Community Hospitals

Debate between Tom Blenkinsop and Guy Opperman

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.

Community Hospitals (North-East)

Debate between Tom Blenkinsop and Guy Opperman

Wednesday 20th June 2012 Commons Chamber

[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.

Oral Answers to Questions

Debate between Tom Blenkinsop and Guy Opperman

Thursday 1st March 2012 Commons Chamber

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

4. What discussions the Church Commissioners have had with (a) the Secretary of State for Culture, Olympics, Media and Sport and (b) the Secretary of State for the Home Department on metal theft from war memorials situated on Church of England property.

[Guy Opperman (Hexham) (Con)]

6. What steps are being taken to protect churches and churchyards against metal theft.

[Tony Baldry]

The Bishop of London, Anne Sloman, the chair of the cathedral and church buildings division of the Church of England, and myself have had numerous detailed discussions with a number of Ministers on the issue of metal theft from church property.

Regional Development (North-East)

Debate between Tom Blenkinsop and Guy Opperman

Tuesday 22nd March 2011 Westminster Hall

[Tom Blenkinsop]

Yes, I know Steve Gibson—I am a season ticket holder at Middlesbrough FC. I partially agree with what the hon. Gentleman has said. Local authorities, business leaders and LEPs have to work within the frameworks and structures that they are given, and they have to make those frameworks and structures work. However, this is a broad debate about the policy, and if I did not talk about the economic implications of the policy, I would not be doing a proper service to my constituents.

Reviving enterprise zones will prove ineffective, even if that aim is achieved at less cost than that of the 1980s model and the zones are redesigned for today’s circumstances. The Work Foundation and the Centre for Cities think-tanks argue in recently published reports that zones created under the now Lady Thatcher and Sir John Major created too few jobs and were too expensive. The Work Foundation has said that such zones typically created only a three-year boost before areas lapsed into depression, and that up to four fifths of jobs were simply displaced from other areas, often within the same town.

London’s Isle of Dogs—now Canary Wharf—was among the most successful of 38 enterprise zones created between 1981 and 1996, but others in places such as Middlesbrough, Speke, Hartlepool and Swansea left a less impressive legacy. The EEF manufacturing association has said that the policy sounds like a return to the past. The rhetoric deployed by the Government indeed sounds attractive, but I signal real caution and suggest to them and to supporters of enterprise zones that they reacquaint themselves with Teesside’s history in the 1980s. Enterprise zones offer potential relief on local business rates, reductions in corporation tax or national insurance contributions, tax credits or capital gains allowances on investment in premises, and the relaxation or fast-tracking of planning processes and capital expenditure subsidies. Did that work in the ’80s throughout the north-east, and throughout all sectors and, more importantly, will it work now in 2011? I had a look at my old economics notes from Teesside university, and all the evidence from the past suggests that enterprise zones did not work, and possibly will not again.

Locally, Middlesbrough’s Riverside Park, which has since been very successful, was designated as an enterprise zone, but all that happened was a rush to get speculative office development off the ground with no tenants and no businesses to fill the new buildings. That, of course, did not worry the developers, who simply benefited from the tax perks from building in an enterprise zone and allowed the empty buildings to be used to make artificial losses, which reduced the total taxation on their developments elsewhere. Such experiences, bar perhaps the Metro centre and Black and Decker in Durham and the London Docklands, were admitted as a failure at the time by the Thatcher Government. In their official evaluation, the Government admitted that between 1981 and 1986 they poured £300 million into the scheme but created only 13,000 new jobs nationally, which equates to £45,000 of public cash per job at the mid-1980s value of sterling. The same study also stated that enterprise zones mainly encouraged job displacement rather than real new jobs, and it showed that 25% of new jobs in enterprise zones were displaced from within the same town.

Repeated today, that type of local displacement risks seriously destabilising our local economy, as it involves artificially enticing businesses into what could be seen as less competitive areas within the same town. On the face of it, it might seem obvious that lower taxes boost business, but that was not borne out by experience. It quickly became clear for the majority of small businesses that their biggest concern was about making a profit in the first place, and about the risks associated with achieving that, rather than about tax on revenue or profit. Questions of rent, skilled workers and access to markets were more significant than a temporary lifting of a tax burden in a specific area rather than across the board.

The only people who benefited in the 1980s were the developers, not wealth-creating manufacturing businesses. We should not dismiss out of hand any proposals to encourage job creation and, for the sake of my area, if the plan goes ahead I will wish it every success, but the evidence of actual gain is thin indeed. Some already established businesses and their owners might see it as a helpful tax avoidance scheme, but that only benefits the already rich by possibly multiplying their wealth and does not create any added value.

[Guy Opperman (Hexham) (Con)]

I congratulate the hon. Gentleman on securing the debate, because it is a very helpful process. I have listened for 23 minutes now, and there is a great deal of criticism of what is being tried by the Government but no alternative being put forward. I look forward with great interest to hearing what the alternative will be—

[Guy Opperman]

The hon. Gentleman says that, but someone has to pay back the £120 million-a-day debt. Speaking as the son of manufacturers who have been in the industry for many years, what the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) describes is not necessarily how my family have found it.

[Tom Blenkinsop]

I will come on to discuss the alternatives. We have seen borrowing increase by £2 billion, and certain policies, which I will come on to later, have economic effects on the national economy, and more profoundly on that of the north-east. Those effects will be part and parcel of the package due to inflation, and the retail prices index is currently running at a 20-year high. Such national policies are being put in place to deal with the deficit, but they seem to do only that, rather than presenting a progressive or prospective economic plan.

Turning to industry, chemical firms with major operations on Teesside, as well as our local steel producers Tata, have grave and well-founded concerns about industrial growth policy. I am, of course, talking about carbon floor prices. A consortium of firms, including SABIC, Lucite International and GrowHow, has recently criticised the Government’s energy strategy, justly claiming that it hinders the competitiveness of UK manufacturers more than any employment regulation or tribunal. The implementation of a minimum price for carbon will add a minimum of 20% to energy-intensive users’ energy bills. If the policy is implemented, our nearby EU competitors will no doubt exploit the situation, as will competition further afield. The policy will hinder further inward investment, and might lead to the departure from our region of good companies that provide long-term, well-paid, skilled work. EU competitors have attempted and then pulled away from equivalent policies. Changes to the carbon reduction commitment scheme, which amount to a £1 billion tax, will also delay green investment and hurt small downstream industry that aids steel production in the UK. Ultimately, potential and existing investors will move abroad to less efficient and less green arrangements, which will not benefit our economy either nationally or regionally.

--- Later in debate ---

[Guy Opperman]

I apologise. That is entirely true, Mr Caton. I could not possibly comment on whether anybody had McCarthyite zealotry.

I have listened to the hon. Member for Middlesbrough South and East Cleveland and hope that he will advance the issue. It is wrong, however, to describe enterprise zones as a bad thing and to say that policies should be implemented in a way that ignores tremendous benefits. I am sure that my hon. Friend the Member for Redcar (Ian Swales) would describe the great benefits of Corus, and we should not ignore the fact that the North East of England Process Industry Cluster has come forward. All of those are good things.

Frankly, it is important, at this moment in time, to deal with deficit reduction. If there is a manifest difference between the proposals of the hon. Member for Middlesbrough South and East Cleveland and ours, it is about whether the deficit is the key or not. I suggest that, at a time in which we are in so much debt, the deficit is always the key, because if we do not address it, we will disappear into a situation akin to that of Greece or Portugal.

[Tom Blenkinsop]

I do not deny that the Government’s plans are sensible, have a point and a logic, and that they might work. The point is about who they will benefit. Is this yet more trickle-down economics, or are we genuinely talking about redistributive economics? Redistributive economics favours the north-east, but I am afraid that trickle-down economics favours the south-east. The Chancellor’s plans may indeed work, but to whose benefit?

[Guy Opperman]

The dispute between us is fairly stark in terms of the extent to which we have the potential to repay. My view is that the Chancellor is trying—this is not something he wanted to inherit—to address the £120 million-a-day debt and to be in a position to do that. I believe that he will take the issue forward and that there are real opportunities in the way ahead. I speak as the representative of a fundamentally rural constituency, but jobs are up and the points made by my hon. Friend the Member for Stockton South (James Wharton) are fair. It will be difficult, but I am absolutely certain that the Chancellor has the right policy.