Stafford Hospital

Joan Walley Excerpts

Thursday 4th July 2013 Commons Chamber

[Jeremy Lefroy]

As usual, my hon. Friend makes a powerful point—that this debate is not just about a relatively small district general hospital, because it will have ripple effects. We have a pretty efficient national health service, but it does run on tight margins, so that if we take one acute hospital out, it could have effects right across the whole region. Local clinical commissioning groups have a vital part to play, and I want to pay tribute to the good work they are doing in developing community services in Stafford.

The third element of co-operation comes from Monitor itself. Under the Health and Social Care Act 2012, Monitor now has responsibility for setting tariffs, including those for emergency and acute services. It would be rather strange if Monitor were to continue the programme introduced in 2009 of constant 4% year-on-year real cuts in tariffs, and then be forced to pick up the pieces of acute foundation trusts around the country that fall into deficit as a result of the tariff cuts it has made. Monitor has the chance to challenge the assumption that acute services can continue to squeeze out annual efficiencies—in some cases, and not just in Stafford—of up to 7% a year, while elective services enjoy a relative feast.

Monitor has the opportunity to ensure that the necessary changes to the provision of acute services are done in such a way that will allow acute services to continue to be provided locally. Monitor itself could become an excellent example of joined-up government, and in doing so carry out its legal requirement under section 62 of the Health and Social Care Act 2012 to promote the

“provision of health care services which…is economic, efficient and effective, and…maintains or improves the quality of the services.”

Finally, the national Government have a vital role to play in co-operation.

[Joan Walley (Stoke-on-Trent North) (Lab)]

I am most apologetic about arriving late to this debate and not having the opportunity to hear the opening part of the hon. Gentleman’s speech. To find a long-term solution for health care in Mid Staffordshire and in North Staffordshire, it is vital that the Minister refers in his reply to the best way of ensuring that the emergency services and all the other services that people want can be retained. That can be achieved only if we have a proper collaboration between the University hospital of North Staffordshire, which must be at the front of—

[Madam Deputy Speaker (Dawn Primarolo)]

Order. Had the hon. Lady been here from the beginning, she would have heard what the hon. Member for Stafford (Jeremy Lefroy) said about that. Her intervention was rather long, and we are running out of time.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

It is a great pleasure to reply to the debate. Let me begin by congratulating my hon. Friend the Member for Stafford (Jeremy Lefroy), and expressing my great admiration for the work that he has done so tirelessly during his time in the House. He has been a tremendous advocate for all his constituents, for the hard-working staff at the trust who are doing their best in very difficult circumstances, for all the people who have rightly spoken out about earlier problems at the trust, and for the patients. He is an example to us all of what a hard-working and dedicated constituency Member should be.

I also congratulate my hon. Friend the Member for Stone (Mr Cash), who has been raising this matter tirelessly for many years. It is a tribute to the efforts of both my hon. Friends that we have got to where we are today.

I can reassure my hon. Friend the Member for Stone that the findings of the Mid Staffordshire inquiry are at the forefront of the Government’s mind. As he will recall, our response to the Francis report set in train a number of important pieces of work. First, we asked Sir Bruce Keogh, medical director of NHS England, to look into 14 hospitals where there had been two years of higher than standardised mortality ratio indicators. That work is now reaching fruition. Following a report as damning as the Francis report, which looked into the culture of the NHS, we thought it right to investigate other hospitals that could give rise to concern, and we now think it right to examine the findings of Sir Bruce Keogh’s report before we report back to the House. We also set in train Camilla Cavendish’s review of nursing and Don Berwick’s inquiry into a minimum-harm and no-harm culture in the NHS. All those inquiries have formed part of our response to the Francis inquiry, and they have all been independent of Government. We shall have the reports in the next few weeks, and we shall then be able to arrange the more considered debate on the Floor of the House for which my hon. Friend has rightly called.

My hon. Friend the Member for Stafford was right to highlight the fact that the health care challenges in more rural areas, where travelling distances are longer, are by definition different from the health care challenges in urban areas. He was also right to highlight the fact that, throughout the NHS, in Stafford and elsewhere, we face the challenge, in both human and financial terms, of better looking after an ageing population and better providing dignity in elderly care.

My hon. Friend was right to highlight the fact that we need to support people such as Julie Bailey, who was treated appallingly in the light of her great courage and conviction. We must support people inside and outside the NHS who have the courage to speak up when there are concerns. We have made that clear in our initial response to the Francis inquiry report. That is why we have set up a whistleblowing hotline and are tackling the cultural issues in the NHS. We will support staff who want to raise concerns, so they can do so free of fear and intimidation. That is absolutely the right thing to do.

It is admirable that local people have continued to come out in full support of their hospital through the Support Stafford Hospital campaign. That was demonstrated by the 50,000 people who marched through Stafford with my hon. Friend in April and by other local events such as the Night of Light event in May. I am sure that we all agree that it is vital that the trust special administrator, currently in place at the trust, develops the right proposals for the future of services at the hospital to provide high-quality, affordable and sustainable services. I will return to that later.

The NHS is about to celebrate its 65th anniversary and its 65th year has perhaps been its most challenging. In that year, we have perhaps questioned some of the things that we held dear. I work in the NHS, I believe in it and I believe that our NHS should be and is one of the very best health services in the world, but when things have gone so badly wrong it is right that we learn lessons from what has happened, that we ensure that we put them right and that we support staff when they raise concerns. It is right that we drill into how to ensure that we listen to staff in learning how to put things right in local hospitals. We must also ensure that we create a culture in which trust managers always listen to what front-line staff tell them. In my experience, when things go wrong in front-line patient care, it is often because there is a disconnect between management and front-line staff. That is why the Government, through the Health and Social Care Act 2012, are embedding in the NHS a culture of clinical leadership, which will benefit patients massively.

On the future of Stafford hospital and the issues raised in the debate, the events that took place led Monitor to intervene and, over the past few years, there has been a whole health economy approach to improving services at the trust. That has led us to where we are today. Monitor, as the regulator of foundation trusts, appointed a TSA at the trust in April 2013 to determine the future provision of services at the trust. As we know, that process is ongoing.

I should be clear that, while the TSA is developing its proposals, I cannot discuss that in much detail. Nor is it known what the TSA is likely to propose. It is right that that process is free of political interference. However, what I would expect, and I am sure that my hon. Friend would agree, is that the TSA fully engages with key stakeholders during that process, including clinical commissioning groups, local health care providers, local authorities and local MPs, which I have been assured is the case. The TSA is legally bound to consult on its proposals and I would expect that any proposals meet the four tests for any service change and reconfiguration, which were set by the former Secretary of State for Health, now the Leader of the House of Commons.

[Joan Walley]

Can the Minister assure me that, following publication of the report by the trust special administrator, as well as the people and communities in Stafford, the people and communities in North Staffordshire will be consulted? There are wider concerns about how any further collaboration will affect health care, which has to be improved in North Staffordshire as well as in Stafford.

[Dr Poulter]

I thank the hon. Lady for her question. As I highlighted earlier, it is absolutely right that the TSA will look at the whole health and care sector in Staffordshire, and of course the implications of any potential change for neighbouring hospitals. That is implicit in the work that the TSA is doing. This is, of course, not an issue I can dictate from the Dispatch Box or the Secretary of State determines. It is for the TSA to decide what its own work is, and it is important that that is done without political interference, so the right decision for local patients in Stafford and surrounding areas can be reached. I am sure the hon. Lady will agree about that.

I appreciate the concerns of my hon. Friend the Member for Stafford that acute services should remain at Stafford hospital. However, the TSA is independent of Monitor and therefore it would not be appropriate for Monitor—or, indeed, Ministers or the Department of Health—to seek to influence this process. My hon. Friend is aware that, at the request of the TSA, Monitor granted an extension to the period in which it can develop its proposals and the consultation period. I understand that the TSA is expected to consult on its proposals between August and October 2013, and I am sure my hon. Friend and his constituents will play an active role in that, and that the views expressed in the House today will be listened to as a part of the deliberations of the TSA and in the consultation process that follows.

I appreciate my hon. Friend and his constituents will experience uncertainty while the TSA develops its proposals. However, the TSA is engaging widely with the broader health economy as these proposals are developed and I understand that includes speaking with my hon. Friend and the Stafford Hospital Working Group. I would, therefore, encourage my hon. Friend to continue this dialogue with the TSA to ensure that his views and those of his constituents are fully taken into account as proposals for the future of Stafford hospital emerge.

I pay tribute to the work of my hon. Friend and my hon. Friend the Member for Stone, because if it were not for their work, we would not be where we are today and the people of Stafford and Staffordshire would be much more poorly represented. Their record speaks for itself and they have our full support in the work they are doing as advocates for their constituents. I look forward to continuing to support them in my role as a Minister, and the Government stand ready to support Stafford hospital.

Question put and agreed to.