Hospital Services (North-East)

Alex Cunningham Excerpts

Tuesday 27th July 2010 Westminster Hall

[Alex Cunningham (Stockton North) (Lab)]

I am grateful to have another opportunity to discuss the need for a 21st century hospital to meet the needs of my constituents and those throughout the north-east; however, I shall be briefer than I was the last time I spoke on the matter.

It was good to hear my hon. Friends talk about specific issues affecting the health of people in their constituencies, and to hear my hon. Friend the Member for Sedgefield (Phil Wilson) outline the benefits that the hospital could bring over and above health. I want to start with an outline of the health picture in the borough of Stockton-on-Tees. Things have improved in recent years, but much still needs to be done. According to the NHS health profile for 2010, which has just dropped through my letter box, in Stockton-on-Tees life expectancy for men living in the most deprived areas is still nearly 12 years less than for men living in the least deprived areas. In relation to early deaths from heart disease and stroke, survival rates have steadily improved over the years: from 160 deaths per 100,000 people in 1998 to about 80 per 100,000 people in 2007. That is half the number of deaths and there is much credit due to our hospitals’ care and to the local PCTs and health programmes. However, we are still well behind the England average in our progress in relation to early deaths from heart disease, stroke and cancer.

What do the decisions made by the coalition Government mean for the north-east and people’s health? A new hospital has been scrapped. That is a huge blow, and it is still not clear why our hospital was chosen, while others have been given the go-ahead. We have had years of planning, as other hon. Members described, and that was discussed in detail in my Adjournment debate on 5 July. I accept that the decision has now been made, but it is not clear what will happen. There is also uncertainty for patients in the scrapping of Labour’s promises. The coalition has scrapped the 18-week waiting list target and the 48-hour GP access target and downgraded the four-hour accident and emergency waiting time target.

There is also great uncertainty for people who work in the NHS locally, who will commission services in the future. I met Dr John Canning, a member of the Cleveland local medical committee, and discussed, among other things, the re-organisation of the NHS and in particular GP commissioning. We await detailed plans, but I am dismayed that the Government, who in opposition promised “no more pointless reorganisations” are presiding over the biggest structural overhaul of the NHS in 60 years. The NHS needs stability; it does not need to be forced to deal with a huge and unnecessary politically motivated structural upheaval at a time of significant financial pressure on public services.

The new GP commissioners will be responsible for ensuring that their patients get the best possible health care in the best possible facilities. I just wonder how they will make those decisions. Perhaps they will send patients many miles to a new hospital with all the services required by the patient close together and under one roof. Alternatively, will they utilise the services at their local hospital, where the care might be very good but the facilities could be less than first class? Some patients make a positive choice to travel to neighbouring hospitals, which have the most modern and up-to-date facilities, and could be expected increasingly to shun local services because they believe, rightly or wrongly, that in that way they will get better treatment.

The strategy outlined by the foundation trust remains the right one. When Stockton-on-Tees borough council met, every member in the chamber voted to ask the Minister to review the decision; that included the Conservative council leader. So can we look forward to a new hospital? The answer could still be yes if it is the true and honest will of the Government. Detailed work on developing a private finance initiative to meet the costs of the new hospital is well under way, but there remains great uncertainty about whether there will be Government support. If the foundation trust completes the work and satisfies Monitor, its financial regulator, that it has a robust project that will work, will the Department of Health approve it and ensure that the people of my constituency and the surrounding ones get the hospital they need and deserve?

--- Later in debate ---

[Mr Burns]

I will certainly explain that when I get on to the specific point about Hartlepool because, unfortunately, as will be unveiled to the shadow Minister and the hon. Member for Hartlepool, their comments today are based on a false premise and show that they do not fully understand the previous speeches on the issue, or the meeting we had at the Department of Health. All will be unveiled shortly, and I hope that the shadow Minister will understand the reasoning behind the decision taken.

As I was saying, as part of the vision, and the moving forward on the White Paper, we want every hospital trust in the country to become a foundation trust. We want to direct every aspect of the national health service at delivering clinical outcomes that are as good as, or better than, any in the world. The north-east is already ahead of the game in many respects. In November 2009, it became the first and only region in England to have all of its NHS hospital and mental health trusts awarded foundation trust status. When the Care Quality Commission reviewed hospital services in the region last year, every single hospital trust and every ambulance service was rated either good or excellent for the quality of their services. That gave the north-east the highest score in England for the third year running.

Among those hospital trusts, Gateshead Health NHS Foundation Trust, Newcastle upon Tyne Hospitals NHS Foundation Trust and Northumbria Healthcare NHS Foundation Trust all received double excellent scores for both quality of services and the use of resources. The high quality of services across the north-east is down to the skill, dedication, creativity and sheer hard work of the thousands of NHS staff across the region. I want to take this opportunity to pay tribute to them and wish them well in their continued success in providing first-class care and services to the people of the north-east.

[Alex Cunningham]

Would the Minister care to help us get a hat trick, and to go from double to triple excellence, by having a brand new hospital for the people of North Tees and Hartlepool?

[Mr Burns]

I admire the hon. Gentleman for his persistence. If he could have a little patience, I shall talk about the points made by my hon. Friend the Member for Hexham, and will then come on to the hospital that has so dominated the debate.

My hon. Friend mentioned Northumbria Healthcare NHS Foundation Trust and its proposal to build a £75-million emergency care hospital in Cramlington. I am advised that planning permission is currently being sought for the proposed site and that further development work is under way. I hope that that goes some way to answering the point that he raised. I will make sure that I write to him during the next week or so on the other points that he mentioned to explain all the outstanding issues.

I shall now turn to the review of the hospital in North Tees and Hartlepool. The hon. Member for Hartlepool specifically raised the Government’s decision to cancel North Tees and Hartlepool NHS Foundation Trust’s proposal for a new hospital building. As I stated in the House in our last debate on this matter on 5 July, the original proposal for a publicly funded capital scheme received Treasury approval in March this year, in the run-up to the general election. In view of the shocking state of the public finances and the desperate need to reduce the £155 billion deficit, which I need not remind Labour Members was left to us by their Government, the Treasury and other Departments reviewed every significant spending decision made under the previous Government between 1 January 2010 and the general election on 6 May.

NHS White Paper

Alex Cunningham Excerpts

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

The White Paper will enable GPs in an area, plus their local public and their local authority, to make decisions about the shape of services rather than its being done by ministerial diktat.

[Alex Cunningham (Stockton North) (Lab)]

The Secretary of State referred to delivering for the patient. Will he guarantee that patients such as those who need a new knee or a new hip can expect their treatment in 18 weeks, or is it more likely to be 18 months under today’s proposals, as it was under the previous Tory Government?

[Mr Lansley]

Ah! That was one of the Opposition Whips’ handout questions, wasn’t it? I will tell the hon. Gentleman that actually, patients are more likely to get their treatment more quickly. Let me give him an example. Patients with rheumatoid arthritis need rapid treatment, but they were losing out and suffering as a consequence of the 18-week target, because hospitals were hitting 18 weeks, but not providing the care needed by those patients in the light of their conditions. We must focus on what is in the best interests of patients, not on what is in the best interests of political grandstanding.

North Tees and Hartlepool NHS Foundation Trust

Alex Cunningham Excerpts

Monday 5th July 2010 Commons Chamber

[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.

--- Later in debate ---

[Alex Cunningham]

Will the Minister give way?

[Mr Burns]

I am very short of time, but yes.

[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.

Oral Answers to Questions

Alex Cunningham Excerpts

Tuesday 29th June 2010 Commons Chamber

[Anne Milton]

May I thank my hon. Friend for his question and pay tribute to him for his continued and persistent lobbying on this subject? I gather that he has been elected a member of the Select Committee on Health, so I welcome him to that position and I am sure that we will meet again at some point.

What is important is that decisions about treatment are made by clinicians, and they will base their decisions on the safety, efficacy, efficiency and outcomes that a particular treatment will provide.

[Alex Cunningham (Stockton North) (Lab)]

The North Tees and Hartlepool NHS Foundation Trust believes that its strategy for one hospital to replace the North Tees and Hartlepool university hospitals is the right strategy, despite the project being dropped by the Government. Does the Minister accept that the trust’s strategy to provide a new hospital and health facilities closer to communities to meet their health needs is correct, that the trust should be encouraged to press ahead with alternative funding models that could still deliver the new hospital, and that its members and the public at large can expect Government support to realise that strategy?

[Mr Lansley]

What I would look for is for the foundation trust to meet the criteria that I published on 21 May in relation to any reconfiguration of services that it proposes for its area. As a foundation trust, I would also expect that, having secured the freedoms associated with that status, it should not ask the Department of Health to meet the whole capital cost of whatever it proposes.