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Robert Halfon tells House of Commons: Harlow needs a hospital for the 21st century: Robert Halfon

News / Wed 18th Oct 2017 at 03:59pm

Halfon PAH

HARLOW MP, Robert Halfon delivered a vital speech in which he promoted the idea of new hospital for Harlow.

The thirty minute debate took place in the Westminster Hall part of the Houses of Parliament.

With Harlow Council bosses sat behind him, Mr Halfon’s speech detailed the many reasons why Harlow (and the surrounding area) needs a new hospital.

The full speech is below.

“I am grateful to the Speaker for allowing this debate today and I am honoured to serve under your Chairmanship.

The Princess Alexandra Hospital was completed in 1966 to provide acute hospital and specialist services for around 350,000 people living in Harlow and the surrounding areas.

Alongside others, I have been working hard to improve health care services for Harlow residents that are fit for the 21st Century. I have worked to secure extra funding and more doctors and nurses for our hospital, and the new leadership team tirelessly do everything possible to improve performance. There is, however, only so much that can be done at the hospital as it stands. The infrastructure is deteriorating, the accident and emergency services are stretched and staff retention remains an ongoing issue.

It is for those reasons that I am putting forward the case today for capital funding for a new health campus in Harlow, bringing together accident and emergency services, GP provision, social care, physiotherapy and a new ambulance hub, bringing health care in Harlow into the 21st Century.

First, some context.

The Princess Alexandra Hospital is in special measures. It was judged as Overall Inadequate by the Care Quality Commission in 2016. It is important to note here, however, that Maternity and Gynaecology was rated outstanding at the inspection and, day in, day out, there is a huge amount of outstanding work ongoing by the Hospital leadership, the Hospital’s Chief Executive, Lance McCarthy, and doctors, nurses and auxiliary staff to provide the very best care they can.

I would also like to take this opportunity to praise the Trade Unions, led by people like Councillor Tony Durcan, Councillor Waida Forman and Daneilla Pritchard, whose only aim is to improve the quality of the hospital care and services for their members.

Much of this improvement work has been noted by the CQC. The report did, however, outline various remaining concerns, from staff shortages to deteriorating mortuary fridges, some of which were no longer fit for purpose and were ordered to be repaired during the inspection.

1. Infrastructure

This leads me to my first and most pressing concern. The Princess Alexandra Hospital is not fit for purpose. It is unable to provide health care fit for the 21st century for Harlow and the wider area.

According to the CQC Report in 2016, and I quote,

“The environment is one of the top risks for the trust. The estate is aged and in need of repairs costing tens of millions.”

Much of the hospital is original and therefore over 50 years old. It has exceeded its useful life and much of the infrastructure is in a state of permanent decline. In addition to the original hospital built in the 1960s, a number of ‘temporary’ structures have been added, many of which have now surpassed their 10-15 year lifespan.

This creates a complicated design, with urgent care spread across the site.

In fact, a 2013 survey rated 56% of the hospital’s estate as unacceptable or below for its quality and physical condition.

This puts the capacity of the hospital to care for those in need at serious risk. It becomes strikingly clear when I hear reports of sewage and rain water flowing into the operating theatres.

The doctors, the nurses, the management team and support staff at the Princess Alexandra Hospital work so hard every single day but their working lives are made so much harder by the Hospital’s deteriorating facilities.

2. A&E

In addition to the ageing infrastructure, the services are under increasing pressure to provide care to residents in Harlow and the surrounding area.

Changes to other local facilities have placed additional pressures on the Trust’s capacity resulting in occupancy levels running greater than 96 per cent. This means that the Princess Alexandra is not only fundamental to the health and wellbeing of the growing Harlow population, but to a wider area, including parts of Hertfordshire and Epping Forest.

The Emergency Department, in particular, suffers. As the CQC reported last year,

“Long waits in the emergency department and capacity issues in the wards meant that patients were not always seen in a timely manner, with many patients in the emergency department breaching four hour and 12 hour targets.”

The Department struggles to deliver the National 4 hour Standard, achieving 72 percent for 2016/2017. Having said this, the A&E saw 10,628 more people in under four hours last year than it did in 2009/2010.

This improvement is astonishing when it is considered against the changes to the nearby Emergency Departments and attendance rates at PAH being 10 per cent higher than the national average – around 200-300 visitors per day.

Chase Farm Hospital near Enfield became an Urgent Care Centre in 2013. The same happened at the Queen Elizabeth II near Welwyn Garden City in 2014. Urgent Care Centres only deal with minor injuries, whilst the Princess Alexandra Emergency Centre deals with these, plus major injuries, including life threatening chest pains and head injuries. All major injuries and illnesses have been dispersed to surrounding Emergency Departments and attendance at Princess Alexandra has therefore been consistently rising.

In order to deal with this strain, the hospital successfully secured £1.95 million of Emergency Department capital funding in April this year, allowing significant building works to support the Department’s work, including the expansion of the medical assessment space. This is coupled with an A&E-focussed recruitment drive to take advantage of the new facilities.

3. Staff

This leads me onto staff recruitment and retention.

Whilst Harlow’s hospital now has 27 more doctors and 35 more nurses than 2010, the vacancy rate and recruitment is a perpetual worry. The nurse vacancy rate for September stood at 25 per cent.

Staff vacancy rates were picked up in the CQC’s report in 2016, where inspectors found that:

“Staff shortages meant that wards were struggling to cope with the numbers of patients and that staff were moved from one ward to cover staff shortages on others.”

The proximity of Princess Alexandra to London plays a major role and, whilst pay weighting is a factor, I have been told by the Hospital leadership and Harlow Council’s Chief Executive, Malcolm Morley, who is here today, that career development is significant.

Princess Alexandra Hospital must compete with Barts and UCL in specialist training and career development. The Retention Support Programme established career clinics and clear career pathways but there is only so much the Hospital can do to compete with the huge investment and facilities at London hospitals.

Harlow needs to be able recruit and retain staff. Part of recruitment is down to the future of hospital itself and part is related to the ability of staff to develop their careers in Harlow. Both of these factors relate, of course, to the Hospital’s infrastructure.

Ministers

“I’ve tried to make sure our NHS in Harlow is a top priority for the government and have had many meetings with the Health Secretary and the Hospitals Minister, both of whom have visited our hospital a number of times.

Most recently, in May, Jeremy Hunt, Secretary of State for Health, met staff and we spoke to the hospital’s leadership team about Harlow’s case for a new hospital. The Health Secretary spoke of the:
“exciting proposals which are coming together to invest capital in upgrading these facilities, including the option of a brand new hospital.”

He also stated that:
“these proposals are at an early stage but upgrading services on this important site will be a priority for a Conservative government.”
Following capital funding announcements for Sustainability and Transformation Partnerships in July, I was informed that:
“Princess Alexandra Hospital is still a real priority [for the Department of Health] and work is ongoing to take it forward”,
and, that the Government is
“on hand to carry on helping get the [Princess Alexandra] bid together.”

My question to the Minister is: Given what the Health Secretary has said about PAH being a priority case, what is the current budget for capital funding and how will it be allocated to new hospitals, such as Harlow?
In autumn 2016, the Secretary of State requested that the PAH board, local CCG and Local Authority partners progress a Strategic Outline Case (SOC).

After considering a number of options,
“the SOC concluded that a new hospital on a green field site, potentially as part of a broader health campus, to be the most affordable solution for the local system and the solution that would deliver most benefit to our population.”

4: New Hospital Proposal

The Health Campus would bring together all the services required to ensure health care in Harlow is fit for the 21st Century – emergency and GP services, physio, social care, a new ambulance hub, a centre for nursing and healthcare training…

Having recently met the Chief Executive of the East of England Ambulance, I know that there has been a significant increase in the number of calls received from critical patients who need a fast response. Harlow now has four new ambulances but the development of a top-class Ambulance Hub would allow huge improvements in this area.

The Health Campus could also act as a centre for degree apprenticeships in nursing and healthcare, bringing specialist training to the East Region. It could build on strong links between the Princess Alexandra and Harlow College and capitalise on the new Anglia Ruskin MedTech Innovation Centre at the Harlow Enterprise Zone.

The Health Campus proposal has been supported by West Essex CCG and East & North Herts CCG, and the Hertfordshire & West Essex STP which brings together 13 local bodies and hospital trusts. A joint letter has also be signed by over ten Councils, including Harlow, Epping Forest, Essex County Council and the Greater London Authority.

Despite recognition from Local Authorities and Ministers alike, there are some NHS England officials who suggest a refurbishment would be more fitting than the development of a brand new hospital due to capital funding constraints. This solution is the equivalent of an Elastoplast; a short term option.

Given the support from the Government and key organisations, we need to be sure that plans for a new hospital are not obstructed. Can I have assurances from the Minister that NHS England and NHS Improvement will work positively with public, private and voluntary sector partners to progress the plans? A rapid strategic solution is needed, rather than a short term fix.

The cost of the new campus model would be between £280m and £490m, depending on the type and preferred method of funding. The Hospital leadership is willing to look at all options to maximise public sector investment, to bring together the public, private and voluntary sectors. Private investment will not involve any kind of PFI contract. The leadership will focus instead on how the private sector works with NHS and how the development can generate revenue flows through social care, for example.

This development also raises the potential development of housing as a source of income or private investment. These are decisions for the future. When private investment is looked at, the PAH leadership will look at supported housing and other similar options.

Moreover, with Public Health England moving to Harlow and creating a world class science hub, we must ensure that Princess Alexandra is an important partner, benefitting from and adding to the success.
The creation of a Health Campus is vital, not only for Harlow, but the surrounding area. The infrastructure the Health Campus would create is fundamental to vitality of community and also the economy of the entire region the Princess Alexandra serves.

Conclusion

I have visited the Princess Alexandra Hospital many times. I defy the minister to find more professional and dedicated staff, doctors and nurses, working day and night to look after the people of Harlow and the surrounding area. I’ve seen incredible work in the A&E, intensive care and the maternity and children’s units.

That is why I know that the staff working in PAH are second to none. However, this professionalism and hard work will go to waste unless our hospital is fit for purpose.

I know that the Secretary of State recognises this given his numerous visits to the hospital and what he has said since. I know that the Minister recognises this given his visit to the hospital this time last year. I know that all the key Local Authorities and Trusts support this. I urge the Minister to do everything possible to ensure that Harlow has a hospital fit for the 21st Century.

Film of Mr Halfon’s speech begins at 1600 hrs below.

http://parliamentlive.tv/event/index/d88cb1dd-c90a-4665-bda6-3af9e6320b72?in=16:00:06&out=16:30:00

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