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As the Secretary of State clearly outlined, we are right to be sceptical about why this debate was called, although I believe that it is perfectly right to look at deficits in the NHS and for Members to consider them seriously. However, it galls me a little to hear some of the comments from the debate, because as a nurse working in a trust, I was asked to forgo half of my pay rise because there was no money to pay staff. Strangely, that was in 1996, when I believe we had a Conservative Government.
We know how much funding has increased. Indeed, the extra cash that has gone to the NHS is astoundingit is something that we dreamed of. Before 1997, we did not believe that that could become a reality. We therefore have to consider what can go wrong against the background of that extra funding to the NHS, and understand why some trusts get into difficulties.
I am afraid that for Surrey and Sussex Healthcare NHS Trust the pattern of decline was set many years ago when Crawley hospital was not invested in, when its priorities were not foreseen, when it accumulated an enormous amount of necessary repair work and when issues connected with the quality of service were not tackled. I know, because I was a night nurse who more often than not worked alone without the support of senior doctors. So, on the day after the momentous election in 1997, I knew that we would face difficulties, because there was no way that a Labour Government would allow the quality issues in the NHS to be ignored. It would have been easier
It would have been easier for us to jog along and not tackle many of the issues. Our local residents would have thought that everything was fine in the NHS, that there were no problems and that there was no need to worry about senior staff or accreditation and the fact that the royal colleges were going to withdraw the support of junior doctors in the trustbut of course we had to worry.
Mr. Blunt: While the hon. Lady is dealing with the issue of deficits I hope that she will not overlook informing the House of her own contribution to creating a deficit at Surrey and Sussex trust by her intervention in 2001 to stop the reorganisation of services between her hospital and East Surrey hospital, which cost more than £10 million and continues to cost that today.
Laura Moffatt: I am very grateful to the hon. Gentleman for raising that issue. I do not know whether he is aware of just what a fantastic contribution he made to ensuring that my constituents knew that I was fighting on their behalf to keep our hospital open. I publicly thank him for his work, because I could not have paid for the publicity that he gave me. I do not think that any Member could be criticised for ensuring that their hospital survives.
As I said, there was a lack of investment in Crawley hospital. Without doubt, it would be closed by now if the Labour Government had not ensured that money was available to keep it going. The agenda was clear. Without a shadow of a doubt, Crawley was ready for closure, because no investment had been made in it. I am therefore deeply proud of my contribution to efforts to ensure that it remained open.
The issue of deficits overshadows much good work. My main complaint is that it is difficult to talk about anything other than deficits in any forum, even when £19.2 million of desperately needed capital investment has been made in Crawley hospital. That money has been used to provide a dialysis unit and to upgrade the
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walk-in centre to an urgent treatment centre that will see people 24 hours a day. Some 85 per cent. of people who came through the door of the walk-in centre will still be entitled to do so to receive emergency care. This debate appears to suggest that everything is wrong, but even in the trust with the biggest deficit in the country significant improvements are under way. Staff are delivering services that I did not even think possible. The trust can offer cardiac catheterisation. People used to go to London to have that done, but they no longer need to do so. A chronic disease management centre is under construction at Crawley so that people can receive walk-in care and will not have to spend weeks in hospital. GPs in my area can now refer dermatology patients for treatment the same week. They used to wait 22 weeks for such treatment.
Mr. Graham Stuart: The hon. Lady said that the Labour Government would not ignore quality issues. Does she think that the doubling of deaths from hospital-acquired infection shows a Government committed to quality?
Laura Moffatt : I am worried about the way in which the hon. Gentleman phrased that question. I worked in an isolation unit, where I cared endlessly for people with hospital-acquired infection. We did not even count the number of people trooping through my ward. A day did not go by without another ward ringing to inform us of another patient who had to be isolated because of hospital-acquired infection. We therefore need to be careful about the way in which we articulate the problem. The way in which we are tackling it now bears no relation to the way in which we did so before 1997. At that time, there was no commitment to address quality issues, and we did not prescribe the drugs that are used today. Soon after the 1997 election, surgeons and medics in my area, particularly those who were dealing with cancer patients, rang us every other day begging us to release drugs for treatment. That no longer happens. I accept that there is a big debate about Herceptin, but, quietly and gently, people are now receiving the services that they need. Locally, people might be upset if services change and there is no longer a hospital on their doorstep that can offer them all the services they need, but when they do receive hospital treatment they know that they will receive a first-class service.
Grant Shapps : I accept that the hon. Lady is speaking with a great deal of sincerity, given her nursing background. However, is she not in the least concerned that things are going off the rails? We have heard many stories about trusts in deep deficitindeed, a deficit of £1 billion may be run up next yearso is she not embarrassed about her Government's performance?
We need to get deficits under control. We have a fantastic campaign group in Crawley that is desperate to have a new hospital. We cannot offer that unless management can control the budget, which will enable us to move forward and offer even more services to more people, thus ensuring that the Labour Government do what people expect them to dodeliver a first-class NHS.
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Mr. Nigel Waterson (Eastbourne) (Con): I am delighted to be able to take part in this timely debate. I called a debate on 6 April about the problems at my hospitals trust. It was the last Westminster Hall debate of the previous Parliament. The position then was extremely grave. The trust had issued a press release referring to extreme pressure on the hospital, 97 per cent. bed occupancy over a period of six weeks and 158 operations cancelled, and it was proposing to close accident and emergency for periods because of the severe pressures. The then chief executive said:
I had a meeting at the time with the Minister of State, the hon. Member for Doncaster, Central (Ms Winterton), which she will remember, and she agreed to put a recovery and support unit from the Department into the local NHS. In short, we had some serious problems.
What has changed since April? We had a general election campaign and suddenly, miraculously, some funds were found to ease some of the bed-blocking problems that we had at the time. We already had the highest level of bed blocking in the entire NHS. We have seen nothing of the recovery and support unit. It may have intervened, but as far as I am aware, it has not been to my local hospital. Extra funding has been put in by the county council. East Sussex county council has again had one of the lowest, if not the lowest, settlements of any county across the country, but in the past four years it has managed to increase spending on older people's services by 35 per cent., despite the fact that over that four-year period its central Government grant has increased by only 1 per cent. if one strips out the money passported to education.
What has the hospital done? It has opened a new, allegedly temporary ward, the Polegate ward, in the car park. It has tried many different ways of reducing the level of bed blocking in Eastbourne and Hastings, yet delayed transfers of care remain stubbornly high. Recently, they nearly reached 100 bedsthat is, 10 per cent. of all the beds across the whole hospitals trust. That has led to cancelled operations. In a six-month period, 472 operations were cancelled at the last minute. This year the trust is expected to make cuts of £17 million.
In August the then acting chief executive sent a letter to all consultants in the hospitals dealing with the overspending, making it clear that reducing the deficit and getting back into balance was a priority alongside MRSA reduction, cancer waits, emergency access, waiting times and so on, and pointing out that tough budget decisions were needed, with no issue off limits for debate. The letter mentioned also
One of the problems with the bed blocking has been the difficult budget for social care in the county of East Sussex. We have the highest proportion of over-85-year-olds in the entire country, which has put an immense burden on social and health care. The county council is spending above average per head on the problem, yet contrary to popular beliefit certainly seemed to be the belief of the Minister who answered my debate in April,
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now the Transport Ministeraverage earnings in East Sussex are some £5,000 less than the average for England.
Since April, the problems have got worse, not better. Staff, patients and their families have experienced intense pressure, a high level of operations have been cancelled and the bed blocking is the worst in the entire NHS system.
In the meantime, we have lost our chief executive, who left in slightly mysterious circumstances, and I have been unable to obtain details of the severance package paid to her. A new chief executive was parachuted into the trust without the post being advertised, without competitive interviews and without any of the other provisions that are normally observed in the public sector. There has been a culture of secrecy at the local trust, although Ministers have stated in written answers that they were not involved. I suspect that the strategic health authority was the real driver behind that culture, but I am yet to accept that there are no ministerial fingerprints. Many of my constituents think that if several hundred thousand poundsthis is a rumour, but rumours can be countered by publishing the detailshave been taken out of patient care for a severance package, the matter should be put in the public domain.
We have a new problem, as well as a new chief executive, whom I wish well given the problems that she faces. Only a few days ago on 9 November, the hospital announced unilaterally that it will turn away patients from out-patients, because it has reached the level agreed in the contract with the local primary care trusts, but the PCTs dispute that point and take the view that it is still under contract. In fairness to the PCTs, they have stepped forward to try to ensure that every patient is seen within the 13-week period, even if patients have to be referred to private providers. I hope that that is what happens, but I do not want to see an additional burden being transferred unilaterally to my local PCTs, not least because they are also in deficit. When I asked the chairman of my local PCT at its annual general meeting in the summer whether the PCT would prioritise patient care or eliminate the deficit, she made it clear that the PCT would put patient care over eliminating the deficit.
I have tabled an early-day motion asking the Government urgently to review funding in East Sussex for social and health care, particularly having regard to the high proportion of elderly people to which have I already referred. I have not yet received an answer to this vital question: will eliminating financial deficits or the clinical needs of patients take priority under this Government?
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