Ipswich Hospital: Orthopaedic Services

Tom Hunt Excerpts

Tuesday 7th July 2020 Commons Chamber

[Tom Hunt (Ipswich) (Con)]

I thank the Minister for being here to respond to this much-needed debate. It is needed because on 14 July, the Ipswich and East Suffolk and North East Essex clinical commissioning groups will make a decision on plans to remove elective orthopaedic surgery from Ipswich Hospital and transfer it down the A12 to a new centre in Colchester, away from the people who rely on it. If the plans were to go ahead, they would represent a downgrade to Ipswich Hospital and make it the only hospital in the east of England that I am aware of not to offer a full complement of orthopaedic services. Despite that, the CCGs’ papers for the 14 July meeting will recommend that the plans be approved.

In many ways, it is disappointing that this debate is needed in the first place. Public opposition to the plans is overwhelming. I will come to the important reasons why later, but first I want to make the House aware of the scale of the opposition to the plans. An online petition to protect orthopaedic services at Ipswich Hospital established by the Orwell Ahead campaign group currently has more than 8,700 signatures, despite having been up for only a few days. I have already shared the petition with the Minister, but I want him to be aware of how many more people have added their names to it since we last spoke.

As well as the number of signatures, I am sure that the Minister and others who have studied the petition will not have failed to notice that it refers to a joint quote from me and the Labour leader of Ipswich Borough Council, Councillor David Ellesmere. Anyone who follows day-to-day politics in Ipswich will know that Councillor Ellesmere and I do not always see eye to eye, but on this issue we are united as the principal national and local representatives of our town. The quote in the petition comes from one of two joint letters about these proposals that we have sent to the chief officer of the Ipswich and East Suffolk clinical commissioning group. Combined, those letters, which detail our cross-party opposition to the plans, stretch to more than nine pages. However, that is by no means the extent of the opposition that has been expressed.

The 12-week consultation on the plans, which ran between February and April, found that almost two thirds of respondents were opposed to the new centre in Colchester. That is despite the fact that the consultation took on board the views of people in Colchester as well as people in Ipswich. Had the consultation taken place just in Ipswich, that number undoubtedly would have been far higher.

Over the last few weeks, that has been reflected in my inbox. I have received hundreds of letters, emails and other messages from constituents about this issue and not one has expressed support for the plans. They include not only former patients who have told me they would not be walking today were it not for the first-rate orthopaedic care currently provided at Ipswich Hospital, but hospital workers, and elderly and vulnerable people who are worried about the prospect of having to travel to Colchester in future.

When the chief executive of the hospitals trust asked me to pass on the correspondence that I have received from constituents so he could address their concerns, I did. I sent over a dossier that was 20 pages long, yet this still only represented a fraction of the correspondence that I have received. It also excluded many people who have contacted me from further afield in Suffolk, who are among the 390,000 people who depend upon the services provided by Ipswich Hospital. Many of them share my constituents’ concerns, and some patients to the north of Ipswich face even longer and more difficult trips to Colchester than patients in Ipswich.

It is clear now that the only way for the concerns of my constituents and others to be addressed is for these plans to be reviewed. Of course, my overwhelming preference is for new plans to be drawn up and for the approximately £44 million that is currently earmarked for a new centre to be invested in both Ipswich and Colchester hospitals. I know that many of the people from across the political spectrum who signed the petition and who have written to me are also tuning into BBC Parliament this evening and are watching what is said here very closely.

I think it is only right to use this opportunity to refute the claim made jointly by the chief executive of the hospitals trust and the chief officer of the clinical commissioning group that the public’s petition is causing unnecessary concern and fear. Leaving aside the substance of those remarks for one second, I point out that this is not the first time that the chief executive of the hospitals trust and the chief officer of the CCG have written a joint letter or made closely aligned statements. Given that the chief officer of the CCG will be at the heart of the decision-making process on this issue, it is questionable why he is already so firmly in line with the trust on its plans. This adds to the widely shared sense that, for all intents and purposes, this decision has already been made, and that the decision-making process has been compromised. I hope that Ministers will consider that very carefully when looking at this issue and at how these plans are being pushed through against the wishes of my constituents.

I think it is clear to almost everyone, except senior NHS management locally, that it is not the public petition that is causing concerns, but the plans themselves. It is the local NHS management who have failed to make the case for these proposals. They are the ones who have failed to take the public with them on this journey. Unfortunately, these latest remarks by the chief executive and the chief officer are just more evidence of that same senior management failing to listen to the public. However, the public’s concerns deserve to be heard and that is why I will set them out very clearly now.

The removal of elective orthopaedic surgery would mean that patients in Ipswich have to travel further for their surgery. There must not be an assumption that everyone will have loved ones who can take them to Colchester and back or that they will be able to take public transport, especially after just having had a hip or knee replacement. Constituents have also told me that it would be harder for them to visit their loved ones who have undergone surgery in Colchester to give them crucial comfort and support.

[Robbie Moore (Keighley) (Con)]

I feel for my hon. Friend’s constituents who potentially have to make that extra journey. In my constituency, I am very fortunate that the Airedale General Hospital provides orthopaedic surgery to constituents on a local basis. Does he agree that the right thing to do is to provide that local service so that his constituents in Ipswich can benefit?

[Tom Hunt]

I agree with my hon. Friend. There is a national challenge when it comes to tackling waiting lists for hip and knee replacements. There is not one hospital across the country that does not have to meet that challenge, but in meeting that challenge, we need to keep services as local as possible for the people who depend on them. That is what I am arguing for this evening.

So far, neither the hospital trust nor the CCG has presented sufficient detail about how vulnerable patients will be supported in making the journey to Colchester, and the reassurances we have received about joint working and engagement with the public just do not cut it. There is major concern among my constituents about the plans, and it is no surprise that people do not support them while this crucial element is not in place.

Secondly, Ipswich Hospital is currently ranked in the top 10% in the country for both hip and knee replacements, and I would like to thank all the surgeons and staff who work in the orthopaedic services. There are real concerns that the fine quality of care currently available to patients in Ipswich will be diminished when combined with the practice in Colchester. Many of my constituents are currently going through an anxious wait for hip and knee replacements during covid-19, but the knowledge that they will receive first-class surgery at their town’s local hospital provides a great deal of reassurance. Under these plans, however, the surgery would certainly not be at their local hospital, and there are fears that the standard of care could be lower too.

[James Cartlidge (South Suffolk) (Con)]

I am grateful to my hon. Friend and neighbour for giving way. It was great to campaign with him in the election; I knew that he would be a doughty fighter for his constituents, and he is showing that tonight. Does he agree that, however we configure services, the priority must be the people he is talking about who are waiting for elective surgery that has been cancelled or shifted back many months because of covid, and we need to focus on bearing down on that backlog?

[Tom Hunt]

I thank my hon. Friend. As I said to my hon. Friend the Member for Keighley (Robbie Moore), I am not blind to the fact that covid-19 is putting huge pressure on the NHS and hospitals up and down the country, including Ipswich Hospital, where the frontline staff have gone above and beyond to serve my constituents. We need to deal with these waiting times, but we need to do so in a way that keeps services closer to people. That is very important.

Under the current proposals, most of the surgeons in Ipswich Hospital’s orthopaedic team would split their time between Ipswich Hospital and the new centre in Colchester. In many cases, this would mean that the surgeon who operates on a patient in Colchester one day will not be there to make crucial check-ups on their patient in recovery over the following days. Only the operating surgeon is best placed to see how their patient is responding to the surgery that they carried out. These personal check-ups are also an important source of confidence for patients. This important aspect of high-quality care would largely be lost under the current plans. Questions have also been left unanswered about the impact of the plans on the highly rated emergency orthopaedic practice, which would remain at Ipswich Hospital, with doctors and resources diverted elsewhere.

This all feeds into a third main concern, which is about the wider effect of these plans on the reputation and standing of Ipswich Hospital. Addenbrooke’s Hospital, Peterborough City Hospital, Hinchingbrooke Hospital, Norfolk and Norwich University Hospital, Queen Elizabeth Hospital, Princess Alexandra Hospital, Colchester Hospital, West Suffolk Hospital and James Paget University Hospital are all general hospitals in the east of England that provide elective orthopaedic surgery. Under the current plans, Ipswich Hospital would become the only hospital of its size in the eastern region not to provide a full complement of orthopaedic services. In fact, James Paget University Hospital in Yarmouth serves a population under half the size of Ipswich Hospital.

The question is, why should Ipswich Hospital be stripped of its first-class elective orthopaedic surgery and placed in such an unusual position? More and more people in Ipswich are beginning to answer that question by looking at whether the merger of Ipswich and Colchester Hospitals has been beneficial to Ipswich Hospital and whether the promises that were made about both hospitals improving together have been kept.

In fact, there are significant doubts that the hospitals trust fully explored the options that would allow both Ipswich and Colchester Hospitals to improve their orthopaedic care together, without one hospital losing core services. My understanding is that a full assessment was not made of repurposing space at Ipswich Hospital, to open up room for two additional operating theatres, and the borough council’s two alternative proposals to the Colchester centre were essentially dismissed out of hand.

The hospitals trust has insisted, the whole way through, that the Colchester centre is the only way to create enough capacity to cut waiting times and cancellations to planned surgery. I have spoken to the hon. Member for Strangford (Jim Shannon) about what we have to do on that across the country.

I ask what justifies these sweeping plans, for many, including within the hospital itself, have doubts that the plans are even justified on their own terms. The proponents of the plans have highlighted that five new operating theatres for hip and knee replacements would be added, and that these would simply replace five existing operating theatres currently in use at Ipswich and Colchester. Cutting waiting times and delays is undoubtedly an important aim, and I am sure, as I said, that there is no hospital in the country where the pressure on waiting lists for hip and knee replacements has not increased due to covid-19. As I mentioned, these plans would largely replicate existing services, at great financial expense and at the unquantifiable cost of moving them further from where people live. It is therefore disappointing that some in north Essex—some of my colleagues in north Essex—cannot see how important it is that both Ipswich and Colchester improve together side by side.

The last major concern I want to mention is that key voices within Ipswich Hospital have been muffled on this issue. The chief executive of the hospitals trust has claimed that the plans are clinically led and that only three out of 27 consultants are opposed to them, but it is my belief that the cards have been stacked in favour of this position. I understand that the 27 consultants he refers to include spinal surgeons as well as surgeons in Colchester. He has also assumed that surgeons who have not directly expressed their opposition to the plans must be in favour of them. Following the private conversations I have had with senior representatives at the hospital who have approached me, I understand that nine out of 12 surgeons at Ipswich Hospital who deliver non-spinal elective and emergency orthopaedic care do not support the proposals, but, understandably, many of them do not want to put their career at risk by speaking out publicly. However, two surgeons did speak out publicly during one of the consultation events, which turned out to be the only one where the audio recording of a public meeting was not uploaded online. It was eventually put online only when the surgeons themselves pointed this out.

To summarise, the plans are incredibly unpopular in Ipswich. The concerns for patients within Ipswich Hospital’s core service are real, and the decision-making process seems to be nothing more than a rubber-stamping exercise to push through the plans against the wishes of my constituents. When I stood for election and won the great honour of being elected as the Member of Parliament for Ipswich, I said to my constituents that I would fight for them with everything that I have. I love my constituency and I love my constituents, and I know how important the hospital is for them.

That is why it is really important for us to be here today. We do need to deal with the waiting lists, and we do need to make sure that people do not wait in pain for hip and knee replacements, but we need to do so in a way that keeps services closer to people. The merger needs to be about Ipswich and Colchester hospitals thriving together side by side, and I will work with my colleagues across the region to make sure that that is the case. At this late stage, I ask the Minister to look into the matter, reflect upon it, and meet me to discuss my concerns before the decision on 14 July.

Health and Social Care Workers: Recognition and Reward

Tom Hunt Excerpts

Thursday 25th June 2020 Commons Chamber

[Tom Hunt (Ipswich) (Con)]

I am disappointed that I was not called immediately after the hon. Member for Strangford (Jim Shannon), who I found out yesterday supports Leicester City. I encourage him to follow his son’s wisdom and to reconsider that and support the Tractor Boys instead. I will talk to him about that another time.

Yesterday in this place I thanked NHS staff and care workers in Ipswich for their incredible work to save lives during the covid-19 pandemic. I reiterate that gratitude for those professionals as we discuss these petitions to recognise their fantastic work and to consider the pay that they receive.

I mentioned yesterday that these workers have taken on considerable additional risk to their own physical health to help look after the most vulnerable. Most of us can only imagine what it is like for them to deal with many sick and deteriorating patients under such tough conditions, always having the thought in the back of their mind that they could catch the virus themselves and potentially pass it on to their loved ones when they leave work that day.

It is clear to me from the correspondence I have received quite how much my constituents want to thank NHS and care workers. There are a couple of stories that I want to elucidate slightly. One is about the local pub on Woodbridge Road, the Lattice Barn, which right now still faces an uncertain future. It closed its doors and there were lots of questions about its finances and so on, but the first thing that the landlord thought about was local NHS staff and how he could open his doors to nurses and frontline NHS workers. Immediately, he thought not about himself but about how he could support our wonderful NHS workers. I also thank Northgate High School and Ipswich School, where all the pupils worked together to make PPE for our frontline workers.

Yes, a monument or a medal would be a good idea. These things are not insignificant, and I do not think they should be belittled. They do matter, and they are a way of us saying collectively, as a society, “We acknowledge what you’ve done and we will never forget it.” However, I encourage the Government to reflect on the strength of feeling in the country and to consider any way that we can increase pay, particularly for frontline NHS workers and social care staff, at the first opportunity. In particular, we should show everybody who works in the social care sector how much we value them and the work that they do, give those workers the status they deserve, and acknowledge that they have been the best of the best. From the bottom of my heart as the Member of Parliament for Ipswich, thank you.

Testing of NHS and Social Care Staff

Tom Hunt Excerpts

Wednesday 24th June 2020 Commons Chamber

[Tom Hunt (Ipswich) (Con)]

It seems like a very long time ago, but I remember making a visit to Ipswich Hospital in February, before the lockdown, when it was still unclear how widespread covid-19 would become. During the visit, I inspected a number of isolation pods that had been constructed in anticipation of a virus. The set-up was a real tribute to the forward thinking and expertise of our NHS staff.

Since then, the efforts of all staff at Ipswich Hospital have been nothing short of exceptional. They have taken on considerable extra risk to take care of the rest of us, and I would like to use this opportunity, on behalf of our town, to thank them and those who work in our social care sector for all the work they have done over the last few months. Of course it is important that we ensure that they have access to as much testing as possible so that they can do their job confidently and so that valuable NHS staff are not self-isolating as a precaution when they may not have covid.

Mental health is mentioned in the motion. We really need to consider the impact of covid-19 on the wider mental health of our country. The mental health aspects of covid will be with us for a lot longer than the virus itself, and it is important that we do everything we can to confront this issue head-on across society in the coming months and years.

Throughout this crisis, I have been in close contact with Suffolk Mind about the important work that it has been doing to support those whose mental health has been impacted by covid-19. To put it starkly, four out of five people in Suffolk feel disconnected from the wider community, and similarly high numbers of people feel that their needs for community interaction are no longer being met. I therefore urge the Minister to take into careful consideration people’s mental health, and the ways in which it has been impacted by covid-19, over the coming years.

Let me also touch on the issue of waiting lists, the extra pressure that covid-19 places on our NHS, and the knock-on impact that has on the treatment of illnesses such as cancer, which has been mentioned, and on the provision of knee and hip replacements. There is a significant challenge in hospitals up and down our country to get on top of waiting lists to ensure that people do not have to wait months—that they do not have to experience delays or cancellations—for hip and knee replacements.

However, when looking to confront that nationally, we should still look to do everything we can to keep orthopaedic services as local to patients as possible. I draw attention to the situation at the hospital in my constituency. Yesterday, I signed a cross-party letter with the leader of Ipswich Borough Council to say that, as the local and national representatives of Ipswich, we do not believe that the plan to open an orthopaedic centre in Colchester is in the interests of the people we represent.

I urge the Minister to take that into consideration, to meet me to discuss my concerns and those of my constituents, and to discuss a way forward that addresses delays and cancellations to hip and knee replacements but in a way that keeps care as close to people as possible.

Health Inequalities

Tom Hunt Excerpts

Wednesday 4th March 2020 Commons Chamber

[Lee Anderson (Ashfield) (Con)]

It is an honour to follow the hon. Member for Coventry North West (Taiwo Owatemi).

It should not matter where one lives in the UK in terms of leading a healthy lifestyle, but we must accept that sometimes there is poor health and the possibility of poor health. I am pleased to see that this Government are not shying away from the challenge, with record amounts of investment in our NHS, now enshrined in law—the largest and longest funding settlement in the history of the NHS. But we all need to start having an honest conversation with ourselves about closing the gap on health inequality, because it is one of the biggest challenges we face in this country. We need to start to admit to ourselves that we must make different lifestyle choices. We must think about the smoking and drinking we are all doing and the lack of exercise.

Loneliness is a big one for me. Loneliness is a killer. Far too many people in this country face life alone, whether that be due to their age, their disability, or just their own personal circumstance. In my community, we have the brilliant Huthwaite Hub, which is a charity I helped to set up four years ago with two brilliant ex-schoolteachers, Dai James and Geoff Jago-Lee. The idea was simple: get a big room, fill it full of woodwork machines, tools and materials, and then invite people who are socially isolated to come along and learn new skills. The community and local business really came together and donated everything we needed, and a lottery grant was the final piece of the jigsaw. The brilliant Huthwaite Hub has now seen hundreds of people come through its doors who otherwise would have been sat at home depressed and surviving on antidepressants. That facility is better than any tablet and has transformed the lives of many people in my area. I invite anybody in this House, and especially the Minister, to come and visit the brilliant Huthwaite Hub.

I sometimes get a little bit fed up with the Labour party using the subject of health as a political football. At the last four general elections Labour has put health at the top of its campaign agenda and has been rejected at the ballot box every single time. Just a few months ago, it suffered its biggest defeat since 1935, which, roughly translated, means, “The public just do not trust it.” Something very noticeable in areas like Ashfield and Eastwood, and in other similar constituencies throughout the country that have always been the victims of health inequality, is that they have always had a Labour MP and Labour-run councils—that is, until the election last year. As somebody once said, “Things can only get better”. There is a Budget coming shortly, which will see record amounts of investment in infrastructure all over the country, especially in places like Ashfield and Eastwood.

[Tom Hunt (Ipswich) (Con)]

Does my hon. Friend agree that, to strengthen the resilience of local communities in combating health inequalities, it might be a good idea for the Government to set up a community wealth fund to be funnelled into some of the most deprived wards, such as Bridge ward in Ipswich, where the healthy life expectancy is around five years lower than the national average?

[Lee Anderson]

I completely agree.

As I was saying, the Budget will see record amounts of investment in places like Ashfield in Eastbourne. That will, in turn, create highly-skilled jobs and better employment opportunities, which will turn the clock back on decades of decline. With this levelling up of wealth in places like Ashfield, I am positive that we will see a levelling up of health. If we are going to make the argument that poor places have poor health, the solution is simple: let us make the poorer places better off by providing better jobs, better education, better training and better opportunities in life, which will only come from a Conservative Government. Already in Ashfield, we have up to £75 million of town centre and future high streets funding coming. We are also looking at opening up old train lines, to increase connectivity. That sort of positive action in Ashfield will increase prosperity in health and wealth.

My wife is currently in Queen’s Medical Centre in Nottingham, after having her third operation in three years. She has had a double lung transplant, an operation to remove 2 metres of intestine and a good old bout of sepsis, and yesterday she had her gall bladder removed. When I told her that I was going to have this week off to look after her, she said, “No, you go down there to Parliament and tell them people in that Chamber that this is a brilliant NHS”—it keeps her alive every single day.

As I said, it is a shame that the Opposition are once again playing politics with a very emotive subject. I want to assure them that in places like Ashfield and other usually solid Labour areas across the midlands and north, we now have hard-working Tory MPs in place who will not only level up wealth but will also level up health.

NHS Funding Bill

Tom Hunt Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Tom Hunt (Ipswich) (Con)]

This is the second time I have addressed the House since my maiden speech. I wish to touch on the important issue of NHS funding and the need to ensure that my constituents in Ipswich get the best possible deal. I welcome the Bill, which will give our NHS the biggest cash increase in its history. The money will support the delivery of our NHS long-term plan and the 40 new hospitals, 50,000 more nurses and 6,000 more doctors that we promised in our manifesto. Of course, all that will be built on solid Conservative economic foundations.

I will work hard to ensure that Ipswich receives its fair share of the funding, which is so important because the disparities between Ipswich and East Anglia and the rest of the country are real and often pronounced. CCG funding per patient is more than £100 lower in Ipswich and East Suffolk than the average in England. We must keep an eye on the funding formula to ensure that areas including Ipswich get the funding for the services they need. That includes GP services, in respect of which our GP-to-population ratio has fallen behind and many local residents say that they struggle to get an appointment when they need one.

In this Parliament we have a unique opportunity to make a real difference to parts of the country that have felt left behind. I will do everything I can to ensure that that message is heard loud and clear.

[Dehenna Davison (Bishop Auckland) (Con)]

Does my hon. Friend agree that as part of that levelling-up priority, it is really important that we restore some of our services and existing hospitals, such as the A&E at Bishop Auckland Hospital?

[Tom Hunt]

Absolutely. The levelling-up agenda touches many parts of the country, including not only the north of England but East Anglia. I agree with my hon. Friend.

I wish to take this opportunity to touch on a recent CQC inspection report on the East Suffolk and North Essex NHS Foundation Trust. The trust was formed following the merger of Ipswich and Colchester hospitals in July 2018. The inspection gave the trust a rating of “requires improvement”, which is of course disappointing, but had just one of the 80 inspection criteria been different, the trust would have received a “good” rating. We should hesitate before we draw direct comparisons between the previous inspection five years ago, which rated Ipswich Hospital “good”, and the latest inspection, which also covered Colchester Hospital, which was previously rated as “requires improvement”. Nevertheless, the report’s recommendations for improvement will be important to bear in mind as we consider health funding going forward.

The report mentioned cutting referral waiting times, improving capacity for emergency mental healthcare, and ensuring that staff have the right training to provide patients with the correct care. All those aspects must be priorities, so I welcome the provision in the NHS long-term plan for better training opportunities for NHS staff, as well as additional staff and funding for mental health services. I trust that the Government will closely consider the specific needs of Ipswich and East Anglia as the plans are moved forward in the interests of levelling up the whole country.

Planning permission has recently been approved for a brand-new £35 million A&E department at Ipswich Hospital, which is expected to open in spring 2020. I look forward to an invitation to cut the ribbon. The new department will make a real difference for the more than 100,000 people it will treat every year. I hope the Government will recognise that and continue to support further significant upgrades in Ipswich.

Investment has been confirmed for a new orthopaedic centre in the East Suffolk and North Essex Trust area by 2024, and I know that many in Ipswich are concerned that it may be located in the centre of Colchester. I want my constituents to know that I will closely monitor the developments around the new orthopaedic centre to ensure that they will be able to access services smoothly and with minimal disruption. I will endeavour to ensure that if the orthopaedic centre is located in Colchester, patients will have to go there only for main operations, and that all other appointments should be made in the hospital closest to them.

The key point is that those twin investments—the A&E department in Ipswich and the new orthopaedic centre, wherever it may be located—may not have happened had a merger into a single trust not taken place. The merger of Ipswich and Colchester hospitals has the potential to provide a critical mass when it comes to delivering the resources that local people need for their health and wellbeing. A further example of that is that, since the merger, radiotherapy treatments for cancer patients in Ipswich have been maintained in Ipswich at the same rate, when there were fears that they might have been moved elsewhere. In addition, the staff vacancy rate, which was 12% before the merger, is now 9%.

I call on the Government to further communicate the benefits of the merger, to give people confidence in the system and to give them every reassurance that both Ipswich and Colchester hospitals can improve together. Rather than there being a situation in which one hospital drags another down, it must be the case that when two hospitals come together, the good one drags up the one that is struggling. It must not be the other way round. I will continue to have a watchdog role in respect of the merger. Some of the initial improvements, particularly the new A&E department in Ipswich, are positive, but I will not hesitate to question any developments that may not be in Ipswich residents’ interests.

Before I move on from the recent inspection report, it would be remiss of me not to congratulate our local NHS staff in Ipswich, who have been identified as delivering outstanding practice in critical care, maternity services and community health in-patient services, as well as good levels of practice in many other areas.

I also wish to pay particular tribute to members of the Indian community in Ipswich, who fill many roles in our local NHS services. Their commitment and dedication to their work is unquestionable. The role that the Indian community plays in our local NHS is one of the driving reasons why I wish to express my wholehearted support for the Government’s plan to attract the top talent from around the world to work in the NHS after Brexit, to help provide vital services on which we rely every day.

It is important that we prioritise those who have the most to contribute. I am glad that the Government have identified this as a priority component of a new Australian-style points-based immigration system that we will bring in, with a preferential visa system for those seeking to work in the NHS.

I recently met the chief executive of Ipswich hospital and have been invited to visit the hospital shortly to meet all the hard-working staff. I look forward to hearing further about how we can work together to improve the hospital that we all care for so passionately.

I wish to make one final key point on NHS resources, which is incredibly important to my constituents and to the public as a whole. Earlier, I mentioned Ipswich’s new A&E department. The business case for this project took almost a year to approve, when it should have taken a matter of months. For every month of delay, I understand that the cost to the taxpayer was around £167,000, which is mainly due to inflation and increased building costs. I am well informed that the approval process for big NHS capital schemes is too archaic and that part of the problem is a merger of NHS Improvement and NHS England and that the new organisation has not had time to streamline its approvals process.

As well as additional investment, we must ensure that hard-earned taxpayers’ cash is being used efficiently at every stage of healthcare provision. I urge the Government to take this into account, too, as we Conservatives continue our long and proud stewardship of the NHS.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. The time limit is six minutes with immediate effect.