I thank Mr. Speaker for granting permission for the debate to be held. I welcome the Minister and look forward to hearing his response in due course. I am pleased to welcome my hon. Friend the Member for Wellingborough (Mr. Bone), who, with your permission, Dr. McCrea, will also participate in the debate and concentrate on some aspects of the future funding of the hospital.

People in and around Kettering are extremely proud of our local hospital. It was founded in 1897, so this is its 110th year on the same site in Kettering. It would be remiss of me to proceed further without placing on the parliamentary record my thanks and those of all my constituents to the doctors, nurses and ancillary and administrative staff at Kettering general hospital for their wonderful work for local people, which is widely appreciated.

Kettering general hospital does wonderful work, and a report by the Healthcare Commission, its latest in-patient survey, which was released today, shows that 95 per cent. of patients at the hospital have rated the overall care that they received as either excellent, very good or good. Only 4 per cent. rated it as fair, and only 1 per cent. as poor. That is a tremendous record. Having said that, it would be remiss of me not to say that there are people in serious circumstances who have been let down by the hospital. The situation of those patients—I am sure that you have such patients in your constituency, Dr. McCrea—is extremely serious, and it is our job as Members of Parliament to ensure that they get the appropriate redress.

I wish to invite the Minister to visit Kettering general hospital. His colleague the Prime Minister visited in February 2005, but his visit was wholly inappropriate. He visited the hospital not as Prime Minister but as leader of the Labour party and held an election rally on the hospital premises. That was a black day for the hospital. I would welcome the Minister, in his capacity as Health Minister, visiting the hospital to see the wonderful work that goes on there and learn first-hand about the challenges that it faces in the years ahead. I hope that he will give that invitation, which I deliver on behalf of the Kettering General Hospital NHS Trust, full and proper consideration. He would get a warm welcome.

I applied for this debate because Kettering general hospital faces real challenges in the next 10 or 20 years, primarily because of the rapid growth that will take place in the local population up to 2031 as a result of the sustainable communities plan promoted by the Department for Communities and Local Government. In north Northamptonshire an extra 52,000 houses are to be built by 2021—in other words, over the next 14 years. The local population will increase by at least a third, and possibly more, which is one of the fastest rates of population growth anywhere in the country. One does not need to be a rocket scientist to work out that if the local population is to increase by at least a third, the medical needs of the population will also increase by at least at third. That, crudely, means that we will need one third more GPs and a one-third increase in hospital facilities.

Unfortunately, against the background of rapid and significant population growth there are significant capacity shortfalls at Kettering general hospital, and the staff are working flat out to meet the health needs of the local population, not least in the accident and emergency department. The situation has been made worse by the forced merger of the local primary care trusts by the Department of Health last year. That was bad news for Kettering general hospital because the now combined Northamptonshire PCT has a cumulative deficit of £44 million, which is to be shared out across the whole of the county. The problem for Kettering general hospital is that it is an extremely efficient hospital, in the way that such things are measured, and the deficit of the Northamptonshire Heartlands PCT, which was responsible for the north of Northamptonshire, was not anything like the deficit of the Daventry and South Northamptonshire PCT.

In other words, health services for constituents in Kettering, Wellingborough and Corby are being cut back because of financial overspends elsewhere in Northamptonshire, and the effect of that has been that Kettering general hospital has had to cut back on some of its procedures. It had to delay the opening of its wonderful new treatment centre in October last year until this April, wards have been closed, procedures have been cancelled and waits have been extended. All of that was the result of the Department’s wrong decision to merge the PCTs in Northamptonshire, against the wishes of the county’s Members of Parliament, including myself.

The cuts have not helped the serious infection control situation at Kettering general hospital. Local people are rightly proud of the work that the hospital does, but it is sad indeed that in 2006 it had the worst record in the whole country for clostridium difficile infections. The figures are slightly distorted because the method for collecting them means that community-based infections are included with the hospital’s infections. Nevertheless, there were 641 cases in 2006—the country’s worst. That rather contrasts with the Prime Minister’s remarks when he visited in February 2005. He said that Kettering was a world-class hospital, but since his visit we have seen not only ward closures, further underfunding, the country’s worst record for hospital-acquired infections and some of the highest mortality rates in the country but also staffing levels driven to what one member of staff who I spoke to in preparation for this debate described as crisis levels. Those are the problems that the hospital has faced, and I commend all the staff for the way in which they have tried to address challenges that have been made worse by some of the decisions made in Whitehall.

I have spoken with consultants at the hospital, and they are confident that measures are now in place to ensure that the hospital’s record of hospital-acquired infections improves. The Department has granted a further £300,000 to help in the fight against clostridium difficile infections. One medical ward is to be fully refurbished, a decontamination room for cleaning hospital equipment is to be set up, hand-washing facilities are to be upgraded and large, high-impact floor signs will be installed to remind all staff, patients and visitors of the need to wash their hands. I hope that the clostridium difficile infection rates at the hospital will improve as those measures work themselves through. Nevertheless, for every one of my constituents who goes into hospital to be treated, only to find themselves staying there longer because they have acquired an extra infection while in hospital, there is a tragic and unacceptable tale.

In preparation for this debate, I was careful to engage with as many representatives of the local health service as I could. I spoke to senior managers at the trust, local GPs, members of the local patient and public involvement forum, consultants and staff. There is very much a shared sense of Kettering general hospital being a valued community facility in which everyone is doing their best against a difficult background. I know that the Health Minister must receive many representations from Members of Parliament across the country for extra resources for their hospital, but as my hon. Friend will demonstrate in a moment, Kettering general hospital faces an almost unique background of consistent and persistent central Government underfunding going back some time. Although attempts have been made to address that, the cumulative underfunding over many years will not be caught up with overnight.

The crisis is made worse by the increase in the local population, and I urge the Minister to ensure that the population statistics that his officials give him match the reality on the ground. If he were to accept the trust’s invitation to come and see the hospital for himself, he would see the pressure that accident and emergency is under, especially at weekends, and the pressure that other wards are under as they do their best to treat local patients.

I will give way now to my hon. Friend, but I would like to impress on the Minister the fact that local people are proud of Kettering general hospital. Everyone wants it to succeed. I hope that the Government recognise the challenges that it faces, and that the Department will do its best to ensure that whoever the Member for Kettering is in another 110 years’ time, they will be able to look back at this debate and say, “Yes, the Government understood the problems that local people faced in respect of their hospital and responded to the challenges.”

I congratulate my hon. Friend the Member for Kettering (Mr. Hollobone) on securing this very important debate. The Minister is very able. I often find that when he is wheeled out, it is because the Government are defending the indefensible, so he appears on television and in debates quite often. I appreciate his attending today.

I am here to talk about Kettering general hospital, because it is the hospital for Wellingborough—there is no hospital in my constituency. My constituents have to go to Kettering, which sometimes involves a journey of up to three quarters of an hour. One of the biggest concerns expressed in surveys in Wellingborough and Rushden is the health service and the fact that we do not have our own local hospital. More than 94 per cent. of local people think that there should be a community hospital in Wellingborough with minor accident and emergency facilities, partly to offset the problems at Kettering general hospital. Kettering would be the major hospital, but a lot of my constituents could go to Wellingborough.

The Minister might say, “That is all well and good, but how are we to fund it?” The problem in our area has been consistent underfunding by central Government. The figures are not mine but the Minister’s—they are Government figures. The situation is perhaps best explained by Sir Richard Tilt, who was chairman of the Leicestershire, Northamptonshire and Rutland strategic health authority. In a letter to the Secretary of State for Health on 15 August 2005, he stated:

“We have an impressive track record of achieving national targets and delivering financial balance. The SHA was categorised as ‘high performing’...We are however the worst funded SHA relative to the national capitation formula which seeks to enable a fair, equitable distribution across the NHS...Kettering General Hospital for example has a reference cost index of 89. Indeed North Northamptonshire is our most pressurised health community. Northamptonshire Heartlands PCT which covers this population (including Corby with its severe health problems) is 32 million pounds (9.9%) below capitation...I am sure you will not be surprised that we believe we cannot deliver both financial and non-financial targets in 2005/06...It will be a simple and inevitable consequence of a growing gap between our allocated funding and the monies we need (as defined by the national formula) to meet the needs of our population.”

That was Sir Richard Tilt in August 2005.

The crux of my argument is that we have a wonderful hospital and terrific staff, but the Government work out what the hospital should get through the PCT and then deliberately and systematically underfund it. I have not heard any Minister defend that and say why it is the case. It is not good enough to say that other areas get more money. That is not an argument to underfund Kettering hospital, and we are not talking about a small amount of money.

In 2003-04, when the Government allocated funding directly to PCTs for the first time, the PCT that covers Kettering hospital received 90 per cent. of the funding that it should have had. The Government said they would give a certain amount, but they gave only 90 per cent. of that figure, which created a shortfall of £22.2 million. In 2004-05, again we received only 90 per cent. of what the Government said that we should have got, which was a shortfall of £24.4 million. Almost unbelievably, in 2005-06 the figure fell to 89 per cent., which increased the shortfall to £29.37 million in that year. The following year the shortfall was £20.16 million, and this year it is predicted to be £15.08 million. If the figures for the past few years are added together, the total underfunding is £111.21 million. That is not the level of underfunding that I have worked out; it is the Government’s own figures.

The Government spend a lot of time trying to work out an equitable and fair funding system for across the country, so why are Kettering and north Northampton consistently underfunded? I am not asking for an unfair share of the national health service budget; I am just asking for what the Government have said the area should have. I hope that the Minister will take that point on board.

I know that the Minister understands the problem and that the Government are trying to reduce the funding gap, but when there is £111 million of underfunding and then the Government say there is a deficit, there is something wrong with the Government’s accountancy and thinking, and it needs to be corrected.

I congratulate the hon. Member for Kettering (Mr. Hollobone) on securing the debate and thank the hon. Member for Wellingborough (Mr. Bone) for taking part. I do not doubt the sincerity of their commitment to Kettering General Hospital NHS Trust and to improving the national health service in their constituencies.

I will try to rebalance the debate slightly, because I do not believe that either hon. Member was entirely fair on the Government’s record of investment in the hospital trust that we are discussing. On the record, it is important to emphasise the significant investment in capital, buildings and people who work for the trust. In the health service in Northamptonshire, there are 357 more GPs, 725 more consultants, more than 6,856 additional nurses and midwives and more than 3,000 additional health care assistants. That is within the East Midlands strategic health authority area, and it represents a big investment in the work force of the national health service. Such investment is having a big impact on improving patient care.

There has also been unprecedented improvement in the fabric of the health service during the past 10 years, and Northamptonshire and Kettering are no different in that regard. In April this year, a new £16 million treatment centre opened at Kettering general hospital, which will enable the trust to increase the proportion of its operations as short-stay procedures. Indeed, it is instrumental to the trust’s plans to deliver the maximum 18-week target for the constituents of the hon. Members for Kettering and for Wellingborough. The treatment centre is the largest single development at the trust in 30 years, and I had hoped that I would hear something about that in the remarks of the hon. Member for Kettering. Other improvements at the trust include a £4.7 million cardiac catheter laboratory, which is being completed on site to improve care for people with heart problems, two new CAT scanners, a new MRI scanner, a new skin care unit, which opened in February 2003, a new ophthalmology unit and an extension to the intensive care unit. In fact, there is a long list of recent improvements to Kettering general hospital.

The hon. Member for Kettering questioned the motives of my right hon. Friend the Prime Minister in visiting the hospital. Given the levels of investment in bricks and mortar, capital, and services that the Government have made since 1997, the Prime Minister was perfectly entitled to visit Kettering general hospital. I challenge both hon. Members to answer a direct question: is Kettering general hospital better provided for today than in 1997?

Yes it is. However, my point is not party political. The population will grow so fast that, although investment is welcome, far more will be needed. Will the Minister look favourably upon the trust’s application for foundation trust status? That decision will be made in the next few months, and it is critical for the future health of the hospital that the Minister grants that application.

I appreciate the hon. Gentleman’s honesty in answering the question directly and admitting that the hospital is significantly better today than in 1997. The question on foundation trust application is extremely important and, if I understand him correctly, he strongly supports the application. I welcome that. The hon. Member for Wellingborough is nodding, and I welcome that support, too.

At the start of his speech, the hon. Member for Kettering mentioned patient satisfaction. A lot is said about our national health service and the quality of services. Today, a survey has been published by the Healthcare Commission, which the hon. Gentleman mentioned. It states that 95 per cent. of patients at Kettering general hospital rate their care as good, very good or excellent. That is a tremendous tribute to the staff who serve his constituents, and I was pleased that he began his remarks by recognising the outstanding service that has been provided to local people.

I am also pleased that waiting lists continue to fall at the trust. As of 31 March 2007, there were no patients waiting more than six months for in-patient treatment and no patients waiting more than 13 weeks for their first out-patient appointment. Of course, the trust faces challenges, and I will turn to infection control in a moment, because the hon. Gentleman mentioned that issue. I do not make these introductory remarks to suggest that everything is rosy and that the trust and the local health economy do not face important issues. However, it is important to place on the record the substantial commitment that the Government have shown to improving health services in his constituency.

Both hon. Members mentioned funding, and I know that they have talked about that issue in the House on many occasions and that it is an important concern for them. In our last round of allocations to PCTs, we recognised that areas of the country have historically received less than their fair share of funding. In the last round of allocations, we accepted that such areas should be moved more quickly to receiving their national fair share. In 2003-04, the most under-target PCT was 22 per cent. below target, which, from memory, was Easington primary care trust in the north-east. As a result of our decision to move PCTs more quickly towards target, no PCT will be more than 3.7 per cent. below target at the end of the current financial year. Along with other PCTs that are below target, Northamptonshire PCT has benefited from an increase in allocations over and above the national average.

In 2006-07, the allocation to the PCT increased to £730 million, which is a cash increase of 12.7 per cent., and in 2007-08 it will receive £817 million, which is a further cash increase of 12 per cent. Over those years, that amounts to a cash increase of 26.3 per cent. compared with the national average of 19.5 per cent. I understand the concerns raised properly by Opposition Members today, but I hope that they agree that that represents a significant dent in the problem and significant investment in their local health services. That increase in funding is the joint largest for any PCT in the country.

I appreciate what the Minister has said and understand his point. However, will he acknowledge that Northamptonshire PCT remains in the bottom range with the biggest difference between what it should get and what it will get? And will he tell me when that gap will finally be closed?

We will look at those issues during the next funding round. In particular, we will look at the pace of change policy in order to see how quickly we can move PCTs from below target to target funding. However, I suggest that the hon. Gentleman directs his questions to the shadow Health Secretary, the hon. Member for South Cambridgeshire (Mr. Lansley). Like mine, his PCT is under its target allocation and has benefited from the changes that the Government made in order better to pick out deprivation when health funding is being allocated. I ask the hon. Gentleman to direct his questions to his Front-Bench colleagues, because their proposals for changing the funding formula, as I understand them, would leave the constituencies of both Opposition Members present worse off. Perhaps they need to pursue that with their Front-Bench colleagues.

On foundation trust status, I welcome the support indicated for the trust’s bid. In my view, it is absolutely the right way for the trust to go in order to build on the sense of improvement that, it would seem from my discussions with the trust’s management, has got going. I think that, elsewhere, foundation trust status has galvanised momentum and maintained local pride and focus. That is the right way forward, and I hope very much that the support of hon. Members today will be replicated throughout the community and that the trust can make that important step forward.

The hon. Member for Kettering mentioned infection control. It is true that the trust has recognised that it has a particular problem with levels of clostridium difficile. In July last year, it recognised that action was needed to improve matters significantly, and action has been taken—in the first quarter of this year, a significant reduction was made in C. difficile rates compared with the first quarter of 2006. From memory—I do not have the figure to hand—that represents about a 36 per cent. decrease. However, he is right to say that there can be no complacency on that important issue. I was grateful that he acknowledged the money that has been made available by the Department to improve infection control—the £300,000 to which he rightly referred. In my view, that will help the trust further to improve its infection control.

In conclusion, I shall pick up a couple of further issues. The hon. Gentleman made a general point about the need for health services in the Northamptonshire area to keep pace with anticipated population growth. I think that both Opposition Members present made that point, and it was a point very well made. The hon. Member for Kettering will know that in the last PCT allocation round an adjustment was made to the funding formula to recognise the latest figures on projected population growth, and I assure both hon. Members that the same thing will happen this time. There is no debate about it: a significant increase in population is expected in their area, and it is vitally important that the health service keeps track of it.

I would like to point out to the hon. Member for Wellingborough that there were some 528 beds in his trust in 2003-04 and that today the number is 598. So there is evidence that the capacity of the service is increasing, and I believe that the trust is looking at increasing further the level of services provided in the surrounding towns. I hope that that is of some comfort to him.

The hon. Member for Kettering said that everyone is doing their best against a difficult background, but I do not accept that. I think that the background is positive. A lot of investment has gone into the trust, which is responding well and improving services, as patients are telling us. However, we are not complacent. I shall work with him to improve matters further and accept his kind invitation to visit the trust and see the improvements for myself.