NHS Workforce and Service Development

Part of Opposition Day — [18th Allotted Day] – in the House of Commons at 3:56 pm on 11th October 2006.

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Photo of Nicholas Soames Nicholas Soames Conservative, Mid Sussex 3:56 pm, 11th October 2006

First, I congratulate NHS staff in my constituency on delivering a wonderful service in a very good hospital. They are nervous and anxious about the future. I also warmly congratulate the shadow Secretary of State on the excellent way in which he moved the motion. I hope that the House listened carefully to the speeches of the two former Secretaries of State for Health, my right hon. Friend the Members for Charnwood (Mr. Dorrell) and my right hon. and learned Friend Mr. Clarke, which were full of wisdom and clarity about the way ahead. I wholly agree with the picture painted by my right hon. and learned Friend the Member for Rushcliffe, who took a tremendously national view of the NHS, to which I wholly and unreservedly subscribe.

In 23 years as an MP, I have never known such anger and anxiety directed at the Government as is now being generated on national health issues. Since I became the Member for Mid-Sussex in 1997, there have been four reviews of hospital services—nothing like as many as experienced by my right hon. Friend Mr. Mates—in my constituency and local area. We have had "Modern Hospital Services for Central Sussex—A challenge for us all" in 2000, and even more ridiculous names such as "Strengthening Hospital Services in Central Sussex" in 2001 and the "Best Care, Best Place" consultation in 2004. Now, 18 months on, we have a new document that sweeps all the rest into the waste paper basket: "Creating an NHS Fit for the Future".

Those reports were all subsequent to a document commissioned by the West Sussex health authority, which was faced in 2000 with growing fragmentation in health care provision, escalating and disproportionate management costs and rapidly accumulating debts, which are at the nub of our present unhappy state. Matters were so serious that the Government asked Michael Taylor, then chief executive of Oxfordshire health authority, to investigate and report on West Sussex as a failing and debt-ridden health authority. His report, which was damning, set out a series of recommendations, which were by and large completely ignored by Candy Morris, who was acting chief executive of West Sussex health authority until its demise. She was also responsible for the NHS consultation documents from 2000. By an astonishing quirk of fate, she is now one of the architects of proposals about to be announced for the apparent deconstruction of the NHS in West Sussex.

Those changes will throw the NHS in Sussex into even greater turmoil than is already the case. What Taylor exposed was a series of top-heavy management structures, in expensive premises—the sort of point made by my right hon. Friend the Member for East Hampshire—involving duplication, replication and wastefulness. No one paid any attention to his warnings and this continuing, wilful mismanagement of the NHS has now led to colossal debts of well over £100 million in West Sussex.

Another important contributory factor in this debacle has been the complete failure of the independent watchdog bodies—first, the community health councils and latterly the West Sussex health scrutiny committee and joint scrutiny committee—to refer any of the proposed configurations to the Secretary of State for intervention and for her to account to Parliament directly on that managerial vandalism.

What the Secretary of State must understand is that when the "Best Care, Best Place" consultation began in November 2004—incidentally, it was a total sham, in which, again, the scrutiny committee failed to act—it was represented to all my constituents and me by the management of the strategic health authority, and most especially by the primary care trust, as the way ahead for the foreseeable future. Many of them were deeply cynical of the Government's motive at the time, but they went along with it.

As recently as 25 May, at a meeting that I called in Burgess Hill in my constituency, the chief executive of the South East Coast strategic health authority—a newly created animal—never mentioned any of the changes that were likely to happen, even though they were being discussed at board level and elsewhere. My constituents and I feel that that amounts to a deceit, a betrayal and totally unacceptable behaviour by the management of the NHS, which has lost its way and has been party to the waste of hundreds of millions of pounds over recent years—money that could quite well have been spent on patient care.

I have referred that catalogue of incompetence and bad practice to the Comptroller and Auditor General, who, alas, cannot take it any further, but he has referred me to his excellent report on financial failings in the NHS. What I hope that the Secretary of State will understand is that we in Sussex think that her Department seems rather like the American Administration: apparently, at the same time, dysfunctional and fragile and unable to admit or unwilling ever to see—let alone to correct—the obvious mistakes that are being made in their name.

The constant reorganisations of the past few years may create for the Government an illusion of progress and reform, but in practice what has often happened in the recent past is that it has produced confusion, uncertainty, gross inefficiency, very serious staff demoralisation in excellent hospitals and, above all, a lack of a coherent sense of direction by managers.

Our area is expected to accommodate 41,000 new houses in the next 20 years; our local infrastructure is woeful. I have drawn to the House's attention on many occasions the infrastructure deficit in my constituency, yet with all the added pressure for existing and future growth it is clear that the PCT plans to downgrade the Princess Royal hospital by removing the accident and emergency department altogether, although I was assured by a Minister at the Department of Health on the Floor of the House a year ago that there was no question of that happening. Indeed, the "Best Care, Best Place" consultation document said that both the Royal Sussex County and the Princess Royal hospitals will keep their A and E departments. Those assurances turn out not to be worth the paper that they were written on.

Brighton, where the A and E department is to be removed in totality, is hopelessly inaccessible by road. Its hospitals simply cannot cope with the load that is being placed on them, with patients constantly being referred back to the Princess Royal hospital. Gatwick airport is only 15 miles away, and there is always the possibility of a major catastrophe. In times of conflict, the Princess Royal hospital would be needed as a casualty clearing station. There is a major and very busy motorway on the doorstep, combined with very high housing and population growth.

This weekend, I hope that thousands of people will march in Haywards Heath in an all-party campaign to support the Princess Royal, to draw the attention of Ministers to the fact that we cannot allow our services to be downgraded, because that is not safe, and to complain about the instability of the service provided to local people. Although I agree with my right hon. and learned Friend the Member for Rushcliffe that there have been many changes for the better and that excellent changes are afoot to move services into the local community, interfering with the fundamental infrastructure of the health service in the way that is being done is a fatal mistake.