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NHS Funding: Essex

Volume 654: debated on Wednesday 13 February 2019

[Sir Christopher Chope in the Chair]

I beg to move,

That this House has considered NHS funding in Essex.

It is a pleasure to serve under your chairmanship, Sir Christopher. I have raised the pressing need for a new hospital in Harlow on more than 20 separate occasions in the House of Commons, and this is my fourth debate on this subject. I thank my fellow Essex and Hertfordshire MPs, many of whom have kindly joined me this afternoon, for their support in the House and in our sustained campaigning efforts to secure capital funding for an all-encompassing health campus.

In May last year, I wrote to the former Health Secretary, my right hon. Friend the Member for South West Surrey (Mr Hunt), to urge the Government to support the capital funding bid at the time for a new hospital. In that respect, I am particularly grateful to my hon. Friend the Member for Broxbourne (Mr Walker); my hon. Friend the Member for Hertford and Stortford (Mr Prisk), who is a stalwart supporter and works closely with me in campaigning for our new hospital; my hon. Friends the Members for Saffron Walden (Mrs Badenoch), for Braintree (James Cleverly), for Brentwood and Ongar (Alex Burghart) and for Chelmsford (Vicky Ford); the Deputy Speaker, the right hon. Member for Epping Forest (Dame Eleanor Laing), who is another neighbour who works with me to ensure we have a first-rate hospital for the 21st century; and my right hon. Friend the Member for Witham (Priti Patel). They all joined me in signing the letter, and they pledged their support for a new hospital to serve our constituents.

I hope the Minister will take away my right hon. Friend’s point that healthcare in Harlow is important, certainly to the people of Harlow and Essex, but also to people in Hertfordshire. People in Bishop’s Stortford, Sawbridgeworth, Hertford and Ware are all looking for this investment, and we hope the Minister will listen carefully.

My hon. Friend has been an incredible supporter; his constituents will know the work he has done to lobby the Government for our new health campus. He makes an incredibly important point: this is about not just a Harlow hospital, but a hospital for the surrounding area that will serve the people of Hertfordshire and Essex, and I am pleased that my hon. Friend the Member for Rochford and Southend East (James Duddridge) is also here.

May I take the opportunity to add my support and that of colleagues in south Essex for the excellent campaign work on the additional provision in Harlow? I wonder whether my right hon. Friend will touch more broadly on the sustainability and transformation plans, particularly in south Essex. If we encourage the Secretary of State to press ahead with those plans, although there are some reservations, that will release capital expenditure in the south and further release pressure. That will not alleviate the problem completely, but it will help the issue across the county.

My hon. Friend makes the funding case for south Essex. As he says, the whole of Essex needs support, and I know he is supportive of a new hospital in Harlow.

The MPs in the surrounding area who wrote to the former Health Secretary said:

“The creation of a health campus…is fundamental to vitality of community and also to the economy of the entire region.”

To provide some context, the Princess Alexandra Hospital in Harlow was built more than 50 years ago, having been completed in 1966. There is a lot to be celebrated about our hospital, but special mention must be made of the maternity unit, which was deemed outstanding in the Care Quality Commission report. It has been selected to feature for a second series of “Delivering Babies”, featuring “The Voice UK” host Emma Willis.

My right hon. Friend makes a very good point about the maternity ward at the Princess Alexandra Hospital, where my 26-year-old daughters were born. Although we are concentrating on Harlow, I want to make the point that £15 million of investment has been made in Clacton Hospital, which is very welcome. However, we are still having trouble recruiting GPs to coastal areas, and I would like the Minister to bear that in mind.

I am delighted that my hon. Friend’s daughters were born in the Princess Alexandra Hospital—not a fact I knew until today. Knowing their father, I am sure he was very proud that they were born in Harlow. I thank him for his support for our new hospital, and I am sure the Minister has heard the point about the need for more health investment in his part of Essex.

As one would expect, the natural ageing of the building means the estate is no longer fit for purpose, nor does it allow for service improvement. The structural materials are crumbling and the fabric of the hospital is outdated, making compliance with regulatory health and safety standards more and more challenging. Not only that, but demand for health services in Harlow has changed considerably since 1966. The population has grown by over 30,000, diagnosed physical and mental health illnesses are on the rise, and, more recently, NHS hospitals in neighbouring constituencies have closed, meaning that the Princess Alexandra Hospital now serves over 350,000 people—well beyond its envisaged capacity.

The impact of these pressures is fronted by both patients and staff. Waiting times in the A&E department are among the highest in the UK, and crowded wards are hampering patient experience. The dilapidated working environment, temperamental equipment and pressurised conditions are taking their toll on staff morale, with any hopes of enhancing performance dashed by factors beyond their control. Does the Minister not agree that we should do all we can to support our hard-working NHS staff and to champion their admirable aim to improve patient care at the Princess Alexandra Hospital?

I congratulate my right hon. Friend on securing this debate, and I absolutely support and welcome his case for investment in the Princess Alexandra. In terms of getting the improvements my right hon. Friend seeks in his hospital, as well as across our county of Essex and in neighbouring areas, it would be good to hear from the Government what plans there are in the 10-year plan to secure funding for the facilities we need.

My right hon. Friend has always been a champion for Essex—there is not an Essex issue that she is not on top of. She has been very supportive of the need for a new hospital in Harlow, and I welcome her signing and supporting the letter we wrote to the Health Secretary. She is right that we need to know how the 10-year plan will help our beautiful county—how it is going to help in west Essex, across the south and right up to the constituency of my hon. Friend the Member for Clacton (Giles Watling).

In spite of the difficulties, the staff have proved they can implement changes. In March 2018, the hospital was brought out of special measures thanks to the incredible efforts of every employee, from the board members right through to the nurses, doctors, porters, cleaners and catering staff. Given the working conditions, it is no wonder that attracting and retaining well-qualified staff is so difficult. In December, the hospital operated at a 13.8% vacancy rate, and the board cited particular difficulty in filling critical nursing roles.

That issue is exacerbated by the promise of higher salaries and competitive training programmes at Barts and University College Hospital, just 30 miles from Harlow, in London. Further, Essex County Council notes the higher wages available in the privately funded social care sector as another magnet attracting staff away from our NHS hospitals. Many of those factors were never envisaged during the hospital’s construction in the 1950s, but we have the opportunity now to build a brand-new health campus that will bring healthcare services in Essex into the 21st century, as well as creating the space and training facilities for longevity.

At the start of this month, the hospital and I were delighted to welcome the Health Secretary; he saw for himself the state of affairs at the Princess Alexandra Hospital. I am incredibly grateful to him for taking the time to speak so meaningfully with the NHS staff, particularly those on the frontline—the doctors, nurses and support staff—to allow him to gauge the realities of the day-to-day operations at the hospital. I take this opportunity to ask whether the Minister will commit to visiting the Princess Alexandra Hospital in Harlow, to continue the Health Secretary’s work. Does he recognise how useful it may be to inform future decisions about capital funding?

The Health Secretary concluded that Harlow has a strong case for capital funding. He stated how impressed he was with what the staff were managing to do in the tight working spaces, and acknowledged that a longer-term solution was essential. The board is doing all it can to set progress in motion. The trust is currently developing a pre-consultation business case and refreshing its 2017 strategic outline case, which will be submitted for approval in June. An event will be held tomorrow with stakeholders to assess the preferred way forward, including for the location of the new health campus, with a final decision to be made next month.

I understand from discussions between the Health Secretary and the trust’s executive board that the Department of Health and Social Care has spent its current capital allocation, and that major capital projects will be considered following the upcoming spending review. Will the Minister provide an assurance that, when the time comes, he will take all the necessary steps and work with the Treasury to release the capital funding for the new hospital we desperately need? Will he also set out a timeframe for that decision?

The trust’s executive board estimates that the health campus would cost £400 million. It is one of the seven new hospital projects seeking more than £100 million. I assure the Minister that that investment would provide a long-term solution, ultimately saving the Government, the hospital and the taxpayer millions of pounds. Princess Alexandra Hospital has been fortunate to receive pockets of Government funding, for which we are incredibly appreciative. In December, it received £9.5 million to provide additional bed capacity, on top of a £2 million investment in September ahead of the busy winter period. Successful capital funding bids led to the four-month turnaround of the £3.3 million new Charnley ward in January and the addition of a second maternity theatre last year.

I acknowledge that the Government are supporting the hospital, but those stop-gap investments were quick fixes when the need became urgent. Surely it is now time to look at the bigger picture. Does my hon. Friend the Minister agree that we must be wise with taxpayers’ money, and that to do so, we must address the root causes of the problems—the reasons why we need additional space for beds and extra funding for our A&E department, which is one of the busiest in the country?

Does my right hon. Friend agree that those problems are not always merely a question of funding but are frequently to do with hospital management, which sometimes fails? We politicians, and the Government, should stand by to offer support and hold management to account.

My hon. Friend is right. We are very lucky that the management of Princess Alexandra Hospital are second to none. We were in significant difficulties, but they turned the hospital around and are doing a remarkable job. They are doing their side of the equation; we need the Government to do the other side.

I am grateful to my right hon. Friend for giving way to me a second time. Does he agree that the issue, and the reason we need long-term funding, is that both our constituencies face significant pressures for additional housing? Simply coping with what we have now is difficult enough. We need long-term funding to provide healthcare to the new communities that will be built.

My hon. Friend again hits the nail on the head. We have a problem at the moment, but we will have thousands and thousands of new houses in our area. It will be impossible to maintain the hospital as is with that population influx.

A new health campus would provide the additional space we desperately need and make a huge difference to patient and staff satisfaction. Patient flow would improve with greater bed capacity. Reduced pressure on staff to turn over beds quickly would allow them to spend more time with patients, delivering the quality of care they are eager to provide. What is more—I know this will please the Minister—the Government would no longer need to fork out millions of pounds for temporary add-on structures to create space for more beds. We have a ward that was literally built on stilts above a car park.

The health campus would take into account the anticipated population growth in Harlow and provide the flexibility that is currently lacking. Working conditions for staff would greatly improve, the attractive state-of-the-art facilities would allow the hospital to recruit from the very best, and of course the skills and training opportunities would be limitless. I am heading up an inquiry on the fourth industrial revolution in my capacity as Chair of the Education Committee, so I am well aware of the skills deficit we face in this country, which is set only to widen in the age of automation.

Sitting suspended for a Division in the House.

On resuming

The health campus would work closely with Public Health England, whose timely move to Harlow in 2022 would allow for unrivalled research and training partnerships.

The hospital is already working with the award-winning Harlow College to provide apprenticeships, and with the University of Essex on training, but we could go further. High-class nursing degree apprenticeships could be delivered at an education centre on site, rather than sending staff away on courses that cost valuable time and money. These career development opportunities would go a long way to improve staff retention, and the board would no longer be forced to pay expensive agency providers to fill vacancies.

In line with the NHS 10-year plan, this digitally enabled, purpose-built health campus would provide the flexibility to adapt and take advantage of technological advances in medicine and science. Harlow would become the health science capital of England if the Department would allow it to have that future.

In summary, we have a hospital that has outstanding staff and is improving daily, yet it has an ageing infrastructure that is not fit for purpose, and it is currently spending millions on repairs that could be spent on the frontline. A new Harlow health campus for the 21st century would save the Treasury money in the long run, because it would mean an end to this constant need for capital refurbishments, hugely cut down on agency staff and help to cut the cost of healthcare in west Essex more generally, providing an enormous number of modern services under one roof.

The hospital, its staff and the MPs who represent them all have grand aims for the future of healthcare in Essex. I urge the Minister and the Government to pick up the baton, to champion our hard-working NHS staff and to dip into the £20.5 billion of additional NHS funding announced in the Budget to deliver the health campus that we desperately need.

It is a pleasure to serve under your chairmanship, Sir Christopher. I congratulate my right hon. Friend the Member for Harlow (Robert Halfon) on securing this debate and on being—I hope he will not mind me referring to him in this way—a warrior for Harlow. There is no doubt that he has made a strong and welcome case for investment in the Princess Alexandra. It is clear that Harlow needs a new hospital, and that a new campus can meet the long-term health objectives of both Harlow and neighbouring areas.

That brings me to the question of the health challenge across the whole of Essex when it comes to funding and investment in the NHS and the delivery of better healthcare services, especially given the significant levels of housing and population growth. There is an irony here: central Government provide money to local authorities for housing, looking at capacity studies, new growth and things of that nature, but we are not joined up enough across Government to release some of those funds back into the health economy.

Importantly—I hope the Minister will recognise this—the comprehensive spending review presents an opportunity for the Government to look at how the funding formulas can be connected to long-term economic and population growth. Of course, to ease pressures on hospitals and the health and social care systems, we also need investment in my constituency in a new multi-purpose healthcare centre that brings GPs and other health practitioners together at a local level. I am grateful to the Department of Health and Social Care, because I recently met the Secretary of State, who endorsed and gave his personal support to a new health centre in Witham and has also put pressure on the clinical commissioning group to work on the delivery of that, as the Minister is aware.

Returning to the point that I made in my intervention earlier, the new 10-year plan for health and the NHS is a perfect opportunity and window to consider how the Department can join up the whole system, make it much more integrated and look at delivery. My hon. Friend the Member for Clacton (Giles Watling) mentioned GPs; in our part of Essex and in rural parts of Essex we struggle to recruit them. We have the excellent Anglia Ruskin University training the next generation of GPs at a rate of 100 per year, thanks to its new medical school, and we want to benefit from that; I think the whole of Essex will benefit from it.

I hope the Minister, in his remarks, will look at the whole health economy in Essex and take on board the case that has been made today that we need not just investment, but a long-term vision from the Department.

Sir Christopher, it is good to see you in your place and to take part in this important debate. I start, as I should, by congratulating my right hon. Friend the Member for Harlow (Robert Halfon) on securing another debate—his fourth—on this matter. He is well known for his tireless work on matters of healthcare in Harlow and across the whole of Essex. My right hon. Friend the Member for Witham (Priti Patel) described him a moment ago as a “warrior for Harlow”; I think that was in response to the compliment he paid her of being a “champion for Essex”. I listened to her speech and her earlier intervention, and I will say that, should she wish to, I would be delighted if she joined me in a debate next Tuesday on the 10-year plan.

My right hon. Friend the Member for Witham is of course right that this is an opportunity. We have set out a comprehensive plan, full of ambitions to link up healthcare, backed up by an implementation plan. I am hopeful, because this is the first time that has been seen. Layer on to that the integration of health and social care in the Green Paper, and I hope she will agree that those are steps forward.

My right hon. Friend the Member for Harlow has not only secured debates, but has had a number of meetings with my predecessor on a number of issues relating to the Princess Alexandra Hospital NHS Trust. I notice that today he welcomed the visit of my right hon. Friend the Secretary of State, who visited the trust two weeks ago. I know the Secretary of State was hugely impressed by the outstanding staff and the good work they do, and I have noted the kind invitation extended by my right hon. Friend the Member for Harlow to come to Harlow, which I accept; I look forward to coming later in the year.

On a number of occasions, my right hon. Friend has raised the proposal to build a new hospital, which demonstrates his commitment to what he and I both recognise as the most important issue in his constituency. The Government recognise that a number of trusts face estates challenges; that is why there is a commitment to upgrade the NHS estate, with £3.9 billion in capital investment for buildings and facilities by 2022-23. I will come on to the comprehensive spending review in a second.

I noted, of course, the interventions from other hon. Members. My hon. Friend the Member for Hertford and Stortford (Mr Prisk) made the point about Harlow’s importance to the wider health economy in Hertford and Stortford, and my hon. Friend the Member for Clacton (Giles Watling) reminded me that we must have the staff in the hospitals. The workforce section of the 10-year plan sets that out.

My right hon. Friend the Member for Harlow knows that the NHS’s buildings and services are being modernised and transformed through the sustainability and transformation fund investment. That money is going toward a range of programmes. I recognise that in July 2018 the trust put forward a revised bid for around £330 million, with potential for that to be funded through sustainability and transformation partnerships funding, private finance contributions and some land disposals.

I know that the bid was well supported and attracted a lot of careful attention but, as my right hon. Friend will recognise, there was strong competition from a range of schemes across the country; the fund was heavily over-subscribed and there was some rigorous prioritisation. I hope he will recognise that officials from both NHS England and NHS Improvement are working closely with the trust. They are supportive of the capital bid that has been put forward and are working with the trust on the programme to look at that bid for the future. They continue to develop the options to tackle the challenges that the people of Harlow and the wider economy face, and to secure that best outcome. I guarantee him that that work will continue, and that I will ensure that I take an interest in his scheme.

I know that my right hon. Friend will have recognised and welcomed a number of tranche 4 bids that did secure some money for the trust for additional bed capacity, improving emergency department performance and patient flow and reducing bed occupancy. That scheme represents a key part of the NHS trust’s plan to dramatically improve and transform the emergency care pathways. I acknowledge that that was not the scheme he wanted, but I hope he will recognise that it has been extremely helpful, and that the trust has made excellent use of that capital.

I know that my right hon. Friend will wish to acknowledge that there has also been wider recognition of bids from across Essex; there was money for Hertfordshire and West Essex in Luton, in the Hertfordshire and West Essex vascular surgery network and in West Hertfordshire hospitals. I hope he will agree that there is continued commitment from the Government to the NHS and to the patients in the wider region.

I will directly address the point that my right hon. Friend raised with the Chancellor of the Duchy of Lancaster. There will be further opportunities to access capital. As my right hon. Friend the Member for Witham pointed out, there will be a comprehensive spending review this year, in which we clearly have the chance to link up those things she mentioned; I entirely take her point on board. My right hon. Friend the Member for Harlow will recognise that the CSR will be when decisions on future capital allocations will be made for the next five years. The 2015 CSR first did that, and that has continued, and we expect it to happen in the next CSR. I assure my right hon. Friend that I have no doubt that the Chancellor of the Exchequer and the Chief Secretary to the Treasury will listen to his financial appeals for his constituents.

I hope that my right hon. Friend recognises the wave 1 and 2 capital funding secured during 2017-18 to support the redesign of the emergency department at the hospital. That was targeted very much at improving those facilities. I hope that he also recognises that that was on top of what I referred to earlier. I am sure he will support, as I do, the fact that that has gone into championing excellence in the paediatric emergency department.

My right hon. Friend mentioned the Harlow science hub and campus programme. Partly owing to his campaigning, there will be a new public health campus in Harlow, and I pay tribute to his efforts. I am pleased to say to him—as I am sure he knows—that that is still on schedule. A phased opening from 2021 will ultimately see approximately 2,700 people based there from 2024. Public Health England and the Princess Alexandra Hospital have discussed what other opportunities for Harlow’s wider health economy might arise from basing the campus there. I hope to be able to share with him more details on that in the near future.

I commend my right hon. Friend’s work in raising support for the Princess Alexandra Hospital NHS Trust’s bigger capital bid. I reassure him that there will be opportunities to access that capital in the spending review process in the latter part of this year. He challenged me on the timeline of that. As someone once closely associated with the former Chancellor, he will know that the Treasury does not easily give out its timelines. “Soon” or “this autumn” are probably appropriate answers to his inquiry.

On numerous occasions, my right hon. Friend has raised the estate issues facing the trust, in the House, in meetings with my predecessors and with the current Secretary of State. I look forward to accepting his invitation to continue working with him on this issue for the people of Harlow and for the NHS in Essex.

Question put and agreed to.