Corby Urgent Care Centre — [Mr Christopher Chope in the Chair]

Parliamentary Candidates: Barriers for Women – in Westminster Hall at 3:59 pm on 13 September 2017.

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[Mr Christopher Chope in the Chair]

Photo of Tom Pursglove Tom Pursglove Conservative, Corby 4:00, 13 September 2017

I beg to move,

That this House
has considered Corby urgent care centre.

It is a pleasure to serve under your chairmanship, Mr Chope. I have to say that in the two and a half years I have been a Member of this place, this is the first Westminster Hall debate that I have ever applied for. The reason is that I think we should use these sorts of opportunity sparingly, for issues that are very pertinent and significant for our constituents. This issue matters very much to people in Corby and the surrounding area, so I felt that it warranted a debate. I am delighted that this opportunity has been granted.

I want to emphasise at the outset that the facility we have in Corby at the moment—the Corby urgent care centre—is class-leading, hugely popular, well used and a beacon of best practice. I know that representatives of Lakeside Plus, which is the current provider, are watching this debate closely. At this point, I want to say a huge thank you to Lakeside Plus for the quality of service it has provided since 2012, when the Corby urgent care centre opened under the coalition Government. I am proud that it was Conservatives in government who delivered this class-leading facility for my constituents. The dedicated staff who work there day in, day out do a remarkable job, and that is something I hear all the time. When I knock on doors in the constituency and am out in the town centre, that is the message I hear loud and clear.

Back on 20 July, I spoke in the final debate before the summer recess, which was an important opportunity, given the press release issued by Corby clinical commissioning group on 13 July that led to concern locally about the potential loss of this service at the end of September. Fortunately, we are in a better position now than we were when I spoke in that debate on 20 July. That is because on 29 August, the governing body of the CCG met, and the CCG subsequently communicated with me to advise that at that meeting a number of things had been agreed to, including a rolling four-month extension to Lakeside Plus’s contract, subject to legal agreement, and a “robust timeline” for patient, public and stakeholder engagement and consultation. That is obviously a very important step forward and, in some respects, provides reassurance to my constituents in the short term.

I understand that the contract extension has not yet been agreed, and the clock is ticking. Once we get to the end of September, that is the cliff edge. I want to see urgent action taken by the CCG, getting around the table with Lakeside Plus to get the contract signed, to take the cliff edge out of the equation, because that is what my constituents are most worried about at this point—and with good reason, because we can conclude that, were the facility to close on 30 September, it would be very difficult for it to be reopened. We must avoid that cliff edge, and I urge everybody concerned to get around the table and ensure that we get the agreement signed as quickly as possible.

Photo of Philip Hollobone Philip Hollobone Conservative, Kettering

I congratulate my hon. Friend on securing this debate and on his tireless efforts, not only in this House but locally in Corby, to fight this cause. It is a hugely popular facility. My constituents in Kettering know that without the Corby urgent care centre, the pressure on Kettering General Hospital would be even greater. The Minister knows how busy Kettering General Hospital is because he had the good heart to visit it recently. I am 100% behind my hon. Friend in his campaign.

Photo of Tom Pursglove Tom Pursglove Conservative, Corby

I am very grateful to my hon. Friend, who has been unstinting in his support for the Corby urgent care centre and the local campaign. He recognises, quite rightly, the pressures that the facility relieves Kettering General Hospital of. Kettering General Hospital is obviously a very important facility in our community. I will touch on those pressures a little bit later, but I very much appreciate his support for what we are doing.

I have talked about the short-term situation. In the longer term, the CCG appears to be committed to much more thorough consultation, first with a pre-consultation, and followed by a thorough consultation on options, which I understand would run between November and January. I welcome that, but I am clear that corners must not be cut in that process. The whole community must be engaged. It is not enough to engage with a group of 700 people in a patient participation group; that is just not good enough.

Photo of Andrew Lewer Andrew Lewer Conservative, Northampton South

I thank my hon. Friend for securing this debate. His reference to Kettering General Hospital and this fairly narrow consultation leads me to ask whether he agrees that not only Kettering General Hospital but Northampton General Hospital would be impacted by this. Have those he has been working with made references to that in the course of their discussions?

Photo of Tom Pursglove Tom Pursglove Conservative, Corby

I am grateful to my county colleague for his intervention. He is absolutely right. As this campaign has progressed since July, I have been receiving communication from people across the county and from outside the county who say they make use of the Corby urgent care centre rather than going to the acute hospitals in our area. I have no doubt that not only Kettering General Hospital but Northampton General Hospital would be affected. This is not just a Corby issue by any means, although it is obviously very important to Corby residents. It is also fundamental to our wider health infrastructure of north Northamptonshire.

I want Corby CCG to be very aware of and alive to the fact that I will be watching the consultation process ahead of us like a hawk, because the consultation that has gone on previously has not been good enough. I think the CCG would recognise, if it were honest, that that has not been good enough, and we need to see improvement. I will not hesitate to ask difficult questions, should they need to be asked. I will also be clear with the CCG that it ought to make no mistake that in the long term we need urgent care facilities in our town. There are a number of key reasons for that.

The first is the growth agenda. There can be no doubt that in north Northamptonshire, there will be increasing pressures on our health infrastructure more generally in the years ahead. We are taking thousands and thousands of new homes, not just in Corby but in east Northamptonshire, Kettering and Wellingborough. That inevitably brings pressures for existing health services.

I have already referred to the KGH pressures, which are very pertinent. I am pleased, as I am sure my hon. Friend Mr Hollobone will be, that the recent Care Quality Commission inspection saw quite considerable improvement compared with the last inspection. We welcome that, but I do not want to see all that good work undone by additional people who would previously have gone to the Corby urgent care centre turning up at A&E.

One flaw in the CCG’s argument to date has been that it has never been able to account for the number of people who currently go to the urgent care centre and who, if that were not available, would go on to Kettering General Hospital. I am very concerned about that. We must not forget that last year, 70,000 people made use of the Corby urgent care centre, and only 6% of those went on to Kettering General Hospital for further treatment. That gives us an idea of the impact here. I think we would also all recognise that Corby has significant and acute health needs, particularly on the back of the fact that we are an industrial town. Our town has been built on our industries, which inevitably leads to acute health needs among the local population.

I know that local people share my strength of feeling on this. The “Save Corby Urgent Care Centre” group has done a fantastic job, particularly online, harnessing local opinion and local support for the campaign. In fact, tomorrow night at the end of business, I shall present a petition signed by more than 2,500 local people in support of the urgent care centre. I pay tribute to Lyn Buckingham, Maria Bryan and others for the work that they have been doing on the issue.

As the local Member of Parliament, I am proud to say that the fact that we have a Labour council in Corby does not mean that we do not work together for what is best for the people of our area. Tom Beattie, the Labour leader of the council, and I have worked very closely on this issue, as we do on others, such as the steel issue, because party politics does not matter when it comes to these issues. People do not want to see politicians squabbling and arguing about petty points; they want solutions to the problems, so I am pleased that that cross-party work continues in our community. I want to say again a big thank you to my Northamptonshire colleagues for their support on this issue, because, as I said, it affects not just my constituents, but people in their areas.

The final thing giving me heart in terms of the strength of local feeling is that I launched a parliamentary postcode campaign on this issue, and although not that many have yet been delivered—that process is going on at the moment—we are seeing hundreds and hundreds returned. I look forward to the opportunity to present sacks of those cards to the commissioners in the months ahead, as part of the consultation process, to hammer home how strongly we as a community feel about the issue. They are also coming in thick and fast on email, and not just from people in Northamptonshire.

I also thank my hon. Friend the Minister for his interest. Obviously, we have just had a recess, which is not necessarily a particularly good time for challenges to occur in constituencies, but I have really appreciated the fact that he has always been willing and available to talk about this issue when concerns have been brought to my attention. That availability is appreciated. Often, politicians are accused of talking about problems, raising issues, but having no solutions. When I look at this issue, there are some things that really stand out for me that I think are just common sense. What concerns me is that when we look at the figures for same-day access in Corby, for example, we are not doing well enough. There are clearly key challenges ahead, and the CCG’s performance on that particular matter has to improve.

However, that should not be at the expense of urgent care facilities in the town, and local people should not be penalised in relation to the urgent care centre as a result of the current contract not having been handled as it should have been by the commissioners. Obviously, the expert determination speaks to that point. I do not need to say any more on that, but local people should not be penalised, in terms of the health services available to them going forward, as a result of the contract not having been handled as it should have been.

It is clear to me that if we improved GP access, the cost of the urgent care centre service would reduce, because if more of my constituents, or more of those people from the surrounding areas, could see their GP on the day that they needed an appointment, they would not have cause to go to the urgent care centre, where they have perhaps been going because the access has not been good enough to date. It should be about doing both: improving GP access at the same time as providing urgent care facilities. I argue very strongly that the cost of the urgent care facilities would be less were the GP access better.

I will continue to advance these arguments in the months ahead. I am conscious that county colleagues who are present may want to say a few words, so I shall wrap up, but I want to be very clear about the fact that losing this facility would be a betrayal of local people. The proof is in the pudding: it is making an impact. The idea of losing it is obscene when we consider that other areas look at Corby urgent care centre with envy. For example, people in Wellingborough want to see, at the Isebrook site, a very similar service replicated. Were we to lose Corby urgent care centre, that would also undermine the whole model that we have been working on, cross-party, for some years. I am talking about a hub-and-spoke model—ensuring that we have the urgent care hub on the Kettering General Hospital site, with a spoke in Wellingborough and a spoke in Corby. That makes absolute sense, and I do not want the good work that has been done on it undone, because this facility is class-leading and can demonstrate that it has made quite an impact. I say again that I am in no doubt that losing the facility would be a disaster for Kettering General Hospital. I also recognise that Corby CCG has responsibility for Kettering General Hospital as its pinned CCG.

As I said in the debate before the summer recess, my message to the CCG remains very clear: please don’t let us down.

Photo of Peter Bone Peter Bone Conservative, Wellingborough 4:14, 13 September 2017

It is a great pleasure to serve under your chairmanship, Mr Chope. I am very grateful to my hon. Friend Tom Pursglove and my hon. Friend the Minister for allowing me briefly to speak in the debate. We have an excellent Minister who has shown a great deal of interest in the concerns of north Northamptonshire NHS.

I congratulate my hon. Friend the Member for Corby both on initiating the debate and on his campaigning across his constituency on many issues, but particularly on Corby urgent care centre. His listening campaign has galvanised support from all over the town and the surrounding areas, and it is the surroundings areas that I want to mention, because people from Wellingborough go to Corby urgent care centre. Wellingborough is one of those towns that does not have an urgent care centre or a hospital, so if someone unfortunately has an emergency, they have to travel to Kettering and, on occasion, to Northampton, which is not a good situation. The urgent care centre allows people to be seen more quickly, and the system really works. I saw one of my constituents who had fallen ill, could not see the doctor that day in Wellingborough, went to Corby urgent care centre and was then referred on to Kettering, so the system works. I am grateful to my hon. Friends the Members for Kettering (Mr Hollobone) and for Northampton South (Andrew Lewer) for being here, because they represent the two constituencies with the two major hospitals. The problem is that if we get rid of Corby urgent care centre, we will finish up with more and more people going to Kettering A&E and to Northampton General Hospital.

For a long time now—since before my hon. Friend the Member for Corby was even elected—there has been a campaign for a hub at Kettering. That would be a national leader and is something that the Department has supported. We would have the urgent care centre in Corby, which we already have; we could have an urgent care centre at Kettering General; and we would have an urgent care centre at the Isebrook Hospital in Wellingborough. That is my plea to the commissioning groups, because I have been round the site where they are going to put the urgent care centre in Wellingborough, but I am afraid the commissioning groups have let us down. I have introduced in this Parliament a Bill, which you may be aware of, Mr Chope, to merge the two commissioning groups, the Northamptonshire Clinical Commissioning Groups (Merger) Bill, because having a Corby commissioning group—the smallest in the country—is hopeless. I am not much more impressed by the Nene group, so let us put them together and see whether we can get something better. I have also introduced a Bill that would bring the hub system to Northamptonshire —the North Northamptonshire (Urgent Care Facilities) Bill.

I am really grateful to my hon. Friend the Member for Corby for letting me speak in the debate. He is doing an absolutely terrific job in Corby. He said right at the beginning of his speech that these debates should be used only for really important occasions. The first time I was in Westminster Hall, the aim was to keep open Rushden fire station, using a listening campaign, and we achieved that, so I hope that as a result of this debate we will ensure that Corby urgent care centre stays open.

Photo of Philip Dunne Philip Dunne The Minister of State, Department of Health 4:18, 13 September 2017

Thank you, Mr Chope, for chairing the debate in your inimitable style. I was intrigued to learn that my hon. Friend Tom Pursglove had not used the precincts of Westminster Hall to raise an issue before; I was somewhat surprised, because he is such an assiduous campaigner for his constituency and such a frequent contributor in the main Chamber. The reason may simply be that he does not manage to find time to get into Westminster Hall, so often does he raise his constituents’ interests on the Floor of the House. It is good to see him so well supported again today by his constituency neighbours from Wellingborough and Kettering.

We have discussed this matter privately and, to a limited degree, on the Floor of the House. My hon. Friend the Member for Corby referred to the Adjournment debate to which he contributed before Parliament rose for the summer recess. We have also discussed during the summer, as events unfolded in a more unpredictable way, what could be done to secure the future of the facility for which he has advocated so well today.

I feel reasonably up to speed with events in Corby; for the benefit of other Members present, I will rehearse a small number of them. I will not go in to too much detail, not least because at the heart of the issue has been a contractual dispute, which has limited the ability of participants to describe the nature of it. That has, in itself, given rise to some problems in communicating to the local population what the problem has been. We remain bound by the confidentiality arrangements around the legal procedure, but suffice it to say that, as my hon. Friend correctly observes, we are close to a point where action has to be taken to maintain the facility from the end of this month.

From my conversations with the CCG leadership in preparation for this debate, I can assure my hon. Friend that on that side of the negotiating table they are determined to ensure that continuity of service is provided through the rolling four-month contract. They alerted him to that contract at the end of last month and are engaging with the provider, Lakeside+, to try to reach agreement. There is no doubt that without an agreement, some of the services would have to be provided in an alternative and less satisfactory way for the local population. That is inevitable, if it is put together in a short timeframe.

It is in everybody’s interest to make this work, but it will be a precursor to a longer-term solution, which is clearly required for the local population. I am pleased that my hon. Friend recognises that such a solution needs to be widely consulted on. Indeed, he is pressing for a more fulsome consultation than is perhaps typical. Given the circumstances surrounding this case, I will be urging the CCG regarding that full consultation. I have been alerted that it is due to start in November, and think that he has been given the same information.

I was not aware of a pre-consultation, and am not quite sure what it means. Hopefully, it means providing an opportunity to ensure that the full consultation is as detailed as necessary. I am quite sure that my hon. Friend will encourage all those who have been in touch with him to participate in that consultation when it gets under way. I was pleased to learn from him about the cross-party nature of the support and full engagement that he has been working, alongside the action group, to generate. I am sure that all those taking an interest will participate in the consultation.

To touch on the substance of the issue, I should say that the GP practice co-located with the urgent care centre has the largest patient list of any GP practice in the midlands, certainly, and possibly across NHS England’s footprint, so it has some unusual characteristics. One of the pressures on that practice, which my hon. Friend alluded to, is access to that GP surgery. Pressure is put on the urgent care centre by the difficulty in securing access to that part of the GP provision in the area. My understanding is that there is a federation of GPs, beyond the immediate catchment of the UCC, but within the CCG area, that has much better access. Work should be done as part of the consultation to see how the performance across the entire CCG area can be improved to relieve some of the pressure on the urgent care centre.

A consequence of that pressure is that the original contract, designed to undertake 120 patient episodes a day, has been dealing with more like 170 patients a day attending the urgent care centre. Of those patients, the vast majority—88%—could be dealt with either in that facility or in the GP practice itself. As I understand it, 12% definitely require treatment at the urgent care centre, and some of those are then referred to either Kettering General Hospital or, in a small number of cases, to Northampton’s A&E facility.

There is a need for an urgent care setting, but there is as much of a need to ensure that those who could be treated in the primary care environment can be. Part of the consultation will look at the appropriateness of a primary care home arrangement. That is an establishment that brings together primary care providers, social care providers and other providers, such as pharmacies, within an area, to provide a more integrated primary care service. That in itself might have benefits for improving access to treatment for the population served by the UCC at present.

My hon. Friend will be well aware of the history of the contracting challenge between the CCG and Lakeside+. I will not exhaust his patience by going into that in any detail, but will simply say that it is the intent of the CCG to re-establish a contractual relationship. The CCG wishes to have this moving forward on a four-month rolling basis while the consultation takes place, and then any subsequent arrangements will need to go out to tender. The intent is that this contract will continue until the successor arrangements are in place, so that there is continuity of care for his constituents—something that the Department absolutely supports.

I conclude by saying that it is really important that we use this public consultation to get the model of care right for the people in the area served by the UCC. That needs to take into account the evidence base for the clinical model, the right to patient choice for the people who will be using it, to meet the local need—my hon. Friend spoke eloquently about the particular local needs in the Corby area, and those are recognised—and also value for money. The approach has to be coherent and comprehensive, to come up with the right solution for the future.

I heard what my hon. Friend’s neighbour, my hon. Friend Mr Bone, said about looking for a similar hub in Wellingborough. I will look with interest to see how his private Member’s Bill progresses, to endeavour to bring that about. I also note his comments regarding the structure of the CCGs in the area. That is really a matter for the STP—the sustainability and transformation partnership—to make progress on and decide the structure of both commissioning and provision of service in the area. It is not really for me to comment on that off the cuff here today, but I note what he says and am aware that this is one of the smallest CCGs in the country. I am also aware that there is a very substantial programme of collaboration already underway with the neighbouring CCG at Nene, so I think that the CCGs themselves see the benefits of closer integration of their working.

On that basis, I say to my hon. Friend the Member for Corby that I will endeavour to keep him informed as matters come to my attention, and I am quite sure he will continue to keep me and the Department informed as well.

Question put and agreed to.

Photo of Christopher Chope Christopher Chope Conservative, Christchurch

Order. As we have got a minute and a half spare, we can go straight on to the next debate because the Minister is here. I now call the next speaker, Mr Linden.