Kettering General Hospital
Philip Hollobone (Kettering, Conservative)
I thank Mr Speaker, through you, Mr Deputy Speaker, for granting me the privilege of holding this debate, and I welcome the Under-Secretary of State for Health, my hon. Friend Dr Poulter to his place. May I also take this opportunity to thank, on behalf of local residents throughout the borough of Kettering, all those who work at Kettering general hospital, whether they be nurses, doctors, consultants or ancillary staff, for all the work they do on behalf of local people. It is hugely appreciated. Many people at Kettering general hospital have worked there for a very long time—20, 30 or, in some instances, 40 years. The hospital is very much embedded at the heart of the local community.
I thank Lorene Read, the chief executive, and Steve Hone, the chairman of the trust, for all the work that they have put into the hospital and for the time they have given me over recent weeks to talk about the hospital’s future. I also thank Councillor Russell Roberts, the leader of Kettering borough council, for his close involvement in trying to sort out the hospital’s future.
It is my privilege to have been elected to serve as the Member of Parliament for Kettering, to stand up and speak out on behalf of local people about issues important to them. There is probably nothing more important to local people than the future of our much loved and badly needed local hospital in Kettering.
The nub of the points that I want to make is that local people simply will not put up with any prospect whatsoever of any downgrade to the accident and emergency facilities or the maternity wing at Kettering general hospital. Those are two highly valued, much prized departments and whoever plans the future of the hospital simply must not downgrade those two vital facilities, because they do a fantastic job in very difficult circumstances.
Kettering is growing extremely rapidly. Over the past decade, the borough of Kettering was sixth out of 348 districts throughout the country in the rapidity of household growth, and 31st in population growth. Few other parts of the country are growing as fast as Kettering. We have always needed our hospital and we now need it more badly than ever.
On public sector transport, the connections between Kettering and the rest of Northamptonshire, let alone the rest of the country, especially to the other acute hospital sites in the south-east midlands, are not good. The road between Kettering and Northampton, the A43, is the most dangerous and most congested in Northamptonshire. The idea that facilities could simply be moved out of Kettering and down the road to Northampton does not work for the staff or patients at the hospital. I say to the Minister that because of the demographics, the increasing age of the population, the rate of population growth, the geography of Northamptonshire and the crucial need for, but lack of, available future capital investment, any rearrangement of acute service provision by the NHS in the south-east midlands must not involve any downgrading of the A and E and maternity departments at Kettering.
The Minister needs to be aware that Kettering general hospital is much loved and badly needed. It has been in existence for 115 years. Local people have been born there, have seen their relatives treated there and have died there. Everyone in Kettering has, at one point or another, been through that hospital. It is a hospital embedded in the local community like few others.
As of today, Kettering general hospital employs 3,100 staff. It has more than 600 in-patient and day-case beds, 17 operating theatres, seven intensive treatment unit beds and three high-dependency unit beds. The obstetric unit delivers about 3,800 babies a year and is where my two children were delivered some years ago. The midwifery department is growing at a rate of between 5% and 7% a year. It includes a neonatal intensive care unit for babies, which is a sort of special care baby unit-plus. There is also a new £30 million treatment centre with enhanced paediatric facilities, which is opening next year.
Kettering general hospital has a level 2 trauma unit in its 24/7 A and E department, which is consultant-led. It currently has five consultants and two locums. Consultants are on site until 11 o’clock in the evening and are on call until 8 o’clock in the morning. Some 3,200 orthopaedic patients—people with hip and knee problems—go through the hospital every year, as well as 2,137 trauma patients. The hospital has a leading endoscopy unit, which basically does bowel screening, and a state-of-the-art cardiac facility, which is now the primary angiogram centre for Northamptonshire and south Leicestershire.
It is true that Kettering general hospital cannot provide the required level of treatment for severe head injuries or severe burns. Such patients are transferred, often by helicopter, to University hospital Coventry down the road, which has a level 3 trauma facility. However, Kettering general hospital is where most trauma patients need to go. Its location, right next to the A14, which is one of the busiest arteries in the midlands, is ideal for the all-too-many road traffic accidents that occur.
Healthier Together is leading a review of acute hospital provision in the south-east midlands that involves the five hospitals in Northamptonshire, Bedfordshire, Milton Keynes and Luton: Kettering general hospital, Northampton general hospital, Bedford hospital, Milton Keynes hospital and Luton and Dunstable university hospital. Kettering general hospital is the most northerly of those. It is 16 miles from Northampton, 24 miles from Bedford, 34 miles from Milton Keynes and 47 miles from Luton and Dunstable. If we lose our A and E or if it is downgraded, it will simply be too far for people to go to those other facilities.
Healthier Together set up six clinical working groups led by consultants, which produced seven highly theoretical draft models for the way in which acute hospital services could be reconfigured. There are now two preferred models. The problem is that, in one way or another, both the preferred models involve effectively downgrading two of the five hospitals. At the moment, the five hospitals all have A and E, trauma, emergency surgery, complex and elective surgery, acute medicine, ITU, in-patient paediatrics, obstetrics, out-patient diagnostics and in-patient re-ablement services. Under the draft proposals, two of them would not have all those services, and my campaign is to ensure that Kettering is not one of those two. It would be an absolute tragedy for local people were we to lose our ITU, our acute medicine facility, our level 2
trauma unit or our emergency surgery unit, or if the much needed recent investment and next year’s investment in improved paediatrics were moved away from Kettering. Up with it local people simply will not put.
One of my big worries about Healthier Together is that, although a lot of well meaning clinicians are leading the review—I know the Minister is a clinician of some repute himself—they need to realise that they are dealing with patients who do not move around as much as clinicians might. Although it might in theory be very nice to have shiny, brand-new hospitals in ideal locations, people do not live like that. Patients and staff need to have straightforward, easy access to hospital facilities.
There is meant to be public engagement in the Healthier Together review process, led by the so-called patient and public advisory group. I am sure that the individuals on that group are doing their best, but I am afraid they are hardly representative of the population of the south-east midlands. I have been on the comprehensive Healthier Together website today and read through all the material, including the minutes of the patient and public advisory group’s recent meetings. The most recent one whose minutes have been published was in March, so the minutes of a lot of meetings have not yet been published. Of the 17 individuals present at that March meeting, one was from Kettering and five were from Milton Keynes. Reading through the material provided by Healthier Together makes it clear that the process is led and dominated by Milton Keynes. I have nothing against people in Milton Keynes, and I am sure they need health services like everyone else, but there are five acute hospitals in the south-east midlands, not one, and the patients of all five deserve fair representation throughout the process. I invite the Minister to look at the Healthier Together review and see whether he is satisfied that patients and clinicians from across the region are being fully engaged in the process. My contention is that patients, doctors, nurses and ancillary staff from Kettering are not fully involved, which they should be.
One of the key points that has been missing from the review so far is recognition of the importance of access to health care facilities. Healthier Together states in its papers that it has set up a travel and transport working group, which has started to investigate the possible effects on journey times if health services are reconfigured. It states:
“An early task included commissioning independent experts to analyse journey times to hospital by private car and emergency ambulance. That analysis focused on travel at peak rush hours—from 7-9 am and from 4-7 pm.”
We do not need an independent expert to tell us that it is almost impossible to drive from Kettering to Northampton down the A43 during peak time without becoming part of an elongated car park, or that if a nurse had to move to Northampton she would find it very difficult to get there in the morning by public transport. There is no rail link between the two towns, and the bus service is intermittent. We do not need an independent expert to tell us that Kettering residents who want to visit an elderly relative in hospital would find it very difficult, without public transport, to go to Northampton, Bedford, Luton or Milton Keynes.
Evidence—if we need more—of the pressure placed on Kettering hospital by the growth in local population was provided a few weeks ago by Monitor’s intervention in order that the hospital improve its A and E targets.
Kettering hospital is treating 10% more A and E patients year in, year out; it is treating more A and E patients this year than last year, but it does not treat 95% within four hours and is in significant breach of statutory targets. Monitor has intervened, quite rightly, and told the hospital to sort that out, which I am confident it will sort out. That situation is indicative of the growth in the local population and the pressure that that is putting on local A and E facilities.
I am grateful for the chance to put the concerns of local people about our hospital directly to the Minister on the Floor of the House, and let me tell him, as plainly as I can, that the situation is completely unacceptable to everyone in Kettering, whatever political party they support or even if they support no political party. We will not put up with our accident and emergency service or maternity wings being downgraded.
Local staff at the hospital are doing their best in difficult circumstances against a background of one of the fastest population increases in the country. Healthier Together needs to get its act together because Kettering hospital is going to have a bright future, whatever clinicians in Milton Keynes might say.
Daniel Poulter (Central Suffolk and North Ipswich, Conservative)
It is a pleasure to respond to this debate and I congratulate my hon. Friend Mr Hollobone on showing great concern for his local hospital, and on expressing so eloquently his support for local NHS services and staff in Kettering and throughout his region. I recognise his long-standing dedication to ensuring that the health needs of all his constituents are met and, throughout his time in the House, he has been a strong advocate for his constituency, not just in today’s debate. He has consistently raised issues on how to improve the quality of health care and outcomes for the people of Kettering, and I congratulate him on that.
It is worth providing a little background to today’s debate. As my hon. Friend eloquently outlined, Kettering hospital had just under 370,000 patient contacts in 2011-12, including more than 85,000 attendances at A and E. That is more than ever before which, as he pointed out, is due to rising population pressures in Kettering and increased population growth. Indeed, the fact that people are living longer presents new and different challenges to the way we deliver health care throughout the NHS.
Let me take this opportunity to recognise, as my hon. Friend did, the hard work and dedication shown by NHS staff in his constituency. There are more than 3,200 staff at the trust, in addition to those who work hard to look after patients in primary care. The dedication and commitment they show to improving the health and well-being of my hon. Friend’s constituents, and those of other hon. Members, makes us all proud of our NHS and the dedicated front-line staff who work tirelessly on a day-to-day basis, often going above and beyond the call of duty to deliver high-quality patient care.
I reassure my hon. Friend that A and E and maternity services at Kettering hospital are safe. The Prime Minister has put that clearly on the record, and I confirm it again today.
Daniel Poulter (Central Suffolk and North Ipswich, Conservative)
It is interesting to find a Member from Nottingham, who I hoped would be in her constituency on a Friday looking after her constituents, taking such an active interest in this debate. However, I am happy to give way once on this issue.
Lilian Greenwood (Nottingham South, Labour)
I am attending this debate because I was here earlier to deal with a private Member’s Bill on behalf of the shadow transport team. Whatever the Minister says, is it not a fact that in the official documents, the “best” option is downgrading Kettering general hospital’s accident and emergency, maternity, children’s and acute services, and cutting a significant number of beds? How can he say that those services are safe?
Daniel Poulter (Central Suffolk and North Ipswich, Conservative)
The hon. Lady is turning this into a political debate, which is exactly what the Labour candidate in the Corby by-election has done. That is completely wrong and what she says is not true—it is scaremongering. There are no official documents at the moment because there is no consultation of that nature at the moment. There is no NHS consultation. Perhaps she should focus more on Nottingham, which is where her constituency is. I am sure her constituents would rather she were on the train back to hold a constituency surgery, which is what I will be doing after this debate, rather than making silly, ill-founded and mistaken political points about matters that bear no resemblance to her constituents’ concerns. I hope she will draw a lesson from this. I know she has been put up to making that point, but this is not the time.
The hon. Lady’s point was ill-founded. There is no consultation active in Kettering at the moment. There were some leaked documents about a range of options, which incorrectly set a number of hares running. The Labour candidate in the Corby by-election has already retracted his position. My hon. Friend has held the debate today because of that scaremongering, and because he is such a strong advocate for the needs of his patients in Kettering and his hospital. He wants to reassure them that Kettering hospital has a viable future.
Daniel Poulter (Central Suffolk and North Ipswich, Conservative)
I will not give way again. This is an Adjournment debate, not a general debate on the Floor of the House. The hon. Lady did not contact me before the debate to say that she would make a point—no Labour Member did. This is not a time to raise those points. The debate is about reassuring my hon. Friend that Kettering hospital has a viable future, which it does. That is confirmed clearly by Healthier Together, which has also confirmed that no active consultation is taking place; that, at the moment, we have only potential options appraisals; that A and E and maternity are safe; and that Kettering hospital has a viable future. I hope that the hon. Lady will put as much dedication into standing up for her hospital services in Nottingham as she has to making cheap party political points in a debate about a different part of the country.
I should now like to address some of the points, questions and legitimate concerns that have been raised, mostly as a result of the outrageous scaremongering by
the Labour party. The Healthier Together programme has been put together, but, as I have said, there is no formal consultation at the moment. I am sure the concerns my hon. Friend so eloquently raised will be fed into it, and that the debate, and the comments of the Prime Minister and Health Ministers, will be part of it.
We recognise, as my hon. Friend has outlined, the importance of proper public engagement throughout any consultation process—as and when it comes. He will be aware that there has already been significant public and stakeholder engagement on how services in the midlands might need to look in future. As he rightly said, there are new demographic challenges—more people are moving into that part of the country—and the process of engagement must continue. If a formal consultation is opened in future, it is important that it meets the clear clinical tests for service reconfiguration. However, I should repeat that no formal consultation has been opened and it would be incorrect to allow any further Labour party scaremongering on that point.
It is worth bearing in mind that part of the reason for the concerns about services in my hon. Friend’s part of the world is the massive private finance initiative debt signed off by the previous Government to Milton Keynes hospital, which has struggled ever since the PFI was signed. That has led to significant pressures on Milton Keynes and other hospitals in the region. As we know, some services are specialist centres. It might be worth reflecting, before any further cheap political points are made, that one reason why there was a discussion about a consultation on services was the big PFI legacy of debt, which is stopping the delivery of high-quality front-line care. That is a direct legacy of the previous Government signing off bad PFI deals in health care. It is worth reflecting on that before any more scaremongering takes place.
When reconfiguration of health care takes place, the previous Government—and this Government—have laid down some key tests of what makes a good reconfiguration. It has to be led locally by local commissioners and decision makers, and my hon. Friend made that point very clearly. Any significant proposed changes to services would be subject to four reconfiguration tests set out by the previous Secretary of State for Health. They are local support for the changes from GP commissioners and clinical leaderships; robust arrangements for public and patient engagement, including local authorities; greater clarity about the clinical evidence basis underpinning proposals; and the need to take into account the development and support of patient choice.
In my hon. Friend’s region there are considerable distances between the hospitals involved and, if at some point in the future a consultation opened up, those greater travelling distances between hospitals would be taken into account as it may impinge on patient choice. I hope that restating those configuration tests is helpful. If there is concern that those tests have not been met, an independent review can be carried out by the independent reconfiguration panel, at the discretion of the Secretary of State. I hope that my hon. Friend finds that reassuring. I reiterate that at the moment there is no consultation formally on the table in Kettering, and its accident and emergency and maternity services are safe.
There are other significant challenges facing Kettering hospital and the local NHS, as my hon. Friend outlined. They are the same as those faced by the NHS everywhere—
ensuring that we have services that are fit for purpose for the future to better look after the many older people—people are living longer—and the need to provide more dignity in elderly care. Part of that is having local bread-and-butter services. My hon. Friend rightly made the point that some health care services have to be regionalised, such as specialist trauma centres. The clinical evidence is that such centres save lives and, in my part of the world, we have one in Addenbrooke’s. Dedicated centres for stroke care also improve care for patients and the quality of outcomes for people with stroke, so that they can resume their daily activities much more quickly. Those day-to-day, bread-and-butter health care services that are so important, such as maternity and accident and emergency—and the cardiac services that Kettering is rightly proud of—are needed at a local level, and I am sure that any test of reconfiguration would confirm that they should remain accessible locally. We are very aware that many parts of the country are not urban. Many people face the challenges of rural life
and the distances to travel between centres. Whenever services are redesigned in the future, it is important that those bread-and-butter services are available for local patients.
I reiterate the fact that there is no formal consultation proposal, and there is no place for scaremongering in these debates. I am sure that the future of Kettering hospital is a vibrant and successful one. I know that my hon. Friend has strongly advocated the dedication of local staff and I hope that he will take my reassurance back to them—so that they do not listen to the scaremongering—that Kettering hospital will still have a viable A and E and viable maternity services, and a very strong future.
Question put and agreed to.