Health Services in Staffordshire

William Cash Excerpts

Wednesday 3rd June 2015 Commons Chamber

[Jeremy Lefroy]

I thank my hon. Friend. She makes a point that I think will be echoed by other hon. Members in the area.

The reason given for the potential closure of the community beds was that more care would be provided at home, but how precisely will that be done? I have to declare an interest in that my wife works as a GP in Stoke-on-Trent. From what I hear, community nursing teams sometimes have difficulty in managing the workloads they have at the moment, so where will the extra capacity come from? Surely it would be more sensible, before those beds disappear—if indeed they are scheduled to disappear—to ensure that the extra community nurses are in place and to show that there is a clear reduction in the need for such beds. I urge the Minister to question any proposed reduction in community beds—even if it is not of the order mentioned in the press last week—at a time when they seem to be most in need.

I will now turn to acute services in general. The University Hospitals of the North Midlands Trust has recently announced the closure of in-patient oncology and haematology at the County hospital. In future, there will be outpatient chemotherapy treatment, but in-patients will be seen in the Royal Stoke hospital. This move was not dealt with in any detail during the public consultation on the proposals of the trust special administrator, nor was it mentioned by the NHS in its information about the changes in services provided to my constituents or to those of my hon. Friends the Members for Cannock Chase (Amanda Milling) and for Stone (Sir William Cash), and my right hon. Friend the Member for South Staffordshire (Gavin Williamson) who are affected.

From a visit to a patient on the oncology unit at the County hospital last week, it was clear to me that the service was not only very busy, but greatly appreciated. Constituents have written to me saying how important it was to have the unit relatively close, so that they could be with their family through stays which were very difficult and often lengthy. Why move what is appreciated and working well? I understand that there are staffing problems, but surely those could be tackled. I ask the Minister to look at this again.

[Sir William Cash (Stone) (Con)]

Does my hon. Friend welcome the statement made by the Secretary of State for Health the day before yesterday regarding the question of agencies and the absolute necessity to make sure they do not rip off the health service? May I also congratulate him not only on his splendid victory, but on the fact that he has just collected the Act of Parliament that he so successfully piloted last year?

[Jeremy Lefroy]

I thank my hon. Friend. He has been a huge support in all these matters, which have at times been extremely difficult. He is absolutely right. I have come across cases of agency workers charging absolutely extortionate fees. I could give the Minister in private—he would be shocked to hear them—one or two examples of what I consider to be close to blackmail.

Another question is raised: if these important services are moving, without mention in the information to my constituents, are other moves planned of which we have no information? The loss of emergency surgery, consultant-led maternity, full level 3 critical care and in-patient paediatrics was—even if most were the wrong decisions—at least clearly set out and communicated with my constituents. These acute in-patient services were not. What we therefore need, and what I have been asking for since last summer, is a clear summary of exactly what services will be available and where.

Of course, this is primarily the responsibility of the UHNM Trust. However, it is grossly unfair to place this burden entirely on it. It has been asked to do a huge job in bringing together two acute hospitals, one of which has been the subject of a major public inquiry. It needs the full support of the NHS through the NHS Trust Development Authority and NHS England. I am asking the Minister to make it his responsibility to do precisely that.

I will now turn to the tender for cancer and end-of-life services throughout the west of Staffordshire and Stoke-on-Trent. The proposal has been developed by NHS England, the four clinical commissioning groups covering North Staffordshire, Stoke-on-Trent, Stafford and surrounds, and Cannock Chase, and Macmillan Cancer Care. The objective is clear: to improve cancer outcomes, which are currently below the average for England and well below the European best, so that survival rates are among the best in England by 2025 and subsequently among the best in Europe.

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[The Parliamentary Under-Secretary of State for Health (Ben Gummer)]

It is a great pleasure to serve in this, your first Adjournment debate of the new Parliament, Madam Deputy Speaker. I am delighted that you have found your seat again. It is a great pleasure, too, to respond to my hon. Friend the Member for Stafford (Jeremy Lefroy), who has been a model for many of us in the 2010 intake in his advocacy of local health issues. He was rightly recognised for so doing in the election, and I am delighted that he, like so many of my hon. Friends, was returned with such a considerable mandate as a result of his hard work. I congratulate him, too, on securing this important Adjournment debate, which continues the battle he has fought on behalf of his constituents over the last Parliament.

Let me say first that the initial meetings I have had in my new position have in large part centred on the issues raised as a result, both directly and indirectly, of the terrible events that befell the Mid Staffordshire trust. My hon. Friend’s bringing of this Adjournment debate is timely in that sense.

I shall first address some of the specific issues my hon. Friend raised about the procurements recently spoken about in the press before moving on to deal with the more general issues. None of this has been particularly helped by some of the comments in the local media. Looking at the CCG’s proposals to improve the organisation of cancer and end-of-life services, which my hon. Friend raised first, I would like to announce to him and the House today that a public-private consortium led by two NHS trusts is now the sole remaining bidder and is in the final stages of talks with the CCG to manage the cancer care pathway. This is an innovative model. I know my hon. Friend has some reservations about it, but it is the first of its kind and it should greatly help to improve and develop services for patients. It is one of the outcomes we wanted to see from the changes in his county, so that health excellence emerges out of the terrible events that occurred. I know we share a common position on that.

Four CCGs are in the process of procuring this consortium to act as a service integrator for the wide range of organisations in the area providing cancer care and to improve the journey of patients in the county and their experience of the care they receive. Dialogue will now continue.

My hon. Friend asked about the role of advisers, consultants and the associated costs. I cannot give him the details now, but I will ensure that they are provided to him. I will ensure also that all officials, including those in the CCG, have the discussion about the role of consultants and advisers in order to satisfy him—or not—on that matter.

Let me now deal with some more general points about the health economy in which my hon. Friend’s constituency sits. It is challenged, and it has been challenged for a long time. Last year, Staffordshire was identified as one of the 11 most challenged local health economies in England. The healthcare organisations in those areas need intensive support to ensure that, as a minimum, services are clinically and financially sustainable over the next five years.

Many of the problems faced by Staffordshire have lain unaddressed for years. Recruitment and retention problems are not unique to the county—other parts of the country experience them as well—but, as my hon. Friend will know, they contributed to the dreadful events on which he has become an expert. Change is needed, not just in the hospitals but in the local health economy as a whole.

As my hon. Friend has already explained, the county hospital in Stafford is now part of the new University Hospitals of North Midlands NHS Trust—in alliance with services in Stoke—but that in itself is not enough to ensure that patients get a better service. That is about much more than a change of management. A solution often used by the NHS involves concentrating services on a single site, so that professional skills are maximised and patients receive much better care.

Although there is a need to reorganise, reorganisation is not just a switch of management location; services themselves must change. That process must be led by local clinicians, working in a partnership between hospital and community, and taking the views of patients into account. The eventual structure cannot be imposed from the outside, nor can there be a “one size fits all” answer. Stafford’s geography, population distribution, transport links and distance to nearby towns and cities, for example, are all relevant to a decision on how services should be set up. Any solution must take account of those factors, as well as others such as disease prevalence and age profile, which are, perhaps, more obviously health-related.

[Sir William Cash]

Will my hon. Friend give way?

[Ben Gummer]

I will, briefly.

[Sir William Cash]

Let me—briefly—remind my hon. Friend that people in the deep rural parts of my constituency are served by the county hospital and the University Hospitals of North Midlands NHS Trust. It is important to ensure that, when there is a lack of easy communication on the motorway, they too are specially looked after.

[Ben Gummer]

That is precisely the point that I made to the clinical commissioning groups when I spoke to them yesterday. I appreciate its importance, and not just on the basis of my own experience of representing an urban seat in a largely rural county.

My hon. Friend the Member for Stafford raised the issue of community beds. I need not advise him to exercise caution when it comes to believing everything that he reads in the press. However, there will be consultation about any changes that do take place, and I know that the Trust Development Authority and the commissioners will work together to ensure that they take place in a coherent fashion. Following my forthcoming meeting with chief executives and the TDA commissioners, I shall be happy to meet my hon. Friend and others to discuss changes in services if that will help to allay his concerns.

I have had detailed discussions with commissioners and NHS England about haematology and oncology services. Although there was a thought that they had been mentioned in original documents, I must say that I, too, found such mentions to be lacking. I am afraid problems of that kind are often encountered in the NHS, and that, in the past, consultations have not been as full or as pertinent as they should have been. I have asked the NHS again to consult specifically on those services, and also to engage in a full and proper consultation with patients and local groups. The same will apply to any other services that may come into question. I take my hon. Friend’s point about the need for a list of services, and I will pass it on to the CCGs, because I think it is important.