East of England Ambulance Service

Thérèse Coffey Excerpts

Tuesday 25th June 2013 Westminster Hall

[Dr Thérèse Coffey (Suffolk Coastal) (Con)]

It is a pleasure to serve under your chairmanship, Mr Howarth. I thank my hon. Friend the Member for Witham (Priti Patel) for leading this debate so well; her speech was a tour de force. I will bear in mind your time limit, Mr Howarth, although I could take the whole 90 minutes to tell the sad tale. It is a pleasure to follow my hon. Friend the Member for North West Norfolk (Mr Bellingham). The East of England Ambulance Service NHS Trust is actually responsible for out-of-hours care in Norfolk, so the left hand should be talking to the right hand.

I also thank the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), and the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), who started work on the issue. It was right for my hon. Friend the Member for Central Suffolk and North Ipswich, a doctor, to take the lead on such matters in Suffolk, but pushing on, consistent performance from colleagues across the counties in the east of England has brought the issue to the fore.

As I suggest, this is a sad tale that started some time ago. My timelines of the issue start in the middle of 2011. We are driven by the experiences of our patients —those who have suffered. Let us be honest: the vast majority of people in our constituencies have a good ambulance service. Once an ambulance arrives, care is very good; nobody denies that. However, too often that excellence of service is concentrated in certain areas of the region in order to meet a false regional performance target, and almost everything else is put aside. It does not matter if only 50% of people in south Norfolk get an ambulance within 90 minutes as long as the regional target is met. That is all that matters to the leadership and the board of the East of England Ambulance Service NHS Trust.

We have had a long series of meetings, Care Quality Commission inspections and promises of change. Transparency has been lacking. The trust has been dragged kicking and screaming into showing its performance targets in a meaningful way—first by county, now at clinical commissioning group level—but that took a long time. It used to say, “You can look in the minutes of your local primary care trust to find response times.” It is unacceptable for those at the very top to say, “Well, that’s all right; we’re hitting our regional target.”

I have used the constituency of the hon. Member for Copeland (Mr Reed) to say that if it can happen in Cumbria and Cornwall, it can certainly happen in Norfolk and Suffolk. It is important that the Opposition spokesman does not try to drag party politics into this debate or talk about finances. The issue is about those at the top having wrong priorities and forgetting that every patient matters.

I have never had to call an ambulance in the east of England, or indeed at all, but I like to think that if I did, I could have some confidence that it would arrive in time. In reality, however, there are not enough ambulances and not enough staff. Mr Andrew Morgan recognised that early on when he came into office as interim chief executive. As Dr Marsh pointed out in his excellent report,

“the current leadership from the board just isn’t strong enough to take them forward…there is a lack of focus and grip from the board which has contributed towards the deterioration of performance across the trust.”

Many of the issues breaking open at the moment have been deteriorating for some time. The non-executives have not shown leadership by asking hard questions and going beneath the surface; they have relaxed and considered only the top regional performance target.

I thank our local newspapers, the East Anglian Daily Times and the Eastern Daily Press. Nigel Pickover and Terry Hunt have done good things to keep up the pressure and stand up for their readers, our constituents, who are patients of the East of England Ambulance Service NHS Trust.

[Robert Halfon (Harlow) (Con)]

And the Harlow Star.

[Dr Coffey]

And the Harlow Star, apparently.

In December 2011, we finally got a meeting with the Health Minister and a range of other people around the table who could have fixed the issue. We were promised that there would be change and more focus at county level, and that patients mattered. The postcode data released in November 2011 showed that that had not been the case. We have never been able to get data at that level since then, because the trust does not want to share it with us and, frankly, I am not sure that I should spend all my time on freedom of information requests.

One of the things agreed at that meeting was that contracts would change. That did not happen, which is one issue relating to trust. In October 2012, Hayden Newton resigned. Coincidentally, that was a week after a series of complaints, including about the case of Nora Dennington, whose family finally went to the press to get an answer after three months. To be fair to Maria Ball, the former chairman of the trust, she got answers to those complaints then and there, and within a week, Hayden Newton resigned.

However, Newton was still on the payroll until the end of March 2013, and the chair at the time gave him a glowing tribute, saying that he would be greatly missed and

“a hard act to follow”

and that under his leadership, front-line staff were still being recruited and quality of care had improved. The chair also said:

“Thanks to Hayden’s stewardship, EEAST is now a stable, sustainable and financially sound organisation”.

I am afraid that the Marsh report blows that out of the water.

I could go on about all the different meetings, but I will not, as I am conscious of the time. What I will say is that patients’ complaints were not being answered, and patients were not being treated as individuals. The board should have seen it in the survey and the climb in sickness rates, and the CQC should have done more than tick the box saying that the trust had passed staff compliance on the basis that appraisals had been done. There was an element of external scrutiny by the CQC, the strategic health authority and, to some extent, Monitor, which did not approve the foundation trust status application, but passed the trust on the governance rating. All those different regulators, as well as the leadership of the board, need to look at themselves to understand why they, in effect, let people down. The board was fixated on getting foundation trust status; it was only focused on the regional target, and it did not matter that residents in Suffolk were being failed, as long as the regional target was okay.

Moving forward, my hon. Friends who have spoken are absolutely right: it is imperative that the remaining non-executive directors resign their posts immediately and that the NHS Trust Development Authority acts on that. The ideal solution for me would be to ask Dr Marsh to come in, whether permanently or on an interim basis, to turn around our ambulance trust, because he has the skills to make that happen. I want Dr Harris to succeed; however, it is important that we do not rely on the management speak to which my hon. Friend the Member for North West Norfolk referred, but recognise that we need to clean the slate.

There are of course external factors—we need to work with GPs and A and E—but much of the problem is internal, because there were not enough training places or staff. Incidentally, it is right that Whitehall should not seek to control everything, but it is vital that MPs have confidence that the NHS Trust Development Authority will take the matter seriously. Furthermore, CQC needs to be quicker—not to be rash, but not to be tick-box driven. It failed the ambulance trust and, more recently, it decided to withdraw from a meeting with MPs to talk about its reaction to the trust plan issued in April.

I could have spoken for longer, Mr Howarth, and I have spoken for longer than you requested, but I genuinely want to ensure that our patients, constituents and residents can rest assured that we will not stop continuing pursuit of excellence on their behalf, wherever they live in our great part of the country—they deserve nothing but the best. Again, if Cumbria and Cornwall can do it, we can certainly do it in Suffolk, Norfolk, Essex and Cambridgeshire. Frankly, until those non-executive directors go, we will not have confidence in the leadership of the trust to make the difference.