Capital Funding: New Hospital in Harlow

Robert Halfon Excerpts

Wednesday 18th October 2017 Westminster Hall

[Robert Halfon (Harlow) (Con)]

I beg to move,

That this House has considered capital funding for a new hospital in Harlow.

It is a pleasure to serve under your chairmanship, Mr Howarth, and I am grateful to Mr Speaker for allowing this debate. The Princess Alexandra Hospital was completed in 1966 to provide acute hospital and specialist services for around 350,000 people living in Harlow and the surrounding areas. Alongside others, I have been working hard for Harlow residents to improve healthcare services, so that they are fit for the 21st century. I have worked to secure extra funding and more doctors and nurses for our hospital, and the new leadership team work tirelessly to do everything possible to improve performance.

However, only so much can be done at the hospital as it stands. The infrastructure is deteriorating. The accident and emergency services are overstretched and staff retention remains a serious problem. It is for these reasons that I am putting forward the case for capital funding for a new health campus in Harlow, bringing together accident and emergency services, GP provision, social care, physiotherapy and a new ambulance hub—bringing healthcare in Harlow into the 21st century.

The Princess Alexandra Hospital is in special measures. It was judged as inadequate overall by the Care Quality Commission in 2016. It is important to note, however, that maternity and gynaecology were rated outstanding at the inspection. Day in, day out, a huge amount of remarkable work is done by the hospital leadership, the hospital’s chief executive Lance McCarthy, and above all the doctors, nurses and auxiliary staff, to provide the very best care they can.

I take this opportunity to thank and praise the health trade unions, led by people such as Councillor Tony Durcan from the nurses’ union, and Councillor Waida Forman and Daniella Pritchard from Unison, whose only aim, whatever our occasional political differences, is to improve the quality of hospital care and the services for their members. Much of this improvement work has been noted by the CQC. Its report, however, outlined various remaining concerns, from staff shortages to deteriorating mortuary fridges, some of which were no longer fit for purpose and were ordered to be repaired during the inspection.

This leads me to my first and most pressing concern. The Princess Alexandra Hospital is not fit for purpose. It is unable to provide healthcare fit for the 21st century and Harlow and the wider area. According to the CQC report in 2016:

“The environment was one of the top risks for the trust. The estate was aged and in need of repairs costing tens of millions”.

Much of the hospital is original and therefore over 50 years old. It has exceeded its useful life and much of the infrastructure is in a state of permanent decline. In addition to the original hospital built in the 1960s, a number of temporary structures have been added, many of which have now surpassed their 10 to 15-year lifespan. That creates a complicated design, with urgent care spread across the site.

A 2013 survey rated 56% of the hospital’s estate as unacceptable or below for its quality and physical condition, which puts the capacity of the hospital to care for those in need at serious risk. That becomes strikingly clear when we read and hear reports of sewage and rainwater flowing into the operating theatres.

The doctors, nurses, management team and support staff at the Princess Alexandra Hospital work so hard, every single day, but their working lives are made so much harder by the hospital’s deteriorating facilities. In addition to the ageing infrastructure, the services are under increasing pressure to provide care to residents in Harlow and the surrounding area. Changes to other local facilities have placed additional pressures on the trust’s capacity, resulting in occupancy levels running higher than 96%. That means that the Princess Alexandra is not only fundamental to the health and wellbeing of the growing Harlow population, but to a wider area, including parts of Hertfordshire and Epping Forest—it is very good to have my hon. Friend the Member for Hertford and Stortford (Mr Prisk) in the Chamber to ensure we get good health services in our area.

[Mr Mark Prisk (Hertford and Stortford) (Con)]

I congratulate my right hon. Friend and parliamentary neighbour on securing this important debate. Does he agree with me that in my constituency and his, ever since the previous Labour Government scrapped their plans for a new hospital at Hatfield, there has been a sense locally that somehow our area has been ignored for capital investment, and that is why his proposal is so sensible?

[Robert Halfon]

As usual, my hon. Friend makes a powerful point. I will come on to how changes in nearby hospitals have had a significant effect on the Princess Alexandra Hospital.

The emergency department in particular suffers. As the CQC reported last year:

“Long waits in the emergency department and capacity issues in the wards meant that patients were not always seen in a timely manner, with many patients in the emergency department breaching four hour and 12-hour targets.”

As I understand it, we have the highest A&E use of any hospital in England. The department struggles to deliver the national four-hour standard, achieving 72% for 2016-17. Having said that, the A&E department saw 10,628 more people in less than four hours last year than it did in 2009-10. This improvement is astonishing when considered against the changes to the nearby emergency departments and with attendance rates at the Princess Alexandra Hospital being 10% higher than the national average, at around 200 to 300 visitors per day.

Chase Farm Hospital near Enfield became an urgent care centre in 2013. The same happened at the Queen Elizabeth II Hospital near Welwyn Garden City in 2014. Urgent care centres only deal with minor injuries, while the Princess Alexandra Hospital deals with those plus major injuries, including life-threatening chest pains and head injuries. All major injuries and illnesses have been dispersed to surrounding emergency departments, and attendance at the Princess Alexandra Hospital has risen consistently.

[Lucy Allan (Telford) (Con)]

My right hon. Friend is making an excellent and passionate speech about the needs of his community—a new town, just like mine. He is setting out the problems of decaying infrastructure against a backdrop of increasing population. Does he agree that, as new town MPs, we should be championing our hospitals at all times? They are the centre of our communities and cement our identity. Hospitals are something people are deeply attached to and they form so much of what the town is, whether it is the Princess Alexandra or the Princess Royal in Telford.

[Robert Halfon]

My hon. Friend has set up the all-party parliamentary group on new towns, of which she is the chair and I am pleased to be vice-chairman. We set it up because we have many of the same problems. Our towns were built at the same time and we have the same issues, whether it is to do with our hospitals or regenerating housing and our high streets. I thank her for the work she does on this and the way she represents her new town and her constituents in Telford.

As I was about to say, the hospital secured £1.95 million of emergency department capital funding in April this year, allowing significant building works to support the department’s work, including the expansion of the medical assessments base. That is coupled with an A&E-focused recruitment drive to take advantage of the new facilities.

That leads me on to staff recruitment and retention. While Harlow hospital now has 27 more doctors and 35 more nurses than in 2010, the vacancy rate in recruitment is a perpetual worry. The nurse vacancy rate for September stood at 25%. Staff vacancy rates were picked up in the CQC report in 2016, in which inspectors found that

“staff shortages meant that wards were struggling to cope with the numbers of patients and that staff were moved from one ward to cover staff shortages on others.”

The proximity of Princess Alexandra Hospital to London plays a major role and, although pay weighting is a factor, I have been told by the hospital leadership and Harlow Council’s chief executive, Malcolm Morley, who is in Parliament today, that career development is significant. Princess Alexandra Hospital must compete with Barts and University College Hospital in specialist training and career development. The retention support programme established career clinics and clear career pathways, but there is only so much that the hospital can do to compete with the huge investment and facilities at London hospitals. Harlow needs to be able recruit and retain staff. Recruitment is related partly to the future of the hospital itself and partly to the staff’s ability to develop their careers in Harlow. Of course, both factors relate to the hospital’s infrastructure.

I have tried to make sure that our NHS in Harlow is a top priority for the Government, and I have had many meetings with the Health Secretary and the hospitals Minister. I am pleased to say that they have visited our hospital a number of times, most recently in May, when the Health Secretary visited the Princess Alexandra Hospital to speak to the hospital leadership team about Harlow’s case for a new hospital. He spoke of

“the exciting proposals which are coming together to invest capital in upgrading these facilities, including the option of a brand new hospital.”

He also stated:

“These proposals are at an early stage but upgrading services on this important site will be a priority for a Conservative government”.

Following capital funding announcements for sustainability and transformation partnerships in July, I was informed that

“Princess Alexandra Hospital is still a real priority”

for the Department of Health

“and work is ongoing to take it forward”,

and that the Government are “on hand” to carry on helping to get the Princess Alexandra bid together. Given that the Health Secretary said that Princess Alexandra Hospital is a priority case, will the Minister say what the current budget is for capital funding and how it will be allocated to new hospitals, such as Harlow?

In autumn 2016, the Secretary of State requested that the PAH board, the local clinical commissioning group and local authority partners progress a strategic outline case. After considering a number of options,

“the SOC concluded that a new hospital on a green field site, potentially as part of a broader health campus, to be the most affordable solution for the local system”—

note the expression “most affordable”—

“and the solution that would deliver most benefit to our population.”

The health campus would bring together all the services required to ensure that healthcare in Harlow is fit for the 21st century: emergency and GP services, physio, social care, a new ambulance hub, a centre for nursing and healthcare training.

Having recently met the chief executive of the East of England Ambulance Service, I know that there has been a significant increase in the number of calls from critical patients who need a fast response. Harlow has four new ambulances but the development of a top-class ambulance hub would allow huge improvements in that area. The health campus could also act as a centre for degree apprenticeships in nursing and healthcare, bringing specialist training to the eastern region. It could build on strong links between the Princess Alexandra Hospital and Harlow College and capitalise on the new Anglia Ruskin MedTech innovation centre at the Harlow enterprise zone.

The health campus proposal has been supported by West Essex CCG, the East and North Hertfordshire CCG and the Hertfordshire and West Essex STP, which brings together 13 local bodies and hospital trusts. A joint letter has been signed by more than 10 councils, including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority.

Despite recognition from local authorities and Ministers alike, some NHS England officials—I stress the word “some”—suggest that a refurbishment would be more fitting than the development of a brand-new hospital, due to capital funding constraints. That solution is the equivalent of an Elastoplast—a short-term option that will do nothing to solve real, long-term problems.

Given the support from the Government and key organisations, we need to be sure that plans for a new hospital are not obstructed. Will the Minister give an assurance that NHS England and NHS Improvement will work positively with public, private and voluntary sector partners to progress the plans? A rapid strategic solution is needed, rather than a short-term fix.

The cost of the new campus model would be between £280 million and £490 million, depending on the type and preferred method of funding. The hospital leadership is looking at all the options to maximise public sector investment and bring together the public, private and voluntary sectors. Private investment will not involve any kind of private finance initiative contract. Instead, the leadership will focus on how the private sector works with the NHS and how the development can generate revenue flows through social care, for example. The development also raises the potential development of housing as a source of income and private investment. These are decisions for the future. When the PAH leadership looks at private investment, it will consider supported housing and similar options.

Moreover, Public Health England’s move to Harlow will create a world-class health science hub. Without exaggeration, once Public Health England has completed its move, Harlow will be the health science capital of the world, Atlanta aside. We must ensure that the Princess Alexandra Hospital is an important partner that benefits from and adds to that success. The creation of a health campus is vital not only for Harlow but for the surrounding area. The infrastructure of the campus would be fundamental to the vitality of the community and the economy of the entire region that the Princess Alexandra serves.

I have visited the Princess Alexandra Hospital many times. I defy the Minister to find more professional and dedicated staff, doctors and nurses. They work day and night to look after the people of Harlow and the surrounding area. I have seen the incredible work in A&E, intensive care and the maternity and children’s units. That is why I know that PAH staff are second to none. However, their professionalism and hard work will go to waste unless our hospital is fit for purpose. I know that the Secretary of State recognises that, given his numerous visits to the hospital and what he has said since. I know that the Minister himself recognises that, given his visit to the hospital this time last year. I know that all the key local authorities, neighbouring MPs and trusts are supportive. I urge the Minister to do everything possible to ensure that Harlow has a hospital that is fit for the 21st century.

[Mr George Howarth (in the Chair)]

Before I call Mark Prisk, he needs to be aware that adequate time must be allowed for the Minister to respond. If he does not appear to be finishing his speech in a timely manner, as I am sure he will, I will intervene to bring in the Minister.