NHS Staff: Oxfordshire

Debate between Victoria Prentis and Lord Vaizey of Didcot

Tuesday 20th February 2018 Westminster Hall

[Mr Edward Vaizey (Wantage) (Con)]

It is a pleasure to serve under your chairmanship, Mr Hollobone, and I thank you for saving the best till last. I congratulate my Oxfordshire colleague, the hon. Member for Oxford West and Abingdon (Layla Moran), on securing this important debate and on her extremely eloquent speech. I echo the way that she opened the debate by paying tribute to our colleagues who work in the NHS. When talking about the problems faced by our NHS locally, we should not lose sight of the fact that we are supremely well served by some extraordinary men and women in our hospitals and GP surgeries, who go well beyond what is required of them to provide first-class care. As Oxfordshire MPs we are also lucky to represent a population that, on the whole, is pretty healthy—indeed, the greatest health care challenge we face is the fact that a lot of our constituents, thankfully, live to a serious old age.

I also want to pay tribute to the hon. Member for Oxford East (Anneliese Dodds) and my two hon. Friends the Members for Henley (John Howell) and for Banbury (Victoria Prentis), for their fantastic speeches. It may be frustrating for the Front Bench that, although potentially there were plenty of goals to be scored, the debate was conducted as all Oxfordshire debates have been since I became a Member in 2005, in the spirit of doing the best for the county.

I want to mention particularly the work of my hon. Friend the Member for Banbury on the Horton General Hospital, which relates to the problem I want to focus on. She has worked tirelessly to maintain services there, and has made it clear to me that although the Horton is geographically well away from my constituency the services that it provides mean that my constituents benefit from choices. The pressures on the local NHS are spread further, enabling a better service to be provided for all. My hon. Friend has come up time and again, as she pointed out, against a culture of secrecy. There have even been court proceedings in which she has been involved. The mind boggles at how the local NHS goes about its business.

Perhaps when the Front Benchers speak we shall go back to playing the traditional national blame game. However, I want to play a bit of a blame game myself—but placing the blame squarely on local NHS management. I do not want to put words into my colleagues’ mouths, but whenever I go to meetings with local NHS management—ably convened by my hon. Friend the Member for Henley—I find that they are passive, unimaginative and deeply bureaucratic. I find the local NHS system completely opaque, and mired in jargon, endless consultation—or non-consultation—and a woeful lack of action.

The CQC report well illustrates the inability of silos to come together for conversations for the greater good of healthcare in Oxfordshire. An example of that is provided by the biggest local issue for me and my constituency: the closure, coming up for two years ago, of Wantage Community Hospital. It closed in April 2016, apparently for justifiable reasons. It is a very old building and its pipes are ageing. There were continual outbreaks of Legionnaire’s disease, so it was closed for safety reasons; but one would have expected some rapid developments to solve that problem. We were promised a consultation that was going to happen in October 2016; that never happened. Then we got a consultation in January 2017, but because of the opaque bureaucracy that my local NHS enjoys that was a phase 1 consultation. Apparently the community hospital was going to be in phase 2, which of course—like the gold at the end of the rainbow—has not materialised.

I took it upon myself at the end of last year to convene a meeting—ultra vires, you might say—of local stakeholders, my local GPs and health managers. It was the first time they had all met together, convened by me, the local MP, not by the health authority. Again, there was complete passivity. I shall not bore my colleagues with the complexities of the attempts to untie the Gordian knot, but clearly one of the solutions for local healthcare in Wantage is the expansion of the local GP surgery. It is owned by a private landlord, Assura, but it seems to me a benign landlord that wants to do the best thing; it would be happy to expand the building. Of course it would receive increased rent as a result. We need, potentially, some financing from the Department of Health and Social Care, but at the very least we need some engagement from health management. I am the one who has effectively brought Assura to the table to discuss how we can develop the GP surgery, to put some proposals on the table and to search for a funding solution. That could involve all sorts of imaginative solutions. I think there will be a meeting at the end of the month to take things forward, but I find it deeply frustrating that I am the one having to drive the process, and not my local NHS management—not that I am complaining, as it is the only way we shall get results.

[Mr Nigel Evans in the Chair]

As to the quasi-national issues that have been raised, I echo much of what has been said. As a convinced remainer—although, sadly, the horse has bolted—may I get well behind the hon. Member for Oxford West and Abingdon and point out that we have, proportionately, twice as many EU citizens working in our local NHS as elsewhere? As the hon. Lady said, it is absolutely reasonable to say that the Government must do more to reassure our European colleagues who live and work here, who contribute their taxes and want nothing more than to be good citizens of our communities, that they are welcome here and that we have nothing against them. I am sure that now that we have Mr Nigel Evans in the Chair that sentiment will be echoed by him at the earliest opportunity.

Housing is clearly an issue, and although I am sure that all our postbags are full of letters from people who do not want an increase in the amount of housing, we need to speak up for all the people for whom it is essential. They include the very people charged with keeping us healthy. I had not appreciated the issue of visas—that is why the debate is so important. I am driven mad by the lack of imagination on the part of the people running our local health service. That came up in what my hon. Friend the Member for Banbury said about the imaginative solutions that her community came up with to secure a senior obstetrician. Shift patterns are an example of what I mean. Nurses leaving the John Radcliffe after 9 o’clock in the evening is something that needs to be looked at.

Parking at the JR is appalling. Surely it is possible for representatives of the local council and the JR to sit down and find a parking solution. An imaginative health authority and imaginative health leaders would look holistically, if I may put it in that way, at the entire working environment for nurses and doctors, particularly in hospitals: how do they get there, how much does that cost, how can parking arrangements be improved and how can permits be given to people who need them for their shift working pattern? That could make such a difference, above and beyond pay. It needs everyone to come to the table. It sounds incredibly boring to keep talking about getting people together for discussions; however, in my time as a Minister—and as a Back-Bench MP—I have often discovered, on bringing together people who I thought probably had regular conversations, that they never sit down to discuss the issues.

[Victoria Prentis]

My right hon. Friend is making the most marvellous speech I have ever heard him make, on a number of issues. I regret interrupting him, but I want to echo what he said and suggest that, as we despair slightly of anyone else taking the action in question, perhaps we as a group—with the Minister if he is willing to be involved—could take the baton and go forward. When I was in charge of fundraising as a volunteer at my local hospital, as I was for many years, I offered charitable funds to look at car parking. That was ridiculous, really, but it was an attempt to break through the bureaucratic impasse that we so often came up against. Let us take matters forward together.

[Mr Vaizey]

I am happy to work with my hon. Friend, particularly considering her back-handed compliment. She has heard hundreds of speeches from me, so for this to be the best she has heard—

Healthcare in Oxfordshire

Debate between Victoria Prentis and Lord Vaizey of Didcot

Tuesday 17th October 2017 Westminster Hall

[Victoria Prentis (Banbury) (Con)]

It is a pleasure to serve under your chairmanship, Sir Roger. I made my first speech about the Horton General Hospital when I was seven. I apologise that many people in this Chamber will have heard it before, but I do not know that you have had that pleasure, so with your permission, I will carry on.

Let us remember what we are talking about. The Horton is not a community hospital. It has been a pleasure to listen to colleagues talk about their community hospitals; we have heard about Wantage and Abingdon, and one rarely meets my hon. Friend the Member for Henley (John Howell) without hearing him mention the Townlands, of which he is very proud. I love community hospitals too; my mother helped run Brackley Cottage Hospital for most of my childhood and until recently, and I think that the marvellous hospital in Bicester still has untapped potential. However, the Horton General Hospital, which I will talk about, is quite different.

The Horton has hundreds of beds and treats about 39,000 people in accident and emergency every year—nearly one third of Oxfordshire’s A&E attendances. What happens at the Horton affects all my colleagues, due to the knock-on effects of closure. Our surgeons are among the top five in the UK for neck and femur operations. It is not a community hospital; it is a fully functioning, very busy district general.

We feel beleaguered. For more than 40 years, the John Radcliffe Hospital has viewed us as a smaller and less academic sibling that can be treated with contempt when staffing is short. In 2008—this is not ancient history; it is nine years ago—the Independent Reconfiguration Panel was asked to consider the last proposed downgrade of paediatrics, obstetrics and gynaecology and the special care baby unit. It conducted, as I hope it will again, a full five-month review and made five excellent recommendations, which I will read once more.

The first recommendation was:

“The IRP considers that the Horton Hospital has an important role for the future in providing local hospital-based care to people in the north of Oxfordshire and surrounding areas. However, it will need to change to ensure its services remain appropriate, safe and sustainable.”

On the proposed downgrades, it said:

“The IRP does not consider that they will provide an accessible or improved service to the people of north Oxfordshire and surrounding areas.”

Other recommendations were:

“The PCT should carry out further work with the Oxford Radcliffe Hospitals NHS Trust to set out the arrangements and investment necessary to retain and develop services at the Horton Hospital. Patients, the public and other stakeholders should be fully involved in this work… The PCT must develop a clear vision for children’s and maternity services within an explicit strategy for services for north Oxfordshire as a whole… The ORH must do more to develop clinically integrated practice across the Horton, John Radcliffe and Churchill sites as well as developing wider clinical networks with other hospitals, primary care and the independent sector.”

I am afraid that none of that happened. The recommendations were made nine years ago, but none of them were followed. The only things that changed were that the traffic got worse and the population of the area grew. Our district council, I am proud to say, tops the leader board for house building.

Less than 10 years later, we now have no obstetrics or SCBU. They went in the blink of an eye, without any real attempt to address recruitment issues or work with us to do so, although we offered and offered. Locally, we remain deeply unhappy and frightened. Patients in the later stages of labour are travelling for up to two hours, and emergency gynaecological operations take place in a portakabin in the Radcliffe car park. We have heard stories locally—in fact, they are all people talk about—of babies born in lay-bys and in the back of ambulances. The data that show statistics of complete births—defined by when the placenta has been delivered—tell a different story; they do not register the reality of people’s experience.

I pay tribute to what my hon. Friend the Member for Witney (Robert Courts) said about Google Maps. Locally, the impression is that the CCG and the trust massage the figures and use them when it suits their argument. I conducted a travel survey of nearly 400 people on their real-life experiences of how long it takes to get from our area to the John Radcliffe Hospital in Oxford. Sadly, those data were not taken on board in any of the CCG’s reports, although the data set was bigger and better than the CCG’s. The CCG provided real data only when we had harangued, pestered and begged it to do so.

I will not go on about how worried I am; I will focus on what we can do to put the situation right. It is true, as all hon. Members have said, that local health providers do not talk to one another. Health Education England’s decision to remove training accreditation for middle-grade obstetricians was the straw that broke the camel’s back for recruitment, yet it remains aloof and makes decisions in a vacuum. Its recent decision to remove accreditation from certain grades of anaesthetists puts all the acute services provided by the Horton at risk. The dean did not communicate that decision to decision makers at the trust or the CCG; I had to tell them at a meeting in August. I do not think that that is an acceptable way to run a healthcare system.

The trust usually tells the CCG what to do. When it does not agree, there is stalemate. The trust, the clinicians and everyone else locally know that the A&E at the Horton cannot possibly be shut, because the knock-on effects on the rest of Oxfordshire and the surrounding counties would be catastrophic. The CCG, however, is determined to press ahead with its consultation that suggests otherwise. Owing to this impasse, we have ended up with a split consultation that means nothing to any of us. Patients’ needs appear to be an afterthought. South Central Ambulance Service, which bears the brunt of the transfers, is carried along as a consultee with no voice at the table when decisions are taken.

One of the main complaints is that local health decision makers do not listen to us. Our latest consultation report described the “universal concerns” of more than 10,000 people from my area who responded to our consultation. I cannot overemphasise the strength of local feeling. We all feel the same: all the elected representatives, of whatever party; a great campaigning group, Keep the Horton General; and even the local churches, which are praying for sense in the clinical commissioning group’s decision making. [Interruption.] My right hon. Friend the Member for Wantage (Mr Vaizey) laughs, but I am afraid it is impossible to overstate how essential our local hospital is to people in our area. He may think it is funny, but we do not.

[Mr Vaizey]

For the record, I am laughing because I have never heard of a church praying for sense from a clinical commissioning group. That highlights the parlous state that we find ourselves in.