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24 Jan 2001 : Column 316WH

Hospital Services (Bradford)

1.30 pm

Mr. Christopher Leslie (Shipley): I am pleased to have the opportunity to debate such an important issue. Shipley, my constituency, is one of five in the Bradford district. There are no general hospitals within its boundaries, but it is served by Bradford royal infirmary and St. Luke's, based in the city, and by Airedale general hospital in Steeton near Keighley.

Of the five Members of Parliament for Bradford, my hon. Friend the Member for Keighley (Mrs. Cryer) unfortunately cannot be here today, although I understand that she will shortly visit Airedale hospital. My hon. Friend the Member for Bradford, West (Mr. Singh) has taken a long interest in the Bradford royal infirmary site, which is in his constituency. I know that he looks forward to the Minister's visit in the near future. My hon. Friend the Member for Bradford, South (Mr. Sutcliffe), who sits beside me here as a Whip, is prevented from speaking in the debate. However, I assure the world at large that he strongly supports hospital services in the district and takes a close and long-standing interest in new investment and developments. I hope that my hon. Friend the Member for Bradford, North (Mr. Rooney) will say a few words later.

Nearly half a million people reside in the Bradford district. The area ranges from relatively well-off communities in the commuter belt to a fairly large area of deprived neighbourhoods with deep-rooted poverty and poor health. Bradford is recognised as the most deprived health authority area in the whole of northern Yorkshire, where more than one third of the population is classed as deprived. Patients, especially those from black and Asian communities, suffer high rates of heart disease, strokes and diabetes.

There are several good facilities in the area, but they need to be improved. St. Luke's hospital typifies the most pressing difficulties that we have in the national health service locally. Most of its site is contained in a series of unconnected 19th-century blocks, between which patients and equipment must be transferred in the open air between buildings in all weather. That is obviously unsuitable for the 20th century, never mind the 21st century. Most of the Bradford royal infirmary buildings are 1930s blocks built in the old Nightingale ward tradition, as open wards. Although the hospital staff do sterling work given the conditions, there are great needs at those hospitals.

Despite those challenges, I am proud of the good NHS systems in Bradford. For example, South and West Bradford primary care group was PCG of the year in 1999. Bradford also won health authority of the year in 2000, an award given by The Health Service Journal. Bradford has received various NHS beacon awards for primary care and hospital care, and Bradford hospitals have won several other awards, including one for cancer care at Bradford royal infirmary.

The overall number of people in the Bradford district waiting for admissions between September 1998 and December 2000 has fallen by 20 per cent. In that same time, the figure of more than 500 people waiting for more than 12 months has been reduced to zero. We have

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successfully implemented winter plans; there have been no bed closures and there has been no adverse impact on casualty. We have some of the lowest rates of delay from discharge in the region, so there has been little bed blocking. There is, too, an increasingly healthy ethos among the NHS staff at Bradford; management is devolving decisions and letting go, allowing frontline staff to make decisions and to make a real difference.

I wanted to set the scene about hospital and health provision in the district, but I also wanted to talk about some of the recent advances that have taken place in the district. A number of those advances are unsung--they have had very little publicity or coverage--but I am immensely proud that, step by step, some investment has been applied and is making a difference. At the Bradford royal infirmary and at St. Luke's, there are a number of improvements.

The Bradford royal infirmary has a brand new accident and emergency department to treat a large number of patients--approximately 100,000 a year. That department is now four times the size of the former cramped facility. A year ago, I spent a Friday evening, up until midnight--one of the peak periods--in the old accident and emergency department, and it was like something from a 19th-century novel. To now have this much larger, better-equipped facility with an improved triage, a separate children's facility, a nine-bay resuscitation unit and improved security for staff makes a wonderful difference for the whole of the district.

This year, the hospital will have a £1 million cardiac catheter laboratory, aimed at more than doubling the number of angiograms that can be performed annually, from 400 to 1000. That will make a huge difference, and is thanks to some of the capital investment. I recently visited the new intensive care beds, which have been operational since December. There are now eight intensive care beds, supplemented by some new high-dependency beds, all of which increase the capacity to serve that large community.

The hospital has a new operating theatre in the ear, nose and throat block, helping to reduce waiting lists. An extra ophthalmologist has been employed to tackle cataract problems, among other ailments, and £1 million has now been approved for the centralisation of paediatric services. More than £500,000 has been made available to improve the out-patient facility at St. Luke's hospital. These are areas where we have great problems in terms of the buildings and services, so step by step, some of the more recent investment has begun to make a difference.

However, it would be remiss of me to fail to mention another great hospital in my district; Airedale general hospital, where I was born in 1972. The hospital was recently ranked as having the seventh-lowest mortality rate in the county on a like-for-like basis without deprivation indices. This is a great sign that the staff and that facility are not only extremely popular locally, but extremely effective. I understand that just this morning the hospital opened the newly refurbished accident and emergency department, where £330,000 has been invested in new X-ray equipment and modern resuscitation facilities. It is coincidentally fortuitous that we are having this debate today to recognise that milestone being passed.

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Also at Airedale, £500,000 was invested in upgrading the admissions and assessment ward that opened at the beginning of December 2000. There was an investment of £750,000 on angiography and mammography X-ray facilities, with extra high-dependency beds installed.

The list is much longer, and I could not possibly cover some of the extra advances that have taken place in the short time that we have for the debate. However, more investment is needed and there is much more to do. The reason for today's debate is to look at how we have been benefiting from new investment, how--before we achieve a truly modern NHS of the highest calibre--we plan for the future, and how we put our foot on the accelerator in terms of investment and hopefully bid for some even better, more radical advances. Bradford has embraced the NHS plan and we are keen to see the benefits of the proposed modernisation programme that it describes. Bradford, as much as anywhere, needs 21st-century buildings and equipment. The main hospital buildings at Bradford royal infirmary are antiquated and inappropriate for today's needs; there is a compelling and urgent case for massive new investment in Bradford's health services to bring acute services into the 21st century.

We want to be in the list of nationally approved new district general hospitals. The district's capital investment programme is being considered as an integrated programme and all the local agencies support it. A great partnership effort went into producing the strategic outline case submitted by the health service stakeholders in the district. It is ambitious and far-sighted, but immensely achievable and affordable with the available new moneys.

The bid is for £70 million of new-build capital investment at the Bradford royal infirmary site and £30 million refurbishment works in addition. The aim is to preserve the best elements of the current Bradford royal infirmary facilities and add on new elements; for example, a new series of operating theatres, a radiology suite, short-stay and day-case units and a consolidated women's hospital at one site.

St. Luke's hospital would become the focus for rehabilitation and post-acute care and be the main out-patients centre. BRI would be the base for all acute work, from emergencies to elective in-patient activities. That would significantly reduce Bradford's split-site problems and help to reduce waiting times and waiting lists. The proposal would improve the working environment for staff and, for the first time, there may be health services in our district that are designed around the patient's needs, and not around the geography and typography of the site and the difficulties of getting round the city.

It is an exciting vision for Bradford district health care in the 21st century, which can come about only because of the extra priority given to investment. Public services are not seen as something that must be scaled down and cut back; there is a belief that the NHS is vital. Our constituents will get what they want: a growth in services and in investment. I know that we have had a lot of Government money, but I strongly hope that the Minister will consider the bid favourably and make the extra investment that we want in the future.

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1.42 pm

Mr. Terry Rooney (Bradford, North): I thank my hon. Friend the Member for Shipley (Mr. Leslie) for securing the debate and the Minister for his commitment to Bradford. We appreciate the regular cheques that arrive; the current one just happens to be slightly larger than the others. We are arranging a party for the Minister next week.

I want to talk about the issues arising from the ageing condition of the Bradford hospitals and the split-site operation. There is a health community in Bradford; the partnerships between hospital trusts, primary care trusts, community health trusts and social services are a model for the health service nationally. They form a partnership of equals, which works exceptionally well.

There is a need to develop those links and to divest many more services from the hospitals. The problem is that because of the state and age of the buildings, many of the revenue costs--perhaps as much as several millions of pounds--are tied up in those decrepit buildings. With bright, modern facilities, money could be released into patient care and into preventative work, an issue about which I am very concerned.

As the Minister knows, there is a health action zone in Bradford, which has been outstandingly successful in treating diabetes. A stack of other innovative proposals is waiting to be developed, but people are reluctant to ask the Government for even more money than the bounteous sums that we are already getting. However, by improving the fabric of the district hospitals, millions of pounds could be released to develop the services.

It is virtually impossible to maintain the buildings to acceptable standards of cleanliness. I speak from personal experience because, a few years ago, my wife had secondary and third infections following an operation. They resulted from poor standards of cleanliness. I mean no disrespect to the cleaners, who do their best and are still suffering from the disastrous compulsory competitive tendering arrangements introduced by the previous Government. Their job is difficult because of the physical structure, appearance, style and texture of the buildings. An above average number of people have to come back to do the job again. There is dead money that nobody wants to spend, which could be invested to develop other services.

I have a particular interest in health concerns among the ethnic minority community. Life style, diet, ignorance and language barriers can all be a problem. Exciting proposals have been made to develop services at the community level rather than institution-based services. Once again, the resource element is holding us back. We do not need any more money; we can release it from the additional costs that we are incurring by maintaining these ancient buildings.

I hope that the Minister will be able to make some pleasing sounds this afternoon. I know of his commitment to Bradford and I enjoyed his visit last year. I hope to see him there again in future--hopefully to open the brand new hospital that I am sure he wants to promise us today.

1.45 pm

The Minister of State, Department of Health (Mr. John Hutton) : I congratulate my hon. Friend the Member for Shipley (Mr. Leslie) on his success in

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securing the debate. I pay a personal tribute to his work in attempting to improve the national health service in his constituency. He has always spoken up for the NHS in Shipley and I know that he will continue to do so well into the future. Along with all my hon. Friends who represent Bradford, I want NHS services to continue to develop in that city. Under this Government, they will.

We have increased resources for Bradford year on year. This year, Bradford health authority received a cash increase on its budget of more than £30 million--6.7 per cent. over and above inflation, or a 9.3 per cent. increase in cash terms. Next year, there will be a real-terms increase of 6 per cent.--more than £27 million in cash terms.

The benefits of those extra resources can be seen in the number of patients treated. Last year, 5.7 per cent. more patients were seen in Bradford than in the previous year. Nationally, waiting lists have come down from the record levels inherited from the previous Government. Not only are fewer people waiting in Bradford, but those who do wait do not have to spend as long on the list. My hon. Friend referred to the progress made in that respect.

The number of patients treated is not the only important factor. As my hon. Friend said, we must also ensure that we have the most up-to-date facilities to treat patients. Bradford has seen significant new investment. Nationally, £115 million has been spent to modernise every accident and emergency department in England that needs it. The accident and emergency department of the Bradford royal infirmary has been modernised at a cost of £5 million. That development, which was completed in October, houses one of the most modern and technologically advanced accident and emergency facilities in the country.

The new unit is a dramatic improvement on the original inadequate facilities. We are gradually sweeping away old and outdated Victorian buildings and replacing them with an NHS fit for the new century. New purpose-built facilities will enable the hospital to assess patients much more quickly, minimise their wait and care for them in a more private and dignified environment.

The superb facility includes a dedicated children's accident and emergency department that provides separate waiting areas, with facilities geared more towards the needs of young people. In addition, the trust has received a further £700,000 from this year's modernisation fund further to improve and modernise its services. That has been spent on new nurse-led clinics, the introduction of booked admissions to allow earlier and more convenient hospital appointments for patients and studying how services can be better delivered for patients in primary care.

In Bradford district, we have invested more than £3 million to equip 130 general practitioners to provide secondary care. That has meant that a total of 20,605 non-hospital out-patient consultations will be undertaken by GPs this year in Bradford, as well as 11,500 procedures that would otherwise have been carried out in secondary care--a better service for patients that frees up hospital time.

We have also provided the Airedale trust with more than £700,000 from the modernisation fund for equipment and building alterations aimed at further

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reducing waiting times and providing additional equipment. Bradford trust has been given new and replacement trailers and X-ray equipment for the Pennine breast-screening programme from the new opportunities fund for cancer services. The Airedale trust, to which my hon. Friend was right to draw our attention, is proceeding with a £3 million procurement to replace radiological equipment.

I am aware that time is limited, but I shall quickly mention a number of other important investments that have taken place in Bradford. An additional £500,000 is to be provided to Bradford health authority to tackle coronary heart disease and my hon. Friend referred to the progress that we are making there. A further £500,000 is to provide 120 extra intermediate care beds, to improve the health and social care of older people. There will be £300,000 from the modernisation fund to enhance security measures for the accident and emergency department. We have made available two additional critical care beds for Bradford hospital and two high dependency beds for Airedale hospital, which have certainly improved care this winter.

Money and equipment is, of course, welcome, but the NHS also needs more doctors and nurses to provide the additional services that patients need. The past three years have seen an additional 340 nurses, midwives and health visitors in Bradford--an increase of nearly 15 per cent. that has been mirrored by increases in medical and dental staff at the hospitals. Significant new investment has taken place, but we can only deliver a more modern and dependable NHS through doctors and nurses delivering services that are better organised around patient's needs. I am pleased that Bradford has delivered on that too.

I was delighted to hear that The Health Service Journal awarded its health authority of the year accolade to Bradford health authority this year. As my hon. Friend is aware, these things do not happen by accident. In Bradford, much imaginative and pioneering work is being done to improve services to patients. My hon. Friend reminded us of my visit to Bradford last year, where some fantastic things are being done by people working in the NHS and their partners in local authorities to improve the health and social care needs of the local population.

My hon. Friend rightly referred to the fact that Bradford has been in the vanguard of establishing new primary care trusts--I think some of the first in the country were set up in his area. That has provided the freedom for local services to modernise much faster than might otherwise have been the case. For example, the Airedale primary care trust is building new primary care surgeries and using new technology to pioneer a shared patient information system.

Bradford City--not the football club, but the primary care trust--has managed to take on additional practice staff and work with partners on a new, assertive outreach mental health team. I was pleased to meet the team last year and find out how they were improving services for people with mental health problems in the city.

Bradford South and West primary care trust has used extensive patient involvement to improve services for patients with coronary heart disease, diabetes, cancer and mental health problems. North Bradford primary

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care trust has been impressive in its imaginative approach to reducing waiting lists and improving access to local services.

Those improvements and successes have been made against a backdrop of a population of almost 500,000, in a district with a wide range of social, geographical, ethnic and health variations. As my hon. Friend said, Bradford is the eighth most deprived district in Britain and one in which there have been wide inequalities in its health experience for many years--a factor that led to the district becoming one of the first health action zones to be established in England in April 1998.

As my hon. Friend the Member for Bradford, North (Mr. Rooney) said, Bradford health action zone continues to receive significant funding to tackle the major health problems in Bradford--this year, we allocated to Bradford more than £4.7 million. The focus has been on diabetes, as my hon. Friend said, as well as rehabilitation, improving health for minority ethnic groups and services in the inner city.

The health action zone continues to make significant progress in tackling inequalities and modernising services to improve health in the most deprived areas of the city. Health action zone initiatives, for example, ensured continuity of discharge arrangements through last winter and maintained waiting times despite increased admissions into hospital.

As my hon. Friends the Members for Shipley and for Bradford, North said, we have recently received a strategic outline case to invest more than £100 million in new acute services in Bradford. The Bradford hospitals NHS trust proposes to create a new hospital facility on the Bradford royal infirmary site to treat acute and emergency patients, as well as a post-acute rehabilitative and out-patient facility at St. Luke's hospital. That will permit the introduction of a patient-focused model of care to enable all acute in-patient activity to be undertaken on one site, and the essential re-engineering of clinical services. It involves a combination of substantial new build on both sites, with major refurbishment of existing 1930s accommodation on the Bradford royal infirmary site and demolition of the Victorian accommodation at St. Luke's hospital. The trust has submitted a strong and well-made case for that re-development. As my hon. Friend is aware, it is being actively considered by the Department of Health and we expect a decision in the next few weeks.

My hon. Friend the Member for Shipley will want to join me today in thanking everyone who works in the NHS and the Bradford district for their tremendous work, day in and day out. We are all committed to providing first-class treatment for every patient. We are replacing the old Victorian hospitals and mindsets and replacing them with a new, vibrant and modern national health service of which we can all be truly proud.

The NHS plan sets out our vision for the future of the health service. The money that we have put into the service in Bradford and the dedication of the staff in the city will ensure that the vision that we all share--all hon. Members who represent Bradford and the Government--will become a reality.

Question put and agreed to.

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