Healthcare in Essex

Petition - Illegal Encampments in Berkshire – in the House of Commons at 10:01 pm on 5th November 2018.

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Motion made, and Question proposed, That this House do now adjourn.—(Iain Stewart.)

Photo of Robert Halfon Robert Halfon Chair, Education Committee 10:03 pm, 5th November 2018

It is a pleasure to see you in the Chair, Madam Deputy Speaker. Thank you for your continued support, as my constituency neighbour, in our campaign for a new healthcare campus in Harlow. You could not have done more to support me, and I am very glad to see you here this evening.

Today, I would like to update the House on the desperate need for a new hospital in Harlow that is fit for the demands of the 21st century. This is now my third debate on the need for a long-term solution to the healthcare crisis in west Essex, and I cannot stress enough the urgency of the situation. The present site, the Princess Alexandra Hospital, serves over 350,000 people and is no longer able to cope under the pressure of an influx of patients. The new healthcare campus, as proposed by the Princess Alexandra Hospital NHS Trust, would encompass accident and emergency services, general practitioner provision, social care, physiotherapy and a new ambulance hub in state-of-the-art, purpose-built facilities.

I thank those Members, some of whom are in the Chamber this evening, who have been so instrumental in the progress of this campaign. In May, they joined me in signing a letter to the former Health Secretary to urge the Government to support the capital funding bid in place for a new hospital. They included my hon. Friends the Members for Broxbourne (Mr Walker) and for Hertford and Stortford (Mr Prisk), my right hon. Friend Dame Eleanor Laing, my hon. Friends the Members for Braintree (James Cleverly) and for Saffron Walden (Mrs Badenoch), my right hon. Friend Priti Patel, my hon. Friend Alex Burghart and my hon. Friend Vicky Ford, who is present and a big supporter of our new hospital proposal for Harlow.

From this, I have gone on to secure a visit to the Princess Alexandra Hospital from the new Health Secretary, who has heard the case loud and clear, and I look forward to welcoming him to Harlow to discuss the future of our healthcare provision in Essex.

As my hon. Friend Lucy Allan—Telford is also a new town—so accurately put it in my first debate on the subject in October 2017, hospitals

“are the centre of our communities and cement our identity”.—[Official Report, 18 October 2017;
Vol. 629, c. 347WH.]

The unwavering support that I have received for a new health campus, both in Parliament and locally, is a testament to its importance, not just to Harlow, but to the wider population of Essex and Hertfordshire.

In March, we received the wonderful news from the Care Quality Commission that the Princess Alexandra Hospital NHS Trust had been brought out of special measures—news on which the former Health Secretary, echoing the sentiments of the Prime Minister, congratulated the hospital in a special video message on Twitter. The chief inspector at the CQC noted that the driving force behind the 18-month turnaround was “the dedicated staff” and “outstanding leadership” team, headed by chief executive Lance McCarthy. I do not believe that enough credit can be given to the staff at the hospital.

I recently visited the Williams day unit, a specialist cancer treatment centre at Princess Alexandra Hospital, for a Macmillan coffee morning. I was struck by the staff’s compassion for their patients and their determination to ensure that, at possibly the most difficult time in a person’s life, the hospital is a happy, welcoming place to come to, to get better and to leave feeling more positive than when they came in.

From my numerous visits to the hospital, in my capacity as an MP and as a patient and visitor, I defy anyone to find better staff than at Princess Alexandra Hospital. In spite of a working environment that is literally falling down around them, thanks to the efforts of every single staff member, from the porters, cleaners and kitchen staff to the nurses, midwives and consultants, 64% of the services are on their way to a “good” or “outstanding” rating.

Special credit must be paid to the maternity unit, which the CQC deemed “outstanding” overall. The team delivers more than 4,200 babies a year, yet their rate of stillbirths is 10% lower than the national average. For those reasons, the maternity department was recently selected to feature in an ongoing documentary with TV personality and presenter of “The Voice”, Emma Willis. I encourage hon. Members to watch that programme on Monday evenings to see for themselves just how dedicated and caring the staff are.

Photo of Robert Halfon Robert Halfon Chair, Education Committee

I will always give way to the hon. Gentleman.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I have always supported the right hon. Gentleman’s contributions in the Chamber since we both came to the House together in 2010. He has clearly outlined the case for healthcare in his constituency. The Government have set aside an ambitious £28.5 billion for healthcare. Does he hope to have some of that money for his constituency? Does he also feel that there needs to be a reduction in red tape so that professionals can use their medical expertise to their full ability? This is about the money, but it is also about reducing the red tape.

Photo of Robert Halfon Robert Halfon Chair, Education Committee

I hope that my hon. Friend the Health Minister knows that a new hospital in Harlow is supported not just in Essex and Hertfordshire, but in Northern Ireland. This is the second debate on the subject that Jim Shannon has attended, and of course I agree with him.

The maternity department serves as the perfect example of how investment can transform patient care under the successful staffing that is already in place, as the labour ward benefits from nine refurbished delivery rooms and a second maternity theatre. However, it also sheds light on the fact that refurbishment is not a fix-all solution. Therefore, does the Minister agree that, were the Princess Alexandra Hospital NHS Trust to receive the capital funding that it so desperately needs to build a state-of-the-art health campus, that would allow every department to flourish, as the maternity ward has already done?

As I have touched upon before, the dilapidation of the estate is hindering any further progress. A 2013 survey rated 56% of the hospital’s estate as unacceptable or below for its quality and physical condition. That was five years ago now and the situation is only deteriorating. With long-term under-investment, we are continuing to put the capability of the hospital to care for those in need at serious risk—just read the reports of raw sewage and rainwater flowing into the operating theatres. Given that time is of the essence, does the Minister recognise the importance of the release of capital funding to the Princess Alexandra Hospital NHS Trust this autumn?

Photo of Vicky Ford Vicky Ford Conservative, Chelmsford

My right hon. Friend is making such a powerful case. I would like to add my support, because all across Essex we need to have world class hospitals. Does he agree that the new facility in Chelmsford, our first ever Essex medical school, will train the doctors of the future and provide the staff to work in his fantastic new hospital when it arrives?

Photo of Robert Halfon Robert Halfon Chair, Education Committee

I thank my hon. Friend for coming here this evening. Her presence is another example to the Minister of how the new hospital in Harlow is supported across Essex. She is a brilliant constituency MP, and she is absolutely right about the staff she mentions in her part of our national health service.

To add insult to injury, the layout of the hospital is convoluted and nonsensical. That is evident to any patients seeking urgent care or any visitor looking to find their loved one. As the former Health Minister, my hon. Friend Mr Dunne, noted in my first debate in July 2017, the hospital suffers from “sub-optimal clinical adjacencies” due to the development of temporary structures. To those who suggest that refurbishment would be a more suitable and less costly solution, I cannot emphasise enough that that is not looking to the long term. The tangled layout of the current hospital, comprising add-on structures and sporadic urgent care, is a direct consequence of short-term financial fixes; my case in point that an Elastoplast solution will no longer stick.

Aside from the natural degradation of the estate over time, the hospital is now forced to deal with new pressures stemming from a rising population and the downgrading of other local healthcare facilities, including Chase Farm Hospital and the Queen Elizabeth II. Cracks are already evident in the accident and emergency department. Back in 1966, the A&E unit was designed for approximately 60,000 attendances per year. It is currently seeing 68% more than that, with 200 to 300 attendances per day. That figure is 10% higher than the national average and, against its size, places the hospital as the busiest A&E department in England.

In the latest board meeting of directors in October 2018, it was suggested that July 2018 was

“the busiest ever month…at the Trust” for the A&E,

“with attendances as high as 9,400” in that single month. The influx of patients is only set to continue, with the relocation of Public Health England to Harlow hosting as many as 2,750 workers based at the site, as well as the Gilston Garden Town development, providing 8,500 new homes in Harlow, and the near-completion of Junction 7A on the M11. Does the Minister acknowledge that to support the trust in meeting the 95% four-hour access target, the Government must do all they can to alleviate such pressure? Does he further recognise that the new, expanded health campus would alleviate this immediate pressure, but also future-proof the hospital, accounting for further population growth?

I am grateful for the Government’s capital investment to realise Harlow’s strategic economic and housing plans, but I ask for the same treatment for our comprehensive healthcare plan. It is not the infrastructure alone that is a burden on the staff. Staff shortages—the hospital frequently operates at an 11% vacancy rate—stem from widespread difficulties in recruiting and retaining well-qualified employees. That is due in particular to Harlow’s proximity to London. According to the leadership team at the hospital, the opportunity for career development, or lack thereof, is a much more significant sticking point for potential recruits.

State-of-the-art facilities and a quality healthcare campus would at least offer the hospital the chance to enter the same race. The new campus and medical training facilities would allow the hospital both to attract and retain the very best staff. It would become an apprenticeships and skills centre, offering high-class, nursing degree apprenticeships.

The spiralling health crisis makes the urgency of the hospital campus all the more pressing. According to the Essex local authority portrait, Harlow has the highest rate of premature deaths attributed to cardiovascular diseases and the third highest rate of diabetes in the country. Hospital staff also deal with high rates of substance misuse, and 66.1% of adults are classed as overweight, which is higher than the national average. Harlow has the largest proportion of 10 and 11-year-olds classed as overweight or obese in the country, at 36.2%. There are many reasons why west Essex should have a health campus fit for the 21st century, but these figures clearly evidence a need.

At the former Secretary of State’s recommendation, the trust put forward its strategic outline case—SOC—in August 2017. The board, clinical commissioning group and local authority partners, together with KPMG, concluded that the health campus model would be

“the most affordable solution for the local system” and

“would deliver the most benefit to our population”.

Since my last debate in July 2018, the timescale for the development plans have changed and the plans are currently in the NHS and NHS Improvement assurance process. The trust is working closely with commissioners, patients and the public to develop a pre-consultation business case and refresh its SOC.

In my debate in October 2017, the former Health Minister, my hon. Friend the Member for Ludlow, so helpfully highlighted:

“The extent to which there is capital available to support very significant projects will depend on how much is made available by the Treasury.”—[Official Report, 18 October 2017;
Vol. 629, c. 352WH.]

As was also noted in the debate,

“upgrading services on this important site will be a priority for a Conservative government”.—[Official Report, 18 October 2017;
Vol. 629, c. 347WH.]

I take this opportunity to thank the Government for the announcement of £20.5 billion additional annual funding for the NHS, and I ask, in the light of this spending and the end of austerity, as the Prime Minister and the Chancellor said, is this not the most apt time to provide the Princess Alexandra Hospital with the bright future that it is determined to have?

My hon. Friend the Minister has gone out of his way to meet me and the chief executive of the hospital trust and to listen to his concerns and mine, and I cannot say how appreciative I am of that. As a key area of contention for my residents, I would be grateful to receive an update on the progress of this funding and a timescale for the economic investment plans. The issues that the hospital faces today are preventable, but all of them are beyond the control of the hard-working staff, patients and visitors. This is on the Government to act. This is on the Treasury and the Department of Health and Social Care to see reason and allocate the necessary funding for a new healthcare campus in west Essex.

Photo of Stephen Barclay Stephen Barclay Minister of State (Department of Health and Social Care) 10:18 pm, 5th November 2018

I congratulate my right hon. Friend Robert Halfon on securing the debate and on securing an early visit from the Secretary of State. As the whole House knows, he is passionate about the future of the Princess Alexandra Hospital in Harlow and he has raised this issue assiduously in a number of debates and interventions in the House. As he referred to, we had a very productive meeting with the hospital chief executive in June, when we discussed a range of issues, including the workforce and services offered at the hospital. That is in addition to an earlier Adjournment debate, as well as an Adjournment debate with my predecessor a year ago and exchanges at health questions. On behalf of his constituents, he has brought these issues to the attention of the House extremely effectively.

I also place on record that I very much recognise that these issues are extremely important to Epping Forest as well, Madam Deputy Speaker. I know how assiduously you have campaigned on behalf of your constituents. Indeed, this is an issue that Members across Essex and Hertfordshire have spoken up on. That was reflected in previous debates and was reflected in the contribution from my hon. Friend Vicky Ford. As we all recall, she was instrumental, as were other Essex MPs, including my right hon. Friend, in securing the new medical school, which, as she said, will help us to deliver the extra doctors to go with the buildings and capital spend, which we are discussing today.

As my right hon. Friend is aware, but for the benefit of the House, we have the sustainability and transformation fund as part of the Government’s commitment to upgrading the NHS estate. This investment will modernise and transform the NHS’s buildings and services, with the money going towards a range of programmes. This is part of the Government’s commitment to spending £3.9 billion on capital investment in buildings and facilities by 2022-23 and alongside the £20.5 billion a year extra that my right hon. Friend referred to. This investment—the biggest ever in the NHS—reflects the fact that the NHS is the public’s No. 1 priority, as indeed it is the Government’s No. 1 priority, and is an indication of the Prime Minister’s personal commitment to funding the NHS and ensuring it is fit for the future.

My right hon. Friend will be aware that the application window has now closed. I know that considerable work was done following the earlier application when a bid of between £500 million and £600 million was submitted. I am sure he will recognise that this was a significant sum but that the further work has brought it closer to the £330 million, and officials in NHS England and NHS Improvement are working closely with the Department to evaluate that bid alongside the other bids. As I mentioned in the previous debate, all bids will be assessed against standard criteria, including their value for money and contribution to transforming services and managing demand sustainably, as well as demonstrating their fit within a wider STP level estate strategy.

My right hon. Friend asked about timescales. The timescales are as previously referred to, with the commitment to decisions being made in the autumn. That position has not changed.

It is worth remembering that STP funding is only one element of support available to trusts. In 2017-18, the trust was successful in securing £2 million of emergency department capital funding to support the redesign of the emergency department. This funding was targeted to improve facilities and support improvements, including investment in paediatrics and the emergency department. In this financial year, capital funding to support winter pressures is also available to the trust, and this funding is part of the £145 million given to 80 NHS trusts across the country ahead of winter to improve emergency care. I understand that this money is earmarked for increasing bed capacity.

As we discussed in the summer, the trust recently exited special measures, with two thirds of services moving to a good or outstanding rating. This is a big achievement, and I know that the focus for 2018-19 is to achieve a good rating from the Care Quality Commission. My right hon. Friend has spoken about this in previous debates, and I join him once again in paying tribute to the staff who worked so hard to take the trust out of special measures.

It is clear that the hospital is a vital element of the local economy. I know that the Princess Alexandra Hospital NHS Trust has been working hard to improve recruitment and retention, and I am pleased that this is still a focus for it. The hospital is one of Health Education England’s nursing associate pilot sites through its lead partner, Hertfordshire Partnership University NHS Foundation Trust, and I am aware of plans for a huge expansion in the numbers of nursing associates through the apprentice route, which will positively impact on the work of the trust.

As I am sure the House is well aware, my right hon. Friend, like me, is a keen supporter of apprenticeships. I know that the hospital has taken on apprentices in the last year but that the number of apprentices is well below the target. It should be noted that any nursing associates in training as part of the scheme I just mentioned will not be included in the apprentice figures. As of April 2018, we know of 18 apprentices starting at the hospital, against a target of 76. I am keen to work with my right hon. Friend to continue the work that he has done in the House to ensure that the hospital meets that apprenticeship target. Both he and I are strongly committed to bringing more apprentices into the workforce.

My right hon. Friend referred to the Harlow science hub campus programme. Partly as a result of his campaigning, there will be a new public health campus in Harlow, at a cost of about £400 million. Not only are the Government making a significant contribution to the NHS, but the fact that the project is still on schedule—and by 2024, following a phased opening from 2021, approximately 2,700 staff will be based there—is a significant tribute to the work that my right hon. Friend has done, along with others, in securing a much-sought-after commitment to Harlow. I know that Public Health England and the Princess Alexandra Hospital have been discussing the opportunities that will arise as a result of the move to Harlow, and I hope to hear more about that soon.

I commend the work that my right hon. Friend is doing to raise support for the STP bid by the Princess Alexandra Hospital Trust. He has raised the estate issues faced by the trust on more than one occasion in the House, and in meetings with the Secretary of State and me, and I know that he raised them with my predecessor as well. We recognise that the hospital estate is in poor condition, which is why I am pleased that the trust has submitted the revised STP bid. I am also pleased that money was made available last year, and will be made available again this year, to make improvements to the hospital in the interim.

I look forward to continuing to work on this issue with my right hon. Friend, and to working on the future of the NHS in Harlow as well as the surrounding region. As has been made clear again this evening, Madam Deputy Speaker—alongside your own work—the patients and staff of the hospital can be confident that they could have no better champion than my right hon. Friend, who has campaigned to secure this much-needed investment.

Photo of Eleanor Laing Eleanor Laing Deputy Speaker (First Deputy Chairman of Ways and Means)

What an excellent, meaningful, well-targeted debate.

Question put and agreed to.

House adjourned.