Kettering General Hospital A and E: 26th June 2013

The Parliamentary Under-Secretary of State for Health (Anna Soubry)
As ever, it is a pleasure to serve under your chairmanship, Mrs Brooke. I congratulate the hon. Member for Corby (Andy Sawford) on securing the debate. He quite properly brings forward his constituents’ concerns about their hospital. I am delighted that he is working with two other Members of Parliament whose constituencies are served by the hospital.

I am especially grateful to the hon. Gentleman, if I may say so, for having contacted my office and spoken to my officials before the debate. If only all hon. Members took such a positive step, because it assists hugely. He is quite right to make the point that this is not the stuff of party politics. I fear that I may not be able to answer some questions that he quite properly asked. If that is the case, I or my officials will write to him to ensure that all the matters he raised and all the questions he asked are given proper and full answers.

I am very pleased that the hon. Gentleman will meet the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), on 16 July, with my hon. Friends the Members for Kettering (Mr Hollobone) and for Wellingborough (Mr Bone). I am sure that there is no connection, but having said that, a frog has entered my throat. I am going to stop for a minute.
 
Annette Brooke (in the Chair)
That would be wise.

Anna Soubry
I am sorry.​

The hon. Member for Corby has raised important issues about accident and emergency services, although I will not be dealing with the national situation. As we know, there have been some issues and problems in emergency departments throughout the country, many of which have been well rehearsed in this place.

Underlying themes and problems are often common to all our accident and emergency departments. Undoubtedly, many of the problems at Kettering’s accident and emergency are exactly the same as those that have caused so much difficulty in other A and E departments in this country. I am pleased that huge progress has been made and that overall performance is improving across the country as might be expected, especially given my Department’s efforts.

The hon. Gentleman has pointed out how health services are under pressure in his constituency and having a knock-on effect at Kettering, and those pressures are being experienced across the whole system. He quite properly identified that the reasons for that are complex. Dealing with those pressures means looking at the underlying causes, which the Department has been doing by working with NHS England.

The hon. Gentleman pointed out that Kettering General Hospital NHS Foundation Trust is experiencing many of the issues that I have highlighted. I am aware that, as he told us, the trust has not met the A and E standard. It has struggled with that difficulty for some time. He will know that Monitor, as the regulator of foundation trusts, has unfortunately found that the trust is in breach of its licence in relation to its A and E performance, as well as wider financial and governance issues. That will cause concern not only to the people who use the hospital, but to its outstanding staff.

Monitor has required the trust to implement an urgent care action plan to ensure that it can return to compliance against the A and E standard. The deadline for that is 1 July, so it will not be long before the trust has to implement it. Monitor is working with local commissioners and NHS England to support the trust to meet that requirement.

I appreciate that the hon. Gentleman feels that further investment is needed to expand facilities at the trust to improve its position. It is right that, as I understand it, he has had meetings with the chair of the trust and other Members of Parliament, and that letters have been written, to request assistance in securing extra capital funding. Some £5 million to £10 million has been requested, so that the trust can redevelop and expand its A and E department.

Of course it is for NHS foundation trusts to develop and take forward their own capital investment proposals, and trusts such as Kettering can apply to the Department for a capital investment loan. We understand that the trust has allocated some of its capital budget this year to make improvements within A and E, and it has worked with commissioners to redesign what we call pathways to improve flow. Hot clinics and ambulatory pathways have been developed, which divert patients away from A and E and avoid GP admissions, which, as we know, often stack up in the Department.

On the matter of whether Kettering has ever closed its doors, I am told that its accident and emergency department has never done so, and it is important to put that on the record. I am told that there was a period ​in February when the hospital trust effectively advised members of the public—I think that this sounds like a sensible piece of advice—to ensure that they only went to A and E if they had had an accident or an emergency. In other words, to use the jargon, they were told to use the department appropriately, because the trust had become aware of a sudden and acute rise in people using A and E. Actually, that is a good message for all of us to take back to our constituents. The department is not called “accident and emergency” for no good reason; it is for accidents and emergencies.

When we had a debate on A and E in the main Chamber, Members from both sides told stories about people presenting at A and E when they could have gone to the pharmacy or just taken a paracetamol. The point I am making is that, often for understandable reasons, people attend A and E when they cannot get the appointment they want at the GP surgery. There is this wider issue that perhaps we do not do what we used to do in the past, which was to self-administer, take advice from our brilliant pharmacies or ring the GP surgery for advice before simply turning up at A and E.

As I have said, meetings have taken place, and, as I understand it, the trust has been working with local commissioners in the way that I have described. The hon. Gentleman mentioned the new Corby urgent care centre. I think I saw it before I was in this position—I was there for other reasons which I am sure the hon. Gentleman will understand—when it was in the process of being constructed. I am delighted that it is now open. It is called an urgent care centre. To be frank, we do not always use the best language when it comes to naming places where patients can go. In fact, the review, which is being conducted in the Department of Health, is looking at the sort of language that should be used, so that people understand where they have to go when they have a particular problem. I am delighted that the centre has opened in Corby and is providing additional urgent care services to the hon. Gentleman’s constituents, which should help to ease the unnecessary attendances at the A and E department of Kettering General.

I also want to mention the East Midlands Ambulance Service NHS Trust, because it is of concern to all of us who represent seats in the east midlands. I know that the hon. Gentleman has rightly talked about how problems with EMAS have affected services in his constituency.

Andy Sawford
I wanted to cover more issues in my opening remarks. The Minister is absolutely right to say that EMAS is a huge concern for all MPs across the region. I am sure that she is aware that the proposal is for the hub that would serve my constituents now to be at Kettering and for the level of service to be reduced at Corby, which is a concern for us.

Anna Soubry
Indeed, and it is right that the hon. Gentleman should raise that concern. I think I am right in saying that Earl Howe, who is the Minister with responsibility for the ambulance service, has agreed to meet the hon. Gentleman. If he has not agreed that, then he just has. In any event, Earl Howe will be more than happy to meet the hon. Gentleman to talk about the various issues.​

The hon. Gentleman will also be aware that the NHS Trust Development Authority has intervened at the East Midlands Ambulance Service NHS Trust and is working with local commissioners to ensure that it has robust turnaround plans in place to improve its performance. The fact that the ambulance service has not been meeting the high standards that we all expect of it has been a long-standing problem in the east midlands. It is now implementing proposals to improve the way it delivers services across the east midlands through its “being the best” programme. That includes the replacement of some ambulance stations, including the one in Corby. It is creating 108 community ambulance posts, 19 ambulance stations and nine purpose-built hubs or superstations to enable ambulances to be dispatched from strategic points across the region to meet demand. I know that the “being the best” proposals have been referred to the Secretary of State by Lincolnshire county council. I do not know whether Northamptonshire will now take the same course, but it may not need to as Lincolnshire has already made the referral. As a result, the Independent Reconfiguration Panel is due to advise in the next few days, so it would not be right for me to make any further comments on that matter.

I will conclude now unless of course the hon. Gentleman wants to intervene again, which I am more than happy about because we still have four minutes.

Andy Sawford
I thank the Minister for giving way again and I am delighted to take up the opportunity to use up a little more of the time we have available. It is of course very welcome news that those proposals have been referred to the Independent Reconfiguration Panel. However, I must say to her that, irrespective of how those proposals proceed, I have no confidence in the trust board of the East Midlands Ambulance Service NHS Trust or in its leadership and management.

I will be interested to hear the Minister’s comments about what role, if any, the Department of Health can play in intervening when there are concerns about the management of an ambulance trust. I know that hon. Members from across the eastern region ambulance service, which also serves some of my constituency, have—frankly—successfully changed the leadership of that service. I feel that we may need to make some progress in that regard ourselves.

Anna Soubry
The diplomatic answer to that is to say that, yes indeed, east of England MPs have quite rightly taken their concerns to the highest level and there has been some serious intervention. There has been a report; we had a 90-minute debate here in Westminster Hall only yesterday on it. I have to say that apparently most members of the board of that ambulance service still remain in place, but the board has a new chair. There has been a full report into the service and there is hope that many of the report’s recommendations will now be put forward.

I must say that the Care Quality Commission, notwithstanding some of the comments that were made last week, can play a hugely important role in looking at the performance of ambulance trusts. I speak now as a constituency MP when I say that I myself have been in contact with the CQC and I urge the hon. Gentleman perhaps to take the same course, because the CQC can ​really play an important role in ensuring that ambulance services and indeed many other providers of health care are absolutely up to standard and providing the services that they should be providing. That may be of some assistance, but I must say that I think things have improved.

Andy Sawford
The Minister says that there are issues at Kettering General hospital’s A and E department that are in common with those in other hospitals. Finally, I draw her attention to the exceptional case for investment in Kettering General hospital, because of the growth in population locally. Corby has the highest birth rate in the country; it is the fastest growing town in the country; and the Northamptonshire area is one of the fastest growing areas in the country, so this is an exceptional case.

Anna Soubry
That is a good point well made, and no doubt this will all be discussed at the meeting to be held on 16 July and the hon. Gentleman will make that point again with all the right force that he should.

I was going to say “in all seriousness”, as if I was being flippant, which I was not being. However, I hope that Kettering General hospital continues to work with Monitor, NHS England and its local commissioners to put in place robust plans for improving its position. That should also include working with all the elected Members in the area, so that we can be sure that the hospital delivers absolutely the best services to the people it seeks to serve and should be serving.

Question put and agreed to.