Urgent Care Centres: Hillingdon
Debate between Karin Smyth and David Simmonds(3 weeks, 6 days ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Minister for Secondary Care (Karin Smyth)
I am grateful to the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) for securing this debate. He mentioned that his wife works in the system, so I pay tribute to her for her service in the local trust.
As the hon. Gentleman alluded to, I am a Hillingdon girl; it is where I was brought up. My brother was born in Hillingdon hospital, some 59 years ago. It was a great pleasure to be there recently with my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales). Some years ago, I predicted that we might have a Labour MP there, so after being around the area for a long time, I am personally very pleased to see that.
The hon. Member for Ruislip, Northwood and Pinner tempted me to move into the wider areas of what are rightly a to-ing and fro-ing on some of the bigger pressures in that part of north-west London and into Hertfordshire. I will not go into that, but it is absolutely right that hon. Members use this platform to share their campaigning on behalf of their constituents.
Service changes such as these are always hard and they are rarely popular. I have been the Member of Parliament for Bristol South for more than a decade, and before that I was an NHS manager, so I have seen many service changes and reconfigurations over the years. Like the hon. Gentleman, I was also a non-executive director in a past life. All the changes that I have seen were done through good consultation, with strong clinical leadership and a good clinical case, and involved patients and the public.
I strongly believe that patients, public and staff are often ahead of the wider system and sometimes of politicians in knowing the balance of the money, the funding, the good value for taxpayers’ money, clinical outcomes and safety. If they are managed well, those conversations and the sorts of debates we are having tonight can often yield better results than maintaining the status quo or decisions made behind closed doors. I am familiar with such debates, as like many of us I often found myself standing where the hon. Member for Ruislip, Northwood and Pinner is, advocating for my constituents against changes that I thought were not in their best interest or not clearly communicated. He was right to secure this debate.
David Simmonds
I agree with every word that the Minister has said about how we get good decisions in the interests of local people, but does she share my concern that there has been no public consultation about this decision at all? There has been very limited engagement even with local residents’ associations about the process and, for the staff involved, there has been some—shall we say—degree of ambiguity about what decisions have been made at each stage of the process. Does she agree that it would be wise at this stage, as a very minimum, to pause, to think again and to undertake that public consultation, so that the NHS managers tasked with making the decisions fully understand the impact on the local community?
Karin Smyth
I will comment on that later. I understand that there is a meeting on Friday, to which I will allude.
In preparing for the debate, I met representatives of the trust, and I am grateful to those in the local NHS for their time in giving some further background. The trust is clear that it would be more efficient for urgent care services to be consolidated at the site in Hillingdon, bringing forward the urgent care nurse practitioner service at Mount Vernon into the urgent treatment centre at Hillingdon hospital. The rationale for having urgent treatment centres alongside A&E is well established clinically.
The hon. Gentleman referenced the 10-year plan—I am pleased he is such a fan—and the direction of travel. I am pleased to say that the trust also believes that people are better served by primary care hubs, so that more responsive care can be delivered closer to where people live. Three such hubs are being developed in Hillingdon, one of which will be in Ruislip. I am sure that he welcomed the announcement this week of the roll-out of the first of the 43 hubs, including the one in Hillingdon, which will deliver the neighbourhood health services model.
Karin Smyth
I understand what the right hon. Gentleman says. I have seen some of those promises made and not delivered over many years. It is important that Members of Parliament are involved and that there is a wide conversation with the ICB and the trust around those changes and the development that they make towards delivering the 10-year plan.
My right hon. Friend the Prime Minister announced that we would bring together NHS England and the Department for Health and Social Care precisely because we think that democratic accountability for £200 billion of taxpayers’ money is important. However, that accountability does not mean micromanaging, or intervening in every difficult decision that the ICB makes. We expect local NHS organisations to make changes and to reconfigure their services as best needed by the people they serve. That is in line with the direction outlined in the 10-year plan.
My right hon. Friend the Secretary of State for Health and Social Care has received several requests to intervene on a number of issues. Having looked at them thoroughly and assured himself that patient safety and access were guarded, he has decided not to intervene in nine reconfigurations. Getting our NHS back on its feet is a team effort, and we have to trust local NHS leaders to deliver. Decisions that affect the people of Hillingdon should be made in Hillingdon—it is not for someone sat behind a desk in Whitehall to make those decisions for them.
Having said that, I want to assure colleagues that that does not mean we will give local leaders a blank cheque to do whatever they like. Yesterday, we published a data tool and league tables that make NHS performance open and accessible, to inspire improvement and deliver a better NHS for all. Those NHS organisations that are doing well will be rewarded with greater freedoms, such as in how to spend their capital, and those that demonstrate the best financial management will get a greater share of capital allocation. We want to move towards a system in which freedom is the norm and central grip is the exception, in order to challenge poor performance.
Improving services for patients should be rewarded; the quid pro quo is that there will be no more rewards for failure. Undertaking the reforms we have set out to make as a Government will require a good deal of trust between central Government and local leaders, and we will build that trust only by showing those local leaders that we trust them to get on with the job and make difficult decisions where necessary.
Karin Smyth
I am going to pursue this point, if I may. Debates about service changes and reconfigurations have gone on since the birth of our NHS. I understand that they are really important for local people, and I understand the level of discussion about this issue and—as the hon. Gentleman has outlined—the wider impact on areas such as Watford. It would be easy for this Government to make ourselves popular by sacking some managers and promising people that services are never going to change, or that they will never close in any part of the country, but we were not elected on a populist platform, and it would not be in patients’ long-term interests not to reform and modernise the system.
We are building an NHS that is fit for the future. That is what the 10-year long-term plan is based on—moving services from hospital into the community, from analogue to digital, and from sickness to prevention. We expect local NHS leaders to make that happen. They must do so with local clinical leadership in the best interests of the populations they serve, and they must do it with the public—we expect open and transparent communications going forward. Local politicians have an important role in that, which Members present in the Chamber have demonstrated ably, and will continue to do so. I would be very happy to maintain contact with the hon. Member for Ruislip, Northwood and Pinner. The wider implications of the issues he has raised need to be outlined to him, and I commit to writing back to him about the consideration that is being given to those wider implications. I note his concerns, and I am happy to continue working with him.
Question put and agreed to.