Mid Yorkshire Hospitals NHS Trust — House of Commons, 2016-07-21
Topic: Health
Yvette Cooper (Labour, Centre-left): My hon. Friend is right, and these are the sort of individual examples that we increasingly hear about from our constituents—from both staff and patients. I have heard from staff in intensive care and in paediatrics who are deeply worried about the pressures and responsibility on them lest something should go wrong on their watch as a result of understaffing. They are deeply concerned that they will be unable to provide the care that is needed and are worried about the implications The trust’s planning guidance suggests that it can cope with up to 22% of the contracted hours not being provided and still provide a safe service. Beyond that, it shows that significant problems are likely to be encountered in delivering the right level of care. Overall, however, the gap is not 22%, but 26% for registered nurses and 30% for registered midwives. In A&E, the average shortfall in contracted hours is 30% and there is a similar 30% shortfall in children’s services. On some wards, the proportion of temporary staff from agencies and the NHS banks is particularly high. On acute assessment wards, 20% of the nursing staff are agency staff. On the short-stay wards, 11% of the nursing staff and 33% of the healthcare assistants are from agencies and the bank It is not just about the pressures on nursing staff. Senior staff at the Mid Yorkshire trust say that they are doing a huge amount of work to address the nursing shortages, but they are even more worried about the shortage of doctors—not just at Mid Yorks, but across Yorkshire. According to the Royal College of Physicians, 14% of the consultant posts at the Mid Yorkshire trust are vacant. In A&E and neurology, there is a particular problem, and there are regular and significant gaps in the contract rota for junior doctors. Some 15% of the acute medicine rota is not filled by contracted staff, and it is 18% for the emergency medicine rota, 20% for the anaesthetics rota and 20% for the surgery rota In practice, the trust is having to fill the rotas either with consultant staff acting down in more junior posts, or with locum staff. It is a choice between doing that and cancelling operations, or turning ambulances away. The trust is, of course, is committed to providing the best service that it can provide and not letting patients down, but locum care means that medical staff do not have the relationships or the knowledge of the system that would enable them to do the best possible job, and it costs far more as well. Because the trust cannot recruit enough contracted staff, its average spend on agency doctors in the first three months of the current financial year was £1.5 million a month—and, as we know, it is a trust that faces significant financial pressures. So what is it supposed to do However, this does not apply only to Mid Yorkshire Hospitals NHS Trust. In the country as a whole, two in five vacant consultant posts went unfilled last year, according to the Royal College of Physicians. In the north of England, there are serious staff shortages in our hospitals. That is what we hear from our constituents. My hon. Friend the Member for Dewsbury spoke of appointments being cancelled and waiting times being affected. What troubles me particularly is the fact that there is now a 20-week wait for the pain clinic. Because of staffing problems, patients who are suffering pain and could be supported and helped are having to wait 20 weeks to be seen What are the Government doing about this? All too often Ministers shrug their shoulders and think that it is someone else’s problem, or that someone else will sort it out. I contacted the Secretary of State in 2010 and 2011 saying that the training numbers that were being set by the Yorkshire and Humber Deanery, particularly for A & E, were not enough, and were certainly not enough to meet rising demand, but nothing was done. Given the scale of rising demand for healthcare and given our ageing population, far too few doctors are being trained. There is also a significant and serious regional disparity, with bigger shortages in the north and the midlands It is incomprehensible, given all those pressures, that the Government should choose this moment to pick a major fight with junior doctors that ends up demoralising them, and drives many of them to consider either going abroad or leaving the profession altogether at a time when we need every doctor we can get The Department of Health is also taking a massive risk when it comes to nursing staff. It is ending nursing bursaries, although in areas like ours that means that many people who could have become great nurses will be put off because they are worried about the debts that they will incur, and about not being able to afford the training. It is also refusing to give a proper assurance to the thousands of European Union citizens who work in the NHS—our trust has often recruited such people because of the shortages at home—that they can stay and fill those crucial posts Referring to nurse training, the Minister who responded to the debate initiated by my hon. Friend the Member for Dewsbury a few months ago said: "Within the current spending envelope…it is simply not going to be possible to achieve the numbers that we wish to see."—[Official Report, 21 March 2016; Vol. 607, c. 1354.] That is not good enough. We need enough nurses, and enough doctors, to provide the care that our constituents need and deserve. That cannot simply be left to Mid Yorkshire Hospitals NHS trust, or to any individual trust in the country So many of the issues are linked, whether we are talking about the training numbers on which the deaneries decide or decisions made by the Department of Health that have an impact on morale, pay or incentives throughout the country. We now need a regional action plan setting out what the Government are going to do, and what NHS England is going to do, to address the serious shortages of both nurses and doctors in Yorkshire, because unless something is done, something serious will happen to patient care. I do not want to warn again about this, as I did some years ago, but it still has not been sorted out, and that is not fair on patients in Yorkshire and throughout our area In the case raised by Mr Fanshawe, Edith Cunningham had a family who stepped in and looked after her while she was in hospital, but many more patients do not have families who can fill the gaps and step in. So for the sake of all of those patients, and for all of those who we—all of us in all parts of the House—will want to get the best possible care, I urge Health Ministers to get a grip on this and get us the regional action plan we need, before patient safety is affected.