Oral Answers to Questions

Tim Farron Excerpts

Tuesday 14th November 2017 Commons Chamber

[Mr Hunt]

I congratulate my hon. Friend on becoming Chair of the Liaison Committee. Of course, I am always happy to meet her, and the issue that she has raised is very important. Our figures show that the number of nursing home beds, as distinct from the number of nursing homes, is broadly stable. There is real pressure in the market, however, and there are real issues about market failure in some parts of the country, so I am more than happy to talk to her about that.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The south Cumbria area is one of the few places in England where patients who need even the least complex radiotherapy treatment must travel for longer than the maximum 45 minutes recommended by the National Radiotherapy Advisory Group. In NHS England’s consultation, which will close on 18 December, will the Secretary of State make sure that access to radiotherapy within 45 minutes is a key criterion in allocating resources so that Westmorland general can be given its much-needed satellite radiotherapy unit?

[Mr Dunne]

I am grateful to the hon. Gentleman for raising that point. We are absolutely aware of the need to have more radiographers and sonographers available to support facilities around the country, and we have currently some 200 radiographers in training. I would like him to write to me so that we can follow up the specific point he makes about south Cumbria.

Valproate and Foetal Anticonvulsant Syndrome

Tim Farron Excerpts

Thursday 19th October 2017 Commons Chamber

[Norman Lamb]

I thank the hon. Lady for her intervention, and I completely agree with her. Interestingly, the original product licence in March 1974 stated this, way back then:

“In women of child bearing age, it should only be used in severe cases or those resistant to other treatments.”

They knew in the ’70s, yet the appalling scandal is that so many women since then have had their life turned completely upside down, with enormous consequences for their children, because they were not told.

[Tim Farron (Westmorland and Lonsdale) (LD)]

My constituent Nicola took sodium valproate through her pregnancy, and her son has chronic fatigue. The impact on her family is immense and expensive. We have fought for, and managed to secure, medical support for her through hospitals in Manchester, but does my right hon. Friend agree that there needs to be a Government fund to ensure that victims have such support, rather than having to rely on their own means?

[Norman Lamb]

I completely agree. I will make the case a little later, but it seems unanswerable and the Government need to reflect on that.

What happened was worse than just the neglect of not telling women. The minutes from the 18 July 1973 meeting of the sub-committee on adverse reactions, a sub-committee of the Committee on Safety of Medicines, have been uncovered. That document reveals a real outrage, because it talks about keeping the information from women—deliberately withholding it

“especially as it could give rise to fruitless anxiety.”

It continued:

“Nevertheless, they thought it would be best if prescribers were all made aware of the nature of the evidence and recommended that a statement similar to that proposed by ICI”—

in respect of another product—

“could be included in all relevant data sheets but not on package inserts so that there would be no danger of patients themselves seeing it.”

That is extraordinary.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 10th October 2017 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right. I am aware of the report that she talks about. We know that half of mental health conditions become established before the age of 14, which is why early intervention is so important. In July, I announced an expansion in the mental health workforce—another 21,000 posts. A number of those will be in children’s mental health, to address the issues she raises.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The Secretary of State may know that because of a reduction in the number of mental health clinicians in Cumbria, the Cumbria Partnership NHS Foundation Trust has now chosen to end consultant psychiatric call-out care from 8 pm to 9 am. It would have started last week, but it is going to start in the next two or three weeks. That means, as I am sure he is aware, that it will not be possible to section people under the Mental Health Acts between those hours unless they are within an NHS facility. People in police stations, people in care homes and people at A&E departments will not be—

[Mr Speaker]

Order. If the hon. Gentleman wants to make an application for an Adjournment debate, he can do that on a subsequent occasion. I think we have got the gravamen of his question.

[Tim Farron]

The question is: does the Secretary of State agree that that is not an appropriate use of resources, and will he provide the resources that are needed?

[Mr Hunt]

The hon. Gentleman raises a very serious issue. I will not go into it in detail now, but I will certainly look into it closely and get back to him, if I may. Obviously it is very important.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 4th July 2017 Commons Chamber

[Mr Hunt]

I was concerned about the general laughter following that comment, Mr Speaker.

I am delighted that my hon. Friend’s father was treated so well, and I very much enjoyed my visit to the hospital recently. She is right: where there are changes in the patterns of training, we need to be very careful to ensure that they do not interrupt the delivery of local services in a disadvantageous way.

[Tim Farron (Westmorland and Lonsdale) (LD)]

The boundaries of the sustainability and transformation partnerships are bound to cause concern about the future of A&E and other acute departments given the nature of them. My area, south Cumbria—relatively sparsely populated and rural—is lumped in with Lancashire, which is largely urban. Will the Secretary of State confirm that the voices of rural communities will not be dwarfed by those of the larger urban ones, and in this week, as we celebrate the 25th anniversary of Westmorland general hospital, will he give guarantees that it will not be closed and will indeed not receive any downgrading as a result of the STP process?

[Mr Hunt]

Westmorland general hospital has a very important future in the NHS and I am happy to give the hon. Gentleman that assurance. I do not think he should be concerned about STP footprints covering both rural and urban areas. However, where there is an issue in his constituency, and many others, it is the response times for ambulances in the most remote areas, and we are looking at that.

Contaminated Blood and Blood Products

Tim Farron Excerpts

Thursday 24th November 2016 Commons Chamber

[Diana Johnson]

Yes. One point I will come to later is the need for some form of inquiry.

To continue my point about why who runs the scheme is so important, a big criticism of the new scheme is the continuation of discretionary payments. Department of Health officials are still not listening to the concerns raised about that. The APPG inquiry uncovered huge issues with the highly conditional and poorly managed discretionary support scheme. One respondent told us:

“The whole system seems designed to make you feel like a beggar”.

I also believe that the trust’s current administrators have not fought hard enough for their beneficiaries, which legally they could have done. Instead, they saw their role as dispassionate managers and conduits to the Department of Health. They left the affected community alone to fight for themselves. If the new support scheme ends up being managed by Atos or Capita it will do nothing to address those fundamental issues, and could even make the situation much worse, adding insult to injury. I call on the Minister to do the right thing and announce that she will scrap plans for a private profit-making scheme administrator, and will replace the current scheme with a more beneficiary run and focused organisation that has no profit motive.

Will the Minister set out exactly what kind of discretionary support the new scheme will provide? It remains unclear whether any or all of the current support will continue. That contrasts starkly with the Scottish scheme, where the financial review group agreed that no one should receive less financial support under the new scheme. Will the Government urgently provide the same guarantee and publish full details of any obligations that the new scheme administrators will be subject to?

There are also issues with the current welfare benefits reassessment regime that many people are having to go through—for example, moving from disability living allowance on to the personal independence payment. Those issues need to be addressed urgently, so that individuals can be passported straightaway on to new benefits. I hope the Minister will agree that that is a sensible way forward for the people affected.

My third concern relates to the families of those affected, who need better support under the scheme. Under the new English proposals, widows and widowers will continue to be eligible for discretionary support—whatever that means; I have raised my concerns about that already—on top of a new £10,000 lump sum, provided their loved ones died at least partially as a result of contracting HIV or hepatitis C. However, many clinicians have already told me that that could mean many people are excluded from assistance simply because their partner’s death certificate does not include mention of HIV or hepatitis C, sometimes at the family’s request. The new proposals could also still be considerably less generous than the support that some widows already receive, because there is a huge question mark hanging over what discretionary help they will get under the reformed scheme.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am grateful to the hon. Lady for leading this debate. Many people around the country are hugely grateful to her, me included. Two of my constituents—Mike Dorricott and Neil Howson—sadly passed away as a consequence of contaminated blood and the diseases that they contracted. Their loved ones have exactly the concern that the hon. Lady indicated: that the dependence on potential discretionary payments is insufficient. The fact that the one-off payment is not backed up by the generosity, regularity and dependability of an annual payment means that such people often have to give up work, lose the ability to have a pension of their own and find themselves in immense hardship.

[Diana Johnson]

That leads me to my next point, which is on the Scottish proposals. As we have heard, they offer a better settlement, particularly for the bereaved, who are guaranteed 75% of their partner’s previous entitlement in addition to continued access to the Scottish discretionary scheme. That gives them much-needed security in a way that the proposed English scheme does not. I ask the Minister to look again at adopting the Scottish model and at providing more guarantees on non-discretionary support for widows and widowers.

My fourth point is about support for primary beneficiaries, which was raised in an intervention. The APPG asks the Government to look again at some groups of primary beneficiaries who need better support than is proposed under the English scheme. I received an email this morning from someone who contracted hepatitis B through contaminated blood products. Under the scheme, they are not eligible for any help, but they have obviously suffered and are suffering still. I hope that the Minister is willing to look at a very small group of people who are not covered.

The APPG believes that if more assistance were provided in the form of non-discretionary, ongoing payments, it would reduce the need for discretionary support and allay a great deal of our constituents’ worries. I urge the Department of Health to consider the contrast with the support announced in the Scottish scheme and whether more non-discretionary, ongoing payments could be made.

--- Later in debate ---

[Alistair Burt (North East Bedfordshire) (Con)]

I begin by congratulating my friend, the hon. Member for Kingston upon Hull North (Diana Johnson), on her consistency on this issue and the work that she and the all-party group have done over a long time. I thank the Backbench Business Committee for allowing the debate to be held. I also welcome my hon. Friend the Minister to the Front Bench. We know that this matter is not among her responsibilities—it belongs to our noble Friend Lord Prior—and I know how difficult it is to deal with something that is not in one’s own portfolio, but I am sure that she will communicate faithfully to the Government the points raised in the debate, although she will not be in a position, I think, to answer all our questions. However, the fact that we are again raising these questions in the Chamber is an important point for her to take back to the Secretary of State and other colleagues.

I want to pick up on a couple of points arising from the speech made by the hon. Member for Kingston upon Hull North. I agree with her about who should administer the scheme. This is not an area in which we should be looking to outsource for ideological reasons. There is an important concern at the heart of this issue. Given everything that we have learned from the United States, we know that the profit motive involved in selling the blood in the first place was a primary source of everything that has happened since. It is really important that we recognise that and show some sensitivity to the fact. I actually think that Government can run some things, and it is good to run some things publicly. We have to choose. In our political lives, we have lived through the Government running British Telecom, British Airways and so on. Things have changed, but it is important that some things be publicly owned, run and dealt with, and this is one of them. I therefore join her absolutely in saying that the Government should think again about how the scheme is administered. They should keep it in public hands where there is at least some democratic accountability. Above all, as she said, we need a group that will act on behalf of the beneficiaries, rather than solely in the Government’s interest. It would have to be very carefully put together.

[Tim Farron]

The right hon. Gentleman is making some really important points. Does he agree that one area in which the private sector could and should be playing a part is in contributing to the compensation? Is there not an analogy—an off-the-shelf scheme we could consider—in how the thalidomide victims were supported through a composite of public funding and funding from the drug companies responsible? Like the Scottish scheme, that system has introduced annual payments and allowed people struggling with conditions that they contracted because of thalidomide to have some security throughout their lives. The same could be afforded to the survivors or the loved ones of those who passed away because of contaminated blood.

[Alistair Burt]

I am sure that the hon. Gentleman will develop that point in his own speech. Of course, the thalidomide compensation was based on a clear line of accountability as the company admitted responsibility. The situation has not been quite the same in this case, for reasons that we all know, but perhaps I can come on to financial matters in a second. I will now move on from the speech made by the hon. Member for Kingston upon Hull North, the majority of which I supported wholeheartedly.

It is a matter of some despair that we are here again. I remember those friends who came to the public meetings in the House of Commons a couple of years ago saying they were actually sick of coming here as they had done so so often over the years. I would be grateful if the Minister could relay to the Government—I have not been able to get this point across—that this drip, drip approach over the years is just not working. The Government can find money at various times for some big affairs. If there is a natural disaster, a dramatic crisis or a banking collapse, vast sums suddenly appear. We have not been able to give this issue the same priority, but it cries out for it. That we are here again is proof that these concerns are not going away and cannot be dealt with drip by drip. Somebody has still not grasped the fact that, for the many reasons that I know colleagues will raise, a settlement is of the highest importance.

I will not rehearse the history, because colleagues indulged me when I raised it in a Back-Bench debate a couple of years ago, so I will not go into it at such great length again. Neither will I cite the accounts of individuals who have come to us because, frankly, I find it too difficult to read them into the record. I have done that before, but I am not able to do so again. Instead, I want to make a couple of personal points and three comments about where we might go from here.

I campaigned on this issue for many years—in government and in opposition; and when I was a Minister and not a Minister. I was pleased that the hon. Lady mentioned David Cameron, because his response to my contribution at Prime Minister’s questions in October 2013 began the current chain of events and continued the progress made over many years. I was grateful that he met me, a constituent and a dear friend of ours. He seemed to understand where we were going, and more money has come into the scheme, which I appreciate.

In June 2015, I was re-invited by the then Prime Minister to join the Government in the Department of Health, at which point I went quiet on campaigning as far as the public were concerned. I know that some people misinterpreted that. My position in the Department of Health was not conditional on the fact that I had been involved with contaminated blood, and neither was my positon in the Foreign Office or my decision to leave the Department of Health of my own accord earlier this year. However, the ministerial convention is clear: Ministers say only what the Government’s position is. We cannot have two colleagues firing away on the same issues, so I did indeed go quiet publicly for a period. Inside the Department, I made my representations to the then responsible Minister, and I want to put on record my appreciation for what my hon. Friend the Member for Battersea (Jane Ellison) sought to do with the scheme. She worked extremely hard, saw a lot of people and tried to do her best.

I think that I made a mistake when the original proposals that the current scheme is based on came forward in January this year. I sat beside my hon. Friend on the Front Bench and while I understood the general thrust, I had not fully grasped the detail, which became clear only in the consultation. My mistake was to think at that time that we had solved the problem—we clearly had not. I got that wrong, but I hope that I have tried to contribute to the debate since, both inside and now outside the Department, as we try to deal with the present proposals. As the hon. Member for Kingston upon Hull North said, they move us on from where we were, but we are not yet there, so perhaps I could say a couple of things about where I think we might go.

First, we got the issue of discretionary payments wrong in the original proposals. A number of discretionary payments have effectively become fixed and people have become dependent on them. That should have been known to the Department, but clearly it was not known in enough detail, which has accordingly led to uncertainty and to people feeling that they might not be financially compensated to the extent that they are at present. That cannot be the case, and I am certainly not prepared to support anything that will make my constituents worse off than they are at present. That was not the intention, so we must make sure that those discretionary payments are included in the new scheme.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 15th November 2016 Commons Chamber

[David Mowat]

My hon. Friend is quite right: research, in the end, is the way we will beat cancer. This country is ahead of all countries in the world in terms of the number of trials going on, including the US. The voluntary sector, including the charity to which he refers, makes a big impact and I congratulate it.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I lost my mum to ovarian cancer just a few years ago. She received outstanding treatment at the Rosemere centre in Preston. That is the centre that my constituents need to travel to for radiotherapy for all forms of cancer, but an average round trip to receive treatment takes about two hours. Does the Minister agree that that is not acceptable, and will he support the Rosemere centre in setting up a satellite unit at Kendal hospital, so that people in south Cumbria can get treatment quickly?

[David Mowat]

I certainly agree with the hon. Gentleman that two hours is a long time. His is a large constituency and I am very happy to look at his specific point and to revert to the House.

Community Pharmacies

Tim Farron Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Norman Lamb (North Norfolk) (LD)]

My central argument is that this is a cut to preventive healthcare and as such is completely irrational, makes no sense and will be a false economy. It will end up with fewer people accessing pharmacies than at the moment, resulting in more pressure on GPs and A&E departments.

I have made the point to the Government before that, by all means, they should do more to get more bang for their buck, to ensure that money is working effectively and that people get good preventive care in their communities, but they should not cut the budget for preventive care. In response to my earlier intervention, the Minister said that the cut was compensated for by the extra investment in GP practices, but that is misleading because the total investment in GP practices for pharmacies will be £112 million between now and 2020, yet in one year, by 2017-18, this budget will be down by £208 million. It is a massive cut to preventive care. It makes no sense at all and is the precise opposite of what the Government claim they seek to do on shifting resources within the NHS.

[Tim Farron (Westmorland and Lonsdale) (LD)]

When I surveyed pharmacists in my community, they told me, among other things, that in what is probably England’s most rural county, more than 80% of pharmacies do not qualify for the rural pharmacy access scheme, and for those that do, that money will be blown away by the larger cuts. Given that staff are already being laid off, does my right hon. Friend agree that one of the greatest areas of damage will be to small, rural pharmacies in areas such as ours?

[Norman Lamb]

I thank my hon. Friend for making that point; it was the second one that I was going to make. As the hon. Member for Central Ayrshire (Dr Whitford) made clear earlier, the impact will be arbitrary, and disadvantaged communities and rural areas will feel it most. Only four of the 15 pharmacists in my community will benefit from the pharmacy access scheme; all the others will not, yet they are needed by their local community.

Kentmere Mental Health Ward, Westmorland General Hospital

Tim Farron Excerpts

Monday 13th June 2016 Commons Chamber

[Tim Farron (Westmorland and Lonsdale) (LD)]

Kentmere ward is the 12-bed adult mental health ward at Westmorland general hospital. It provides essential in-patient acute mental health services to people in South Lakeland and beyond. Four weeks ago, the Cumbria Partnership NHS Foundation Trust, which looks after mental health in the county, proposed to close the ward by the end of June, with new admissions ceasing at the end of May.

This is the second time in my time as our Member of Parliament that the ward has faced the threat of closure. Ten years ago, similar proposals sparked a huge outcry from local residents. Thousands of people signed petitions and wrote to health bosses, and about 3,000 of us marched through Kendal town centre in pretty shocking weather to voice our opposition.

The campaign took many, many months, but we won. Our victory in saving the ward was a hugely important moment for our community. Mental health is often a taboo, so the suffering of those living with mental health conditions, and of their families, often happens in silence and in private. In the face of a threat to the services that those with mental health conditions rely on, far too many people would choose to look the other way—but not in South Lakeland. The campaign showed that local people were prepared proudly to stand up in solidarity with those living with mental health conditions and with their families. I am therefore extremely proud of my community. In the face of this latest threat, the character of our community is once again shining through.

Westmorland general hospital is the main hospital serving the Lake district, the western Yorkshire Dales, Kendal and much of the rest of rural southern Cumbria. I have learned over the years that the tendency to overlook the health needs of rural communities such as ours means that I need to be permanently vigilant in my defence and promotion of our hospital. The campaigns we have run to win new cancer services, to prevent the closure of the hospital itself and to increase surgery at Westmorland general are testament to the fact that ours is a special community, which will fight with unique energy and tenacity for mental and physical healthcare that is high quality and accessible. Once again, it appears that we must roll up our sleeves and fight to defend our services.

As I said, the ward provides 12 beds, the majority of which are usually full at any given time. The people occupying these beds are often suffering from the most serious mental health conditions. For much of the time, the majority of patients staying on the ward are under section.

The apparent trigger for the proposed closure came after the Cumbria Partnership NHS Foundation Trust was inspected as part of Care Quality Commission’s comprehensive inspection programme last November. Its report, which was published in March, awarded a rating of “requires improvement” to the Kentmere ward. In particular, the CQC highlighted concerns relating to privacy, access to outdoor areas and the internal physical structure of the ward. Having visited the ward myself, most recently on Saturday, I have to say that the quality of staffing and patient care is absolutely outstanding. In fact, the CQC itself was surprised that the trust’s response to the report was to close the ward, believing that the upgrades needed to meet required standards were perfectly feasible. Let me be clear: this ward is providing excellent care from outstanding staff in a physical setting that requires some improvement. It most definitely does not require closure. Indeed, the CQC has been clear that it did not recommend closure, or anything of the sort.

As I said, the ward is situated in Westmorland general hospital. The partnership trust that is responsible for mental health in Cumbria is a tenant of University Hospitals of Morecambe Bay NHS Foundation Trust. The hospital is a fairly modern building, with plenty of car parking and a beautiful setting looking out towards the Lakeland fells and the Howgills. Put bluntly, if you have to go to hospital, I cannot think of anywhere more pleasant you could be, and that is not unimportant when supporting people living with mental health conditions. The hospital building is not full. There is a great deal of space on the site, with ward space that is not used or under-used. There are enormous opportunities, with a little bit of imagination, to seek more spacious, more suitable, better-quality accommodation elsewhere in the hospital.

It is clear, then, that Kentmere ward needs upgrading. It is not ideal that it is on the first floor. There could do with being more space for the unit as a whole and greater privacy for the patients. There will be projected costs of a completely new building to meet the requirements of an upgrade. The Minister may have seen those projections. They will no doubt be expensive, and the conclusion that he is probably meant to draw from whatever scary numbers he has been given is that the only affordable solution is to close the ward. He is expected to read his brief and fob me off. However, I know him well, rate him highly, and know that he has much better judgment than that.

The reality is that the needs of patients in South Lakeland could be met on the current Westmorland general hospital site. An immediate project should be launched, alongside the hospitals trust, to ensure that there is a larger unit with ground-floor access that has greater levels of gender segregation, greater privacy, greater dignity, and greater safety. If there is a will, then the way is staring us in the face. Whatever the challenges, which we acknowledge, in upgrading this unit, it is obvious from my conversations with patients, their families, staff, the CQC and the trust that there are serious concerns about the incredibly detrimental impact that closure will have on patients’ conditions.

[Rachael Maskell (York Central) (Lab/Co-op)]

What the hon. Gentleman is saying very much echoes what happened in York when the hospital closed nine months ago. The consequence has been loss of life to my constituents. It seems that primacy in decision making is given not to clinical need, but more to the physical environment, and that has to be wrong, does it not?

[Tim Farron]

I am extremely grateful to the hon. Lady for her intervention and wish to express great solidarity with her in the campaign that she is running in York. It is of great concern to me that the CQC will make recommendations that will require improvements, and potentially not offer solutions to maintain a plausible and sustainable provision instead. The judgment we have to make is, “Is a good service that is not perfect better than no service?”, and of course the answer is going to be yes.

As I said, the quality of care in Kentmere ward at Westmorland general hospital is excellent, as stated in the report, and the staff are excellent. The ward needs upgrading—that is a given—but its closure would harm the health of some of the most vulnerable people in our community. It is utterly unacceptable that those people will have to be shipped off to Barrow, Whitehaven or Carlisle rather than being treated much closer to home in Kendal. What is more, there is no guarantee that those far distant wards will have the capacity to accommodate them. Already, patients sometimes face the immense journey to Manchester, for example. For many less well-off residents, a round trip to these alternative wards of up to 100 miles, with many hours on the bus or train, will put family and loved ones beyond easy reach. It is the patients who would be harmed if they were cut off from their families and friends and missed out on all-important visits. Instead of the reassurance of familiar faces and surroundings, they would face this dark time alone and in an unknown place.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Gentleman know whether any issues have been raised by veterans’ organisations or by veterans themselves? Ex-soldiers and former service personnel are clearly—

--- Later in debate ---

[Jim Shannon]

Does the hon. Gentleman know whether there is a need to address that issue? A lot of veterans in my constituency need help. Does his constituency have the same problems as mine?

[Tim Farron]

The hon. Gentleman draws attention to an extremely important matter, namely the plight of so many veterans. It seems that we are happy for brave women and men to provide loyal service and to put their lives on the line for us, but they are often dropped when they return from duty. There are incidences of mental health concerns for them and their families in the years after their return, and I am not clear that we as a general community provide the support that we should. That support can sometimes be provided by the community, but sometimes it needs to be provided in a physical setting as well. I am grateful to the hon. Gentleman for his intervention.

A recent Government report showed that the closure of this ward in South Lakeland would leave our part of the world with among the worst access to mental health services in the entire United Kingdom. Out of the 6,688 open ward stays in adult acute mental health in-patient care in England alone over the past year, only 263 patients —4% of them—received care 30 miles or more away from where they lived. The closure of the Kentmere ward would leave vast numbers of South Lakes residents—including all of Kendal, as well as many other rural areas—even further away from those services, as the closest alternative in-patient ward is in Barrow, 35 miles away from Westmorland general. The most likely alternatives are further away still: Carlisle is a 45-minute drive, at best, and Whitehaven and Manchester are both more than 70 minutes away, if the traffic is kind.

The provision of replacement community support, which has been offered to compensate for the closure of the ward, would be inadequate. More community support would, of course, be welcomed, but that must be in addition to, not instead of, the 12-bed unit. Increasingly, the majority of patients in the unit are under section, and one cannot section people in the community.

By the way, when people are sectioned, there is an immense impact on our local police force. Closure of the unit in Kendal would mean that our local police force, which is already heavily stretched, under-resourced and under pressure, would have to take patients vast distances across Cumbria to far-off mental health units, taking officers off the beat and threatening the safety and security of our rural communities.

The last time I spent a night out on the beat with our local police force, I was stunned by how much of its time was spent dealing with various kinds of mental health issues. Indeed, that was pretty much all it did on that occasion. Anecdotally, police officers locally tell me that up to half of their workload can involve dealing with people living with mental health conditions. Their dedication and compassion in being the first line of support for incredibly vulnerable and often distressed people and their families is overwhelming, and I am proud of them. However, our police are already working beyond their physical capacity; the closure of Kentmere ward would just add to that pressure. It is unacceptable.

Local people recognise the damage that closure of the ward will have on patient welfare and are once again uniting to make their concerns heard as we stand together to fight to put a stop to the proposed closure. There has been an overwhelming response from local people to the campaign, and as of today our petition has reached 5,500 signatures.

Last week, we were encouraged, in the face of such massive public opposition, as we were able to secure a much welcome but temporary victory: the trust announced that a final decision is to be postponed while it looks at whether the ward can be upgraded and improved to meet CQC standards, which means that it will now stay open and continue to admit patients over the summer. The vulnerable patients I met over the weekend continue to get treatment close to home. If we had not achieved this victory, they would already be being carted off to Barrow or Carlisle—far from home, and far from loved ones. News that new admissions will continue to be made throughout the summer is also welcome.

I am grateful to the trust for listening to our concerns and thinking again. I personally thank every single one of the thousands of local people involved in our campaign. Between us, we forced the trust to hold back on closure. I am especially grateful to volunteers from South Lakeland Mind, and to the local media outlets that have shown such strong support to the campaign. This is only a temporary reprieve for Kentmere ward, and our work is far from complete. My message to the people of South Lakeland is that this is the moment to step up our campaign, energised and encouraged by this success and spurred on by victories in campaigns for our hospital over the last few years. My message to patients and their families is: we will stand with you and we will not give up, because we must not give up.

It has been very clear from my discussions with the trust over the last few days that its default position is still to close the ward. I have one very specific request of the Government this evening. Will the Minister clearly instruct the Cumbria Partnership trust not to close this vital ward? While the trust looks at upgrade options and alternatives, I ask him to make it very clear, right here and right now, that closure is off the table.

I have spoken to many local residents about the matter over the past few weeks, but a conversation I had with one lady struck me particularly hard. She is regularly treated for her mental health condition at the unit, and she was clearly extremely distressed by the thought of having to trek miles from home to receive care if the ward were to close. Her condition has been visibly exacerbated by the tangible threat from this proposal. A decision by the Minister to instruct the trust, tonight, not to go ahead with closure could directly alleviate the worry and anxiety of that lady and many more like her.

The long-term effects of closing the unit would be far greater than the short-term savings. If the Government are serious about mental health, they must put words into action and prove it by stepping in and preventing the closure of this vital ward. The closure of the ward would be a serious backward step for mental health care in South Lakeland, and the Minister has the opportunity to prevent it. On behalf of the people of the South Lakes, I ask him now to take the opportunity to save Kentmere ward.

[The Minister for Community and Social Care (Alistair Burt)]

There is no pressure here, then. I thank my friend, the hon. Member for Westmorland and Lonsdale (Tim Farron), for securing this debate and for his vigilance in raising such an important subject, which matters a great deal to his constituents. I put on record my appreciation for the work done by the NHS in Cumbria and I thank the staff for their hard work and commitment to patients. In doing so, I acknowledge what the hon. Gentleman said about the police. As we in the Chamber who know about these matters are aware, the police do a great deal of work in this area. The crisis care concordat, which was piloted by the right hon. Member for North Norfolk (Norman Lamb), has made a considerable contribution to the way in which we look after those with mental health issues at times of crisis, and the police have been intimately involved. I fully accept what the hon. Gentleman has said about the amount of such work that the police in south Lakeland are involved in.

I am fond of South Lakeland. Bury Grammar School had a house at Helsington, near Brigsteer, which I am sure is in the hon. Gentleman’s constituency. I remember the place extremely well. It is a beautiful area, and its constituents are entitled both to good service from an MP and to the best quality services.

Let me turn immediately to the subject of the debate. Cumbria Partnership, the provider trust, announced in May its decision to close Kentmere unit following information from the CQC that highlighted the environmental constraints on the unit. Kentmere is an old mixed-sex unit with no access to outdoor space. The hon. Gentleman’s concerns and comments about the decision have been widely reported. As he knows, and despite what he said at the conclusion of his remarks, this is a matter for the local NHS. Neither I nor any other Minister have a role in the decisions that are taken. The hon. Member for York Central (Rachael Maskell), who spoke forcefully about Bootham Park in York, also knows that well.

However, I understand, as the hon. Gentleman rightly says, that the NHS now says that the unit will not close as announced and that decisions will depend on further work. It is, therefore, worth setting out the background and indicating the interest that I have in making sure that the best possible services are provided, while recognising that the old levers of Ministers and the NHS are not quite as they were.

Mental health services for Cumbria are commissioned by the NHS Cumbria clinical commissioning group. Cumbria Partnership NHS Foundation Trust is the provider of mental health services for patients in Cumbria. The CCG has been working on a new mental health strategy for Cumbria for some time. It is fair to say that one of the problems that the NHS, in common with other public services, faces in Cumbria is the geography. The largest towns are at the northern and southern ends of a region that covers a large area, and it is difficult to travel between the smaller towns because the roads are often slow. This means that the NHS has to make difficult decisions about where and how to provide services. To put it bluntly, everything cannot be available in every local community. While cost is a real factor, the main problem is maintaining quality. It is not about saving pennies; it is about making sure that the quality of service is high.

Like everyone else, NHS clinicians learn and improve through experience. Skills that are not being used will decline. Facilities seeing only a few patients tend to lack the patient throughput needed to ensure that services remain of high quality. The cost of employing staff is the main factor driving the cost of services, and providing services from a greater number of locations means that more staff are needed. There are only so many staff to go round. The NHS invariably finds that larger units do better in terms of patient outcomes, but the question is where those larger units should be located. Inevitably, decisions taken by the NHS will disappoint those areas not chosen.

NHS services in Cumbria overall—not just mental health services—are facing a range of challenges, and in many cases the reasons are the same. The northern part of the area is part of a success regime aimed at improving all patient services; the issues at the University Hospitals of Morecambe Bay NHS Foundation Trust in recent years are well known. It is against this background that the NHS is considering what should happen at Kentmere and what is best for the hon. Gentleman’s constituents. Cumbria Partnership announced on 17 May that the Kentmere unit would close from the end of June 2016. At the same time, it was announced that the adjoining health-based place of safety would close at the end of May. The trust said that the decision was a result of quality and safety concerns raised by the Care Quality Commission. The CQC had inspected the unit in November 2015 and its report was published in March. However, the CQC says that the decision to close the ward and the health-based place of safety is not a necessary outcome of the findings of the CQC inspection, to which the hon. Gentleman referred. In short, while it did identify problems, the CQC report did not recommend the closure of the unit.

The report clearly highlighted concerns about the ward environment, which it said placed service users at risk and did not support good care and treatment. Something does need to be done about those concerns. The unit, which treats men and women, does not meet minimum standards on single-sex accommodation and has poor access to outside space. As I understand it, one issue is that privacy for bathing and sleeping cannot be guaranteed on the mixed ward. That poses an obvious risk to patients.

On 25 May, the trust gave a reassurance that the closure would be temporary and that timescales for the closure would be reviewed. I now understand that, following discussions with the CQC and with commissioners, any decision on closure will be delayed to allow further exploration of what improvements can be made. More needs to be done, and I will say a bit about that later. It says here that the trust accepts it did not get its messages right on the closure, and I think that hon. Members will probably agree strongly with that. Many hon. Members will be aware of similar experiences in other areas, and I think the NHS needs to think carefully about how it communicates with patients and the public, particularly when the news is not good. The facts need to be clearly set out, and it is important not to rush to announcements prematurely.

These circumstances reminded me of the closure last year of Bootham Park Hospital in York, in the constituency of the hon. Member for York Central. There are differences, in that the CQC recommended the closure of Bootham Park on patient safety grounds, which is not the case here. But the report produced on the closure by NHS England makes a number of observations about how difficult processes such as this need to be handled by the NHS. I have discussed this matter with the hon. Lady and I would be happy to discuss these matters further with the hon. Gentleman if we get an opportunity to do so. These are difficult decisions to get right—safety considerations really matter and when things are identified as needing to be put right, they must be put right—but the question then becomes how to do it, on what timescale and what the options are. I will come to that in a moment. The difficulty of handling such decisions, and the way in which they have not been handled well at Bootham Park, reminds us of the importance of getting such decisions right. The report on Bootham Park, particularly in relation to owning and communicating decisions, has been made public, and I have placed a copy of the report in the Library.

As I have said, in relation to Kentmere ward, we have moved in the space of a few weeks from a permanent closure to a temporary closure, and then to the unit remaining open while more work is completed. The safety of patients has to be the primary concern, and we would be failing patients if the NHS continued to tolerate the risk to the quality and safety of care that the environment at Kentmere places on local services. Something needs to be done, and it is up to the local NHS to decide what that is, but I do not think it will do so on its own. That is where the hon. Gentleman and his friends come in.

The CCG recognises that mental health services in Cumbria need to improve and it has already involved service users, their families and carers on this project. Much of the work so far has shown, not surprisingly, that patients want better services closer to home in their local community. Later this year, NHS Cumbria CCG will therefore be consulting about the future configuration of adult in-patient mental health beds across Cumbria. That will ensure it has the right beds in the right place, with a sustainable service that the local NHS can staff for the future. The CCG has already said it will not support any permanent service change at Kentmere without full public consultation.

In preparation for this, the CCG is looking at the current configuration of adult in-patient mental health beds, benchmarking how it is managing mental health needs across Cumbria with other mental health providers and advising on areas where the NHS needs to develop services to meet future needs. The CCG also needs to make sure it has the right kind of beds in place—for example, facilities for children and young people, older adults and psychiatric intensive care beds.

[Tim Farron]

There is not much time left, and I am very grateful to the Minister for giving way. I want to point out to him, first, that there is not a single tier 4 adolescent or child mental health bed in the whole of the county of Cumbria, and secondly, that the 12 beds on Kentmere ward are nearly always full and the majority of them are for people under a section, so there is no opportunity for community options. It is not the case that there is a lack of demand.

[Alistair Burt]

I take the hon. Gentleman’s point. I cannot be as au fait with the situation as him, but I fully understand the point in general. Whereas there is a tremendous move towards improving community services, which is important and vital in its own right, that cannot be a total substitute for the in-patient acute beds that are needed. I understand his point, and that is my view and the Department’s. Getting the right balance is important, but the one is not a cheap substitute for the other. Such services are an important component, because it is important that more is done in the community to keep people away from acute beds and make sure they do not need them, but I entirely take his point.

NHS Cumbria CCG is working with its providers—mainly the foundation trust, as well as clinicians, service users and carers—to help develop the model of care it will need in the future to deliver its vision of improved mental healthcare and sustainable services. I am told that public consultation will be carried out in line with best practice and the latest Government guidance. There will be sessions for stakeholders and the public to share their views, ideas and concerns in communities around the county. I spoke to health service chiefs this afternoon in preparation for this debate, so I know how seriously they take the point about the need for consultation, as well as that they recognise the communication difficulties in relation to how they have got to where they are and that they are open to such a consultation. I therefore urge the hon. Gentleman and his constituents to involve themselves fully in that consultation, which will shape whatever happens to Kentmere in the long term.

Tempting as it is to follow the hon. Gentleman’s suggestion that I should decide on the configuration of services, I am afraid that I cannot do so because that would be outside my authority. I wish him, the hon. Member for York Central and other Members in the House good night and good luck.

Question put and agreed to.

Oral Answers to Questions

Tim Farron Excerpts

Tuesday 5th January 2016 Commons Chamber

[Mr Hunt]

The inquiry has only just started, but I thank my hon. Friend for her interest in it. The important conclusion that we have drawn from what happened at Southern Health is that this issue is much broader than one trust. We are not as good as we need to be at investigating unexpected mortality in the NHS. Southern Health is perhaps an extreme example, but the problem is much more widespread. A cultural change is needed, and we are determined to do something about it.

[Tim Farron (Westmorland and Lonsdale) (LD)]

Will the Secretary of State undertake to support Morecambe Bay, the other hospital trust in Cumbria, as it moves out of special measures, by confirming the commitment made by the coalition Government to underwrite the capital costs of a radiotherapy unit at Westmorland general hospital and to support the uplift in tariff needed to sustain that unit?

[Mr Hunt]

I will happily look into that. I cannot give the hon. Gentleman the answer now, but we would want to do everything we can to support that trust. It has been through a very difficult time and has made huge progress. We want to help it on its way.

Maternity Services (Morecambe Bay)

Tim Farron Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Mr Hunt]

I do not know the answer to the last question because we have received the report only very recently, but we will do this work as soon as possible. Indeed, if we have cross-party support, it may be that we can expedite the process. The hon. Gentleman worked very closely with James Titcombe and is absolutely right to talk about the seriousness of what happened. As with the Francis report, however, I would caution against the idea that this problem will be solved if a few more nurses are struck off. We need accountability—that is incredibly important—and where there is wrongdoing, people must be fully held to account. The big lesson is the lack of openness, transparency and trust. It is quite possible that the reason some people did not speak out about poor care is that they were frightened of the consequences of doing so. They thought they would not be listened to. Other industries, such as the nuclear industry in which James Titcombe worked or the airline industry, have managed to create a culture of trust where people on the front line who make mistakes feel able to speak out and be supported if they do so. That is the most important lesson we need to learn from today’s report.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I, too, want to the thank the Secretary of State and the shadow Secretary of State for their entirely appropriate contributions, both the statement and the response, on this immensely sensitive and deeply personally upsetting series of circumstances. I want especially to pay tribute to the families who lost loved ones as a result of what Dr Kirkup referred to as

“serious failures of clinical care”.

He refers to the report as a damning indictment.

The dignity and determination of parents such as James Titcombe and Carl Hendrickson have led to this awful truth being laid bare today. Those parents are an inspiration to me, and they should be to all of us. I want to pick up on one point in particular that was raised during the Secretary of State’s statement. Dr Kirkup expresses disquiet that the NHS and the parliamentary ombudsman chose not even to investigate what has now been shown to be the needless deaths of at least 11 babies and at least one mother. May I press the Secretary of State to go further than he has in his statement and do everything in his power to ensure that the watchdog for patients is not a lapdog for senior managers? Patients need a powerful, effective independent investigator who listens to those who grieve, like the Morecambe Bay families, and not one who dismisses them without even an investigation.

[Mr Hunt]

My hon. Friend is absolutely right. There were, clearly, very serious flaws in the way the Parliamentary and Health Service Ombudsman operated, particularly in the case of Joshua Titcombe. My hon. Friend will know that the PHSO is accountable to this House through the Public Administration Committee, and not through the Government and the Department of Health. The Public Administration Committee is considering this issue in a great deal of detail to see what lessons need to be learned. I think one of the issues is the level of expertise within the PHSO and, with the greatest of respect, a certain lack of confidence in its ability to understand when there has been a clinical failure. I think everyone agrees that one of the things we need to do is to ensure that it can draw on medical expertise. It needs to make sure that its culture is as open and transparent as the culture it would like to see inside the NHS.