Unavoidably Small Hospitals

Rishi Sunak Excerpts

Tuesday 6th September 2022 Westminster Hall

[Rishi Sunak (Richmond (Yorks) (Con)]

It is a pleasure to speak under your chairmanship, Mr Hollobone, and thank you for accommodating me at a late stage in the debate. I had not planned on speaking, but this morning I saw the Order Paper and it turned out that I had more time on my hands than I had anticipated! It is a pleasure to be here with my hon. Friend the Member for Isle of Wight (Bob Seely) to discuss this very important topic.

I am here to speak about the Friarage Hospital in Northallerton, in North Yorkshire, which is in my constituency. It is one of the smallest district general hospitals in the country, serving a rural population of over 100,000 people and covering an area of a thousand square miles, stretching from the North York Moors at one end to the central Pennines at the other, bordered by York in the south and Darlington in the north. When I was first elected in 2015 and when I was campaigning before that, I told my constituents that the hospital would be my No.1 priority.

The reason for that is simple. Of course the NHS is the country’s most prized public service but, as we have heard in all the contributions from hon. Members today, the accessibility of healthcare in rural areas specifically is an issue of acute anxiety and the pattern over several years had been in a negative direction. Indeed, as I was being elected, my local hospital had lost its consultant-led maternity unit. Shortly to follow was the loss of paediatrics. That had an enormous impact on the local community. They feared for the very future of our beloved local hospital and I committed to do everything I could to reverse the flow of services away from it to ensure a bright future for the Friarage.

As my constituency neighbour, my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake), rightly pointed out, when healthcare organisations look at such things they tend to think about centralisation, because it looks very efficient on a spreadsheet wherever they might be sitting, but it does not work for our constituents. One thing I will say to the Minister is that she should send a strong message to trusts, particularly those that cover large urban centres and smaller rural hospitals in the same area, to always think about accessibility when they make their plans, which I do not believe they always do as well as they could. Secondly, I echo my hon. Friend’s recommendation about booking appointments. That is a simple, practical thing and trusts can do a good job of it when members of the public have the option to travel to smaller hospitals nearby or to others further away and to get the timing of those appointments right. That has an enormous impact on people’s ability to access the healthcare that they need.

Shortly after I was elected, I had to deal with a challenge that we have already heard about today—the downgrading of our A&E. However, that marked a turning point and I say to the Minister that what followed can serve as an example of what the future of small rural hospitals can look like. Under the leadership of Dr James Dunbar and his team, at the Friarage we pioneered an innovative new model of an urgent treatment centre that is open 24 hours a day and is consultant-led, with a clinical decisions unit. That means that it can provide a far greater range of healthcare to my constituents, including far more care for children than would typically be found. The unit is staffed superbly by nurse practitioners. It is working brilliantly and all I will say to the Department of Health and indeed to trusts where there is a similar challenge is to look at the model and see how it can be replicated around the country because, as I say, it is working brilliantly and has saved the loss of all emergency services at our hospital.

My other recommendation to the Minister and the Department is on recruitment and staffing issues, which we have heard a lot about already. It was clear during the work that I did that often the guidance from the royal colleges exacerbates some of the issues that we have heard about. My hon. Friend the Member for Thirsk and Malton said that anaesthetists are a case in point. A specialisation has occurred over decades, whereby anaesthetists used to be generalists and now we have sub-specialties. It is very difficult for small hospitals to accommodate those sub-specialties, and we need to look with the royal colleges at what safe staffing models might work to ensure the sustainability of our services.

I must commend the South Tees trust, because after repeated efforts from my hon. Friend the Member for Thirsk and Malton and me, it has focused fully on ensuring the future of the Friarage. I thank Simon Stevens for visiting the hospital in his previous capacity and understanding the challenges, and the pervious Health Secretary, my right hon. Friend the Member for West Suffolk (Matt Hancock). Since then, thanks to the philanthropy of the late Sir Robert Ogden, we have a new Macmillan cancer centre, which is providing fantastic care, a new diagnostic centre, an MRI scanner, a dialysis unit and an ophthalmology unit, all of which save my constituents a round trip of up to four hours to the much larger James Cook hospital. They are all delivering fantastic care closer to home.

I will give the Minister another example of innovation from the local team. James Dunbar came up with a new ambulatory care unit, which means that we can do emergency treatment on the same day. In the first year of its operation, it saved over 4,000 overnight stays, so it is not just a model for rural hospitals but a beacon for how the NHS can work more broadly to reduce the pressure on our bed capacity.

Most recently, I am delighted that the Government and the Minister responded to my long-running campaign to get new investment in our operating theatres. They date back to the second world war and are in urgent need of refurbishment, so I am delighted that the Government have said that they will provide £30 million of investment to refurbish all the operating theatres to the latest and greatest standards. That will have several benefits. Most importantly, it will send a very strong signal to my community about the future of the Friarage. It is very clear that the Friarage is not going anywhere and people can have confidence in its future, which helps with recruitment and retention, as we have heard. People are attracted towards working at smaller hospitals when they know that their career will be something they can bank on and that there is interesting work to do. This investment will absolutely secure that and ensure that we can attract the nurses, doctors and other staff that we need.

The Friarage also serves as a model for how we will tackle the backlogs more generally, because the hospital will be a new surgical hub with all the associated auxiliary services that are required. That means that we can now double the amount of elective surgery and do it closer to people’s homes. In the scheme of what the NHS spends, that investment will provide a very high rate of return by increasing the amount of surgical throughput. The doctors and nurses I saw just the other day—chief medical officer Dr Mike Stewart, chief surgeon Matt Clarke, and theatre nurse Sarah Baker—are all incredibly invigorated by what they can now do for our community, and that will help more broadly serve us to get the backlogs down faster, which I know is a Government priority.

I say to the Minister that it is important that small hospitals are recognised, which is something that is said very clearly in the five-year plan. It is important that the NHS continues to deliver on that. My experience locally is that that is happening, and I ask her to take on board some of my suggestions. I will close by paying tribute to the incredible doctors, nurses and staff at the Friarage, and to the Friends of the Friarage charity. I said to them when I was first elected that they would be my No. 1 priority, and they will continue to have my full support.

[Mr Philip Hollobone (in the Chair)]

We now come to the Front-Bench speeches. I call Feryal Clark for Her Majesty’s Opposition.