health

Iain Stewart Excerpts

Tuesday 18th September 2012 Commons Chamber

[Iain Stewart (Milton Keynes South) (Con)]

I am grateful for the opportunity to speak about community health services in Milton Keynes. Before I outline the issue that is causing concern locally, I will set out the background.

Milton Keynes council, the primary care trust and Milton Keynes Community Health Services have a 12-year history of working collaboratively to deliver jointly commissioned and provided services to the citizens of Milton Keynes. That has been possible because the three organisations share a common vision and common values, and are committed to the principle of local services for local people. The collaboration has supported a transformational approach, which has delivered financial efficiencies and good quality outcomes for people. There is a single joint management structure, which manages combined budgets and resources, and works to a single operational policy.

The collaboration covers mental health and learning disability services, intermediate care services for older people and community equipment. Additionally, there is an integrated pathway involving adult community nursing, end-of-life care, community matrons and social workers. I put on the record my deep appreciation of the invaluable role that those dedicated professionals play in our communities. They often go unsung, so I would like to take this opportunity to record my gratitude.

To achieve such a locally tailored, integrated model is one of the admirable aims of the Government’s health and social care reforms yet, oddly, our successful local model may be at risk because of administrative factors. I hope that common sense can prevail.

Last year, it was hoped that there would be a managed transfer of the community health services to Milton Keynes Hospital NHS Foundation Trust. However, that was not achievable within the required timetable and the PCT enacted a temporary divestment to Bedford Hospital NHS Trust, in full agreement with the strategic health authority and in full knowledge of the anticipated later divestment to the foundation trust. That is an acceptable hosting arrangement that will allow the integrated model to continue.

On 14 December last year, the PCT wrote to the foundation trust, inviting it to submit a proposal for the managed transfer of the community health services, which was to be considered by the PCT board at the end of February this year. However, on 22 February, the cluster PCT received e-mail communication from the head of provider development at NHS East Midlands, which advised that it should follow an open tendering process.

On 11 April, following strong representations from the council and local health partners, a positive meeting was held with Bob Ricketts at the Department of Health, where it was indicated that a managed transfer of the community health services to the hospital would be possible, subject to SHA assurance. However—the situation gets more complicated—a letter from Sir Neil McKay, of NHS Midlands and East, advised that the transfer was no longer possible and that the PCT should proceed towards a competitive tendering process for NHS providers only.

On 12 June, my hon. Friend the Member for Milton Keynes North (Mark Lancaster) and I raised questions in the House on this issue. In response, the then Secretary of State for Health urged the PCT and the SHA to ensure that any decision was in the best clinical interests of patients. He stated that it must meet the views of clinical commissioners of the future and those of the public, not least as expressed through the local authority.

Following that, NHS Midlands and East met Milton Keynes council and its partners to discuss the position adopted by the SHA. It was agreed that a meeting should be convened to assess the case for an integrated care organisation. However, it was also agreed that the cluster PCT should continue with a twin-track approach, including an expressions-of-interest process.

Finally, on 11 September, NHS Milton Keynes and Northamptonshire cluster PCT received advice from the NHS Midlands and East SHA to progress with an NHS-only competitive procurement for the services currently provided by Milton Keynes Community Health Services. There has, therefore, been a sequence of contradictory advice from different parts of the NHS, which has thwarted the ambitions of the council, local health partners and patients’ representatives to achieve the best local solution for our citizens—an integrated care organisation in Milton Keynes.

All that is happening at a time when the NHS landscape is changing. The SHA and PCT will be wound up next year, and there is an acute services review that may change the configuration of the local hospitals. My call, and that of my hon. Friend the Member for Milton Keynes North and many local people, is quite simple: the temporary hosting arrangement should continue for the time being, until the new NHS landscape is settled and a sensible permanent arrangement can be found. My hon. Friend and I have raised this matter with the Secretary of State. In welcoming the Minister to his new role, I hope that he will ask the Department to intervene in any way that it can to achieve the common-sense solution, for which there is much local appetite.