Westmorland General Hospital

Part of the debate – in the House of Commons at 10:08 pm on 20th June 2006.

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Photo of Tim Farron Tim Farron Leader's Parliamentary Private Secretary, Cross-Portfolio and Non-Portfolio Responsibilities 10:08 pm, 20th June 2006

I am grateful for the opportunity to address the House on the future of the coronary care unit at Westmorland general hospital in Kendal in my constituency. The unit is under severe threat of closure. The board of the University Hospitals of Morecambe Bay NHS Trust recently launched a public consultation on the future of Westmorland general hospital. The trust presented four options, all of which would leave Westmorland general with acute medical services cut and reduced hospital beds, and three of those options would lead to the closure of the excellent coronary care unit.

It seems clear that the options presented, with the exception of the unspoken fifth option—to maintain the status quo—all threaten patient safety in the south Lakeland area, so I seek the Minister's assistance in securing the future of Westmorland general hospital in the interests of local people and of the hundreds of thousands of tourists who pass through the area every year.

The trust states that the proposed closures are a result of a £6.3 million deficit in its budget and the subsequent need to achieve cost savings. I sympathise with the trust in that respect, but I am reminded of the Secretary of State's repeated undertakings that, in the process of trusts moving to balance their books, there would be no threat to patient safety. For example, on 7 June, the Secretary of State said:

"I've always been clear that there should be no trade-off between high quality patient care and actions to improve financial management."

I therefore hope that the Minister will seek to intervene, given that the options presented for consultation by the trust all threaten high quality patient care and compromise patient safety.

People in my constituency who have a suspected heart attack or another acute condition such as a stroke will normally be transported by ambulance to Westmorland general hospital in Kendal. Should emergency admissions close at Kendal, the next nearest hospitals are in Lancaster and Barrow. Closure of the Kendal unit would lead to a significant increase in travelling times for people with acute conditions before they can be stabilised in hospital. It has been said that paramedics could stabilise patients with acute conditions in a similar way to doctors in hospitals, but that argument is erroneous. As the Minister knows, paramedics have a limited protocol for the administration of clot-busting drugs—in about 90 per cent. of cases, paramedics cannot administer life-saving clot busters and must concentrate on getting the patient to hospital safely and as soon as possible.

My constituency is large and rural. It includes parts of the Lake district and the Yorkshire dales and the rest of the south Lakeland area. The prospect of getting a patient with a suspected heart attack from Grasmere or Garsdale to Lancaster instead of to Kendal fills me and thousands of my constituents with incredulity and dread. I have spoken to many heart patients, health professionals and others who tell me that the additional journey time to Lancaster or Barrow would significantly threaten patient safety. The Minister will be well aware of the golden hour within which patients with acute conditions must be stabilised in order to give them the best chance of survival. Three quarters of my constituency lies more than an hour's drive to Lancaster or Barrow, and that does not include the length of time for an ambulance to get to a call-out in a remote rural area.

Although the local ambulance service is excellent, it already struggles to meet target call-out times and depends upon dozens of excellent first responder groups around south Cumbria to provide on-the-spot assistance to people with acute conditions in advance of the arrival of the ambulance. The coronary care unit at Westmorland general hospital is excellent and has committed, talented staff and a track record that is second to none in our area. As one might expect in a large trust area, each of the three hospitals—Lancaster, Barrow and Westmorland general—has a coronary care unit. Of the three, Westmorland general at Kendal has the record for the quickest door-to-needle time: the administration of clot-busting drugs to patients in the shortest and safest period following their arrival in hospital. In addition, 75 per cent. of patients reach Westmorland general hospital within acceptable time limits, which is the same figure as the hospital in Lancaster, but there is no doubt that that figure will drop significantly if patients are transported further in the event that the Kendal unit closes.

It hardly takes an expert in geography or transport movement to work out that the closure of the Kendal unit would make it impossible for people in south Lakeland to get to Lancaster within current target times. I cannot stress too strongly that the longer the time before the administration of crucial clot-busting drugs, which, in most cases, cannot be done in an ambulance and must be done at hospital, the greater the permanent damage to the heart and the greater risk to patient survival. That brings me to a crucial point—the additional pressure that will be placed on the ambulance trust as a result of any reduction of services at Westmorland general hospital.

Earlier this year, the Secretary of State kindly met me and the hon. Members for Lancaster and Wyre (Mr. Wallace) and for Morecambe and Lunesdale (Geraldine Smith) to discuss NHS services in Morecambe bay. At that meeting, in response to a question on a separate matter, the Secretary of State remarked upon the senselessness of one part of the NHS making savings by shifting additional cost burdens on to another part of the NHS, yet that very situation will be encountered should emergency medical services be removed or reduced at Westmorland General hospital. The knock-on effect will be an increase in ambulance journeys across a county boundary and an increase in the pressure placed upon paramedics as they attempt to keep patients going for much longer periods of time on journeys of up to twice current lengths.

Just as the hospital trust has not released any details relating to the money that it hopes to save as a result of the various options to downgrade our hospital, neither has there been any assessment of the likely additional costs that our local ambulance trust will incur as a direct consequence of the downgrading. How can it be right to allow one NHS trust to move towards balancing its budget by placing additional financial difficulties at the door of another trust at the expense of public safety?

Good use of public money is a major consideration in the Government's efforts to tackle the problem of NHS deficits. The Minister will therefore be concerned to hear that, just three years ago, a state-of-the-art cardiac catheterisation lab was built at Westmorland general hospital at a cost of more than £2 million. That lab would in all probability be forced to close were there not a coronary care unit on site to support its work. This is tangible evidence that Government investment in the NHS will be wiped away as a result of the trusts current proposals.

University Hospitals of Morecambe Bay NHS Trust serves a population of 320,000 people. Most trusts of that size are urban or suburban in nature and have one large hospital. In our area, we have two district general hospitals at Lancaster and Barrow and a major third hospital, Westmorland general, in Kendal. The cost of operating three hospitals as opposed to one is vast—comfortably more than the size of the trust's deficit, and perhaps more than twice that amount. The Minister will be aware that no meaningful element of the funding formula even remotely addresses the huge additional cost of operating health services in a rural area such as ours.

Let me reiterate how important it is that the Morecambe bay trust area retains three hospitals. There are 80,000 people in my constituency and, in addition, hundreds of thousands of tourists all year round, no doubt including many Members of this House from time to time. The overwhelming majority of those people live or stay in places where it is simply not possible to get to hospital in Lancaster or Barrow in a safe period of time. To each of those people, the threat to close Westmorland general hospital to acute admissions and, in particular, those with suspected strokes or heart attacks is a threat to their safety and an unacceptable escalation of risk. I ask the Minister to conduct an urgent review of funding for trusts covering rural areas to take account of their actual spending needs and to ensure that they are not forced into proposing unsafe options for local health care.

In each of the options presented by the hospitals trust, Westmorland general hospital loses beds, acute admissions wards and rehabilitation wards, as well as the capacity to deal with, for example, suspected stroke patients or patients with diabetic emergencies. In all but one of the options, it loses the excellent coronary care unit. In each case, that would threaten the safety of local people and tourists and cause additional anguish and distress for patients, particularly older people, who would have to be treated a long way from their homes, making it much more difficult, and sometimes impossible, for them to receive visitors.

What is more, there are no plans significantly to increase capacity at Barrow or Lancaster. Given that there is already huge pressure on beds and resources at both those hospitals, it is inevitable that the quality of provision will suffer as a result of these cuts. The unspoken fear is that that downgrading of services across our area, particularly at Kendal, threatens Westmorland general hospital's very survival. Some have made the disingenuous case that it is no place for emergency medical cases because of the Royal College of Physicians' general advice that consultants should not be on call at more than one hospital site. However, given that consultants are on site at Kendal almost every day anyway and that, in rural areas, proximity to the population is an even greater consideration when thinking about patient safety, it seems clear that the Royal College of Physicians would not wish to undermine the viability of vital emergency services in rural areas and that its advice is taken out of context in this respect.

I hope that the Minister will take urgent steps to prevent the downgrading of Westmorland general hospital, because the options proposed by the trust and their knock-on effects would be contrary to the Secretary of State's promise that none of the savings being made by trusts should lead to patients suffering a reduction in service. In seeking ways to enable the trust to present acceptable options, she may wish to consider the fact that the local strategic health authority has announced a surplus of £33 million and that a small amount of that surplus could be used to take the pressure off Morecambe bay to prevent it from making damaging decisions that threaten patient safety.

In January, I joined more than 2,000 constituents in a march through Kendal in protest at the primary care trust's plans to close mental health wards at Westmorland general. That campaign was broadly successful, as adult mental health services have since been saved. My constituents and I are resolute in our support of our local hospital. We have not developed campaign fatigue since that victory and we are now engaged in another campaign to save local services.

I am truly grateful for the opportunity to speak, because the debate could not have come at a more crucial time for my constituency. The Minister will be pleased to hear that I have no appetite for point scoring, finger jabbing or making accusations. My purpose is to seek her help in preserving the future of emergency medical admissions at Westmorland general hospital.

A familiar and sobering sight in my constituency, especially in the summer months, is the helicopter air ambulance flying to rescue injured people on the fells and lift them to hospital for emergency treatment. I cannot help thinking that, if relatively small financial pressures are allowed to lead to the closure of Kendal hospital to acute medical admissions, those who meet calamity on the fells and are rescued by helicopter will be in a much less perilous position than residents of the lakes and dales and the rest of south Lakeland who suffer a heart attack or a stroke, whose lives will hang in the balance on a journey of an hour and a half along tourist-clogged country lanes to the nearest hospital.