NHS

Thérèse Coffey Excerpts

Wednesday 5th February 2014 Commons Chamber

[Jeremy Lefroy]

I have no doubt that some of those things will have caused increased pressure. That brings me nicely to my next point.

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

My hon. Friend may not be aware that a briefing was given by the College of Emergency Medicine to Members of Parliament. One of its representatives, I believe it was Dr Mann, was asked by hon. Members about the closure of walk-in centres and he replied that there was an initial blip but that levels went back to what they were before. So in his view those closures made very little difference.

[Jeremy Lefroy]

We do not have sufficient data on this. I urge the Government to examine how we can collect more data about the reasons why people come to A and E and whether their visits could have been prevented by other provision. I am sure that that can be done in some cases, but at the moment we are arguing at cross purposes because we do not have sufficient data.

Another point, on the lack of integration, relates to discharges. There is pressure on hospitals to discharge people, particularly the elderly, because of the pressure on beds. One GP in my constituency raised this issue, citing one of their patients who was improperly discharged and saying that they were very distressed at the condition in which they found him. Stafford hospital has come up with a solution, which it will implement shortly, whereby every patient with complex needs will not be discharged unless it is absolutely clear that they have proper care in the community to go to. We would expect that for all patients, and I am very glad that Stafford hospital is taking that up.

The final reason to mention is that patients are often confused about where to go, and I am therefore glad that the Government have undertaken a review of the classification of A and E departments. We have A and E departments, urgent care centres and minor injuries units, and we have various grades of A and E. We need a national classification that makes it clear what services people can get at which point. Often people turn up and find that they have come to the inappropriate place.

I also wish to make a few remarks about the competition matters that have been raised in the debate, and I do this from a local perspective. The trust special administrators for the Mid Staffordshire NHS Foundation Trust have proposed that Stafford hospital should merge with University Hospital of North Staffordshire in Stoke and that Cannock hospital should merge with Wolverhampton’s trust. That is the right solution, it is not being opposed and we are not finding any problem with competition law. There is a big difference between the acute and non-acute sectors. As the acute sector runs in a tight way around the country, it is very difficult to see how there can be much competition in provision within it, because that has been provided exclusively by NHS trusts up to now. Within the non-acute sector we have found in my constituency that, under competition rules, an NHS service that went to the private sector under the previous Government has come back into the NHS under this Government, because it was determined that the NHS would provide a better service. So this does work both ways; it does not always go the way some people think it might.

We must not lose sight of the real hard work that people are doing in A and Es up and down the country. Almost all the work that goes on there is incredibly good and is what our constituents need, but we must make sure that the points that I and others have outlined are dealt with, because with the demographics going the way they are, we will face increasing pressures year on year.

--- Later in debate ---

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

It is always a pleasure to speak about the NHS in this House and to recognise the hard-working staff who do their best for their patients and our constituents. I am pleased that the shadow Secretary of State is still in his place. I recognise that the NHS is important to him, but I strongly suggest that his accusation that Government Members are complacent is far from the truth, as the evidence of nearly four years in government shows.

The right hon. Member for Leigh (Andy Burnham) is rightly proud, as are other Labour Members, of increased spending on the NHS during their 13 years in government, but he is at risk of seeing that as the only way of helping patients. My concern is that that led to a complacent attitude under Labour that simply putting in more money would solve everything, with the result that it missed the opportunity to make significant reforms.

Instead, over the past 18 months in particular, the Care Quality Commission has been truly strengthened. There is now no concern about opening the lid on the problems that we know exist in parts of our NHS. Many Members will bring such examples, from our casework, to the House today. That is why I am proud that we have strengthened the CQC through an independent inspector of hospitals. At times, I have criticised the CQC for being too timid and for not being prepared to be more public about its concerns and to go in and act. However, the short-notice inspections are important in ensuring that patients feel confident that they will get not only excellent treatment, as they largely do, but the care that they deserve when they are under the custodianship of the NHS.

I cannot see how Government Members are being complacent in any way, but another element of complacency on the part of the Opposition crept in with the suggestion that targets were the right thing. We all know that if we do not measure something it often does not get done. With regard to ambulance services, however, while the regional targets of 75% of patients being covered within eight minutes of red 1 calls may well have been met in most of the country, that did not show what was actually happening on the ground. My hon. Friend the Minister of State, and the Under-Secretary, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), have been vocal for a long time in pressing the case for not just hitting a regional target, but focusing on individual patients. Complacency set in whereby it was thought that as long as we were hitting our regional target everything was fine, yet we knew, as MPs, that everything was certainly not fine.

In the east of England, resources were focused on the main urban centres. People out in the countryside—not even that isolated, but in smaller towns or villages—were almost ignored because they did not help the centre to hit its regional target. If they had broken their hip, it almost did not matter that they were lying on the floor for four hours waiting for somebody to come, because it was not a life-threatening injury. The hon. Member for Warrington North (Helen Jones), who is no longer in her place, referred to the North West ambulance service. I am proud that Members of Parliament from across the east of England—I particularly mention my hon. Friend the Member for Witham (Priti Patel)—have worked together to hold our ambulance service to account, with the outcome that we managed to get its entire board replaced. That was a very difficult thing to do, especially when we were at times accused of attacking and undermining the NHS. In fact, far from showing complacency, individual MPs were working together to make sure that patients came first, not some artificial target that was bad for patients.

I wanted to say thank you to the hon. Member for Leicester West (Liz Kendall), who is sadly no longer in her place on the Opposition Front Bench, because she put me in contact with Anthony Marsh, who was chief executive of the West Midlands ambulance service and is now, thanks to action by this Government, chief executive of the East of England ambulance service. During his very short tenure, he has already been able to bring a new sense of urgency and a recognition that staff are not coming through the pipeline quickly enough, and he is doing something about that. I am confident that when we meet him next week, we will be able to understand his plans even further.

One of the reasons I was accused of Gove-itis earlier is that it frustrates me that Members of Parliament are accused of complacency when in fact they are working hard to help their constituents. Far from being complacent, we have approached this in a consistent way. I recommend to MPs from other parts of the country that instead of just waiting for someone in Whitehall to act on these issues, and mocking MPs who say they are working hard to press their case and hold their local board to account, they should get on and do it, not just wait for others to do so. I give credit to NHS England. At times, getting it to recognise the real problems that we were facing on behalf of our constituents felt like wading through treacle, but it has finally got the message, and together we are starting to turn the situation around.

We have heard about aspects of hospital provision. I do not wish to go on for too much longer, Madam Deputy Speaker, because it is important that everyone who wants to have their say can do so. In fact, I am putting in a bit of a bid for an Adjournment debate in Westminster Hall about NHS funding and the elderly population. [Interruption.] Well, if you don’t ask, you don’t get. I listen to patients in my area who have 200-mile round trips to get to the specialist hospitals. We are concerned about a potential reconfiguration of stroke services that would make it physically impossible for patients to be seen within 60 minutes of the 999 call being made. As a consequence, as my hon. Friend the Minister of State will know, we have been pressing the case for more funding to be given to areas of rural sparsity in light of the fact that geography matters in trying to deal with such situations.

I recognise that Labour Members feel strongly about the NHS, but so do Government Members; it is a universal thing. As we continue to support the NHS, there is no way that we can ever be accused of complacency. The reality is that we are dealing with the issues, not putting a lid on the problems. We have had the Francis inquiry and we continue to work on many of its recommendations. I am therefore very happy to support the Government’s amendment.