Maternity Services (Morecambe Bay)

Lord Walney Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Mr Hunt]

I am happy to do that. In fact, I can not only tell my hon. Friend what we are going to do, I can tell him what we have done. The main purpose of the new CQC inspection regime, with a chief inspector of hospitals and a special measures regime, is to make sure that these issues come to light much more quickly. The new regime has been very active: 20 trusts—more than 10% of all trusts in the NHS—have gone into special measures. We have seen dramatic improvements.

I would like to make a broader point to my hon. Friend’s constituents. He speaks very wisely when he says that this is not about the dedication and commitment of front-line staff. He is absolutely right. The Royal Lancaster infirmary is not the main focus of the Kirkup report, but of course as part of the same trust it suffered from the same management failings. There are Members of this House who have had problems at the Royal Lancaster infirmary and found that they were not listened to when they made complaints, because proper management was not in place. That will have affected his constituents. I hope they will take encouragement from the changes that have happened recently in that regard.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I thank the Secretary of State for the dignified and fitting way in which he was able to name some of the grieving parents and the babies they lost. We cannot escape the painful conclusion from the report that our hospital was compromised by some shocking failures in care and a deeply inappropriate defensiveness from certain individuals. Does he agree that the scale of failure laid out in the report may well serve to reopen the criminal investigation? Will he support the healing process that is now needed in our community, with resources if necessary, so that we can move on from this? Finally, will he set out a timetable by which he will look through all the recommendations and report back to the House on whether the Government will accept them? Will that be before the election?

Francis Report: Update and Response

Lord Walney Excerpts

Wednesday 11th February 2015 Commons Chamber

[Mr Hunt]

I add my congratulations to my hon. Friend, who makes an important point. The heart of the problem of whistleblowing is the confusion between employment law and patient safety. We need to divorce those two things and put in place a proper procedure to ensure that the right thing happens if someone raises a concern about patient care, and that it can be externally investigated to ensure that the trust did the right thing. Issues of employment law and someone’s professional behaviour should be pursued on a completely different track—those things are rightly and properly a matter for the courts. It is precisely because of the kind of issue he talks about that people are afraid to speak out. They worry that if they do, even if they win at an employment tribunal, they might never get a job again. For that reason, we welcome the shadow Secretary of State’s commitment to work with us and put on the statute regulation-making powers making it illegal for NHS organisations to discriminate against former whistleblowers.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Secretary of State and I spoke last week about the importance of the upcoming Kirkup report. Grieving families in my constituency want to be able to move on from the tragedies they have suffered and see proper change in the culture at Morecambe Bay. What happened was not right and is still under criminal investigation. Will the improvements the right hon. Gentleman has announced today be in place when the report is published, and does he agree that the response to it must be neither whitewash nor witch hunt? If he does, how can he help make it happen?

[Mr Hunt]

I thank the hon. Gentleman for the close interest he has shown in this issue and the constructive way in which he has engaged with families locally to try to get to the bottom of a really terrible tragedy. He puts it better than I could. We need to implement the recommendations in a tangible and real way so that something actually changes, but we do not want to do it in a way that has unintended consequences. That is why the focus of what Sir Robert is saying this time is not about new criminal sanctions. Although the law has a role—we changed the law on wilful neglect, for example—this is about creating a supportive culture through which people want to listen and learn when others speak out. Of course, if people do not, there should be sanctions, but that should not be the primary motivator.

NHS (Government Spending)

Lord Walney Excerpts

Wednesday 28th January 2015 Commons Chamber

[Dr Poulter]

As the hon. Lady will be aware, front-line staff use IT and understand the importance of joining it up to benefit patient care while also protecting confidentiality. On the point about district nurses, she is right that we need to transform the model of care, which is why the Government set up the £5.2 billion better care fund—to ensure we join up more effectively what happens between our acute hospitals, the wider NHS and adult social care. This approach will be transformative, delivering better care for the frail elderly and providing more care in people’s homes.

Of course, part of that is about changing work force models and ensuring that staff who have traditionally worked only in hospitals, supporting people with long-term conditions such as multiple sclerosis, can also work in the community. [Interruption.] The hon. Lady is chuntering away, but I have answered her question in an informed and sensible way, having spoken about how our work force models need to change as part of our investment in integrating and joining up care so that patients looked after now in a purely hospital environment can have access to staff across both community and hospital care, which is important for people with long-term conditions such as diabetes, multiple sclerosis and dementia. I hope she can support that.

It is also important to consider some of the equally important funding decisions we have made in maternity care. In 2013-14, we provided £35 million of capital funding for the NHS to improve birthing environments, which represents the single biggest capital investment in maternity care for decades. That has benefited more than 100 maternity units, including through the establishment of nine new midwifery-led birthing centres in eight areas, and transformed many local maternity services across the country. Improvements delivered by our maternity investment fund include: more en-suite bathroom facilities in more than 40 maternity units, providing more dignity and privacy for women; more equipment such as beds and family rooms in almost 50 birthing units, allowing dads and families to stay overnight and support women while in labour or if their baby needs neonatal care; and bereavement rooms and quiet areas at nearly 20 hospitals to support bereaved families after the thankfully rare but always tragic loss of a baby.

Our £35 million maternity investment has made a big difference to the experience mums and families have of NHS maternity services.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

Will the Minister give way?

[Dr Poulter]

I have been very generous in giving way, but I must now make some progress.

[John Woodcock]

rose—

[Dr Poulter]

No, on this occasion, the hon. Gentleman will have to forgive me.

Our capital investment in maternity services, which, as I said, is the biggest for decades, is making a big difference to mums, dads and new families. Thanks to our investment in the midwifery work force, we now have the highest ever number of midwives working in our NHS—about 2,000 more than in 2010—providing more personalised care and support for women and new mums. However, we must all recognise the challenges facing our health and care system in the months and years ahead. NHS England’s “Five Year Forward View” argued that we needed to do more to tackle the root causes of ill health through a radical upgrade in prevention and public health; to give patients more control over their own care, including through the option of combining health and social care, and new support for carers and volunteers; to ensure the NHS changes to meet the needs of a population that lives longer; and to develop and deliver new models of care, local flexibility and more investment in our work force, technology and innovation, some of which I have already outlined.

That is why the Government have provided additional funding for NHS front-line services in 2015-16, including £200 million to pilot new care models and £250 million for the first tranche of the new £1 billion fund, spread over the next four years, for investment in new primary and community care facilities to support our GPs and primary and community care work force in the important work they do. In community care, we are committed to undoing the terrible mistake that was Labour’s 2004 GP contract, which left so many people, particularly the frail elderly, without the GP care they needed at evenings and weekends. Our investment will support GPs to provide care for patients seven days a week so that patients will once more be properly supported during evenings and weekends. We are also training an extra 5,000 GPs, in addition to the 5,000 extra we have already seen under this Government, to provide that care.

We are clear, however, that if the NHS is to meet the challenge of increasing patient demand and expectations, it cannot stand still. By 2018, 3 million people in our country will have three or more long-term conditions, so we must continually adapt and change how we deliver care to support patients, families and carers, and deliver more care in people’s homes and communities. For our part, and as part of our plan for our NHS, not only are we delivering a strong economy so that we can protect our NHS budget, but we will continue to be ruthless in delivering greater efficiencies in estate management and procurement and in reducing back-office costs so that we can reinvest that money in front-line patient care. Furthermore, we will continue to back front-line staff with the training, equipment and new technology they need to do their job and provide high-quality patient care, which is why we have already made available an additional £2 billion down payment to deliver NHS England’s “Five Year Forward View” and why the Prime Minister has committed to continuing to protect our NHS and ensuring that it has the additional money it needs to deliver first-class patient care in the months and years ahead.

In conclusion, I would like to thank the dedicated NHS staff working incredibly hard to keep us well looked after and safe in this busy winter period. As a practising doctor—I know Labour does not like it, given its dearth of real-life experience and the number of former special advisers on its Front Bench—I know how hard our NHS staff work and how dedicated they are to delivering the highest-quality patient care. I remind the House that we have been able to increase the money available to our NHS only because we have the growing economy to pay for it; because our long-term economic plan is working; and because, under this Conservative-led Government, there are more people in work than there were under Labour. Anybody who does not have an economic plan for the economy—and Labour has no plan for our economy, as has certainly been clear in today’s debate—does not have a plan for the future of our NHS. Through economic policies and by creating growth and jobs, we have been able to announce additional NHS funding for 2015-16 without having to raise taxes, including on people’s homes, as Labour would like to. This gives our NHS the funding it needs to begin implementing the plan set out in NHS England’s “Five Year Forward View”, so that it can continue to be a world-class, sustainable health service, delivered free at the point of need.

When we came into power, we took two big strategic decisions with our NHS: to increase funding and to cut bureaucracy and waste, and to reinvest that money in more doctors, nurses and front-line staff and to improve front-line patient care. That is exactly what we have done, so the choice on 7 May will be clear: between a Labour party that bankrupted Britain and would do so again, at the same time bankrupting our NHS, and a Conservative Government, committed to securing our NHS by delivering a strong, stable and growing economy.

--- Later in debate ---

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I have a great deal of affection for the hon. Member for Daventry (Chris Heaton-Harris), but I have to say to him that the only people who are using that word are those on the Government Benches, because they apparently have nothing to say about the future of the NHS under the stewardship of a Conservative Government—God forbid—or about the real crisis that our accident and emergency services are suffering across the country. I should like to hear a little more from them about what they actually plan to do, rather than hearing this ridiculous nonsense.

We all know that the national health service faces major funding challenges in the years to come. NHS England has set that out clearly, and we have put forward concrete proposals to raise the extra money that our NHS needs. That will involve increased funding and, I have to say, radical reform. The merging of health and social care is a major undertaking that will unlock huge efficiencies and deal with one of the major pinch points of inefficiency that is wasting billions of pounds as well as creating great difficulties in people’s lives. Families simply do not know where to turn at the moment.

That scale of ambition has not been matched by the Government. In fact, at the very moment that they should be encouraging front-line workers to innovate and work together from the bottom up to come up with the new ideas necessary to take the NHS to a new level, they are tying them up with the red tape of compulsory competitive tendering. That is the last thing those people need at a time when a radical new approach to delivering services is needed.

I want to focus on the specific funding situation in the University Hospitals of Morecambe Bay NHS Foundation Trust. It is regrettable that the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter), who is a doctor, refused to take my intervention on the subject of maternity services. He must know, given that we have been talking about my maternity unit and maternity services across the Morecambe Bay area for some years now, that the situation is now critical. It will be the subject of a major report in the next couple of weeks, and there are real funding issues involved.

I shall run briefly through the trust’s recent funding history. In 2011, the University Hospitals of Morecambe Bay NHS Foundation Trust announced that it was facing a cut of £15 million—around 4% of its annual budget—as a result of the efficiencies and cuts to hospital funding being required by the Government. At that stage, it managed to avoid reductions in front-line staffing and facilities. The required additional spending resulting from the clinical and staffing failures found by the serious Care Quality Commission reports led to the trust’s finances falling into deficit by about £25 million annually. Ministers are still insisting that that must be eliminated.

The Better Care Together reconfiguration plan was submitted to NHS England and Monitor by the trust last July. It set out a scheme that would allow for up to £18 million of annual savings achieved over a five-year period. The trust, NHS England and the Department have been going backwards and forwards on the details of this plan, but it has boiled down to this basic point: innovative changes in approach and some difficult decisions mean that local health care experts are proposing to reduce the trust’s deficit by a full 70%, but—this is the key point—our whole area is clear that the unique combination of geographical isolation, poor transport links and severe health needs in pockets of some of the worst urban deprivation in the country in Barrow make this a unique case, meaning we cannot go further than that 70% proposed reduction without cutting deeply into vital services across our hospitals.

It is a shame that the hon. Members who represent the Royal Lancaster infirmary, which is part of Morecambe Bay’s trust, are again not here to make this case. However, I want to ask the Minister something, and she can rise now or deal with this in her summing up. Will she follow the lead of the shadow Secretary of State, recognise our unique case and pledge to bridge the gap? Until we get that promise I will keep working with anyone in our community across Morecambe Bay who will join us in demanding the funding deal our hospitals desperately need.

The hon. Members for Lancaster and Fleetwood (Eric Ollerenshaw) and for Morecambe and Lunesdale (David Morris) are not here to stand up for their hospital today, so I will be out at the weekend with the people who will replace them as MPs: our brilliant candidates Amina Lone and Cat Smith. We will not stop until our hospitals are secure. The Government are proving themselves to be not up to this job, so they should get out of the way.

National Health Service

Lord Walney Excerpts

Wednesday 21st January 2015 Commons Chamber

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I want to talk about the situation in hospitals across the Morecambe bay area, and I shall start with the inquiry into neonatal deaths at Furness general hospital. The inquiry is led by Dr Bill Kirkup, who distinguished himself as a member of the independent Hillsborough inquiry panel. It has now heard from more than 100 witnesses, of whom I was the first, over a period of nine months. That has involved regular long trips from Barrow to Preston for the grieving families, who have had to relive those deeply traumatic periods in their lives in great and painful detail.

There has been a lot of talk about politics today, and about its relationship with the national health service. I do not think we should deny the real differences between our parties; we should be prepared to debate them and to put the choice before the British people at the election. That will involve disagreement, argument and debate. However, it pains me to hear the Secretary of State accuse me and other Opposition Members of being selective in the way in which we talk about the problems in the NHS. I have to say to him that I do not care if the Morecambe bay inquiry turns out to be politically difficult for any side. As the Minister of State, the right hon. Member for North Norfolk (Norman Lamb), knows, I helped to secure the inquiry on behalf of the grieving families, who, with great persistence and determination, persuaded me of the need for an independent examination to run alongside the criminal inquiry, rather than taking place subsequently. I am determined to get to the truth, and I am determined that lessons should be learned, no matter how painful they might be for anyone.

The Secretary of State is no longer in his place, but if he wants to stamp out shabby political point scoring I advise him to have a word with his colleague, the hon. Member for Morecambe and Lunesdale (David Morris). It is a shame that the hon. Gentleman has not attended this debate to stick up for his own local A and E, which I know is facing real pressures. The last time the inquiry was in the news, the hon. Gentleman used those neonatal deaths—which did not relate to his constituency or to the hospital there—to call for the resignation of the shadow Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham). I am sorry to speak so frankly, but if someone is prepared to use the deaths of babies for this kind of political stunt because someone in Tory central office suggests it or just because they themselves think it is a good idea, there is not much they will not do. So just as the families, who have gone through so much in their grief, will not forgive anyone who does not face up to the full gravity of the findings that are coming, so I will not forgive anyone who uses this inquiry for political sport.

For all the problems, and I understand that the inquiry may well make difficult reading, we in Morecambe bay and at Furness general hospital are not the next Mid Staffs. There will be no excuse for anyone who allows the destabilisation and turmoil that the region has suffered to be recreated in Morecambe bay just because it fits the narrative composed by Lynton Crosby or some election agent in Downing street. I hope I will get some assurance from the Minister on that point in his winding-up speech. It is also important that this inquiry, which I understand is to report in the middle of next month, is dealt with fully but is not allowed to divert focus from the real problems the trust is enduring now and the need for a proper funding solution to put our hospitals on a more sustainable footing.

Let me briefly address the pressures currently being felt in Morecambe bay. Ambulances have been mentioned, and the hon. Member for Blackpool North and Cleveleys (Paul Maynard), whom I have the pleasure of following, spoke of his local hospital in Blackpool. Patients in south Cumbria will often travel by ambulance to Blackpool. Sometimes that is a good thing, because of the real expertise available, but too often recently ambulances have been diverted from where they are needed in south Cumbria to serve the Blackpool area because of shortages there. On 5 and 6 January, two ambulances, one serving Ulverston in my constituency and the other Millom in the constituency of my hon. Friend the Member for Copeland (Mr Reed), had to come to Fylde and the Blackpool area. Obviously, once they were there they were required to serve other patients needing help in the Fylde and Blackpool area, leaving the service in south Cumbria severely stretched—and all this when the beginning of January had seen a 25% year-on-year increase in ambulance call-outs across the north-west. We urgently need from the Government not only action to relieve the pressure on accident and emergency departments, but a recognition that areas such as Furness, which are out on a limb, can end up in a difficult situation because of ambulances being redirected around the country.

There have been real pressures on A and E in my constituency, as there have been across the country. Two weeks ago, when this issue last flared up in the Commons, the University Hospitals of Morecambe Bay NHS Foundation Trust was cancelling all non-urgent operations so as to be able to deal with the crisis in A and E. I have spoken to people in the trust today and they say that the situation has eased a little in recent days but remains fragile. All these problems must be addressed, but I have repeatedly pressed the Government on this. I was so grateful to the shadow Secretary of State, on his recent visit to Morecambe, for the assurances he gave on recognising the unique geographical situation of Morecambe bay and the funding priority it would get under a future Labour Government. Our population of 300,000 is spread out across the Morecambe bay area and the transport links are difficult. If things are to be easier, our area ought to be more compact and served by one big general hospital, and it cannot survive with the three hospitals it has unless very severe cuts in services are made. We are still waiting for an answer from the Government on whether they will recognise that case and provide us with the long-term extra funding that our area needs.

Oral Answers to Questions

Lord Walney Excerpts

Tuesday 13th January 2015 Commons Chamber

[Jane Ellison]

It is exactly that kind of flexibility that we so much welcome in the “Five Year Forward View”, recognising the potential of smaller hospitals. My hon. Friend’s local hospital, which he champions so well, can apply to be one of NHS England’s prototypes, and I would encourage it to do so.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

Does the Minister accept the case made by commissioners and the trust in Morecambe Bay that, notwithstanding all the efficiencies and changes in services, the trust could not close its deficit, due to its near unique geography and health need, without significantly cutting vital services for the area?

[Jane Ellison]

These are clearly difficult local questions that local health leaders need to look at. If there is a particular issue the hon. Gentleman would like to draw to our attention, we will certainly be able to examine it. I recognise that unique geography is involved, but steps are already being taken by NHS England to try to close some of those gaps and to deal with those challenges that smaller hospitals face, working with Monitor and looking at, for example, the tariff regime. I encourage him to look at that, too.

Oral Answers to Questions

Lord Walney Excerpts

Tuesday 25th November 2014 Commons Chamber

[Norman Lamb]

My hon. Friend is absolutely right about the importance of early interventions. Next year, we are introducing for the first time a six-week maximum waiting time standard for access to psychological therapies to start treatment for conditions such as anxiety and depression, and a two-week standard for starting treatment for those suffering a first episode of psychosis. I am also calling on every FTSE 100 company to sign up to Time to Change, so that they can show leadership in how they deal with their employees.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

It is one thing to say it, but completely another to do it. I am sure that the whole House will recognise improvements that happen, but does the Minister understand the scale of the crisis, not simply in the NHS but in the education system where more and more young people are increasingly finding that they simply cannot get anything like the support they need at increasingly difficult points in their lives?

Five Year Forward View

Lord Walney Excerpts

Thursday 23rd October 2014 Commons Chamber

[Mr Hunt]

I am absolutely delighted to do that. The new hospital inspection regime we have introduced has shone a light on some outstanding leadership. One of the best examples is Basildon hospital, which had terrible problems, including blood-stained floors, blood on the carpets and syringes left lying around in wards. That failing hospital has been turned around by an inspiring chief executive, Clare Panniker, and in the space of just 18 months it has now officially been rated as a “good” hospital by the CQC. We welcome the brilliant leadership of a growing number of female chief executives.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

GP commissioners in Morecambe bay are doing exactly the kinds of things mentioned in the report by shifting their focus from primary care to prevention. They know, however, that all the things they could do will not come close to closing the £25 million deficit. The Government say that they have to close it, but doing so would decimate hospital services. Will the Health Secretary listen to our case about the special funding needs of the area?

[Mr Hunt]

I am very happy to look into that. I recognise that all clinical commissioning groups face very real financial challenges to balance their books. That is why the report is so important, because it says that we cannot go on like this for ever and we have to look at changing the model decisively. It addresses the three things that could give hope to the hon. Gentleman’s CCG: increased real-terms funding based on a strong economy; more imagination in looking for efficiencies; and innovation and technology. We are absolutely committed to doing those things.

Special Measures Regime

Lord Walney Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

Such reports will be used. Members of the public will be involved in the inspection regime and the way that care homes respond to complaints and concerns raised by families will be an important part of what the new chief inspector looks at.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

We all hope that the special measures regime speeds up the improvements that are needed in Morecambe Bay hospitals, but does the Secretary of State accept that the turmoil that those hospitals have been in for years now will never properly end until the Government recognise that the trust simply cannot deliver services with the same level of funding, given the almost unique challenges of rural isolation, severe deprivation and health need in the area?

[Mr Hunt]

I thank the hon. Gentleman for the work he has done with James Titcombe on the tragedy that happened at Morecambe Bay. I think there are particular issues in that trust owing to the fact that it is on two sites that take a long time to travel between geographically. The point of the new regime is to ensure that those issues get surfaced and that Ministers and the system have to address them. I hope that that is what will happen.

Oral Answers to Questions

Lord Walney Excerpts

Tuesday 10th June 2014 Commons Chamber

[Mr Hunt]

My hon. Friend is right about the seriousness of the issue of antimicrobial resistance. Some 25,000 people die in Europe every year as a result of the failure of antibiotics—more than die in road traffic accidents. I raised the issue at the World Health Assembly and I have discussed it closely with the Prime Minister.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The Health Secretary will be aware that the chair of Morecambe Bay trust has stood down today, ahead of what is expected to be another critical report from the Care Quality Commission about services. What guarantees can the Health Secretary give the worried people who are served by the Furness general hospital that its A and E department will be protected and the vital national industries that depend on its services will continue to be able to rely on them?

[Mr Hunt]

First, I thank the hon. Gentleman for the work that he does locally, in particular with people such as James Titcombe, who has campaigned extensively to improve the quality of care at Morecambe Bay. I assure the hon. Gentleman that whatever the problems are at Morecambe Bay, we will be transparent and open, and we will make sure that we deal with them promptly. That is why we have had these independent inquiries. We will look closely at what the report says and make sure that we act quickly.

Urgent and Emergency Care Review

Lord Walney Excerpts

Tuesday 12th November 2013 Commons Chamber

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

The response that the public health Minister gave to my written question showed that ambulance response times have increased over the past two years in 11 out of 12 trusts in England. Why is this happening?

[Mr Hunt]

Just as there is more pressure on A and E departments, there is also more pressure on ambulance services. We are treating that as very much part of how we support accident and emergency services over the coming period. There are particular pressures in the London area, the east of England and the east midlands, and we are doing everything we can to put those problems right.