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Threat to
West Sussex hospitals raised in Parliament Arundel & South Downs MP Nick Herbert spoke about the threat to West Sussex hospitals in a House of Commons debate last week. During the debate, he said: Nick Herbert (Arundel and South Downs) (Con): I notice that the Minister recently won The Spectator award for the Minister to watch. We have had little choice about that this afternoon as he has been the only Minister that it has been possible to watch. I am sure that he will be acutely conscious that previous winners have included Estelle Morris and Christopher Leslie. We did not have to watch them for long. The Minister knows, because I mentioned this to him when he kindly agreed to see me about this issue—we have not yet had that meeting, but I am sure that he will honour the generous promise that he gave me—that I am especially concerned, as all Opposition Members here are, about the reconfiguration of acute health care facilities in relation to my constituency, because it is comprehensively affected by what our local health authorities are proposing. The following are acute hospitals in West Sussex: the Princess Royal hospital at Haywards Heath, St. Richard’s hospital at Chichester, and Worthing and Southlands hospitals in Worthing and Shoreham. None of them is in my constituency, but all of them serve my constituents and all are in the firing line when it comes to the potential downgrading of A and E and maternity facilities. They already face difficulties. Between the four trusts that serve my constituency, 1,000 jobs have been cut, or there has been an announcement that they will be cut, and 100 beds have been lost. The principal concern that I want to articulate on behalf of my constituents, who are watching the progress of the proposals with enormous anxiety, is the travel distances and times that will be involved if they have to go to units that are much further away from them than the units are currently. Right in the middle of my constituency, in the downs, is a little village called Washington. There is even a place called the White house in Washington, to which I have been—that is almost certainly the first and last time that I will ever have tea in the White house in Washington. At the moment, the nearest hospital—Worthing hospital—is just 8 miles from Washington. Should Worthing be downgraded, the travel times involved in going to an A and E department could increase by 2.5 to 5 times, if patients have to travel as far as Portsmouth. I could make that argument across my constituency. People, particularly the elderly population, are extremely worried about the increase in travel times that they may have to face, not just for A and E services, but for other treatments that they need. Someone came to my constituency surgery the week before last who was having cancer treatment in Brighton. She lives in the middle of my constituency and was already having to make a round trip of some 40 miles three or four times a week for treatment. That was taking hours out of her day and she was extremely worried about it. That is the prospect faced not just by a minority of people in my constituency but, potentially, a majority if the acute facilities that I am talking about are moved away from them. Furthermore, people face a potential increase in travel times along roads that the Government have continually failed to upgrade. The A27 in particular does not resemble anything like a coastal highway; it is a coastal car park. People are worried about the travel times for ambulances should there be additional travel times to A and E facilities. We are constantly told that the reconfiguration is about bringing new facilities closer to people’s homes and delivering great centres of excellence in what the Minister called “regions”—in this case, in Brighton and Portsmouth. The point is that we have seen no credible or costed proposals for the services that are meant to be brought closer to communities. We have seen none. In a rearguard action the Prime Minister started a few weeks ago to make the case for the changes and the documents by Sir George Alberti and Professor Boyle were published. Those documents amount to just seven and 12 pages respectively. They include many attractive photographs, anecdotal argument and diagrams, but no costings whatever. It is impossible to make a judgment on whether the proposed reconfiguration of health care will be financially sustainable or will save money, which is presumably what it is intended to do, when no costings have been provided either locally or nationally. There may well be a strong case for saying that bringing care closer to people’s homes will be more expensive. A great mistake that the Government have made, to which my hon. Friend the Member for Eastbourne (Mr. Waterson) alluded, is that the reform proposals that they are now purporting to set out are in fact being elided with cost-cutting proposals. That is what this is really about. We all know that. It is about addressing local deficits. The trusts have been instructed to cut costs on a very short time scale, and that is the real purpose of the proposed downgrading. Health Minister (Andy Burnham): The hon. Gentleman is digging his own grave with that point, because it is he and his colleagues who are seeking to put those two things together. They are seeking to put the deficits and the pressures that there are this year in some parts of the country together with the longer-term structural changes that are needed in some parts of the country to ensure that those health communities are fit for the future. That is precisely the point. For their own purposes, the hon. Gentleman and his colleagues are trying to weld those two things together to create an impression that this is all finance driven, rather than safety driven. If the hon. Gentleman feels able to throw away the Alberti report, claiming that it is glossy nonsense or whatever he was trying to say, that is a dangerous thing to do and will not serve his constituents. Nick Herbert: The point that I made was that the Alberti document and the Boyle document are completely uncosted. We have seen no credible proposals from the Government, either on clinical grounds or on cost grounds, that demonstrate whether the proposals will deliver affordable health care locally, yet we are told that a reason for the changes is that there is a need to save money. The local trusts and the health authorities are clear that the reason why the proposals are being considered in relation to acute hospitals is to save money. The closure of major hospitals—at one point, it was even being considered that we would have no acute facilities in West Sussex at all; now, apparently, we have a reprieve and will possibly have one where there are currently three—is designed to save money, and the Minister should not pretend otherwise. The Minister dismissively talked about people pulling out placards. Yes, 25,000 people have marched in West Sussex. Yes, 250,000 people have already signed petitions across West Sussex. That is a staggering number and it will increase. People are going out on cold evenings to hold 24-hour vigils because they are immensely concerned about what is going on. They are, quite rightly, subscribing to the notion of something that the Government constantly espouse—patient choice. The question that I put to the Minister is: if people are not to be allowed to choose to keep their local hospital, which is what they clearly want, what does patient choice mean? Andy Burnham: Will the hon. Gentleman give way? Nick Herbert: Just let me finish. If people are not to be allowed to choose their local hospital, which is what the NHS website proposes that they should be able to do, what does patient choice mean? Perhaps the Minister, instead of intervening on me, will answer that question when he winds up the debate. The truth is that the consultation that we have been offered in West Sussex has been largely a sham. In April, members of the strategic health authority came up and spoke to West Sussex Members, but they made no mention of the proposed downgrading of acute hospitals. We now know from minutes of the board meeting that were leaked that in fact they had been proposing that downgrading since the beginning of the year. Not surprisingly, people are extremely suspicious about whether the objections that they are registering in their hundreds of thousands in West Sussex will make any difference to the Government’s thinking, because they fear that the die is cast. What are the Government doing to make the consultation a real process? We know that they have delayed the process, but we also know that they are planning to recruit a director of communications each for the South East Coast and for the East of England strategic health authorities. For a salary of £90,000 a year, that person will have to “Understand public perception and patient experience of health care services”. That is all right, but the next job purpose is to “Deliver appropriate and timely information to the Ministerial Briefing Unit.” Is, then, the purpose of the director of communications to ensure that Ministers are armed more effectively with the facts? Another task is to “Translate and communicate effectively the vision that health reform policy can transform local health systems for the benefit of the patient”— in other words, to propagandise on behalf of the trust. The Minister talked about hearing the voice of local clinicians. Let me tell him that we cannot hear the voice of staff in the NHS, because locally they have been forbidden to speak out. When ambulance drivers and paramedics were asked by the local trust whether they would do an interview with Sky TV to speak for the changes proposed by the trust, they refused to a man and woman because they do not believe that the proposed changes are safe or viable. From that moment on, they were banned from talking to the press at all. Indeed, some of those whom I met recently feared that they could not even talk to their local Member of Parliament because of that stricture. I would be grateful if the Minister would confirm in his winding-up speech that it is perfectly proper for local NHS staff members to talk to their MPs about their fears. We all fear that there will be a salami slicing process with acute hospitals and that once they lose their A and E departments, the process of downgrading will continue. I have good reason to fear that because of what happened with a hospital that serves my constituency—the Princess Royal hospital in Haywards Heath. I am sorry that my hon. Friend the Member for Mid-Sussex (Mr. Soames) could not be here today because I know that he would strongly share these views. Just a year ago, a consultation process called “Best Care, Best Place” resulted in the loss of trauma cases from Haywards Heath to Brighton. The hospital is barely able to cope with the transfer of patients now and will be still less able to cope with the transfer of tens of thousands given that A and E admissions and attendances are on the rise across the county. In March 2005, the then Minister of State for Health, the Secretary of State for Work and Pensions, told my hon. Friend the Member for Mid-Sussex, in relation to this proposed health care change: “There is no question of A and E services being downgraded or becoming a minor injuries unit. That is not going to happen.”—[Official Report, 16 March 2005; Vol. 432, c. 383.] Just one year later, local health authorities are considering precisely that further downgrading of the A and E unit in the Princess Royal. Of all the hospitals in West Sussex that are likely to be downgraded to become minor treatment centres, or whatever is to happen—and we simply do not know—the Princess Royal is most in the firing line because it is on the east of the county. That promise has been breached just one year later. How can we accept the assurances of Ministers and health officials about how we are to enter this brave new world of care closer to the home when we cannot even take assurances that were given on the Floor of the House just one year ago? Can the Minister understand just how angry people are given that they have received such assurances from Ministers and health officials and that those assurances were so flagrantly and cynically breached? The Minister cannot allow the blame for the deficits to be landed at the door of local health authorities. There has been substantial Government mismanagement of the NHS that I could go on to discuss for some time, but will not. I shall, however, point out that the cost of endless reorganisation has to be laid at the Government’s door. We have seen the abolition of GP fundholding, the creation of 330 primary care trusts and now the halving of that number. We have seen the abolition of health authorities to create 28 strategic health authorities and now the halving of that number. There has been enormous disruption in West Sussex. The latest reorganisations across the country have cost more than £320 million. I wonder what the local cost has been compared with the deficits that have grown up in the local trust.
People do not understand why money has to be spent on management consultants
and endless reorganisations, yet they face the potential downgrading of
much-loved local health care facilities. I beg the Minister to reconsider
this issue and to understand just how strongly people feel. I beg him to
consider that he has not properly set out the alternatives to the current
structure of acute hospital provision and I should be grateful if he were to
see me as he kindly promised. |
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