On 1 May, during a debate on the private finance initiative and the health service, I raised the problems encountered by north Durham hospitals, and the difficulties caused by the delay surrounding the private finance initiative. I am therefore grateful for the opportunity presented by the Adjournment to put before the House the increasing problems faced by people of the area as the crisis in hospital care mounts.
In May, I reported that five wards had just been closed and that services had been transferred from Shotley Bridge hospital to Dryburn hospital, without consultation, because of financial problems caused by an overspend last year coupled with the need to make a further £2 million raving in the current financial year.
The accident and emergency unit had already closed at Shotley Bridge and had been transferred to Dryburn. Over the summer an increasing number of problems were reported with accident and emergency services, to the extent that the trust acknowledged that people were having to wait for too long and that new procedures would have to be introduced.
In a report to the trust board in October it was stated:
The main problem is, however, that many patients are having to wait for a considerable period of time following an assessment, for their treatment…In relation to the emergency admissions via the A and E Department, whilst the number of admissions has increased, the number of patients having to wait to be admitted to a ward in excess of 2 hours has increased considerably.
I am pleased that the trust has recognised that serious problem, and is seeking to tackle it, although I understand that no additional resources have yet been identified for the additional staff it knows will be necessary.
Those words hide many individual experiences that have come to light in the past few months. In their own way, each has been distressing, but they have also contributed to a general crisis in confidence in the ability of the accident and emergency service at Dryburn hospital to cope with the range of patients from the area.
There are also additional problems for constituents, particularly in my area, who now have to travel a minimum of 14 miles to the accident and emergency department. One constituent came to see me and recounted how he had been taken by ambulance to hospital having been mugged outside his home late at night. He was eventually attended to at the A and E unit, but then he had to make his own way home. That cost him about £15. I have been told that that is now the norm—that patients will be taken to the accident and emergency unit, but will then have to find their own way home. None of us had worked that out in the early stages of the debate on the transfer.
There has also been an increase in the number of cancelled operations—again, that has been acknowledged by the trust. I wrote to the trust in July, following receipt of a letter from Mrs. Eccleston of Shotley Bridge. Her father was admitted to Dryburn hospital on 25 June. He was not allowed to eat and was prepared for theatre on Thursday 27 June, but his operation was cancelled and she was asked to take him home. He was readmitted the following Monday.
He was allowed no food and was prepared for the operation on Tuesday 2 July, but his operation was cancelled again. Mrs. Eccleston wrote:
I feel the services which the North Durham Trust provide are becoming somewhat of a joke, and patients are suffering, no matter what quality measuring the trust claim to provide. I feel that two admissions, five days in hospital—on fluids only and two doses of Pecolax—a very severe acting laxative—on an 80-year-old man—and then to have the operation cancelled twice is no longer tolerable.
The story does not stop there. I and my colleagues—I am delighted to see my hon. Friend the Member for North Durham (Mr. Radice) here—were informed in September that the business case for the new district general hospital had been refused by the health authority because it was too expensive. Having initially been promised that the private finance initiative route would bring real savings, which could then be used to develop community services in the Shotley Bridge and Chester-le-Street areas, including the development of new community hospitals, we were appalled to hear that the planned new hospital was to cost more in year-on-year revenue costs than the two hospitals continuing would have cost. I believe that the health authority was right to say that that was unacceptable and that a scheme which was, at least, revenue neutral—that is, one that would not cost any more than the two existing hospitals—would have to be prepared, so it was back to the drawing board.
We were also told that the trust had put it to the health authority that to make necessary savings because of current budget deficits the trust wanted to proceed with the further rationalisation of services from Shotley Bridge to Dryburn. Again, the health authority rightly said that it would not sanction further rationalisation until it was satisfied that the physical capacity of Dryburn was adequate to take the new services and the additional patients. My constituents are horrified at the suggestion that the transfer of services should go ahead with no guarantee of a new hospital and without necessary improvements to Dryburn having been approved or carried out.
It is no exaggeration to say that there is now a crisis. Dryburn hospital is not ready to take more patients or to be responsible for more specialties. There are bed shortages now, as well as inadequate theatres. This week, we have been sent a letter by the consultant staff committee—I know that the Secretary of State was also sent a copy of the letter, so I am sure that the Minister has seen it. The letter outlines the consultants' growing concern. The consultants support the interim rationalisation of services from Shotley Bridge to Dryburn, but they are doing so because the quality of service is deteriorating and they feel that they cannot wait for a guarantee of the new district general hospital.
The consultants identify two key areas of capital investment: in coronary care and intensive care and in creating extra operating theatres. Dr. Robson, who is chair of the consultants committee, says that those two projects are an absolute requirement before the move can take place. He adds that the trust's financial position is such that it could not hope to fund such developments itself. He writes:
Consultants are now concerned … with simple, critical issues of patient care.
He goes on to say:
Colleagues feel that already they are unable, because of bed and theatre limitations, to offer the quality and quantity of service which is desirable.
Whichever way one looks at this matter, it is a crisis. The PFI case is having to be rejigged—the new case is with the health authority, but has not been agreed, so the Government have not yet seen it. The financial position is driving a hasty rationalisation without adequate facilities and the public feel that they are the last to be considered. Their confidence is being shaken again and again. We are facing the worst of all worlds: there is to be no new district general hospital, but the services are to go from Shotley Bridge. The whole saga is one of unfulfilled expectations and broken promises.
I am not here to condemn any individual or to lay blame, but the Government have to accept responsibility, both for the often chaotic way in which the changes in the health service have been approached and for the way in which the private finance initiative has been pursued. There is no time left for any procrastination.