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The process has involved the panel and the stakeholder group meeting regularly. I tried hard to attend most of the panel’s meetings, because I wanted to listen to other constituents and clinicians who have a particular view, even if it is an opposing one. Sometimes difficult issues were aired, but everybody dealt with each other with courtesy and kindness, and listened to the views of others in a manner that should be replicated in this House when we discuss crucial issues that make us feel
incredibly anxious and worried that somebody might not share our view. The whole process took almost a year, as was necessary; it needed to be inclusive and to ensure that, each step of the way, those who were assisting with the process on the stakeholder group, and the public, were consulted. The people who took part were decent, good and honest, and they had to come to some difficult decisions.
We followed a programme, looking at particular parts of the service in detail. This was not just about saying, “Look you are going to have to change. We are going to keep changing our minds about how we are going to provide this service.” We started with a blank sheet. We started by asking what we wanted and what was the most important thing for us. We started by looking at the fantastic radiotherapy services that we receive St. Luke’s hospital in Guildford, but getting to that hospital involves a very difficult and long journey. People are very grateful for those services, but what if we were to have a linear accelerator in Crawley? Would that not be the most amazing thing to set up to supplement our cancer services? That was one of the recommendations of the review.
We wanted to examine how we can genuinely help carers in our homes and support them in a much more meaningful way. We wanted to consider how we ensure that we protect children. Even before our debates yesterday on the publication of the Laming progress report on children’s services within local authorities, our review had already decided that there should be more health visitors for the Crawley area to assist parents—the review was ahead of the game in saying that we know how to protect children and we know what will be needed for the future. Our experience was far from combative; it was collaborative and co-operative, and it allowed us all to contribute in a atmosphere in which we did not feel fearful about raising our voice or having a different point of view from other people in the room. This was a good way of reviewing our services.
Astonishing changes are contained in the review; because we started with a blank sheet, it did not have the flavour of clinicians just saying, “This is what we need to do, because we are going to save money this way. The service will then be better.” Often I am sure that that is true, but we addressed the issues that were really important to people. We examined the expensive 0844 numbers to which many GP services have signed up; we were committed to examining how to ensure that people do not have to pay too much to contact their valuable GP services. We wanted to find a way to re-establish good links between Crawley and East Surrey hospital—there used to be a shuttle bus, but sadly it was withdrawn by the acute trust at the time, and that made people extremely angry. The review accepted that that change made people angry, and brought everyone around the table, including the trust, the borough council and county council, to discuss how to re-establish a decent link between the towns in the area and the acute hospital that serves the most-ill patients.
Given that the principle that we needed a 24-hour accident and emergency department that would accept seriously ill patients—such as those with heart attacks, who can get an angioplasty done in next to no time—had been accepted, we also needed to accept that people need to be able to access the hospital. That is why I was delighted that the review recommended that Crawley
hospital should have more beds. Because of its grass-roots nature, the review understood the pressure on beds in the acute trust and the need to provide valuable services. The hospital makes a valuable contribution to health care in the area, and it is probably the largest such hospital run by a PCT.
The review process now has a different feel to it, and we all feel that we can sign up to it. I hope that the Minister will feel able to use it as an example of how to approach continuing reconfigurations. Our fabulous NHS will continue to change. For example, we will have more care at home and we will begin to lose the reliance on the hospital as the front door of the NHS. I hope that the Minister will be able to tell me that she will use this review as a good example of how to change services locally.
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The Parliamentary Under-Secretary of State for Health (Ann Keen): I congratulate my hon. Friend the Member for Crawley (Laura Moffatt) on securing this debate on health services in the north-east area of West Sussex. If I may say so, this is a unique occasion, as two nurses are discussing business in the House today. I know that this matter is of great importance to my hon. Friend and her constituents, and I appreciate the comments that she has made. She is known for her commitment to her constituents and to health services. She is in a unique position in being able to assist in the review, and she has shown great leadership in doing so.
I congratulate NHS staff in West Sussex on the hard work that they have put into improving services and performance. Millions of people receive high quality and safe services every day. The best of the NHS is among the best health care in the world and we should all be proud of its achievements.
The review of health care and health services in the north-east of West Sussex was commissioned by West Sussex primary care trust in May 2008. That followed the “Creating an NHS fit for the future” programme and consultation, which took place during 2007-08.
In terms of acute health care, the fit for the future programme was concerned primarily with services in the south of West Sussex, along the coast at Chichester and Worthing, and at Haywards Heath in mid-Sussex. It was therefore felt that further work was needed to look at the future of services in the north-east of West Sussex.
An important point that I wish to stress at the outset is that the organisation of health care is decided not by Ministers or civil servants in Whitehall, but by local health care professionals on the ground. Organisational change conjures up a host of images, not all of them positive, and has become a euphemism for closures and downgrading of hospitals, as my hon. Friend outlined. It is not about closure or downgrading, but about the NHS adapting itself to new patterns of care, using leading edge technology and care pathways to treat people more quickly, more safely and in more convenient settings.
The north-east review was therefore set up, and it was led by a panel of nine professional and lay people chaired by Sir Graeme Catto, president of the General Medical Council. The review panel was asked to identify significant gaps in health care provision in the north-east
sector of West Sussex. It was then asked to make recommendations to West Sussex PCT on a way forward to help improve the health and well-being of people living in the north-eastern area of West Sussex. Furthermore, the aim of the review was to ensure not only that people have quality services but that they have better access to these services.
Led so admirably by Sir Graeme Catto, the review undertook an extensive consultation process whereby it engaged with health care experts, local authorities, voluntary organisations and a 100-strong stakeholder forum that met on a number of occasions. The review also engaged with special interest groups including older people, people with long-term conditions and the black and minority ethnic communities. West Sussex PCT’s board received the review panel’s report on 29 January 2009. The panel made a total of 45 recommendations, which the PCT board has supported in principle while it develops a detailed response and action plan.
The north-east review panel reported a number of key findings, a few of which I shall now mention. Generally, the area had a healthy and relatively wealthy population, but a number of deprived wards were identified in the Crawley area. Although the PCT, in partnership with local authorities, had targeted initiatives to support those deprived communities, the take-up of some health services by black and minority ethnic communities was reported as low. Although the greatest proportion of the population lived in urban areas and towns, a number of people living in rural areas were adversely affected by poorer access to health care. It is estimated that the population of the area is likely to increase by a greater proportion than that of the county as a whole.
There had been less investment in a number of services in the north-east sector than in the rest of the county, especially as regards therapy services and some aspects of nursing. I am sure my hon. Friend is pleased that one of the review’s recommendations is that a shortfall in in-patient capacity should be met by patient improved pathways and improving productivity at Crawley and Horsham hospitals. I understand that West Sussex PCT has agreed to consider the opening of closed wards at those hospitals to supplement the overall secondary care system in the area.
West Sussex is planning to address the current shortage of health visitors in Crawley by this autumn to ensure equity of provision in the area and to support the arrangements for the safeguarding of children. The review also recommended more female GPs for black and minority ethnic communities by spring 2010 to encourage take-up of health care services by members of the minority communities.
I understand that the West Sussex health overview and scrutiny committee has been involved with the
review process. It established a taskforce in June 2008 to scrutinise the north-east review. The taskforce met on a number of occasions and took part in panel and stakeholder forum meetings. The West Sussex health overview and scrutiny committee was presented with a review of the consultation process in December 2008. I understand that the committee was broadly satisfied with the consultation process. The content of the report was discussed at a committee meeting on 24 February and 18 recommendations were made. That will help the PCT board make a final determination on the original recommendations in due course.
I am advised that as well as the West Sussex overview and scrutiny committee a majority of the stakeholders engaged with during the review are supportive of the process and have welcomed the recommendations in the report. They include the mid-Sussex and Crawley practice-based commissioning groups, local district councils and the stakeholder forum. That support is encouraging and will enable the process to move ahead smoothly. It is obvious, as my hon. Friend said, that the consultation looked at good practice in the area.
I am sure that my hon. Friend agrees that the decisions being taken in her area about health are being led by the local NHS, with the support of local clinicians, the public and, indeed, their Member of Parliament. The local NHS is determined both to improve the quality of service that the public receive and to provide better access to services. I urge her and fellow MPs to continue to work constructively with local NHS organisations and NHS South East Coast to ensure that the residents of north-east West Sussex are provided with the very best health services now and in the future.
Those services are funded by taxation but they are also supported by many different organisations, and with your permission, Mr. Deputy Speaker, I should like to mention today’s fundraising event. It relates to health not only in the UK but around the world. On this special day—red nose day—I congratulate in particular the brave celebrities who climbed Kilimanjaro to raise more than £1 million: Gary Barlow, Chris Moyles, Cheryl Cole, Fearne Cotton, Alesha Dixon, Denise Van Outen, Ben Shephard, Kimberley Walsh and Ronan Keating. The British public are supporting red nose day and Comic Relief to raise money not only for health and children in the UK, but for much-needed help in the developing world.
I thank you, Mr. Deputy Speaker, for allowing me to make those remarks on this day, and I thank my hon. Friend for raising such an important debate.
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