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Adjournment (Summer Recess)

It is a pleasure to make a brief contribution to this summer Adjournment debate. I wish to take this opportunity to raise just one issue that affects my constituency, but given the comments of many hon. Members it is the same issue that affects many of theirs—the crisis in health care in our constituencies. I raise the issue of health care in Harrogate and Knaresborough with particular sadness, because throughout my time in the House I have been at pains to point out my thanks and admiration for all those clinicians, managers and support staff who have made health care in my constituency a beacon of excellence. My constituency is blessed with arguably the finest and most dedicated group of general practitioners to be found anywhere in the UK. Those GPs have embraced reform, modernisation and the move to enhance the opportunities to deliver ever more services by primary care. We also have a general hospital, the Harrogate and District NHS Foundation Trust, which was ranked as a three star hospital for three consecutive years before achieving compliance status as a foundation trust in 2006. It currently sees 100 per cent. of cancer patients within 14 days and treats them within 31 days of diagnosis. It also treats 100 per cent. of elective patients within 13 weeks, and it has one of the lowest rates of hospital MRSA in Britain. And it has balanced its books in every single year since 1992. All that has been put at risk by the Government’s boom and bust policies and the arrogant tactics of the PCT, which appears more interested in pleasing its paymasters in London than patients in north Yorkshire as its officers scramble for posts in the new PCT structure. I say that with sadness, because until recently the Craven and Harrogate PCT delivered its services effectively, and it has remained in financial good health since its formation. In the space of six months, however, the local GPs are close to declaring a vote of no confidence in the chief executive of the PCT and are openly refusing to implement cuts in services that will put their patients at risk—good on them. I would like to believe that, but the problem is that there is currently no accountability within the service. Unaccountable people in unaccountable quangos have made the decisions, which affect a significant number of my constituents. The GPs were up in arms after the PCT issued new guidelines effectively blocking all but critical and urgent referrals. The guidelines cancelled access to treatment such as dermatology and led to the vetting of referrals through an internal administrative sieve. The proposals, which were presented without consultation with GPs, ignore GPs’ ethical, professional and regulatory obligations. GPs provide the primary care bedrock to our NHS service, and it is important that we recognise their position. It is unacceptable for non-clinical staff to make judgments about GP referrals, as if GPs refer patients simply for the fun of it. Consultation is key in tackling any difficult situation in any organisation, and it is crucial in the NHS. I hope that the Deputy Leader of the House will persuade the Secretary of State for Health to make such consultation a statutory requirement, not an add-on, in future. The GP referral issue impacts directly on both secondary and tertiary care, which means a direct impact on the Harrogate and District NHS Foundation Trust. Again, relationships have not simply broken down, because the two bodies are about to end up in court, where the worst case scenario is the closure of one of the country’s most modern and most successful hospitals. The hospital’s crime is that it treats patients too swiftly and too effectively. To deal with that, it must cut its activity by making patients wait for treatment until their conditions deteriorate, which means that staff and facilities will be under-utilised. More than £1 million of activity is being purchased from the private sector as part of a bizarre notion of choice. My constituents have been told that they can choose a hospital for their treatment provided that it is not their local NHS trust, which is the politics of the madhouse. Last year, the Harrogate trust was actively encouraged to take on more work, treat more patients and decrease waiting times and lists, all of which was in line with the Government policy of payment by results. The trust delivered the results: £3 million worth of extra patients in record time with top quality results, but the PCT has refused to pay up. The patients have been treated and the hospital has incurred the costs. At no time did the PCT discourage the activity, but it now claims that it does not have to pay and that the hospital should absorb the costs in the coming year. No business in the land could operate in that way, let alone one with a hugely expensive infrastructure. My local hospital cannot survive having its base budget slashed while being told to maintain current levels of activity. The Government must intervene in this dispute, if only to clarify their own policy. Foundation trusts are paid by activity or they are cash limited with their activity determined by an outside non-clinical body—one cannot have it both ways. They cannot be expected to ride two horses at the same time. The Secretary of State must accept that the £3 million deficit that my trust faces should be managed over an equivalent number of years and that from now on all activity commissioned must be paid for by PCTs. The future of health care in Harrogate hangs by a thread as we speak. If the current policies of the PCT go unchallenged—I suspect that a new chief executive and a new board will be required to win back the confidence of the clinicians—then Harrogate could see its hospital closed and its GPs become ever more disillusioned. I sincerely hope that the Minister’s right hon. Friend, the Health Secretary, is able to step in before it is too late.