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Southend Hospital

Volume 626: debated on Thursday 6 July 2017

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

I am grateful to Mr Speaker for giving me the opportunity to raise on the Adjournment the future of Southend hospital. In so doing, I congratulate my hon. Friend the Member for Winchester (Steve Brine) on his promotion to Under-Secretary of State for Health. I know he will do a splendid job. I must warn the House that I will not take any interventions, because I have a lot to say, and I am sure my hon. Friend the Minister will not take offence if we do not split the half-hour available exactly.

I am absolutely furious that it is necessary for me to raise in the House the future of Southend hospital. We are all gathered here after what in my case was the 10th time I have been a parliamentary candidate in a general election, and I certainly did not enjoy this particular experience. I am a conviction politician. I am not in the school of, “Oh, it’s a choice between the red and the blue team. I support the blue team, and if the going gets tough I might slide over to the red team.” I support things, and one of the things I support is an enterprise culture. I hope that businesses can make a bit of profit, the country can do well and we can spend money on our wonderful health service.

As I look at the Dispatch Box, I recall 34 years ago standing just behind the now Leader of the Opposition—we both had rather long hair in those days. All I would say is that I think he and I hold the same views today as we did 34 years ago. Let me say this and get it off my chest immediately. I do know a bit about the health service. Colleagues stand up and say that they are expert in this and expert in that. It does not matter what age they are, but I think there should be a little bit of respect for how long we have been here and for experience. I go back to the time when I was a junior Parliamentary Private Secretary to Michael Portillo and Edwina Currie and we had our departmental office in Elephant and Castle, and I was there when we first moved into 79 Whitehall, so I do know a little bit about the health service, and a little bit about sustainability and transformation exercises, which I will come to in a moment.

Not only that—I know a little bit about politics. Unlike all my colleagues, I held a challenging seat not once, not twice but three times between 1983 and 1997—just like my hon. Friend the Member for Thurrock (Jackie Doyle-Price) has now. I have moved on to a slightly more comfortable seat in terms of support for the Conservative party, but I never ever forget how tough it was.

My inspiration in politics is the late Baroness Thatcher. Unlike many colleagues in the House, I was a colleague of hers and knew her when she was at the top of her game; not only later in her life when perhaps she was not firing on all cylinders and romanticising about things. She is my inspiration, frankly. Of course, she never went along the populist line; she always did what she thought was in the best interests of the country. I say to my hon. Friend the Minister that during Mrs Thatcher’s time as Prime Minister, when we had a huge Conservative majority, I was able to stop Basildon A&E closing within two days. In Basildon, our garden backed on to the grounds of the hospital, and I now live five minutes from Southend hospital. As I look at our situation today, there is no way that I, the Member of Parliament for Southend West, am going to allow the hospital in the heart of my constituency to have its A&E downgraded. There is no way that I am going to allow it not to have 24/7 access. There is no way that I am going to allow ambulances with blue lights flashing not to stop at Southend hospital.

Getting back to the campaign, colleagues up and down the country think they had a tough campaign because of the manifesto and the style of the campaign, but the rudeness I encountered in this campaign disgusts me. The things that people—young, middle aged and old—now say to us, the politicians who take the blame for decisions made by bureaucrats and others who are paid twice as much as we are, and the way they use the F-word and C-word, disgust me. On social media, the mickey is taken about of me because of “cake”. Shame! Shame on any youngster who thinks it is a laughing matter, when my constituent Leah Betts died of an ecstasy overdose. Shame on Channel 4, which got people into the building when the then Minister Tony Newton was checking with his civil servants and thought there was a drug called cake. It is an absolute disgrace. Those people who think it is funny now were not even born when my constituent died. The general tone of this election campaign was jolly disappointing.

For me in Southend, at the heart of it all was a campaign called Save Southend A&E. I am furious that those who were behind the proposals did not get the politics. Behind the scenes, I had been organising health summits, where we got decision makers in SEPT—South Essex Partnership Trust—dealing with mental health services, representatives of the clinical commissioning groups of GPs, and the hospitals to talk to one another. I was not at all happy with senior management, who are paid large salaries—it is all in Hansard over the years.

I get frustrated that the longer one is an MP, the more one is ignored. I think of the chairmanship I am privileged to hold of the all-party fire safety rescue group. It was not just Conservative Ministers or Liberal Ministers; it was Labour Ministers who accepted the wrong advice. We all know the dire consequences of our advice being ignored.

To get back to the health service, with 15 minutes to go, one individual was going to stand against me in the general election on the issue of the A&E. There was all the online abuse. We had rallies. We had mass demonstrations. It was a nightmare, but I can look after myself. I have not survived for 34 years in Parliament because people have been looking after me. I am arrogant enough to say that I know what I am doing. I know a bit about people, because before I became an MP I owned an employment agency, so I have interviewed hundreds of people. It annoys me that others think they know better than I do on this issue. I say to my hon. Friend the Minister that in future, when anything that involves Southend hospital is being done—including by bureaucrats and officials—pay the hon. Member for Southend West the courtesy of telling me what is going on. I should be told first.

On the proposal to dumb down Southend A&E, the argument is lost—completely lost. In the election manifesto on which we fought the recent campaign, we see on page 67 the heading “Holding NHS leaders to account”, followed by a part of the manifesto that I shall repeat over and over again if I am not listened to:

“We will also back the implementation of the plan at a local level, through the Sustainability and Transformation Plans, providing they are clinically led and locally supported.”

For goodness’ sake! A politician does not ask a question speculating what the answer might be. Unknown to me, we had clinicians employed by the people suggesting these proposals openly speaking out against any changes. It beggars belief that just two weeks ago the person running Southend A&E—I will not name them—went to Rochford Council for a meeting and tore the proposals apart line by line, word by word. How on earth could the arrangements for A&E be changed if the very person running the scheme speaks against it? I have any number of examples of clinicians, GPs and others who are openly speaking against the proposals. It is certainly not clinically led.

Hospitals are not perfect—not by a long run—but I wish to pay tribute to everyone who works in the national health service. I do so not in a patronising way—I know that there are all these arguments about the public sector pay review and all of that—but because they do a fantastic job. Although it is sometimes forgotten, all Members of Parliament are human beings, so we all get unwell and we all have family members who get unwell. We are grateful to GPs and hospital consultants for the wonderful work they do for us time after time. Of course MPs are the ones who hear the complaints when someone is not looked after well, but we must never allow that to cloud the overall fact that we have a wonderful health service.

I was a member of the Health Committee for 10 years, which is not a short time. I went all over the country, and all around the world—you name it; I have been there and seen it—and I returned to the UK with the view that we have the best health service in the world. However, because people have the highest possible expectations, no amount of money will deal with all the issues. There is the situation with this baby, and the President of the United States reckons he is going to sort it out. But there is no limit to the amount of money that could be spent on the health service. The women and men who work in our health service are absolutely marvellous.

I also want to point out that the people who came up with these suggestions have presumably not yet started talking about the ambulance service. I have any number of people telling me that the idea that we can transfer people to Basildon A&E is just not on, for all sorts of reasons. I have heard many reasons why that cannot happen.

I really want to praise Southend hospital and the wonderful things the people there achieve. Only last Thursday the Countess of Wessex, who has a particular interest in babies, opened the Kypros Nicolaides foetal medicine unit, which helps around 45 women each month with specialist foetal medicine care. It is absolutely tip-top. The latest Care Quality Commission report gave the A&E department good ratings. It had been underperforming for a while, but we have now got it up to a good level of performance. The simulation suite has recently celebrated its first anniversary. This state-of-the-art suite has been used to deliver a wide range of training opportunities designed to look and feel like a real patient bay, and it can replicate any medical scenario. Last November the brand new £3 million state-of-the-art endovascular hybrid theatre was opened. This new cutting-edge suite combines all the features of a fully equipped operating theatre, with an interventional radiology suite, and it includes ultra-modern imaging and operating equipment for complex endovascular work.

Our hospital has always had a wonderful reputation for treating people with cancer. It has also always been first class at treating people who suffer strokes. Basildon has really been the centre of excellence for people with heart problems. Southend hospital has the Red2Green system. The initiative has seen positive results across all the wards, ensuring that every day is valuable for patients in the hospital’s care through early daily review by senior clinical staff expediting investigations, treatments and early safe discharge home. The last thing we want is elderly people spending too long in hospital and catching infections.

There is funding for GP streaming. The Department of Health announced allocation of A&E capital funding to ease pressure on emergency departments in time for winter 2017, and we are absolutely delighted with that. We are also delighted with the £180,000 that we have received to help with cancer. A patient-led assessment of the care environment was undertaken in May. Although the formal outcomes will not be available until later this year, the informal comments from the volunteer inspectors were very positive. Thrombectomy training is a cath lab-based technique where a blood clot is directly removed from the brain’s arteries. This is fantastic technology, and Southend will be not only top of the country but top of the world in this discipline, which is wonderful news.

A team at Southend University hospital are using innovative 3D presentation technology with radiotherapy to allow patients greater insight into the machines used for cancer treatment. Everybody is obviously very frightened when cancer is diagnosed, but this therapy will help with the treatment, and it helps the patient to feel more positive and confident that they will beat the disease. A maternity training simulator has been introduced, which enhances patient care, and a new paediatric insulin pump service improves diabetes care for children. Southend University hospital’s team were recently highly commended in the Health Service Journal value in healthcare awards, and a dementia day room funded by Southend Hospital Charity’s appeal was recently opened.

Anyone who works in the health service—whatever they do—has a gift. I am not terribly good at looking after other people when they feel unwell. Frankly, it makes me feel unwell. How a surgeon cuts someone open, I do not know. Someone has to do it—brain surgery and all that. These women and men are absolutely blessed and splendid. I speak from the Conservative Benches, and we used to be seen as the enemies of the national health service. The situation is quite the reverse; we totally support and value the health service. As long as I am the Member of Parliament for Southend West, I will ensure that Southend University hospital has not only a bright future, but a glorious one.

I very much enjoyed the speech by my hon. Friend the Member for Southend West (Sir David Amess). I congratulate him on securing this debate and commend the fire in his belly that always shines through when he speaks in this House, or anywhere else, on behalf of his constituents. They are lucky to have him. I congratulate him on his re-election once again last month.

It is a strange that there is nobody in front of me and everybody I am talking to is behind me, but such is the layout of the House of Commons—and I am of course talking to you, Madam Deputy Speaker.

I understood before I came into the Chamber, and I certainly understand now, that there is significant local concern about the future of the A&E at Southend University Hospital NHS Foundation Trust. My understanding is that Southend A&E will continue to provide substantial emergency services 24 hours a day, 7 days a week, and any change—I underline, any change —to this position would need to meet the four tests of service change. For clarity, let me outline those tests, because they really are the bottom line of any proposed service change in the health service in England. First, proposed service changes must have support from commissioners; secondly, they must be based on clinical evidence; thirdly, they must be able to demonstrate public engagement; and fourthly, they must consider patient choice. An additional NHS England guidance has been added—that proposed service reconfigurations should be tested for their impact on overall bed numbers in the area, and the impact thereof on safety. It is important to set that out very clearly.

The work of the success regime has now fed into the Mid and South Essex success regime sustainability and transformation plan.

I would like to introduce Broomfield hospital in Chelmsford into the discussion as one of the hospitals in the mid-Essex area along with the three in Southend and those in Basildon. I congratulate my hon. Friend the Member for Southend West (Sir David Amess) on bringing so much experience to this debate. Broomfield is deeply loved. It serves our newest city. We too need our 24-hour consultant-led A&E. NHS England made it clear to me on Monday that it is not only 24-hour, but consultant-led. Can the Minister confirm that? Can he also confirm that any decisions made will put patient safety first? The future of our NHS relies on first-class training and innovation in Chelmsford. As part of the mid-Essex area, we have the country’s first new medical centre. Will the Minister confirm that he supports that medical centre?

Order. The hon. Lady’s question is slightly tangential to the subject of the debate, but I appreciate that she has made a connection. The Minister might be able to make the connection between the subject of the debate and her question, but I know that he will concentrate on the subject of the debate introduced by the hon. Member for Southend West (Sir David Amess).

I will, Madam Deputy Speaker. I could feel you bristling at the length of the intervention. I can assure my hon. Friend that none of the options being considered includes the closure of any of the three A&Es, and all will continue to provide emergency care 24 hours a day, seven days a week.

I was mentioning the work of the Mid and South Essex STP, which was published in November 2016 as part of the work to ensure that there are sustainable services in mid and south Essex. There is now a major workstream looking at service configuration across the three hospital sites. Work led by clinicians in 2016 arrived at five possible future configurations for consolidated specialist services across the three hospitals. As well as providing the majority of routine hospital care for its local population, each hospital site would provide some centralised specialist services.

Let me briefly outline the current thinking as it has been set out to me. Southend hospital will continue, as I have said, to provide substantial emergency services 24 hours a day, seven days a week. In addition, it will be a centre of excellence, as my hon. Friend the Member for Southend West rightly said, for planned care, alongside its already well-established cancer centre and radiotherapy services. Basildon hospital will provide enhanced specialist emergency care—for example, specialising in the total management of major life-threatening illness. Broomfield Hospital in Chelmsford will provide a combination of specialist emergency and planned care, with the potential to provide a specialist centre for children. I have to emphasise that these ideas are being further developed by the clinical groups as we speak. No single preferred option for consultation has been arrived at.

Let me now turn to the proposals for emergency care. It is important to note, and I wish to reiterate, that in all potential options for hospital reconfiguration currently being discussed, Southend hospital would continue to provide emergency services 24/7. An options appraisal process was held earlier this year involving clinicians, stakeholders and local people. The higher-scoring options listed one hospital as the provider of specialist emergency care. Basildon was identified as the better location for that. Southend and Chelmsford would continue to provide emergency services, but they would be less specialised than Basildon. Southend would instead specialise in planned care, cancer and radiotherapy, building on the excellent work already being done at the hospital. There would be separate units specially designed to give fast access to assessment and care for older and frail people, children and people who may need emergency surgery. In some cases, that could include an overnight stay, if necessary. Those units would involve both health and social care so that patients could return home as quickly as possible with any continuing support and treatment that they may need.

The potential services in the A&E and assessment units at Southend would be able to respond to a range of emergency needs, some of which could be initiated by a 999 call and may involve an ambulance. The possibility of Basildon hospital being the provider of specialist and complex emergency care has benefits for local patients. It would have several teams of specialists ready to provide immediate access to state-of-the art scans and treatments around the clock, which is not always possible in the current three general hospital A&Es.

I also understand that the practice of taking patients by ambulance from Southend to a specialist centre is already established. For example, people who suffer an acute heart attack in Southend are currently taken by ambulance to the Essex cardiothoracic centre—that was easy for me to say—in Basildon. I have been advised that that arrangement has been in place for many years. Separating some of the major emergency work in that way releases capacity and resources for planned surgery and other treatments.

For the local NHS, new centres of excellence across the hospital group in both planned and emergency care have the potential to compete with the best in the country to attract high-calibre staff and bring the best of modern and world healthcare to mid and south Essex. I emphasise that in all options currently under discussion, about 95% of hospital visits would remain local at each hospital.

As I have stated previously, the programme is currently under discussion and I am advised that the aim is to launch a full public consultation at the end of the year at the earliest, centring on a single preferred option. The public consultation will explore in detail the benefits and implications of the proposals and will inform plans for implementation. Engagement with staff and local people will continue to influence and refine plans at every stage. That is a key principle, as I have said, in local reconfiguration of services, and it has to be right that the process is guided by those who know and understand the local area best.

In conclusion, as a constituency MP I completely appreciate the concerns of my hon. Friend the Member for Southend West, whom I again commend for his work.

I should have said in my speech that all my literature had headlines such as, “David pledges support for 24/7 A&E service”. I felt that I was not believed, so it is good that my hon. Friend has repeated that we will have 24/7 care. Finally, given that morale at the hospital has been ruined over the past few weeks, it would be great if we could have a ministerial visit at some stage, perhaps even from the Secretary of State.

I thank my hon. Friend for that offer and will pass it on to the Secretary of State, although I am not entirely sure whether he or any of his Ministers can compete with royalty.

In the 30 seconds I have left, I commend my hon. Friend for his work on those issues affecting his constituents. He is a doughty champion for them. I think they do believe him, because they re-elected him admirably just a few weeks ago. I encourage both him and his constituents to maintain an open dialogue with the local NHS, as I know they will, especially during the pre-consultation and consultation phase, and reassure him that Southend A&E will continue to provide substantial A&E services.

Question put and agreed to.

House adjourned.