|Previous Section||Index||Home Page|
Mr. Derek Wyatt (Sittingbourne and Sheppey): I congratulate the hon. Member for Canterbury (Mr. Brazier) on securing this Adjournment debate. I almost want to call him my hon. Friend, as he has been outstanding in keeping me informed about everything that has happened in this matter. Cross-party support in the matter has been evident for four years, and the hon. Gentleman and I have gone together to see Secretaries of State. We have displayed our anger together, and sometimes we have found it impossible to understand the answers that we have been given.
At this late stage, I hope that my hon. Friend the Minister will consider seriously the points made about cancer by the hon. Member for Canterbury. That is the health service's top priority, and I honestly do not feel that we will have a centre for cancer in east Kent of which we can be proud.
I also want to draw my hon. Friend the Minister's attention to the fact that the Kent and Canterbury's accident and emergency department is a disgrace. She must recognise that immediatelythat is, now. I do not believe that we can be proud of something that is so bad. Are not there hit squads that can be sent in to improve matters, or is no extra funding available? Are there no mobile rooms that we can use to help matters? There must be a way to take people off the trolleys. The A and E provision is demeaning, degrading, disgusting and awful. I ask my hon. Friend to reflect seriously on the urgent answer to the problem. We need that answer tomorrow, not in three or four weeks.
Finally, is it possible for my hon. Friend the Ministeror the Secretary of State, or another health Ministerto make an unannounced visit to Kent and Canterbury hospital? In that way, the state of the A and E department can be seen. It beggars belief.
The first point has to do with transport. The transport links to Ashford and Margate are atrocious. There is little or no public transport, and Faversham has many elderly or disadvantaged people. Both groups tend to be heavy users of the health service, but in effect they are being disfranchised by the process.
The second point is that there is no funding to build up local cottage hospitals, such as the Faversham cottage hospital. That hospital could not take over from the Kent and Canterbury, but it could help.
The third point has to do with cancer care. The out-patient model proposed by East Kent health authority is unproven anywhere in the UK. It has been rejected by all consultants, and by the Royal College of Radiologists. The Maidstone hospitalto which all inpatients would transfer, under the proposalsis already overstretched. The proposed model simply could not cope.
The Parliamentary Under-Secretary of State for Health (Yvette Cooper): I congratulate the hon. Member for Canterbury (Mr. Brazier) on securing a debate on an issue that he has raised many times. I know that he did so in a debate that was replied to by the Under-Secretary of State for Health, my hon. Friend the Member for Salford (Ms Blears).
As the hon. Gentleman said, East Kent health authority published a consultation document on 5 December on the modernisation of health services in east Kent. It set out four options for acute-service reconfiguration. As the hon. Gentleman also said, the three-month consultation period ended last week, and the responses are now being considered in the health authority.
All the options enable the hospital to treat the majority of patients whom it currently sees in its accident and emergency department, and to have a 24-hour nurse-led minor injuries unit as well as providing day surgery and out-patient services, orthopaedic services for older people, community assessment and intermediate care. The options also include provision of a day-care hospital, out-patient clinics, midwifery-led low-risk maternity services and cancer services.
There has been intense consultation, arousing passions and strong views in all parts of the health community and the local community in general. I am advised that staff at Kent and Canterbury hospital were consulted extensively on the shortlisted options between March and August last year, and that staff consultation included one-to-one with consultant staff to review the case for change and the shortlisted options.
I am also advised that four workshops were held and were well attended by consultant, nursing and therapy staff. Four seminars also took place across east Kent to involve staff in the evaluation of the shortlisted options. All consultant staff, senior nurses, therapists and managers were invited. Three workshops were apparently held in January to review the "network of care" arrangements in east Kent. Members of the clinical policy board and three other lead clinicians, two of them from Canterbury, have worked to specify the relationship between east Kent's hospitals. At the last of the workshops, specialist services were discussed in depth.
I am advised that the consultation gave all involved an opportunity to comment and express their views. I am also advised that the community health councils were content with the consultation process.
The exercise was carried out by a joint sub-committee of East Kent health authority and East Kent Hospitals NHS Trust boards, which draws its membership from across the health community. The sub-committee set up a reference group to examine the processes of the consultation to ensure that it had been robust and inclusive, and had allowed all interested groups to have their opinions heard.
Yvette Cooper: I understand the points that the hon. Gentleman is making. Clearly many of them concern the options themselves, and must therefore be taken into account by the health authority when it considers its responses to the consultation. I am also advised, however, that there were extensive consultations on the shortlisted options before the period between March and August last year, and I understand that the community health councils are content that the consultation process has been robust and proper.
The process from here on in is that a joint sub-committee of the trust and health authority boards is responsible for considering all responses and making recommendations to both boards by around the end of March. The two boards will then decide how to proceed, and a recommendation will be passed to the new strategic health authority, the Kent and Medway, which will make recommendations to Ministers. It is the boards' responsibility to base their decision on the consultation responses. If community health councils object to the recommendations, they will be referred to Ministers.
The hon. Gentleman will therefore understand that if we are to ensure that those processes are properly carried out, it would be inappropriate for me to pre-empt not only the boards' decisions but those that Ministers may have to make if the recommendations are referred to them. However, I will attempt to respond to some of the points raised by the hon. Gentleman and other hon. Members during the debate.
My hon. Friend the Member for Sittingbourne and Sheppey (Mr. Wyatt) asked if Ministers could visit Kent and Canterbury hospital. I can tell him that the Under-Secretary of State for Health, my hon. Friend the Member for Salford, intends to visit the hospital in the coming weeks and will have the chance to listen to views at that time.
Hon. Members also raised issues of capacity in the area. I can tell them that there has been considerable extra investment in east Kent. I agree that capacity in the area needs to increase, and that East Kent health authority continues to need additional investment, as does the NHS throughout the country. Next year, East Kent health authority will receive an increase of 9.85 per cent. in cash terms, which is an increase of 7.17 per cent. in real terms. The Government are determined to continue those increases in funding because clearly we are dealing with issues of long-term underfunding and lack of capacity throughout the health service. We will continue to address those issues.
In addition, the Government are providing £845,000 from the modernisation fund to improve patient access schemes in east Kent; £935,000 to help the move to six-day working for day surgery; additional money for dermatology and orthopaedics; £2.1 million to help to ease Kent-wide problems associated with delayed transfers of care; and £250,000 to streamline accident and emergency services and provide support for rapid access to therapies, diagnostics, pharmacies and porters.
Hon. Members referred to accident and emergency services. The Government have acknowledged the severe pressures on A and E, particularly during the winter months. The trust has acknowledged that Kent and Canterbury hospital has faced considerable pressures, particularly in the A and E department. The Department of Health's winter and emergency services team visited the trust recently. It recognised the excellent work being done by staff at the trust, but identified some areas that must benefit from improvement, and made several recommendations.
An intensive support team of six people has been identified to work with the trust over the coming months. That team, comprising experienced doctors, nurses and health care professionals, will help to develop plans to modernise the A and E department with emphasis on the clinical governance agenda. It is important to be clear that the issues are not simply additional capacity and investment. We need reform and modernisation to make sure that care is provided in the best possible way and using the most up-to-date methods.
Hon. Members also referred to cancer services and I can assure them that their points have been heard by Ministers. If community health councils refer these issues to Ministers, they will certainly be considered.