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Queen’s Recommendation having been signified—

Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a) (Money resolutions and ways and means resolutions in connection with bills),

Question agreed to.


Order for Second Reading read.

Question, That the Bill be now read a Second time, put forthwith, pursuant to Standing Order No. 56 (Consolidated Fund Bills), and agreed to.

Bill accordingly read a Second time.

Question, That the Bill be now read the Third time, put forthwith, and agreed to.

Bill accordingly read the Third time, and passed.

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Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),


Question agreed to.

Mr. Speaker: If it is convenient to the House, I shall take orders 6, 7, 8 and 9 together.

Motion made, and Question put forthwith, pursuant to Standing Order No 118(6)(Standing Committees on Delegated Legislation),

Constitutional Law

Representation of the House

Question agreed to.


Mr. Speaker: If it is convenient to the House, I shall take motions 10, 11 and 12 together.


Constitutional Affairs

Education and Skills

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Mr. Speaker: If it is convenient, I shall take motions 14 and 15 together.



Environment, Food and Rural Affairs


London Buses

10.29 pm

Bob Spink (Castle Point) (Con): I rise to present a petition backed by a document containing more than 4,500 signatures. The initiative is the brain child of Valeria Martinelli and Tom Wright who are battling on behalf of people who use London buses and London Transport—which includes many of my constituents—who have to endure inconsiderate behaviour. The petition runs parallel with my own campaign against increasing levels of threatening and bad behaviour on London buses.

The petition states:

To lie upon the Table.

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Maternity and Paediatric Services (Teesside)

Motion made, and Question proposed, That this House do now adjourn. —[Huw Irranca-Davies.]

10.31 pm

Mr. Iain Wright (Hartlepool) (Lab): I am grateful to have the opportunity to raise the future of maternity and paediatric services in Hartlepool and Teesside, which also takes into account the future shape, sustainability and viability of the university hospital of Hartlepool.

I wish at the outset to pay tribute to the staff of the North Tees and Hartlepool NHS Trust. They have delivered a first class service to patients over the past few years, with ongoing uncertainty regarding services, their location and the finances of the trust. I know that only too well. In the past eight months, they have provided me and my family with a professional level of care following my grandmother’s death at the hospital on 20 April and eight days later, when my 12-year-old son suffered a stroke. All the health professionals working in the trust are a real credit to the NHS and the local area and must be supported as much as possible.

If my hon. Friend the Minister is expecting some sort of diatribe, as often happens in these circumstances, or me to argue that the hospital should not change but should deliver the same services, at the same site and in the same way as it always has, he will be disappointed. I fully recognise and accept the drivers that are pushing the Government towards the reconfiguration of hospital services. Thanks to rapidly accelerating medical technology, tests and procedures that in the past would have had to be done in a specialist centre can now be done in the local community. Professor Sir Ara Darzi illustrated that vividly in the presentation of his report on acute services in Teesside in July 2005. He said that 15 to 20 years ago cataract removals would have involved a lengthy stay at a specialist eye infirmary. Now, he claimed somewhat flippantly, the procedure can be done in a mobile unit in a Tesco car park. Operations that often meant a stay in hospital of several days or even weeks can now be treated as day cases.

I also understand that in order to receive the best specialist care available it is often necessary to be treated in bigger, more specialised hospitals. In such places, consultants are able to see larger numbers of patients, which in turn means that they can become cutting-edge specialists, working with the latest equipment and highly trained and experienced staff. I am also aware that people want to receive care as close to their home as possible. People, rightly, are more demanding in all aspects of life, including their health care, and want reduced waiting times and more choice about when, where and how they are treated. I am keen to see those trends develop and accelerate. I want to see continuing advances in medical technology provide a revolution in health care, so that treatments hitherto thought possible only in hospital, such as chemotherapy, can be provided in the community or in a patient’s home.

Professor Darzi, in his review of acute services in Teesside, was able to address those long-term challenges
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in a highly skilled way. He was extremely sensitive to local nuances—appreciative, for example, of strong and proud differences between the towns of Teesside. He was also aware of the “sucking-in” of specialist services over a number of years from north of the Tees to the James Cook university hospital in the south of the area. That has destabilised services provided at both university hospitals at North Tees and Hartlepool through the removal of some key clinical interdependencies that have contributed to the pressures on waiting time targets at James Cook.

The number of cancelled operations at James Cook over the past few years has been acknowledged by the hospital’s NHS trust—South Tees—as demonstrating

Professor Darzi devised a service model that addressed those difficult challenges. He recommended that the university hospital of Hartlepool should continue to provide a consultant-led accident and emergency service and acute medicine. It should also host a new centre of excellence in women’s and children’s services, including consultant-led maternity and paediatric services, gynaecology and breast surgery. The hospital should increase its in-patient elective surgery portfolio, particularly in orthopaedics. Major trauma and emergency surgery out of hours should move to North Tees. For its part, the university hospital of North Tees should become the main centre north of the Tees for emergency surgery, with expanded intensive care facilities. The site should continue to provide a full accident and emergency service and acute medicine.

North Tees should develop as a centre for major complex surgery, including hosting a new North Tees complex surgical centre providing upper gastro-intestinal cancer services for the whole Teesside area. It was also recommended that vascular surgery should be developed at North Tees as part of a clinical network with the James Cook university hospital.

Under Darzi’s model, each hospital would become a regional centre of excellence, able to recruit and retain staff of the highest calibre, thereby providing the best possible standard of care.

Ms Dari Taylor (Stockton, South) (Lab): Does my hon. Friend accept that if the Darzi report was implemented, as he is suggesting to the House, women and children from my constituency would face a journey four times longer than they face at present? In the main, they would have to go to Middlesbrough before they could go to Hartlepool, so in practice, they will stop in Middlesbrough and go to the James Cook hospital, thus not attending Hartlepool university hospital. The throughput of patients at Hartlepool will be significantly less, which will threaten a new department; indeed, it will close a department while North Tees has already lost an excellent gynaecology and paediatrics department.

Mr. Wright: I appreciate and respect my hon. Friend’s comments, but I disagree with them. I hope to speak about the element of choice, which is a central plank in the Government’s manifesto on health policy.
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The degree of choice for my constituents is somewhat different compared with that for my hon. Friend’s constituents.

Under Darzi’s recommendations, some services would migrate from the James Cook site to the university hospitals of North Tees and Hartlepool and to the Friarage hospital in Northallerton, thereby freeing up capacity at James Cook and enabling the hospital to achieve its waiting time targets. The model—crucially, in my opinion—provides the Hartlepool and North Tees hospitals with a sustainable future by offering distinct specialisms. With everybody giving a little, everybody in Teesside wins.

However, the recent referral of maternity and paediatric services in Teesside to the independent reconfiguration panel undermines the work of Darzi and a sustainable future for all the hospitals. His recommendations are interdependent and relate to one another. It would be difficult to unravel one piece without undermining the whole thing. If Hartlepool does not achieve status as a centre of excellence for women’s and children’s services, will my hon. Friend the Minister tell us whether, in terms of acute hospital services in the Teesside area, everything is now up for grabs? Does it mean that Hartlepool could become the site for complex surgery? Does it mean yet another review—the third or fourth in five years? Such questions and uncertainties make it clear to me that Darzi needs to be implemented as it stands, in full.

The specific configuration of services recommended by Darzi appears sensible, appropriate and responsive to local needs, both now and in the future. A significant increase in the number of older people in Hartlepool is forecast in the next few years: a rise of about 25 per cent. by 2021. People over the age of 60 will constitute more than 15 per cent. of the total population of Hartlepool. That demographic change will have a profound impact on the design and delivery of public services, particularly health and social care provision. The higher proportion of older people will mean a greater need for the co-ordinated configuration of planned and emergency surgery, with elective surgery a major part of Hartlepool hospital’s work, and it will still, rightly, have access to a full consultant-led A and E service and an emergency surgical option. That is why the full implementation of Darzi’s recommendations is so important.

Frank Cook (Stockton, North) (Lab) rose—

Mr. Wright: I give way to a proud son of British west Hartlepool.

Frank Cook: I am most grateful to my hon. Friend. Darzi’s remit was specifically to do “whatever is necessary” to preserve the Hartlepool hospital and his suggestions were numerous and widespread. His report cannot be implemented fully, contrary to what my hon. Friend wants, because the James Cook university hospital in south Tees has said that it is not having it, that it is not going to happen and that it should go away. Full implementation simply cannot happen.

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