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Princess Alexandra Hospital, Harlow

Volume 642: debated on Tuesday 5 June 2018

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

It is a pleasure to see you in the Chair, Madam Deputy Speaker. I thank you for your support for a new hospital in Harlow, as my constituency neighbour.

I want to update the House on the desperate need for a new hospital in Harlow that is fit for the 21st century. The hospital would bring together A&E services, GP provision, social care, physiotherapy and a new ambulance hub in state-of-the-art, purpose-built facilities. Success in securing the capital funding, for which there is already a bid in place, could make this a reality for Princess Alexandra staff and patients in Harlow and across the region.

When I debated Harlow’s hospital last October in Westminster Hall, it was in special measures. In March, following the Care Quality Commission inspection, we heard the amazing news that the Princess Alexandra had left special measures. In fact, two thirds of services were on their way to a good or an outstanding rating. I said it then and I will say it again: this is a testament to the extraordinary hard work of all Princess Alexandra Hospital staff, including the cleaners, porters, nurses, doctors, kitchen staff, support staff and, of course, the leadership and management. I would like to give a particular mention to Nancy Fontaine, head of nursing and one of the most remarkable NHS workers I have ever met. Nancy will soon be leaving the Princess Alexandra to help another hospital, but I take this opportunity to thank her for her work. It is people like her who make the NHS what it is.

The Health Secretary congratulated PAH staff in a video—a sentiment seconded by the Prime Minister. In his message, the Health Secretary not only noted the impressive CQC report and the outstanding work in the neonatal department, but made it clear that it is the staff who make a hospital and that good care is the result of their instinct to do the right thing for patients. The Health Secretary and the former Hospitals Minister, my hon. Friend the Member for Ludlow (Mr Dunne), have both visited the Princess Alexandra a number of times, speaking to the staff and the leadership there. I know that the Health Secretary and the current Hospitals Minister—to whom I am hugely grateful for engaging with me regularly on this issue—are aware of the capital funding bid in place.

The leadership team, headed by chief executive Lance McCarthy, have been developing their case for capital funding since the Health Secretary made the request in autumn 2016. The team are due to resubmit the final plans next month. I understand that the trust is one of seven schemes requiring more than £100 million of capital and that funding for some schemes will be announced in the autumn. I ask the Minister, when will we learn of the progress of these capital funding bids?

Does my right hon. Friend agree that Princess Alexandra Hospital has a great future if it is allowed to have that future?

I thank my hon. Friend for being a huge supporter, along with other colleagues here today—my hon. Friends the Members for Hertford and Stortford (Mr Prisk) and for Saffron Walden (Mrs Badenoch). They understand that this is not just an issue for Harlow, because a new hospital will benefit the entire—

Motion lapsed (Standing Order No. 9(3)).

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

My hon. Friends understand that this is not just an issue for Harlow but for the surrounding areas of Essex and Hertfordshire. My hon. Friend the Member for Broxbourne (Mr Walker) is exactly right—for our hospital to have a future, we need a new hospital.

I commend my right hon. Friend for his championing of this important cause. He is right to point out that while this facility is important for the people of Harlow, it is just as important for the people of Bishop’s Stortford, Hertford, Ware and other towns represented here today. It matters to the whole region. I hope that he will emphasise that point and that the Minister will take it on board in his remarks.

I am very proud that my hon. Friend and I share a constituency office and work together on an enormous range of issues. His support and backing is recognised by his constituents because they understand, as he does, that a new hospital in Harlow will benefit not just Harlow but all the surrounding areas and residents.

The hospital’s infrastructure is deteriorating. As my hon. Friend the Minister stated in response to my question on 8 May 2018, the Government

“recognise that the Princess Alexandra Hospital…is in a poor condition.—[Official Report, 8 May 2018; Vol. 640, c. 537.]

While the hospital leadership has been proactive in seeking out funding—last year, the trust secured £2 million to redesign the emergency department—long-term under- investment means that the estate is extremely fragile. A survey in 2013 said that 56% of the hospital’s estate was rated as “unacceptable or below” for its quality and physical condition.

Not only is the hospital falling apart, but the layout is unco-ordinated and problematic. To use a horrible euphemism, there are “sub-optimal clinical adjacencies”, in the words of the previous Minister. Urgent care is spread across the site due to the sporadic development of temporary structures, making it very difficult for patients seeking care to find their way around and for the hospital staff caring for them.

Does my right hon. Friend agree that short-term investment is only a bandage and a fresh overhaul is needed due to the permanently declining facilities? Does he also agree that given how many of my constituents use the Princess Alexandra, the three new garden communities that are being planned mean that we need a huge influx of investment for infrastructure in our area?

I am hugely grateful for the support of my new neighbour, who is a brilliant representative of her area. She is exactly right. We cannot just carry on with Elastoplast solutions, however welcome, because that cannot sustain the hospital in the long term. She also makes the crucial point that we are going to have thousands more houses in Harlow and the surrounding areas, and we need a hospital that is fit for purpose—fit for the 21st century. I think that the Minister will hear the views of my neighbours and realise that this is not just a Harlow issue but something that is very important to Essex and Hertfordshire.

Obviously, I am not one of the right hon. Gentleman’s neighbours, but I am always here to support him on the issues that he brings forward. One of the things that comes to my attention back home, but I am sure that he will have the same issue, is that healthcare needs to be accessible to all people. We can jump in a car and go to the hospital, but other people may have to depend on a bus or a train, or on someone giving them a lift. Does he agree that local trusts need to have accessibility as a precursor to providing care? If someone has accessibility, they can get there; if they do not, it does not matter where the hospital is.

The hon. Gentleman says we are not neighbours, but we are kind of neighbours in the make-up of the current Parliament. He is absolutely right, and he makes the wider point about the support needed for the NHS.

The hospital also experiences issues in recruiting and retaining staff. Harlow’s hospital now has 27 more doctors and 35 more nurses than in 2010, and the leadership has made great efforts to improve staff retention and staff stability at the PAH. It is now among the best in the sustainability and transformation partnership. However, the trust still runs an 11% vacancy rate, with a key deficit in nursing recruitment and retention. The vacancy rate and recruitment are a perpetual worry, and the reasons for that appear to be twofold. The first is proximity to London, which makes pay weighting a serious factor. The second is perhaps more significant. The hospital leadership has told me that opportunities for career development, or the lack thereof, are off-putting for potential recruits. The hospital must compete with Barts and UCL in specialist training and career development. Last year, the retention support programme established career clinics and clear career pathways, but there is only so much the hospital can do to compete with the huge investment and top-class facilities at London hospitals.

There is unbearable and increasing pressure on A&E services at the Princess Alexandra due to the downgrading of other local healthcare facilities, including Chase Farm Hospital and the Queen Elizabeth II. The population of Harlow and the surrounding area is growing, and the additional influx of patients has led to occupancy levels at the hospital consistently running higher than 98%. The A&E department sees 200 to 300 patients per day—that is 10% higher than the national average. This is a small hospital in a medium-sized town. The Care Quality Commission agreed in its most recent report that that makes it difficult for staff to tend to patients in a timely manner.

While the hospital is working incredibly hard to make improvements and has successfully upped the four-hour emergency care standard record, the chief executive and management have told me that the estate and infrastructure are simply undermining the staff’s ability to carry out their roles well and negatively impacting on the hospital’s overall performance. It is clear from the occupancy level statistics that the Princess Alexandra is fundamental to the health and wellbeing of the population of Harlow and the wider area, including parts of Hertfordshire and Essex, as my colleagues and I have stated today.

In the light of that, I wrote to the Secretary of State for Health last week along with seven colleagues representing neighbouring constituencies: my hon. Friends the Members for Broxbourne, for Hertford and Stortford, for Saffron Walden, for Brentwood and Ongar (Alex Burghart) and for Braintree (James Cleverly), and my right hon. Friends the Members for Epping Forest (Mrs Laing) and for Witham (Priti Patel). We wanted to make it clear that the development of a new hospital health campus is fundamental to the vitality of the community and the economy of the entire region. We asked the Health Secretary for his support for the hospital’s capital funding bid, and I hope to receive his positive response soon.

It is clear that there are a number of complex and interlinked issues at the Princess Alexandra. Those problems make it very difficult for the hard-working staff to provide sufficient healthcare to Harlow residents and those living in my colleagues’ constituencies. The development of a new purpose-built hospital health campus would answer each and every one of those problems. First, it would allow high-quality and state-of-the-art facilities to be developed in a carefully planned manner. The staff would no longer be working in temporary structures, and patients and visitors would be able to find their way around the site easily.

Secondly, the investment in new facilities would draw nurses, healthcare assistants and auxiliary staff to the hospital and provide a welcoming working environment in which they could see out a long career in the NHS. Thirdly, the new hospital health campus would redevelop the emergency care services at the PAH. That would create a working environment in which staff truly had the capacity to meet the needs of the many patients seeking help, without the fear of a bed not being available.

While regeneration of the current site has been considered, it is widely accepted that building a new hospital health campus on a different greenfield site would be most affordable and provide the greatest benefit to the patients served by the PAH. The hospital’s current location in the town centre may partly explain the very high A&E use, and it makes further expansion of the hospital incredibly difficult. A new greenfield site on the outskirts of the town would mitigate these problems and allow the town-centre land to be redeveloped into much-needed housing for Harlow’s growing population. Additionally, developing a new hospital on the current disjointed site would require the existing set-up to be demolished before starting work on the new health campus. This would lead to huge disruption for patients seeking help and for staff who would need to carry on working for a number of years.

As I have previously mentioned, the hospital is vital for the economy of the entire region. Developing a new hospital health campus could act as a centre for degree apprenticeships. I know that the Minister, like me, is passionate about improving skills and apprenticeships in the health service. The hospital health campus could build on the existing hospital’s strong links with Harlow College and the new Anglia Ruskin MedTech innovation centre. It would bring specialist training to the eastern region, and it would send the message that Harlow is a place to start and develop an amazing and long-term career in the national health service. The hospital health campus would allow so many hundreds of my constituents, and those of my hon. Friends, to climb the ladder of opportunity. The degree apprenticeships and training opportunities would help people across the east of England to get the education, skills and training they deserve and to achieve the jobs, security and prosperity that they and our country need.

Finally, I want to explain that this debate is only part of an ongoing and wide-reaching campaign for a new hospital health campus in Harlow. As I have mentioned, I had a debate on this subject last year, and I have tabled 10 early-day motions, asked 40 written questions and kept in regular contact with Health Ministers. As I have said, I am hugely grateful to my hon. Friend the Minister for his regular dialogue with me. In fact, may I ask him now whether he will definitely meet me and the hospital’s chief executive, Lance McCarthy, to discuss the hospital health campus proposals further, and will he actually join us at the hospital in Harlow so that he can see the current site at first hand?

I am here today because of the desperate need for a new hospital campus in Harlow. This is probably the most pressing issue that our town will face for a generation. The new hospital proposal is backed by ten local councils—including Harlow Council, Epping Forest District Council, Essex County Council and the Greater London Authority—and by the West Essex clinical commissioning group and the Hertfordshire and West Essex sustainability and transformation partnership, which brings together 13 local bodies and hospital trusts. It is also backed by the seven neighbouring MPs I have mentioned, some of whom are in the Chamber.

The people I represent, and those represented by my colleagues and constituency neighbours, deserve better. Patients deserve to be treated in a safe environment, without the threat of their operation being cancelled due to sewage—I repeat, sewage—flowing through the operating theatres. Visitors should be able to find their poorly relatives easily, without snaking their way through a muddled and confusing hospital estate, wasting valuable time that they could have spent with their loved ones. The hard-working staff should have top-class and purpose-built facilities so they can tap into their instincts and provide the very best care they can. They should be able to progress their careers at the hospital and to build a community around their working lives—building an even better Harlow and protecting our NHS as they do so. Training opportunities should be provided so that our young people or those who wish to retrain can gain skills and climb the ladder of opportunity, flexibly and close to home. I am here this evening to show the Government that the Princess Alexandra bid for capital funding is not just about the materials from which the hospital is built; it is more important than that. It is time that healthcare in Harlow was brought into the 21st century.

I pay tribute to my right hon. Friend the Member for Harlow (Robert Halfon). He raises the important issue of the future of the Princess Alexandra Hospital in Harlow, and is quite right to draw the attention of the House to it once again. As he said, he has raised this in a previous Adjournment debate, through multiple questions and in meetings with Ministers, including me, and he has secured visits from my right hon. Friend the Secretary of State and from my predecessor, my hon. Friend the Member for Ludlow (Mr Dunne).

The strength of my right hon. Friend’s campaign is further reinforced by the number of colleagues here this evening. Dare I say, Madam Deputy Speaker, that I am sure the constituents of Epping Forest take a great interest in Harlow’s future hospital; this issue concerns you as well as my hon. Friends the Members for Saffron Walden (Mrs Badenoch), for Broxbourne (Mr Walker) and for Hertford and Stortford (Mr Prisk), who are all here signalling their support for this important capital programme.

I join my right hon. Friend in paying tribute to Nancy Fontaine, the chief nurse and deputy chief executive. She has played an important, transformative role at the Princess Alexandra over the past few years and may now, I understand, be moving to a new post. She has played a key role in taking the Princess Alexandra out of special measures—a distinction achieved in March this year. The trust improved its overall CQC rating, having been rated good in the effective and caring domains. That is a tribute to Nancy Fontaine, the senior leadership team and the entire staff of the hospital, who have worked so hard.

I also recognise that, as my right hon. Friend said, Princess Alexandra Hospital does face problems with the condition of its estate and buildings; he and I have discussed the issue during oral questions, and the Secretary of State has also recognised the point. NHS Improvement has advised that the condition of the hospital is not currently fit for purpose. It is right that plans are made to improve the estate and that those plans should be locally driven.

As my right hon. Friend will be aware, the Government fully support the upgrading of the NHS estate to bring the NHS further into the 21st century. That is why we have committed £3.5 billion of additional capital funding in the 2017 autumn Budget to support the most ambitious programme of investment in buildings and technology that the NHS has seen to date.

My right hon. Friend referred to the application from the Princess Alexandra, and he will be well aware that the strategic outline case was put forward in July 2017 with the support of the local authority, outlining the various options that had been considered. The strategic outline case concluded that the best option was to build a new hospital, potentially as part of a broader health campus on a new site. The trust secured local support from the clinical commissioning groups and the sustainability and transformation partners for that strategic outline case, which has been through the necessary local healthcare governance procedures. I am pleased that plans for the new hospital and health campus are supported so strongly by local NHS stakeholders.

The trust submitted a bid in autumn 2017 for STP capital for its integrated healthcare campus scheme, which was intended to replace the existing Princess Alexandra Hospital estate. The trust’s capital bid at that time asked for between £500 million and £600 million. That was not considered sustainable; the bidding process feedback asked the trust to revise its capital plans to a more realistic level.

It is also worth reminding the House, and this is partly a tribute to the success of my right hon. Friend’s campaigning for Harlow, that that sits alongside the many millions of pounds secured for the public health campus, which is due to open in phases from 2021. He is correct to identify the opportunities that both schemes bring for a wider NHS career as part of the investment the Government are making—not just in Harlow but in the healthcare of the region, reflected by the support of colleagues in the House.

Alongside those two schemes, the same STP, Hertfordshire and West Essex, also put in a bid for more than £600 million of capital funding in the same bidding round of autumn 2017 for the redevelopment of the West Hertfordshire Hospitals NHS Trust Watford site. That is a signal of the amount of capital the Government are putting in and the need for the local plans to reflect the competing bids around the country as part of that appraisal. There have been other capital schemes, such as the £2 million to which my right hon. Friend referred, given to improve emergency capacity for the winter.

I look forward to hearing about the trust’s updated plans for how it intends to transform the way care is provided to patients through integration with community and primary care, rather than just re-provide capital assets. Schemes are required to demonstrate affordable revenue assumptions and value for money, and to fully consider disposing of surplus assets to part-fund their developments.

My right hon. Friend asked about timing. Given the challenges that the trust faces, I appreciate that it is a key issue for his constituents. An announcement will be made in the autumn on the next round of STP capital allocations, and I will continue our regular dialogue with him as that progresses. Bids are due by mid-July; I know the trust is fully aware of that timescale and I expect it is working closely to it.

I want to pick up on a comment my right hon. Friend made about the workforce. While capital is key to the redevelopment of the Harlow estate, it has to sit alongside wider workforce planning. The long-term nature of workforce planning has sometimes meant that there has perhaps been insufficient focus on this area. That is why the Government are bringing forward, through Health Education England, a workforce strategy this summer to look specifically at how we better plan for our workforce. I know that, particularly through his chairmanship of the Education Committee, my right hon. Friend champions a cause that is close to both our hearts: apprenticeships and how we better use them within the workforce. I am keen that he continues to work with the trust to expand the number of apprenticeships on offer. Based on quarter 1 to quarter 3 data, it has so far offered 10 apprenticeships, against a public sector target for the trust of 72, with a half a million pound apprenticeship levy to be allocated. There is therefore scope for the trust to continue its efforts on apprenticeships as part of that wider agenda. I know my right hon. Friend will continue to champion that agenda.

In conclusion, what is recognisable from the presence of my hon. Friends the Members for Saffron Walden, for Broxbourne and for Hertford and Stortford, as well as the constituency interests of other Members in the Chamber, is that this scheme is not just about Harlow but about the wider health care needs of the region. It is one that the Secretary of State has taken a close personal interest in, visiting on more than one occasion. It is one that my right hon. Friend has assiduously raised in the House and has done so, rightly, again today. I reaffirm, as I said to him when we last debated this matter on 8 May, that we recognise that the Princess Alexandra hospital estate is in a poor condition. That is why the bid that I expect in mid-July is timely. I look forward to the bid addressing the transformation challenge. It is part of the Government’s wider £3.5 billion commitment to the NHS estates until 2022-23. I know my right hon. Friend will support his local STP in the transformation the system needs. I look forward to continuing to work with him as part of the plans to ensure the NHS is fit for the future in Harlow and in the surrounding region.

Question put and agreed to.

House adjourned.