Oral Answers to Questions

Tom Blenkinsop Excerpts

Tuesday 11th June 2013 Commons Chamber

[Mr Hunt]

Sir Bruce is free to meet anyone he likes. Actually, he had a meeting with MPs last month, which the right hon. Lady could have attended if she had wanted to do so, and there was extensive engagement with local south-east London MPs before the decision on Lewisham hospital was made.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

8. How many accident and emergency departments he visited in an official capacity in winter 2012-13.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I regularly visit a range of services across the NHS. Since taking up post in September 2012, I have visited 28 NHS front-line services, including seven A and E departments.

[Tom Blenkinsop]

Will the Secretary of State confirm that a freedom of information request to the Department of Health revealed that he did not visit an A and E unit until April 2013, a full six months after his appointment and despite a clear A and E crisis over the winter-spring period under his supervision?

[Mr Hunt]

As ever, the Labour party is being selective in its use of information. As I have said, I visited seven A and E departments, including over the Easter period when we had some severe A and E pressures that I wanted to investigate for myself. Let me tell the hon. Gentleman about another thing that this Government have done that his Government never did: it is not just Ministers who are going out on to the front line; we have asked all our civil servants to go on to the front line for up to four weeks. I am extremely proud that my Department will be the first to connect with the front line in that way, and am even prouder of the response from my own civil servants, who embraced the scheme with great enthusiasm.

--- Later in debate ---

[Mr Jeremy Hunt]

I congratulate my hon. Friend on her determined campaigning on this issue. She will agree that we must allow the law to follow its course. The police are looking at the five reports on hospital safety that were undertaken, the inquests and the lists of patients who appear to have been treated badly, and they are talking to the relatives of those patients. We must allow them to do their work, but no one is above the law, and particularly in this case it is important that justice be done.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

T10. With the Department of Health having awarded Cleveland fire brigade £198,000 from its social enterprise investment fund, will the Minister confirm, pursuant to concerns raised by the Fire Industry Association, that his Department undertook an assessment as to the compliance with the European state aid regulations of the state’s funding of community interest companies that compete to take business away from the private sector?

[Dr Poulter]

I would be very happy to look further into the issue and to meet the hon. Gentleman to discuss it.

A and E Departments

Tom Blenkinsop Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes an important point. I commend him for the extremely responsible and committed way in which he has been keeping an eye on what is happening in his local hospital. He is absolutely right to suggest that, before implementing any big reconfiguration, we need to be certain that what we are doing will improve patient care and not damage it. I will continue to ensure that that is the case.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

We know that walk-in centres alleviate the pressure on A and Es. How many walk-in centres have shut since May 2010?

[Mr Hunt]

I can assure the hon. Gentleman that many more walk-in centres would be shut if we had to cut the NHS budget, which is what the Labour party wants to do.

Accident and Emergency Provision (North-East)

Tom Blenkinsop Excerpts

Wednesday 13th February 2013 Westminster Hall

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

Government targets say that no more than 5% of patients should wait longer than four hours in accident and emergency departments, yet on Monday 14 January, The Northern Echo reported that the North East Ambulance Service

“has admitted that it is struggling to meet demand, after an elderly Parkinson’s Disease sufferer waited 11 hours before being taken to hospital. North-East Ambulance Service (NEAS) NHS Trust bosses said a surge in winter-related call-outs meant it was having to prioritise patients. NEAS has apologised to 84-year-old Eileen Anderson, of Marton, Middlesbrough, after it emerged ambulances are queuing for hours at hospitals across the region before being able to hand over patients.”

Mrs Anderson is a constituent of mine, and although that may be an extreme example of the delays that are occurring, unfortunately, it is not an isolated incident.

Late last year, the health care regulator, the Care Quality Commission, reported that 33% of people spent more than four hours in A and E—that was before this winter—while research shows that the number of people waiting for A and E treatment in England has risen by 47,000. Those waiting times are the worst in almost a decade. Nationally, almost 1 million extra visits to A and E units across England were recorded by the Department of Health in 2010-11, with a doubling of trolley waits—people waiting in A and E for longer than four hours to be admitted—in a single year. A freedom of information request revealed that eight-hour trolley waits almost trebled between 2009 and 2011.

The CQC has warned that 17 hospitals are understaffed and cannot guarantee patients’ safety. The excellent James Cook university hospital, which serves many in my constituency, including Mrs Anderson, has said that delays in admitting patients are being caused by insufficient staff and a lack of available beds. My most recent information is that the hospital is holding weekly meetings with ambulance bosses in an attempt to alleviate delays. The trust should be praised for taking action, but the fact that action is necessary is indicative of a sorry state of affairs.

[Pat Glass (North West Durham) (Lab)]

I have recently had a very unfortunate experience of the NHS involving admissions to A and E. Both my parents have been admitted to A and E over the past two months. Their care has been absolutely excellent—I could not criticise it at all—but staff took the opportunity to tell me that the staffing levels, particularly at weekends, in A and E and on wards is putting life at risk, which is surely a concern to us all.

--- Later in debate ---

[Tom Blenkinsop]

I thank my hon. Friend for that point, which I will try to extrapolate from during the debate.

Paramedics say that delays prevent them from responding to calls, and fear that such delays could lead to a tragedy. As recently as last week, it was reported that the hospital was the second worst in the north-east for hospital handover delays of longer than two hours. Any hospital handover delay of more than two hours is classified as a serious incident by the NEAS. Of equal concern is the fact that in December, the hospital failed to meet national targets of responding to 75% of the most serious incidents—classified as red incidents—within eight minutes; its result was 69%.

Accident and emergency departments are the foremost example of NHS front-line services. If they appear to be failing, it is hard to deny that something is not right. It is not justifiable to have patients queue in a corridor, as Gladys Herbert had to. She described the situation:

“It’s as plain as the nose on my face there’s not enough beds and not enough staff in the hospital”.

That occurred at James Cook hospital, where there was a queue of up to 10 ambulances at one point. Frankly, that is an appalling risk to patient safety. The Prime Minister has personally promised to protect the NHS, but he is leaving patients such as Mrs Anderson and Mrs Herbert waiting longer in pain and discomfort.

[Andy McDonald (Middlesbrough) (Lab)]

I rise to support my hon. Friend, and I congratulate him on securing this debate. I entirely support what he is saying, because some weeks ago my own mother lay on a hospital trolley for five hours at James Cook hospital, waiting for admission to a ward. Ambulance staff had to remain with her until she was admitted before they could go on to their next task, which is a complete and utter mismatch of resources. I support my hon. Friend’s comments.

[Tom Blenkinsop]

My hon. Friend makes an excellent point. It is a sorry state of affairs, and personal experiences, that people from our area are reporting. The warning signs are there, and I believe front-line staff when they say, as has been reported:

“Somebody is going to die somewhere down the line and it could be the most vulnerable, children. Families of sick people arrive at hospitals and expect to find them in a bed, but they are still outside in an ambulance.”

In fact, a tragedy has already taken place. Last year, an ambulance crew brought a patient to the hospital, but he was not officially handed over to A and E staff. Before he could be seen by a nurse or doctor, he went into a fatal cardiac arrest. The patient, who has not been identified, died at James Cook university hospital, having waited for emergency treatment for more than two hours.

The delays are obviously stretching resources all over the place; for example, ambulances from as far away as Lancashire are being brought in to cover other emergencies. I fear that, with changes in NHS provision elsewhere in the north-east and north Yorkshire, James Cook hospital’s resources might become even more stretched. Surgeries’ general reduction in their late opening times for out-of-hours appointments in some areas across the north-east is putting further pressure on regional A and Es. For example, in County Durham, 69 GP surgeries offered late opening appointments in 2011, but in 2012 that was down to 61 surgeries, which is a 7.6% drop. In Newcastle, 33 GP surgeries offered late appointments in 2011, which dropped to 24 surgeries in 2012. In Hartlepool, 15 GP surgeries offered late appointment times in 2011, but that dropped to 10 in 2012, which is a 31.3% decrease. As the Minister will admit, triage is essential, and that is enormously helped by walk-in centres in my constituency, across Middlesbrough and in Redcar, especially as regards less affluent transient populations who are often not on GP registers.

As the Minister knows following the meeting he kindly agreed to have with me and a representative of the trust, urgent care provision in east Cleveland is facing particular problems. The trust claims to be taking steps to resolve the problems, but if the issues are not resolved, I fear that in the interim—and possibly in the longer term—a reduction in urgent care provision in east Cleveland might further increase the demand faced by James Cook hospital’s accident and emergency department, as patients search for alternative treatment. To an extent, we have already seen that with the draw-down in services at Guisborough general hospital’s minor injury unit.

[James Wharton (Stockton South) (Con)]

I congratulate the hon. Gentleman on securing what is an important debate for many of our constituents. Many of my constituents use James Cook hospital—some by choice, because it is such a good hospital. The hon. Gentleman is talking about the reorganisation of services across the north-east and its impact. We have seen A and Es closing, or being focused in smaller areas to provide specialist care. How would a new hospital at Wynyard impact on future service provision for our constituents?

[Tom Blenkinsop]

I thank the hon. Gentleman for his input. A hospital at Wynyard would be an excellent provision for the region. It was planned by the previous Labour Government. That was as part of a different financial package and under a different scheme, but it was always in the Labour Government’s plans. It is good that the present Government also want that to happen. However, we are discussing current services, and the impact of the reduction in moneys on James Cook hospital and services in east Cleveland and north Yorkshire, which he will no doubt have read about in the local press.

Changes in provision for A and E departments in north Yorkshire might increase the pressures faced by James Cook hospital. In the neighbouring constituency of Scarborough, the trust has given assurances as to the future of overnight A and E services, but local people feel that there are uncertainties over the future of those services. In Northallerton, the Secretary of State for Foreign and Commonwealth Affairs, the right hon. Member for Richmond (Yorks) (Mr Hague), has been campaigning against cuts to services, particularly maternity services, at the Friarage hospital. In Malton, the minor injuries unit has been closed at weekends. I fear that if services at those hospitals are further reduced, additional demand might be placed on James Cook hospital, despite the fact that it already struggles to cope with demand.

When someone is taken to hospital in an ambulance, most reasonable people would expect them to receive care and treatment very quickly. Although I accept that demand is difficult to predict, I certainly do not expect my constituents to have to wait two and a half hours after been taken to hospital by paramedics. I do not hold nurses or doctors responsible for that; after all, more than 5,000 nurses have been cut across the NHS since May 2010. The situation is more likely to have been caused by the budgetary squeeze and the organisational changes that local NHS trusts find themselves dealing with due to the Government’s cuts and unnecessary NHS reorganisation.

I hope that my examples make it clear that there are serious problems on Teesside and across the region, and that they cannot be allowed to continue. I appreciate that the Minister is monitoring the situation with regard to urgent care staff in other hospitals in my constituency. I would be grateful if, alongside that process, he closely monitored A and E performance at James Cook university hospital. There is a very real danger that the situation could deteriorate. At the moment, the capacity for the hospital’s A and E department is 60,000 patients a year; that is what it was designed for. This year, it expects almost double that figure—105,000 patients. That is a time-bomb waiting to go off, which would have repercussions across the region.

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[Dr Poulter]

It is absolutely right to say that any review of A and E provision, and urgent care provision, must take into account travelling distances and transfer times to hospitals and between hospitals. Those issues will be part of the discussion and the review, although they are not the major thrust of what Sir Bruce is doing. However, a number of hon. Members have arranged to meet my ministerial colleague Earl Howe, who is currently examining several issues related to ambulances, and I am sure that he would also be pleased to see the hon. Lady to talk through some of the local issues in more detail.

Increased pressure on hospital services is not necessarily unusual for this time of year, notwithstanding the fact that it is completely unacceptable for there to be long handover delays or for people not to receive prompt and high-quality treatment. There are winter pressures that occur every year, and the Government will always do all we can—the previous Government did what they could as well—to ensure that the NHS is robustly funded and supported to meet such fluctuations in demand.

The Department of Health conducts daily monitoring of the winter pressures for all acute hospital providers. I am aware that South Tees Hospitals NHS Foundation Trust has James Cook University hospital as its main acute site—of course, it is also the local hospital that most of the hon. Gentleman’s constituents will attend—and the trust, like other organisations, has experienced some additional pressures in recent months. However, under the trust’s own internal criteria, the pressures that it experienced during late December and early January were identified as level three on a scale of one to six, which demonstrates that the trust has been busy. It is important to highlight, however, that it has been coping with those additional pressures, notwithstanding the issues raised in the debate, including the need to upscale the community-based response to prevent patients who would be better looked after in the community from being in an acute hospital setting in the first place.

It is also important to say that we expect all NHS commissioners and providers to ensure that appropriate measures are in place to manage any increases in demand, particularly during the winter. The delays in patient care that have been outlined eloquently by hon. Members are simply unacceptable, be they in A and E departments or in ambulance journeys to hospital. Delays are of concern, and the local NHS trusts and their partners must ensure that they step up their local strategies to cope with unexpected increases in demand.

We always needs to be aware of such seasonal variations in the NHS. That is why the Department of Health has given more than £300 million to the NHS specifically to deal with winter pressures. However, it is for local NHS providers to recognise that that extra investment has been made and to co-ordinate their response with the community, particularly through highly skilled community intermediate care teams, which help to get older people back home from hospital as quickly as possible so that they can be better looked after in their own homes.

The other main concern expressed by the hon. Gentleman was about ambulance performance. Delaying ambulances outside A and E departments, as a result of a temporary mismatch between A and E and hospital capacity and the numbers of elective emergency patients arriving, is simply not acceptable. There is a need for the local ambulance trust and the local hospital to work more constructively together, to ensure that such delays do not happen. That might be about having better triage, or the local ambulance trust might need to put more resources into the front line in the local area.

I also take this opportunity to say that the Government have provided £330 million of additional funding specifically to help the NHS cope with the winter pressures this year, so that patients receive the treatment they deserve. I understand that South Tees Hospitals NHS Foundation Trust received more than £1 million from that additional funding, and Middlesbrough primary care trust has received a further £264,000. Investment in social care services will also benefit the broader health system, but that requires the local trust to ensure that it uses the money wisely to address the concerns raised in the debate.

In January, the hon. Gentleman and I had what I thought was a constructive meeting with the trust, and I hope that will be the foundation for him and other local MPs to engage constructively with the trust to encourage a quick solution to the problems that have been outlined. One good thing that came out of the meeting, as the hon. Gentleman already knows, is that there is now an active process going on for the recruitment of specialist nurses to the smaller hospitals—the community hospitals —in the local area. When those nurses are in place, that will be a big step forward; I hope those hospitals will be open for additional hours, which will help to take pressure off acute settings.

In response to growing demand, an overall increase in ambulance activity and longer stays in hospital owing to more complicated medical conditions, I understand that the trust has already taken some specific measures, with £650,000 of investment being put into extra nurses and consultants. To deal with times of acute winter pressure, a bed winter ward will also open. The trust is also now working actively with its partners to redesign patient services, along the lines of the rapid response teams and intermediate care teams that I described earlier, to prevent inappropriate hospital admissions in the first place. In addition, it is exploring the development of a separate paediatric A and E department to create extra space for patients.

I am sure that the hon. Gentleman would have hoped that some of those measures would have been in train earlier, but following our meeting, and after the trust has listened to this debate, I am sure it will be all the more determined to do what it can to put things right in the future. As he knows, through our engagement I am taking an active interest in these issues and I will welcome further discussions if there are more problems in the future, because the delays that have been described today are unacceptable.

[Tom Blenkinsop]

The Minister has been very constructive in previous meetings and the response that he has given today has been very constructive as well. On specialist care staff for Guisborough hospital and East Cleveland hospital, he knows from our meeting that the trust has advertised those positions four times already. Would he be willing to meet me again if the fifth attempt also proves unsuccessful?

[Dr Poulter]

I have already made the offer, and I do so again now, that I am very happy to meet again. The trust is now taking the issue very seriously and is putting in place robust measures to deal with the concerns raised during this debate and when the hon. Gentleman and I met the trust. I understand that there are 16 applicants for the posts, so a good number of people have applied. I am hopeful that after the interviews on 25 February there will be additional nursing capacity in those local health care settings, to ensure that the scope of the community health care response is improved. Also, I hope that the number of hours that the services are available will be increased, because as the hon. Gentleman knows community health care is about taking pressure off acute A and E services wherever possible, and ensuring that people who can be treated locally are treated locally. That is why those two hospitals—Guisborough hospital and East Cleveland hospital—are such important care settings.

I hope that we are now in a better position, after this debate and through the actions that the trust is already taking—following our meeting earlier in the year—to deal with some of the challenges. I again congratulate the hon. Gentleman on securing the debate, which has been constructive, and I know that he and I will be meeting again if the situation in his area does not improve.

Thank you, Mr Crausby, for chairing the debate.

NHS Commissioning Board (Mandate)

Tom Blenkinsop Excerpts

Tuesday 13th November 2012 Commons Chamber

[Mr Hunt]

That is a very important question. We are going to avoid that because I will not be signing any big national IT contracts. The initiative will be locally led and locally driven. Guidelines will be laid down to make sure that all the systems developed in different parts of the country are inter-operable. That is very important, but we will not have any grand plans nor will there be a big single database, so we can thereby avoid some of the problems. We must none the less be prepared to grasp what technology changes can mean for the NHS, just as they do for the rest of society.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

On 23 October I raised with the Secretary of State unacceptable delays of two and a half hours for the transfer of patients from ambulances to James Cook University hospital accident and emergency in Middlesbrough on 27 September. Last Thursday night for one hour and last Friday morning for one hour, owing to bed pressures, patients in ambulances were diverted from James Cook to North Tees hospital, and 14 planned operations were cancelled the same Friday and the following Saturday. Is not the mandate completely dependent on whether the Secretary of State is in control of the remit of his Department?

[Mr Hunt]

The mandate makes it clear that waiting times targets must be met. That is a very important part of the mandate. I continue to be extremely concerned by what the hon. Gentleman tells me about what is happening in his constituency, and I look to his local NHS to come up with a sustainable, rapid solution.

Oral Answers to Questions

Tom Blenkinsop Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Mr Hunt]

My hon. Friend is absolutely right: that is a mendacious scare story that is being put out on the ground. Real-terms spending on the NHS has increased across the country, which has not been possible across all Government Departments. Because of that, we are able to invest more in patient care, cancer drugs, doctors and facilities across the country, and indeed in Kettering.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

2. How many patients waited longer than half an hour in an ambulance to be transferred to accident and emergency in each year since 2009-10.

[The Secretary of State for Health (Mr Jeremy Hunt)]

The Department’s records date back to 2010-11. The number of ambulance handovers delayed by longer than half an hour was 63,892 between 1 November 2010 and 24 February 2011 and 77,543 between 1 November 2011 and l March 2012.

[Tom Blenkinsop]

On 27 September, patients and paramedics were left waiting outside James Cook university hospital in Middlesbrough for two and a half hours before being handed over. Dr Clifford of the college of emergency medicine described such delays as being due to an unacceptable mismatch in demand and supply. Does the Secretary of State agree with Dr Clifford, and what steps will he take to ensure that those problems do not recur for my constituents?

[Mr Hunt]

I am extremely concerned about what happened on 27 September. I can confirm to the hon. Gentleman that all the red 1 calls on that day were met within the target time of eight minutes, but the delays were completely unacceptable. I know that the trust is taking measures to ensure that the problems are not repeated, particularly looking forward to the winter time when there is likely to be extra pressure on ambulance services. I will follow the matter very closely, and I expect the trust to come up with measures to ensure that his constituents are properly safeguarded.

Community Hospitals

Tom Blenkinsop Excerpts

Thursday 6th September 2012 Commons Chamber

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

I thank the hon. Member for Totnes (Dr Wollaston) and the Backbench Business Committee for securing this important debate. We can see from the number of hon. Members across the Chamber who want to talk about this that it is a valid and timely debate. I also welcome the Minister to her new position in the Health team.

As many hon. Members and the Minister of State will know, community hospitals play a vital role in my constituency; Guisborough hospital and East Cleveland hospital are essential to East Cleveland’s health and well-being. I was privileged to secure an Adjournment debate on the future of community hospitals in the north-east on 20 June. While it was certainly good to hear from the hon. Member for Hexham (Guy Opperman), for instance, about the good work that community hospitals do in his constituency, it was clear from other hon. Members that some community hospitals are struggling. A general consensus was apparent to me that patient choice is key to this whole matter. While patients should be able to receive care at home, that is not necessarily what patients always want, and it is not always necessarily appropriate. Community hospitals therefore have a real role in providing care to such people, as well as in the provision of out-patient services, especially in rural areas.

With the Health and Social Care Act 2012 causing reorganisation that has cost the local NHS tens of millions of pounds on Teesside alone, it is perhaps not surprising that many trusts appear keen to centralise services to larger hospitals. In my constituency, we have already seen a significant reduction during this Parliament in the services available at Guisborough hospital, with the closure of the Chaloner ward and a reduction in minor injuries provision. Similarly, constituents have told me that they have been unable to receive the services that they need at East Cleveland hospital in Brotton. This is deeply worrying, as more than 50% of my constituency is rural, and I know how constituents without a car can struggle to attend hospitals further away, such as the James Cook university hospital near Marton, Easterside and Park End in the south Middlesbrough part of my constituency.

I know that this problem is unfortunately replicated around the country. In the South Tees Hospitals NHS Foundation Trust area alone, a district general hospital in Northallerton—the Friarage—and Redcar’s primary care hospital are facing problems due to the centralisation of services. With the reallocation of public health funds as well, which are used primarily for community nursing, we are seeing what I can only describe as a vice-like grip between the reduction in services in community hospitals and the reduction in funding for community nursing, especially for palliative care for elderly and vulnerable people.

[Guy Opperman]

I accept that the hon. Gentleman is a champion for his constituency, but he surely accepts that this is a process that started under his Government. For example, his maternity unit closed in 2006, so it is not something new.

[Tom Blenkinsop]

I can tell that the hon. Gentleman has a good memory, because that point was raised in my debate. While many services at that hospital have been closed in recent months, the maternity services at Guisborough were centralised at James Cook and the community was consulted on that. However, I did not see any proper community consultation when services at East Cleveland hospital and Guisborough were very much reduced.

Also, a massive number of long-serving, skilled nurses, mainly women, have been leaving Guisborough hospital before reaching retirement age. That is very worrying. They are choosing to go to other hospitals or simply to leave their careers altogether. The trust acknowledges that this is happening, and the reasons include stress, a lack of available nurses on the wards and the low-paying contracts being offered.

This seems to involve a central funding issue for the trust. The James Cook University hospital is now consulting the community on privatising wards at the hospital. So, while the trust is centralising services away from the community hospitals, it is also trying to find other funding sources to pay for the services that it has centralised. That suggests that this is a central funding issue and nothing else.

I sincerely hope, for the sake of my constituents, that the Minister takes urgent action to address the problems faced by district, general and community hospitals. Such action should include commissioning a database of information on what they do, providing trusts with the funds that they need to secure the future of those hospitals, and replacing the money that they have been forced to waste on an unwanted, unnecessary, top-down NHS reorganisation.

Business of the House

Tom Blenkinsop Excerpts

Thursday 6th September 2012 Commons Chamber

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

I congratulate the Leader of the House on his new position. May I also express my disappointment that the Government reshuffle did not deliver a Minister for Teesside? I say that because figures from the Office for National Statistics have today shown that South Teesside has moved from 14th to second in the country for its number of households with no work. May we have a statement on why the number of workless households in Teesside has increased so desperately in the past year?

[Mr Lansley]

I am surprised that the hon. Gentleman did not put that in the context of the overall reduction in the number of households with nobody in work, which I believe is very much to be applauded.

National Health Service

Tom Blenkinsop Excerpts

Monday 16th July 2012 Commons Chamber

[Mr Burns]

Not at the moment.

The motion states that seven out of every 10 acute hospital trusts in England missed their savings targets for the first half of 2011-12, referring to their cost improvement plans. Not only did the right hon. Gentleman use out-of-date figures—figures for the whole year are now available—but he again misrepresented what they mean for the performance of the NHS. Across the NHS, acute NHS trusts plan to save £1.3 billion during 2011-12. In the end, they saved £1.2 billion. More than half—57%—of the shortfall was concentrated in just 10 NHS trusts in significant financial difficulties— 10 NHS trusts that he ignored when he was Health Secretary but that we are getting to grips with. I would point him instead to the £4.3 billion of efficiency savings made in 2010-11 and the further £5.8 billion of efficiency savings made in 2011-12. Primary care trusts and strategic health authorities have reported a surplus of £1.6 billion in 2011-12, money that is being carried forward and made available for 2012-13 and thereafter.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

Will the Minister give way?

[Mr Burns]

No, I will not.

Unlike the right hon. Member for Leigh, who championed cuts to the NHS, this Government are investing more in the NHS, more in front-line care, more in staff and more in treatments.

Care and Support

Tom Blenkinsop Excerpts

Wednesday 11th July 2012 Commons Chamber

[Mr Lansley]

We are very clear—I hope I have been clear—that the adoption of a universal deferred payment scheme gives people an opportunity. We are not talking about something that people are required to do; rather, they can choose to do it. One of the things that has most distressed some of those who go into residential care settings is that, as a consequence, they are required to sell their homes—they are forced to do it. What we have announced gives people an opportunity for that not to happen, but as the White Paper and the progress report make clear, we would like to proceed on the basis of a funding model, based on the Dilnot commission, that enables people also to have a cap on their care costs. If we can do that, the combination of the two will be an effective solution.

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

Without a cap on costs, which is what the Dilnot commission proposed for universal deferred schemes, will this measure not potentially leave some families with massive debts to pay when their loved ones die, far in excess of the £35,000 cap that the commission proposed?

[Mr Lansley]

I am sorry that the hon. Gentleman has read out the Whips’ question, but he did not listen to the last answer. We are both implementing the universal deferred payment scheme and proposing in the draft Bill that we should legislate for that. We are, as I have made clear, supporting the principle of Dilnot that we should implement a capped-cost model with an extended means test, but we have to demonstrate, as we know, that it needs to be paid for, and if those decisions involve public expenditure, they must necessarily be held for the spending review.

Community Hospitals (North-East)

Tom Blenkinsop Excerpts

Wednesday 20th June 2012 Commons Chamber

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

In December 2011, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow) told me:

“Local community hospitals provide a vital community resource to support patients in need of rehabilitation, recuperation and respite care”,

and that they support

“a rapid return to independence and good health.”—[Official Report, 12 December 2011; Vol. 537, c. 560W.]

It was a pleasant surprise to find myself agreeing with him. Unfortunately, community hospitals, especially those in my constituency and in the north-east, are facing ever more challenges.

Hospitals such as East Cleveland hospital and Guisborough hospital play an essential role in the communities that they serve. My constituents prefer and would ordinarily choose to receive care near their home and their family, whether it be palliative, minor injuries or maternity care. That is also the case elsewhere in the north-east and north Yorkshire, where my colleagues and local residents have been speaking out to protect and extend the services in their local community hospitals and district general hospitals, which are increasingly under threat.

Demographic change means that we are increasingly dealing with social care. Given that community hospitals tend to be truly local and cherished, and the need for health and social care to be seamlessly integrated, it should be painfully obvious that local community hospitals are able to provide effective liaison between NHS staff and local adult social services, especially when discussing arrangements for the discharge of elderly patients and their continued need for community-based care facilities and services. The Government are, at least nominally, following the previous Labour Government’s good example of recognising the importance of patient choice.

[Mr Graham Stuart (Beverley and Holderness) (Con)]

The hon. Gentleman is giving a powerful speech that rightly highlights the importance of community hospitals. Does he, like me, regret the fact that more than 3,000 beds in community hospitals were closed by the last Labour Government? Does he recognise that only a huge campaign across this House made them see the error of their ways and reverse their savage cuts to this most vital of local assets?

[Tom Blenkinsop]

Any intervention in this debate must be put in the context of the fact that more than £600 million from my region is going to be relocated to the south-east. I know that, as a Yorkshire MP, the hon. Gentleman will be concerned about the news of the cuts to Yorkshire’s health care services that came out only today in The Northern Echo. We can talk about the whys and wherefores of that, but there is certainly a kernel of truth in it. Community hospitals and secondary hospitals, such as James Cook university hospital on the border of my constituency, are having to consolidate and centralise their services far more than has been the case before.

[Alex Cunningham (Stockton North) (Lab)]

I congratulate my hon. Friend and fellow Teesside MP on securing this debate. I know how hard he works on behalf of his constituents to secure access to the services that they need, particularly health services. Is he surprised that there will be more cuts, particularly in the light of the £50 million that it is costing to reorganise the NHS on Teesside?

[Tom Blenkinsop]

I am not surprised, to be honest. A couple of days ago, the Newcastle Journal reported that a freedom of information request had demonstrated that even after the NHS redundancies that we have seen, which I think cost approximately £60 million, a further 1,000 nurses are set to be cut in the north-east region.

The role of community hospitals is as important as ever. Despite the apparent importance of community hospitals, I fear for the future of hospitals such as those in Brotton and Guisborough in my constituency, the five other community hospitals of the South Tees Hospitals NHS Foundation Trust, and the trust’s district general hospital, the Friarage, which is at the heart of the Foreign Secretary’s constituency. All those hospitals are seeing a reduction in services as a consequence of the Government’s health reforms and austerity package—whether the reduction of minor injuries provision, the closure of the Chaloner ward at Guisborough hospital or the downgrading of maternity and paediatric services at the Friarage, which even the Secretary of State has branded “unacceptable”.

Ultimately, communities, patients and employees recognise that only so many services can be cut before the future of the hospitals themselves is brought into question. They are concerned that the Government are failing to do anything whatever to prevent those reductions in services. [Interruption.] I give way to the hon. Member for Redcar (Ian Swales).

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. May I suggest to the hon. Member for Redcar (Ian Swales) that if he wants to intervene, it is better if he actually stands up rather than waving his hand?

[Ian Swales]

Thank you for your advice, Mr Deputy Speaker.

I congratulate my neighbouring MP, the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop), on securing this important debate. My daughter was born in Guisborough hospital in his constituency, but that would no longer be possible as the maternity unit closed in 2006. The withdrawal of services from older community hospitals, and the failure to put services into new community hospitals such as Redcar, are top-down decisions. Does he support more locally based commissioning driven by clinicians?

[Tom Blenkinsop]

I believe in an excellent quality of service, and yes, it was regrettable that the maternity unit at Guisborough hospital was closed. As the hon. Gentleman will know, my predecessor fought to save that service. In fact, there was a wide campaign by the local trust and all local politicians to keep it open. Unfortunately, more people opted to use the maternity services at James Cook hospital, which was part of the choice agenda that all parties believe in. I am sure the Minister does as well.

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[Mr Deputy Speaker]

Order. I allowed the intervention, but I am not sure what the connection is between the north-east and Northern Ireland.

[Tom Blenkinsop]

The current Prime Minister, when he was Leader of the Opposition, identified Northern Ireland and the north-east as areas where the public service cuts should primarily take place. That is the similarity. Of course, the north-east leads all other regions in the United Kingdom on exports, so there was some smoke and mirrors in that argument. There are indeed a number of Members who are introducing petitions against the closure of health services, including a number who are in the Cabinet.

The centralisation process is well under way at Guisborough hospital, in my constituency, and that is just one example of what is happening across the north-east. The hospital has already been forced to operate a reduced service owing to staffing pressures, opening only from 9 am to 5 pm on weekdays and 8 am to 8 pm at weekends instead of the usual round-the-clock service. The Chaloner ward there is an eight-bed unit providing palliative, post-operative and respite care, with dedicated nursing care for a variety of medical conditions. There is also an out-patient suite and a minor injuries unit. Closing the Chaloner ward could eventually mean the end of the hospital. The maternity service has already been lost, and closing the ward would leave only a residual out-patient service and the Priory ward on the site. East Cleveland hospital, in the Brotton area of my constituency, offers even more limited services than Guisborough, and I have often spoken to constituents who have been forced to seek treatment elsewhere.

My main concern is that hospitals such as Guisborough and Brotton will become marginalised owing to a continuous reduction of funding from South Tees Hospitals NHS Foundation Trust, as more and more services are consolidated at James Cook university hospital. It takes nearly an hour to reach that hospital by bus from Guisborough, and even longer from the more rural parts of my constituency—and that is under the very generous assumption that such bus services will still be available.

It may be politically expedient for some to argue that such decisions are solely the responsibility of the relevant trust and are somehow detached from being the responsibility of central Government, but they are unfortunately a worrying national trend. No one trust can take the blame, and the scrutiny must instead be of the Government who force them into such a position. For example, I have read that in Sutton,

“a cloud has gathered over St Helier”

district general hospital, where accident and emergency services are under threat, to such an extent that the Minister of State, the hon. Member for Sutton and Cheam, has started a petition against the closure in his own constituency, despite the fact that it seems to be part of a broader pattern that is perhaps caused by his own Department’s policies.

Given all the campaigns that are emerging throughout the country to save services at local hospitals, I find myself asking why there seems to be such a decline in the provision of services. Despite the Government’s localism agenda, it appears that services are becoming more centralised to larger hospitals, leaving community hospitals with empty beds and abandoned wards.

[Dr Phillip Lee (Bracknell) (Con)]

Does the hon. Gentleman agree that the consolidation of acute and emergency services, and the reconfiguration of services in the north-east and across the country, are about not just the cuts and austerity to which he refers—I do not agree with him on that—but the changes in how health care is provided? Does he also agree that the community hospitals that he seeks to support are best placed to deliver chronic care, not acute care?

[Tom Blenkinsop]

There is an element of truth in what the hon. Gentleman says, but I will come to that when I make suggestions. Community hospitals have a role as part of an overall package, but I have seen an erosion of those services in my locality. The reason I have introduced this debate is that a pattern is emerging in the north-east and across the country in how services are allocated by trusts.

[Guy Opperman (Hexham) (Con)]

I applaud the fact that the hon. Gentleman has introduced this debate on behalf of north-east community hospitals. I want to address the issue of the quality of the service provided by them. We retain maternity services in Hexham. The service is so popular that Northumbria Healthcare NHS Foundation Trust has said that it is hopeful that more women will choose to have their babies there. Does he agree that that is an example of a community hospital going forward?

[Tom Blenkinsop]

I praise the hon. Gentleman—it sounds like the services in his constituency are going forward and doing very well—but I am addressing the broader pattern in my local area and elsewhere. Some worrying trends are a symptom of the Health and Social Care Act 2012, which I opposed vociferously—that is on the record.

The future of community hospitals is being plunged into uncertainty because of the 2012 Act. With responsibility for commissioning health care services now falling to clinical commissioning groups, and with primary care trusts being axed, centralisation is a real temptation both for the CCGs and for the foundation trusts that have taken over responsibility for the management of primary care hospitals in Teesside.

Another future scenario for community hospitals is the possibility of privatisation. As cuts are made, commissioning groups could look outside the NHS to provide their services. That happened in Suffolk in March, where Serco won a £140 million contract to manage, among other things, the area’s community hospitals. Neither the public, who cherish their NHS, nor workers, want that, and there is a concern that such deals are made solely to save money and not necessarily to improve patient care. In the north-east, where health inequalities are most pronounced, such moves could lead to a significant decrease in the quality of service offered, and to a loss of any long-term strategic vision that might exist to tackle such deeply ingrained public health problems.

When I challenged the Prime Minister about the future of community hospitals and district general hospitals at Prime Minister’s questions last week, all he did was cite a supposed increase in funding to the “primary care trust” in my constituency—he is so oblivious and out of touch that he failed to realise there are, in fact, two primary care trusts: NHS Redcar and Cleveland, and NHS Middlesbrough.

Regardless of what spin the Government put on the state of the NHS, it is clear that the NHS throughout the country is struggling financially. In GP magazine earlier this week, research collected through a series of Freedom of Information Act requests showed that nine out of 10 trusts find themselves “rationing” care such as cataract surgery and knee and hip operations. If trusts have to do that, there is clearly an issue with funding, despite the Government’s assertions, especially when trusts such as Redcar and Cleveland have to spend tens of millions of pounds to deal with the consequences of the 2012 Act.

I worry that many trusts, when faced with the real possibility of having to reduce clinical services, will turn towards centralising them and taking them away from community and district general hospitals. They will certainly be wary of extending the services offered in such hospitals. Redcar primary care hospital, which is in the neighbouring constituency of the hon. Member for Redcar (Ian Swales), needs such an extension, but the localisation agenda is threatened by the lack of funding necessary to pursue it.

The Health Secretary and Prime Minister need to remember the pledge they made in 2007 to protect district general hospitals, and to listen to what communities, patients and medical professionals are saying about the importance of securing the future of community hospitals. It would take some of my constituents, such as those in Cowbar, 45 minutes by car or around three hours by public transport to reach the large hospital 20 miles away into which services are being consolidated. I imagine the situation is even worse in more rural parts of the north-east and north Yorkshire. That is clearly not acceptable. Individual members of the Government, such as the Foreign Secretary and Minister responsible for care services, have been critical of the effect of the Department of Health’s policies on the provision of services in local hospitals following campaigns by angry and worried constituents, but it is time for the rest of the Government and the other Health Ministers to act. Steps need to be taken, and funding provided, to ensure that patients have the choice to receive as many services as is medically possible in hospitals near their homes, not as a replacement to care at home or in more specialised hospitals, but to complement it.

--- Later in debate ---

[Mr Burns]

I am extremely grateful to my hon. Friend, because I understand that the campaign for that decision was kept up for more than 25 years. I congratulate NHS North of Tyne, Haltwhistle council and the friends of the hospital, as well as my hon. Friend, for all their work in ensuring that it is finally happening.

[Tom Blenkinsop]

It is good to hear that every penny saved will go back into the NHS. My main fear is that the new funding calculations that the Secretary of State for Health is proposing will be based not on deprivation but on age, which means that, as shown by studies by Durham university—a fine institution in my region—more than £600 million of the health funding that is currently given to north-east health services would be redirected south.

[Mr Burns]

I certainly note the point the hon. Gentleman makes, and I have read a number of his local newspapers, in which he and a number of his hon. Friends have been making it too. I am delighted that he accepts my argument that every single penny that is saved from the £20 billion of efficiency savings—which, of course, we inherited from the last Government and accepted, because it was the right policy to pursue—will be reinvested in the NHS.

I think the hon. Gentleman attended Health questions on 12 June, at which the right hon. Member for Newcastle upon Tyne East (Mr Brown) raised the funding formula and the basis for it with me. I explained that a variety of factors, of which health is one, will determine the allocation of funding—just as it was determined under his Government—and that the question was also being looked at by an independent body. I have seen the newspapers, and I fully appreciate that the hon. Gentleman and his hon. Friends are trying to drum up a storm by suggesting that they are going to be hard done by. However, if he reads the answer I gave to his right hon. Friend the Member for Newcastle upon Tyne East in Hansard, I hope it will reassure him, on reflection, about the current situation.