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Out-patient Facilities (Rushden)

Volume 485: debated on Thursday 11 December 2008

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

I should like to thank the Speaker for granting me the opportunity to debate one of the most controversial matters to affect my constituency since I became a Member of Parliament. I would also like to thank the Minister of State, Department of Health, the hon. Member for Exeter (Mr. Bradshaw) for his attendance, and I look forward to his response. He is a highly regarded Minister and has a reputation for listening to fair arguments. However, I assumed that the Minister replying to my debate would be the hon. Member for Corby (Phil Hope), as he is the Minister for the East Midlands, a Health Minister and, more importantly, the local Member of Parliament who directly benefits from the closure of Rushden out-patient facilities. We could have had a real debate, with proper questioning, between two hon. Members who know in great detail the issues that will be discussed this evening.

I would like to give a little background detail about my constituency that I think will help. My constituency comprises the two major towns of Wellingborough and Rushden, and a large number of outlying villages and towns. It does not have a general hospital, a community hospital or a minor injuries unit. When my constituents need to go to hospital, they have to travel long distances to either Kettering or Northampton. The Wellingborough constituency is a second-class relation to the other constituencies in Northamptonshire when it comes to health care provision. Kettering and Northampton have general hospitals; Corby has a minor injuries unit and is soon to get a community hospital; and Daventry has a community hospital. Wellingborough has nothing, except very limited out-patient facilities at the Rushden Memorial clinic and at the Isebrook facility in Wellingborough.

Our out-patient facilities are now under threat. Kettering General Hospital NHS Foundation Trust wants to close the Rushden Memorial clinic and move all out-patient services out of the town of Rushden and into a small town in the Corby constituency. Naturally, I am outraged at the proposal to cut even more public services for the people of Rushden. This is a cut too far, and the move cannot be allowed to happen, especially given that the Rushden Memorial clinic was originally paid for by Rushden people for the benefit of Rushden people.

The Rushden Memorial clinic, which provided out-patient services for the people of Rushden, was opened in 1950. It was paid for by the people of Rushden and workers in the local shoe and boot industry. The memorial clinic was dedicated to the memory of the 138 men, women and children from Rushden who lost their lives during the second world war. It is immoral to move those services—the only ones we have—out of Rushden. The proposal is an insult to the town and the people who live there. It is not just me who is outraged. As I said at the beginning of my speech, this is the single biggest issue to affect the constituency since I became a Member of Parliament in 2005. I have been inundated with letters, e-mails and telephone calls from worried and upset constituents. As yet, I have not received any representations in support of the proposal.

I would like to read just a few of the many e-mails and letters that I have received; they show the strength of opposition to scrapping out-patient facilities in Rushden.

A lady writes:

“My opinion is that we desperately need these facilities in Rushden as Rushden is much bigger than Irthlingborough. We do lack quite a few facilities in Rushden, and considering our nearest hospital is 9 to 10 miles away, people will find Irthlingborough difficult to get to if they do not drive. I strongly support you that this should go ahead in Rushden.”

Another constituent writes:

“I would like to put forward my extreme disgust at the way this was released to the public. This has not been discussed in any way and completely without patient consultation. I attend the Outpatient Department at least 8 times a year…I am in almost constant pain in my joints and I am now experiencing giddy spells when I move my head. This makes it virtually impossible to drive myself to the clinic and my husband would have to take time off from work to take me to my appointments and, as he works over an hour’s drive from Rushden, this means that if I have an early afternoon appointment, he has to take the whole afternoon off. If the clinic were to be left in Rushden I can get there either by walking or a friend can take me if school hours permit. I can drive short distances but four miles away is pushing it a little. I gave up work recently for this reason.”

A couple write:

“We now read they are to move the outpatient facilities to Irthlingborough. What utter nonsense, the population in Rushden is increasing at an alarming rate so why are they considering this move? Is it to get even more money for the land? We were told that the land was being sold to get the money to build a new outpatients so what the hell has happened to this plan? The whole thing is ridiculous.

We need an A&E. Having to go to Kettering is mad. Most of Rushden feels this is needed and no one seems to care about the needs for Rushden. We are fed up with the attitude towards this town”.

A lady writes to me:

“The people who are making these changes…should let the people of Rushden have their say. After all, it is our town, our lovely town, that is why we chose to live here.”

As these comments, and hundreds like them that I have received, clearly show, it is not just a question of retaining the existing health provision in Wellingborough and Rushden—we need more health provision. We need our fair share of health provision, which has been denied to us for so long. The Government now favour an approach for community hospitals in which a hub-and-spoke system feeds into the main hospital—in this case, either Kettering or Northampton. It would therefore be common sense to put the first community hospital in an area with no hospital provision, but unfortunately common sense does not prevail in this case. There is no valid reason, despite the many excuses one hears from Kettering General Hospital NHS Foundation Trust, why outpatient facilities should be closed in Rushden and moved to Irthlingborough.

Rushden is the largest town in east Northamptonshire, and it is growing rapidly. There are good transport links from Rushden to other parts of east Northamptonshire.

Irthlingborough is a small town that is virtually unreachable by public transport. Let us look at the comparative size of both areas. If one looks at the historic population census for 2001, bearing in mind the fact that my constituency has grown considerably since then, one sees that Rushden and its hinterland has a population of over 38,000. Irthlingborough has a population of just 8,000. The main acute hospital serving Rushden, Corby and the rest of east Northamptonshire is Kettering general hospital. The distance from Corby to that hospital is 9.3 miles; the distance from Rushden to the hospital is 14 miles. Corby already has a minor injuries unit, and is first in line in Northamptonshire to get a new community hospital, as recently announced in the local media.

We have not been given one single decent reason by the foundation trust why it wants to close Rushden’s facilities and move them into the Corby area.

I would like to point out that it is not just my constituents who oppose the plan. I have received many representations from Corby constituents pleading that the out-patient facilities be kept in Rushden because it is much easier for them to get there than to Irthlingborough. An excerpt from just one e-mail that I have received makes the point:

“I live in Raunds and use public transport to access the outpatients department in Rushden. There is a fairly decent bus service between Raunds and Rushden which is half-hourly. If the outpatients moved to Irthlingborough, I would have to take two buses to get there as there is no service between Raunds and Irthlingborough. The alternative would be to travel all the way to Kettering which is a very long bus journey away and the buses only run two-hourly. Therefore the move would not benefit the patients living in my part of East Northants who rely on buses.”

However, the proposed site in Irthlingborough is not only inconvenient for people who use public transport. If my constituents from Rushden and Higham Ferrers had to travel by car to the proposed Irthlingborough site, they would have to go across the infamous Chowns Mill roundabout on the A45. That roundabout is widely recognised by the authorities as a danger to pedestrians and motorists. Only recently, unfortunately, a pedestrian was killed while trying to cross it. At rush hour, Chowns Mill roundabout is so busy that there are extensive queues leading up to all approaches. The district council, the county council, the highways authority and the Government have all stated that the roundabout needs a grade-separated junction and a safe passage for pedestrians to cross. But once again, the Wellingborough and Rushden constituency is way down the line when it comes to public funding and the grade-separation scheme is not even in the regional assembly’s forward programme for capital schemes.

I now want to talk about the Rushden project: “The Rushden what?” you may ask. You would be forgiven if you had not heard of it because health authorities in Northamptonshire have been working hard to brush it under the carpet and pretend it never existed. The Rushden project was formed many years ago. Many local people have been involved in the Rushden project, myself included, before and after I became an MP. It was always the purpose of the project to bring the three NHS facilities in Rushden together on one site. The project was to have an enhanced and comprehensive health facility to serve the people of Rushden and its surrounds, and it had always been planned that the site would be the Rushden hospital site. The logic behind that was that the site already hosts one of the NHS facilities and there is extensive land on which to build, with the additional advantage that the land was owned by the NHS.

The Rushden hospital site is huge. It has good transport links and there is plenty of land to build an all-embracing health facility. But the NHS is proposing to sell off the land on the Rushden hospital site. What for? It is for more housing, so we will get more people and less health service. Where is the sense in that? The Government and the health service have to sit up and realise that that cut to health facilities in the Wellingborough and Rushden constituency has to stop. My constituents live in the worst part of the worst-funded primary care trust in the country. That is a fact and even the Secretary of State for Health has admitted it. Recently, he said:

“Every other PCT has moved to within about 3.5 per cent. of their target through this pace of change process…I think Northampton were the only ones that were more than 3.5 per cent.”.

There we have it from the Health Secretary himself. In other words, my area, in the last three years, was underfunded by £101,746,000. The Government admit that Northamptonshire is the worst funded PCT in the country and yet we are not being given the funding and provision that the Government themselves say that we should get.

I want to consider Kettering General Hospital NHS Foundation Trust’s proposals to close Rushden out-patient facilities and move them out of the town. The foundation trust will claim that it engaged in a public consultation exercise to gauge local opinion. What utter rot. The consultation was completely flawed. It was one of those consultations whereby one asks questions that are not relevant and then claims that a consensus has been reached.

First, the consultation was sent out to a limited number of people. Secondly, it did not mention the proposal to move out-patient services out of Rushden. There was no reference to the proposal to move out-patient facilities to Irthlingborough. If the consultation had been genuine, it would have said, in a straightforward manner, that the proposal was to put the out-patient facilities in Irthlingborough. Had it said that, the consultation would have had a completely different result. Indeed, the consultation document intimated that out-patient facilities would stay in the town. The public, the local council and I were not given the facts. The information came to me only through a leak, and I put it into the public domain.

All I have been able to establish is that there is an issue relating to finance. The foundation trust claims that it has a developer who is willing to build the facilities and lease them back to it at a reasonable rate. Who are the developers? When were they appointed? When did the plan go out to competitive tender? Why has the decision been made in such an unorthodox, cloak-and-dagger way? The foundation trust claims that it examined possible sites in Rushden and found them unsuitable. How can the Rushden hospital site, which the NHS owns, with plenty of land on which to build, great transport links, and in the biggest town in east Northamptonshire, not be suitable? Local councils are providing the foundation trust with a list of alternative sites in Rushden. I do not believe that the sites in Rushden have been properly investigated.

Let me read what one of my constituents has written to me about Kettering general hospital’s supposed public consultation:

“We believe the recent public exercise regarding the extension of the Wymington Road hospital site to provide mental health facilities for the area, was just an expensive ploy to divert the public’s attention away from the fact that the ‘Hayway’ clinics, and the Rectory Road practice are in the pipeline to be moved to Irthlingborough. The proposed site there we believe will be difficult to be reached by any means except by private car or taxi; not a viable means for elderly people.”

I agree. I have here a copy of Northamptonshire Healthcare NHS Trust’s consultation document. It is very nice and glossy, with lots of pictures and, in the middle, there is a map. I do not know if you can see it, Mr. Deputy Speaker, but in the middle of the map, it states in bold letters: “Future Health Facilities”. My constituents were outrageously misled.

I run the “Listening to Wellingborough and Rushden” campaign. I believe that, as a Member of Parliament, it is important to listen to the views and concerns of the people whom one represents. There has been the most extraordinary explosion of outrage about the hospital’s proposal. As part of my campaign, I am writing to every person in Rushden to make them aware of the trust’s proposals and to ask for their opinions now that they have the full facts. I will publish the results of that survey at the end of January. I have also organised a public meeting on 23 January so that local residents can come along and voice their concerns.

I am grateful to the Minister for listening to my speech. I appreciate that he does not have direct power, given the new status of the foundation trust hospital. However, I would appreciate any comments he might have on the situation and any answers to the specific questions I have raised. If he cannot answer those questions now, I would be most grateful if he wrote to me.

I congratulate the hon. Member for Wellingborough (Mr. Bone) on securing this debate. As is usual when there is a potential constituency interest for the Minister who is directly responsible, I am replying instead of my hon. Friend the Member for Corby (Phil Hope), as I am sure the hon. Gentleman understands.

I begin by paying tribute to the NHS staff across the hon. Gentleman’s constituency and in the whole of Northamptonshire for their hard work and dedication, which is delivering a better-quality health service than ever, benefiting not only his constituents, but constituents in England as a whole. Before addressing his concerns about Rushden Memorial clinic, I would like briefly to explain the context. During these first 60 years of the NHS, society, technology and medicine have changed beyond all recognition. Today, patients with more and more conditions can be and are treated and cared for closer to their homes, or even in them.

As part of this year’s major long-term review of the NHS, each strategic health authority in England published a vision for further improving health and health care in its region, based on the work of a number of consultation groups in each area. A key finding of those local reviews was that for planned care, more could and should be provided closer to people’s homes. The changes in health care in Northamptonshire are taking place in that context. The other thing that needs to be made clear is that decisions on how local health services are organised are no longer made by Ministers in Whitehall, but by autonomous NHS professionals on the ground.

I am advised that when Kettering general hospital applied to become a foundation trust in 2006, it consulted the population of north Northamptonshire about its application and the services that it proposed to offer. Those proposals included the trust’s plan to deliver more services from local out-patient units. I am advised that 92 per cent. of respondents said that they supported the trust’s plans. When it developed its plans to establish a new out-patient facility in Irthlingborough, the trust contacted the health overview and scrutiny committee of Northamptonshire county council to establish whether a formal consultation period would be required.

As I am sure the hon. Gentleman will know, overview and scrutiny committees are made up of elected councillors from the local authority and can insist that proposals be consulted on, and if they are still unhappy about them, refer them to the independent national reconfiguration panel. I am further advised that the chair and deputy chair of the Northamptonshire overview and scrutiny committee, which has a Conservative majority, advised that the proposals were “not significant enough” to warrant a formal consultation. However, it is always open to the overview and scrutiny committee to revisit the issue if it wishes.

During the public engagement period, the trust set out a number of criteria against which it would select its preferred site. The first was accessibility. The new facility had to be accessible to the people living across East Northamptonshire. The second criterion was affordability. The development had to be affordable within the trust’s finances. The third criterion was future flexibility. The population in the hon. Gentleman’s constituency and in wider Northamptonshire will continue to grow significantly over the next 20 years. Any building will need to be flexible enough to accommodate that growth. The fourth and final criterion was deliverability. The current premises, to which he referred, are Victorian and are not considered suitable for the range of out-patient clinics that the trust wants to provide. Any new facility must therefore be available quickly. In that context, Kettering general hospital looked at the clinics that it currently provides on the main Kettering site and found that many could be safely moved from the main hospital into a brand new local facility in East Northamptonshire.

The population of Northamptonshire is currently around 680,000 people, but that is predicted to rise to 715,000 over the next five years. The current out-patient unit at Rushden Memorial clinic can accommodate only 8,000 clinic appointments each year. The trust estimates that any new facility would need to be able to accommodate approximately 40,000 out-patient attendances, together with a further 70,000 diagnostic tests, which represents an almost tenfold increase in the number of procedures undertaken at the clinic. The majority of those out-patients will come from East Northamptonshire. The proposed on-site provision of diagnostic services, such as X-ray, ultrasound and blood testing, would mean that local people in the hon. Gentleman’s constituency would be able to access a one-stop service. Otherwise, they would need to attend an out-patient clinic and then have to travel to Kettering general hospital for follow-up tests.

The trust considered four options for its proposals. The first was to relocate the out-patient facility to the planned redevelopment in Rushden town centre. I am advised that that would be unlikely to take place until 2011 at the earliest. The second option was to relocate the out-patient facility to the Rushden hospital site. As I have already said, Kettering general hospital’s plans encompass approximately 40,000 out-patient attendances and a further 30,000 diagnostic tests annually. The trust believes that that would require a larger space than the 1.5 acres allocated by the Northamptonshire health care trust for other health provision. It is therefore unlikely that that option would deliver a new facility in the required time frame.

Furthermore, the trust intends its redevelopment to provide a calm therapeutic environment for people with mental health problems and learning disabilities. Kettering general hospital considers that the volume of traffic associated with the level of its planned out-patient activity would not only be difficult for the Rushden hospital site to accommodate, but would compromise the delivery of the trust’s planned mental health services.

I am grateful to the Minister for this helpful response. I hope that he will not misunderstand the situation, however. What he has just said relates to the little piece of yellow that I attempted to show on the map. The Rushden hospital site is enormous—there is plenty of room to build these facilities there—and it has a direct link to the Rushden by-pass, so I am not sure why there would be transport problems involved.

I am grateful to the hon. Gentleman for his advice, and I urge him to take up those detailed concerns with the primary care trust and the acute trust. I know that he has already had discussions with them, and that they would be happy to continue those discussions.

The third option considered was to extend the existing provision at Rushden Memorial clinic. I am advised, however, that the present site could not accommodate the increase in the numbers of patients that the trust plans for the area. Even if extension of the building were possible, it would be very difficult to continue delivering the present range of clinics on site during the building work.

The fourth proposal involves the new site at Irthlingborough, which is 2.7 miles from the present clinic. The proposed new facility there would serve the whole population of East Northamptonshire, not just Rushden. Of course, any development must be easily accessible to everybody who needs to access its services, including those travelling from outside the town. Kettering general hospital and Northamptonshire PCT advise me that Irthlingborough is their preferred option because it would provide a brand new building built to the trust’s requirements. The alternatives would have meant the trust converting an existing building, with poorer results. As the hon. Gentleman said, a third-party developer, who will assume the planning and development risks, is providing the building. The trust will be able to rent the building from the developer, meaning that the trust can afford the scheme. Otherwise, the trust believes that it would need to raise about £4 million to purchase the land and build its own facility. It also says that the new site could be available for the public to use from January or February 2010.

The trust believes that the new facility, being directly off the A6 and supported by regular public transport links, will be accessible to people from across East Northamptonshire. The site also has the potential to be expanded in the future, which would enable the trust to develop additional services for the area, such as a minor injuries unit and a fracture clinic. The trust estimates that these proposals mean the hon. Gentleman’s constituents would save almost 130,000 travel miles a year, through being able to be treated closer to home, rather than having to travel to Kettering or further afield.

The hon. Gentleman made some other, more general points about health care in his constituency. He has often raised the issue of health care funding and facilities in Northamptonshire. I am sure that he will have noticed that the 2009-10 and 2010-11 revenue allocations to primary care trusts were announced by the Government this Monday. I am also sure that he will welcome the fact that over the next two years, funding for Northamptonshire Teaching PCT will increase by 11.9 per cent. to £983.4 million. This is one of the highest funding increases in the country; only 15 PCTs in England will receive a greater percentage increase. I am afraid that I have to tell him, however, that the primary care trust no longer has the accolade of being the furthest from its target. By 2011, Northamptonshire will be only 1.4 per cent. away from its target, and many other PCTs will be a great deal further away from theirs, so that is good news for his local area on the funding front.

The increase in funding has been matched with a growth in facilities in the hon. Gentleman’s constituency. I am sure that he will have been delighted by the opening of the new GP practice in Higham Ferrers last year. He will also know that Kettering general hospital provides for out-patients at Isebrook hospital in Wellingborough. I am sure that he is also aware of the proposals for a new primary care development there—it is due to open in 2010—and the plans for a brand new community hospital.

That last point was interesting news. Can the Minister tell me when the new community hospital is going to open in Wellingborough?

I cannot give the hon. Gentleman an exact date, but the primary care trust and Kettering general hospital are quite clear that it is something that they are interested in looking at. He will have to ask them about the actual time frame.

Northamptonshire PCT also has ambitious plans for four new GP-led health centres in the county, including one in Wellingborough, which are planned to open in the next two to three years—

House adjourned without Question put (Standing Order No. 9(7)).