Kettering General Hospital Urgent Care Hub

Debate between Jim Shannon and Philip Hollobone

Tuesday 3rd September 2019 Westminster Hall

[Mr Philip Hollobone (Kettering) (Con)]

I beg to move,

That this House has considered the urgent care hub at Kettering General Hospital.

May I say what an unexpected pleasure it is to see you in the Chair, Mr Bone. I am sure that we will all benefit from your wise guidance and counsel. I thank the Speaker for granting me this debate and welcome the Minister to his place. We are joined today by Mr Simon Weldon, the outstanding chief executive of Kettering General Hospital, our very popular local hospital. Of course, you will know him as well as I do, Mr Bone.

Kettering General Hospital is an extremely popular and well-liked local hospital. It is 122 years old this year, and still occupies the site that it first occupied in 1897. There cannot be many hospitals in the country that are still based almost entirely in their original locations from more than a century ago.

Today, we are talking about the urgent need for an urgent care hub on the Kettering General Hospital site. We need the urgent care hub because the hospital is such a popular one that it simply cannot cope with the number of patients admitted to A&E at the moment. Everyone—all the local NHS professionals in every NHS organisation in Northamptonshire—agrees that the best solution to the challenges the hospital faces is £49 million for the development of an urgent care hub on the site, which the hospital needs.

An urgent care hub would basically be a one-stop shop for GP services and out-of-hours-care, an onsite pharmacy, a minor injuries unit, facilities for social services and mental health care, access to community care services for the frail elderly, and a replacement for our A&E department. The most crucial aspect of that is the A&E department, which was built 25 years ago in 1994 to cope with 40,000 attendances each year. Last year, 91,200 patients came through that very same A&E. This year, we are on track to pass the 100,000-mark for patient attendances, which is well over 150% of the department’s capacity. By 2045, 170,000 attendances are expected at the same site

[Jim Shannon (Strangford) (DUP)]

It is not only Kettering General Hospital—A&Es across many constituencies suffer from similar problems. Does the hon. Gentleman agree that we would all benefit if, in A&Es—particularly that of Kettering General Hospital, which the debate is about—there were better patient care and a better working environment for health professionals? In A&Es, it is important that health professionals are happy in their work and feel that they can move forward in what is possibly the most stressful specialty. In the long run, the investment to which the hon. Gentleman referred will pay for itself in better patient outcomes and better staffing capacity.

[Mr Hollobone]

I am most grateful for that unexpected contribution from Northern Ireland—it is always a delight to see the hon. Gentleman in his place, and I thank him for his support. Of course, I agree that A&E facilities across the country are under pressure, but that pressure is particularly acute in Kettering, not least due to the number of houses that are being built locally, the increase in the local population and the fact that—thank goodness—we are all living longer. In Northamptonshire, there has been a particular increase in the number of elderly patients who are served by the local hospital. I thank the hon. Gentleman for attending and for his support.

In 2016, Dr Kevin Reynard of the national NHS emergency care improvement programme visited Kettering’s A&E and concluded that:

“The current emergency department is the most cramped and limiting emergency department I have ever come across in the UK, USA, Australia or India. I cannot see how the team, irrespective of crowding, can deliver a safe, modern emergency medicine service within the current footprint.”

Simon Weldon is also extremely concerned about patient safety. He said to me that unless we get the situation sorted, sooner or later there would be a patient death in Kettering’s A&E.

An impact of the incredibly cramped department is that staff do not have clear lines of sight on some of the most unwell patients to monitor their conditions appropriately. Privacy and dignity for patients cannot be maintained due to overcrowding and cramped spaces. Patients wait longer than the national limits, as there is physically not enough space to treat the numbers coming through the door. Children have to wait in open corridors and go through adult areas to receive treatment. A lack of space to offload ambulances often results in long queues and inhibits ambulance response times to 999 calls. The A&E rooms do not comply with many current health building standards and there is a lack of natural daylight.

The Care Quality Commission and other inspections have consistently raised multiple concerns, for both adult and paediatric patients, about the size and limitations of the estate. Most importantly, as I have described, the number of patients has now reached a critical point and staff need to manage safety daily, patient by patient. For health professionals who take pride in their job, the challenges of working in Kettering A&E are becoming unbearable.

In the next 10 years, local population growth is expected to far exceed the national average and our catchment includes the fastest growing borough outside London, in our neighbouring constituency of Corby. In the last census, out of 348 districts across the country, Kettering was sixth for growth in the number of households and 31st for population increase, while Corby has the country’s highest birth rate. Our local area has been included as part of the Cambridge-Milton Keynes-Oxford corridor, in which there is a commitment to build 35,000 new homes in the next 10 years.

Kettering General Hospital expects a 21% increase in over-80s and 10,000 more A&E attendances in the next five years alone. Despite some temporary modifications over recent years, including moving other patient services off the hospital site to accommodate delivering safe emergency care, detailed surveys show that there now remain no further opportunities to extend the current department and that a new building is required on the site.

Following those safety reviews and surveys, the hospital has developed a business case for a fit-for-purpose emergency care facility that will meet local population growth for the next 30 years. It was developed with all health and social care partners across Northamptonshire, so that patients can get a local urgent care service that meets all government guidance on good practice, ensuring that they get the care they need to keep them safely outside of hospital and that they are cared for by the right clinician at the right time, first time.

The urgent care hub would be a central cog in a whole-system approach to delivering urgent care services to meet the needs of the population, and it would work alongside GP, mental health, community and social care services. The hub continues to be identified as the highest clinical safety priority across the whole of the county by Northamptonshire sustainability and transformation partnership. It was also approved by the NHS Improvement midlands and east regional team as the highest priority submission for central capital funding.

We are talking about £49 million and about Northamptonshire being the only one of all 44 STP areas in the country not to receive any capital funding at all in the past four waves of such funding from the Department. Why is that the case? If the Minister were to agree to the urgent hub proposal, he would put that wrong right. The trust can access only £3.5 million annual capital through its own funding, and the county, Northamptonshire, has only £20 million, but that is used simply to maintain essential equipment and to repair heating and lighting systems. Kettering General Hospital therefore requires central funding or some form of private financing to build the facility.

A bid has been submitted as the highest clinical priority for funding across the whole of the NHS in Northamptonshire, and for NHS Improvement regionally, but Government capital allocation announcements over the past few weeks have not included the urgent care hub, nor any other moneys for Northampton or our local region. I simply do not understand why Kettering General Hospital has been missed off the list. The national NHS Improvement team has indicated that no further STP capital funding will be announced until spring 2020, although I understand that the Government are now reviewing all spending allocations across all Departments in the comprehensive spending review expected later this week. Local people will be very surprised if Kettering General Hospital is not included somewhere in that review.

Given the clear patient safety concerns at Kettering that have been recognised locally, regionally and nationally by NHS experts, what process did the Government follow to award schemes the central NHS capital allocations in recent weeks? Why was Kettering not included? Why were some awards made to areas with no apparent clear and worked-up business case, when Kettering has such a case? Given the lack of access to further NHS capital funding, what are the alternatives for Kettering General Hospital without a central grant of funding from the Department of Health? Furthermore, how are the Government correlating healthcare decisions with the locations of planned growth in housing?

I do my humble best as the local elected representative to express such concerns. The chief executive of the hospital, Simon Weldon, would have made a far better job in this debate than me, but I will quote some of the dedicated healthcare professionals in our local hospital. They will outline the challenges that they face far better than anyone else.

The head of children’s safeguarding at the hospital, Tabby Tantawi-Basra, said:

“Children have to wait in corridors alongside seriously unwell, drunk or mentally unwell adults. This causes a serious safeguarding concern as our staff are not always able to have line of sight on them.”

Sarah Parry, who is a nurse in end-of-life care at the hospital, said:

“When a patient is brought into A&E dying or already passed away, there is no space where relatives can sit quietly to receive the news and grieve. We can’t even make them a cup of tea—they have to share a facility with the staff room!”

Jacquie Barker, the head of adult safeguarding, said:

“We know from the Winterbourne View scandal that the lack of privacy and dignity for vulnerable adults seriously impacts their mental wellbeing. Sadly our facilities mean even our most vulnerable adults are looked after in very cramped conditions, sometimes next to disruptive or aggressive other adult patients.”

Claire Beattie, the head of nursing medicine at the hospital, said:

“Our staff work tirelessly to keep patients safe under the most difficult of conditions. The way the treatment areas are configured means they struggle to easily communicate or ask for help, and if patients are deteriorating then it isn’t always easy to see that quickly and give the urgent help they need.”

Leanne Hackshall, the director of nursing, said:

“Patients are so close together they can almost hold hands. And if someone is being sick or coughing badly in the next space then every other patient worries about who they are so close to.”

Polly Grimmett, the director of strategy, said:

“As Director on call in August, we had over 100 patients in the department for most of the night and it’s only safely meant to fit 40—there were 10 ambulances with patients queuing. This is meant to be our quietest month so who knows how bad it will be in December!”

Nicola Briggs, the director of finance, said:

“If we stopped spending any money at all on necessary things like replacing light bulbs or fixing equipment, then it would still take us nearly 15 years to save up enough money ourselves.”

The urgent care hub is, as far I am concerned, the No. 1 priority for local people in Kettering. The general hospital is much loved, and we need more investment to cope with the growth in the local population and to care for our increasingly aged population. I invite the Minister to visit the hospital and to see the A&E department for himself. If he does so, he will follow in the footsteps of two previous Ministers with responsibility for hospitals and the previous Secretary of State.

The problems are well known in the Department of Health, and I simply do not understand why £49 million—not very much in the context of the size of the whole NHS budget—cannot be allocated to fund the badly needed urgent care hub at Kettering General Hospital. All the local NHS bodies agrees that the hub is the answer to the difficulties and challenges faced by the hospital.

More patients are being treated at Kettering General Hospital than ever before. Their treatment is increasingly world-class, and I thank all the dedicated NHS professionals in our local hospital for their magnificent work. In order to help them face the challenges ahead, we urgently require £49 million from the Government for this badly needed urgent care hub facility.

Colombia Peace Process

Debate between Jim Shannon and Philip Hollobone

Tuesday 18th June 2019 Westminster Hall

[Jim Shannon]

I agree with the hon. Lady. Clearly, paramilitary groups think that they are above the law, and they are carrying out atrocities. They need to be accountable and to stop that; if the peace process is to go forward, we need to ensure that those who have the power are doing their best to stop these things.

There have been kidnappings, and people have gone missing. In Northern Ireland, we always wished for the remains of those who were kidnapped, murdered or disappeared to be found and returned to their families. It is important to have that in place—for families to have the final resolution of being able to bury their loved ones in graves, and to have time to grieve for people who had disappeared. The hon. Member for Cardiff Central referred to many examples of people being disappeared, although in one case the person was found because the security forces were still trying to dispose of his body.

I am my party’s spokesperson for human rights, and they feature at the top of my agenda, in whichever country they are being abused. We need action to stop women being sexually abused and horribly tortured by security forces. We also need to help those activists—we have been aware of some of them for a number of years—who have been kidnapped and disappeared. Some journalists, who are spokespeople for human rights issues and who have made the world aware of what is going on, have disappeared and never been found—any dissent has been trampled on right away.

I am not any smarter than anyone else—far from it—but coming from Northern Ireland and having a personal knowledge of the country, I perhaps understand more than some others in this place the emotional trauma that is passed from generation to generation of those who have suffered at the hands of paramilitaries, as well as the impact and lasting legacy the hon. Member for Sheffield, Heeley (Louise Haigh) referred to in her intervention. That can only be dealt with in two parts. First, we must allow time for wounds to heal over without anyone picking open the scabs. That means an end to violence and the threat of it, so that people can grieve and learn how to exist in a new nation where everyone is equal. Secondly, opportunities are required for things to be different—for children to be educated and get paying jobs, for skills to be taught, for work to be made available so that people can earn a wage, and for communities to recover.

We should do more, while not overstepping. I look to the Minister, whom I respect greatly, and who understands my passion for these issues, to explain the view of the Department, in particular, and the steps that can be taken so that we can play a small but valuable part in this process for peace.

[Mr Philip Hollobone (in the Chair)]

I have two observations to make. First, rarely can a country-specific debate have been held immediately before a presidential audience to which the Minister of State responding has been invited. Secondly, we have a little more time available for the Front-Bench speeches than we thought. As long as the process is not abused, I am prepared to be flexible with the guideline limits for the Front-Bench speeches.

Healthcare: East Midlands

Debate between Jim Shannon and Philip Hollobone

Tuesday 30th April 2019 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

Whether we are discussing healthcare in the east midlands or in Northern Ireland, the issue of suicide is prominent in my constituency. When I became its MP in 2010, the level of suicide among young people was at its highest. That was dealt with through the involvement of community groups and of people in the community who had lost loved ones. There was also interaction with church groups and those of faith. By coming together, we reduced the incidence of suicide, and by working alongside healthcare in Northern Ireland, which is a devolved matter, we found that together, we could address the issue. It took both the community and healthcare to make that happen.

[Mr Philip Hollobone (in the Chair)]

Before Mr Tredinnick responds, I remind the Chamber that there is half an hour of Back-Bench time left, with two other Members seeking to contribute.

Childcare for Fostered Children

Debate between Jim Shannon and Philip Hollobone

Tuesday 19th December 2017 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate, Mr Hollobone. I congratulate the hon. Member for Wigan (Lisa Nandy) on securing the debate and on enabling us all to make a contribution if we so wish—I clearly wish to do just that.

I am pleased to see the Minister in his place and to have heard his early concession—if that is what it was—to the hon. Member for Wigan. We will wait to hear what he has to say at the end of the debate, but I am sure, as is always the case, that he will be most helpful to us, the Members of this House.

This is a worthy debate, and one to which I certainly wish to contribute. I am the proud grandparent of the most beautiful little girls in the world—Katie who is eight and Mia who is three. Thankfully, they do not look anything like me; they are lovely young girls and will have probably all the boys in my part of the country chasing them when the time comes. When I look at those feisty little girls, who take no nonsense from anyone and are so wise for their age, I am thankful for the home life they have, which sees them so well adjusted. That is something we are very thankful for; indeed, all of us, as parents, would be thankful for that. I am so very aware that not all children have that stability, and I believe it is our duty to do the best we can to intervene here, which is why the hon. Member for Wigan has introduced the debate.

I want to place on record, if I may, Mr Hollobone, some remarks about Northern Ireland. I understand very well that this is an England-based debate, but I want to have on the record where we are on foster care in Northern Ireland. The hon. Member for Colne Valley (Thelma Walker), sitting here on my left, made representations to the Backbench Business Committee to ask for a debate on foster issues, and we look forward to contributing to that debate in the new year.

While I understand that this is clearly an England-based debate, as the childcare hours apply only in England, I want to set the scene in terms of need in our society. In Northern Ireland 2,212 children were living with foster families on 31 March 2016. That is nearly nine tenths—some 88%—of the 2,500 children looked after away from home. There are approximately 2,095 foster families in Northern Ireland. The Fostering Network estimates that fostering services need to recruit a further 200 foster families in the next 12 months. That could be dealt with in answer to the hon. Lady’s debate, and we look forward to that.

In England, 53,420 children were living with foster families on 31 March 2017. That is nearly four fifths of the 68,300 children looked after away from home. There are 44,625 foster families in England. The Fostering Network estimates that fostering services need to recruit a further 5,900 foster families in the next 12 months. The hon. Member for Wigan mentioned a figure of 7,000. The figures I looked at were slightly different, but whether it is 5,900 or 7,000, it clearly tells us one thing: there are not enough foster families.

You may wonder why I am raising the issue of foster care places and need, Mr Hollobone. If good, hard-working people who worked two jobs and had love in their hearts but not necessarily the time to be there straight after school and so on could access childcare places, we may well find more people were able to foster. They could do their day’s work like so many other families and offer support and help to children who need it. That is how I see it, and it is what my contribution will focus on. I hope it will support what the hon. Member for Wigan said, what every one of us will say in our contributions and what the Minister will say in his response.

Many of these children crave the routine that living in a busy functioning household entails. While some people may believe that their normal working hours may preclude them from providing a loving home for a child, that is not the case. When my two grandchildren come to our house—I am not there all the time to see them—it is great because at 7 o’clock we can give them back. It is fantastic. It is one of the wonders of being a grandparent. We get all the fun, but when they get a bit rowdy or tempestuous at night when it is time to go to bed we can return them to their mum and dad with great pleasure. When my wee girls come, they love the busyness of the house. They love the fact that their grandmother and perhaps their grandfather are busy around the place. Whatever we are doing, they want to help. If I am doing repairs in the workshop, they want the hammer. That is not a good thing, but sometimes they want to have a hammer in their hands. I am always very careful with what they are doing. It is that busyness that they want. I believe in my heart that young people want to be part of a busy functioning household.

The hon. Member for Coventry South (Mr Cunningham) asked the Secretary of State for Education about the extension of additional child care hours to foster carers—I spoke to the hon. Gentleman beforehand and told him I was going to mention this—and I was heartened to learn that the Department is minded to consider that extension. I hope that the Minister will tell us that, too. I add my voice to the calls of my colleagues and ask for consideration of the benefit that the extension could produce, with more people willing to add a foster child into their family while being able to work part-time and keep their career in place.

In 2015, only one in 10 mothers were able to be a stay-at-home mum and only one in 100 fathers were able to stay at home. The family has changed and more people need to work, but we need to ensure that those who have the ability and desire to foster children in a warm and loving home are not put off by worrying about needing to put the child into some form of day care. That does not mean they are unable to meet the needs of the child. As long as there is a routine for children, I believe that the scheme and change to childcare that the hon. Member for Wigan clearly outlined could encourage more people to realise that they can have it all.

[Mr Philip Hollobone (in the Chair)]

I call Thelma Walker.