I beg to move,
That this House has considered Shropshire’s NHS Future Fit process and the future of services at the Princess Royal Hospital, Telford.
It is a great pleasure to serve under your chairmanship, Mr Gray. Like all Members, I come to the House to champion the needs and concerns of my constituents at every opportunity that presents itself. That is what the people of Telford have sent me here to do. Without doubt, the issue that has caused the most concern and anxiety to my constituents over the years is the future of our Princess Royal Hospital. I am delighted that my hon. Friend the Member for The Wrekin (Mark Pritchard) is here, as the hospital is sited in his constituency and his constituents are as affected by the issue as mine.
The reason our hospital has caused our constituents so much concern and anxiety is that for the past four years our local hospital trust has been deliberating how best to deliver emergency care for Shropshire in the future. While we would all agree that that is an important decision that is worth getting right, no one could have imagined that no resolution would have been found four years after the deliberations began.
Despite very public and sometimes acrimonious debates playing out in the media, not a single communication has been sent to my constituents explaining to them what the hospital trust proposes for the future of our hospital. By contrast, my constituents have received a constant barrage of claims directly from our local council. Every time they get a council tax bill or email from the council, the council claims that our A&E and our women and children’s centre—a brand new and much-valued asset in our town—are under threat of closure. Although the hospital trust tells me and others that those claims are entirely untrue and wholly misleading, the trust has not at any time publicly contradicted the council; nor has it told my residents that the information they have received is misleading or untrue. As the deliberations have dragged on without any resolution, my constituents have become increasingly anxious and uncertain about the future, and they are becoming angry.
It is worth putting this into context. Telford is a rapidly growing new town, with an expanding population, set in the heart of rural Shropshire. We have significant pockets of deprivation and health inequalities, and worse health outcomes and lower incomes than our more affluent neighbours in rural Shropshire. We also have lower car ownership, so residents are much less able to travel long distances to access care. The council has told us that our A&E and women and children’s unit are definitely being considered for closure. We are told that those services will be taken from an area of greatest need and moved to the more affluent neighbouring county town of Shrewsbury—is it pronounced “Shrowsbury” or “Shroosbury”?
My hon. Friend says “Shrowsbury; I say “Shroosbury” and so do all my constituents. That highlights one of our great differences.
The hospital trust has reassured me that it is not the case that services are being moved, but it is my constituents who need reassurance. I make the simple plea that the Minister put on the record that, whatever delivery model the hospital bosses decide for the future of emergency care in Shropshire, our Princess Royal Hospital will continue to have A&E care delivered by emergency consultants, and that our brand new women and children’s unit will continue to deliver services to women and children.
I congratulate my hon. Friend on securing the debate. The women and children’s unit, which opened two years ago and cost the taxpayer £28 million, is very welcome in Telford and central and east Shropshire. Does she agree that the same arguments that prevented the women and children’s unit from relocating to Shrewsbury two years ago are even stronger today because of the expansion of Telford and environs? The demographics of the county also show that the majority of its children are in the youngest part—Telford and its localities.
My hon. Friend is absolutely right: the women and children’s unit is a vital resource in an expanding population with many young women and children. That is because Telford is a new town; many people come to build a new life and build their family. That resource is vital to us, and the concept of moving it elsewhere so soon after it has been brought to Telford is farcical. I am assured that that is not happening, but we need clarity. At the end of the day, if people keep telling us something, ultimately we are going to believe it is true.
I congratulate my hon. Friend on securing this important debate. She will know that both our hospitals—Shrewsbury and Telford—are in the same hospital trust. I pay tribute to the way that she has campaigned on this issue. Does she agree that the Labour-controlled Telford and Wrekin Council is behaving highly irresponsibly in whipping up these fearful campaigns and trying to frighten constituents about the long-term consequences of Future Fit? Will she go further in encouraging it to act more responsibly and in telling the Minister that the council ought to be spoken to about not whipping up such levels of concern?
My hon. Friend is absolutely right: we have seen some shameless politicking around this issue. The local council has weaponised our hospital year after year, which is not helping the process of reaching a decision. I will talk about that in more detail later, because it is a vital point. The council should be working constructively with my hon. Friend the Member for The Wrekin and me to try to get the best possible hospital emergency care for all our constituents, but that is not happening now. That is why it is important to highlight this issue and bring it to the Minister’s attention.
There is no avoiding the fact that the body charged with deciding what our future emergency services will look like has been inept in its communications. Despite the growing uncertainty, anxiety and ultimately anger of my constituents, not once has that body been willing to communicate with them. Although a consultation is planned at some point, year after year goes by and that has not happened. Each year, my hon. Friend the Member for The Wrekin and I come to this House to beg the Secretary of State for Health to intervene, and each time nothing happens. We have moved no further forward.
For many years people throughout the country were fed up with Whitehall and Westminster and successive Secretaries of State for Health interfering in local health decisions. The Government recognised that, and as part of the devolution agenda said that local health decisions should be made by local doctors, clinicians and medical practitioners. Does my hon. Friend accept that that is right? Does she also therefore accept that those decisions are being made locally, and without interference from Whitehall, which is part of the misinformation, disinformation and fake news campaign of the Labour-led Telford and Wrekin Council?
My hon. Friend is absolutely right: this is a process led by local clinicians who were supposed to come up with a local decision that suited local people. However, that has not happened, and I see no light at the end of the tunnel. The process is in stasis; there is utter paralysis in the decision-making process, and all the while our Labour council is making hay with the total vacuum of information. We cannot go on saying, “It is nothing to do with Government. It is supposed to be a local issue,” because that has not worked. I will come on to the difficulties that that is now creating in recruitment and retention of vital consultants, who make the whole service operate for everybody.
It is not right that the local decision makers are failing to contradict our local council. It is not right that they are not standing up to some of the bullying rants that we hear day in, day out on our airwaves and read in our local newspaper, in which the local council tries to convince the electorate that the A&E and children’s services will close. The mixture of fear and the weight of NHS bureaucracy keeps the local decision makers like rabbits in the headlights. Nothing is happening.
In fairness to those tasked with delivering this decision-making process, they will not have reckoned on the weaponising of our local hospital for political purposes and have not factored that into the work they are doing. We have seen the local council threatening the NHS with judicial review. We have seen the local council sending out letters with every council tax demand claiming that our hospital is at risk. It has been organising street protests, whipping up anger, misleading people and misrepresenting the proposals, and turning public meetings into events where our local clinicians, who are doing the best possible job for our patients in Telford, say they have felt intimidated and unable to do their job.
The propaganda machine in Telford is well oiled. At every coffee morning that I host, and at every school I visit, someone will ask me, “Why are you closing our hospital? Why do you want to move services away from your home town to Shrewsbury?” That technique has totally failed to win elections in Telford, but it none the less has successfully created huge anxiety and prevented the evolution of our emergency care for the future. Playing politics with our hospital has been the trademark of Telford’s council leadership, with complete disregard for the consequences for our area and our future healthcare. Instead of working constructively for the best healthcare for our people, they have simply engaged in a never-ending war of words, whipping up anger and even trying to bring down the local health trust officers.
Instead of a brand new facility that we could all be benefiting from and new investment, now we have dwindling services that do not meet the needs of local people, despite the best efforts of staff. That paralysis has put our services at risk. It has led to difficulties in attracting and retaining staff, so much so that there is now a genuine risk that insufficient staff may lead to night-time closures of our A&E—and if that does happen, I hold the Labour leadership of our council totally to blame.
My constituents have lost out in these political games. We have hours of council officers’ time being spent, constant activity of the council PR department and expensive lawyers threatening the NHS with legal action. We do not even know how much of our council tax has been spent on this, although we do know that £100,000 has been set aside for campaigning activities, which really should not be the role of a local council. The time has now come when it is not enough to stand by and for Ministers to say that this has nothing to do with Government. I accept fully that it did have nothing to do with Government, but it is evident that because local politicians have hijacked the process, it is now wholly out of control. It is also evident that the local NHS has spent millions on a decision-making process that has failed to reach a decision.
My hon. Friend the Member for The Wrekin and I have pleaded with Ministers time and again, year after year, but we are still no further forward. Nothing has changed, and our constituents are none the wiser about the future of their hospital. I invite the Minister to try to give some clarity to my constituents. They deserve to know what is proposed on this most important of issues. If the council is misleading them and providing them with misinformation, they deserve to know that too. This issue matters to my constituents. I am here to represent their needs and concerns, and that is what I am doing today. It is not good enough for Government to wash their hands of something that matters so much to my constituents and the future of our town.
I invite the Minister to work with me, with my hon. Friend the Member for The Wrekin, with the Minister of State, Department of Health, my hon. Friend the Member for Ludlow (Mr Dunne), who is responsible for hospitals, and with the Secretary of State for Health to try to find a practical way to end the complete paralysis that has ruined the prospect of great emergency services in Telford. There is money to invest in better emergency care but we are not even able to access that money in funding rounds because we cannot reach a decision. I look forward to the Minister’s comments.
It is a pleasure to serve under your chairmanship this morning, Mr Gray. It is also a great pleasure to respond to my hon. Friend the Member for Telford (Lucy Allan). She articulated the case on behalf of her constituents with considerable passion, and I will do my best to address some of the points she made.
My hon. Friend talked about the activities of the council with regard to this ongoing issue. I have to say, as the Conservative MP for Thurrock, which has a Labour council, that it all sounded very familiar. I am afraid that perpetrating fake news is in the DNA, and Labour does not like to have lost successive elections. I am sorry that she has had to tolerate that, but I am even more sorry that her constituents have had to.
When we discuss the future of our local health services, we want to take the community with us. Naturally our constituents get worried about change; they are always worried about the possible diminution of services. The only way we take the community with us is by having real dialogue, based on real proposals and real facts. The fact of the matter is that all the council is doing is engaging in speculation, and I personally find that deeply irresponsible. It is not the job of anybody involved in local leadership to foment fear, and I really do regret those actions. Sadly, I am afraid we cannot expect any better. I am really pleased that my hon. Friend has taken advantage of the opportunity today to make the case for her constituents and to highlight those issues. The way we will take people with us on any change in the health service is by mature discussion and reflection and by advocating on our constituents’ behalf.
I would like to reiterate the point that my hon. Friend the Member for The Wrekin (Mark Pritchard) made. We all voted for the Bill to ensure that local communities were empowered to make these decisions. It is right and proper that local people at the coalface of providing these services are empowered to make the decisions to improve them and make them future-proof. However, in our case, it really has broken down. The most important thing the Minister can do is to work with her officials to ensure that changes are made when we cannot get an agreement in a locality, because, as my hon. Friend the Member for Telford (Lucy Allan) said, this has continued for four years, causing a great deal of concern and instability for the hospital trust.
I thank my hon. Friend for that intervention and will make two points in response. He is absolutely right; the whole purpose of how we structure the NHS now is that communities are empowered to make decisions. That is why it is all the more irresponsible for the council to be engaged in this speculation. The reality is that no decision will be taken on the future of services until the consultation has taken place and all those responses have been analysed. The community will have its say before any change, and anyone who suggests otherwise and is engaged in speculation really should not. Could my hon. Friend remind me of the second point he made?
The point I wanted to make was that certain communities in the United Kingdom have come together, across parties and across the whole of the county. Northumberland, where this process has worked very well, is a case in point. Unfortunately, in areas such as ours, where a council is acting deliberately provocatively and from a political perspective, that has not come to fruition. I want the Minister to ensure that her Department takes that on board when planning for future ways to improve this process.
It is a matter for reflection that this has been going on for four years, which generates considerable uncertainty. Clearly we should reflect on that, to ensure that the process becomes more efficient. Equally, it takes time to have those debates. I know that the particular issues under consideration here are quite difficult to grapple with. The important thing is that the local NHS is seen to be leading the debate and not allowing anyone else to fill that vacuum when there are decisions to be taken.
My hon. Friend the Member for Telford invited me to make some comments. Obviously there are limits, but perhaps I could set out the process, so that we can put in context exactly where we are now. As I mentioned, all service changes will be based on the fact that they deliver real outcomes for patients and will be taken forward in consultation with the local community. Ultimately, the most important factor is that this is what is best for the health service in the area, driven by clinical leadership. Again, it really should be the local NHS leading this debate, and not local authorities filling the vacuum.
The issues that my hon. Friend raised affect not only her and my hon. Friends the Members for The Wrekin (Mark Pritchard) and for Shrewsbury and Atcham (Daniel Kawczynski), but also service users in Wales. As she alluded to, it has now been four years, so everyone knows that change is in the air. Until the vacuum is filled, there will continue to be uncertainty. I expect the CCG to bring forward a consultation, to have an open discussion as soon as it can. I urge everyone to participate fully in the consultation and I encourage my hon. Friend the Member for Telford to lead that debate. Where there are issues that she is concerned about, she should challenge the local NHS leadership, and where there are things that she welcomes, she should highlight them.
The proposed service changes should meet four key tests: they should have support from GP commissioners, be based on clinical evidence, demonstrate public and patient engagement, and consider patient choice. Until those four criteria can be met, no decision can be taken.
On the clinical evidence points, there was a so-called independent review, which the two clinical commissioning groups—Shropshire and Telford and Wrekin—and the NHS hospital trust commissioned. KPMG undertook that review. How independent it was and how knowledgeable KPMG, headquartered here in London, is of Shropshire’s health system is questionable, but I will just ask the Minister this. On clinical evidence, does she agree with me that if the demographics show that the younger part of Shropshire county is in Telford, it would not make sense to relocate the new—two-year-old—£30 million women and children’s unit from Telford to Shrewsbury, where there is an older, or elder, population?
Of course everybody wants to be able to access health services as close as possible to where they live, and my hon. Friend’s points about demographics are sensible. However, it is also important that we build critical centres of excellence. Where everything is together in one place, people can get better care. Wherever these services are ultimately located, there is a strong case for the children’s unit to be by strong A&E services, but obviously that needs to be tackled as part of the debate. My hon. Friend questions whether the KPMG study was objective. These are really serious questions that he should put to the local NHS leadership when we get into open consultation. I know he is looking for comfort from me, but I am not best placed to make the decision sitting in Whitehall.
I am grateful to the Minister for giving way again; she is being very generous. Does she agree, though, in terms of transparency and openness and the fact that the public purse will have paid for the KPMG report, and given the seriousness of the issues, that that report should be published in full, in its entirety, for the public to see, in particular the Shropshire Star, which has done an excellent job in holding the local authority’s feet to the fire, to use one councillor’s term, on some of its most outrageous claims about this process?
It surprises me that the report is not in the public domain, according to what my hon. Friend has just said, if it is informing the approach that is being taken. I tend to take the view that sunlight is the best disinfectant, and if things are not done in an open and transparent way, the conditions are created for exactly the kind of speculation and scaremongering that we have been talking about. Having said that, I reiterate that the consultation has not yet started. It is very important that when the consultation does start, the CCG makes extremely clear the basis on which it is going forward with the proposals that it chooses.
I do not need to advise my hon. Friends of exactly what we are talking about. Clearly, they know more about their local healthcare situation than I do, and it is clear that local NHS leaders have to address significant challenges in bringing forward the entirety of their proposals as they affect the Royal Shrewsbury Hospital and the Princess Royal Hospital in Telford. I understand that they are 18 miles apart. In some areas of the country, that might not seem far at all, but when we are dealing with communities that have very separate identities, they could be oceans apart. That is another reason why we need to be very clear in our dialogue with those communities about why we are bringing forward the conclusions that we are.
Clearly, at a time when there is no money, things that it would be nice to have are not possible. It would be nice to duplicate services in both locations, but frankly that is not a luxury open to us at this stage in the economy, so where there is duplication of services, where we could bring them together and make a better service as a result, we should explore that. It is up to the local clinical leadership—there is a clear task and challenge for them—to demonstrate that whatever they bring forward will deliver better outcomes for patients. When it comes to winning over public hearts and minds, the public will not get away from the fact that services are being moved away from them. Automatically, there is a diminution of service in their mind, but bringing services together can often make a better service. We can see, with patient outcomes in particular circumstances, where that has been achieved. I therefore encourage the CCG to bring forward as much evidence as possible in making its case.
Of course, we all understand that whenever the consultation takes place, after four years of quite feverish speculation on some parts, people will be nervous. I encourage all my hon. Friends to continue this debate in public and with Ministers, so that we can reassure the public that we have their best interests and those of patients at heart with whatever decision is taken. As I have said, the more transparent and open the debate is, the better. Perhaps between them, my hon. Friends can lead the CCG to have those public discussions, away from the council, away from organised intimidation at public meetings, which will not lead to the best outcomes for patients at all. I have witnessed this myself. The left is very good at organising mobs at public meetings, but the last thing we want is for local clinical leaders to bring forward proposals in the best interests of serving the community and then be intimidated, by those who shout loudest, into changing their views because they are faced by a herd.
This is a very important point for the Minister to perhaps share with the Department for Communities and Local Government and other Ministers. Of course councils have the right to challenge processes. Even though Telford Council’s leader and all his team are completely bereft of any medical credentials, they have the right to challenge, but we need to consider whether they have the right to use taxpayers’ money for political campaigns. I think that the Minister will be interested to see some of the literature that Telford Council has sent out and perhaps share it with her colleagues at the DCLG, to see whether we can do anything more to tighten up the rules on how councils spend their council money.
My hon. Friend makes an excellent point. Local authorities are all a function of who leads them, and some leaders are prepared to go further than others when it comes to engaging in debate. I also observe that there is currently an inquiry by the Committee on Standards in Public Life into abuse. Perhaps it could look beyond the abuse of parliamentary candidates and consider the kind of intimidation of clinical leaders at public meetings that my hon. Friend the Member for Telford has referred to, because this is all part of the space of public debate, and it is not helping our democracy that debates are taking place in unhelpfully fevered situations. We recognise of course that emotions will run high and that people will be passionate about the issue. We live in a mature democracy; we should be able to have our debates and discussions based on mutual respect and fact, but I am afraid, from things that my hon. Friend has described, that that has perhaps been missing.
In the short time I have left, I will just say that I hope the CCG brings forward its proposals as soon as possible, because the sooner the debate gets out in the public domain, the more informed it will be.
Question put and agreed to.