the first opportunity that I have had on the behalf of my constituents to thank publicly the Secretary of State, his ministerial team, the entire civil service team and all their families for what they have contributed in this national effort. I thank all those people through him.

Local authorities in Bedfordshire have the highest incidence rate of coronavirus across the east of England. The Secretary of State said in his statement that the processes are in place to escalate concerns if there needs to be a local lockdown, but there are local concerns about the availability of local data. What is the current state of localised data? What efforts is he making to improve its availability?

[Matt Hancock]

Localised data is available through the work of Public Health England and local directors of public health, including the director for Bedfordshire, and then through our survey data, although that is stronger at the national level than at the regional or local levels. Pulling all this data together, and then ensuring that it gets to the decision makers so that they can base their decisions on it, is the task of the joint biosecurity centre. I will ask its head to write to my hon. Friend with details of the data it has on Bedfordshire and what further data it is working on in order to answer the questions that my hon. Friend rightly asks.

Coronavirus

Richard Fuller Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

We are all in agreement that nobody, including those who are self-employed, should be penalised for doing the right thing. How we get that support to them is a different question, because SSP is paid by the employer and the self-employed do not have an employer. We will bring forward a solution to that particular policy conundrum.

[Richard Fuller (North East Bedfordshire) (Con)]

The Grand Princess cruise ship will finally dock in Oakland today, allowing 140 Britons, including at least four of my constituents, to disembark. My right hon. Friend mentioned a few messages about the support that will be given. A lot of the Brits on the ship feel that the UK has not responded as strongly as the Americans. Will he use this opportunity to say a little more, or will he perhaps get the Foreign Office to contact constituents on the ship directly?

[Matt Hancock]

The Foreign Office will be putting out more information, because it leads in that policy area. We will be repatriating the Brits and we are working with the Americans to ensure that we can get them home safely. We have full confidence that the American public health system will be able to help those individuals off the ship and on to planes to come home.

Oral Answers to Questions

Richard Fuller Excerpts

Tuesday 28th January 2020 Commons Chamber

[Sally-Ann Hart (Hastings and Rye) (Con)]

4. What steps he is taking to improve access to GPs.

[Richard Fuller (North East Bedfordshire) (Con)]

6. What steps he is taking to improve access to GP surgeries in North East Bedfordshire constituency.

[Stuart Anderson (Wolverhampton South West) (Con)]

11. What steps he is taking to improve access to GPs.

--- Later in debate ---

[Matt Hancock]

My hon. Friend is right to ask. It is incredibly important that we get the right number of GPs, not least to reduce the amount spent on locums, who can be very expensive and often do not know the local population as well as salaried GPs. Her local clinical commissioning group is developing a new-to-practice fellowship in Hastings for GPs starting out in practice in order to encourage more doctors into practice and then to support them. It is also working with primary care networks so that more can become GP trainers and take on students. We are expanding the numbers going into GP training—there were record numbers last year—but I want the numbers to go up again and to make sure that Hastings gets the GPs it needs.

[Richard Fuller]

As part of the council area with the second-largest population increase in the country, the people of Biggleswade, Sandy, Arlesey and Stotfold are at their wits’ end over access to GP appointments. What special attention will the Secretary of State pay to those areas of large population growth to make sure that increases in housing are matched by increased access to GPs?

[Matt Hancock]

That is an incredibly important point. We have a manifesto commitment to ensure that where there is new housing there is also new primary care. Just as a new housing estate will often require a new primary school and new transport links, so we need to put in the GPs as well.

Agenda for Change: NHS Pay Restraint

Richard Fuller Excerpts

Monday 30th January 2017 Westminster Hall

[Catherine McKinnell]

I thank the hon. Lady for that intervention—I think that many of us are surprised that we agree so entirely with the hon. Member for Kettering (Mr Hollobone). She raises an important point about the concern that many people up and down the country feel about some of the Prime Minister’s early actions in her time in office.

There are real concerns that the continuation of pay restraint in the NHS threatens to undermine the very benefits that Agenda for Change was supposed to bring to employers and staff. A centrally imposed cap on pay rises limits employers’ ability to respond to recruitment and retention problems while compromising the extent to which skills and competencies acquired by staff throughout their careers can be properly recognised and rewarded.

The extended nature of the pay restraint imposed first by the coalition Government and now by the Conservative Government also throws up this question: what is the point of having an independent NHS Pay Review Body, given that the Minister is clearly content to impose a figure on NHS Employers and staff each year? Indeed, the Royal College of Midwives has warned that the policy

“undermines the integrity of the system; and will cause lasting damage to the morale and motivation of staff, worsening the staffing crisis in the NHS.”

Despite the widely promised but yet to materialise extra £350 million a week for the NHS, we all know that our health service faces real and significant challenges in financial terms, both now and in the years ahead.

[Richard Fuller (Bedford) (Con)]

I add my congratulations to the hon. Lady on securing this important debate. She has somewhat moved on to the topic of Brexit. In Bedford hospital, to fill vacancies in our nursing staff we have relied on bringing in staff from the European Union. Does she not agree that the Government have a choice: they can continue with pay restraint if they wish, but if so we must retain that ability to attract people from within the European Union and secure the rights of those already here?

[Catherine McKinnell]

The hon. Gentleman raises some important points. I would never admit to having strayed into the subject of Brexit in this important debate on the NHS, but his comments are on the record and should be noted by the Minister. As NHS Employers stated in its 2017-18 submissions to the NHS Pay Review Body:

“The NHS continues to face unprecedented financial and service challenges. The majority of trusts fell into deficit during 2015-16 and the overall shortfall has now reached over £2.5 billion… The financial settlement for the NHS up to 2020 is extremely challenging, with employers set ambitious targets to deliver efficiency savings. At the same time, demand for services continues to rise. Performance indicators show the service is under great pressure as demands for care increase and other public services reduce provision.”

NHS and Social Care Funding

Richard Fuller Excerpts

Wednesday 11th January 2017 Commons Chamber

[Mr Hunt]

Let me answer the hon. Gentleman’s question. I said that I would write to him, and I will do so. He may have noticed that there are other issues that we are dealing with, which is why I may not have had time to sign the letter. The £400 million extra for local authorities over the next two years will make a significant difference and he should recognise that.

[Richard Fuller (Bedford) (Con)]

I am attending this debate because there will be constituents in Bedford and Kent who are concerned about the headlines that they have read. I am pleased that the Secretary of State will correct some of the points that have been made. What our constituents want to know is what is being done, or what should be done. I listened for 33 minutes to the shadow Secretary of State—the Labour spokesman on the NHS—on this issue, and there was not a single new idea other than spending money. Will my right hon. Friend please provide some practical answers to the problems that are being raised in the papers?

[Mr Hunt]

My hon. Friend is absolutely right, which is why I will be talking later about our solutions to these problems.

Oral Answers to Questions

Richard Fuller Excerpts

Tuesday 20th December 2016 Commons Chamber

[Mr Hunt]

The hon. Lady might have noticed that I personally did not talk very much about that £350 million. Whatever resources we have post-Brexit will have to be set in the overall economic context, but of course the great thing is that, post-Brexit, that will be a decision for this Parliament.

[Richard Fuller (Bedford) (Con)]

Many members of the NHS workforce across Bedford and Kempston come from the EU, but many others come from Caribbean countries, the Philippines, India and many countries in Africa. Will my right hon. Friend make sure that, in the future, people from those countries are given equal access to work in our NHS as that for EU nationals?

[Mr Hunt]

The benefit of Brexit will be that we can take precisely such decisions in this Parliament, because we will get back control of our borders. I am grateful to my hon. Friend for mentioning the very important work done by people from outside the EU in the NHS. Because I happened to meet the Philippines ambassador last week, I want to pay credit particularly to the Filipino workers in the NHS and the social care system, who do a fantastic job.

Oral Answers to Questions

Richard Fuller Excerpts

Tuesday 15th November 2016 Commons Chamber

[David Mowat]

I give the right hon. Gentleman the categorical assurance that better mental health is a fundamental part of what the STPs are trying to achieve, as are better cancer outcomes and better integration of adult social care. If an STP does not include those things, it will have to continue to evolve until it does.

[Richard Fuller (Bedford) (Con)]

The Mayor of Bedford, Dave Hodgson, and I have a common approach to the STP in Bedford—it is ably led by Pauline Philip, the chief executive officer of Luton and Dunstable hospital—but he is frustrated that he is not being involved and that his voice is not being heard in the process. Will my hon. Friend ensure, when he reviews all the STPs, that he gets a guarantee in every single case that the local authorities have bought into the plan, and, if not, that they will not proceed?

[David Mowat]

I give my hon. Friend the categorical assurance that if local authorities and the NHS managers doing the planning work have not engaged properly, the plan will not be considered to be complete. That does not mean that every local authority has a veto on its STP.

NHS Sustainability and Transformation Plans

Richard Fuller Excerpts

Wednesday 14th September 2016 Commons Chamber

[Ms Abbott]

I have to make some progress.

[Richard Fuller (Bedford) (Con)]

On a point of order, Mr Deputy Speaker. Is it a requirement for a Member of this House to know the difference between a debate and a monologue?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

It is for me to make that decision. I am quite happy for the shadow Secretary of State to decide whether she wishes to give way or not. In fairness, this is an Opposition debate, and the hon. Lady is leading it. Let us not have any more pointless points of order. I am worried about how many Members want to speak; I want to try to get everybody in.

--- Later in debate ---

[Richard Fuller (Bedford) (Con)]

Change in life is frequently a source of anxiety or downright scary. When people are young and change schools, when they get married or when they start a job, that change is scary. There is nothing scarier for a community than change in how its health services are provided, so perhaps it is not surprising that the NHS has found managing change to be one of the most profoundly difficult things to accomplish.

As the hon. Member for Central Ayrshire (Dr Whitford) mentioned, we frequently face substantial or overwhelming challenges in society, with people growing older and having more complex needs, and the requirement for more expensive equipment and supplies to meet ever increasing standards for and expectations of healthcare in our country. The NHS was presented with two options for change. One is radical and will meet those challenges in a fine future that offers great health outcomes for all, but sounds a little too scary. The other option is the incremental approach, which will move things along a little bit. It will not deal with the fundamentals but it will enable us to feel that we retain the institutions and structures with which we are familiar.

As someone who was born in Bedford hospital, grew up in Bedford and now represents Bedford, I am very familiar with each of the buildings and institutions in my community. To see them change is a very scary thing. When we consider processes of change, we have to recognise that the population start from that position of anxiety. It is therefore important that Members do not play on those anxieties. It is not effective opposition to create scare stories ahead of an outcome. That is not in the public interest. We can raise concerns, yes, but in a way that looks to the sensitivities of local situations. That is what I would like to focus on in my remarks: the specific circumstances of my part of the country.

I welcome the STP approach because of the integration of care with health and because it provides local authorities with a voice, for the first time, in decision making about local care choices. For the first time, the NHS will not be getting its own way, if this process lives up to the promise of local decision making. That will be helpful in getting local support and control. In my own locality, we have a cross-party community approach. We have a Liberal Democrat mayor, a Liberal-Labour group on the council and Conservative Members of Parliament. We are all united in an approach of wanting our voice heard on local care in the NHS. An STP is a way of us having that.

[Dr Philippa Whitford]

Would it not therefore have been more effective, particularly if there is cross-party working in the local authority, to have local consultation early on about what could be gained in exchange for what might be felt to be lost?

[Richard Fuller]

I very much appreciate the hon. Lady’s question, because it gets to my point. I am actually quite sceptical about what consultation means. She might not know that Bedford has been through a review process for our acute services. I was trying to measure the length of that process in terms of Members of Parliament for Corby: it preceded Louise Mensch becoming Member of Parliament, carried on through the whole period of Andy Sawford being Member of Parliament, and is now taking up the time of my hon. Friend the Member for Corby (Tom Pursglove). We do not involve Corby any more; it is now just Bedford and Milton Keynes. That process included consultation and participation, with the NHS saying that it wanted to listen to people. It consulted them, yes. Did it listen to them? No. It was the NHS’s own process. It ticked all the boxes, but it was a complete and utter disgrace to local accountability.

I do not have distrust of Pauline Philip, chief executive officer and leader of our STP, and I do not need to know everything. I want to know that our local authorities are having their voice heard in the process just as much as our local CCG, as they are our representatives. I feel relatively comfortable that the process will lead to options that are more acceptable to the population, because it involves local authorities as well as the NHS. We should, however, expect the outcomes of the process to be highly varied around the country. Some will be correct and acceptable, and will go forward. Others will be controversial, and others will be downright wrong. We should not curse this whole process across the country, because it achieves a difference in outcome in different parts of the country. We should be prepared to look at each on its own merits and judge them accordingly.

[John Glen (Salisbury) (Con)]

Is there not a real challenge to reconcile the reticence to change and adapt with the clear imperative to have new technologies and new ways of doing things that can offer a step change, which are often resisted? Consultation will not necessarily deal with that.

[Richard Fuller]

My hon. Friend is right. I come back to the central part of what is different about STPs: they involve local authorities. On issues such as mental health and care in the community, that voice will be heard much more clearly. Our local authorities represent our local people—that is their interest. Their voice will make a substantial difference.

I have two brief final points about Bedford to which the Minister can perhaps reply. First, our CCG is under legal direction. Will that affect local decision making? Secondly, our CCG set up a joint committee with Milton Keynes to review acute services. Is he in a position to assure me that that joint CCG will not take any part whatever in the decision processes when the result of the STP is reached?

Bedford Hospital

Richard Fuller Excerpts

Tuesday 28th June 2016 Commons Chamber

[Richard Fuller (Bedford) (Con)]

It is a pleasure and an honour to have secured this debate to talk about the future of Bedford hospital and, in doing so, to praise the efforts and work of the clinicians, nurses, porters, cleaners, caterers and management at our hospital. It is also an opportunity for me to talk about some of the experiences that have affected the hospital over the six years I have been a Member of Parliament. In that time, the most significant impacts have come as a result of actions taken by those within the senior NHS structures.

On the basis of my six years’ grassroots experience, I want to talk about the impacts of some of those processes on my local hospital. In doing so, I am joined in spirit by the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), who, because of his ministerial responsibilities, cannot speak today. As a Health Minister—although not the Minister responsible for hospitals—he is somewhat constrained in what he may say publicly, but he has provided tremendous support to me and the hospital as it has traversed difficult times in recent years, so I want to put on the record my thanks to him.

Right at the start of my time as an MP, when we were considering the future of hospitals and possible reorganisations, my right hon. Friend, who has been a Member of Parliament, whether for Bedfordshire and for Bury, for 20 or 30 years—so he has a long perspective on this—made an observation to me that the Minister might want to reflect on. He said that in his time organisational fads had come and gone. At one time, the fad might be to centralise, but wait long enough and the fad will be to decentralise services, and that affects not just the health service but many other aspects of public service management.

I want to talk about Bedford hospital and its performance. I am personally extremely grateful to the hospital. I was born there and went there when sick with pneumonia—as the House can see, I made as full a recovery as I could have wished. I am grateful to the hospital for being there at important times in my life, and I know that many of my constituents feel likewise. It is not a big hospital in the grand scale of things, but neither is it a small hospital; it is one of those that many of our constituents would recognise as that local district general hospital that is such a feature of many towns across the United Kingdom.

In my time as an MP, there has been one dramatic moment, where, because of poor guidance, the deanery removed junior paediatric doctors from the hospital. In the past when that happened, the deanery never put junior doctors back, but for the first time in its history it did, because it recognised the level of support and the need for paediatric services in Bedford. The turnaround was a signal achievement by the hospital and came within six months of its positive review by the Care Quality Commission.

A few years later—in fact, earlier this year—the CQC came back to do its overall report for Bedford hospital. It provides a grid, Madam Deputy Speaker, and you may have seen them at your hospital area reviews, when lots of different services and functions are described and coloured yellow, green, red and blue. Blue is best, as of course it always is, and then we go down through green and yellow to red. Bedford hospital had no reds—not even one of 30 or 40 measurements taken by the CQC. Everything and every aspect of the organisation of our local hospital was working at a level that may have required some improvement, but that provided a level of care in which we in the Bedford community could have trust. Overall, the hospital achieved the same ranking as three quarters of our hospitals do—“requires improvement”—but Bedford hospital was right in the upper quartile of those quality ratings.

The hospital has shown itself able to recover from its problems and it has demonstrated that it delivers good care outcomes. What it has also demonstrated is its ability to start to meet some of the financial challenges that many hospitals in the country have. Two years ago, the hospital had a very substantial deficit, and I shall come on later to a nearby hospital that had an even more significant one.

In the financial year ending in April this year, Bedford hospital met its target of losing only £18 million and it is now on target to achieve its next benchmark of reducing the losses to £10 million. I would, of course, like the hospital to be in surplus, but the direction of travel and rate of progress being made are something from which we can take some comfort. I hope that the Minister will be able to talk about the experience of other hospitals across the country in reducing their deficits and say whether Bedford is moving at the right pace and in the right direction in comparison with many other hospitals.

It is interesting to note that between 2013 and 2015-16 the number of A&E admissions in Bedford went up from 13,600 to 19,300—a very significant increase. As the Minister knows, it is often the case with hospitals that the more A&E admissions they have, the bigger the strain on their finances. The improvement in Bedford hospital’s finances is coming at a time when more and more A&E work is being carried out. Interestingly, the A&E performance of Bedford hospital last winter was in the top 10% of hospitals in the country as a whole.

My final point of praise for Bedford hospital is about the level of connection and support it has in the community. We have a vibrant Friends of Bedford Hospital, as well as a strong charity that raises considerable sums—millions of pounds—for the hospital, including money to support the development of a cancer unit. This is not public money provided by the NHS, but money provided through the strength of charitable giving in Bedford, Kempston and across Bedfordshire by people who know and love their hospital. It is perhaps not unique in the country, but the level of charitable support in place for the hospital is certainly something of note.

If the hospital had been left on its own and the doctors had been left to work out their clinical pathways and to meet the challenges of ever-increasing demands for better care quality as well as the financial challenges of achieving a surplus, I think it would have done very well indeed. There is no resistance to change. The other feature of my six years as an MP, as it affects our hospital, however, has been an ongoing, going-nowhere review that started off as a review of five hospitals back in 2011 and has now been reduced to a review of two hospitals—at Bedford and Milton Keynes.

The five hospital review was rather ambitiously called “Healthier Together”, but after the Corby by-election, it got relabelled as “Healthier Together; Happier Apart” because of the strength of feeling of local people about the performance of the review of hospitals in Northamptonshire. The review of Bedford and Milton Keynes has gone on essentially for a significant number of years, but with very little progress indeed. This has come at a considerable cost. The costs of the “Healthier Together” five-hospital review were anticipated to be £2.2 million. The subsequent review, just between Bedford and Milton Keynes, cost £3.2 million in its first phase and is expected to cost a further £1.3 million this year. In the context of a hospital that is trying to reduce its costs —whether or not this money is funded out of the hospital, the CQC, Monitor or NHS England does not matter—these are considerable sums that have been spent on reviews that have not delivered.

I want to talk about why they have not delivered. The first reason is that despite, perhaps, the best efforts of people on the ground, the original structuring of the Bedford and Milton Keynes review never had any public support. Many people in Bedford understand that their loved ones will go to other hospitals if they need extra care: if you get a heart attack in Bedford, you go straight past Bedford hospital to Papworth; if your child is very sick, they may go to Great Ormond street; if you are pregnant and have a very difficult pregnancy, you may well find that the last stage of your pregnancy and birth take place at Luton and Dunstable. But in very few regards do the people of Bedford look for their health care towards Milton Keynes.

So the original structuring of this review failed to understand where public support might naturally come from, which is why in the general election—I know the Minister, my friend, is aware of this—I was strongly of the view that it made sense for people in Bedford and Bedford hospital to look for ties with Addenbrooke’s, a well-regarded hospital which many in Bedford understand. Many people think it delivers the quality of care they need at the high end and believe it would form the core of a much stronger and better and more appropriate alliance than a forced-together merger with Milton Keynes.

That would not have been the only clinical partner, but it could have been the core partner if those in charge of the review had so permitted. I also think that not only did the review lack public support, but this pushing together of Bedford and Milton Keynes importantly also lacked clinician support—support from the doctors and the consultants, who are the ones we would look to to say, “What is the right way for us to achieve those higher quality standards in care?” Their eyes would also have looked elsewhere than this review of Bedford and Milton Keynes. These issues did not arise at the last minute. They arose and were known about for many, many years, and I want to talk in a little while about why on earth the review continued with that lack of support from both the public and clinicians in Bedford.

It is fair to say that when the initial numbers came out and people looked at the financial models for these reviews, there was a series of errors, so much so that they had to go back and redo all their analysis, further undermining public confidence in this review. Some of the options presented were quite scary: “Should we close A&E in one hospital and move it to another?” or “Should we drop maternity services and paediatrics in one hospital?” These are scary options that those doing a full analysis will of course want to be able to model, but at the slightest change of certain assumptions, they would flip completely from saying, “Yes, we should keep maternity and paediatrics” to “No, we shouldn’t.” The sensitivities in some of these important decisions suggest too heavy a reliance on financial modelling, rather than on the instincts of the clinicians and the local public about how they feel care quality targets can be set. Yes, that will be within a financial envelope, but this over-reliance on financial modelling was another error in this review, and perhaps one that carries on into other reviews across the country.

This review has been going on since June 2011, with all these weaknesses in errors, sensitivities, lack of clinician support and lack of public support. One would have hoped the message had got through, but unfortunately has not. The review was essentially, as I have called it a number of times, a “zombie” review; no matter how much people would say, “This has no future prospects”, and however much it would be knocked back, the “zombie” review would rise up and continue to walk forward.



The problem with that was that it created such an enormous amount of doubt and uncertainty. I think that our hospital in Bedford could do with a restructuring of its A&E department, so that patient flows work even better than they do now. Less stress would be placed on our doctors and nurses who work in A&E, because it would be easier to move patients through the hospital. Such an investment would be very worthwhile. It would not cost the Treasury a significant amount, and it would pay its way in a few years—not even a double figure. However, it cannot be considered while a question mark may still be hanging over our hospital’s future. I pay enormous tribute to its staff, who have held together strongly and with great spirit in the face of that doubt and uncertainty.

That brings me to my more immediate reason for raising this issue with my hon. Friend the Minister. Let me begin by making a point about joint clinical commissioning groups. CCGs hold our budgets and, on our behalf, spend money on healthcare in our local communities, whether it is primary care or acute care. As we know, they must make certain decisions about where the money should go, but they are also empowered to make some structural decisions. A few years ago, we introduced a statutory instrument under which, instead of making decisions on their own and only for their areas, CCGs could create a framework that would allow them to make a decision together, rather than a decision having to be endorsed by the constituent CCGs one by one in the knowledge that it was right for their individual areas.

Of course, that sets up the potential for mischief as well as the potential for good decision making. If a strong CCG feels that it can dominate a broader group, the interests of the minority can be pushed to one side. That is why I forced that decision on to the Floor of the House. In the last Parliament, I was the only MP on the Regulatory Reform Committee to vote against the creation of joint CCGs. I did so because I could see the potential for mischief. Although I would not say that the members of the Bedfordshire and Milton Keynes joint committee have been mischievous, I do think that the process casts further doubt on the wisdom of putting that system together.

Two weeks ago, the final straw broke the camel’s back. The joint committee produced a report containing its recommendations, which was given full publicity. A very worrying headline was splashed across my local newspaper, saying that maternity services in Bedford were to close. When our local media—BBC Three Counties Radio, or another of our local papers—wanted to talk to those who had produced that very scary report, they were told, “We cannot talk to you, because of purdah.”

What goes through the minds of people who are entrusted with our healthcare, and who think that it is OK to throw a report out into the public domain and then back away and say, “We cannot say anything about it”? What logic says that publishing a report is not a breaking of purdah, but talking about it is? It seems to me that those people did not know what they were doing. I am very grateful to Simon Stevens, the chief executive of NHS England, who wrote back to me on 27 June. Referring to those two points, he said:

“With hindsight, the meeting should not have been scheduled during the purdah period and the report should not have been released.”

For me, that is the final straw. I have experienced the final straw a number of times in this regard, but I do not think that the public can possibly have confidence in a group of people who will do something that is so scary and then run away—and when the head of NHS England describes it as a great and grievous error, it is time for the joint committee to be dropped. But no! This has not ended; it has paused. How long do we have to wait for this review to reach its bitter end and to be closed?

I want to hear from the Minister today what the logic is behind continuing the Bedford and Milton Keynes healthcare review. It has no local support from the people or the local clinicians of Bedford. It has no respect for the public, given the way in which it puts out pronouncements and then runs away. It does not even fit with NHS national strategy. In those circumstances, a pause is not good enough. It is time this review was killed off—ended, kaput, no more! The people who go to our hospital want to know that they can look to and trust a single process in relation to the future of that hospital, and the people who work in that hospital want to have the confidence that they can control its future on behalf of their patients. The nonsense of the review carrying on is affecting my constituents and my local doctors. It is also disrupting the national strategy of the NHS.

The Minister will be aware of the comprehensive programme reviewing the implementation of the NHS five year forward view. It is called the sustainability and transformation plan—the STP—and it is a pretty good plan. I read the “Five Year Forward View”—as I know you did, Madam Deputy Speaker—before the election. It was an important document that we should all read, and it was a good document because it pointed in the right direction in relation to the needs of an ageing population and the importance of integrating care in the community with our acute services. The plan is the sort of plan that people, politicians and clinicians can get behind. The direction of travel was made clear, and the STP is the implementation tool that is being used to achieve that across the country. It will not satisfy everyone—indeed, I am sure that it will come up with some challenging solutions—but it is consistent with the national strategy and I believe that it is the right approach to take nationally.

In my own region, the STP involves not only Bedfordshire but Luton and Milton Keynes. Importantly for our area, it is being led by an extremely capable hospital chief executive, Pauline Philip. She is the chief executive of Luton and Dunstable University hospital. She will of course have to balance her interests as the head of a hospital that would naturally like to take more under its own control with the understanding that there is a responsibility to keep a sustainable acute services area and, most importantly, to gain the support of local authority areas.

I am reflecting on why that other review is still paused, given its inadequacies and lack of fit, so here are some observations that I hope the Minister will respond to. In my experience, in discussions about this over the past six years, there has been too much bureaucratic infighting between Monitor and the NHS Trust Development Authority, which seemed to think, prior to its merging into NHS Improvement, that the hospitals in its arm of the health service were the ones to protect, regardless of the consequences for hospitals in the other arm. Milton Keynes hospital, the other hospital affected by this review, was frequently seen to be being indulged, while more severe restrictions were placed on Bedford hospital. For example, while Bedford hospital was achieving a reduction in its losses, Milton Keynes hospital was being indulged for increasing its losses. Where is the fairness in that?

I also want to ask why the boundaries were selected in this way. It appears to me that the boundaries relating to Bedford and Milton Keynes were drawn in a way that was perhaps correct for locating the problem, but that they had no chance of being the right set of boundaries for finding the solution. That is fine. When we look at problems, we often set up boundaries to understand them. I understand that, but what I have observed as a Member of Parliament is intransigence in those who have been running this process to understand that although they may have the correct boundaries for the problem, they need to be creative beyond those boundaries to find a solution. Year after year, square pegs were shoved into round holes. It was not working, and yet there was an intransigence in those who managed the system just to keep on keeping on, wasting millions of pounds in the process and reducing not increasing public trust in the NHS.

I would therefore ask Simon Stevens, who I think has the right strategy, what is going on in the mid-tier of NHS management. Who is in charge? It seems that there is one plan in the STP, which is Simon Stevens’s plan, but somebody else must have a dog in the hunt as well, because that is the only explanation for why the Bedford and Milton Keynes review has not been killed but paused. It is time to hold to account those who started the review and who have kept it going at the cost of millions of pounds beyond the point of there being any confidence in it. I do not mean our local CCGs; I mean the mid-tier of NHS England. I want the Minister to say today that he will examine the matter and ask probing questions about how inertia in bureaucratic processes can go unchecked for so long, causing so much uncertainty, with so little logic. Even when it is apparent, as it is today, that it strikes against the structure of the national NHS strategy, implemented through STPs, it was paused, not cancelled.

I have seen something in the past few weeks that does have congruence with the national strategy and does have the support of local people. It is a plan that was put together by Bedford Borough Council. The mayor and I disagree on many things, but he has done a first-class job with councillors from all parties. I want to make particular mention of Councillor Louise Jackson, the Labour councillor for Harpur ward, and Councillor John Mingay, the Conservative councillor for Newnham. They put together a plan that drew in the resources of PwC, which had done a similar review of Tameside. They specified something that could happen and work for their hospital and their community, and then gave it to the STP and to the national process for evaluation. It is a plan that the people of Bedford can get behind. It is certainly a plan that carries my support and the support of all local politicians and the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt).

The future of Bedford hospital is strong and positive. It wants to change and to meet the challenges set by NHS England. The most important thing that we have to look after as Members of Parliament is the health and wellbeing of our constituents. Our interests are in their wellbeing, not in any institution, and in patients’ futures. People must be able to expect the right level of quality services in A&E, paediatrics and maternity to be available in their local community in a town the size of Bedford, which is growing at a rate. The hospital has such deep connections with the community and such strong charitable support, and there has been such positive action even during this period of doubt and uncertainty. I hope that the Minister will reflect not only on the national impact, but on his ability to bring that period of doubt and uncertainty to an end.