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Leeds Children’s and Maternity Hospital

Volume 459: debated on Tuesday 1 May 2007

I am grateful for the opportunity to debate a crucial issue for Leeds, West Yorkshire and beyond.

A stark fact, which we are not at all happy about, is that Leeds is the only major city in this country without a dedicated children’s hospital. The experts have said for 18 years that we need one; leading consultants have made the case for 15 years, and parents have campaigned relentlessly in recent years. The city and its people want to change the situation and the campaign for a new hospital has the support of all Leeds and regional MPs, the city council and councillors of all parties. Yet, on 17 March this year, the parents and children of Leeds received a terrible blow. The development of the dedicated children’s and maternity hospital for which they had campaigned so hard only a few years before was to be shelved, possibly indefinitely.

The Leeds Teaching Hospitals NHS Trust’s official statement confirmed that plans for the hospital will be severely delayed, blaming a lack of money, as well as the rising costs of the project. The trust stated that the project’s affordability had not been proven, and that it felt that it would be unable to make the required repayments for the hospital under the proposed private finance initiative scheme. As the news reverberated around the community, it confirmed many people’s fears that the appalling NHS situation in Leeds has had a devastating impact on health services and has led to the hospital being cancelled.

Geoff Stagg, father of 14-year-old brain cancer sufferer Craig and campaigner for the new hospital, summed it up:

“I feel totally let down. We thought the hard work was over in getting the Government to agree”

to the hospital;

“to be told now that there’s no money for it is a huge blow”.

The Leeds children’s and maternity hospital was due to open its doors in 2012, as a dedicated state-of-the-art, 370-bed facility for treating children and providing maternity care. It would have centralised services for children that are currently provided predominantly by two sites, as well as others, across the city. It was also due to include one of only three children’s liver units in the country and to become the biggest centre for transplants in England. Now it is unclear when—or, crucially, if—the facility will open, and children in Leeds and the wider area are left without the dedicated facility that they so urgently require.

Three years ago, the go-ahead for the hospital was finally granted, marking the culmination of a long and hard-fought campaign, led since 2002 by parents Jonathan Abbott and Carol and Dean Maddocks after they witnessed the conditions in which the dedicated and excellent staff on ward 10 of St. James’s university hospital in Leeds were forced to treat young children. Jonathan Abbott has described the crowds of ill, grey adults standing around the entrance of the hospital smoking, as he wheeled in his young son Josh, who suffered from a rare form of cancer, and the complete absence of privacy on the ward. At the end of Josh’s treatment, he removed his son from the ward, so that he could die in a place where he felt comfortable.

Carol Maddocks talks of similar problems when her daughter, Alice, was being treated in 2002 for aplastic anaemia, now thankfully in remission. Carol’s memories of that time are of cramped conditions and of having to take Alice, already suffering from the after-effects of her treatment, on long and draining journeys across Leeds between St. James’s and the Leeds general infirmary, so that her treatment could continue.

Jonathan Abbott and Carol Maddocks made a promise that they would not let other children go through what their children had experienced. With Carol’s husband, Dean, they launched the campaign to improve children’s facilities in Leeds. Their campaign was taken up by other parents and local organisations, such as Candlelighters, which does so much for children with cancer in Leeds. Politically, it gained the full support of Leeds MPs and Leeds city council. It was backed by the Yorkshire Post, the Yorkshire Evening Post and other local media and, most importantly, received huge support from members of the local community, 3,000 of whom signed a petition.

Despite what has happened, I must take this opportunity to praise Carol, Dean, Jonathan and all the extraordinary people who led that successful campaign and inspired Leeds and its citizens to stand up for our children. It was a remarkable campaign, and on 27 July 2004, it finally reached a conclusion when the former Health Secretary, the right hon. Member for Airdrie and Shotts (John Reid), gave the green light for funding for a new dedicated children’s and maternity hospital in Leeds. The decision was greeted with joy throughout the city. Trust executives issued a statement heralding the development as vital to providing children across Yorkshire with the care that they need. Neil McKay, chief executive of the trust at the time, called it “fantastic news”. It is not surprising that Jonathan Abbott, Carol and Dean Maddocks and everyone else who fought so hard have been utterly shattered by the news that the children’s hospital will not be going ahead as promised.

Why, with all that support and political will, has the project been shelved? According to the trust, the major reason for the delay in the development of the hospital, which was due to commence at the site of St. James’s university hospital, is the trust’s current and projected debt. The trust also says that the projected costs have spiralled from £230 million to £650 million—an almost threefold increase. It is unclear why costs have risen so dramatically. However, when questioned, sources at the trust have pointed to a need to refurbish existing adult facilities, a need for new facilities not included in the original plans, such as a car park, and the fact that the required contingency fund for the hospital has risen to £213 million—almost the entire cost of the original plan. That raises questions about the suitability of the original plans. Jonathan Abbott has questioned why there was a three-year consultation period costing an unknown sum if the plans were simply to be shelved. There have also been suggestions that the trust has proposed a top-of-the-range option, including the car park and rebuilt trust headquarters. The matter must be clarified as soon as possible.

How did the trust suddenly arrive at the hugely inflated figure of £650 million? Is it indeed the most expensive option and, if so, can less costly options be brought back to the table that would still deliver the necessary fundamental change in care? But the key question for the Minister and her colleagues to investigate and answer as a matter of urgency is why there is such a significant difference between the figures presented originally, which were current until a few months ago, and the costs now being presented by the trust.

How the decision was taken and announced has also caused an uproar. Very senior medical representatives were not told until after the news leaked out, and campaigners found out from newspapers. It was described by Dr. Richard Vautrey, medical secretary of the Leeds local medical committee, as

“a bolt from the blue”.

Our serious concern is that the decision was taken by an interim chief executive in an informal meeting and without consulting the senior medical professionals in charge of delivering children’s and maternity services, never mind general practitioners, campaigners, parents and the wider community. That is not an acceptable way to run the NHS. I ask the Minister to investigate how the decision was taken, why it was taken and how it was communicated.

It is absolutely correct that the hon. Gentleman has identified when the decision was allegedly taken to delay the process, but in the interests of clarity, can he confirm that any attempt to say that the Government—that is, Ministers—have axed the hospital would be highly inaccurate?

I shall go on to say that. I have made it clear that we do not know what the decision is, which is why we need a proper inquiry by the Department into how it was taken and, more importantly, why. There is much anger about the way that the trust has behaved, and rightly so, but it is also clear that the decision to shelve the plans is, unfortunately, symptomatic of the massive financial difficulties in which trusts in Leeds and across the country have found themselves in recent years.

Estimates vary, but according to its own figures, the Leeds Teaching Hospitals NHS Trust is seeking to reduce a deficit projected to reach £9 million by the end of the year, as part of a £30 million to £50 million deficit faced by the city as a whole. The Secretary of State for Health has obliged trusts to make savings of 2.5 per cent. each year. In an organisation with a turnover of more than £700 million, that is a considerable amount. It has led to a number of closures and cuts in the Leeds area, including ward closures and cuts of about 430 posts as part of a cost-cutting plan aimed at saving £84 million in the next three years, and has instigated a recruitment freeze.

I think that all of us would agree that the figures must be carefully scrutinised, but will the hon. Gentleman confirm that not even the strategic health authority knew about the decision, never mind the Minister?

As far as I am aware, virtually no one knew apart from the board of the trust when the decision was taken.

What the hon. Gentleman just said appears completely to contradict comments that he made just this week in the Yorkshire Evening Post, where he suggested that Leeds MPs, apart from himself, had been wrong to suggest that anybody other than the trust was responsible. In the 25 years that I have been involved with the NHS, the Leeds Teaching Hospitals NHS Trust has always had a deficit. It had a deficit in 2004, when permission was given to do the detailed planning for the hospital, not for it to go ahead. It continues to have a deficit, and many of us have asked almost monthly whether that would impinge on the ability ultimately to submit the bid for the hospital. The answer that we have been given was no. Does the hon. Gentleman accept therefore that much of the responsibility for the issue actually rests with the trust itself?

Of course I do, and that is why I have asked the Minister to review the overall management of the hospital service in Leeds. The problems are abundantly clear. However, it is regrettable that the hon. Gentleman wants to move away from the unity that we have had on the issue.

I need to make some progress. I will come back to the hon. Gentleman shortly.

Why do we need the hospital in Leeds? Medical experts in the city agree with each other and issued a joint statement in which they expressed fundamental concern over the

“current and future failings in the provision of care for children”

in the city. They stated that

“the present state of children’s services in Leeds is not fit for purpose.”

That is shocking and appalling. The fact that children are at risk in our hospitals should be our immediate and primary concern.

At present, there are two paediatric departments within three miles of each other. Given the complexity of paediatric medicine, children are therefore not getting the service that they require. For example, Dr. Sally Kinsey, consultant paediatric haematologist, stated:

“In the very recent past, a young girl had to wait seven hours to be transferred from St. James’s to the infirmary. She was having a torrential life-threatening nose bleed and the only out-of-hours services were at LGI.”

Not only is patient care compromised, but the other side of the coin is that the current situation does not make economic sense. There is duplication of services, and the two sites require multi-layers of middle-grade staff. That is a huge expense to the trust. As Professor Thomas said,

“the duplication of expertise in two paediatric intensive care units is the finances of a madhouse.”

It is important to make it clear that all assessments and accounts from patients, parents and senior health professionals show that the ability of our excellent teams to deliver children’s and maternity services is being undermined. In the words of one consultant, the teams

“can't treat as many people as they would like in they way they would like to.”

What will happen to children’s and maternity services in Leeds? We have had some back-pedalling from the trust, which is now making much of the fact that work on the new hospital has been postponed—albeit indefinitely—not cancelled, but the reality is that a hospital that was given the go-ahead in 2004 has been shelved indefinitely. It is also clear that there is little prospect of that changing without high-level political involvement and a radical overhaul of the financial position of the NHS in Leeds.

I am sorry, but I have only two minutes.

As for alternative solutions, it is clear that there is no plan B. I want the Minister to be in no doubt that medical as well as public opinion is clear that we need a single-site, purpose-built children’s hospital at the St. James’s site. Only that would allow key services to be located together, including a large, equipped paediatric intensive care unit and an out-of-hours service. It would end the need for children to be shuttled around various health care sites and to be treated in unsuitable conditions.

Dr. Keith Brownlee, paediatric consultant, has stated:

“We feel very strongly that without that provision”—

the hospital—

“it’s difficult to be confident that we can keep these children safe from cross infections.”

Dr. Richard Vautrey has stated:

“GPs and consultants are united over the need for a new dedicated children’s hospital.”

But Carol Maddocks puts it most powerfully of all. She says that anything other than a new, dedicated hospital would be

“like putting a sticking plaster over a gaping wound”.

As her fellow campaigner, Jonathan Abbott, said,

“Leeds Teaching Hospitals NHS Trust must reverse this decision—otherwise they will place a death sentence on our children’s medical care in Yorkshire.”

The purpose of this debate is to point out the need for the Department of Health and the Government to address the problems with the running of hospital services in Leeds. The Secretary of State for Health must admit that “the buck stops here” if people are being failed in our hospitals. First, the Government must determine why Leeds services are in such a mess, with neither local people nor health professionals having any confidence in how hospital services are run. Ultimately, the only thing that people in our city will accept is a new children’s and maternity services hospital in Leeds. It has support across the political spectrum of the public, the media and the business community. The people of Leeds have been waiting too long.

The hon. Member for Leeds, North-West (Greg Mulholland) is to be congratulated on securing this debate. He will probably be aware that other Leeds Members—my hon. Friends the Members for Elmet (Colin Burgon), for Leeds, North-East (Mr. Hamilton), for Pudsey (Mr. Truswell), for Leeds, West (John Battle) and for Morley and Rothwell (Colin Challen) are here today—have also helped to ensure that Ministers are aware of the strength of feeling about this important matter. As someone who lives in Doncaster, not too far away from Leeds, I obviously have an interest, too.

I know that my hon. Friends from Leeds had several discussions with the chief executives of the trust, the PCT and the strategic health authority to express their concern before taking the matter to Ministers. The hon. Member for Leeds, North-West may be aware that several of my hon. Friends who represent Leeds constituencies have already met the Minister of State, Department of Health, my hon. Friend the Member for Leigh (Andy Burnham), to discuss the issues. My hon. Friend the Member for Pudsey also led a deputation including parent campaigners Carol Maddocks and Jonathan Abbott and the consultant at the forefront of the campaign, Dr. Ian Lewis, to meet my colleague the Minister of State. On the same day, the Minister of State also met my hon. Friend the Member for Pudsey, senior NHS executives from Leeds and the chief executive of the strategic health authority, Margaret Edwards. My hon. Friend the Minister of State was planning to visit Leeds as a result of those meetings, but he has had to make allowances for the pre-local election purdah.

I have listened to what the hon. Member for Leeds, North-West said about the concerns of parents and families living in Leeds and west Yorkshire. The key message of the parents’ campaign is that very ill children, their families and dedicated health professionals are fighting terrible illnesses in a clinical environment that does not always help them to deal with the physical and emotional trauma involved. The services are scattered between different sites, requiring youngsters who are often in great distress to be shuttled about. As a mother of three, I count my blessings that I have never had to deal with such a situation. Children are treated in areas that lack the necessary privacy, and there is inadequate accommodation for parents, whose constant presence is an essential part of their children’s battle against life-threatening conditions. Those concerns have been recognised and the debate on dealing with them has been won, which is why we are in the middle of a process to provide the best possible services.

Before today’s debate, my hon. Friends from Leeds made me aware of the Yorkshire Evening Post campaigns—the one in 2004 and the one now—that have so graphically portrayed in human terms the case for a children’s hospital. The newspaper is to be commended for enabling young patients and their parents to make their own case, in their own words, as to why Leeds and west Yorkshire need services that are much more child-centred. Those profound messages have been heard, loud and clear, and we want to act on them.

My colleagues in the Department of Health and I were concerned to hear from campaigners, consultants and hon. Friends, and from the hon. Member for Leeds, North-West today, about the dismay at the way in which the matter has been handled. I fully appreciate the consternation that that has caused in Leeds and west Yorkshire. I understand that reassurance has been sought from the trust about its financial position and that it would not impinge on the “Making Leeds Better” bid, and that that assurance has been given.

My hon. Friends said that had the issues been raised with them before the announcement was made, they would naturally, in the circumstances, have wanted immediate meetings with senior NHS managers in the city and with Ministers to raise their concerns and discuss possible alternative action. We are addressing that issue. Things change over time—building costs and other factors change. I understand that there has been talk about the car park and the council’s requests concerning it.

Let us remember that the children’s hospital bid is not due to be submitted until December 2008, following the detailed consultation that must take place. That is 20 months away. I share my hon. Friends’ feelings that they would have expected any problems to be talked through with those most closely involved in the project, such as parent campaigners, clinicians, health professionals, local MPs, the local authority and other agencies. Clearly that was not done in the most open and appropriate way. I would also have expected the strategic health authority to be informed prior to any announcement regarding the bid, and for the Department of Health to be notified. That is why I found it disturbing to say the least when I read the following headline in the Liberal Democrat’s “Focus” leaflet: “Children’s hospital axed”. The article goes on to state:

“The Labour Government has axed plans to build a new £204 Million Children’s Hospital at St. James’s.”

That is taking political grandstanding too far. The article is not true; it is a complete misrepresentation.

It is extremely regrettable that the Minister is using an issue that clearly has the support of all MPs to score petty party political points. [Interruption.] As the muttering from hon. Members suggests, I find it extraordinary that we have a Government who claim to have saved the NHS but who will not take responsibility for hospital services in Leeds and the NHS as a whole.

We have trebled the amount of money that we provide to the NHS, which is why we can discuss how to make the changes that are needed. For example, funding in Leeds is to increase by 17.4 per cent. between 2006 and 2008. A new £220 million oncology wing on the St. James’s university hospital site will receive its first patients next year. Four excellent local improvement finance trust schemes, on which £20 million has been spent, have brought services closer to the community. Those services are already open to patients and their families. The children’s hospital proposal is part of looking to the future and deciding how we can meet the needs of families now and in the years to come. It is only right that I correct any misrepresentation of the facts, because such misrepresentation does not help politicians or the reputation of politics, and it certainly does not help the people on the ground who have campaigned for this service.

Does my hon. Friend the Minister share my concern that although the hon. Member for Leeds, North-West (Greg Mulholland) is trying to present an all-party approach to the Minister, he rejected my request for two or three minutes to speak on behalf of myself and my colleagues?

I shall give way to the hon. Gentleman in a moment. Mr. Atkinson, you will be only too well aware that during Adjournment debates on a local issue that many hon. Members have taken up, other hon. Members can usually ask the MP who has secured the debate for some time in which to speak. My hon. Friend the Member for Pudsey makes an important point. If this is an issue on which people can work together—and I believe that it should be—the hon. Member for Leeds, North-West has missed an opportunity.

The hon. Member for Pudsey makes an extraordinarily disingenuous point. I made it clear that although this is a 15-minute debate, I would welcome interventions from other MPs from Leeds—particularly if they were constructive interventions, which I must say they have not been. When a meeting was arranged with the Minister of State, I was not invited to attend by the hon. Gentleman, so his point is rather hypocritical.

On a point of order, Mr. Atkinson. Will you clarify a couple of points for me? First, is it not the case that when a Member secures an Adjournment debate, he or she is not restricted to 15 minutes? Secondly, is it not entirely at the discretion of the hon. Member who has secured the debate to allow other Members to contribute?

The answer is yes to both of those questions. The debate is a half hour debate and if the hon. Member who has raised the topic wants to speak for the entire time, they may do so—although obviously in that case they would not receive a response from the Minister. And, as the hon. Gentleman rightly says, it is up to the Member who introduces the debate to decide whether to allow another Member to contribute.

On a point of order, Mr. Atkinson. I raised that point with the Table Office and that was the advice that I was given. However, I also note that the hon. Member for Pudsey could not answer my question about why I was not invited to the meeting with the Minister of State.

As I was saying, I would have expected the strategic health authority to be informed before any announcement was made regarding the bid and the Department of Health to be notified. It is unfortunate that that was not done, but the strategic health authority and the Department of Health are now helping to make sure that we get the figures right. The officials in the Department and the strategic health authority are playing a constructive role, which is a world away from the very party political basis of some campaign literature issued during the local elections. In the “Focus” leaflet to which I have referred and, I understand, in other leaflets and letters the headline has been that the Labour Government are axing plans. That is a complete misrepresentation and is disgraceful.

Children’s services in hospitals and in communities are a major priority for us. On 15 March, the Minister of State, Department of Health, my hon. Friend the Member for Leigh, announced a consultation on the future of payment by results. That will look at the future financing of specialised services, including children’s services, under payment by results. That is important because it will set out what currently happens, but also seek to ensure that services that are so important to children and their families, and to clinicians who provide their expertise and devotion, are rewarded fairly. The consultation will also set out future options to ensure sustainability. As well as having buildings, it is important that there is the finance and throughput to ensure that services can be developed and invested in.

The consultation will touch directly on services such as those that Leeds aspires to provide through a dedicated children’s and maternity hospital. We want to look at how that aspiration can be converted into reality for the children and parents of Leeds and west Yorkshire. With our colleagues at the strategic health authority, we will look at some of the figures that the trust has identified to determine how realistic they are. We will identify ways in which we can be clear about what are extra costs and what can be dealt with in other ways.

Does my hon. Friend agree that the only way to get a children’s hospital in Leeds is to stop trying to use the issue to score party political points? Opposition parties in Leeds should refrain from doing that and work together with the rest of us to achieve that goal.

I agree with my hon. Friend. These are not impersonal issues. I imagine and know the daily pain that campaigners are experiencing as parents of sick children—they are not detached from the issue. We must be careful in the language that we use and the impression that we give as it may unduly create fears and distract us from getting on with the job, which is to sort out the figures with the trust and ensure that they are correct and fit for purpose. That is the constructive approach and, dare I say it, the responsible approach to tackling complex issues, which should not be made more complex, frightening or stressful for those who are most closely involved.

Ultimately, the people on the ground in Leeds must be the ones who make the plan work. The rigorous process that the strategic health authority has now launched is one that should have been undertaken locally before any unexpected announcement was made. That point has been clearly made. Discussions should have been held with parents, health professionals and all the other people who are committed to the project. I have no doubt about the huge amount of support among those people.

I know that there is some concern among parent campaigners that the project has grown well beyond the original children’s hospital scheme that was presented in 2004. Part of the job that we now have is to work out how much of that was bound to happen because that is what happens with such projects, and how much relates to other issues that may need closer attention. The plan includes changes to a wide range of adult and community services in the city. The trust says it has also included a huge car park to meet the concerns of the city council. There is a sizeable extra amount included in its figures to cover possible changes in costs over time, which is also the subject of some debate. All those aspects need to be fully examined. The NHS in Leeds will be doing its job to ensure that it meets its next deadline for the outline business case approval by the end of next year.

Plans for a Leeds children’s and maternity hospital have not been cancelled. It is the ambition of the strategic health authority, the Leeds Teaching Hospitals NHS Trust and Leeds primary care trust to centre children’s services on one new site in the city. Those are the stated aims of the “Making Leeds Better” programme and I understand that that remains the case. Only after full public consultation will a final decision be taken on the future of services in Leeds.

It being Two o’clock, the motion for the Adjournment of the sitting lapsed, without Question put.