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16 Jan 2007 : Column 228WH—continued
The fund will pay for major improvements in community infrastructure across the country. It will create a new generation of community hospital facilities, and it is for local communities throughout the country to make their case to secure part of that fund. I accept the points made by Liberal Democrat Members about ownership and local communities’ wish to feel a part of such hospitals, but that is exactly what the community hospital fund makes possible. It encourages a strong partnership between local government and the NHS, and we want proposals from local communities that are not ticked off according to a prescriptive definition, but which meet local communities’ needs and are defined by them.
Exactly such a scheme has been approved. The Minehead community hospital is in a part of the country that hon. Members know well. It has been allocated a major amount of funding to transform it into something healthy and living. I do not believe that hon. Members feel that that is inappropriate. In fact, it provides the sort of local ownership that they are calling for the Government to provide.
I would like to finish by taking head on the point of the hon. Member for Westbury (Dr. Murrison) about the funding formula being politically driven. That is an absurd and outrageous allegation. Politicians would be accused of interfering if they went to every consultation and said “That is right” or “That is wrong”. Conservative Members are calling for an independent NHS. Do they really want Ministers to crawl over every proposal, or do they want no accountability?
Miss Anne Begg (in the Chair): Order. We must now move on to the next debate.
Health Services (Teesside)
11 am
Frank Cook (Stockton, North) (Lab): First of all, Miss Begg, may I ask you to convey my thanks to Mr. Speaker for permitting me the opportunity to raise this issue in the Chamber this morning? On countless occasions, I have occupied the Chair that you occupy now, Miss Begg, as Deputy Speaker here, but this is only the second time that I have availed myself of the opportunity to raise an issue from the Floor. In doing so, I am rather pleased and relieved that my hon. Friends the Members for Stockton, South (Ms Taylor) and for Hartlepool (Mr. Wright) are in attendance. Hartlepool is my home town. I managed to escape the rope—I do not know whether he will, but I wish him well. However, I thought that one or two other Members might have attended because although the issues I am raising relate directly to that area in the north-east, I shall make some comments on the general reorganisation of the health service.
Perhaps the easiest way to achieve my aims this morning is to approach the matter historically—rather than hysterically, which I am afraid is how far too many comments have been made in the past, without true regard for the facts. I suppose that I have been concerned about the hospitals involved ever since Frank Harsent was rejected as director, which goes back some years. We had some very troublesome exchanges when trying to mollify the acrimony between my home town of Hartlepool and my adopted town of Stockton. My hon. Friend the Member for Stockton, South will remember some of those episodes with tinges of regret, as do I.
The aspect of the saga that concerns us now, however, really started with a phone call that I received when in the USA in the early months of 2004 from Sue Coward who told me that during the by-election, in which my hon. Friend the Member for Hartlepool was thankfully elected, voters were being terrified by claims from the hyenas of the political savannah—the Liberal Democrats—that Hartlepool general hospital was under threat of closure. That was a downright lie, and they knew it, but as ever that did not stop them propagating inaccuracies.
I was so concerned that I phoned the chairman of the primary care trust, the leader of Stockton borough council and my contacts in Hartlepool and alerted them to it. That resulted in the Home Secretary, who was then a Health Minister, and the Prime Minister, issuing statements saying that Hartlepool general hospital was not under threat, which of course was true. Nevertheless, that campaign went ahead, but my hon. Friend won the day and the Liberal Democrats were discredited by their false accusations.
The outcome was that the Tees review conducted by Ken Jerrold under the chairmanship of Tony Waites was put on the shelf and almost allowed to gather dust. Professor Ara Darzi—a noble man, and I will not hear a word said against him—was given the task of making sense of it all. His remit was that first he should read Ken Jerrold’s review and then recommend measures to preserve Hartlepool general hospital. That was an astonishing instruction bearing in mind the fact that the hospital was not under threat of closure.
Professor Darzi set about his work with a will, and quickly produced a report that could have been submitted, but it was then thought by elders and betters that it might be a bit embarrassing if it was announced before the general election. At that time, my hon. Friend the Member for Hartlepool was already sitting with us on the green Benches and contributing effectively to our debates. There was a worry, though, because a general election was in the offing, so it was thought that it would be better if the report was published afterwards, but the later publication had to be justified, so the idea was proposed by a gentleman whom I shall not name to extend the terms of reference to include the James Cook university hospital and the Friarage hospital in Northallerton.
That was done, and finally we got the Darzi report, which was a magnificent piece of almost critical path analysis—it had arrows going left and right, and Departments going here, there, up, down and all around. It was beautiful, and to the uninitiated it looked convincing, but to the medical profession I am afraid that it was an outright disaster. Many have said that and many have acted on it: we lost an outstanding orthopaedic surgeon called Mr. Miller, who moved to Liverpool because he was unhappy with what was happening—although he still comes back to Teesside to get his hair cut. We lost an eminent paediatrician and gynaecologist who went south. I happen to know also that an anaesthetist with 30 years’ service at the hospital is looking to finish his professional career elsewhere. They are all excellent senior men disturbed by the Darzi proposals.
Staff at the James Cook university hospital south of the river were not disturbed at all. In professional, collective unanimity they said, “It’s not going to happen and we’re not going to participate.” The Darzi report as it was first presented was doomed to failure from the outset, because the medical profession would not have it. Now we are left with a residual concern manifesting itself in the pages of Hartlepool’s local press. It seems that there is still a fear that the hospital is under threat of closure. I state quite boldly that it is not under threat of closure and never has been, and—as people will hear from the words that I shall utter this morning, if I am allowed—it never will be until such time as it collapses into a pile of dust.
Agencies in Hartlepool are seeking to acquire the maternity and paediatric services at the University hospital of North Tees, which has an excellent maternity and paediatrics unit. It is a centre of excellence—so much so, in fact, that it was opened six and a half years ago by none other than my right hon. Friend the Prime Minister, accompanied by his good lady, Mrs. Blair. North Tees’s record is superb—indeed, it is second to none—because right next door, in the same building, are the emergency surgical services that are necessary to take care of cases that might go awry, when mother nature gets awkward. Hartlepool wants to take that unit, yet it does not have the emergency surgical services. There seems to be a hiccup—is that the word?—or at least a glitch in the logic being applied. To take a unit on which millions of pounds have been spent and convey it 12 or 13 miles to the north-east, where it will not have immediately to hand the necessary back-up services that it has at North Tees, is frankly madness.
If we consider the proposal in terms of demography, it is even screwier. Hartlepool is my home town, and my family still live down there. According to the figures for 2005, the population of Hartlepool is 90,000. That is a lot of people—or at least a lot of Hartlepudlians. They are formidable one by one, so 90,000 of them can be a real problem, although I am sure that my hon. Friend the Member for Hartlepool realises that. However, the same figures, from the Office for National Statistics, show that the population of Stockton is 186,700. In other words, it is more than twice the size. Yet we seek to remove the maternity unit from the larger area and take it to the smaller one. That is another glitch in logic.
My hon. Friend the Member for Stockton, South and I have also recognised already that because of the distances involved many of her constituents will not naturally and instinctively make a beeline for Hartlepool. There is nothing wrong with Hartlepool, by the way—I want to survive the rope as well. For some of those constituents, Hartlepool is a distance of between 19 and 21 miles. They will make a beeline for the James Cook university hospital of South Tees, south of the river. I have known the Minister for many years and hold her in high regard. She is an intelligent lady and will not need me to tell her that the James Cook university hospital is already in serious trouble, with saturation of medical cases, and has overspent to a mega degree. It is a wonderful hospital, by the way. It has saved my life a couple of times—much to the consternation of some of my Labour party colleagues—and I hope that it will continue to do so, but it has hugely overspent. However, the people from Stockton, South will make a beeline there simply because it is 15 miles closer than the hospital in Hartlepool
The whole idea of even considering moving the maternity and paediatrics unit from Stockton to Hartlepool beggars belief. I just cannot understand it. Hartlepool has never been under threat and it never will be. Why will it not be under threat? Let me try to put the matter in military terms. When our young men and women are in a firefight and get wounded in a foxhole, their first port of call is the person next to them—the person sharing the foxhole—or they shout for a stretcher bearer. That person comes along with their casualty pack, and might give the victim a shot of morphine, put on a tourniquet and bandage the wound up. That is primary health care.
The next step is to get the casualty removed from there to secondary care, which is usually a mobile army surgical hospital. As a matter of fact, I am going to visit one of those units tonight, here in London. It is a unit that has been used more than any other unit throughout the Iraq and Afghanistan campaigns. Those units perform wonderfully well and I pay all tribute to them. The casualty is moved from primary care to secondary, to the MASH. Having received attention there—successfully, I hope—they undergo CASEVAC, or casualty evacuation, to a tertiary hospital, probably in Frankfurt or in this country.
The health service is having to adjust its structure to a similar pattern—not identical, but similar. We are developing primary provision, through our paramedics in ambulances, our nurse practitioners in GPs’ surgeries, and GPs themselves. That must be the
pattern throughout the country. The GPs, the nurse practitioners and the paramedics in the ambulances in the north-east perform so well already and will perform even better as we develop the service to its full potential. I suggest that they will provide the primary care and that Hartlepool university hospital will provide secondary care, as will the North Tees university hospital in Stockton.
However, our constituents who need more specialised attention currently have to go south of the river to the James Cook university hospital, increasing the congestion there, up to the Royal Victoria infirmary in Newcastle or down to Jimmy’s in Leeds. Those two hospitals will provide secondary care, so what are we going to do for tertiary care? Are we going to depend on the James Cook, the RVI or Jimmy’s too? That does not make sense at all. I suggest, as I have suggested many times before, that in seven, eight or nine years’ time, regardless of what happens tomorrow, we are going to need a tertiary hospital north of the River Tees to take care of the larger communities of Stockton and Hartlepool. There is no doubt in my mind about that. Mark my words: it will happen because it has to happen.
I have been talking for about the right amount of time, but I will take a couple of minutes more if I may. I would ask the Minister to take the advice that I offer to her Secretary of State. Tell her to ignore the dust storm that has raged for so long as a result of the Darzi report and to let that dust settle. If it settles in a manner that buries the report—without burying Professor Darzi, of course—I will be a happier man and the world will be a safer place. However, if the dust does not bury the report, I urge the Minister to advise the Secretary of State to put the issue of maternity and paediatrics on the highest shelf, out of anybody’s reach, and forget it. She should then take down the Tees review, so ably completed by Ken Jerrold, and praised so highly by every medical authority that read it that it took my breath away. She should look into that report to see what we can put in place to resolve the problem, if it still exists. I do not think that there is a problem; we should leave the issue of maternity and paediatrics as it is. Hartlepool has a pretty good maternity and paediatric service anyway; why would we want to add to it when we have only half the number of people?
Hartlepool’s advocates will say, “Hartlepool is not just Hartlepool—it includes Blackhall, Easington and Horden,” but Stockton has similar surrounding areas. Not only that, but the town has developed enormously to the south since the 2005 figures were published. It is now developing along the A66 towards Darlington. Its population is far larger than 186,700.
The Secretary of State should look carefully at the Tees review, which is much more sensible. Ken Jerrold was in place for years. Professor Darzi is a very bright man, but he had little time and a bowdlerised remit that had been changed for him. That was not his fault; other people changed it—I do not want to get too heavily into that, but it was not very wise.
The Tees review is valuable because its first priority is patient care and community need, which is where we should have started in the first place. Sadly, however, the Lib Dems changed the argument right from the
start, saying that there was a threat that Hartlepool hospital would close. It has not and will not, regardless of what the hyenas say.
All Members involved have received a letter from Peter Carr of the strategic health authority, which states:
“You are aware that the Secretary of State for Health, in August 2006, asked the Independent Reconfiguration Panel to undertake a review of maternity and paediatric services in Teesside following representations made by local authority overview and scrutiny committees.....there is a possibility that the results of the Panel’s work and its advice to the Secretary of State could be published at the end of this week.”
I wonder whether we will hear something to that effect later in this debate. The letter continues:
“Whatever the Panel advice...it would be helpful for David Flory and I to meet with you to discuss the outcome.”
I have arranged for representatives of the strategic health authority to come to my office first thing on Friday morning, at 9 o’clock or half-past 9, to discuss the issues. My hon. Friend the Member for Stockton, South has agreed to be there, and I invite my hon. Friend the Member for Hartlepool to join us, although the authority would meet him separately anyway.
If the issue is not resolved in the sensible way, the electoral consequences in Stockton will make those in Hartlepool seem like nothing. Frankly, Stockton’s reaction will be indescribable. There are other things to be said, but I leave that to my hon. Friends. I thank hon. Members for listening.
11.24 am
Mr. Iain Wright (Hartlepool) (Lab): I congratulate my hon. Friend the Member for Stockton, North (Frank Cook) on securing this debate. A couple of weeks before Christmas, I secured an Adjournment debate in the House on maternity and paediatric services in Hartlepool. During that, my hon. Friends the Members for Stockton, North and for Stockton, South (Ms Taylor) and I had a number of clashes, and I look forward to something similar today.
I do not want to talk about Professor Darzi and the independent reconfiguration panel’s look at maternity and paediatric services. They carried out a series of consultations. I was interviewed twice, and I understand that they provided their report to the Secretary of State for Health on 18 December. As my hon. Friend the Member for Stockton, North mentioned, it is anticipated that the report will be published some time this week.
In Hartlepool on Thursday, there was a meeting attended by members of the public and the chairman and chief executive of the North Tees and Hartlepool NHS trust, during which the first phase of Darzi’s recommendations was discussed. Patients and clinicians universally recognise that the first phase has been an immense success since it was introduced on 14 December, and there is no reason to suggest that all Darzi’s recommendations would not have similar success. I shall come to that.
I want to talk about the provision of health services in general. In all parts of the country, health services should be based on clinical safety, best practice and specific local considerations and wishes. The residents of Teesside deserve no different from those in other
parts of the country; indeed, there is a strong argument that because of our legacy, the people in our area deserve better than average.
People who design health services for my area need to be aware of, and take into account, the specific geographical, historic and demographic factors that demonstrate that in Teesside one size of health service provision does not fit all. On the Order Paper, the title of this debate is “Provision of health services on Teesside”. However, in many geographical, administrative and—most crucially—psychological respects, Teesside does not exist. Although the towns of Hartlepool, Stockton, Middlesbrough, Darlington and Redcar and Cleveland occupy a relatively small geographical area, they are very distinct and have proud and separate identities of their own.
It is significant that in many areas there was very little public support for Cleveland county council. Since its abolition and the establishment of unitary authorities in 1996, coupled with the election of a Labour Government the following year, all areas in the sub-region have improved. Co-operation takes place between the local authorities, but autonomy remains important because of local considerations. Centralisation has been avoided—perhaps health bureaucrats could take heed of that.
Hartlepool has a particularly distinct identity, although I would say that. It is compact and separated geographically from other parts of what is known as Teesside. In addition, in the past few decades population growth and migrant flows into the town have tended to come from south Durham—the former pit villages of Blackhall, Horden and Easington and the new town of Peterlee—rather than from the Teesside area.
There are many family ties between Hartlepool and south Durham, and as my hon. Friend the Member for Stockton, North said, the university hospital of Hartlepool not only serves Hartlepool’s population of 90,000 but is the major hospital centre for the 50,000 or so people from Easington and south Durham. My hon. Friend the Member for Easington (John Cummings) could not be here today—he is performing a duty similar to yours, Miss Begg, in another part of the House—but he suggested that I mention those issues on behalf of his constituents. When we have taken those issues into account, we need to consider taking health provision northwards, not only into my town but into Easington. That applies particularly in the new era of “choose and book”, in which family ties, which help patients who have had hospital treatment to recover, will be a major consideration.
It is unfortunate for health bureaucrats that population areas do not come in neat bundles subject to clear administrative boundaries. Professor Darzi rejected an option that I shall mention in a moment, but now that it appears that all of Darzi’s recommendations are up for grabs, I will say that there is a strong case for reconfiguring NHS trusts in the area to reflect local health considerations, with greater ties between Hartlepool and Easington, to tackle the acute health inequalities. I suspect that more people in my constituency would feel at ease with and have greater loyalty to a Hartlepool and South Durham NHS trust than to the current arrangements.
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