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Mr Simon Burns (Chelmsford) (Con)
I congratulate my hon. Friend the Member for Redditch (Karen Lumley) on securing what she rightly describes as an important debate. May I say how pleased I am to see my hon. Friends the Members for Bromsgrove (Sajid Javid), for Worcester (Mr Walker) and for West Worcestershire (Harriett Baldwin) here today? Together with my hon. Friend the Member for Redditch, their commitment and interest in the NHS in Worcestershire is second to none. They make a fine team, fighting on behalf of their constituents for the finest health care, which, as my hon. Friend the Member for Redditch said in her closing remarks, is at the forefront of the modernisation of the NHS outlined by my right hon. Friend the Secretary of State. I am delighted to hear of my hon. Friend’s commitment not only to increasing choice for her constituents but to our modernisation programme; local decision-making will give far greater flexibility in effecting local health economies.
I take the opportunity to pay tribute to the many who work so hard to deliver high-quality NHS services in Redditch but, equally important, across Worcestershire, for the benefit of my hon. Friend’s constituents and those of the other hon. Members who represent that fine county. They do a tremendous job, and the Government will support and empower front-line staff to continue improving services like none before them.
I join my hon. Friend in welcoming the creation of the Worcestershire Health and Care NHS Trust. The new trust will manage all mental health services in Worcestershire, and all community services currently managed by the PCT’s provider arm. That can only be of benefit to the people of Worcestershire. Sarah Dugan, formerly chief executive of NHS Dudley, has been appointed as chief executive of the new trust, and the full board should be in place by the end of March. It will officially come into being on 1 July, giving it sufficient time to complete its registration with the Care Quality Commission.
The people of Worcestershire are also benefiting from the new Malvern community hospital, which, as my hon. Friend the Member for West Worcestershire said, was recently opened by the Princess Royal. The hospital brings together the expertise of nurses, physiotherapists, occupational therapists, speech and language therapists, dieticians and a Macmillan team to provide integrated, patient-centred care for patients in the community and in their homes. Providing more NHS care in that way is essential if we are to improve health outcomes while making significant efficiency savings across the health service. Frankly, outcomes are of the utmost importance to our constituents, as part of their care pathway.
My hon. Friend the Member for Redditch is concerned also about the current shortage of full-time health care professionals, which is due in part to restrictions on recruitment from outside the European Union. I appreciate that she is concerned because of the impact that the problem is having on her constituency. The Government’s policy on immigration seeks to balance the obvious benefits that people can bring to the UK while limiting additional pressures on local services such as housing and schools.
We still want the UK to benefit from the brightest and the best individuals who can contribute positively to the UK economy and to the NHS. The Department of Health is working closely with the UK Border Agency to ensure that the NHS has continued access to the best candidates, in order to provide the best quality care for NHS patients. I hope that that goes some way to reassuring my hon. Friend that we are aware of the situation and are working to find a practical solution that stays within the general philosophy and the wider scope of our immigration policy.
My hon. Friend raised a related issue—the ongoing impact of the working time directive. The Government committed themselves in the coalition agreement to limiting the application of the directive in the UK. The Department of Health and the Department for Business, Innovation and Skills are working closely together to achieve greater flexibility in the application of the directive in the NHS.
I understand that Worcestershire Acute Hospitals NHS Trust currently has 24 vacancies for middle-grade doctors in specific specialities, including emergency medicine, paediatrics and anaesthetics. That has caused the trust to rely on expensive short-term locum doctors. I agree with my hon. Friend that that is a far from ideal situation. She rightly said that if one is paying more for locum doctors it means that there is less to be reinvested in front-line services. In the current economic climate, it is crucial that we save as much money as we can from inefficiencies, or working practices that need to be improved, and that every penny of those savings is reinvested in front-line services for the benefit all of our constituents.
It is the responsibility of NHS trusts to plan and manage their demand for temporary staff in the context of local business and work force planning. Worcestershire Acute Hospitals Trust is actively looking to recruit doctors from the Europe Union; as my hon. Friend said, the trust had success recently in recruiting doctors from Poland and the Czech Republic. Eight of the 24 vacancies have thus been filled, and I assure my hon. Friend that every effort is being made to fill the rest. I totally agree that it is crucial that the trust is able to fill those placements as quickly as possible.
My hon. Friend mentioned the success of cancer care in Worcestershire, as did my hon. Friends the Members for Worcester and for West Worcestershire. Worcestershire Acute Hospitals NHS Trust has been held up by the national cancer survivorship initiative team as an example of how to run a successful prostate cancer service. It reflects extremely well on the staff of the trust that they have been able to deliver that quality of care—and received justified recognition for what they have achieved. The trust has just celebrated the first anniversary of its being declared a level 1 paediatric oncology shared-care unit, for providing better and more local care to children and families in Worcestershire. There is now a Macmillan cancer information and support centre at each of the three hospital sites. I join my hon. Friend in welcoming these developments, as it means better quality cancer services for her constituents and those of other Members.
I am glad to see that Worcestershire Acute Hospitals NHS Trust, University Hospitals Coventry and Worcestershire NHS Trust, and Warwickshire NHS Trust are working together to build a new specialist radiotherapy centre in Worcestershire. That is a subject and an interest that is close to the hearts of all Worcestershire Members, but particularly to those here today. As my hon. Friends will know, patients in Worcestershire travel in excess of a million miles every year for treatment, but by the end of 2013 the centre will mean that 95% of radiotherapy and almost all chemotherapy will be delivered within the county.
I am sure that my hon. Friends as well as the people of Worcestershire will accept that that is the right way to go, because when it is justified—it certainly is in these circumstances—care should be provided as locally as possible so as to reduce or eliminate the need for people to travel too far, especially if it is not necessary. My hon. Friends will agree, particularly for cancer care and radiotherapy, that it can be extremely upsetting, distressing and uncomfortable to people to have to travel long distances rather than being treated in the local hospital. For Worcestershire patients to have to travel in excess of a million miles every year for treatment is excessive, and I congratulate the Worcestershire trusts on coming up with such a proposal.
The trusts will work with existing cancer service providers to ensure that there is no disruption for patients who are currently receiving treatment. As my hon. Friend has said, they need to decide whether to locate the new centre at Worcestershire Royal hospital in Worcester or at the Alexandra hospital in Redditch. The local NHS will work with patient and clinical groups to make a decision as soon as possible based on the clinical and operational benefits of each site.
I understand that my hon. Friend has been encouraging the trust to locate the centre in Redditch. I suspect that my hon. Friend the Member for Worcester is doing exactly the same with regard to his constituency. I can assure my hon. Friend the Member for Redditch that her views will be taken fully into consideration when the decision is made. I hope that she is satisfied with that. She realises that it would be totally inappropriate for me to seek to interfere with the process because it must be decided locally—by local clinicians and local trusts. I am confident that a decision will be reached at the appropriate time, and I urge all my hon. Friends to have some patience because an announcement will be made in due course.
Oncology patients and diagnostics will continue at Alexandra hospital, Worcestershire Royal hospital and at Kidderminster hospital. I hope my hon. Friends will be reassured and pleased by that.
My hon. Friend also raised concerns over the impact of GP-led commissioning on local NHS services, following her recent meeting with health care professionals in Redditch. While the new commissioning arrangements will be led by GPs, they will work not in isolation, but in partnership with their clinical colleagues. When one starts to bring together clinicians from primary, secondary and community care to discuss how best to design local services, organisational distinctions quickly fall away. The conversation instead becomes one about the most appropriate pathway of care for a particular group of patients. I am pleased to say that that is already starting to happen in Worcestershire. Again, that must be the right way forward.
There are currently two pathfinder consortia in Worcestershire: South Worcestershire GP Commissioning Consortium and Wyre Forest GP Commissioning Consortium, with a third group, covering Redditch and Bromsgrove, in the pipeline.
Worcestershire Acute Hospitals NHS Trust is starting to build good relationships with these new consortia and has already had some very positive discussions with its GP colleagues. Indeed, each hospital, including the Alexandra hospital, has set up a commissioning board and is already meeting regularly with GPs. The trust’s recent restructuring has enabled its senior clinicians and management team to develop further the relationships, and individual boards are now in place at each hospital site. That will allow the hospitals to work with consortia on a regular basis and jointly to agree the most appropriate way in which to provide safe, effective, patient-centred care for the people of Worcestershire.
Whatever concerns have been voiced by local clinicians in my hon. Friend’s constituency, I hope that the practical experience of working with consortia—as opposed to working separately from them via primary care trusts—will soon change minds. Once the pathfinders have established themselves and their working practices and become more familiar with their enhanced role within the modernised NHS as laid out in our White Paper, I am confident that they will come to appreciate the system. GPs have the best knowledge of their patients’ requirements. For the vast majority of patients, their first contact with the NHS is through their GP, and GPs are best qualified to identify their needs and requirements. I am sure that as the system beds down, GPs will come to appreciate their greater independence and their proactive role. In effect, there will be a bottom-up provision of commissioning for the health care requirements of patients rather than the existing top-down procedures through the PCTs. It will be a boon not only for GP consortia in Worcestershire but throughout England as the system becomes more established.
My hon. Friend is concerned about the possible impact on the Alexandra hospital of the financial challenges that lie ahead. Last year, the Alexandra hospital made a surplus of approximately 1.3%, which was roughly in line with the trust’s surplus. Figures for this year are not yet available. However, as part of the need for the NHS to make up to £20 billion of efficiency savings in the coming years, Worcestershire Acute Hospitals NHS Trust faces a significant efficiency target in 2011-12. The Alexandra will have to find its share of those efficiency savings. Budgets are in the process of being set and hospital teams are currently identifying where savings and efficiencies can be made. I hasten to reassure my hon. Friends about the savings. Every single penny of those savings will be reinvested in front-line services, providing care for the constituents of my hon. Friends and people elsewhere in the county, and, indeed, the country. It is crucial that we make savings to cut out inefficiency and ensure that the provision of care is of the highest quality and delivered in the most effective and efficient way. Let me repeat again, all of the £20 billion that is saved over the time period will be reinvested in front-line services. That is what providing health care is all about. That is what we will do and what must happen so that we can maximise the money available for front-line care for patients.
The trust assures me that it has no plans to reduce the status of A and E services at Alexandra hospital, which I hope reassures my hon. Friend. Indeed, the terms of reference for the ongoing surgical review at the site state that there must be a viable A and E service in Redditch. I trust that my hon. Friend and her constituents will be reassured by that commitment.
My hon. Friend was also concerned that rural constituencies such as her own may be losing out under the NHS allocation formula. Rural communities generally have a higher proportion of elderly people and, because of the increased difficulty in reaching providers, rural populations may make less use of health services. Some argue that the previous formula may have disadvantaged such areas.
The Advisory Committee on Resource Allocation examined the issue but found no evidence that an adjustment was needed for rural areas other than the continued need for an emergency ambulances cost adjustment to account for geographical variations in the cost of ambulance services. However, my right hon. Friend the Secretary of State has asked ACRA to look again at the unavoidable cost differences in rural areas in the light of the move to GP consortia. ACRA is due to report its findings to the Secretary of State in June 2011. I cannot anticipate what those findings will be, but it is important to get an independent body to examine an issue that is of great concern not only to my hon. Friend but to other hon. Members who represent rural constituencies in England.
In conclusion, there is a great deal to be positive about in Worcestershire, and I am sure that my hon. Friends will agree with me on that. The addition of a new radiotherapy centre is a particularly exciting new development. Indeed, all my hon. Friends showed great enthusiasm for the centre, calling it a positive enhancement of local health care. They also expressed their wishes as to where it should be located. Even more exciting is the changing nature of the clinical relationships that our modernisation of the health service will bring and the potential for significant improvements in NHS services for my hon. Friend’s constituents.
I am delighted to have had this opportunity to discuss the local health service in Worcestershire. There is a lot of positive news. My hon. Friends still have to express some of their views to the relevant authorities, and in due course, decisions will be taken.