Acute Hospital Services

Part of Opposition Day — [6th Allotted Day] – in the House of Commons at 6:04 pm on 21st February 2007.

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Photo of Iain Wright Iain Wright Labour, Hartlepool 6:04 pm, 21st February 2007

I am actually grateful for that intervention. I hope that I made it clear that I feel profoundly disappointed and let down. More importantly, the people of Hartlepool feel profoundly disappointed and let down. However, if we consider the 50 years from the formation of the NHS to the election of a Labour Government in 1997, the Conservative party was in government for 35 of them. One reason for our relying on the hospital far too much because of insufficient investment in primary care is Conservative Governments' complete failure to invest in primary care. We are now suffering the consequences.

Let me proceed with the wishes of the people of Hartlepool. We should not be under any illusion about certain situations, as I think that regional health bureaucrats have a vested interest in running the health service and related matters according to their own specific wishes and requirements. I am profoundly concerned that public consultation is merely lip service.

It may sound as if I am arguing for the status quo—carrying out the same services in the same way on the same site in the same buildings—but I am not. I am ambitious and impatient to see advances in medical technology push health and clinical services out of hospitals and into the local community—even into local people's homes. I agree with virtually everything in the document "Keeping it Personal", written by the national director for primary care and published earlier this month. I agree with the wish to take pressure off acute services and provide even higher-quality primary care using multidisciplinary teams from PCTs, social services and other agencies to co-ordinate and better manage all a person's specific health needs.

I agree with the need to grow and develop NHS walk-in centres to relieve pressure on accident and emergency departments and I agree with the desire to see services such as those provided by GPs, dentists, opticians and pharmacists co-located in a single complex and even linked with other public services such as police and housing in a neighbourhood. I also understand and appreciate the drivers for specialisation and centralisation. I know that in order to receive the best specialist care, there is often a need to be treated in bigger more specialised hospitals. In such places, consultants are able to see larger numbers of patients, which means, in turn, that they can become specialists in their field, working with the latest equipment and with highly trained staff.

The Government's vision, as advanced in the White Paper on health services, is for treatment to be concentrated more and more on primary care, while moving it away from a hospital setting. I believe that that is appropriate. However, I stress that Ministers need to appreciate that that vision cannot be rolled out across the country in a blanket fashion. If the NHS truly is a locally devolved organisation, the pace of change needs to be dependent upon local circumstances and to take into account an area's long-term health needs and socio-economic and demographic forces, coupled, crucially, with an assessment of the current state of primary health care in that area.

I am a history graduate and a big fan of the principle that we cannot know where we are going unless we know where we have come from. That is why I believe that the pace of change will vary in different areas and should set the pace of any reconfiguration of hospital services. Pace should also vary. Professor Darzi's comments that I mentioned earlier are so valid because a move to centralise hospital services on a single site will not address the health needs of Hartlepool today and will put service reconfiguration ahead of primary care becoming embedded in the local area. The proposals for change to my hospital and hospital services simply put the cart before the horse.

Primary care services in Hartlepool are underdeveloped and inappropriate for a town with such acute health needs—a consequence, as I mentioned in my response to Michael Gove, of a lack of investment for something like 50 years. My constituency has 47.5 GPs per 100,000 weighted population—one of the worst ratios in the country. The Government are doing something about it, making Hartlepool a spearhead PCT with additional funding to tackle the problem of recruitment and retention of doctors, but I passionately believe that if services are to be pushed further off on a hospital site away from Hartlepool, that will highlight the acute need to have services brought into communities, and provided by GPs and associated primary care teams. The infrastructure and staffing need to be in place and developed. Frankly, despite progress in Hartlepool over the last five to 10 years, I simply do not believe that we are yet in a position to do that.

The same, I think, could be said for facilities within neighbourhoods. Throughout much of my life, GP surgeries in Hartlepool have been sub-standard. A recent estate audit in the town found that five of the 17 GP premises in Hartlepool were in poor condition, with only six meeting the criterion for "satisfactory". There is an acute shortage of space in those surgeries, which hinders their development and their potential to offer a wider range of services.

Again, there are tantalising glimpses of what could be achieved. The Headland surgery has recently opened, providing comfortable and modern health facilities in the heart of one of the most deprived areas in the country. Alongside a pharmacist attached to the complex, the surgery has operating theatres available for day-patient cases, and the local authority has built a sports centre next door, emphasising the link between health and exercise. Local and co-ordinated health services provided in the centre of a community—that is the future of the NHS in the 21st century. But that model needs to be rolled out extensively across the town, and that will take upwards of a decade.

Hartlepool primary care trust has pledged to build a modern facility in the very centre of town, on the site of the former Barlow's building. This would provide reassurance to the people of the town that health improvements were being made and not merely being removed from them, by moving them out of town. This facility is planned to host a suite of GP and dental surgeries, as well as providing a minor injuries unit 24 hours a day, seven days a week for strains, sprains and cuts, in addition to a walk-in centre offering health information, sexual health advice and treatment for a range of minor illnesses such as coughs, colds and infections. This again is positive news, but the facility—which is being funded by the LIFT scheme, which was mentioned earlier—is something like three years behind schedule. It needs to be provided as soon as possible to offer health services in the very centre of Hartlepool.

It is little wonder that, because of long-term inadequate primary care services, the town has relied on the hospital. The number of admissions to Hartlepool's accident and emergency unit has risen by 42 per cent. in the past four years. This demonstrates the inability of many people in my town to access primary care facilities. A move to push health services further away from the population, without sustained and rapid investment enabling primary care infrastructure and facilities to be up and running ahead—and I stress ahead—of any further migration of services away from Hartlepool, would undermine any good will that the Government's increased spending on health has achieved over the past decade.

One of the key principles of health services is that they should be readily accessible. A hospital sited away from Hartlepool—a town with one of the lowest levels of car ownership in the country—would therefore be very problematic. In our debate on the future of bus services a fortnight ago, I described the poor service available for the people of my constituency accessing services at the University hospital of North Tees. The present site does not work, and any new hospital runs the significant risk of not working either, in terms of access to public transport. Any new hospital—not to mention the present one—needs to tackle the massive problem of access by providing a first-class transport system. I have already mentioned in the House the problem of congestion on the A19. That would be exacerbated by the building of a new hospital. Ministers need to work with all those involved—local authorities, local councillors and the local NHS—to provide a practical and comprehensive solution to people's transport and access needs.

As I mentioned at the start of my speech, the independent reconfiguration panel's report threw up more questions than answers. In order to address the important issues of community health facilities and transport, as well as the questions of where any new hospital would be sited, how it would be funded and whether it would be sustainable if it were to be small scale, I wrote to the Minister of State, Department of Health, my right hon. Friend Ms Winterton, in January. I am pleased to see her on the Treasury Bench tonight. I hope that the meeting that we have arranged will be positive and will result in the start of real progress on the ground.

Following the acceptance of the panel's recommendations by the Secretary of State for Health, the past month has seen the people of Hartlepool feeling battered, sore and let down by this Government. A great deal of work and co-operation will be needed to rebuild their trust. I hope that the Ministers on the Front Bench will start that rebuilding exercise now, by making a concerted effort to tackle the problems and concerns of my constituents, and doing what is right for the health needs of Hartlepool.


Keith Jones
Posted on 23 Feb 2007 3:09 pm (Report this annotation)

Mr Wright and his other Labour MP colleagues are, by now, so used to everything being said by the Cabinet last year; five years ago; tomorrow, being later reversed or torn up, that Mr Gove's comment went completely over the top of Mr Wright's head.

He is NOT properly representing the people of Hartlepool - he should resign in protest at the duplicity of Tony Blair over this matter and let the people of Hartlepool have a fresh vote on the matter.