Jamie Reed (Copeland, Lab) Link to this | Hansard source

A preponderance of health-related issues and debates is raised at this time of year, and I am sure that that will be especially true if the forecasts of a harsh winter are even remotely accurate. The issues that I wish to raise are, sadly for west Cumbria, neither seasonal nor unusual, but endemic to the area. As one of the youngest Members in the House and as someone with the privilege of representing the constituency in which I was born and raised, I know that they have been a problem for 20 years. Stability in the west and north Cumbrian health economy is desperately needed, as two decades of uncertainty and anxiety have eroded the morale of staff and the confidence of patients throughout the area. That must change.

West Cumbria consists of approximately 150,000 people who are dispersed in towns and villages covering a huge geographical area that is served by a poor road infrastructure. Car ownership is in the lowest bracket in the country, and public transport is woefully inadequate. As a result, urban towns and rural villages, although often technically close to one another are isolated by the difficulties associated with the communications infrastructure. As regards health services, west Cumbria is covered by the West Cumbria primary care trust, the North Cumbria acute hospitals NHS trust and mental health and ambulance trusts established in the same area. All those trusts recently informed the public that they must fundamentally examine the way in which services in west Cumbria are delivered.

The PCT did so on 18 November, when it circulated to some staff, but not all, proposals for changing services in west Cumbria, including the closure of all beds in community hospitals in Millom, Keswick, Workington, Maryport and Cockermouth. The community hospital in Workington is brand new, and was opened by my hon. Friend the Member for Workington (Tony Cunningham) about a year ago following new investment of £12 million. The proposals were sent to staff in the PCT, and an accompanying press release was sent to the media. Neither my hon. Friend nor I was notified, and we still await official notification. In the absence of that basic courtesy, I have relied on members of the PCT who have sent me anonymous copies of the proposals, and the reporting of the local and regional media. That is a scandal, which I utterly condemn.

Most importantly, given the difficulties posed by geography, the sparsity of population, low car ownership, poor public transport and an ageing population, the proposals to remove hospital beds from west Cumbrian communities were a disgrace. Moreover, they were made at a time when the NHS, both nationally and in north and west Cumbria, has received record levels of investment. It is not an exaggeration to say that our local health service has more money than it has ever had, and has received record injections of investment since 1997.

To avoid accusations of politicking, in preparation for our debate my office asked the House of Commons Library—an independent, non-partisan resource—to provide figures for investment in the West Cumbria PCT and its predecessor since the Government were elected in 1997. I was delighted to find that allocations for west Cumbria have increased by 96 per cent. over that period—effectively, they have doubled.

My hon. Friend the Member for Workington and I began working for the withdrawal of those proposals as soon as we learned about them, and in doing so brought the matter to the attention of Health Ministers, including the Secretary of State and the Under-Secretary of State for Health, my hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne), who is present tonight. There are a number of reasons why Health Ministers were as aghast as me. First, the proposals make no sense given the record funding since 1997.

Secondly, the proposals do not reflect our manifesto pledge, which we made in May this year, to

"develop a new generation of modern NHS community hospitals . . . These state of the art centres will provide diagnostics, day surgery and outpatients facilities closer to where people live and work."

Thirdly, the proposals are entirely contrary to the very precise thrust of health policy in this country. The forthcoming White Paper will outline the details in the spring, but let us be clear about the policy direction. The Secretary of State for Health recently told a meeting of the NHS Alliance that

"we need to focus on primary health and community services—where 90 per cent. of people's contacts with the NHS take place".

In a truly refreshing and insightful address, my right hon. Friend also told the same audience that from the consultation undertaken by the Department of Health, it is clear that people

"want more care and treatment closer to home, in community hospitals or health centres—although we have to become much smarter at engaging people at an early stage in designing and considering options that involve fewer beds and other changes to acute hospitals alongside better services in the community."

That point is particularly telling, because the PCT consultation in west Cumbria was also launched against the background of what is likely to lead to a new acute hospital for west Cumbria. Like any new hospital in the UK, it would be smaller in size—I stress that services should not be diminished—which is right for the model of health care that is being progressed through not only national policy but, more importantly, through the advocacy of patients and health care professionals.

In short, any new acute hospital in west Cumbria—or a comprehensive refurbishment of the existing hospital, for that matter—will rely on a network of fully functioning, fit-for-purpose community hospitals. Consequently, those proposals threatened not only the community hospitals themselves, but the delivery of a new acute hospital by a separate trust—a quite incredible state of affairs. Will the Minister consider whether the community hospitals are in the wrong trust? Perhaps the acute hospital trust would be a better place from which to run community hospitals throughout west Cumbria, which is an idea that certainly makes sense to me.

The acute hospital in west Cumbria, the West Cumberland hospital, which is in my constituency, is an issue to which I hope to return at a later date, but for now I inform the House and the Minister that any new hospital must be of an equal status to the other acute hospital maintained by the same health care trust in Carlisle, in order not only to achieve social justice in the provision of health services in west Cumbria, but to deliver equality of access and equal standards of health care throughout north and west Cumbria.

Jamie Reed (Copeland, Lab) Link to this | Hansard source

If the hon. Gentleman does not mind, I want to get on. If he has any telling or pressing points, we can discuss them outside the House or he can write to me.

I urge the Minister and his Department to pay close attention over the coming months to this unfolding issue and, in particular, to the principles that I have outlined: equity of access and of standards. At this point, I ask the Minister to assess the funding formula for the NHS within the forthcoming White Paper and ensure that issues such as socio-economic factors and sparsity of population are addressed.

Returning to the PCT, only this Friday I met clinical staff at Millom community hospital and the friends of Millom hospital to discuss the PCT's proposals. I expected anger, anxiety and dejection among those whom I was to meet, but I must extend to the Minister their sincere thanks and appreciation following his intervention. Like me and my hon. Friend the Member for Workington, the staff, friends and users of Millom hospital were delighted to learn about the Minister's intervention and are now hopeful for the future, given the plan that he has identified. The people of Keswick, Maryport, Cockermouth and Workington are also equally grateful.

The Minister will correct me if I am wrong, but the plan states that West Cumbria PCT is in line for a record cash boost over the next two years totalling more than £30 million, which is nearly twice this year's underlying deficit. Local health chiefs must spend that money wisely following a much needed detailed debate and consultation on how to redesign services for the better. Over the next three months, the consultation in west Cumbria, which, as I understand it, will be undertaken by the strategic health authority rather than the PCT, will explain how the existing infrastructure of community facilities will be expanded. The Minister will visit west Cumbria in the new year to ensure that all of the above takes place.

As a result, the PCT's proposals have, as I had hoped, been withdrawn. Let me assure the Minister that at no point did anyone believe that those proposals belonged to the Government. There is widespread acknowledgement of the fact that Labour is the only party with the interests of the NHS at heart. The Minister might be interested to learn that in my constituency at the last general election the Conservatives campaigned on a platform of reduced health spending and health service privatisation, and received their worst result for almost 100 years. The persistent and continual Conservative threat to the health services of west Cumbria rightly led to the Tories in Copeland receiving the lowest number of votes since the NHS was introduced. That damning condemnation of the Tories' health policy, and attitude, shows precisely how the people of Copeland and west Cumbria value their health services. I can put it no better than a farmer constituent who told me at the weekend that he would rather let a fox look after his chickens than let the Tories look after the NHS.

Two groups are central to any consultation and redesign of services in west Cumbria—patients and staff. Patients are not slow in coming forward with their views. Civic engagement is evidently lacking in several policy areas, but health is not one of them. However, sufficient consideration needs to be given to the views, hopes, concerns and often wise and insightful suggestions of front-line service providers in west Cumbria. Having spoken to a good number of health care professionals from across a broad spectrum of services and professional standing, I know that all too often they do not feel that their knowledge and experience is valued, or even considered relevant, when management boards launch consultations. I urge the Minister to ensure that the new consultation in west Cumbria pays sufficient attention and proper regard to the views of health care professionals, who will after all deliver the model of care that is agreed on.

West Cumbria PCT, against a background of record investment, is projecting a recurring deficit for next year of approximately £15 million. It is absolutely right that all trusts should be expected to balance their books. However, the fundamental question that lies at the heart of this debate is this: where has the money gone? I know that the Minister is as keen as me and my hon. Friend the Member for Workington to find the answer, and I hope that he can help us in that endeavour, particularly in light of the effective doubling of investment since 1997. It is clear that the various trust boards serving west Cumbria are not working together. West Cumbria cannot sustain a viable health economy on that basis. I therefore ask for the Minister's help in achieving this for the benefit of all its health service staff and patients.

One of the most pressing medical issues in west Cumbria is its lack of dentists. I appreciate that that does not fall within the Minister's brief and is the responsibility of the Minister of State, my hon. Friend the Member for Doncaster, Central (Ms Winterton), but it is entirely relevant to the scope of this debate. I was recently honoured to welcome the university of Central Lancashire to the Westlakes science park in my constituency, where the university has established a significant permanent presence. UCLan has an excellent academic and medical research record. On the strength of that, I approached the vice-chancellor and the dean of the Westlakes campus to discuss the possibility of the university's helping to expand dentistry provision throughout west Cumbria. I am pleased to say that it has, as part of a higher education consortium involving Lancaster university, the university of Liverpool and St. Martin's college, submitted a bid to the Department of Health, which if successful would see a dental school established in west Cumbria.

This week, my hon. Friend the Member for Workington and I will write officially to the appropriate Minister to express our support for the bid and to outline precisely the direct and exponential benefits that such a development would have in west Cumbria with regard not only to dental provision but the wider health service agenda. I hope that the Minister will urge his departmental colleagues to give due detailed consideration to the bid.

I thank the Minister for the close personal attention and effort that he has given to this issue. I look forward to meeting him in west Cumbria in the new year, when I hope that we can progress the agenda of improving the health services serving west Cumbria in a sustainable, effective and permanent manner, while serving the needs and aspirations of patients and staff.