Mike Penning (Hemel Hempstead) (Con): I am pleased that the Minister of State, Department of Health, the right hon. Member for Doncaster, Central (Ms Winterton) has returned to the Chamber because, unusually for me, I am about to praise her. I congratulate her on the mental health Bill that is to be introduced, on which my colleague on the Labour Back Benches, the hon. Member for Bristol, North-West(Dr. Naysmith), worked so hard on the Health Committee and the Regulatory Reform Committee on which he serves. He is truly an expert in the field. I hope that much of the work that has been done on previous Committees is incorporated into the Bill that will come before the House.
One aspect of mental health provision is particularly important. It is right that we do not have the sort of Victorian institutions that I grew up around. The Runwell hospital in Essex, which was close to my home and where many of my friends used to work, was an appalling institution where people were sent for reasons that had nothing to do with mental health. It was right and proper that care in the community was introduced.
However, I have raised with the Minister previously my grave concern that at times people need help which cannot be delivered in their homes or in the community by their local GPs and other experts. Very often, people want to admit themselves to a ward, not only to get the help that they need, but so that their carers can get the help that they might need at times. Sadly, some of those wards are under threat as a result of the deficits in some mental health trusts—not least St. Julian’s ward in St. Albans in south-west Hertfordshire.
So many of the patients and carers to whom I have spoken need such wards as a safety net. The wards need not be full every day or every weekend, but they should exist as a facility so that when care in the community cannot quite cope with individual cases, patients can be admitted to a ward. In the vast majority of cases, those are self-admissions. There is a great deal of fear out there that we pushed too hard down the avenue of care in the community, believing that everything could be done outside a ward—often outside a secure ward.
There is also fear—ill-founded in many cases—that people who go into a ward are a danger to the public. Very often, they are admitted because they are a danger to themselves, and they know it. That is a difficult mental health issue, as I know the Minister recognises. Although I praise the work that has been done and look forward to the Bill, the contraction in secure wards must not go too far, or we will have even more problems in the community. I am pleased to see the Minister nodding, indicating that that will be looked at.
Before I go on to speak about the circumstances in my constituency, I shall deal with another aspect of health that worries me greatly: health in the armed forces. I have the honour of participating in the armed forces parliamentary scheme, and I also had the honour of serving in the Army when I was much, much younger. I recently visited the Army recruiting centre down on Salisbury plain. A matter of grave concern is the shortfall of about 7,500 servicemen, especially in the infantry and the Royal Artillery. Furthermore, almost 10,000 servicemen and women are sick and unable to be deployed on operational duties. That is a huge figure for a standing Army of fewer than 100,000. Together, those numbers mean that about 17,500 servicemen and women are unavailable for operational duties.
If the contraction of medical services in the armed forces continues, that will place an increasing burden on the health service. I asked the senior generals in charge: who was signing off the soldiers—who was responsible? Was it the medical officers in the armed forces?
Angela Watkinson: My hon. Friend makes an important point. On Remembrance day this week, I spoke to servicemen who had been retired for a considerable time, but who were clearly still suffering the long-term effects of active service and had not had any treatment.
Mike Penning: Any Government of any political persuasion should look after their armed forces, who have given so much to the country. It is extremely worrying that such reports are still coming through.
I asked the generals whether so many people were unavailable for operational duties mainly because of injuries resulting from conflict, and the answer was no. In most cases, sickness notes are signed by civilian doctors—GPs—who do not necessarily understand the ethos of the armed forces quite as well as they should. Many of the ladies and gentlemen who serve in the armed forces may not be operationally available to serve in Iraq, Afghanistan, Sierra Leone or elsewhere around the world, but they may be able to do a desk job or something while they are recovering from their injuries.
I was most grateful to General Viggers when he said that many servicemen who have had amputations as a result of injuries sustained in Afghanistan and Iraq would not automatically be discharged from the armed forces, as would have been the case when I served in the Army, when those with a serious injury would have been thrown out on to the dustcart. These days, common sense prevails and people’s skills are used.
Daniel Kawczynski: My understanding from what the Prime Minister has said in the House previously is that he will consider giving the armed forces only a dedicated wing of the hospital in Selly Oak, whereas on the continent many countries have a specific hospital in their capital city that is purely for their armed forces and their relatives, who, in the event of the deaths of their partners obviously need that special care as well. Does my hon. Friend agree that our country, which has the best armed forces in the world, should also have a dedicated hospital for our armed forces?
Mike Penning: As a former soldier, I could not agree more. I am due to visit Selly Oak hospital in the near future; it does some fantastic work. Selly Oak is working hard, but the ethos in the armed forces is completely different from that in a civilian establishment.
I ask the Minister to look carefully at health care for our armed forces, which in most cases these days because of the closure of military hospitals is provided by civilian GPs and surgeons. It is important to look after our servicemen and women when they are in desperate need. Will the Minister also look into why so many of our armed forces are sick or unavailable for operational duties? Ten per cent. of the standing Army seems a huge amount; a figure that we probably would not accept on the civilian side.
Mr. John Hayes (South Holland and The Deepings) (Con): As my hon. Friend has made such a compelling case, would he use this opportunity to invite the Government to make time in their agenda to debate more fully the issues that he has raised on medical services for the armed forces, because I do not think that the House has said or done enough about that?
Mike Penning: I could not agree more. We have defence and armed forces debates every year, but this is a specific area that needs help. Servicemen and women would like to hear the House debate matters that are of such importance to them and, most importantly, to their loved ones. Sadly, today, we have seen four of our brave servicemen and women brought back from Iraq after the terrible, tragic deaths on Remembrance day just outside Basra.
The Minister will not be surprised that I come now to the reconfiguration, cuts, closure, sackings, or however one wishes to describe what is going on at this moment at a board meeting of West Hertfordshire Hospitals NHS Trust, which is deciding what to do about local medical provision in south-west Hertfordshire. For some months now a consultation has been under way. Earlier the Secretary of State went on and on about local involvement, democracy or consultation in the way in which the health service is provided within our communities. I was fascinated to hear how she wants more and more people to be involved. I have the honour of representing a constituency that could not be more involved in the future of its general hospital. It has been campaigning for 30 years to try to keep it open, under successive Governments. I freely admit that there were pressures in the ’90s to close Hemel Hempstead hospital, but a decision was made long before 1997 that that general hospital—with full A and E and maternity services, and built for the community as a new town—must stay open because of the services that it provides to 250,000 to 300,000 people.
Investment from the previous Conservative Government—nearly £70 million—was made and massive rebuilding took place. New buildings opened and everybody seemed happy. Then, in 1997, this Government came to power. Within weeks, they closed the consultant-led maternity unit at Hemel Hempstead hospital and moved it to Watford. Since then, there have been continual closures at the hospital—
Sir Nicholas Winterton: Ministers are not listening.
Mike Penning: That is because they have heard it all before. They are not listening to my constituents either. During the ongoing consultation process, we have written to the Secretary of State on many occasions. She has been sent tens of thousands of letters asking her to visit Hemel to explain why she wants to close the local general hospital. Hon. Members may be interested to know that she turned up a couple of weeks ago. She did not go anywhere near the hospital, of course; she went to the local social services department. There was a small demonstration outside comprising ladies with pushchairs, people in wheelchairs, elderly people on walking sticks—oh, and a Member of Parliament, namely myself. The Secretary of State did not come past to look at their banners and try to understand the local community’s concerns. Instead, the police were called and three patrol cars arrived, at huge expense to my constituents. At the same time, she was hopping over a back fence to try to get through the back door and run away from my constituents and the local media. That is the kind of listening process that she has been undertaking in my constituency.
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): How do the hon. Gentleman’s demands for intervention from the Secretary of State fit with his Front Benchers’ policy of operational independence for the national health service? Has he explained to his constituents that their policy is that the Secretary of State should not interfere at a national level in the local decision-making process?
Mike Penning: That is the most feeble intervention from the Front Bench that I have heard for a long time. Has not the Minister noticed that his Government are in power and that his Secretary of State is in charge of the future of our hospital in Hemel Hempstead?
Daniel Kawczynski: They are in office, but not in power.
Mike Penning: My hon. Friend makes a good point. When we return to power at the next election, we will empower local authorities and local people to ensure that that sort of thing does not happen. At present, sadly, the Secretary of State is in charge of the future of my local health service. The Minister keeps nodding and wittering from a sedentary position—if he would listen for a while he might learn something about what goes on in local democracy.
For months, letters have gone to the Secretary of State asking her to intervene. She has the power to appoint the chairman and the chief executive of the trust and to remove them if she is not happy.The Government have been complicit throughout with the proposals to close the vast majority of the hospital. Nevertheless, there was a consultation process, because that has to take place under the legislation. The results of that consultation were announced a few hours ago in Watford at the meeting of the board of West Hertfordshire Hospitals trust. Eighty-five per cent. of respondents said, “Leave Hemel Hempstead hospital alone—we do not want it to close.” Yet the chief executive of the trust stood up and said that he wanted to go ahead with the proposed closures.
Such closures and amalgamations are devastating for a local community. I agree with the hon. Member for Wyre Forest (Dr. Taylor), my colleague on the Health Committee, who talked about keeping local services local. We hear a lot about choice in the health service these days, but there is no choice if one has nowhere to go. Under the proposals that are being nodded through by the board, the chief executive will order the removal of all acute services from Hemel Hempstead hospital to Watford general hospital. By the way, I should add that Watford is one of the few places left in Hertfordshire with a Labour MP. Elective surgery will go to St. Albans. All the services of a full general hospital, which was built for the new town that was its community—not all constituencies represented by Conservative Members of Parliament are rural; mine is a new town with some serious social and economic problems on the estates—will go. If we are lucky, we may be left with an out-patient and diagnostic department.
Hon. Members may be interested to know that the trust has already been in discussion with developers, and that an informal meeting took place with the local authority—representatives of which had to attend, whether they wanted to do so or not—about redevelopment and building houses on the hospital site. When the Secretary of State goes on and on about local engagement and involvement, it is frankly a sham. The decisions are based purely on financial deficits.
At a public meeting, when I asked the medical director of the trust whether he would close the hospital and cut all the services if it were not for the deficit problem that he had been told to sort out, he replied that the cuts were based not on clinical need but on financial problems. He will probably get the sack for admitting that, but at least he was honest, which is a damned sight more than Government Front Benchers’ comments on the state of the health service today.
I shall sit down in order to let many of my colleagues talk about the health service and its importance to them. However, I emphasise that decisions are being made today that affect my constituents’ future. I think that we shall be among the first to be hit by the cuts. It appears that, by Easter, there will be no hospital in Hemel Hempstead. That is a disgrace.
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