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Charles Hendry (Wealden) (Con): I congratulate my hon. Friend the Member for Eastbourne (Mr. Waterson) on securing this important debate. I am grateful that a number of us will have a chance to contribute.
I agree with every word that my hon. Friend said. He has expressed perfectly the views of local consultants, GPs, the public and the local media. They have all been simply appalled by the decision to downgrade the facilities at Eastbourne district general hospital. I join my hon. Friend in commending the campaigns that have been run by Liz Walke and Margaret Williams on behalf of both hospitals. They have made sure that this has been one united campaign to put the case for the hospitals along the East Sussex coast.
People in my constituency, which is right next door to Eastbourne, are mystified about how the decision has been reached. The area is fast growing. Hailsham is one of the biggest towns in inland East Sussex, and its residents would have a similar journey to the one outlined by my hon. Friend if they were required to go to Hastings or Brighton to have their babies. They are deeply concerned about that. In most cases, everything would be all right, but there would undoubtedly be anxiety at the time. A number of cases would be borderline, and some, we believe, would result in tragedy.
In Sussex, we have an outstanding ambulance service. Paul Sutton, who runs it, is one of the most outstanding public servants I know, as well as one of the most inspirational public figures in the health service. Those in the ambulance service tell us openly that they are good at dealing with a stroke, a cardiac arrest or a road traffic accident, but they do not have experience in dealing with pregnancy complications. The Minister might say that they will be trained in those areas, but the whole argument has been that maternity cases should be dealt with by people who have a specific expertise in the subject and who have sufficient throughput of cases to ensure that that expertise is enhanced daily. Relying on the ambulance service to deal with the most borderline and marginal cases is not the right way forward.
The decision also overlooks the fact that the part of the county affected will grow rapidly. We expect 10,000 new houses to be built in Wealden over the next 20 years, the bulk of which will be built in the area around Hailsham, Polegate and Willingdon. Further south are the south downs, while further north is the area of outstanding natural beautyboth areas are protected. We know that the population will grow. My constituents do not understand why, when we are experiencing such pressure from new housing and population growth, important public services, such as maternity services, are being reduced and downgraded.
Let me say a little about the process. When it started, I called on the East Sussex Downs and Weald primary care trust and the West Sussex primary care trust to carry out a joint analysis of the case. This point is particularly relevant to the hon. Member for Lewes (Norman Baker) and his constituents, as well as mine. Our constituencies are right on the border of East and West Sussex. We were told that that joint analysis was not necessary, that they could readily follow on from each other and that the two were significantly separate. However, we have ended up with a big question mark hanging over the Princess Royal hospital in Haywards Heath, which is where people from Uckfield and the surrounding area in my constituency go to have their babies delivered. If that hospital were downgraded, which is possible, those people would prefer to go to Eastbourne rather than anywhere else. However, the fact that the decision about Eastbourne was made first means that that option is not available. If we were to lose the Haywards Heath facility, the 20,000 people in Uckfield would have to rely on the hospitals in Hastings or Brighton.
I would love the Minister to join us in an attempt to drive into Brighton in the rush hour. It would not matter whether we started in Eastbourne, Hailsham or
Uckfield, because she would quickly understand why the drive is simply not an option for a pregnant woman in an emergency. It is possible to reach the outskirts of Brighton quickly enough, but it can take another 30 or 40 minutes to get from there to the hospital in the city centre. The service is simply not good enough, and that is a source of profound concern to people expecting to give birtha moment that is likely to be one of the most important in their lives.
A further concern has to do with the conduct of the meeting at which the decision was made. It took place in Uckfield, in my constituency. We were told at the outset that it was not a public meeting, but that it was a private meeting being held in public and that members of the public were therefore not allowed to speak. However, especially unattractive was the sight of a bouncer6 ft 4 in tall, and 20 stone in weightwho had been hired to shut up members of the public who dared to speak.
The people who attended were predominantly elderly. They included midwives, nurses and GPs, and there were also a couple of Members of Parliament and a bishop in the hall. When my hon. Friend the Member for Eastbourne tried to address the meeting, the bouncer moved him to one side, but most despicable of all was having to see the Bishop of Lewesa completely non-political figure, who speaks with passion about the community that he servesalso being moved aside when he attempted to speak at the end of the meeting.
I remonstrated with the bouncer afterwards. We expect such behaviour in Zimbabwe, where bishops are regularly beaten up on behalf of the Government, but what have we come to in this country when a public quango has to be defended from a bishop by a bouncer? I hope that the Minister will agree that it is not acceptable for decisions to be reached in the way that I have described. People were rightly angry at the decision that was made, but the way it happened was an appalling abuse of power.
I wrote to the PCT chief executive to remonstrate, and he responded by defending the right to have a bouncer present. For me, however, the fact that such a meeting could be conducted in that way will remain as one of the most horrific and abiding images of my time as a Member of Parliament.
My constituents feel a great sense of confusion about why we are having this debate at all. We are in the 21st century, and Britain is the sixth richest country in the world. The south-east contributes more to the countrys wealth than any other region outside London and, given our rapidly growing population, we should be investing in our health and maternity services and not allowing them to be run down.
We appeal to the Minister to say, even at this late stage, that she believes the decision that has been taken is wrong. If it is referred to her, we hope that she will overrule it, as it is categorically wrong for all constituents across east Sussex.
Michael Jabez Foster (Hastings and Rye) (Lab):
I am grateful to have this unexpected opportunity to contribute to this debate, and I apologise that I was not here when it began. Most especially, I apologise to the
hon. Member for Eastbourne (Mr. Waterson) for not seeking his permission to speak, but I did not know that I would have the chance.
I sympathise with what the hon. Member for Eastbourne has said, and he is right to suggest that I would be jumping up and down, screaming and behaving in an antisocial manner if the decision had gone the other way. With respect to him, however, he is wrong to suggest that the decision was in any way political. When the matter came up for debate, I approached Ministers and said, Will you make sure that we do not lose our maternity facilities in Hastings? They replied, No, this is a matter for the PCTs. We will get involved only if the matter is brought to our attention subsequently.
I am convinced that the judgment was not a political one. Indeed, I suspect that most members of the PCTs involved are card-carrying Tories. I know for certain that the chairman of the Eastbourne Downs PCT and some of the executive directors are leading Conservative figures, so it is bizarre to suggest that this was a political judgment. It may or may not have been right, but the idea that it was a Labour Government fix is entirely wrong. I hope that my right hon. Friend the Minister will discount that view entirely; it is simply not the case.
It is important to know the history. Some time ago the hospital trust decidedthe hon. Member for Eastbourne referred to thisthat it would like to operate on one site. It decided that that site should be Eastbourne, because there was a business case for that. It took the view that if prospective parents lost the Eastbourne site, they would go to Brighton or somewhere else whereas parents from Hastings would have no choice. The business case was to have the site in Eastbourne, and I was outraged by the suggestion that finances should somehow affect the judgment of social need.
Many of us believe that the right answer was to try to see whether it was possible to have a double sitea continuation of the site in Eastbourne and a consultant-led service in Hastings. That would have been my preferred option if it had been possible. Much of the campaign was about that. However, with respect to the hon. Member for Wealden (Charles Hendry), his local council voted in favour of a single site in Eastbourne. There was no unanimity. I hope I am wrong, but I believe that the council in Lewes also voted for a single site in Eastbourne.
Michael Jabez Foster: Perhaps I am wrong; I do not know. However, local authorities at one end of the county took one view while authorities at the other end took another. There was a bit of a turf war and not quite the unanimity that the House has been led to believe there was.
The real issue is whether the right decision was taken. Who should have received the benefit of the consultant-led service? There is no equality of value in the two claims. If it had been possible, I would have been happy to have had an Eastbourne consultant-led service and a Hastings consultant-led service, but I know that the Government are keen to improve maternity services and that they want greater coverage of consultants. We therefore asked the royal college a number of questions, and the answers that I heard were that there were no significant differences
in the safety between small units of 1,500 and 3,000. That is an argument in favour of two sites, but the answers also said that there would be significant difficulties in recruiting and retaining consultants at very small sites. I do not know whether that is right or wrong, but that is what was said and it was a proper consideration for the PCT to take account of when deciding whether one or two sites would be feasible.
Of course we would like two sites but if that is not feasible, one has to make a judgment on where the site should be. If the trust came to the view that there should be single site, I unashamedly believed that that site should be in Hastings. Why? It is not simply a question of social needs. The hon. Member for Eastbourne referred to the social needs of Eastbourne, and I am sure that there are pockets of deprivation there. However, Hastings is the 29th poorest town in Britain. The social needs are so significant that it would be bizarre to suggest that Eastbourne should be preferred to Hastings on social grounds. That is nonsense.
I understand that Liz Walke and Margaret Williams, the leaders of the campaigns, did sterling workMargaret Williams in the Hands off the Conquest campaign did exceptionally soand I suspect that they reached an agreement that they would not give way on the two-site option. However, the PCT came to the view that there had to be a decision for one site. Once that was made, Hastings was clearly the right choice, and not just because of the social needs of the 29th poorest town in Britain
There is also the problem of the difficult geography. Getting 21 miles along the Marsh road is a challenge, although the word challenge might be a euphemism. It is almost impossible to do the journey at the wrong time of day. It is a problem and we need to consider how it can be resolved. However, the geography is also in Hastings favour. My constituents do not all live in Hastings; they live in Rye, Camber, Iden and to the east of Hastings, where they would have no option if they were required to go to Eastbourne in an emergency.
I understand that the decision to save the accident and emergency departments at Hastings and Eastbourne, which was made some time ago, is an important factor. If there is proper training, true childbirth emergencies at the Eastbourne end of the county can be dealt with in accident and emergency, although that is not the preferred option. No one would go past an accident and emergency entrance if a mother was in distress. That is what I am told, but I would like the Minister to comment further on that, and to confirm whether that is the case.
Mr. Waterson: The hon. Gentleman is making an important point. Assuming that the loss of maternity services does not have a domino effect on accident and emergency and paediatric services in my local hospital, he is right to say that there is a real issue at stake: anaesthetists and those who are not gynaecologists or obstetricians may have to deal with difficult issues such as caesareans and related complications simply because there is not time to get the mother to Hastings. Does he agree?
Michael Jabez Foster:
Yes, I agree that it is important that an arrangement be in place, so that there are facilities for dealing with such emergencies in the accident
and emergency departments, which will continue to exist. Of course, that is not the first choice, because although it may well save the mothers life, the chance of saving the babys life is smaller, unless expertise is readily available. That is understood. However, such cases are exceptional, although I do not say that the issue is unimportant. It is wrong to suggest that they will be a regular occurrence; they are exceptional occurrences, but we have to consider them when designing the scheme. I am sure that the hon. Gentleman has already written to the PCTs and the hospital trust, as I have done, to ask them what arrangements they intend to put in place to ensure that such emergencies are covered, if and when there is a single siteand it appears that there will be a single site in Hastings.
Of course it is disappointing if it is decided that there must be a single site, but we must consider what will happen if that judgment has been made, and made properly. I believe that the consultation was very thorough. I am sorry to hear about the problems in the final meetings, and they need explanation, but the consultation was certainly long and thorough. The Government kept out of it completely. I have to say that I have a view about that: I would not leave the matter to the PCTs. I would have the judgment made by Government, but that is not how it is. That is not how things happen these days. We have to rely on the PCTs, and they came to that judgment.
If the Minister accepts the PCTs decision to have a single site, and if the Governments ambitions to improve maternity services and ensure greater consultancy cover make that inevitable, the PCT was right to decide that it should be in Hastings, but that should not be the end of the debate. The debate should now be about finding a way to ensure that those at the other end of the county in Eastbourne receive the back-up that is necessary if we are to ensure that there is no loss of life or discomfort as a result of the changes.
Norman Baker (Lewes) (LD): I am pleased that the debate started early, as it gives me the opportunity to contribute. I apologise to the hon. Member for Eastbourne (Mr. Waterson), but I was caught slightly unawares and was two minutes late for the start. He and I do not agree on much, but we happen to agree on this subject, and I agree almost entirely with his comments this evening.
Let me deal with the point about politics that the hon. Member for Hastings and Rye (Michael Jabez Foster) made. I do not know whether politics has played a part or not, but he is most insistent that it did not. I have no evidence that it did, but I point out to him that the recommendations resulting from the consultations on health services in East Sussex and West Sussex mean that facilities in the very few Labour seats in the area will be left intact, while those in Conservative seats and those that my constituents use will be lost. It is therefore not surprising that on that evidence, some people have reached the conclusion that politics may be a factor. Of course, it may be a complete coincidence, but that is the conclusion that they have reached.
I am disappointed by the contribution of the hon. Member for Hastings and Rye. Of course he must stand up for his constituents; all of us in the House must do so. If we do not stand up for our area, who will? I thought the hon. Gentleman had recognised the value of the two-site option, but he seemed to be moving away from that in his contribution this evening.
The campaign was extremely effective and embraced all sections of the community, which was heartening for all of us who believe in democracy and people power. I do not believe that the campaigning by Liz Walke in Eastbourne and Margaret Williams in Hastings was tactical. I think the campaign was based on an analysis of the facts and a genuine belief that a two-site option was the best solution for those involved in the health service and particularly for expectant mothers. That is what has been driving the campaign, not some sort of back-room deal to try to keep two sites going.
The hon. Member for Hastings and Rye argued, rightly, that his constituents east of Hastingshis constituency stretches quite a long way east of Hastingswould have difficulty reaching Eastbourne. That is true, but there are constituencies west of Eastbournenot least of all minewhich face a similar situation. I have constituents in Seaford, the biggest town in my constituency with 25,000 people, who are seeing maternity services at what they regard as a local hospital taken away from them. I have large numbers of people in Polegate who regard Eastbourne as their local hospital and who are seeing maternity services there taken away. I have in my constituency villages such as Alfriston, where people would take a similar view. They are to the west of Eastbourne.
What are the alternatives for my constituents? As the hon. Member for Wealden (Charles Hendry) correctly said, a parallel, but not connected, process is going on that is leading to consideration of the maternity services at the Princess Royal hospital in Haywards Heath. Many of my constituents will look to Eastbourne or to Haywards Heath, but not particularly to Brighton, and they may find out that both Eastbourne and Haywards Heath are losing maternity services. It is a disgrace that there has been no connection between those two processes. The case for a connection was made early on, but as the hon. Gentleman rightly said, a disconnect was put in place so that no proper consideration has been given to the impact of the closure at the Princess Royal, if it goes ahead, on constituents in my part of the world or, I am sure, in Eastbourne and Wealden.
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