Medical and Clinical Practice
14th December 2006
Hemel hospital: "Not reconfiguration, but closure" Mike Penning tells MPs
4.46 pm
Mike Penning (Hemel Hempstead) (Con): As I said in an intervention, I am a proud member of the Select Committee on Health, which, earlier this week, issued a fantastic but damning report on NHS deficits. For the record, that Committee is Labour dominated with a Labour Chair.
Recommendation 29 states:
“The Department of Health has begun to tackle the deficits.”
That is the good bit, but it goes on:
“However, we are concerned that ... current policies are encouraging short term measures that may further destabilise the situation and”
are not
“in the ... long term interests of the NHS.”
Let us look at one example of short-term measures that are destabilising the NHS in west Hertfordshire. I am not the MP for Hertfordshire, but am proud to be the MP for Hemel Hempstead, which sits in west Hertfordshire. The acute trust that looks after my constituency is West Hertfordshire Hospitals NHS Trust.
The Minister referred to consultation on the future of facilities in my constituency. I must inform him that the consultation is over. It finished one month ago. The result was that 86 per cent. of the consultees who responded were opposed to the removal of services from Hemel Hempstead general hospital, which was built in the 1960s for the constituents of the new town and has been extended with funding. However, an independent review of that consultation was put to the trust’s board one month ago. The review was carried out by Clear and the gentleman who attended the meeting was John Underwood. Those of us who have been in the House in different capacities recognise that name because John Underwood was a director of communications for the Labour party before the current Government came to power. I understand that the company has carried out consultation and reviews of consultation extensively around the country and, every time, it came up with the conclusion that proposed cuts, which were opposed locally, should go ahead. John Underwood has another role: he is chairman of the Labour think tank, Catalyst.
I leave it to the House’s discretion, and its thoughts, whether that review of the health service in my area was independent when it was carried out by the Labour party on behalf of the Department of Health. I asked, naturally, whether that consultation specialist contract had gone out to tender. It had not. I understand that the company was appointed on the recommendation of the strategic health authority and the Department of Health.
Let us consider what the consultation, which was rejected by my constituents and local people, proposed. Hon. Members mentioned their concern that accepting cuts in maternity and in accident and emergency acute services is the thin end of the wedge. I am sad to say that my constituency is at the forefront of that thin end of the wedge.
Tim Loughton: How can it be at the forefront of a thin end of a wedge?
Mike Penning: It is very painful, I can assure my hon. Friend. Let us say that, sadly, we lead the way in cuts.
The acute accident and emergency department, which has received substantial investment over the past 15 years—first under the previous Conservative Government and then in the past three years under this Government—will be closed and moved to Watford. Along with it will go the brand new stroke and cardiac units, the MRI scanner and all acute facilities. Their closure marks the end of acute facilities in my general hospital. At the same time, the trust is going ahead with its removal of elective surgery to St. Albans. It means that in 18 months’ time, not one in-patient bed will be left in a general hospital that caters for the largest town in Hertfordshire. That is not reconfiguration, but closure—closure that will affect the day-to-day lives and prospects of my constituents.
I speak with some experience—I hope—because for many years I was a fireman. One duty in which I trained and specialised was attending road traffic accidents. I can say to the Minister with confidence and knowledge that if one does not have an accident and emergency unit with back-up acute facilities, including intensive care—that unit is closing—and a high dependency unit, lives will be lost.
I am sure the Minister will say that the problem is going to be addressed with more paramedics and acute ambulances. I asked the outgoing chairman of the ambulance trust—good job I asked the outgoing chairman; he would not have been allowed to speak to me or tell me the truth if he were staying—how many new ambulances we will get. The answer was none. How will we keep people alive and transport them not only from my constituency, but from St. Albans, which has already lost its accident and emergency unit, past the most dangerous junction of the M1—junction 8, where there are more accidents than anywhere else in the south—to Watford?
Let me provide the Minister with a geography lesson. Watford has a football ground, Vicarage Road, which is the home of Watford football club. A few months ago, I pushed a hospital bed with several thousand of my constituents from a hospital in my constituency.
Tim Loughton: Big bed.
Mike Penning: It was a very big bed; there was a coffin on it to symbolise how many lives would be lost.
We pushed that bed from the hospital in Hemel Hempstead to Watford general hospital. Fortunately, Watford were not playing at home. I wish Watford every success and I hope that they stay up, because they are struggling in the Premiership. However, Saracens rugby football club was at home, and it has crowds of about 3,000 to 4,000. There was mayhem, but not because of the demonstration led by my constituents. Incidentally, the demonstration was not party political. I am sure that there were as many Labour supporters on the push as there were Conservatives, although I am not so sure that there were too many Liberals present. Perhaps that is not fair because the parliamentary candidate was there—I apologise; it is just that there are not that many Liberals in my part of the world. Anyway, there was chaos because the police have to close the roads around Vicarage Road when there is a home game.
Andy Burnham: First time there was a big crowd there.
Mike Penning: The Minister can be derogatory towards the town of Watford. My constituents will be conscious of that remark, too.
The most important thing is lives. If one closes the roads, how does one get an ambulance into Watford? Hemel Hempstead hospital is in the heart of the town, with the best road links anywhere in Hertfordshire. The investment has been made, but the decision has been made to close the hospital completely. The Committee report said that the measures were short-term, and I passionately believe that. I asked the trust chief executive whether he would make such devastating cuts to services if the trust were not in deficit and if the strategic health authority and the Government were not forcing it to cut back so much to rebalance its accounts. The director of medicine, who is brand new to the area, stood up at the meeting and said, “Of course I wouldn’t. These clinical cuts would not be taking place if it were not for the deficits of my trust and PCT.”
The Minister knows that I raised the matter with the Secretary of State in Select Committee hearings. I asked her whether it was fair that people in her constituency in Leicester receive about £400 more per head than my constituents. As we heard, she said that the people in Hertfordshire are healthier than people in Leicestershire. It was the most astoundingly arrogant comment I have ever heard from a Secretary of State. However, no Opposition Member and none of our constituents is calling for parity throughout the country. We are not saying that everyone should receive exactly the same funding.
In my constituency, we would need less than £100 per head to bring us inside the deficit, and none of the cuts would need to take place. We could discuss clinical need and reconfiguration based on clinical effectiveness, but we are not doing so. We are discussing them based purely on the fact that the trust in my constituency does not receive enough money to look after the acute needs of my constituents. That situation is in the public domain, and it is wrong.
The Minister has said that with modern technology we can treat more people in the constituency, get them out of hospital quicker and look after them. I have heard other Ministers say the same in the Select Committee and in the House. That would be interesting in west Hertfordshire if it were not for a leaked letter from the PCT to GPs, saying that it is going to make district nurses redundant because it cannot keep them on and balance its budget.
The Minister cannot have his cake and eat it. We are close to Christmas, and we do not want a major conflict, but our constituents are frightened. He cannot say that the Conservative party is scaremongering, because yesterday every GP’s surgery in a consortium under the Dacorum primary care trust, which administers an area that I represent in part with my hon. Friend the Member for South-West Hertfordshire (Mr. Gauke), signed a vote of no confidence in the trust. They are not convinced that their patients’ safety can be adhered to with the reconfiguration of acute services.
Unless the Minister can prove that every GP in my constituency is a Conservative—they may be, but we cannot assume it—he must accept that they are genuinely worried about the clinical care and treatment of their patients. With that in mind, I can bring the Minister up to date by letting him know that a judicial review of the way in which the consultation took place was launched today against the trust. It is not just a case of Conservatives demonstrating with banners. With my past, I have not been on the demonstrators’ side in many demonstrations. I have certainly been on the other side trying to prevent some of them, although I must stress that that was in Northern Ireland in the 1970s. However, people are not simply scaremongering, and it is demeaning for the Minister to indicate as much. People and GPs are worried.
I have a final point to which I should like the Minister to respond. Day in, day out, I receive anonymous e-mails and phone calls from members of staff in the NHS locally, telling me what is going on. They say to me, “Please, Mike, do not tell anybody that I am telling you this or giving you this document, because I will get the sack.”
Mr. Tyrie: Absolutely. We get that the whole time.
Mike Penning: It goes on every single day.
Like everybody in the House, I am an elected Member, and every member of the NHS has the right to be represented by their Member of Parliament. Will the Minister instruct every trust in the country not to threaten their staff with action if they speak to their MP? If any trust has included that threat in its contract with staff, it must be removed immediately. It is undemocratic, fundamentally wrong and an insult to the House.
Mr. Tyrie: Further to that, does not my hon. Friend think that it would be helpful if strategic health authority chief executives were permitted to represent their private concerns and those of their senior staff that their area is underfunded relative to the national cake? At the moment, they are debarred from participating in national debate. Would it not be helpful if the Minister could give strategic health authority chiefs an assurance about that as well?
Mike Penning: My hon. Friend makes an important point, which I raised recently with the chief executive of my SHA at a public meeting. I said to him, “If you cannot guarantee the health care of my constituents—in other words, if you cannot do your job because you are not being funded correctly—you should get on a platform and say so.” He said, “I am not allowed to do that. That is the job of the politicians. I have to do what I’m told.”
I know that the Minister is an honourable man, and I hope and pray that the Secretary of State is of similar ilk. In evidence to the Select Committee, she said that the NHS as a whole would be in balance by March 2007 and that she would take personal responsibility if that were not the case. Can we assume that she will resign if the NHS is not in balance by 2007?
5.1 pm
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OTHER CONTRIBUTIONS TO THE SAME DEBATE
Mike Penning (Hemel Hempstead) (Con): I freely acknowledge that Hemel Hempstead hospital has had substantial investment in the past 10 years in new cardiac unit, stroke and birthing units and extensive modernisation of the accident and emergency department, all of which will now be closed because of the funding crisis in the NHS.
Andy Burnham: As the hon. Gentleman knows, consultation will begin soon in Hertfordshire and will be developed in the new year. He might accept this point: there are four acute hospitals serving the county that he represents, a county of roughly 800,000 people. The problems that he is describing are long standing, and he should accept—
Mr. Andrew Lansley (South Cambridgeshire) (Con) rose—
Andy Burnham: I will give way to the shadow Secretary of State in a moment, but first I shall develop my point. My local authority has a population of about 320,000 and one acute hospital. The hon. Member for Hemel Hempstead (Mike Penning) should acknowledge the long-standing debate in his county about ensuring appropriate secondary provision without siphoning off funds and preventing money from being available for other areas. I have answered his question, and I give way.
Mr. Lansley: I am grateful. I hope that my hon. Friend the Member for Hemel Hempstead will forgive me if I pre-empt the point that he was going to make. I visited Hertfordshire the Monday before last. The people there have been debating for four years how they should respond to changes in clinical practice. The message that the strategic health authority is sending them even now is, “We need greater specialisation and greater concentration of services in major units in order to deliver.” That is what Members of Parliament in Hertfordshire signed up to in the investing in health strategy—they signed up to a new hospital at Hatfield. Just weeks ago, the East and North Hertfordshire NHS Trust said that, for reasons of affordability, it could not go ahead. What the Minister will tell the House should be happening is precisely the opposite of what is happening. The concentration of services in a new central unit will not happen in Hertfordshire. How does he explain that?
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Mike Penning: I suggest that the Minister read the report by the Select Committee on Health. I had the honour of being a member of that Labour-dominated Committee. It criticised almost everything that the Minister has said and called for an inquiry into the funding formula. It cannot be right that constituencies in some parts of the country get twice as much money through their PCT as constituencies in other areas—The Secretary of State acknowledged that to the Committee—and it cannot be right that a Secretary of State comes before a Select Committee and says that the reason that her constituents get £400 per head more than, for example, my constituents is because my constituents are healthier. That is absolute madness. It does not matter whether someone who is knocked down by a car is healthy, because they still need an accident and emergency department at the end of the street.
Andy Burnham: The Government will respond to the Committee in due course, but I refer the hon. Gentleman to what the hon. Member for South Cambridgeshire said a moment ago. He acknowledged that the burden of disease is higher in constituencies such as mine and that therefore more money should go to them. I fail to understand how the policy that the hon. Member for Hemel Hempstead and his colleagues are advocating is substantially different from the funding formula as it currently is.