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Peter Bottomley (Worthing, West) (Con): I echo what the hon. Member for Lewes (Norman Baker) said. I am glad that this is a non-party, all-party campaign and I am sure that the hon. Member for Crawley (Laura Moffatt) would join us in our debate, were she in a position to do so. In Worthing, the local Labour party, Liberal party, Conservatives, the non-political and the mediathe Worthing Herald and Splash FM in the lead, with the support of The Argus and the other papershave done a great job. I do not know how often the Minister has called a meeting of local residents to find that 6,500 people have turned up, and called another meeting to find that 8,500 have turned upat a conservative estimatebut that is how keen people are to take part in the debate and to ensure that their voices are heard properly. Even more important than the popular voice and that of the patients are those of the doctors, nurses and support staff in our hospitals.
I shall make reference to one detailed paper that the Department of Health has seen. In the agenda contained in the primary care trust board papers for a meeting on 25 June, item 7 includes the heading Financial Implications of reconfiguration documents. Page 7 gives information that is not referred to by the primary care trust in any other paper that I have seen. That is a scandal, and I want the Minister to tell the strategic health authority and the primary care trust to reissue the consultation documents spelling out that under options 1 and 3 there will be savings to the national health service, which have not been taken account of, of up to £24 million even when scaled back by a factor of 50 per cent. It is shocking and misleading, and it is either a mistake or it is deliberate.
I want the Minister, if she can in the next hour or so, to get page 7 of the annexe to item 7 of the agenda paper on financial implications. If we are told that there are calculated figures of £13 million here or minus £18 million there, and a £24 million saving to the health service is missed out because it happens to affect a hospital outside Sussex and Brighton and HovePortsmouth, in Hampshirethat should be taken account of. If the Minister reads pages 1 to 6 on the financial implications, she will see no other reference to that information. It is contained in one box on page 7 and I bet that 999 in 1,000 will never have spotted it. I do not believe that the independent directors of the primary care trust board or the strategic health authority knew it. My local papers did not spot it, and neither did the experts who considered the options. That is not fair or plain dealing, and I hope that the Minister will ask the chairmen of the SHA and the PCT whether they knew it or whether it was known by the people on the executive side. Did the lead director know it and, if so, why was it not mentioned at the PCTs public meeting? That is not right.
I now switch to a health meeting held in the House of Commons this morning. The health economist who attended said that there was no evidence that moving to massive acute hospitals makes a significant difference to outcomes. If the Minister asks the chief executive of the SHA, Candy Morris, for her recent exchange with Mark Signy, an acute medical specialist at Worthing, she will find a couple of things. First, when the clinical
reference advisory group summed up what Mark Signy said in reference to acute medical admissions, it stated:
Only 1 per cent. of admissions require a primary angioplasty and therefore this procedure would not influence reconfiguration.
Only 1 per cent. of medical admissions require a primary angioplasty (indicated for a particular type of heart attack known as a ST elevated Myocardial Infarction) and therefore this procedure would by itself have a direct influence on local acute hospital configuration
a direct contradiction. We have to assume that it was merely a mistake, and the word not was left out. However, given the number of people who will have read that letter from the chief executive of the SHA, she should write a press notice to say that she agrees with the specialist that the procedure does not have that influence.
The Prime Minister has quoted Professor Sir George Alberti and Roger Boyle as saying that the fact that 500 lives a year might be saved around the country means that one life might be saved every eight months in Worthing and district. I argue for at least two acute hospitals in West Sussex. I am not arguing about whether the one hospital should be in Worthing or Chichester, but for two hospitals. The Minister should require the SHA to re-consult on the option for at least two hospitals, with accident and emergency and maternity departments, so that the public can be consulted on that. At the moment, we are left with good grounds for judicial review, which the Secretary of State must know about. From the beginning, the SHA wanted a review and said so. The lead director said so. I am grateful to Derek Waller of Arundel, who has made that rather plain in his analysis of the East Sussex and West Sussex papers.
I could say a great deal more to the Minister, but I will make this point briefly. No hospital in Germany that I know of has more than 3,500 births a year and yet our plans are to have 4,000 or 6,000 in onea baby factory for West Sussex. I know of no argument that all the babies born in Worthing should be moved to Brighton. In fact, a lot of the movement seems to be the other way. The Minister ought to ask the SHA and the PCT whether they have consulted mothers and mothers-to-be on that and what the trends are.
On accident and emergency, if significant numbers of clinicians at Worthing hospitalI think that the same would apply at Chichesterbelieve that it is not just saving one life every eight months that matters but avoiding losing two or three lives a month because of people having to go on journeys, that is all the better.
I end with something rather personal. I came back on the day of the state opening of Parliament to find my wife in pain. A GP dropped his surgery and diagnosed an ectopic, and we got to St. Thomass hospital in eight minutes. If that had happened in Worthing after the plans had been carried through, my wife would have died. I do not think that I care about her more than other people, whatever their age, care about their spouses, partners, friends or neighbours. I want the Minister to make the PCT consult again on the two accident and emergency departments and two maternity departments and get the financial figures out in the open.
Mr. Nicholas Soames (Mid-Sussex) (Con): I intend to be brief, because my hon. Friend the Member for Arundel and South Downs (Nick Herbert) set out the basic case clearly and many other colleagues wish to speak. The hon. Member for Lewes (Norman Baker) is a welcome supporter and has made a powerful case for the Princess Royal hospital.
This is the fourth time in seven years that the Princess Royal hospital has come up for review. That is no way to run a health service or look after patients, and above all, it is no way to treat the staff. The staff of the Princess Royal know perfectly well that there is absolutely no clinical evidence for the changes, although they have to be cautious in saying so.
On the face of it, the proposals are genuinely absurd. The Princess Royal is 15 miles south of one of the biggest international airports in the world and five miles or less from a busy motorway. It is in the centre of one of the fastest-growing parts of the United Kingdom, which has a rapidly increasing and increasingly young population. It sits in West Sussex, which, I do not have to remind the Minister, covers more than 770 square miles and has more than 750,000 people, a struggling transport infrastructure and a growing ageing population.
Infrastructure is about more than roads, railways, sewers and health and social services. It underpins national and local well-being. People in my constituency and elsewhere know that, and a powerful case will be made to the Minister, to whom I am grateful for saying that she would receive a delegation to talk about the matter. We will fight this every inch of the way.
Most importantly, the people in mid-Sussex, who have been through an awful lot with the health services in the past seven years, want an assurance from the Minister, if the so-called consultation is to be seen to be realI know that she will intend it to be realthat the powerful, detailed and sustained views expressed locally will be listened to and paid attention to when it comes to the shake-up at the end of the process.
Finally, I urge the Minister to understand that there is nothing synthetic about the anger and disappointment that is felt not only in mid-Sussex but across the whole of Sussex. I hope that she will acknowledge that.
Mr. Francis Maude (Horsham) (Con): The debate is timely and I congratulate my hon. Friend the Member for Arundel and South Downs (Nick Herbert) on securing it. In the long period during which I have been a Member of Parliament, I have never had so many complaints and concerns and so much anger expressed to me about the state of hospital services as in the past few yearsthat is as they are today in West Sussex, let alone how they would be after the Governments plans were put into action.
My hon. Friends have described vividly our concerns about the proposed depletion of hospital services, particularly in West Sussex. I do not want to repeat them, but I add that the model being proposed for the southern end of West Sussex has already been put into effect in the north end. Over the past 10 years or so, Crawley hospital has effectively been downgraded from an acute to a community hospital. Way back in 1998, a
joint health care NHS trust was formed between Crawley and the East Surrey hospital at Redhill, specifically to provide synergy and specialisation.
We were assured that small amounts of care would be transferred from Crawley to Redhill and that that would be itno more salami slicing. But then the salami slicer got to work again, and gradually more and more services have been taken away from Crawley. Now the only hospital that serves much of my constituency and the whole of Crawley is at Redhill.
It is no criticism of the wonderful staff at Redhill to say that it is a hospital in crisis. I have a sheaf of complaints, cases and concerns from relatives of patients who have died there in appalling circumstances. Its staff are utterly demoralised and it is in crisis. To meet the Governments top-down targets, ambulances have been queuing outside A and E, so as not to get patients into the A and E queues, to make the numbers look better. The situation is intolerable and should not be allowed to continue. The proposals would make it much worse.
My hon. Friends the Members for Mid-Sussex (Mr. Soames) and for Arundel and South Downs and the hon. Member for Lewes (Norman Baker) made a strong case for maintaining the Princess Royal as an acute hospital, and I totally support that. It serves some of the villages and communities at the eastern end of my constituency. Even as it is, it cannot serve constituents who live in the Horsham area, Crawley or villages as far away as Billingshurst, which are already uniquely inconvenienced in their lack of access to acute hospital care. Under any of the options proposed by the SHA and the PCT, that would get worse.
I wish to make a quick point about accessibility. We always hear the same thing when such proposals are mootedthat what is crucial is not how far away the hospital is and how long it takes to get there, but how quickly paramedics can reach people. That is true in some cases, such as cardiac cases, but it just is not true in others, such as strokes. A stroke is caused by either a clot or a bleed, and the treatments are diametrically opposed in the two cases. The critical thing in avoiding a person being permanently damaged is the speed with which they can be got to hospital and scanned. If a stroke is caused by a clot, as most are, and anti-clotting agents are introduced quickly, a stroke can be almost completely or, in many cases, completely reversed. Think of the savings in the cost to the NHS and society as well as the human cost of so many stroke patients not needing continuing care.
Accessibility really matters. If my constituents become totally dependent on East Surrey hospital and, I suppose, the Royal Sussex at Brighton, they will find them both inaccessible. A constituent of mine in Billingshurst who sustained a serious injury had to wait 45 minutes before the ambulance got there, and it then took another hour and a half to get from Billingshurst to Redhill to the A and E. Time was not critical in that case, but there are plenty of cases in which it is. I am told that the air ambulance cannot even land in Brighton, so the difficulties are not overcome by air access. The matter is serious.
My case is not only that we need to keep what exists but that we need more. We need to reverse the ill-judged changes that have seriously affected the Horsham and Crawley area. I would make the case for a new hospital to serve Horsham and Crawley. As the Government should know, much more housing is being imposed on
the area. Indeed, the Prime Minister talks generally about imposing more houses, and none of us is against more housing development, but we do insist that there is a proper assessment of infrastructure needs, and hospital services are central to that. The case for not only keeping what we have, but reversing some of the changes that have been made is therefore increasingly powerful.
I urge the Minister to take this issue seriously. Several hon. Members have said that we are taking a non-partisan approach, and that is absolutely right. Other partiesparticularly local Liberal Democratshave supported the campaign against hospital closures and the case for a new hospital to serve Horsham and Crawley. I do not wish to make a particularly partisan point, but the local Labour party in both Horsham and Crawley has been conspicuous by its absence and silence, and that causes concern. I therefore urge the Minister to listen. The new Prime Minister has made much of his willingness to listen, and the Minister has a good opportunity to get brownie points with himif I can put it like thatby showing that she is willing to look again at the course to which the Government are apparently committed, but which will be very damaging for a large part of West Sussex.
Derek Conway (in the Chair): Order. Just to help those hon. Members who still want to speak, let me say that the winding-up speeches should really start at 3.30 pm, but my intention is that they will start at 3.40 pm, which might help those who still want to catch my eye.
Charles Hendry (Wealden) (Con): I congratulate my hon. Friend the Member for Arundel and South Downs (Nick Herbert) on securing the debate and on the way in which he introduced it. I agree very much with everything that he said and with other hon. Members who have spoken. I hope that the Minister will already be in no doubt that our constituents are confused and baffled. They hear the whole time that the health service is awash with money and that extra money is going in, but they see that health service provision in Sussex will potentially be devastated.
However, our constituents are more than confusedthey are angry as well. They are partly angry about the process that has been adopted. In East Sussex, we have already gone through most of the consultation exercise, so we have a good idea of what will happen in West Sussex. What has happened has not been adequate. There is anger, for example, among the 15,000 constituents in and around Uckfield who get their health service provision in West Sussex. When the public meeting came to Uckfield, they could talk about provision only in Hastings and Eastbourne, which none of them access, rather than at the Princess Royal hospital. If they were to lose the Princess Royal, they would rather that their facilities were transferred to Eastbourne, but that option is not being made available. A completely arbitrary and unsatisfactory divide has therefore been created, when the issue should have been dealt with holistically across the county.
People are also angry at the presumption of closure. There is cynicism because they believe that the decisions have already been made and that, regardless of how strong their case is or how persuasively they make it, the decision will ultimately be to downgrade or close units at these important hospitals. There is also anger that the status quo is not being included, as it should be. We have had to fight for option 5 to be included at Eastbourne and Hastings, and there is now the whole issue of whether the status quo should be an option in West Sussex. I therefore hope that the Minister will take away with her the real sense of anger at the way in which things are being handled.
I also hope that the Minister will be seized of the fact that the proposals will have a devastating effect on many of our constituents. People at the southern end of my constituency face the loss or significant downgrading of maternity services at Eastbourne and the potential loss of the accident and emergency and maternity units at Haywards Heath. Those who live in the town of Uckfield can get to Haywards Heath in 15 minutesthat would certainly be no problem by ambulancebut it could easily take them one hour to get to Brighton. When I last went to Brighton, it took half an hour to get to the outskirts and 45 minutesin absolutely dense traffic on clogged roadsto do the final three or four miles, and even an ambulance would be hard pressed to improve significantly on that time. We also face the loss of the homeopathic hospital in Tunbridge Wells, which serves many of our constituents in East Sussex.
We are moving in entirely the wrong direction. We are seeing pressure for new housing as never before, but those responsible are taking account only of known new housing and not of new housing that is inevitable, but which has not yet been allocated space. In Wealden, for example, we will be expected to accommodate 400 new houses every year for the next 20 years, but that is not being taken into account in the calculations. Based on such miscalculations, it is assumed that the number of people who will wish to access maternity services in Eastbourne will decline. That approach is fundamentally flawed and needs to be looked at again.
We must also be in no doubt about the consequences of expecting people to travel to Brighton, rather than to the Princess Royal in Haywards Heath. That extra hour or 45 minutes will, as colleagues have said, mean the difference between people surviving or dying. We recently had an impressive presentation by the head of the South East Coast Ambulance Service NHS Trust, who said that the ambulance service is brilliant at dealing with road traffic accidents, strokes and cardiac cases, but that it is not good at dealing with pregnancies involving difficulties. There are serious concerns that, if staff end up having to sort out a complicated pregnancy on a journey that is longer than would otherwise have been necessary, the well-being of the infant and the mother will be put at risk.
This country already does badly in terms of the survival rate for cardiacs. In Seattle or Finland, 50 per cent. of those who have a heart attack out of hospital are alive two years later, but the figure in this country is 6 per cent. The figure in Sussex and the south-east is starting to pick up, and we are seeing an improvement for the first time, but there is real concern in the ambulance
service, which gave us those figures, that the figures will decline if people are expected to be treated in ambulances, rather than in the hospital closest to them.
If the Minister does come to Brighton, I hope that she will do so not just in the middle of the day, but on a Saturday night. I have been to the accident and emergency unit at 1, 2 and 3 oclock in the morning, and I was appalled by the conditions. Transporting people for an hour more than is necessary to a massively overcrowded hospital in a busy city centre is not the right way to deal with people in emergencies. I hope that the Minister will respond to those issues. I know that she cannot give us the response that we want and say that the proposals will be put on hold, but I hope that she will say that our views will be listened to.
I was in the main Chamber a little while ago to hear the Secretary of State setting out the details of the health review, and what came out of that was a determination to listen. If the Minister listens to the doctors and clinicians in Sussex, rather than to the managers, she will find that there is no support for the measures that we are discussing; if she talks to the public, she will find that there is no support for them either. I therefore hope that she will say that any decisions must be put on hold while the Government carry out their protracted new review. I hope that she will tell us that any decisions must be based on what is wanted and needed locally and that, at the end of the day, they must truly be based on clinical need, rather than financial circumstances.
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