Oral Answers to Questions

Alec Shelbrooke Excerpts

Tuesday 12th June 2012 Commons Chamber

[Mr Lansley]

An increased number of hip and knee revisions is one of the consequences of an ageing population. I welcome Tim Briggs’ report, “Getting it right first time”. His recommendations are sensible. I am pleased to note that it has the support of the British Orthopaedic Association, as well as clinicians in London. It will help us build on the progress that is being made, to which I referred. The latest figures show that the proportion of hip fracture patients who receive all elements of the best practice tariff has risen from 24% in 2010 to 37% in 2011, and to 55% in 2012. That achievement has attracted international interest and is undoubtedly saving lives.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

10. What improvements in public health outcomes he anticipates by the end of the decade.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

This year, we published our public health outcomes framework, which will last from 2013 to 2016. It sets out two high-level outcomes: to increase healthy life expectancy and to reduce differences in life expectancy and healthy life expectancy between communities. This is the first time that a Government have published a public health outcomes framework, and the first time that there has been ring-fenced money for public health.

[Alec Shelbrooke]

On 31 July 2010, I smoked my last cigarette. Every day since then has been a struggle and I still consider myself to be a smoker. Will my hon. Friend outline for the House what support the hundreds of people in my constituency and the tens of thousands of people around the country who are in the same boat are getting to improve public health outcomes?

[Anne Milton]

I heartily congratulate my hon. Friend on his considerable success, which he has put on the record. We have a number of initiatives, not least the NHS’s quit helpline. There has been a rise in the number of people phoning it and in the number of people who are attempting to quit. He is an example not only to his constituents, but to many Members around the House.

Oral Answers to Questions

Alec Shelbrooke Excerpts

Tuesday 18th October 2011 Commons Chamber

[Paul Burstow]

My hon. Friend is right to raise the issue of ensuring sufficient awareness of the pathways that exist for people to gain access to those services. I understand that the east midlands specialised commissioning group has recently carried out a review of non-invasive ventilation services. I shall ask the group to write to him in more detail.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

12. What steps he is taking to assist patients to access a greater range of NHS services.

[The Minister of State, Department of Health (Mr Simon Burns)]

The NHS constitution gives patients the right to make choices about their care. The Government are committed to empowering patients. Our goal is for patients to have more choice of treatment.

[Alec Shelbrooke]

What steps is my hon. Friend taking to ensure that my constituents requiring cardiac services will have access to the care that they need in Leeds?

[Mr Burns]

My hon. Friend raises an important and controversial issue, as he will have heard when listening to my right hon. Friend the Secretary of State earlier and the debates that he has attended in the House on this subject. We are determined that proper facilities will be made available, based not on money but on the high quality of care, particularly for children. An independent review is being carried out by the joint committee of primary care trusts, which is expected to announce its recommendations later this year.

Congenital Cardiac Services for Children

Alec Shelbrooke Excerpts

Thursday 23rd June 2011 Commons Chamber

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I will try to be brief to allow as many of my colleagues as possible to speak.

I do not want to take up too much time in defending the case for Leeds because that has been done exceptionally well by many others. Like me, a good number of the Leeds MPs who now occupy this place were city councillors there, including my hon. Friends the Members for Leeds North West (Greg Mulholland) and for Pudsey (Stuart Andrew) and the hon. Member for Leeds East (Mr Mudie)—a distinguished leader of Leeds council who was very much involved in achieving our aim of having the children’s hospital all in one place. As Leeds councillors, we had personal experience of this matter when one of our colleagues died of heart disease in his early thirties. He was from the black and minority ethnic community, which makes up 23% of the population of Leeds. Sadly, that community has inherent heart problems. That has been overlooked, and it needs to be given weight in the review.

We have heard about many of the flaws in the review. The Minister rightly says that he does not have any influence over the review, which is independent, and as individual MPs we probably do not have much influence over it either. What we do have, however, is this place. Twenty-four hours ago, we were knocking nine bells out of each other. It was raucous and it was fun; we made some serious points and we were having a go. Today, from across the Chamber, some very serious speeches have been made. No matter which side of the House we are on, politics does not come into it. This House is speaking with one voice, and that voice should be heard by the people carrying out the review.

When Members of a House such as ours, which can be so confrontational, all come together, that shows the real power of our parliamentary democracy. Although the Minister, and we as individuals, may not have any direct influence on this process, it would be extremely foolish for the people involved not to take note that we will almost certainly not divide on the motion and that we all support it, including the Minister himself and the Government. My constituents are always asking whether we can work together, and we can. Everyone has come together to say that the House of Commons says that the review needs to be looked at again and other options need to be developed. That is a powerful message that I want to go forth to the people who are carrying out the review.

Children's Heart Surgery (Leeds)

Alec Shelbrooke Excerpts

Thursday 3rd March 2011 Commons Chamber

[Stuart Andrew]

I entirely agree. I was about to deal with that point. I believe that there is a very strong case for Leeds. It has the capacity to expand, and is within a two-hour drive for nearly 14 million people. It has one of the highest population coverages among all the units in England, with 5.5 million people in the Yorkshire and Humber region. Leeds is, of course, centrally located in the north of England, and can accommodate patients from outside the current catchment area.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I congratulate my hon. Friend on securing a debate on an issue that is vital to the people of our city. Leeds is not only central, but has been described as the motorway city. It has excellent rail links as well, which makes speedy access to the hospital possible.

[Stuart Andrew]

I am beginning to think that some Members have already seen my speech. I am getting ahead of myself. We have the M1, the A1, the M62 and excellent rail links, which make Leeds very accessible. The Leeds Hospitals NHS Trust has centralised children’s services, which I think meets the requirements of the Department of Health’s critical interdependency report. On 18 February the British Congenital Cardiac Association, which is a leading support organisation of the safe and sustainable review, released a statement saying:

“For these services at each centre to remain sustainable in the long term, co-location of key clinical services on one site is essential.”

Leeds General Infirmary is at the forefront of work on inherited cardiac conditions, and has an excellent record of providing safe, high-quality children’s heart surgery. The Yorkshire region has significantly higher birth rates than other parts of the country, particularly the north-east, and there is no doubt that demand will increase.

The review is informed by the overall opinion that a reduction in the number of centres is the best way in which to secure a safe and sustainable future service. It is guided by four principles, and I believe Leeds more than meets their requirements. The first is quality. The paediatric cardiac service at Leeds General Infirmary extends from pre-natal diagnosis to the treatment of congenital heart disease in adults, with excellent clinical outcomes. It has high standards and a personal service, and, as I have said, is located very centrally.

During the assessment process, Sir Ian Kennedy and his assessment panel visited every children’s heart surgery unit in England. They produced individual assessment reports on each of the units two weeks before the presentation meeting at the joint committee of primary care trusts on 16 February. At the meeting, the four reconfiguration options were presented. They were based on a number of factors contained in the panel’s assessment reports. However, I understand that there are significant factual inaccuracies in Sir Ian Kennedy’s report on the Leeds unit, and that its representatives were given no opportunity during the process to comment or request amendments of the factual inaccuracies before decisions were made about the configuration of the options for consultation.

At a meeting of the all-party parliamentary group on heart disease on 9 February, when asked when units would be able to challenge and amend inaccuracies in their reports, Jeremy Glyde, the programme director of the safe and sustainable review, said that that could be done during the consultation process.

The reports that the reconfigurations were based on contain fundamental inaccuracies, but they can be challenged only during the consultation period to decide which option is preferred. For Leeds, these inaccuracies include the following. Sir Ian Kennedy’s report documented that Leeds has no transition nurse and separate paediatric intensive care unit; neither point is factually accurate, to the extent that his assessment panel actually met, and talked to, one of the unit’s three transition nurses. The joint committee of primary care trusts advised at its meeting on 16 February that Leeds had stated that it could not do more than 600 operations. Again, that is factually incorrect— Leeds was never asked—but it was stated as the reason why two of the 14 options that were considered were discounted. The commissioners have acknowledged that this was an assumption and not based on what Leeds had said. In the pre-consultation business case for Leeds, start-up costs were reported as £2 million. That figure was not provided by Leeds, and is not representative of the accurate costs provided to the safe and sustainable review panel.

--- Later in debate ---

[Stuart Andrew]

I absolutely agree. For hearts, time is of the essence. We need to be sure that people can get where they need to be quickly. I met my hon. Friend’s constituent the other day, and she spoke very powerfully and emotionally about what that meant in her case. I cannot imagine how families in these situations must feel. It is imperative that there is a facility close by.

Returning to the reviews, there are also inconsistencies in the application of some of the principles. So, for example, Liverpool and Birmingham are in all the options because of density of population and access for patients, but the same does not seem to apply to the Leeds case. That is odd and I do not know why the Liverpool and Birmingham cases are different.

Not enough emphasis has been given to co-location. The facility at Leeds general infirmary is wonderful now—I am given to understand that it is the second largest children’s service in the whole country—so taking away its heart unit and the expertise that has been gathered there over the years is strange. This is not just about children’s heart services, because the process has failed to seek views from adult congenital patients. The doctors who operate on the children also operate on the adults and it appears obvious that wherever the children’s heart services go, so, too, will the services for adults. Will they have had an opportunity to be consulted on what was going to happen to those services? This is about a much wider point than just children’s services.

[Alec Shelbrooke]

My hon. Friend may be coming to this issue, but could he comment on the fact, which has been put forward every now and again, that Newcastle is favoured because its facility performs adult heart transplants? We recognise that surgeons have equal skills and just because somewhere does the adult heart transplants, it does not necessarily mean that we should move the children’s heart surgery to that department.

[Stuart Andrew]

That is a very valid point and I shall shortly discuss something that was said the other day because it will comment on that.

I shall conclude now because I know that a couple of other Members have expressed an interest in speaking in this debate. I understand that this process is going to be difficult and that there is a need for a review. Severe problems have been experienced in parts of the country and it is right that a clinically led decision is made, but I want that decision to be made on the basis of facts that matter to local people and that are accurate. As I have mentioned, there are real problems with the assessment and the options that have been mentioned. Emotions will of course run high, because this is a very emotive subject. It is incredibly moving to listen to the families I have been speaking to since this matter first arose. They describe how their children and their babies were so close to death but how, thanks to the expertise that was provided at this location, which they were able to reach, their children are at least here and receiving the wonderful care that is provided, although they may be poorly.

There is a case to be made for the facility at Leeds in terms of geography, population and access. We like to tick boxes in this country and everything is ticked in this case for Leeds. I would be grateful if the process could be examined. Some powerful comments were made and cases were mentioned at a meeting held with parents and clinicians here on Tuesday. They are desperate for this unit to remain open. As someone said at that meeting, the doctors should move where the patients are; it should not be the other way round.