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3 Feb 2003 : Column 117—continued

Mr. Peter Luff (Mid-Worcestershire): I am delighted to hear the hon. Gentleman say that. There is considerable concern in Evesham, expressed this week in the Evesham Journal, about the consequence of the primary care trust deficit for beds in the community hospitals in Evesham, and, indeed, in Pershore. I hope that he will emphasise the point that community hospitals have a huge contribution to make in relieving the very real problems that exist at Worcestershire royal infirmary.

Dr. Taylor: I thank the hon. Gentleman for his intervention, which underlines my comments about the importance of intermediate care beds.

In addition to my plea for the Government not to cut beds, I want to emphasise the fact that we must have new management. Doctors and nurses are continually praised in the letters that I get. The annual audit letter points out that the current management has failed, and that it has had two years to work at it since the trusts merged. There have been two votes of no confidence in the management by large majorities of consultants—a point that allows me to digress for a few moments on the relationships between doctors and managers throughout the health service. Ministers in the Department of Health have played down this point, which I have mentioned before. However, a British Medical Journal leader of 18 January described the tension between doctors and managers in these terms:

Because the problem is so real, at the end of March the British Medical Journal and the Health Service Journal will publish issues completely devoted to it.

I have another suggestion. We welcome the diagnostic and treatment centre that will be provided at Kidderminster, because that, too, will ease the load on

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the acute hospital. We also welcome the proposal for an orthopaedic centre, which will help even more by taking patients not only from Worcestershire, but from other parts of the west midlands. Whatever else is developed at Kidderminster will ease the situation in the whole county, and nurses will come to staff it. We have already seen, through the very welcome renal unit that was developed at Kidderminster—thanks greatly to the Government and to the Department of Health—that nurses have flocked back to staff that unit. So if we develop the diagnostic and treatment centre and the orthopaedic centre, nurses will come back, which will ease the agency nurse problem for the whole county, and ease the load on the acute hospitals.

The final point is that the Department of Health is about to produce a document on configuring hospital services. I will hypothesise, and express hope, about what it may include. I believe that it will recognise that big is not always necessarily the best, and that local services are absolutely vital. Local emergency centres are being tried in places such as Penzance and Bishop Auckland to take the strain off the larger hospitals, while keeping services local. Something like that is needed in Wyre Forest and Worcestershire to take the pressure off other services in the county.

The reasons for that are incontrovertible, and I shall give some specific examples. Not so long ago, an ambulance went to the house of a man with diabetes whose wife could not rouse him because his sugar level had gone too low. The ambulance men could not rouse him so, purely and simply for an injection of glucose into a vein, they had to take him 20 miles. That is ridiculous.

Minor fractures that cannot be coped with in the minor injuries unit clutter up the accident and emergency department at Worcester. I had a letter this morning concerning an 87-year-old lady who had collapsed in church. Her 88-year-old friend went with her on the ambulance to Worcester, where she was sorted out. There were no beds and that lady could not be admitted, so they were told to go home. There were no arrangements made for them and they had to make their own way home.

I am appealing for a change in management, no bed closures, an acceleration of the diagnostic and treatment centre and a look at the advantages of starting a local emergency centre for Wyre Forest to benefit the whole county.

9.57 pm

Mr. Michael Foster (Worcester): Thank you, Mr. Speaker, for this welcome—and perhaps unexpected—opportunity to speak about NHS hospitals in Worcestershire. I congratulate the hon. Member for Wyre Forest (Dr. Taylor) on bringing to the House the subject of the importance of NHS care in our county.

On Friday evening, I took it upon myself to do a spot check on the Worcestershire Royal hospital. I went to the reception in the main foyer and asked to see the duty manager, at which point I was taken around the wards that I wanted to see. I saw for myself, at first hand, some of the issues that had been making the headlines in the local papers. I can confirm to the hon. Gentleman that there was one manager with me and that I was left to talk to staff and patients perfectly freely. They gave me their

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personal views of the position of the hospital, which seem to have made the headlines in a local paper this evening.

The hon. Gentleman said that he aimed no criticism at nurses and doctors who are working so hard in the hospital; neither do I, and I did not infer that the hon. Gentleman did. In my press release, I said:

That is the point that I should like to reinforce to the hon. Gentleman. When criticisms are made of the hospital, they affect nursing staff on the front line. Those are the words of the nurses to whom I spoke on Friday; they are not my words. When we debate the future of health care in our county, we should be careful not to give the impression that our health service is not doing the best it can for patients. If we are going to have a go at management—as seems to be the thrust of the hon. Gentleman's case—we must do so on specific grounds and not in a general way that can be interpreted by friends, neighbours and those who work outside the hospital as something of which the nurses and doctors should be ashamed.

When I was talking to patients, it was clear that they had the utmost regard for the nurses and doctors at the hospital and for the work that they are doing—

It being Ten o'clock, the motion for the Adjournment of the House lapsed, without Question put.

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Caplin.]

Mr. Foster: Patients go out of their way to praise the cleanliness of the new hospital. I mention that because my mother was a nurse and she has a thing about the cleanliness of hospitals "in her day", as she would describe it. I spoke to a patient whose wife was also a former nurse and she had the same bee in her bonnet: cleanliness really counted for something. That patient had to occupy a bed at the Royal Worcestershire although he was actually waiting for a bed at the Queen Elizabeth hospital, Birmingham, so that he could receive the next stage of his treatment. That should not be taken as criticism of Worcestershire's ability to cope, but of the wider health economy of the region.

The hon. Member for Wyre Forest made some valid points about management and, on Friday, I shall take up with the chairman, Mr. O'Riordan, the issues about gagging staff. That is a serious point and it should be addressed by the hospital. However, when my right hon. Friend the Secretary of State opened the new private finance initiative hospital, he held a meeting with staff behind closed doors and I suspect that they said exactly what they felt. I am sure that none of them would have been threatened by the management for speaking to the Secretary of State about their concerns.

In relation to the district auditor's letter and the financial position of the acute trust, the projected overspend of about £6 million is worrying. However, the problem will not be relieved by a 20 per cent. cut in health spending, nor by refusing to back increases in taxation to pay for resources for the health service. I take the hon. Gentleman's point, however: agency costs

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were much higher than budgeted. I think he said that they were £7.5 million higher than expected, so they could be responsible for the £6 million deficit.

However, I am sure that the hon. Gentleman would like to congratulate the trust on taking seriously the points raised about agency costs. It has negotiated a 10 per cent. reduction in agency fees with the British Nursing Association, which I am sure that he welcomes. My concern is that the extra resources going to the health service are giving a green light to ripping off the NHS, which should be deplored by everybody.

The hon. Gentleman should also congratulate the trust on using NHS Professionals—an initiative that has freed up more people to undertake agency work. A local NHS Professionals manager has been appointed to oversee and promote the use of more temporary staff from that agency. What would happen to patient care at the hospital if budget limitations meant that agency nurses could not be used? Awful though it is to have an increased deficit due to the use of agency care, there is no real alternative for NHS hospitals unless permanent, trained nursing staff are in place. Getting the full complement of staff to service the hospital so that it can work at full capacity must be the aim for all of us.

The reason the hospital cannot recruit enough staff is that it cannot draw on a big enough pool: not enough people were trained 10 years ago to fill our current vacancies. However, I applaud the hospital for the efforts that it is making to recruit extra staff.

The hospital trust has sent me a briefing note, detailing the number of vacancies that it hopes to fill in the near future. The hon. Gentleman did not mention it in his contribution, but I am sure that he would welcome the fact that 30 international nurses commenced their adaptation programme in the week beginning 20 January this year, that 31 student nurses who qualified at University college, Worcester in March have expressed an interest in working in the trust, that 24 nurses from India will be joining the trust in the spring, that 10 nurses have been recruited locally since December 2002, and that 41 student nurses have already applied for jobs in the trust from the August school.

The trust launched a new recruitment campaign in the local media in December. That campaign has continued into the new year. By 17 January, the trust was processing 123 application forms submitted because of those advertisements. That welcome initiative by the trust should be applauded but, unfortunately, the hon. Gentleman did not mention it in his contribution. [Interruption.]

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