(9 years, 5 months ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Mrs Linda Riordan (Halifax) (Lab/Co-op)
I am delighted to have secured this debate on health services in Halifax, and I will focus particularly on the proposal to close the accident and emergency department, which is the most important issue that has faced Halifax since the banking crisis of 2008. The axe hanging over Calderdale Royal hospital has been handled in the most underhand way. People have been left in the dark over the future of the services they need and value the most. That is simply not acceptable.
I hope that today’s debate will shed some light on what is taking place. I also place on record the excellent health care staff that we have in Halifax, and the nurses, doctors, consultants, clinicians and everyone in the NHS wider health family who do a superb job in difficult circumstances. That is why, as Healthwatch Calderdale has found, although it is sometimes difficult for patients to get an appointment with their GP, the clinical treatment administered by GPs in the district is good and makes a positive contribution to residents’ health in the area. It is, however, the future of A and E that has caused most worry and concern in the town, and the Government, the clinical commissioning group, and the trust’s approach to the whole debate has been lacking in openness and transparency.
I will focus on three key areas in my speech: the funding of health services in Halifax; the so-called consultation and engagement process; and the future of A and E. Those factors tie the whole debate together and I hope that today, the Government can at least provide me and my constituents with some answers in those important areas.
Let me set out briefly the background to the case. Calderdale Royal hospital opened in 2000 thanks to investment from the then Labour Government. It was a new, modern hospital to serve communities across Halifax and Calderdale. There were concerns at the time that the new hospital might not have enough capacity—it did, although that is rather ironic when we consider the arguments and debates that are used to justify the closure of A and E in Halifax. Any problems back then have been overcome, and the hospital has proved a real success story.
The hospital serves communities across Calderdale, and right across to the Lancashire border to the west. It is estimated to have a catchment area of nearly 200,000 people—some as many as 30 miles away. We are talking not about a small, rural hospital, but a major health centre in the heart of an urban area. Why does that matter? It matters simply because it underlines the importance of the hospital services, including A and E, to thousands and thousands of my constituents. The hospital is at the heart of local health services and needs. That is a reason to invest in health services in Halifax, not to cut them; to keep wards open, not close them; to protect A and E, not put it on a life support machine, its future clouded in doubt, with Ministers and the clinical commissioning group playing for time to deal with the issue post the general election in 2015. Questions are dodged, not discussed. Information is wrapped in secrecy and the people of Halifax and Calderdale are, it would appear, treated with contempt on this issue. This is their hospital. These are their health services. They deserve some answers.
That is the brief history. Where are things at today? Well, frankly, it is all a bit of a mess. At its heart are the inherent contradictions in the Government’s approach to health policy across the country generally, and in Halifax specifically. Let us take a look at some of them. The Government say the funding of hospitals is not a problem. Why then is there a funding shortfall in Halifax of potentially £50 million? I noticed this week that Monitor is to investigate the trust to understand why its finances have deteriorated so much. This is an extraordinary amount of money by which to be in deficit.
We all know that the Government’s desire to cut A and Es like the one in Halifax is to save money. It has nothing to do with improving patient care.
Craig Whittaker (Calder Valley) (Con)
At a recent debate in the Calder Valley with my Labour opponent, I asked him eight times whether he had been out to see the doctors, nurses and decision makers about the strategic review. His answer was no, he had not been out to see them and he had not read the strategic review. He said, instead, that he was following the hon. Lady’s lead and the lead of the candidates in Halifax. Will the hon. Lady tell me how many times she has been out to see the decision makers and whether she has read the review?
Mrs Riordan
I thank the hon. Gentleman for that intervention. Talking about confusion—that is what the whole debate is about today—let me remind him of his article in the Halifax Courier last week, in which he said:
“There are no proposals to close our A and E”.
Then we have the Conservative candidate’s website for Halifax:
“On the frontline defending the A&E cut in Halifax”.
There is his answer.
I use the health service regularly: I am a patient and I visit my GP regularly. The Government say that funding for hospitals is not a problem but we all know they want to cut the A and E. I know the Minister will get up in a moment and tell me that Halifax has not suffered health cutbacks in the past four years. Well I can tell him that I use Halifax hospital regularly. Recently, there have been staffing cuts, ward closures and fewer and fewer beds available on the wards. Sadly, I fear that Halifax is suffering cuts, cuts and more cuts. If there is not a funding problem, why are these reductions taking place? Is it a lack of demand for services?
If there is a funding problem, why do the Government claim to have protected health spending? Both cannot be correct. I say today that what Health Ministers are being told in Whitehall offices and what is happening on the ground in places like Halifax are miles apart. Ministers urgently need a reality check if they think that closing Halifax’s A and E will not put lives at risk.
Mrs Riordan
No. I am sorry, but I must make progress now.
I would be grateful if the Minister explained to me the reality of the funding situation in Halifax. What has the clinical commissioning group been required to do? What front-line services will be a cut as a result of this financial black hole? My constituents want some answers today—they do not want fobbing off until next May. This issue is too important to be kicked into the post-general election long grass.
The issue has never gone away in the town, despite the best efforts of the powers that be. Now, more than ever, is the time to set out why the A and E is important and needed in Halifax and Calderdale. I am not here today to discuss Huddersfield hospital or play the two off against each other. For the record, I want both to stay open, serving their communities as they have done for many years. Both cater for diverse and distant communities. To outlying communities, the local A and E is, quite literally, their lifeline, their reassuring presence should tragedy strike. In that sense, I have to say that the issue of engagement, consultation and information over Halifax A and E has been handled pretty woefully.
Mrs Riordan
No.
There has been buck passing, misinformation and a lack of honesty and clarity. Neither the CCG, the trust nor the Government have stood up and accepted responsibility for what has taken place. Just because things have gone a bit quiet does not mean that this is not the biggest issue in town.
It is difficult to know where to start. First, there is the closure by stealth that seems to be taking place. I have here articles from the Halifax Courier about people being driven regularly across to Huddersfield for treatment. I could talk about the staff cuts or the stealth cuts that could easily render the A and E a glorified walk-in centre. It is just not good enough, and people across Halifax are right to be angry and dismayed, especially when they read contradictory stories such as those I have read out. If the plan is to close the A and E, why do the decision makers not say so? Let us stop this nonsense that an A and E will stay in some form or another. That is rubbish.
Mrs Riordan
No.
If the existing 24-hour access with full A and E services is axed, it will not be an A and E. It is as simple as that. It is time to stop the spin and give us some substance.
Mrs Riordan
No.
The Government and the CCG know that they cannot do this. They know that there will be a public backlash; they have read the newspapers, seen the rallies, heard the debates and studied the letters. There is not one person in my constituency saying this is a good idea, or, if there is, I have yet to come across them. This is closure by stealth, by secrecy and by drawing out the whole sorry process over months. I and thousands of other people are not going to walk on by and let this happen.
The facts speak for themselves. This a hospital that only opened in 2000. It is an A and E unit that treats thousands of people every year and a hospital that serves people within a 30-mile-plus radius. We are already reading about a winter crisis in A and E—there was a major one last weekend—and what is the Government’s answer? To close them down. We cannot deal with one crisis by causing another. The way to deal with the A and E issue is to invest in the service, reassure people about its future and not put lives at risk.
I say not to the Minister but to the people making these decisions: do not take people for fools. If they strip away A and E services, stop 24-hour care, create an appointment system and move services to Huddersfield, we will not have an A and E service; we will have a glorified walk-in centre or an extended GP service. Will the Minister outline the case for closing Calderdale A and E? I have not heard one decent argument so far, so I would be grateful if he put the Government’s position on the record.
Mrs Riordan
No.
So what do I propose now? There is now a window of opportunity. The “Hands off our A and E” campaign has worked so far: we have delayed the closure, put the issue at the front of the debate and kept the issue at the top of the agenda. However, there is a lot more to do. The issue might have gone quiet, but it has not gone away. The so-called engagement process over the summer months was pathetic. A few afternoon meetings to hear people’s opinions is not good enough. I expect better, and more importantly, my constituents expect better.
Three things need to happen. First, there needs to be proper engagement. What are the plans? What is the impact likely to be? So far, we have had none of these, which has left people in the dark. Secondly, there needs to be proper consultation. Not one-way but proper two-way consultation that actually listens to people and takes notice of their views, and this needs to be done properly, not in the half-baked way we have seen so far. Thirdly, there needs to be a full reassessment of the hospital services offered in Halifax. It is beginning to get treated as a branch hospital, not one at the heart of health services. I have said that I use that hospital regularly, which I do. I have had a few appointments recently, and I have been referred to Calderdale Royal, but when I get the appointment through the post, it is always at Huddersfield hospital. That is what patients are experiencing across Halifax.
People need to be told straight what is taking place. The lack of information over the last few weeks and months has been almost as bad as the decision to axe the A and E in the first place. Let us not pretend that an A and E will exist in some form or another post-2015. There either is an A and E or there is not. The time has come for the Government to come clean on their plans; they should set them out, so we can have a proper consultation and a proper debate. This time, however, the people of Halifax need listening to.
The time has come to say “enough is enough”. The facts are clear that without an A and E in Halifax lives will be put at risk. These unnecessary cuts to front-line services will be a body blow to all ages and all sections of the local community. That is why people have been taking to the streets to protest at these proposals. That is why across the whole spectrum of community opinion, there has been a united voice of, “Save our A and E”.
I hope that the Minister can shed some light today on what exactly is going on. The people of my constituency, who need and deserve the best possible health services in Halifax expect nothing less. It is time to come clean and spell things out. In the run-up to the general election, people expect to know what is going to happen to their local A and E unit. I say today, loud and clear, that the fight to save the A & E goes on, and deserves to be a successful one.
The Parliamentary Under-Secretary of State for Business, Innovation and Skills (George Freeman)
I congratulate the hon. Member for Halifax (Mrs Riordan) on securing this debate. I know that this is an issue of concern to her and to my hon. Friend the Member for Calder Valley (Craig Whittaker), as well as to a number of other Members locally. The issues around proposed changes to health services in Calderdale and Huddersfield have been debated in this House before.
Of course, the configuration of health services is an important issue for many Members and their constituents. We all agree that patients should receive the best and safest care possible. I know these issues are of keen interest locally, with Members from across the political parties taking a close interest in the changes. People always worry about any change in the NHS, because it is such a loved and respected institution. However, it is not right to play on these anxieties. Change is necessary to ensure that the NHS can offer modern, high-quality care fit for the 21st century.
It is slightly disappointing that the hon. Lady has adopted such a partisan approach. In the period running up to an election, NHS reform is not well served by party politics, and I note the hon. Lady’s refusal to accept interventions from my hon. Friend the Member for Calder Valley. I think we need to hear from people on both sides of the House. I have taken the trouble this week to talk to staff and doctors at the front line locally who are leading the work on this issue, to hear from them what they are planning and what they hope to achieve. I hope that hon. Members, including the hon. Lady, take the time to do the same; I know they would appreciate it.
Let me say a few words about our general approach to reconfiguration before touching on the specifics of the case. The Government are clear that the design of front-line health services, including A and E, must be a matter for the local NHS. It is local clinicians—not me or anyone in Whitehall—who will make decisions about health care in Halifax. That is how it should be. The NHS has a responsibility to ensure that people have access to the best and safest health care possible, and to plan for the future to ensure that safe and sustainable services are available to all patients now and in generations to come.
Reconfiguration is about modernising the delivery of care and facilities to improve patient outcomes, to develop services closer to home and, most importantly, to save lives and improve patient safety. That is why we must allow the local NHS continually to challenge the status quo and look for the best way of serving patients. All these service changes are being led by clinicians and are based on a clear, robust clinical case for change that delivers better outcomes for patients.
The health economy across Calderdale and Huddersfield is working to develop a shared vision for the future provision of high-quality, sustainable services. This work is necessary to respond to the challenges facing the local health economy. As in many areas, the NHS in Calderdale and Huddersfield needs to adapt to an ageing population, increased prevalence of long-term and lifestyle-related illnesses, the needs and aspirations of patients and increased pressure on our public finances. The truth is that local services are currently fragmented, with some duplication and inconsistency of outcomes. There is a need to reduce preventable hospital admissions and enable and support people to live in their own homes for as long as possible. I welcome the fact that the local NHS is looking into how community and in-hospital services can be provided to deliver the best outcomes for local patients.
Craig Whittaker
The Minister will recall that the hon. Member for Halifax (Mrs Riordan) did not say whether she had read the strategic review of our area’s health authority, but if she had, she would have seen that it contains no proposals to close the Halifax A and E. Can the Minister confirm that?
George Freeman
My hon. Friend has made an excellent point. I think it important to be guided by what the local professionals—clinicians and NHS staff—are saying. I have spoken to them this week, and I can indeed confirm that there are no plans to close the A and E at present. A clinically led consultation is taking place, quite properly, and before the local NHS leadership recommends any decisions, they will be the subject of public consultation with local people.
Mrs Riordan
I can tell the hon. Member for Calder Valley (Craig Whittaker) that I have read the strategic review. Let me also make it clear that when the consultation began, the acute trust recommended the closure of the Halifax A and E.
George Freeman
As I have said, the local NHS leadership is looking at all the issues on behalf of the patients whom they are there to serve. My point is merely that playing party politics is not helpful. We need to be guided by the local clinical experts. It is important for the NHS to engage widely on the future provision of health services, and it has done that over the last three years. Thousands of local people have given their views on what matters most to them, and that feedback is shaping thinking locally.
Local clinical commissioning groups are focusing on the phased delivery of improvements in community services ahead of any changes in hospital services. Our health system is evolving to adapt to the new landscape of modern medicine, and I think it is in the interests of our patients to encourage that, provided that it is led by clinical decision making. Local commissioners recognise the need for change in hospital services, and I suspect that, as a user, the hon. Lady would recognise that as well. The local NHS believes that the way in which services are currently organised in Halifax does not deliver the safest, most effective and most efficient support to meet patients’ needs. Patients rightly expect that when they see the initials “NHS”, they can expect the very best service that is available, and when they do not receive that service, it is incumbent on the system to adapt so that they do.
The trust is affected by shortages in middle-grade doctors and the high use of locums in A and E, which has an impact on the safety of patient care, and difficulties are involved in providing senior consultant cover overnight and seven days a week. Those are classic problems, which often affect smaller hospitals. We need to ensure that we are delivering the very best care to our patients.
There is often a need for inter-hospital transfers owing to the lack of co-location of first-class services on both sites. The co-location of emergency and acute medical and surgical expertise can result in significant improvements in survival and recovery outcomes, most notably for stroke and cardiac patients. Those who are most seriously ill, with life-threatening conditions, have a much greater chance of survival if they are treated by an experienced medical team that is available 24/7.
It is right for the local NHS to address those challenges to ensure that it can continue to deliver safe, sustainable, high-quality services. Heaven forbid that the hon. Lady should fall ill and require any of those services, but I am sure that, were that to happen, she would want to receive the very best care, and that if that were available in Huddersfield, she would want to be treated in the best possible place. To that end, Calderdale and Huddersfield NHS Foundation Trust has considered a number of options for the future delivery of services, one of which involves one hospital delivering planned care and the other delivering unplanned care. At this stage, no proposals have been ruled in or out. Preferences have been expressed in regard to how services can best be delivered, but no decisions have been made, and I can confirm that there are no formal proposals for changes in hospital services.
In August, the local CCGs decided to delay public consultation on hospital services. While they are signed up to the need for change, they have chosen first to focus on the delivery of improvements in community services in order to build confidence in the changes and demonstrate to local people the benefits they are confident they will deliver. That seems to me entirely appropriate. The CCGs are following a process of change. They understand the need to take people with them, and to build confidence in the changes that they propose. It is incumbent on all Members to encourage and support our NHS leadership locally in building that public confidence in the services.
Change can be difficult to explain to patients, particularly the most vulnerable and elderly patients whose focus is, rightly, on the immediate availability of care. Patients’ reasonable anxieties are often exacerbated by speculation in the media about potential changes and their possible local impact. Services are sometimes described as closing when in fact they are simply being provided in a neighbouring facility or changing for the better in response to advances in treatment.
I know that local people care deeply about the future of their local health services and will want to be involved in decisions about the future of their local hospitals. This is, and should be, a locally led process. Local people should continue to make their views known to those developing proposals for the future of local services, as they have done throughout the engagement process. I also want to encourage them to listen to the reasoning behind any proposals from local NHS clinicians and management for any service changes. I encourage the hon. Lady to work with the local NHS as it further develops its proposals. I know that the CCGs have met hon. Members and are happy to continue to do so.
When talking about potential changes to hospital services, it is important to remember that it is the services, the people and the co-ordination—not the bricks and mortar—that really matter in getting people the right care at the right time. The flexibility and co-ordination of services are just as important as how they are geographically configured. In supporting our local NHS we often end up supporting the current institution—the building in its present location and configuration—but we need to allow the service to evolve and allow our local clinicians and NHS leadership to develop the best possible provision for the people it is designed to serve.
The NHS is one of the great institutions in the world; it is one of this country’s great legacies. Ensuring that it is sustainable and that it serves the best interests of patients sometimes means taking tough decisions. Freezing a service in aspic out of love for it will not allow the NHS to develop and maintain its leadership in the provision of 21st century health care. These decisions are made only when representatives of the local NHS, working in collaboration with local people and local authorities, are convinced that what they are proposing is absolutely in the best interests of their patients.
I make no apology for the fact that it is this Government who have taken these decisions out of the hands of the politicians and the mandarins in Whitehall and put them into the hands of local clinicians and local NHS managers who have the interests of local patients at heart and who are driving those decisions in their interests. It is important that the NHS in Calderdale and Huddersfield develops solutions that will allow it to provide high quality, safe, effective and sustainable services to local people for generations to come.
Craig Whittaker
I recall when the Labour Government took the acute services from Halifax and sent them to Kirklees in 2005. I campaigned strongly against that at the time, but I was wrong because it appears that we now have a greater life-saving institution locally. Can the Minister tell me whether there is any evidence around the country that having specialists in one place, rather than having them split between several sites, does in fact save lives?
George Freeman
My hon. Friend makes an important point. There is a huge amount of evidence—which the Department is keen to publish and disseminate in order to inform the debate—that in many areas, particularly in relation to respiratory and cardiac conditions and to diabetes, the centralisation of services in specialist centres drives up clinical outcomes, improves patient safety and prevents avoidable death. Patients have a right to expect us to put in place a framework that allows the NHS to evolve. We need to find ways of ensuring that those services that are best provided locally—community-based services—are provided in that way, and that those requiring increased specialisation in centres of excellence and expertise that operate 24/7 are also available. That is what the local NHS leadership is endeavouring to do, and we should support them in that because it is in the interests of the patients, whose NHS this is.
Question put and agreed to.