Five Year Forward View

Andrew Stephenson Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

As I have just told the House, I welcome a report that says we need to invest more in general practice. There has been historical under-investment over decades, which is why more and more resources have been sucked into the hospital sector. We are calling time on that and saying that we have to invest more in primary care, community care and out-of-hospital care. It is a big change for the NHS, and I think that the hon. Gentleman’s practice managers will be thrilled to hear it.

[Andrew Stephenson (Pendle) (Con)]

The Secretary of State may be aware that the excellent Airedale hospital, which he has visited, in the neighbouring constituency to mine, has been highlighted in “BBC News” coverage today, especially for its telemedicine service, as an example of what the future of evolving heath care may look like. Will he join me in congratulating the excellent staff at Airedale hospital on embracing change and pioneering new models of care?

[Mr Hunt]

I am delighted to do so. Airedale is mentioned in the “Five Year Forward View” as an example of how technology can be transformative. It has a system under which older people in the locality are given a red button, and as long as their TV is turned on, all they have to do is press the red button and they are talking to a nurse. That is immensely reassuring for them, and it means that they are more likely to stay healthy and happy and to live at home for longer. That is better for them and for the NHS, and it is a real model.

Special Measures Regime

Andrew Stephenson Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

No one is keener than my hon. Friend and I to get the trust out of special measures as quickly as possible, and I thank him for the many representations he has made with respect to North Cumbria. I know that the trust is disappointed not to come out of special measures, but it is now rated good in terms of being caring, and the CQC said in July that the staff were supportive to patients and those close to them, so some encouraging things are happening at the trust, and we will do everything we can to help it to go the final furlong.

[Andrew Stephenson (Pendle) (Con)]

I very much welcome the progress that has been made at East Lancashire hospitals. Following action by the Secretary of State last year, the trust has now recruited more than 200 new nurses, nurse support staff and consultants. In March, a new state-of-the-art £9 million urgent care centre at Burnley was officially opened to the public, replacing the old A and E department, which was downgraded under Labour in 2007. Given that poor performance at the trust was established back in 2005 and that the last Government failed to act on it, how can we ensure that future problems are addressed speedily, rather than being hushed up?

[Mr Hunt]

I thank my hon. Friend for his interest in his local hospital and I agree with him that the trust has made good progress. There is a simple way to ensure that these things get acted on quickly and that is to make sure they are public. When things are public—when they are transparent and everyone knows about them—the NHS and Ministers have to act, and that is the purpose of this system.

Oral Answers to Questions

Andrew Stephenson Excerpts

Tuesday 26th November 2013 Commons Chamber

[The Minister of State, Department of Health (Norman Lamb)]

Throughout this Parliament we have ensured that extra funding has gone into social care to recognise the fact that council budgets have been under strain. The point that I made earlier—that there has been a 50,000 reduction in delayed discharges to social care—demonstrates just how well they are doing under significant pressure.

[Andrew Stephenson (Pendle) (Con)]

T9. What progress have the Government made in driving up standards and transparency in hospitals, social care and general practice?

[Norman Lamb]

The Government’s response to the Francis report demonstrated that openness and transparency are critical. As a result of the steps that we have proposed, this will be the most open health system anywhere in the world. That is something we should be very proud of.

Hospital Mortality Rates

Andrew Stephenson Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

We do need to draw those lessons, and the sad lesson from this afternoon is that that change in culture with respect to transparency and accountability does not extend to the Labour party. Voters will notice how unwilling Labour Members are to accept that things went wrong on their patch.

[Andrew Stephenson (Pendle) (Con)]

Given what today’s report says about capacity issues at Blackburn hospital, and that the hospital is struggling to deal with the number of patients, serious questions again have to be asked about the decision to downgrade Burnley hospital’s accident and emergency department under the previous Government in 2007, which was consistently supported by the shadow Secretary of State when he was in office. Will my right hon. Friend visit Pendle to meet some of the affected families to reassure them that lessons have been learned from the mistakes of the past?

[Mr Hunt]

I will be delighted to visit my hon. Friend’s hospital, as well as those of many colleagues. I am sure I will learn a great deal when I do so.

Oral Answers to Questions

Andrew Stephenson Excerpts

Tuesday 16th July 2013 Commons Chamber

[Dr Poulter]

The hon. Lady is absolutely right to highlight the fact that we need more transparency in data and that patients have a right to know about the quality of surgical care, but it is also right that we need to look at that carefully across the different surgical specialties, and particularly at the different criteria that might also impact upon good care and good health care outcomes, particularly in oncology.

[Andrew Stephenson (Pendle) (Con)]

Two-year-old Oliver Rushton in my constituency has cerebral palsy and needs a selective dorsal rhizotomy if he is to be able to walk or stand on his own. Unfortunately, after considerable delay, Oliver’s request for NHS treatment has been turned down. He is now getting the treatment, but only after an incredible fundraising effort from his parents, who have personally raised £40,000 to pay for it. Will my hon. Friend meet me to discuss the case?

[Dr Poulter]

I would be very happy to meet my hon. Friend to discuss that case and the commissioning arrangements for the procedure, and indeed other treatment for patients with cerebral palsy.

Care Quality Commission (Morecambe Bay Hospitals)

Andrew Stephenson Excerpts

Wednesday 19th June 2013 Commons Chamber

[Mr Hunt]

The criminal sanctions apply to boards for withholding information about safety breaches at their trust, and as I mentioned earlier, we are considering whether those sanctions should apply below board level. We want to wait for Professor Berwick’s advice on that, because there is a balance between proper accountability for mistakes and the need to create that culture of openness, where people report mistakes that they might see a colleague making, which might not happen if they were worried about criminal prosecutions. I want to take the advice of an expert on that.

[Andrew Stephenson (Pendle) (Con)]

I and the people I represent are rightly proud of our NHS. However, from Morecambe Bay to Mid Staffordshire we have had a series of scandals. Can the Secretary of State reassure patients that the previous Government’s culture of secrecy and neglect will now be torn apart and replaced by a new, transparent, accountable health service that treats patients with dignity, rather than as numbers?

[Mr Hunt]

The big challenge of our times for the NHS is to make that culture change, and it is a huge organisation. With 1.3 million people, we will do this only if we tap into and harness the desire that they have to do their jobs to the highest standards of patient safety, treating people with dignity and respect. That will be the key to unlocking success.

Social Care Funding

Andrew Stephenson Excerpts

Monday 11th February 2013 Commons Chamber

[Mr Hunt]

There are some things that we can learn from Scotland and some things that we cannot learn. Scotland has a very good record in identifying people with dementia, and the point that the hon. Lady makes about helping people to live at home for longer is a very good one. Care costs incurred in domiciliary care for people who are living at home will count towards the £75,000 cap, so we hope to have many more flexible ways for people to provide for themselves and be able to live at home happily and healthily for longer.

[Andrew Stephenson (Pendle) (Con)]

I welcome today’s statement. Most welcome to my constituents will be the increase in the means-test threshold of state support from £23,000 to £123,000. Given that December’s figures from the Land Registry put the average house price in my constituency at only £114,000, will my right hon. Friend confirm that these proposals represent a very good deal for Pendle home owners, most of whom are on low incomes and of only modest wealth?

[Mr Hunt]

That is absolutely the point. The group of people we are targeting with these proposals are not the most vulnerable, because they already get all their care costs covered if their assets are less than £23,000, but the people one step up from that, who in many cases have worked hard, saved all their lives and paid off their mortgage, but have a house that is not of sufficient value to cover the social care costs they need. I hope that these proposals will be very welcome in Pendle.

Suicide Prevention

Andrew Stephenson Excerpts

Wednesday 6th February 2013 Commons Chamber

[Stuart Andrew (Pudsey) (Con)]

I am grateful for the opportunity to take part in the debate. I pay tribute to the hon. Member for South Antrim (Dr McCrea) and all Democratic Unionist party Members for bringing this important debate to the Floor of the House. I am sure they were tempted to debate many other issues, but it is important that we discuss suicide prevention, which is a crucial but difficult issue.

Yesterday, I spoke of some of the most difficult times in my life. I was lucky to have the support of a loving family and great friends, but many unfortunately do not have that. Before being elected, I worked in the hospice movement. In that time, I got to know a lot of the patients well, and, sadly, death became a norm—I did not want to use that word, but I am sure hon. Members understand what I am getting at. Bereavement is always difficult, but suicide bereavement is a different type of bereavement altogether.

Sadly, I say that from personal experience. When I was in the sixth form, I remember vividly walking in and a friend saying to me, “Have you heard about that boy?”—I will not mention his name. He had taken his own life because he had been bullied at school. I remember all the students sitting in the common room in complete and utter shock. All I could think about were the questions going around in my head. What could I have done? Why did I not spot that he was in that difficult place? If I am honest, those questions still haunt me today. In more recent times—since I have been elected as a Member of Parliament—there was the very sad case in my constituency of a father who killed his entire family and then himself.

The suicides I have seen and experienced have had a tremendous effect on the people who are left behind. That is why the debate is important, but more importantly we should act and not just talk about suicide. We must also start right at the beginning and change people’s attitudes. How many times have hon. Members been on a train that has been delayed because somebody has taken their life, and the instinct of some passengers is to moan about the delay, forgetting that somebody has lost their life?

Hon. Members have spoken a lot about attitudes to mental health. I am very proud of the fact that a lot of work has been done in the Chamber to address that. It is a good start to try and take away that stigma. I pay particular tribute to my hon. Friend the Member for Broxbourne (Mr Walker) and the hon. Member for North Durham (Mr Jones), who have spoken openly about their own personal battles. As hon. Members have said, however, suicide is a much wider subject than just mental health; it can be about finance, careers or family breakdown. It is important that we address all those issues, which is why I welcome the fact that the suicide prevention strategy is in place. It is important that the strategy is not just a piece of paper; it has to be backed up by action, and it is good to see that happening. Crucially, it is partly about identifying the risks.

[Andrew Stephenson (Pendle) (Con)]

I agree with what my hon. Friend is saying. In January, suicide-proof fencing was installed at a multi-storey car park in Nelson in my constituency, from which eight people have died in the past 10 years and a further 18 people have had to be talked down by police. I raised this issue on the Floor of the House in October 2010 in an Adjournment debate led by the hon. Member for Bridgend (Mrs Moon), yet it still took the car park owners years to act. In addition to what my hon. Friend is saying, does he agree that businesses have a key role to play in identifying risks?

[Stuart Andrew]

I am grateful to my hon. Friend for that intervention. He is absolutely right: we need to do everything we can—talking to individuals themselves or lessening the risks—to identify those areas. A lot of work has been done in the prison system to try to improve cells to reduce risks. Businesses also have an important role to play.

It is important that the strategy targets specific groups who we know may be vulnerable. Targeting young people will be important, because we want to change attitudes in the future. We also have to look at why so many young men are committing suicide. We have been talking about mental health, but let us face it: men are not very good at talking, and that is part of the problem. As we move into the digital age and we all spend so much time on our computers, being used to talking with others will lessen over time. I fear that we will have a generation who will be even worse than the current one in talking about their problems.

Improving access to “talking therapies”, the strategy’s four-year plan, and expanding it to all ages and different groups, is important. From my own experience, I know that we need to ensure that there is as much work on school intervention as possible to deal with bullying and violence. We must allow people to talk about the threats they feel, whether they are sexual abuse or bullying at home. We also have to remove barriers for people who are disabled, or who have mental health or other long-term conditions. We want to make them feel that they can play a full role in our society and do not become isolated.

Areas that require emphasis have been highlighted by a constituent of mine. I pay tribute to Mike Bush. He and I are unlikely friends. He describes himself as “red socialist”, but he and I have become very good friends and I have a huge amount of respect for him. He has done tremendous work in this field and is an active member of the all-party parliamentary group on suicide and self-harm prevention. On many occasions, he has highlighted the importance of working with bereaved families. I welcome the fact that the strategy gives greater prominence to measures that support those families; being there and helping them to cope with a family member whom they are worried might commit suicide, and helping them cope with the aftermath of someone who has committed suicide.

Getting better information through the research that is being offered can only be a good thing, but the emphasis must be on support, and I completely agree with the hon. Member for Bridgend that we need to ensure good national provision. We need to ensure that suicide prevention measures are available in every part of our country. In particular, bereavement support needs a suicide angle to it, because it really is very different. In my time at the hospice, I saw how fragmented bereavement services were around the country, but specific suicide bereavement support is even more fragmented.

I hope that as the strategy develops we will continue to work with the many wonderful organisations we have in this country, many of which have been mentioned today, such as the Samaritans. The APPG is a great start, bringing together a coalition of organisations with a wealth of experience, but it is also important that we listen to family groups that have been through this dreadful experience. What makes Martin House children’s hospice such a wonderful organisation is that it is parent-led. The parents describe the care they need, and that is why it can offer such wonderful support. In the same way, the best strategy for dealing with suicide will come from those families who have experienced it.

We need action on cyber-bullying. Bullying has existed in schools for many years, but it has taken on a different form now. People can be bullied at school, but when they get home it continues through the social networking sites and the computers in their bedrooms. In a sense, these children and young people are suffering from a silent bully. The suicide websites have been touched on. We must do more to close them down completely.

I hope that we can offer further training for organisations and—perhaps—the police in helping them to deliver that bad news. I have had several constituents tell me that they almost felt sorry for the police officer delivering the news because it was so difficult. It is important that these organisations be aware of the wealth of information out there. I am glad that the “Help is at Hand” document has been mentioned, because it is not used enough.

In conclusion, suicide is tragic in every sense: the loneliness of the person doing it, the long bereavement for those left behind, the guilt they suffer for years after and the great risk that they themselves might go on to commit suicide. It is crucial that we face this risk. This debate is just the start: let us now address and act on it.

Dementia

Andrew Stephenson Excerpts

Thursday 10th January 2013 Commons Chamber

[Andrew Stephenson (Pendle) (Con)]

It is a pleasure to follow the hon. Member for Bridgend (Mrs Moon). I pay tribute to her thoughtful and emotional contribution. I pay tribute also to the right hon. Members for Sutton and Cheam (Paul Burstow) and for Salford and Eccles (Hazel Blears) and to my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) for securing today’s debate and for their equally thoughtful contributions.

I shall focus my remarks on my area, Pendle, and the Lancashire Care NHS Foundation Trust’s current consultation on dementia care services across the county. In my constituency there are 1,114 people diagnosed with dementia, compared with 1,060 people in 2010. As we all know, dementia can affect anyone. It is not just an old person’s illness and we know that there are hundreds of different types of dementia, so getting the correct diagnosis is one of the biggest challenges wherever one lives in the country.

My maternal grandmother, Mary, suffered from dementia brought on by a series of strokes. Although I was only young at the time, I remember going to visit her in Withington hospital in Manchester, where after any particularly bad period she was given six weeks’ assessment. I remember the locks on the doors to the ward, for patients’ own safety, and watching as the grandmother I knew and loved slipped away from us. However, for many I have met in Pendle the emotional heartbreak is even worse, with husbands and wives diagnosed with this terrible condition in their mid to late 50s, their hopes of an enjoyable retirement together dashed, their dreams shattered.

Thankfully, the support available to dementia sufferers has improved significantly in recent years. In my constituency, although some people have raised concerns about getting the correct diagnosis from their GP, we have Memory Services, based at Maple house in Burnley general hospital, to which many people are correctly referred. With the help of Lancashire county council and the Alzheimer’s Society, East Lancashire Community Dementia Forum runs a dementia café in Colne on the fourth Thursday of every month, at the Arcadia café on Windy Bank—the importance of dementia cafés and the roles they can play has already been mentioned. Last May, I went along to the café, which runs from 2pm to 4pm, and found that providing information, advice and refreshments in a relaxed and friendly environment was a great idea for both those suffering with dementia and their carers.

In August, I was also pleased to attend a meeting of the Alzheimer’s Society’s carers support group at Walton lane community centre in Nelson. We discussed a huge range of topics, including respite facilities, the hospital beds situation, pathways to diagnosis, the difficulty for Alzheimer sufferers of qualifying for blue badges, disabled facility grants, day care and standards of care, among many other topics. Following the meeting, I took up several of the broad points with the NHS, Lancashire county council and Pendle borough council and pursued a number of individual cases. In the same month, I also attended the East Lancashire Community Dementia Forum at Brierfield library, when the focus was on short breaks and respite care.

Let me turn to Lancashire Care NHS Foundation Trust’s consultation on specialist dementia care services in Lancashire. The consultation opened on 3 December and runs until 25 February, with an opportunity for Pendle residents to discuss the options with representatives of Lancashire Care on Monday 28 January at Training 2000 in Nelson. Much of the information contained in the consultation document sounds very positive and few dementia sufferers or their carers would disagree with it. For example, it states that 83% of carers and people with dementia said that being able to live in their own home was very important to the person with dementia. It states that people with dementia should be moved as little as possible and, therefore, community or home care is the best option. It notes that significant progress has been made in Lancashire and that over the past year 93% of dementia care contacts were in the community, supported by specialist teams.

However, the consultation document goes on to state that there were trends over the past three years of reduced admissions, readmissions and lengths of stay from the population in central Lancashire. If that could be replicated across the whole county, it suggests, the demand for specialist in-patient services could be expected to decrease to the point where those admitted would make up a much smaller group, and it is likely they would only be those detained under the Mental Health Act.

On that basis, the trust proposes two options. Option 1 is to reduce the existing 65 specialist dementia in-patient beds across four sites in Lancashire to just 30 such beds on a single site. That single site would be in Blackpool, which could not possibly be further away from my constituency, which is in the Pennines on the Yorkshire border. Option 2 is to have 40 dementia in-patient beds on two specialist sites, one in Blackburn and one in Blackpool. Option 1 gets three pages of glowing support, whereas option 2 gets two pages, almost a third of which points out its “Issues”—or, should I say, “Disadvantages”?

I have in my hand the consultation document, which is available in all libraries in Pendle, Ribble valley and the rest of Lancashire. It even goes so far as to have a wonderful diagram showing the two options available—option 1 includes a nice little flower, whereas option 2 has a mucky bit of grass. Now, call me a cynic, but I remember a similar document, ironically entitled “Meeting Patients’ Needs”, being published under the previous Government. It led to our local accident and emergency department at Burnley general hospital being downgraded, despite massive and cross-party public opposition. Although I am a massive supporter of the work done by Lancashire Care, sadly, the consultation document strikes me as very similar. When reading it, I cannot help thinking that the decision in favour of Option 1 has already been taken and that the consultation is all about getting the public to rubber stamp it.

I, for one, will not be voting for Option 1. I will not be supporting the relocation—given the location of Blackpool, it can hardly be called centralising—of all specialist dementia in-patient beds, for a range of reasons. Primarily, the location is in no way central to the population served. It would be almost impossible for friends and family to get to without a car, and even then it would be a very long drive. Given the distance, it would be almost impossible for contact to be retained between the dementia sufferer and not only their family, but their community care team.

We are talking about only a small number of people who would need to use these specialist in-patient beds, but the reduction from the current 65 beds to 30 beds is too much, too soon. The Blackpool option, if approved, would be up and running in 2015, and even the consultation document admits that current usage of the 65 in-patient beds across Lancashire stands at 46, or 70% utilisation. I appreciate that redirecting resources from in-patient services to community services will help to reduce dementia admissions, but with growing dementia rates and an ageing population, just 30 beds for a county the size of Lancashire seems too few. The lack of information provided on how community services will be enhanced with redirected funding also gives me great concern.

In Lancashire, there are already at least 17,600 people aged 65 or over with dementia, and these numbers are expected to rise to more than 25,600 by 2025. We are also seeing increasing numbers under this age being correctly diagnosed with dementia. After speaking to a number of local GPs and local health commissioners in East Lancashire, I know that many of them, too, will be supporting the option of two sites with 40 beds between them rather than one with 30. I hope that other clinicians, people with dementia and their carers will also support this option and respond to the consultation before it closes on 25 February.

health

Andrew Stephenson Excerpts

Tuesday 18th September 2012 Commons Chamber

[Andrew Stephenson (Pendle) (Con)]

I recently spent the day out and about with the North West ambulance service and want briefly to cover my experiences with them.

The North West ambulance service is England’s largest ambulance service, with more than 5,200 staff, 109 ambulance stations and three control centres. It deals with more than 1 million emergency calls every year and although it also provides a non-emergency patient transport service, my day focused on the emergency medical response that it provides 24 hours a day, 365 days a year.

On Thursday 30 August I joined local paramedic Andy Swinburn in a rapid response vehicle that was responding to emergency calls across the Burnley and Pendle area. Although I am sure that many hon. Members would enjoy being in the passenger seat of an emergency services vehicle with the blue lights flashing, I wanted to witness the challenges faced daily by staff from the Barnoldswick, Nelson and Burnley ambulance stations.

During the shift, the vehicle I was in responded to nine blue-light emergencies, seven of which were in my constituency of Pendle. I am told that that was a quiet day, and it certainly was compared with the day before, when the air ambulance was called out twice to east Lancashire. For someone such as me, however, who had never spent any time with the ambulance service before, it certainly seemed anything but quiet.

During the day, the paramedic I was with dealt with everything from people having dizzy spells and epileptic fits to suspected heart attacks and someone who had serious-looking head injuries after falling from a ladder. In between calls and when I met other paramedics at the Nelson ambulance station, we discussed a range of issues from the classification of different emergency incidents and the value of the eight-minute response time through to problems caused locally by alcohol and drug misuse.

We also discussed the question of which hospital a patient is taken to, which has been an issue of much concern among people locally after Burnley general hospital’s A and E department was downgraded to an urgent care centre in 2007. The people involved in the calls we responded to during the shift were taken to Airedale, Burnley and Blackburn hospitals, depending on which was best placed to treat the individuals concerned.

We also discussed something of which I was previously unaware, which is that paramedics are currently unable to prescribe drugs. I would appreciate the Minister’s thoughts on that—I, too, welcome him to his new role. It seems entirely logical to me that if a senior paramedic can diagnose a problem while in someone’s home, they should be able to prescribe the required drugs rather than having to call out a GP or take the individual to hospital.

Another issue worth considering is the basis of commissioning of ambulance services. When asked about ambulance services, the public will invariably put the speed of response above all other concerns, including the quality of care. The eight-minute response performance indicator in part reflects what the public say they want. However, some of the paramedics I spoke to felt that if they were commissioned on the basis of being able to treat people with certain conditions at the scene, usually the person’s home, there could be considerable savings to the NHS. That links to my point about paramedics being able to prescribe the required drugs.

Although such a commissioning move would undoubtedly have a range of knock-on impacts, it was clear from the day I spent with the ambulance service that many people did not want to be admitted to hospital and would have much preferred to have stayed in their own home. I know that the Minister, given his background, will be acutely aware of not only the cost of hospital admissions, but the stress and other complications that such admissions can lead to.

Overall, I felt that the day gave me an invaluable insight into the work of our local paramedics and the ambulance service. Although I have never needed to use the ambulance service—thank God—it was hugely reassuring to see the professionalism and dedication of those who work in it. I will conclude simply by extending my thanks to the North West ambulance service, to Andy Swinburn, the senior paramedic I spent the day with, and to all our local paramedics for the remarkable job they do.