Bill Presented — Infrastructure (Financial Assistance) Bill
Andrew Gwynne (Denton and Reddish, Labour)
I thank the Backbench Business Committee for granting this important debate today and I congratulate Dr Wollaston on the eloquent case that she made in opening it. I also congratulate and welcome the new Minister to her place. She was a slightly unconventional Parliamentary Private Secretary to the former Minister of State for Health, Mr Burns. I say “unconventional” because, as Guy Opperman observed, PPSs are usually seen and not heard. I am sure that she will be even more vocal now that she has the freedom to speak from the Government Front Bench, and I look forward to our exchanges in the coming weeks and months.
As many Members have testified today, community hospitals play an important role in the communities they serve. They provide rehabilitation and follow-up care, and they can help to move care, diagnostics and minor injury and out-patient services, among others, from acute hospitals back to the community. They provide planned and unplanned acute care and diagnostic services for patients closer to home, and contribute to the local community by providing employment opportunities and support for community-based groups.
It is clear that people generally prefer medical treatments to be taken nearer to their homes and families, whether that involves palliative care, minor injury services or maternity care, and those are exactly the services that community hospitals can help to deliver. Indeed, the Department of Health has estimated that about 25% of hospital patients could be better cared for at home or in the community.
Community hospitals usually also have good relationships with their local communities, and are often supported by local fundraising. We have heard from a number of hon. Members today about the great work being done by friends groups up and down the country. I pay tribute to those groups, and to the staff and volunteers who work to make those groups and the hospitals happen. Staff in community hospitals can also build personal relationships with local patients and carers as they deliver continuous care from outside the hospital environment. That is an important point that should not be overlooked.
It is fair to say that community hospitals continue to play an important part in local health care provision. Their role is valued, and we are right to support it. Labour continues to be committed to community hospitals, when they represent the best solutions for local communities. I take the point made by John Pugh that they might not be the solution everywhere.
My own constituency is served by three large district general hospitals and not one community hospital, but I acknowledge that other parts of the country have a very different geographical make-up, and that community hospitals are the right way forward for the provision of health care in those communities.
Community hospitals can provide a vital step between social care and acute care, and Labour would seek to develop them further. For example, it might be possible for GP or dentistry services to be offered in more community hospitals, which could make some that are only marginally viable at the moment more viable for the future. That possibility should be explored.
Some concerns remain, however, and I hope that the Minister will be able to offer the House some reassurance today. One of the most pressing tasks for the NHS in the coming years will be better to co-ordinate services around the needs of patients, and that might well mean that community hospitals have to change the way in which they provide services and the buildings from which they provide them. She will know, however, of our concerns about the Government’s structural reforms, which will make the co-ordination and delivery of services far more difficult. We believe that the future requires the integration of care, yet the Government’s policies are driving us more towards fragmentation. We know that they are already having a profound effect on the NHS. A recent survey of NHS chairs and chief executives by the NHS Confederation found that 28% described the current financial position as
“the worst they had ever experienced”.
A further 46% said the position was “very serious”.
It is also clear that the financial challenge will continue for many years after 2015, and all this could have an effect on community hospitals, whether it be the reduction of minor injuries provision, the closure of wards or the downgrading of services. As Dr Lee suggested in what I thought was a thoughtful contribution, these can sometimes be the right choices for an area. Sometimes, however, they will not be and they will just be financially driven; here, there is a danger that community hospitals will provide an easy cut for bureaucrats.