EU Working Time Directive (NHS)

Robin Walker Excerpts

Thursday 26th April 2012 Westminster Hall

[Charlotte Leslie]

My hon. Friend makes an extremely good point, and I know that he has first-hand experience in this area.

Professional expertise and intuition, not looking at a list of tick boxes, enables doctors to spot that something is wrong with a patient. If doctors are not able to make a subtle comparison between how a patient was yesterday and how they are today, their intuition and expertise will be undermined. We have all seen constituents who have felt that they have been subject to an endless conveyor belt of doctors, and have been made to feel like a product on a conveyor belt instead of the focus of a dedicated team looking after them. The move to treating patients as products on a conveyor belt is worrying, and undermines the very good ethos of our NHS. Clinicians back that up. One third of surgeons in a recent survey said that handovers had been inadequate and, worryingly, the Royal College of Physicians found that three in 10 thought that their hospitals’ ability to deliver continuity of care was poor or worse. A similar survey of GPs found that one third thought that their hospitals’ treatment was dangerous. I cannot emphasise enough the urgency of the matter.

[Mr Robin Walker (Worcester) (Con)]

To add to the chorus of support, one of my constituents is John Black, a famous surgeon from Worcester, and past president of the Royal College of Surgeons, who told me that if there was one thing the Government could do for the NHS, it would be to take up this issue and get it sorted out. Does my hon. Friend agree that the Government must take up the cudgels with Europe and fight for our interests?

[Charlotte Leslie]

My hon. Friend anticipates a point that I will come to later. I pay tribute to the work of John Black and others on this issue. If there was only one target that the NHS should enshrine, it is continuity of care, because after that so many things follow.

European Court of Justice rulings—I do not want to be too technical, but they are the SiMAP and Jaeger rulings—have caused tremendous problems for the profession. First, inactive on-call work is required to be counted as working time. Therefore, if a doctor is on call but inactive and perhaps sleeping on the premises, it is counted as on-call time, which makes life very difficult for hospital trusts organising rotas and getting the time available. Secondly, if a doctor overstays their allocated shift, perhaps because they are about to hand over, but have to stay on for an extra hour, perhaps because a patient has had a cardiac arrest, they are required to take compensatory rest to make up for that immediately afterwards. If that doctor has a clinic some time the next day, they will have to take an hour of rest time, cancelling that clinic, because the European Court of Justice dictates that. Potentially, patients who have turned up at hospital and are ready and prepared for surgery will have their clinic cancelled because the Court ruling says that the doctor must be forced to take rest. That is obviously a tremendous inconvenience for patients, beyond continuity of care, and a nightmare for the hospitals trying to make accommodations.

Hospital Services (Worcestershire)

Robin Walker Excerpts

Wednesday 2nd March 2011 Westminster Hall

[Karen Lumley]

As you can see, Mr Hood, we have a debate among ourselves about where the cancer centre should be sited. Obviously, we in Redditch and Bromsgrove have the advantage of lots of space to build the cancer unit, and we have already started a local campaign to bring the unit to the Alexandra hospital.

[Mr Robin Walker (Worcester) (Con)]

I am grateful to my hon. Friend for giving way and grateful to my hon. Friend the Member for West Worcestershire (Harriett Baldwin) for the point that she made. I am sure that my hon. Friend the Member for Redditch (Karen Lumley) would acknowledge that the Worcestershire Royal hospital already has considerable expertise in cancer treatment. Will she join me in urging our right hon. Friend the Minister to ensure that, wherever such services end up being placed, they are supported, as they are a vital component of a strong and much needed cancer strategy for our county?

[Karen Lumley]

As you can see, Mr Hood, the feeling among us is quite strong. We have all campaigned together to try to secure a unit in Worcestershire and we are all very grateful that we are to get that unit—we just need to know where it will be. But wherever it is built, I am very pleased that, by the end of 2013, 95% of the radiotherapy and chemotherapy patients will be treated in Worcestershire. That is the message that we all want to get across. The ability of my constituents battling cancer to receive their treatment close to home and to know that the treatment is the best available will, I hope, make a real difference. The new facility will match the already excellent care that the trust offers—care that means that it was ranked in the top 20% of trusts in the national cancer patient experience survey.

The news of the radiotherapy unit and other successes is encouraging. However, like many other MPs, I am very concerned about the money that is spent providing locum doctors to cover staff shortages. I hope that the Minister will deal with that today. The number of locum doctors employed has increased dramatically in the past 10 years. Trusts face acute shortages of middle grade doctors. Locum doctors are expensive. They should be used only to fill unforeseen gaps in staffing or when there is a dramatic increase in work load. They should not form part of the regular staffing arrangements as they do now.

We all know that we must make cuts in the public sector. However, I cannot see why my constituents should face reduced public services because money is being spent inefficiently. A cost-effective NHS will offer greater scope in how we care for people in our communities, both in Redditch and nationally.

The problem has been exacerbated by the European working time directive. Reducing—unnecessarily, I believe—the number of hours that doctors can work leads, of course, to a reduction in the number of hours covered by doctors available to hospital management. That is combined with the new strict immigration rules, which have resulted in far fewer doctors being able to emigrate from India and Pakistan and increased the pressure on hospitals as they try to fill an increasing number of vacancies.

The result in Worcestershire Acute Hospitals NHS Trust, which has 24 vacancies at the moment, is that money that could otherwise be directed to caring for patients is spent on locum doctors, the agencies that they come from and the bureaucracy involved in short-term employment. If we are to succeed in reducing public spending, we can no longer rely on short-term solutions. I understand that the trust has been actively recruiting doctors from Poland and the Czech Republic. Initiatives such as that must continue. However, the idea being explored whereby non-medical roles are created to support rotas and treatment concerns me. The trust considers that option “undesirable”.

It is not only doctors in hospitals who are anxious about the impending changes. I have met GPs recently—I do so regularly—who have shared with me their concerns about the establishment of the NHS commissioning board. When each GP must be a member of a consortium, their job will have to include commissioning services. The doctors in Redditch whom I meet regularly are equally concerned about the unequal funding for shire counties. I hope that that will be addressed sooner rather than later. There are also concerns about the reorganisation taking away local knowledge of the complexities of our county and its problems. Bromsgrove and Redditch GPs will do their best for their patients—I hope that, when the changes are introduced, they will be fully skilled to do the best job that they can.

In summary, I am delighted that we are finally getting a cancer care unit for Worcestershire—I hope that it will be in Redditch. However, I hope that the Minister will address my concerns about the expensive use of locum doctors and the concerns raised by local GPs. I welcome the coalition Government’s commitment to local health care being delivered by local clinicians in our own localities.