I turn to the questions that I have been asked. The hon. Member for Angus (Mr. Weir) asked where Scotland stands in all this. I understand that negotiations are taking place between the Executive and the powers that be at Westminster on the question of exemption. I cannot give him any more details at present. The hon. Member for Oxford, West and Abingdon made it clear that Catholic adoption agencies can continue to do their work; he also said that he hopes that they will not take the ball away. I agree. I accept that the Catholic agencies do great work, and I hope that they will continue to do so.
Paul Rowen (Rochdale) (LD): I thank the House and the Speaker for the opportunity to initiate this short Adjournment debate on health services in Rochdale. Health services and well-being affect all of us. We are all users of the national health service and hon. Members from whatever political party are proud of and committed to it. I pay tribute to the many health professionals who work in the acute, primary and tertiary health services in Rochdalebe they general practitioners, consultants, nurses, dentists, opticians and health visitorswho do a fantastic job often in difficult circumstances.
My purpose during this debate is to highlight some of the concerns that I and the residents of Rochdale have about the Governments health agenda and its effect on my constituents. I shall comment on the acute primary and mental health services, but time constraints mean that I shall concentrate on issues of concern rather than on the positive developments that I readily concede the Government have initiated.
Ten years ago, when the Prime Minister was Leader of the Opposition, he declared that there were less than two days to save the NHS. Ask anyone today what that means and most people in Rochdale would consider it a sick joke. Our NHS is in decline. Rochdale is the 25th most deprived borough in the country and contains Central and Falinge ward, in which the Rochdale infirmary is based. That ward has one of the worst morbidity rates in the country, with an average life span of 68 years. None the less, we are faced with the loss of the accident and emergency department and childrens, maternity and other services. Those changes are the result of the Healthy Futures and Making it Better consultations taking place in the north-west and north-east sectors of Greater Manchester.
I thank the Secretary of State for Health who, a couple of weeks ago, agreed that the Making it Better consultation should be referred to the independent review panel following requests received from the overview and scrutiny committees of Rochdale, Bury and Salford councils.
Mr. David Chaytor (Bury, North) (Lab): The hon. Gentleman and I have discussed the question of maternity and childrens services in Rochdale and Bury on several occasions. As the Secretary of State has referred the issue to the independent reconfiguration panel, does the hon. Gentleman think it would be useful for the Rochdale infirmary support groupthe friends of Rochdale hospitalto meet the parents support group at Fairfield hospital in my constituency to discuss providing a joint response to the independent reconfiguration panel when it comes to Greater Manchester to consider again the proposals for maternity and childrens services?
Paul Rowen: I thank the hon. Gentleman for that intervention and I agree wholeheartedly. After talking to a consultant at Bury yesterday, I believe that there is much that Bury and Rochdale can do together and I would be happy to facilitate that.
I welcome the reassurance that the Minister, the right hon. Member for Doncaster, Central (Ms Winterton), gave the hon. Member for Manchester, Blackley (Graham Stringer) that all previous promises and commitments are on the table. Such openness is to be welcomed. I am sure that she is aware that the Healthy Futures consultation is currently the subject of an application for judicial review from the Fitton family. I pay tribute to their courage following the loss of one of their boys.
I want to place on record, and make the Minister aware of, some of the concerns of the people of Rochdale about the consultations. We are not opposed to change for the better, and we accept that change is inevitable. However, we want a fair review of the options and we want the people of Rochdale to have a fair opportunity to make their proposals.
Primary Health Care Trusts have the duty to consult on substantive changes and reconfiguration of services and should present genuine options and not a predetermined programme for reconfiguration in order to be fully accountable to the local community.
That did not happen in the Making it Better consultation, as the only option presented for the Rochdale infirmary was an urgent care centre. Retaining the accident and emergency department at the infirmary was never considered, which is why our application for judicial review has a genuine chance of being accepted: there was no genuine option presented for the infirmary.
Although the Healthy Futures consultation agreed to the option of retaining maternity and paediatrics services at Rochdale, and at Fairfield hospital in Bury, when it came to the final decision-making process, totally spurious figures were produced for the cost of the various schemes. For example, there were claims that an extra 1,000 births per year at Rochdale infirmary would cost £43.5 million and that rebuilding the maternity unit and creating a children's service at north Manchester would cost nothing. We know that health bosses are giving figures that support their predetermined agenda and I am determined not to allow that to happen.
I thank the friends of Rochdale hospital, who are ably led by Father Arthur Nearey, together with Councillor Ashley Dearnleyleader of the Conservative groupCouncillor Jean Ashworth, and Carol Ashworth-Lord who represents the midwives. My only regret is that the local Labour party has failed to take part in our campaign. I have no doubt that at the appropriate time the Rochdale electorate will bear that in mind.
When the independent review panel is constituted I will ask it to look at the letter written in March last year by the consultants of Bury and Rochdale, which states that we should work together in a shared unit based on both sites. That model, which has the support of clinicians, will be far cheaper than a newly created service at north Manchester and will provide a better geographical balance.
Mr. Chaytor: Regarding the consultants letter of last year, unless it is different from the one that I received, my recollection was that 17 of the 20 paediatricians working at either Bury or Rochdale signed a letter confirming that they thought a single site would be appropriate, not a shared operation on two sites. Perhaps there is a second letter.
Paul Rowen: It is true that part of the letter said that, but, from talking to consultants at Rochdale, I know that further discussions were taking place about what joint services could be provided on both sites. If we are to have a genuine chance of providing the geographical coverage needed, facilities must be provided on both sites. That will be a far cheaper option than a newly created service at north Manchester. I hope that the independent review panel will give the proposal serious consideration and that Rochdale and Bury can work together to make it a reality.
The Pennine Acute Hospitals NHS Trust is responsible for the Rochdale infirmary. It is the largest non-teaching trust in the country and was established four years ago. The trusts management has been heavily criticised by consultants, the unions, and Professor Alberti in his report published last year. It is heavily in debt and the chair and chief executive left under a cloud. Four years ago, I criticised the need for a four-hospital trust and subsequent events have demonstrated that it is too unwieldy. I hope that the Minister will consider alternatives, including splitting the trust into two; one based on the sites in Rochdale and Bury and one based on the sites in Oldham and north Manchester. That solution would be welcomed locally.
Rochdale PCT is a three-star trust and in the top 10 per cent. of PCTs in the country. The merger of Rochdale and Heywood and Middleton PCTs into one unified trust is a welcome move that builds on the strengths of both trusts. The Government say that changes in primary care services will negate the need for continued provision of many acute services based in hospitals. I support that, but the reality on the ground at the moment is rather different.
The LIFTlocal improvement finance trustscheme to provide 10 combined centres throughout the borough of Rochdale is years behind schedule. Only one of the 10 centres has as yet received planning permissiontwo years late. I am aware, from talking to GPs, that there is real resistance to leaving purpose-built GP centres, which they own, for private finance initiative buildings with increased costs. Of 69 GPs in Rochdale, only one practice, as far as I am aware, has so far agreed to move.
I want an assurance from the Minister that acute services at Rochdale infirmary will not be discontinued until replacement primary care facilities in Rochdale are in place. If she cannot give that assurance, she should not be surprised if we regard the Prime Ministers pledge on the NHS as hollow rhetoric.
Perhaps of more concern is the development of ICATSintegrated clinical assessment and treatment serviceswhich involves privately run treatment and diagnostic centres. Concern has been expressed elsewhere today to the Prime Minister about the effect of those centres on locally provided, publicly run NHS facilities. Can the Minister tell us where the centre for
Rochdale will be sited and what analysis her Department has done of the effects on existing NHS services?
The Minister is aware, from our meetings on the provision of dental services in Rochdale, of my concern in that regard. She has admitted that, between 1997 and 2005, NHS dental registrations in Rochdale, under the old system, fell from 57 to 35 per cent. The new contracts change the way in which patients are counted, but that does not negate the fact that the number of people entitled to an NHS dentist has continued to decline. In an area with Rochdales index of deprivation, that is not acceptable. I acknowledge that the PCT has opened an additional dental centre at Castlemere community centre and commissioned an additional two dentists, but that is a drop in the ocean when compared with the number of dentists who have gone to the private sector in the past few years. I would welcome an open debate with the Minister on what we can do to restore an NHS dental service to Rochdale. At the moment, an emergency-only service through the dental access centre is all that is available for the majority of Rochdale residents.
I want to comment briefly on the provision of mental health services in Rochdalethe responsibility of the Pennine Care NHS Trust. Despite additional investment in capital refurbishment at the Birch Hill site, I am concerned that the trusts current deficit will result in further cuts in community servicesa sector that has traditionally been underfunded not only in Rochdale but elsewhere. We need a commitment that there will be more investment, not less, in community mental health services.
The NHS is acknowledged as the only living creation of the 1945 Labour Government. It was the product of a report written by Beveridge, a Liberal MP. We need to see that the words of the present Government are backed by actions and that there is a commitment to a full and free NHS delivered locally in Rochdale in the area of need. I look forward to the Ministers response.
The Minister of State, Department of Health (Ms Rosie Winterton): I congratulate the hon. Member for Rochdale (Paul Rowen) on securing the debate. He has raised concerns on a number of occasions about health service provision in his constituency, including dental services, to which I will return. It is also very good to see my hon. Friend the Member for Bury, North (Mr. Chaytor) here and being allowed to contribute to the debate, because he has been greatly concerned to represent his constituents with regard to the health service provision in his area.
I will return later to some of the details and questions raised by the hon. Member for Rochdale, but I should like to start by reflecting on some of the progress that has been made in his constituency. I was a little disappointed when he talked about the decline of the NHS in his area. I hope that he will join me in celebrating some of the improvements that have been made, not least because many of them are due to the very hard work and commitment of local NHS staff and have led to real changes in the quality of the services that are delivered.
Of course, that hard work and commitment has been backed up by increased investment locally. The Heywood, Middleton and Rochdale PCTI am glad that the hon. Gentleman welcomed the joining together of the trustsis benefiting from that investment. In the current financial year, the PCT has received £288 million, which will go up to £316 million next year. We are talking about a real-terms increase of 6.7 per cent. As a result, waiting times have plummeted and there have been major local achievements. The NHS walk-in centre in Rochdale is well established and has made a major contribution to reducing the burden on local accident and emergency departments, but it is also often extremely convenient for the local people who use it.
The PCT, together with Bolton PCT, is developing a new generation of primary care facilities through the LIFT programme. The hon. Gentleman raised concerns about the LIFT scheme, but it is progressing well. We expect financial close in the next three months or so. It is true to say that some GPs prefer to retain their old premises, but I gather that the majority of GPs are backing the improved services that LIFT centres will deliver. We will see real improvements for patients. I can assure the hon. Gentleman that there is no intention of closing existing acute services until the LIFT schemes are operational. The plans for some 13 new health and social care centres will attract investment of some £80 million to the area over the next 10 years.
When talking about changes where services have traditionally been offered in acute hospitals, it is important that we consider the benefits that can be secured through such investment in the community. Across the whole of England, there is a shift from district general hospitals down to community services. That is better for people because the services are closer to home and it leaves the acute hospitals to do what absolutely needs to be done in a hospital setting.
As the hon. Gentleman said, the pattern of future service provision in Rochdale and the wider area has been the subject of much public discussion over the past 18 months, as part of two reviews of health services across Greater Manchester. He mentioned the Healthy Futures review that looked at changes to acute hospital services across north-east Manchester. There was good public engagement in that consultationabout 4,000 formal responses were received.
In September, the joint committee of PCTs decided that three of the hospitals covered by the reviewFairfield general hospital, North Manchester general hospital and the Royal Oldham hospitalwould provide acute medicine and accident and emergency services. It also decided that Rochdale infirmary would be developed as a local hospital that would provide a range of services including dental, mental health and social services.
I want to touch briefly on dental services because the situation in Rochdale is an example of why it is important to devolve money to local level. Previously, if a dentist left the NHS, there was no money left locally to replace those services. Under the new system, at least there is money locally to provide some of the services that the hon. Gentleman mentioned. That has
been happening in Rochdale. There is still some way to go, but at least we are able to retain money locally, so that services can be recommissioned.
The hon. Gentleman talked about mental health services. We have developed new community mental health services, and we have been anxious to ensure that those services do not suffer disproportionately if there are financial constraints or problems. I am glad for his support for mental health services. It is important that they continue to be delivered effectively, because that is the way to ensure that people have access to them not only quickly, but, crucially, in their own communities, so that we can reduce hospital admissions as much as possible.
Paul Rowen: I welcome the Ministers comments on this vital issue. One problem that I have been hearing a lot about in my surgeries in the past few months is that of delays in getting people appointments. People are being told that they will have to wait for months. I would be pleased if the Minister looked into that, because that is the real effect of the deficit: people are not getting appointments quickly when they desperately need them.
Ms Winterton: Of course I will look into that, but I emphasise that, given the shift in the way that mental health services are developing, we are also reaching out to more people. Mental health services are now working much more closely with local authorities to ensure the kind of social care that is so necessary for people with mental health problems.
The hon. Gentleman mentioned a second reviewthe Making it Better review of in-patient maternity, childrens and neo-natal services in Greater Manchester, east Cheshire and High Peak. That was another major review and consultation, which covered some 13 PCTs. The consultation process received more than 50,000 responses, representing the views of about 240,000 individuals. That is a very good indication of the interest that local people took in the development of their services.
On 8 December, the joint committee of PCTs decided that four hospitalsHope hospital in Salford, Trafford general hospital, Fairfield general hospital in Bury and Rochdale infirmarywould no longer provide in-patient maternity and paediatric services. Hon. Members will know that the decisions on Healthy Futures and Making it Better were supported by the two relevant joint overview and scrutiny committees. However, the overview and scrutiny committees of Salford city council and Bury metropolitan borough council both referred the
Making it Better decision to the Secretary of State for Health. Rochdale metropolitan borough councils overview and scrutiny committee referred the decisions on both Making it Better and Healthy Futures to the Secretary of State.
I was pleased to tell the hon. Gentleman and other hon. Members during oral questions, so that they had notice, that the Department was asking the independent reconfiguration panel to undertake a review of the issues surrounding the reconfiguration of in-patient services for women, babies, children and young people in Greater Manchester.
I was glad to hear the positive suggestion of my hon. Friend the Member for Bury, North that it would be good to take a joint approach to giving evidence to the independent review panel about the issues that affect both sites. He also made the important point that it is vital to get the support of clinicians when changes are being made and to consult them closely.
My right hon. Friend the Secretary of State for Health has asked the IRP to review the decisions related to the Healthy Futures decision in light of the referral from the Rochdale overview and scrutiny committee. We are now working with the IRP to establish the terms of reference for the two reviews and a timetable for their completion.
I hope that hon. Members understand that the IRPs involvement in reviewing the Making it Better and Healthy Futures decisions makes it inappropriate for me to comment in detail on the concerns that have been raised today. I can, however, make some more general points about health inequalities that the hon. Gentleman talked about and deprivation in those areas. We are tryingthis is particularly important in addressing health inequalitiesto ensure that services are accessible. That is why the NHS walk-in centre in Rochdale and the primary care centres that I mentioned are extremely important.
The hon. Gentleman talked about journey times. The north-west has a top-performing ambulance service, which has provided very good and efficient services. Indeed, it made the point in the consultation that it could provide them with the new reconfiguration. It is important that that is considered in the review.
Paul Rowen: I understand what the Minister is saying, but I ask her to talk to the ambulance drivers who use those roads. During peak hours, it is impossible to get from Rochdale to Fairfield or Oldham in the times stated.
Ms Winterton: I am sure that all hon. Members will want to raise such issues with the IRP, whether or not they agree with that statement. We have made the referral to the IRP, and I assure the hon. Gentleman and my hon. Friends that we have high-quality services not only in Rochdale, but across the whole of Greater Manchester.