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I have spoken mainly of interventions at school and early years settings, but getting children reading well is a challenge that necessitates efforts from all places—not just schools and early years settings, but, crucially, parents and wider communities. It is only through sustained and joined-up efforts by organisations and individuals that we will help every child to become a good reader. However much value we add through high-quality school and pre-school provision, support from family and the home environment, particularly in the early years, can make an even greater difference to children’s cognitive development. The earlier parents become involved in supporting their children’s literacy, the greater the impact will be. According to the National Literary Trust, even at age 16 parental interest in a child’s reading is the single greatest prediction of achievement.
Yesterday I met Save the Children to discuss its ongoing work in that area, as mentioned by my right hon. Friend. It has shown how families and communities can contribute to the development of good readers through its Families and Schools Together programme and the Born to Read partnership programme, which links trained volunteers to struggling readers.
In my own county of Norfolk, more than 10,000 children take part every year in the summer reading challenge at local libraries. That helps to prevent the summer dip in literacy skills, which is particularly damaging for disadvantaged children. It also encourages families to read with their children and create an inspiring home-learning environment.
This year Norfolk launched the Raising Readers campaign, which aims to bring the wider community on board. Backed by the Eastern Daily Press, one element of the campaign is to encourage business and voluntary groups to give staff two hours’ unpaid leave a month to visit schools and read with children. I was delighted to visit the Kid Ease nursery in my constituency a couple of weeks ago, during which I read to and with three and four-year-olds.
A range of measures, including the pupil premium, the expansion of free early years education and changes to school accountability measures, will make a difference to many young lives and narrow the unacceptable attainment gap holding back social mobility in this country. However, we require society as a whole to mobilise to address the challenge at hand and work together with parents and schools so that we can look forward to a time when every child will finish primary school as a good reader and go on to enjoy a lifetime of reading.
Madam Deputy Speaker (Dame Dawn Primarolo): May I ask the Front Benchers to share the remaining time between them?
4.43 pm
Kevin Brennan (Cardiff West) (Lab):
May I thank the Backbench Business Committee for choosing this debate and congratulate the right hon. Member for Mid Dorset and North Poole (Annette Brooke) on securing it? I must confess that I had not realised that she was right honourable. I know that a very high percentage of Lib Dems have been knighted, received damehoods or been made right honourable, but in her case it is thoroughly
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deserved for the work she has done over many years in this House and her commitment to children’s issues, particularly that under discussion.
I also congratulate all the other speakers, including my hon. Friend the Member for Liverpool, West Derby (Stephen Twigg), who is my former boss, the Chair of the Select Committee, my hon. Friend the Member for Huddersfield (Mr Sheerman), who is a former Chair of the Committee, and the hon. Member for Norwich South (Simon Wright). They will forgive me if I do not discuss their contributions—as I was going to do—given the time available.
There are a number of points to make about the achievement gap in reading between poorer children and their better-off peers. First, it is a real problem. As the right hon. Lady said, current Government statistics show that one child in every four leaves primary school unable to read well, which means that each year 130,000 children are already behind when they start secondary school. Of those, a disproportionately large number are from disadvantaged backgrounds; the proportion who leave primary school unable to read well rises to 40% for children on free school meals. We know that it is a real problem, so it is right that we are debating it today and that we will continue to do so.
Secondly, it is not a new problem. Successive Governments have made efforts to close the achievement gap. The previous Labour Government made extensive investment, politically and financially, starting with the literacy hour and progressing to schemes such as Every Child a Reader. I could cite evidence of the success of those programmes, including from the Institute for Public Policy Research’s 2012 report, “A long division: Closing the attainment gap in England’s secondary schools”, which clearly showed that the attainment gap between the richest and poorest students narrowed between 2003 and 2011. Despite that, we know that poorer children are still much more likely to have fallen behind in reading by age 11 than their better-off peers.
Thirdly, the issue really matters. Being behind in reading at age 11 has a massive impact on an individual’s life chances, but it also has a massive impact on the country as a whole. More people who are out of work or on low pay are functionally illiterate—one in four in both instances. More pupils who are excluded from school lack literacy skills. More young offenders and prisoners are poor readers. The list goes on. We can reasonably extrapolate from those statistics and observations that at the macro level crime is higher and economic growth is lower as a result.
Fourthly, this issue has become party political. In my opinion, it should not be. I am not trying to blame anyone in particular for that phenomenon; we are all politicians and we all have to make our case in order to win power and govern in what we believe to be the country’s best interests. That is the trade we are in and, in my view, it is an honourable one. However, as a former school teacher from a working-class background, I hope that it is possible to reach a consensus on a longer-term approach to making progress on closing the achievement gap in reading.
Of course, many of the root causes of the problem lie outside the immediate influence of school. Many parents are poor readers, as we know from the statistics, and
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they are therefore not in a strong position to help their children at home, even when well motivated to do so. Fifthly, therefore, this issue is not just about schools. We need to develop policies to support parents and families outside schools, especially in the early years. We are concerned about the overall impact of Government policies, whether in relation to Sure Start, as was mentioned earlier, or financial support to poorer families. Whatever the level of spending available to any Government, we ought to be able to agree on the types of policies beyond school that will help to tackle the problem.
I noticed a press release today from the Sutton Trust pointing out new analysis showing that parents from the richest fifth of households are four times more likely to pay for extra classes outside school for their children than those from the poorest fifth. I think that we should certainly look at the policy implications for supporting initiatives to give extra support, outside school or at the end of school, to pupils from poorer backgrounds. There are quite a few good initiatives out there for that, and the pupil premium might be a good way of supporting them.
Sixthly, we should make every effort, as politicians, to evaluate what works, including in schools. That is why Opposition Front Benchers welcomed the setting up of the Education Endowment Foundation, which the hon. Member for Norwich South (Simon Wright) referred to. It gives us the opportunity to start doing what so many people tell us they want us to do in education, whatever political party we belong to: to set longer-term policies.
The Minister of State, Department for Education (Mr Nick Gibb) rose—
Kevin Brennan: Does the Minister want me to give way?
Mr Gibb: I was hoping that the hon. Gentleman would come to the end of his remarks, because I want to allow my right hon. Friend the Member for Mid Dorset and North Poole (Annette Brooke) to speak as well.
Madam Deputy Speaker (Dame Dawn Primarolo): Order. I will be the one to decide that. The maths is that you have eight minutes each and there will then be a minute for the right hon. Lady.
Kevin Brennan: Thank you, Madam Deputy Speaker. I was attempting to split the time as per your instructions. I do not have too far to go. I was about to try to bring a note of consensus to the debate before I was, if not rudely interrupted, certainly interrupted.
If we achieve such longer-term policies, they will bring the quiet revolution that we need, which will last and succeed, rather than a noisy revolution that is doomed not to last. One feature of the most successful jurisdictions in education, which is rarely mentioned, is the stability of their policies. Those policies are based on evidential consensus, rather than on faddish policy making. What matters in teaching children to read is what works.
Over a long period, politicians have spent too much time telling teachers how to do things and not enough time telling them what we want to be achieved and
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letting them use their initiative, innovation and skill to achieve it. That point relates to the importance of training, the quality of teachers, which has been mentioned, and continuing professional development. The quality of teaching is what will make the biggest contribution to tackling the reading gap in schools. I will conclude my remarks on that point to give the Minister and the mover of the motion time to finish the debate.
4.51 pm
The Minister of State, Department for Education (Mr Nick Gibb): I thank the hon. Member for Cardiff West (Kevin Brennan) for that and apologise for intervening earlier.
I am grateful to my right hon. Friend the Member for Mid Dorset and North Poole (Annette Brooke) for securing this debate on what is, in everyone’s view, the most important issue in education. It has been a very good and well-informed debate.
It cannot be acceptable that in 2014 almost 18,000 boys aged 11 cannot read any better than a seven-year-old, nor that in 2013, one in five pupils on free school meals did not achieve the expected standard in reading at key stage 1. As the hon. Member for Liverpool, West Derby (Stephen Twigg) said in an excellent contribution, poor reading can lead to behavioural problems, with one in 10 14-year-olds who are poor readers becoming persistent truants, compared with just 2% of other children.
Nothing in education is more important than making sure that every child can read. To paraphrase my right hon. Friend the Member for Mid Dorset and North Poole, if you don’t learn to read, you can’t read to learn. Of course, our concern about reading standards should not simply be about the utilitarian benefits of reading. In and of itself, reading is one of life’s great joys. No child should be denied the chance to experience that joy for themselves, no matter where they live or what their background. She spoke about delving into other worlds. That is a good phrase to show why reading is so wonderful. We want all children to become fluent and enthusiastic readers. We want them to have the solid grounding in the systematic synthetic phonics that they need to decode the words on the page; the knowledge and appreciation to understand what they are reading; and the enthusiasm and experience to develop a lifelong love of books.
As was said by my hon. Friend the Member for Huddersfield (Mr Sheerman)—I call him my hon. Friend because of our years of service together during his chairmanship of the Select Committee—these issues start very early. For some children, they start even before they are born. Research shows that nothing is more fundamental to a child’s later outcomes than early language development. It is the key to mastering communication and literacy later on. Of course, a huge part of that development depends on parents reading, singing and talking to their children. The early years sector also has a crucial role to play, as my right hon. Friend the Member for Mid Dorset and North Poole said. We know that high-quality early education from the age of two has a lasting impact on children’s development.
Nowhere is the need to get children off to a flying start more pressing than for disadvantaged children. As my right hon. Friend pointed out, there is an 18-month
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vocabulary gap between children on low incomes and children on high incomes when they arrive at school. If that is left unchecked, they continue to slip further and further behind. That is why, from this September, we are giving some 260,000 of the country’s most disadvantaged two-year-olds 570 hours of funded early education. That is double the number of children who were eligible last year.
Early years education has to be of a high quality. As my right hon. Friend said, quality is as important as quantity when it comes to early years education. We are also introducing reforms to the national curriculum, which come into force today, giving ever higher importance to reading and literacy.
Of course, all of that depends on children mastering the essential skill of decoding in the first place. As my hon. Friend the Member for Norwich South (Simon Wright) said, it is right that we should base our practice on what the evidence says works. International evidence shows that the systematic teaching of phonics is the most effective way to teach children to read. It helps all children, particularly those from disadvantaged backgrounds, become fluent readers.
We are absolutely committed to ensuring that the high-quality teaching of phonics in primary schools continues, which is why we have introduced the light-touch phonics check. In the pilot in 2011, 32% of children in the 300 schools involved passed that check. In 2012 that rose to 58%, and last year it had risen to 69% of all pupils meeting the expected standard. That was a significant rise, but just 56% of pupils on free school meals met that standard compared with 72% of other pupils—there was a 17 percentage point gap, which we need to close. Some local authorities, such as Newham, did extremely well in that check, with 76% of pupils passing, but others did not achieve so well, including some in affluent areas. I was encouraged by the initiative to improve reading in Liverpool that the hon. Member for Liverpool, West Derby described. I am sure that we will see a significant rise in Liverpool’s phonics check results as the years go by. We want to ensure that all children are secure in their basic phonic reading skills.
One point on which I did not agree with my right hon. Friend the Member for Mid Dorset and North Poole was the starting date of formal education. There is no evidence that it is damaging. The Cambridge review of primary education in 2010 found no clear relationship between starting age and reading achievement, but some studies have found a small and temporary advantage to younger starting ages. My view is that delaying the start of formal education and the teaching of reading would widen the attainment gap, as children from more affluent and educated homes would learn to read at home and other children would not. That gap would continue to grow exponentially once they started their education. In fact, the majority of parents are happy for their child to begin school in the September following their fourth birthday. As we know, and as my right hon. Friend pointed out, children develop at different rates, particularly in the early years, and it is to be expected that some parents will feel that their child is simply not ready to start school when they are four. To allow for that, the admissions code makes it clear that parents can request that their child attends part-time or that their entry is delayed until they reach the point of compulsory education.
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The Government’s overall plan for education is to raise academic standards, make every local school a good school and significantly improve standards of behaviour in our schools. We want to close the attainment gap between those from poorer and wealthier backgrounds, not just in reading but across all academic subjects. However, reading represents the foundation of education, and we need all young people to be reading fluently and with increasing speed by the time they reach key stage 2. We need them to read voraciously throughout primary school, so that they not only become accomplished readers but develop the habit of reading for long stretches of time. That is how we can ensure that every young person achieves their full potential to be as well educated as their ability will allow. That means that they can benefit from all the opportunities that this country has to offer.
4.58 pm
Annette Brooke: I thank all the Members who have contributed to the debate. We have achieved quite a lot in our limited time—perhaps we can get a high score for that. What pleases me most is that we have established that the issue matters, and that we all concur that an individual’s joy of reading is crucial, along with the other social and economic outcomes that we all want to see. Reading is so important that we need to look at the evidence and put as much emphasis as we possibly can on giving every child the best start in life.
That this House has considered the achievement gap in reading between poorer children and their better-off peers.
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Wanstead Hospital
Motion made, and Question proposed, That this House do now adjourn.—(Mel Stride.)
4.59 pm
John Cryer (Leyton and Wanstead) (Lab): I wish to thank Mr Speaker for granting this debate on the closure of Wanstead hospital in Redbridge in north-east London in my constituency.
Wanstead hospital has not existed as a full general hospital since it closed in 1986. It is where my hon. Friend the Member for Ilford South (Mike Gapes) was born 62 years ago—it is his birthday today, so I wanted to mention it. Hon. Members will have noticed all the bunting hung outside to celebrate that event, and he is happy for me to point it out. What remains of Wanstead hospital are two intermediate care wards called Heronwood and Galleon. The care is usually provided to elderly people who have perhaps been ill or in hospital and are not well enough to go home, and they need intermediate care before they can return to their homes.
This issue affects not only the London borough of Redbridge but three London boroughs: Redbridge, Barking and Dagenham, and Havering. It stretches from the boundary of Redbridge in the west to the boundary between Havering and Essex in the east—a huge swathe of north-east London. The plan is to take the three boroughs, cut all the intermediate care beds—there are currently 104—and reduce them to 40 beds located at King George hospital in Ilford. Apart from anything else, that is six miles from Wanstead so it is a long way for people in my constituency, many of whom are elderly, to travel. The facility in Dagenham at Grays Court is being closed, and the biggest facility is Wanstead hospital, which has 48 intermediate care beds over the two wards. We have already lost 35 beds in St George’s hospital—not to be confused with King George hospital—which is in Hornchurch in Havering and is an old RAF hospital. Those beds were lost last year and the plan is now to concentrate all the intermediate care beds in one place in Ilford at King George hospital.
The ongoing consultation has been produced and launched by an obscure and unaccountable group led by chief officer Conor Burke and the chairman, Dr Mehta. This group is not a clinical commissioning group; it has an overall strategic planning role above the CCG. Conor Burke and Dr Mehta are accountable to a small board that is made up of representatives of the three CCGs from those boroughs—hardly a shining example of democratic accountability.
It is basically a deeply flawed consultation. I was told by Conor Burke and Dr Mehta on 13 June that they might possibly be engaging in a consultation that would lead eventually to the closure of what remains of Wanstead hospital and those two wards. They did not volunteer that information; they said that there might possibly be a consultation only because I asked what the future held for Wanstead hospital. They said not that it was closing at that point, but that there might be a consultation. I asked three times for an assurance—which I received—that I would be informed as soon as the decision to consult on the future of Wanstead and the other facilities was made. I was not told about that decision. I found out about it only on 18 July when I received a letter with a consultation document stating that the consultation
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was already under way. If they treat elected representatives like that, God knows how they treat members of the public. It calls their track record into question.
The consultation document has not been made widely available, and I receive e-mail after e-mail saying that it is difficult to get hold of it or access it online. It is not in the libraries, GP surgeries or community centres—at least not the ones that I or anybody I know frequent. The document sets out a series of options, and then states, “This is the option we want.” It is clearly pushing respondents in a particular direction. That is not a clear, fair or neutral consultation. They are saying, “We’ll set out a few options for you, but this is the one we want, and if you respond, we want you to support this option.” That is clearly what the consultation document says, as anyone will see, if they can actually get hold of it. Only a couple of hours ago, I received an e-mail from a constituent I know quite well who told me about her difficulty—she is an articulate, intelligent person—getting hold of the consultation document and then responding online.
Another great difficulty, and a point that has met with another rebuff, was the request to extend the consultation deadline. The consultation started in July and will end on 1 October, but there has been call after call to extend it until 31 October, because most of the current consultation period falls in the holidays and most people do not know it is happening. I have met scores of people in Wanstead and elsewhere, even people who have used the facilities, who do not know the consultation is up and running. One of the richest ironies of the process is that the newly elected health scrutiny committee on Redbridge council—all people elected on 22 May—clearly requested an extension to 31 October, but so far the health tsars in north-east London have said it is not necessary.
The plan put forward by the senior health managers was to create two teams. The community treatment team, which provides care in people’s own homes—I have nothing against that, but I think we need the intermediate care beds as well—is not available after 10 pm, and the intensive rehabilitation team stops at 8 pm. It is promised that the CTT will respond to any call within two hours, but if someone needs help at 3 o’clock in the morning, when both teams are off duty, they will need to call the out-of-hours service or the emergency services, which I think is inadequate for a lot of people in need of intermediate care.
Both teams are up and running and seem to have done a good job. The reaction from the public who have received their care has been very positive—I cannot dispute that. However, we now see a proposal to introduce massive changes to intermediate care across a huge swathe of north-east London, including three of the biggest London boroughs—Havering is the second-biggest and Redbridge is one of the biggest—based on very little evidence. There have been intermediate care beds at King George for only a year, and the beds lost at St George’s in Hornchurch were cut only last year, in 2013, yet we now face a huge cut in bed numbers and their concentration in a facility that has been run for only a year, with two relatively new community-based teams, both based at King George hospital. The system is just not tried and tested. In my view and that of most of the people I represent—in my experience—we are
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not in a position to say the system will work, yet those beds will be lost, and once beds are lost, they are rarely got back.
The health tsars tell me that the beds are not being used. I dispute that. For one thing, last winter, which was very mild, 75 out of the 104 intermediate care beds were used. That is a relatively low number, but, as I say, it was a mild winter. If this or next winter is very cold and harsh and intermediate care beds are needed, we will only have 40 located at King George, rather than what we used to have, which was three far more accessible facilities across the three boroughs. I am being told stories off the record—nobody has gone on the record—by NHS staff and constituents that people are being turned away from Wanstead hospital and sent to King George in Ilford in order, I can only imagine, to massage the figures. I am also told by doctors and nurses who work for the health service that it is quite difficult to get into Wanstead hospital. Again, that will bring down the bed occupancy figures, adding grist to the mill of the senior health managers who are keen on getting bed occupancy down, so that they have a perfect justification for closing Grays Court and Wanstead hospitals and putting 40 beds in the King George hospital.
The Minister will be acutely aware, I imagine, of the difficulties experienced by local hospitals, by which I mean general hospitals. Queen’s hospital in Romford has faced enormous difficulties, as I am sure she will be aware. Capacity at Queen’s was forced down because the Care Quality Commission felt that the hospital was not capable of dealing with the relevant number of people—particularly in maternity, but in other areas, too. Whipps Cross hospital in my constituency has also had significant problems, receiving a series of very critical reports from the CQC.
King George hospital, where the intermediate beds are planned to be located, has been under threat of closure for years. It is only because of the stalwart efforts of my hon. Friend the Member for Ilford South and others in campaigning to keep the hospital open that it is still there. It could close at some point in the future. Against that background, with all those problems in the acute trusts across north-east London, it seems to me that taking out all the intermediate care beds with huge cuts and putting in 40 beds in Ilford at the King George is, at best, a foolhardy decision.
Let me make one more point about the consultation—the lack of accountability. The whole process, in my view, has been deeply flawed. Perhaps the greatest talking point among my constituents is the pig-headed refusal to extend the deadline to the consultation until the end of October, which seems a fairly modest sort of request. The demand for it was overwhelming and the scrutiny committee elected on 22 May called for the extension, yet the senior health managers in north-east London seem absolutely determined to refuse that relatively modest request.
Why are these senior managers so unwilling to respond to public opinion? It is because they do not have to respond to public opinion. The two people responsible for this exercise were not elected. I am not saying that there was a glorious era when everybody running the NHS was elected—such an era never existed—but these two people were certainly not elected and they are not particularly accountable. If they are at all, it is to a fairly obscure board, indirectly appointed. That has
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resulted in a process that provides a pretty disgraceful example of sweeping aside the wishes of local people, local councillors and locally elected representatives, and saying, “We know best. If only all these daft people would leave us alone and let us get on with it, we can make all the decisions and run the health service efficiently.”
I do not say this as a party political point, but I do not think the national health service was set up for the convenience of well paid senior managers whose wages are paid by the taxpayers I represent. The NHS was set up by Nye Bevan after the second world war in order to provide care for everybody. In future, we should move to a position whereby the people who use the NHS and run it at the sharp end should be far more involved in decisions about how to provide care that will always be free at the point of need. There has to be a change. This exercise has brought home to me just how unaccountable so many senior NHS managers are. If they are unaccountable, they will not care what the people who use the facilities for which they are responsible think. Their lack of accountability has to change in the long term.
Madam Deputy Speaker (Dame Dawn Primarolo): I call the Minister.
5.14 pm
The Parliamentary Under-Secretary of State for Health (Jane Ellison): Thank you very much, Mr Deputy Speaker—Madam Deputy Speaker, I apologise.
Stephen Pound (Ealing North) (Lab): It has been a long day.
I congratulate the hon. Member for Leyton and Wanstead (John Cryer) on securing this debate on issues that are clearly of great importance to him and his constituents. Before I try to address some of the issues he has raised—I have listened carefully to what he has said, and if there are issues to which I cannot respond now, I will certainly take them up with NHS London—I would like to put on the record my thanks to all those who work in the NHS, not only in his constituency but right across the service, for their dedication to providing first-class services to his and all our constituents.
As the hon. Gentleman is aware and as he described in his speech, Wanstead hospital closed in 1986 so the services that are the subject of this debate are provided from the Heronwood and Galleon unit on the site of the former hospital. As he said, it houses 48 rehabilitation beds in two wards, and it is one of three community rehabilitation units providing intermediate care for people in the three boroughs of Barking and Dagenham, Redbridge and Havering. The two other units are located at Grays Court in Dagenham and the Foxglove ward at King George hospital. The proposal put forward by the clinical commissioning groups for the three boroughs is to centralise these services at King George hospital, and that is the subject we are addressing this evening.
As the hon. Gentleman described, the three local CCGs outlined five possible options for the future of intermediate care services in the document issued on
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9 July. I understand what he says about the preferred option steering people, but we would also probably be critical if local health leaders did not tell us what their preferred option was. I suspect we would want them at least to tell us what their thinking was in order to guide the public and be transparent. The proposals are currently the subject of a full 12-week public consultation. I understand that he has recently met Redbridge CCG and has expressed his concern, as he has done again tonight in the House, about the current length of the consultation, asking for an extension. That is being considered by the CCGs and I have asked that they respond to him as soon as possible after this debate, having given that further consideration and heard the strength of his feeling on the subject.
On support for the proposals, I know that in June, as partners on the local integrated care coalition, the three local authorities all agreed the content of the intermediate care pre-consultation business case. That includes the case for service change and the proposal for the local CCGs to go to public consultation. Subsequently, the three local CCG governing bodies all agreed to go to consultation and to consult on the preferred option, which we have described. I also understand that the Havering health and wellbeing board is very supportive of the proposals, urging the CCGs to get on with the proposed changes more quickly. Discussions are to be held next week with the health and wellbeing boards for Redbridge and Barking and Dagenham.
The head of nursing at the Partnership of East London Co-operatives has described the proposals in positive terms, and a number of positive comments have been made about the innovative ideas on home care, which the hon. Gentleman has been fair to describe as positive and good for his constituents. I know that in Redbridge the CCG is continuing to engage with community groups, some of which he has alluded to, in order to explain the proposals in more detail, and that is quite right. I was concerned when he said that members of the public locally are not clear about what is happening and do not feel that they are in the know, because these processes should always have at their heart the desire to convey what is being proposed to the public in order that they can comment meaningfully on them.
Under the preferred option, the overall number of rehabilitation beds provided would reduce from 104 to 40, with the capacity to increase to 61 should the need arise. On the face of it, that does sound like a very significant reduction, and I can understand why the hon. Gentleman and other local people may be concerned when they hear those figures. Local people needing intermediate care have generally been cared for in beds at community rehabilitation units, which means that the number of intermediate care beds across his area is relatively high compared with many other areas. However, I am advised—he made mention of this in his speech—that many of those beds are not being used because there is insufficient demand. The latest bed figures for August show that 49 intermediate care beds—47% of the total capacity—were unused across the area for that month. I note that he disputes those figures, and he makes a fair point about the waxing and waning of demand across the year. I would certainly hope that the local clinicians and managers who put these plans together would take into account those shifts in demand across the year.
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The CCGs have also heard from the public that people want to be cared for and supported in their own homes wherever possible. That is a consistent message we get from the public across a range of health services. Keeping people at home helps them to stay independent for longer, and they recover just as well, and in some cases better and more quickly, at home. That is why the CCGs are developing a model of care where people are cared for and supported in their own homes, not in hospital. That model has been developed by clinicians, with, properly, input from patients and carers. However, patients who need a community bed will still be able to get one. The CCGs believe that concentrating all the rehabilitation beds on one site is the best way to develop high-quality care for the hon. Gentleman’s constituents and other patients who need to stay in a rehab unit.
Clinicians locally believe that that is the safest way to provide care and the best way to provide care of consistent quality. Concentrating the service on one site would enable staff to maintain their practice standards and share expertise more easily. The hon. Gentleman referred to the fact that the CCGs have been trialling two new services—the community treatment team and the intensive rehabilitation service. The community treatment team provides short-term intensive care and support so that people can be cared for in their own home, rather than in hospital. That is something that my constituents, his and other Members’ constituents say all the time: they would much prefer to do that. The intensive rehabilitation service provides support, such as physiotherapy, for people in their own homes and further reduces the need for patients to stay in community beds.
Figures for the last seven months are very encouraging. They show that nearly all patients supported by the community treatment team—90%—do not go on to be admitted to hospital. There are important issues to consider such as knock-on effects and the sustainability of local health services. The intensive rehabilitation service is similarly successful, with 90% of patients able to recover at home without needing to go to hospital.
Before the trial of the new services, patients waited an average of five days to access bed-based care. Since the trial, patients are able to access community beds or the intensive rehabilitation service in less than two days on average. Most people who need the community treatment team are contacted within two hours. We should pay tribute to the innovation that has taken place and to some excellent local service delivery.
I understand that patient satisfaction ratings for both the new services have been consistently high across the three boroughs since the trials began. The results of the latest satisfaction survey, published in June, were taken from patients recently discharged from the community treatment team, and it is good to hear patients being positive about their experience. In Redbridge, patient satisfaction with the service scored an overall average of 9.5 out of 10; 94% of patients and relatives said they would be “extremely likely” to recommend the community treatment team service to family and friends—the new family and friends test is being introduced across the NHS and is a good measure of what people really think of the service—and 100% of community treatment team patients were responded to within two hours.
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Most of the patients surveyed felt that they either would have attended A and E or would have been admitted to hospital if that service had not been available, which goes to my point about the sustainability of local acute services. Since the trial started, 7,600 patients have been seen by those two new services, 1,000 from Redbridge. Only 1,300 patients would have been seen in a “beds only” service. Therefore, we can see service change bringing great quality of service to the hon. Gentleman’s constituents and others in the area.
Demand for rehabilitation beds has further reduced during the trial of the new services as more people are being cared for at home. I am advised that, during July, 46 of the available 104 beds were unused, as I have mentioned.
The Government are clear that reconfiguration of front-line health services is a matter that should be led by the local NHS. It is best placed to know the needs of local people and it knows how to deliver them. Putting the patient first is central to that, although it always concerns me when hon. Members bring to the House their worries that consultation and transparency have not been as good as they could be. I note the hon. Gentleman’s points, as will local health leaders, with concern. I know that they have met him on a number of occasions. I am sure that we will meet him again to take up those points, but at the heart of reconfiguration is the all-important issue of putting patients first and delivering a better service for all patients. The NHS in London, as elsewhere, has to constantly evaluate the way in which services can best be tailored to meet the needs of local people and improve standards of patient care.
I recognise that proposals for service change inevitably arouse public concern, and that is why it is important that we get consultation processes as good as they possibly can be. It is absolutely the role of hon. Members to express those concerns, to hold all of us who are involved to account, to engage with local clinical and operations leaders and to test the NHS’s response to those concerns.
I know that the hon. Gentleman has both corresponded and met senior staff from the local NHS, and I have met local health leaders, and I hope the response he received from the chief officer of Redbridge clinical commissioning group has gone at least some way towards addressing his concerns about the proposed reconfiguration of intermediate care services. The consultation on the proposals is open until at least 1 October and, as I said earlier, an extension is being considered. I undertake after this debate to further draw to the attention of local health leaders the strength of feeling the hon. Gentleman has expressed tonight about the need for more time for him and his constituents, but I urge him to participate and to make his constituents’ views known during the course of that consultation, as he has done tonight in the House.