North Tees and Hartlepool NHS Foundation Trust
(13 years, 9 months ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Alex Cunningham (Stockton North) (Lab)
Thank you, Mr Speaker, for allowing me to speak on this subject this evening in my first Adjournment debate. I am only sorry that it must focus on such a seriously worrying subject. I had hoped to have more time for this debate, but my learning about this place has taken a huge leap forward. I have learned tonight that Conservative Members appear to have more interest and certainly more expertise in the activities of pedlars and Robin Hood than they do in the health of the nation.
I called for this debate in the light of the statement made to the House by the Chief Secretary to the Treasury on 17 June that the new hospital to replace the North Tees and Hartlepool university hospitals will no longer receive Treasury funding. As a former non-executive director of the North Tees and Hartlepool NHS Foundation Trust, I was closely involved in the planning of future health care for the area over some considerable time. This was not a project rushed through to beat a deadline, but one that was carefully planned over years. I will address that in more detail this evening.
This hospital would have served local people from a number of constituencies, not just my own but others including Stockton South, Hartlepool, Easington and Sedgefield, and I am pleased to see colleagues from those areas in the Chamber tonight. I know from speaking to other Members, at least those on this side of the House, that there is huge disappointment, but little surprise, that the coalition has already begun slashing spending on front-line services. It is already abundantly clear that this programme of deep cuts will have a serious impact on people in Teesside and the north-east.
I wish, first, to set out the background to the decision to build a new state-of-the-art hospital to serve our communities, which was planned to open in 2015. Although the Chief Secretary was correct in saying that final approval for this £464 million project was granted in March, the project has been on the drawing board for more than five years. It dates back to a 2005 report by eminent clinician Professor Sir Ara Darzi on acute services in Hartlepool and Teesside. In 2006, an independent reconfiguration panel report stated that
“a modern hospital to replace the existing out of date hospital buildings should be provided on a new site in a well situated location accessible to the people of Hartlepool, Stockton-on-Tees, Easington and Sedgefield.”
I had cause to visit one such modern hospital this weekend, and I wish to place on record my personal thanks—I hope that the Minister will join me in this—to the plastic surgeons and the staff of ward 35 at James Cook university hospital for their care and expertise, and for saving my finger.
Let us be clear that the two hospitals that currently serve our communities operate to the best of their abilities and have excellent staff. However, the hospitals are showing their age and must be replaced if we are to maintain and improve health services in our area. I want my area to have the same modern facilities that I benefited from over the past couple of days.
Mr Iain Wright (Hartlepool) (Lab)
I congratulate my hon. Friend on securing this debate, which is very important to a large number of hon. Members. Will he confirm that the whole driver for this reconfiguration has been a clinically led approach—led by eminent doctors and surgeons—and that the decision made by the Chief Secretary takes us back to square one, with no plan B?
Alex Cunningham
I certainly agree with that. I know that it is the view of clinicians and other health professionals that it will be impossible to sustain two hospitals with the full range of services and facilities needed to serve our communities. Indeed, patients in our areas have to access different services at the two different sites, which are 14 miles apart.
The new hospital was to be a vital element of wider health care reform in our region and would have delivered clinically sustainable hospital services in the single hospital while delivering a much wider range of services in the community much closer to people’s homes, including three new integrated care centres in Billingham, Hartlepool and Stockton. There is no doubt that there has been some controversy about the plan to build one “super hospital” to replace the two outdated ones, as well as unease among some in the community about the location chosen. I firmly believe, however, that the plan would have provided improved services for local people and that it is ultimately the right plan for the NHS trust to pursue.
James Wharton (Stockton South) (Con)
I am grateful to the hon. Gentleman for giving way. I also note with interest that he is perhaps the first hon. Member in the history of this House to brandish his middle finger at Mr Speaker and to receive no reprimand for it.
The hon. Gentleman has acknowledged that the hospital’s location between two communities is somewhat controversial locally. The representations that I have received from my constituents have, almost without exception, praised the Government’s decision and criticised the proposals for the hospital at Wynyard. Let me read him one short example of an e-mail that I received only the other day:
“The decision is a sensible one. Leaving aside the reckless economic folly of committing funding the country does not possess and blatant politicking by Labour in promising such funding in marginal constituencies the truth is that this hospital was vehemently opposed by a significant number of local people on grounds that it was geographically in the ‘wrong’ place for both communities, had no public transport links and would seriously affect A19 and A689 traffic flows”.
Does the hon. Gentleman accept that the views of his constituents and mine are mixed, at best?
Alex Cunningham
These issues were extensively explored with the public. There was detailed and extensive formal and informal consultation involving public meetings, leaflet drops to households and a radio campaign. The Government had promised additional funding to tackle some of the transport issues and communities across the place were in favour of the hospital.
I must outline why the new hospital should remain a priority for the new Government.
Grahame M. Morris (Easington) (Lab)
I congratulate my hon. Friend the Member for Stockton South— [Interruption.] I am sorry—we will get that one next time. I congratulate my hon. Friend the Member for Stockton North (Alex Cunningham) on securing this debate. People in my constituency and the five others that were to have been served by this new hospital need to know why this project was cancelled when three other schemes elsewhere in the country were approved. The Minister is being coy in his written answers to questions, but we really need answers. The need remains. Issues of health inequality need to be addressed. I want to place it on record that south Easington, which would be served by this new hospital, is one of the most deprived communities in the United Kingdom, as identified by the indices of multiple deprivation. Health inequalities still play a significant role in determining life expectancy and quality of life. Health inequalities remain a big issue: they are inequalities not just in terms of outcomes but in access to health care resources—
Mr Speaker
Order. May I say very gently to new Members, whose passion for this subject I respect, that although the hon. Member for Stockton North (Alex Cunningham) is showing great forbearance there is a difference between a speech and a short intervention?
Alex Cunningham
Mr Speaker, I agree with the long intervention and the facts laid out by my hon. Friend the Member for Easington (Grahame M. Morris).
In Stockton-on-Tees, just over a quarter of residents live in some of the most deprived areas of England. Early deaths from heart disease and stroke and from cancer are higher than the England average. Inequalities are starkly demonstrated by the fact that a man living in one of the least deprived areas of Stockton can expect to live just over 10 years longer than a man living in one of the most deprived areas.
Since 1997, however, early death rates from heart disease and stroke have fallen markedly and early death rates from cancer have also fallen, albeit more slowly. We have also seen a narrowing in the gap between our area and the rest of the country. Things are improving for my constituents, and my concern is that the coalition’s decision will see a halt to and possibly even a reversal in these positive outcomes. The NHS is too important to be turned into a party political football, however. Those listening to this debate back in the north-east this evening do not want to hear us point scoring. I have heard you say yourself, Mr Speaker, that that is the sort of behaviour that turns people off politics and politicians.
I wholeheartedly welcome the commitment shown by the Prime Minister and his party to the NHS, and I would like to draw the attention of hon. Members to a statement that he made during the election campaign. He said:
“The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.”
I could not agree more with the Prime Minister’s statement, but I fear that his words are not being followed by his actions. As we all know, it is all too easy to make promises in politics. The real test is whether we stand by our word once the votes have been counted.
During the election campaign, the Conservative party claimed that it was now the party of the NHS. I doubt very much that people who went to the ballot box on 6 May and put a cross next to the name of their Conservative candidate thought that the right hon. Member for Witney (Mr Cameron) would be authorising the cancellation of a long-awaited new hospital just weeks later. We all acknowledge that cuts have to be made to reduce the deficit, but this is a much needed front-line service, and I will not stand by and let this project disappear without a fight.
Of course, 6 May gave us not a Conservative Government but a Liberal Democrat and Conservative coalition, so I urge Members to refer to the document “The Coalition: our programme for government”, which states:
“We are committed to the continuous improvement of the quality of services to patients.”
Again, I warmly welcome that statement, but I fear that when push comes to shove, it will mean very little to my constituents and those in neighbouring areas. This coalition seems intent on cutting spending without fully realising the human cost of the cuts. This decision is a backward step for the communities that would have been served by the new hospital, and it does not tally with the Prime Minister’s claim that the Conservatives are now the party of the NHS or with the coalition’s document.
Since the announcement on 17 June, I and other Labour Members have met the chair and chief executive of North Tees and Hartlepool NHS Foundation Trust. They are understandably extremely disappointed that, after the many years of hard work creating and fine-tuning the plans for the future of health services in our region, those plans have been sent back to the drawing board. It is not only the foundation trust that is unhappy with the decision: on Saturday 26 June, other Members and I attended a rally in Hartlepool to highlight local opposition to the decision, which grows by the day.
I have also received encouraging support for early-day motion 273, which asks for a review of the coalition’s decision. To date, it has received 42 signatures—regrettably, only from Members on this side of the House. I hope that it will not only be Labour Members arguing this evening that their constituents should not lose out after waiting so long for an agreement on the future of health care in our area.
One of the key questions that I hope the Minister will answer this evening is why this particular project has been scrapped. The Chief Secretary to the Treasury said in his statement to the House that his decision to cut £2 billion of public spending, including on our new hospital, was guided by a principle of fairness. At the moment, we feel as though we have been subject to an arbitrary decision. I have yet to hear any persuasive argument as to why people in the north-east have had their new hospital withdrawn while schemes such as the Royal Liverpool hospital, the Pennine acute hospital and the Epsom and St Helier hospital are going ahead. What advice did the Minister receive from his Department that led to the conclusion that the North Tees and Hartlepool project did not represent value for money, compared with the other projects?
The Chief Secretary to the Treasury told the House on 17 June that our new hospital was
“assessed against a number of other major build projects that were at the same stage of development; those schemes are more urgent.”—[Official Report, 17 June 2010; Vol. 511, c. 1051.]
I would appreciate a little more clarity from the Minister about what was meant by that statement, and I request that he publish the criteria used and the detailed comparisons carried out against the project. The North Tees and Hartlepool project was, according to my right hon. Friend the Member for Leigh (Andy Burnham), the top priority for the NHS. We would like to know why it has slipped down and out of the queue.
In answer to my question on 29 June about the strategy developed by the foundation trust, the Secretary of State for Health did not rule out other ways of making our new hospital happen. I noted that he said it needed to fit his new criteria and that the trust should not ask the Department of Health to meet the whole capital cost of whatever it proposes. Does that mean that some funding could be made available and the balance raised by the trust using its existing powers?
I urge the coalition to work with Members on the Opposition Benches as well as with the foundation trust to look at new and innovative ways of funding the project and ensuring that local people are not left behind. Will the Minister confirm that more time invested in developing a new solution to fund the new hospital will not be a waste of time, and that he and his coalition partners have not set themselves against any new hospital in our part of the country?
If we do not find a solution and build a new hospital, what will happen? The chief executive of the North Tees and Hartlepool NHS Foundation Trust has publicly acknowledged that there is a chance that Hartlepool hospital could close, whether or not a new hospital goes ahead. I know that my hon. Friend the Member for Hartlepool (Mr Wright)is extremely anxious about that. We could end up with one hospital. I want it to be a new one.
There is much more at stake than just health care and a new hospital. The location for the hospital was Wynyard park, a 700 acre high-end mixed-use development accommodating residential and business properties.
Phil Wilson (Sedgefield) (Lab)
I congratulate my hon. Friend on achieving the Adjournment debate. I shall be brief. I expect the point that he intends to make is about added value arising from the project. The business park would have attracted high-value private sector jobs in medical research in an area that needs them. They would have reached the site as a result of the £10 million that would have been introduced into the transport system.
Alex Cunningham
Exactly. The new hospital would have kick-started development in the area, creating many thousands of jobs. The owners of Wynyard park believe that the new hospital would have been a considerable incentive for investment by others to develop the type of industries mentioned by my hon. Friend. Most important of all, the coalition’s decision to scrap the new hospital will have a major detrimental effect on continuing the work to close the gap between the unhealthiest and healthiest in our communities.
I am therefore grateful to the Minister, who has agreed to a request from my hon. Friend the Member for Easington (Grahame M. Morris) for a meeting to discuss how we can keep our hospital project alive. I look forward to the meeting to discuss the way forward and will listen intently to his response this evening, in the hope that the door to funding is not already firmly closed. At present there are many more questions than answers about the future of acute services in our region. What is the future of health care, of our strategy for a new hospital, and of the organisations, such as the foundation trust, that plan care? There is so much doubt.
Roberta Blackman-Woods (City of Durham) (Lab)
Does my hon. Friend agree that that meeting is an important opportunity for the coalition Government to demonstrate some commitment to reducing health inequalities in the north-east, tackling deprivation and supporting a new hospital?
Alex Cunningham
Most certainly. The project is also about jobs and tackling deprivation. Tremendous progress has been made on health inequalities in our area, and I want to see that work continue. The good people of Stockton, Hartlepool and the surrounding areas deserve better than this, and I can assure the Minister that my hon. Friends and I will fight passionately to ensure that they are not left behind.
The Minister of State, Department of Health (Mr Simon Burns)
I begin by congratulating the hon. Member for Stockton North (Alex Cunningham) on securing the debate on the future of the North Tees and Hartlepool NHS Foundation Trust and its hospitals. I join him, with the greatest pleasure, in congratulating clinicians, GPs, ancillary workers and all those who work so hard on Teesside, in the north-east and in the rest of the country to provide a first-class quality health care service for the people of this nation.
The decision to cancel the North Tees and Hartlepool NHS Foundation Trust proposal has to be seen within the context of the wider economic climate. This year’s budget deficit of £155 billion—inherited, I gently remind Opposition Members, from the previous Government—illustrates the scale of the economic challenge facing this Government. As part of this Government’s determination to face that challenge head on, the Treasury and other Departments have reviewed every significant spending decision made between 1 January and the general election on 6 May. As the proposed new hospital scheme at the foundation trust received the previous Government’s approval only in March, the North Tees decision formed part of that review.
In these tough economic times, it is essential that all major hospital building schemes be affordable. On 17 June, as the hon. Member for Stockton North rightly said, my right hon. Friend the Chief Secretary to the Treasury announced to this House the decisions of the Government’s review of spending commitments. The review cancelled 12 projects throughout Government and considered four major NHS capital investment schemes with a total capital value of more than £1.2 billion.
The size and funding of the schemes were considered in relation to the nature of the organisations concerned. The aim of granting foundation trust status is to give such bodies greater financial independence. As well as being able to keep any internally generated resources, foundation trusts have greater freedom to borrow from either the public or the private sectors, and, by requiring an allocation of public dividend capital from the Department of Health of more than £400 million, the proposals were not consistent with that financial independence.
Mr Iain Wright
What local clinical advice did the Minister and his ministerial team take prior to the decision to scrap the new hospital?
Mr Burns
If the hon. Gentleman waits, as I develop my argument I shall continue to explain the reasons for cancelling the scheme within the public spending review.
Treasury and Department of Health Ministers, myself included, decided that, overall, these factors—affordability within the changed economic climate and the foundation trust status—weighed more against the scheme for North Tees and Hartlepool than against the other three schemes for the Royal Liverpool and Broadgreen University Hospitals NHS Trust, Epsom and St Helier University Hospitals NHS Trust and the Royal National Orthopaedic hospital. For those reasons, the Government withdrew their support for the scheme.
If I may, I shall just answer one question that was mentioned in an intervention on the hon. Member for Stockton North. The question was, “Why North Tees and Hartlepool and not the three other schemes?” After looking into the situation, we found that, for example, the Royal Liverpool university hospital building is not compliant with fire safety regulations, and that its mechanical and engineering services are more than 30 years old and at increasing risk of failure. Some 94% of St Helier hospital’s buildings are more than 50 years old, and the 2007-08 data show that the total maintenance backlog for the Royal National Orthopaedic hospital is £53.8 million; for Epsom and St Helier it is £23.8 million; for the Royal Liverpool it is £16.3 million; and for North Tees and Hartlepool it is £3.5 million.
Grahame M. Morris
On the point about affordability and the Minister’s suggestion that the foundation trust look towards PFI, how would such a proposal be more affordable when the evidence suggests that PFIs are 14 to 20% more expensive to deliver? The need certainly exists, and we need to deliver quality health care, but affordability suggests that the public purse is the best way to do it.
Mr Burns
I am very grateful to the hon. Gentleman. Earlier today, his right hon. Friend the Member for Leigh (Andy Burnham) made the point that it would be cheaper to have a new hospital than to maintain the existing two ageing hospitals. I do not believe that that is accurate. The business case actually showed that the whole-life costs of continuing to operate and provide services from the two hospitals were very similar, but slightly lower than the whole-life of costs of operating and providing services from the proposed new facility. Over the appraisal period of 35 years, the total net present cost—that is, the whole-life cost—of building, maintaining and operating the new facility was £5.033 billion, but the cost of repairing defects, maintaining, operating and providing services from the two existing buildings was £5.024 billion.
However, the North East strategic health authority, Hartlepool primary care trust and Stockton-on-Tees primary care trust have pledged to continue working closely with North Tees and Hartlepool NHS Foundation Trust to plan and develop the best possible health services for the local population of Hartlepool and North Tees. I understand that the chief executive of North Tees and Hartlepool NHS Foundation Trust is currently reappraising the available options. As I have said, NHS foundation trusts have greater financial independence, which includes consideration of the private finance initiative. I am advised that the chief executive of the trust has already said that the PFI is one of the options that he is looking at, but any new proposals must be realistic, affordable and provide value for money. I cannot in any way give any guarantees that such a scheme would or would not be approved. Like all schemes, any proposals that might come forward would have to be considered on its merits and in the light of the economic climate at that time.
The local health economy is also ensuring that the wider momentum project, which involves bringing health care services closer to communities, will continue. I am delighted that on 10 May this year, the new integrated care centre known as One Life Hartlepool, located in Hartlepool town centre, opened its doors to patients. Hartlepool primary care trust has transferred a range of community services into this new £20 million facility. The PCT is working with North Tees and Hartlepool NHS Foundation Trust to agree a programme for moving a range of out-patient services into the building. In addition, work is continuing on the outline business cases for integrated care centres in Billingham and Stockton.
In conclusion, any new proposals to develop—
Alex Cunningham
I have just one question. Will the funding for those two centres in Stockton and Billingham be guaranteed?
Mr Burns
As I understand it, the finance is in place, and I assume that the measures will proceed on that basis.
Any new proposals to develop local NHS services must be affordable, but they must also now take into account the further criteria on service reconfiguration recently set out by my right hon. Friend the Secretary of State. I believe that it is vital that any proposals focus on improving patient outcomes, are based on sound clinical evidence, increase choice for patients, and have the backing of GP commissioners. I, like the hon. Gentleman, his hon. Friends and everyone else in this country, want a high-quality NHS that is accountable to patients and led and controlled locally. This Government have been elected on a platform of real-terms increases in the NHS budget for every year of this five-year Parliament. But hand in hand with that, we must have an NHS that puts patients at the centre of high-quality care and delivers care that is efficient, productive and, importantly, affordable. This must be the case nationally; it must also be the case locally, including for the people of Stockton North and Teesside.
Question put and agreed to.