Healthcare: North Staffordshire — House of Commons, 2017-10-23
Topic: Health
Gareth Craig Snell (Labour, Centre-left): The hon. Gentleman, like me, wants the best for the constituents of Stoke-on-Trent, but it is far too easy simply to blame the hospital for our wider concerns about the health economy in Stoke-on-Trent and north Staffordshire. He is right about the combined trust making great headway—for example, in dealing with mental health—but he, like me, will still have people coming to his surgery to complain that they have to wait four, five or six months for a referral to the child and mental health adolescent support team; that they ring the access and crisis number and it rings out; or that they have been unable to find a bed with a mental healthcare provider. In Staffordshire, the latter is virtually impossible; in the west midlands, possibly slightly easier. Either way, this is a national issue that is not being addressed and which is not of the making of the hospital in Stoke-on-Trent To take the hon. Gentleman’s point slightly further, the CCG in north Staffordshire currently has a programme of slashing and burning all those support services and peripheral services that keep people from having to go to hospital in the first place. There is now no support for drug and alcohol services as a result of decisions by county councils, city councils and the CCG. Previously, these people were not presenting with acute problems in hospitals, but they now have no recourse to support and will end up presenting in A&E, in expensive treatment centres, getting the wrong sort of help for their conditions Independent support services in north Staffordshire for people presenting in hospital due to domestic violence are also being looked at and could be lost. The north Staffordshire users group, which recently changed its name to Voice, has had all its funding withdrawn by the CCG, meaning that people with mental health conditions can no longer advocate or receive support to advocate for the help and support they need. Again, that will compound the situation in our acute setting, but small, lower cost interventions from the community or the third sector could have prevented such people presenting Furthermore—I know this is not unique to north Staffordshire—the social care system in Staffordshire is a problem, not least because getting people out of hospital into social care is a problem. The Royal Stoke, Stoke-on-Trent City Council and Staffordshire County Council routinely have unacceptable wait times in hospital, and more and more people are having temporary arrangements put in place and having their care packages changed while they are being delivered, which we all accept is not good for patients, for providers or for our overall health economy, because every change will cost money I know that the Minister has received numerous substantive briefings from healthcare providers across north Staffordshire—I know that mainly because they have told me and partly because I would not tell them what I was going to say today so they had to cover a multitude of areas. To save the Minister having to regurgitate facts already shared with MPs, I have prepared what I hope are simple questions which, if he can answer them, will provide us with an opportunity to move the debate forward. Everybody, irrespective of party politics, wants to move forward. We want a hospital that has the funding it needs; community care provision that meets the needs of people in our communities; a mental health system that not only responds to people when they hit crisis point, but actively works with them to ensure they do not get to crisis point in the first place; and a social care system that allows people who need care at home to receive it Will the Minister commit himself to providing a full response to the community care bed referrals from Staffordshire County Council and Stoke-on-Trent City Council, and respond to the letters from the Members whom I mentioned earlier? Will he do that as a matter of courtesy, if nothing else, even if his response is "We are rejecting the referrals"? At present those beds are mothballed, and the consultation is being rerun. The Minister has an opportunity to ensure that 168 community care beds are returned to our health economy this winter, which would significantly reduce pressures on A&E departments I ask the Minister to use whatever powers he has to intervene between the University Hospital of North Midlands Trust and the clinical commissioning groups to ensure that the £10 million of fines are waived, because they constitute the difference between our hospital’s getting through the next 12 months and its crawling through the next 12 months on its knees. It does not make financial sense to penalise a hospital further for not meeting targets that it has struggled to meet because of its funding crisis. That is perverse economics by anyone’s standards I should be grateful if the Minister would guarantee that the £9.9 million from the Department of Health and the £14.9 million from NHS England which were promised to Royal Stoke University Hospital so that it could cope with taking on the responsibilities and, dare I say, the burdens of the county hospital for a short time as part of the trust special administrator model will be handed over to Staffordshire as a matter of urgency. That money is already budgeted for in Royal Stoke’s plans, and is part of the amount that would enable it to reduce its deficit from £119 million to £69 million. Without it, we shall face a winter of absolute crisis Would the Minister consider convening a meeting to reassess the 2018-19 and 2019-20 cost improvement programme figures of £35 million each? Asking the hospital to take a further £70 million out of its operating budgets over the next two years is akin to asking someone with no money to pay a huge fine. It will just rack up more debt, and will end up being fined for not meeting its financial targets and fined further for not meeting its medical targets. This is a vicious and horrible circle, and I hope that, if the Minister cannot do so himself, the Secretary of State will use his powers to halt it so that we can have a little breathing space in which to try to solve the problems in our hospital Will the Minister intervene to ensure that the £19.5 million that is owed to Staffordshire County Council for the better care fund to help relieve the pressure on local authorities that are trying to deliver social care can be handed over? NHS England should have handed over that money, but it has not done so, and the delay has caused the better care fund to have a deficit. If the money is released, the assessment programme that was meant to alleviate some of the hospital’s problems with discharging may be able to continue, but without it we shall be storing up problems for the future My next request involves a personal interest. As I am sure the Minister will know from his briefings, Staffordshire was a pilot area for a cancer care contract undertaken by Marcus Warnes of the CCG. The CCG hoped to procure a provider to deliver cancer care services, and £890,000 of public money was spent to that end—including staff time, the total came to nearly £3 million—only for the contract never to be let, and the process to be aborted. I appreciate that we cannot go back in time and rewrite the process, but what we can do is learn the lessons from Staffordshire to ensure that no other CCGs go through such an appalling and bungled procedure that wastes taxpayers’ money. I should be grateful if the Minister would consider convening a meeting that would enable us to learn the lessons and share them with other CCGs so that we, and they, do not make the same mistakes in the future Let me end on a convivial note. Nearly 18 months ago my predecessor, Mr Tristram Hunt, invited the Secretary of State to visit the hospital. During the by-election that I fought in February, the Secretary of State came to Stoke-on-Trent, but did not go to the hospital. On my own behalf and that of my hon. Friend and neighbour the Member for Stoke-on-Trent North (Ruth Smeeth), I invite the Minister, or one of his colleagues, to come to Stoke-on-Trent, not so that we can have a stand-up row about the future of our hospital, but so that we can actually start the process of healing it. No one in Staffordshire wants to see our hospital fail, but we are currently walking down that road blindfolded All I ask is for the Minister to address the seven simple questions that I have put to him, and if he were to take up the offer to visit us, he would be most welcome.