Health spokesperson’s reply to MP’s parliamentary debate on DGH decision

Anna Soubry, the Parliamentary Under-Secretary of State for Health, told Eastbourne MP Stephen Lloyd that the controversial decision to temporarily downgrade maternity services at the DGH was a ‘local decision’.

Mr Lloyd secured a Parliamentary debate in the House of Commons about the unpopular decision to create a stand alone midwifery-led unit at the DGH and to maintain a consultant-led obstetric service at the Conquest in Hastings.

He told the Commons it was an ‘extremely challenging situation’ and added, “As the Minister will be all too aware, the IRP is the independent expert on NHS service change and advises the Secretary of State for Health on contested reconfiguration proposals in England.

“In 2008, it finally published its recommendations, which were that consultant-led maternity, special care baby, in-patient gynaecology and related services must be retained on both sites – at Eastbourne District General Hospital and the Conquest Hospital at Hastings.

“Despite clear guidance from the IRP on how the hospital trust must remedy the problem, four years later a report from the national clinical advisory team, or NCAT, has deemed maternity services in East Sussex unsafe.

“That has given ESHT the opportunity to downgrade Eastbourne’s maternity from a consultant-led department to a midwife-led department almost immediately and, because safety is involved, without consultation.

“The trust managers have achieved exactly what they failed to achieve all those years ago.”

“I am extremely angry that we have found ourselves back where we were, with my hospital losing its consultant-led maternity services. We are back to the point at which we fought and won all those years ago, only now it seems it was a Pyrrhic victory and that in fact we have lost.

“Eastbourne is to forgo its consultant-led maternity after all. Frankly, I think that is outrageous – absolutely outrageous.

“Eastbourne is the fastest growing town in East Sussex. Our fastest growing demographic is 25 to 45, the age at which most people have children.

“The road connections between Eastbourne DGH and the Conquest Hospital in Hastings are appalling – that was highlighted by the IRP report five years ago and they are still dreadful.”

Mrs Soubry replied, “I congratulate my hon. Friend the Member for Eastbourne (Stephen Lloyd) on securing this debate. Given that no doubt many people in his constituency will, I hope, read all my speech and all the comments I make, it is very important that I make a number of matters very clear.

“As I am confident that he knows extremely well, this decision does not lie with the Department of Health. When he asks me a series of questions, which of course I am more than happy to answer, he must know, and those reading or listening to this speech must know, that these decisions are local decisions.

“The coalition Government have taken the view that it is only right and proper that decisions of this nature regarding the provision of NHS services are made locally. My hon. Friend, quite properly, comes to this place to raise these matters on behalf of his constituents.

“I make no complaint at all about any Member of this place doing that, because, in many ways, it is our primary job. However, it is also absolutely imperative that when hon. Members, like my hon. Friend, come here and put forward a complaint on their constituents’ behalf, it is made clear where the decision-making process lies and where the responsibility lies—and it lies at a local level.

“That is why, in replying to his speech, I rely on information provided to me not by my officials in the Department, because they are not party to this decision, but by the various trusts, knowing the processes and understanding that this, as he must know, is a local matter.

“I am told that the trust has been experiencing challenges in recruiting doctors for the specialties associated with obstetric and paediatric services.

“This has been followed by advice the trust has recently received from local clinicians and the national clinical advisory team. That advice, I am told, indicates that the trust’s current maternity and paediatric services cannot continue as they are.

“I am told that the current arrangements are unsustainable in terms of delivering a safe service to patients. I am sure that my hon. Friend has at heart a desire to ensure that all his constituents receive safe treatments and the safe delivery of their babies. That must be his, and indeed everybody’s, priority.

“I am told that it is because of those factors – the shortage in recruitment and the safety of patients – that the trust has had to take urgent action, primarily on the grounds of patient safety. As my hon. Friend knows, the trust met in March and made a temporary decision – this is not a permanent decision.

“I am told that this is a temporary measure whereby the consultant-led obstetric service, neonatal services, including a special care baby unit, and in-patient paediatric and emergency gynaecology services will, in order to make sure that they are safe, be provided by Conquest hospital alone.

“I have been given information and am placing it before the House to ensure that the good people whom my hon. Friend represents have the full picture. It would be a serious allegation to suggest that the information with which I have been provided is false. I can say only what I have been told, which is that it is a temporary decision.

“That is combined with the establishment of a stand-alone, midwifery-led maternity unit, alongside a short-stay paediatric assessment unit at Eastbourne district general hospital. This means that if a paediatric patient requires in-patient admission, they will be transferred to Hastings under the interim change.

As yet, no woman or child has been transferred to Conquest hospital. I understand that the project plans are in place for the delivery of the interim configuration of maternity and paediatric services, providing a single-site service at the Conquest hospital from May 7.

“My hon. Friend is fully aware that the trust has confirmed, as I have said, that this is a temporary change and, indeed, that a strategic and long-term solution will need to be agreed within 18 months. It is also important to remind hon. Members that I am told that the process will be led by local general practitioners and what we now call local clinical commissioning groups.

“I am conscious that the clock is against me, but there is much I wish to say. I press on my hon. Friend that, as I have said, there are no specific proposals at the moment. I am informed that in order to develop a solution, the future of maternity and paediatric services is being considered as part of a separate, countywide programme called Sussex Together, which will bring together doctors, nurses and health professionals, in conjunction with local authority colleagues from across the county, so there is a real opportunity to improve health services and outcomes across organisational boundaries.

“I will, of course, write to my hon. Friend to try to answer all his questions. I wish I had been given notice of them, because I could have answered them today, but I am precluded from doing so. At the moment there is no point in my meeting any of his good constituents who are leading the campaign, because there is nothing that we in the Department can do. As I have said, this is a local decision and it is temporary.

“The trust’s latest decision has been taken on urgent safety grounds as a temporary solution, and CCGs—clinicians, doctors and nurses—hope to and will find the long-term solution to the problem. In arriving at that solution, CCGs will want to assess proposals against the four tests that have already been outlined. Adhering to those tests and continuing to focus on the needs of the local population will ensure that proposed changes to services are locally led, not Government-driven or directed by Whitehall.

We hope that everyone will work together, including the local authority’s health and wellbeing board. Moreover, the health overview and scrutiny committee is a very important organisation that can refer proposals to the Secretary of State. It comprises democratically elected members and professionals, all of whom can ensure that the right thing is done.”