---

Health Care (Norfolk)

It is a pleasure to serve under your chairmanship, Mr. Marshall, for the second time this morning. We move seamlessly from Kosovo to Norfolk. I welcome this opportunity to speak in this short debate, which I am holding against the background of Norfolk primary care trust's proposals, published in July 2007, for intermediate care services and, more recently, the Darzi review, which is proposing further reconfiguration of health services, which when firmed up will obviously have an impact on Norfolk and my constituents in Mid-Norfolk. As in other parts of the country, health care in Norfolk depends very heavily on the work of our health professionals—doctors, nurses, specialists and carers—who do more than just the statutory hours that they are expected to work for the money that they earn. Between February and June last year, Norfolk PCT conducted a review, as I have said, of intermediate care services. There was quite widespread public consultation, which produced considerable local opposition to what was seen as a cost-cutting exercise at a time when Norfolk, along with many other PCTs, was heavily in debt, and to the closure and possible reduction of local community hospitals. On 16 May last year, I initiated a half-hour debate in Westminster Hall on the future of St. Michael's hospital in Aylsham in my constituency. On 24 July, Norfolk PCT approved a set of proposals that provided for 178 beds spread over five community hospitals in Norwich, Dearham, Kelling, north Walsham and Swaffham. Unfortunately, St. Michael's hospital was down to close. On 18 October, Norfolk's health overview and scrutiny committee effectively put that closure on hold for four months, because it was concerned about the alternative care plans proposed for Aylsham and the surrounding area. I declare an interest in that I live not in Aylsham but eight miles away in Reepham, so for me and my family what happens there is more than just academic. Since the closure was put on hold, Norfolk PCT and the Aylsham group, which brings together local representatives, and on which I sit, have been in negotiations. I want to lay before the Minister a series of points, which I suspect that he will say are not his direct responsibility to a certain extent, owing to devolving responsibilities down to PCTs on many such matters. Nevertheless, he should have taken a view, not least because of the resource implications and the fact that we might very well be overtaken by the Darzi review. The PCT is concerned, because St. Michael's represents the only community hospital serving in the old Broadland PCT area, but has said that an analysis of the usage of the hospital established that only 24 beds on average were used by patients registered with Aylsham practices. It has been considering the most appropriate way in which to sustain the outpatient and therapy services provided at the hospital and to commission beds in the prospective nursing home planned for the site. It points out the requirement for sufficient beds to meet the needs of Aylsham people and that the consideration is for five beds at the nursing home. However, that figure is for guidance rather than prescription. I consulted with local doctors who believe that the number of beds—five—is far too small, not only for meeting the current criteria but for meeting the likely population growth in the area over the next five to 10 years based on Government statistics, not those provided locally. That last point is important. The re-development of the site has, from the outset, involved a close partnership between Norfolk PCT and the Aylsham care trust. At the beginning of December 2007, the PCT's provider services made available to Aylsham care trust the spatial requirements for the therapy and outpatient services that could be provided within a community facility, which was to be built for Aylsham care trust with the development of the overall site. Negotiations are now going on between the Aylsham community and Norfolk PCT. I bring that to the Minister's attention because my constituency is a microcosm of problems affecting health care throughout Norfolk. Pressures are greater or smaller, and I am not suggesting that Norfolk necessarily has tougher health care challenges than other parts of the country. It has specific health care challenges—not least an ageing population. There is also the sheer size of the area covered. One of the biggest challenges facing the health authorities, as in education, is presented by the distances involved in people getting to some form of health care or in merely transporting them around. It is obviously a different matter for urban areas. Norfolk PCT has proposed the Aylsham health campus project. I do not think that that would have come about if the scrutiny committee had not deferred the matter for consideration for up to four months—it is fascinating to see what a little pressure does in getting PCTs to introduce proposals. Its objectives are to"““examine the health needs of the population of Aylsham … consider the ways in which a health campus at Aylsham could meet those needs … consider whether a health facility in addition to the Aylsham Care Trust Community Centre is needed or viable …consider how co-ordination can be achieved between the Community Centre, health services and the residential home””" and to"““consider the appropriateness of a 'well-ness' facility””." I have not yet managed to find out what a ““well-ness”” facility means. Is there such a thing as an ““unwell-ness”” facility? If there is, I think that I, and many other MPs, would meet every criterion. The final objective is to"““consider the appropriateness of facilities for GP training and other GP activities not necessarily required to be provided at the two practices””" in Aylsham. At the moment, therefore, the decision has been made to close St. Michael's hospital, and many of its supporting facilities, which will affect the health care of an area larger than Aylsham. A number of beds at the hospital have been used by people from as far away as the north Norfolk coast and Norwich, which demonstrates that there is a bed shortage throughout Norfolk, although I accept fully that health services must be flexible. Nevertheless, negotiations are ongoing between the PCT and the local community. As I said, I do not think that, if the scrutiny committee had deferred the decision, we would have reached that stage. What do we, the local community, want for the future of health care in Aylsham and the surrounding area? That forms part of the negotiations. The Aylsham group believes that the hospital should remain open, but has expressed a willingness to compromise to the extent that"““replacement services should be in place and proved to be effective before the hospital is closed.””" The date for the closure of the hospital is 2009. The PCT has now been asked to keep the hospital open for five years for the following reasons. If at all possible, I would like the support of the Minister, at least indirectly. The reasons are that the percentage of elderly population in the area is about 30 per cent., which is 10 per cent. above the Norfolk average, which itself has a fairly high percentage nationally, although it cannot beat places such as Bournemouth and Eastbourne, and that we must consider the further projected population growth. Current discussions, as part of the local development framework, indicate additional housing for the town of Aylsham and the surrounding area. I know that from talking to the local authorities. We have no way of knowing the success of staff recruitment for the nursing home, or indeed for the home care teams. The Minister knows that the combination of looking for savings in health budgets, and the medical assessment that the best way of dealing with many people who are ill or have had an accident is by looking after them in their home, will mean the redeployment of staff, and challenges in recruiting and retaining staff in areas where, given the geography and road communications, many of them will spend a great deal of their time on the road.