NHS Re-organisation

Daily Telegraph
Here we go again.  There have been rumours for weeks.   Now there’s a formal invitation to be briefed on the forthcoming “strategic” merger of Kent’s NHS “commissioning groups”.

In 21 years as Sevenoaks MP I’ve known one constant – endless NHS re-organisation.  When I arrived in 1996 there was just one District Health Authority.  This was then split into a new West Kent health authority and several GP fundholding practices.  In 1999 these were merged into the Sevenoaks and Tonbridge Primary Group.   In 2002 this became the West Kent Primary Care Trust.  In 2006 this Trust was merged again, with two neighbouring Primary Care Trusts to form the North West Kent Primary Care Trust.

Then came the Lansley reforms.  His massive Bill, burning up hours of parliamentary time and much coalition political capital, swept away the Primary Care Trusts, on which GPs were already represented, and replaced them with Commissioning Groups (on which more GPs were represented).  Our West Kent Commissioning Group took effect in 2013.

Now its days, too, look numbered.  A statement last month suggests each of Kent’s eight Commissioning Groups will now be brought together to form “a single strategic commissioning function”.  Our commissioners have explained: “it has become clear to us collectively that there is a need for some aspects of the commissioning of NHS care to be more joined-up.”   So new notepaper, new senior posts, yet more change.

That’s only part of the ever-changing NHS mosaic.  Higher up, the South East Thames Regional Health Authority became the South Thames Regional Health Authority in 1994.  In 2002 this was split into smaller “strategic” health authorities, in our case the Kent and Medway Strategic Health Authority.  In 2006 this was enlarged to become the South East Coast Strategic Health Authority.  In October 2011 that merged with two neighbouring strategic health authorities to become the South Coast Strategic Health Authority.  Just 18 months later it was abolished altogether.

Beyond primary care, the same upheaval. Mental health and community services were originally provided to Sevenoaks by the District Health Authority.  In 1997 mental health services were transferred to a new Invicta Community Trust.  In 2002 Invicta merged with the Thames Gateway Community Trust to form the West Kent NHS and Social Care Trust.  Four years later the West Kent and East Kent NHS and Social Care Trusts came together to form the Kent and Medway NHS and Social Care Partnership Trust.

Meanwhile other community services moved in 2009 from the Invicta and Thames Gateway Trusts to West Kent Community Health, which in 2011 merged with East Kent and Coastal Kent Community Services NHS Trust to form Kent Community Health NHS Foundation Trust.   Ambulance services were run by Kent Ambulance Service: in 2006 this merged with the Surrey and Sussex Ambulance Services to form the South East Coast Ambulance Service NHS Trust.

In the midst of this bureaucratic turmoil survives Sevenoaks Hospital, founded in 1870.  But its day-to-day operations are becoming increasingly complex.  Since 1997, it’s been owned by Invicta Trust, by the West Kent Primary Care Trust and by NHS Estates.  Now owned by NHS Property, it’s run by Kent Community Health NHS Trust, with clinics run by various NHS organisations – even some from Sussex.

I make that at least 19 different bodies that have been “running” the NHS in Sevenoaks, almost one for every year I’ve been its MP.  All these changes have been accompanied by hopeful PR, promising better patient service.  But each has involved more cost and more management time which could be better spent on patients. So much change erodes public confidence: nobody really knows who is responsible for what.

Ever-changing bureaucracies undermine local institutions and affections.  In twenty-five years we’ve moved from local to district, from strategic to local, and now back up to county again.  Who can be sure of the right level at which to allocate resources and prioritise services when there’s nobody in charge long enough.

The damage isn’t just to patients and the public but to front-line staff.  It is our hard-pressed nurses and doctors who have to re-adjust their reporting procedures, to cope with fresh layers of bogus accountability, to learn the latest jargon of the newly merged.  This isn’t why they joined.   And we don’t need more of it.    After serving as a surgeon in the Second World War my father joined the NHS as it began: in 25 years he dealt only with a single regional hospital board.  Are we really better served now ?

There are now 32,000 senior managers in the NHS, paid over £65,000 a year: 7 per cent up on a year ago.  Remember the empty St Edward’s hospital in Yes, Minister – the best-run hospital in the country, but which had no patients.  If we’re serious about putting patients before paperwork, it’s time we stopped endlessly re-organising the NHS.

Honouring Lizzy Yarnold in House of Commons

Lizzie Yarnold at Pyeongchang 2018
Lizzie Yarnold at Pyeongchang 2018

Michael has tabled a motion to the House of Commons in honour of Lizzy Yarnold’s “magnificent success” at the PyeongChang 2018 Olympic Winter Games.

Yarnold became the first Briton – and the first skeleton athlete – to win successive Winter Games golds when she claimed victory last Saturday on an historic day for Team GB.

Michael’s tribute follows news that Yarnold, originally from West Kingsdown near Sevenoaks, is now the most decorated British Winter Olympian.

The Sevenoaks MP also called on the Government to recognise Yarnold’s achievement with a lasting commitment to youth sport.  Members of Parliament from different parties continue to add their names to the motion in support.

Michael said: “Many congratulations to our double Olympian.  Let’s use this momentum to set up a talent programme, helping our young people access any specialist sports equipment needed to succeed in events like the skeleton.”

Welcome News: Extra Funding for Kent

Michael has welcomed the extra funding for Kent announced today by the Communities Secretary Sajid Javid.

The announcement comes after Michael and other Kent MPs pressed the Communities Secretary to release additional funding in the forthcoming Local Government Finance Settlement and follows his visit to Sevenoaks yesterday morning.

In recognition of the growing need for Social Care, the Government is providing an extra £166 million Social Care Grant to Local Authorities across England for 2018/19.  Kent will get an additional £3.9 million next year.

Additionally, Kent County Council will benefit from being one of just 12 authorities piloting the retention of Business Rates, which is expected to generate around £25 million next year.

The Sevenoaks MP has also applied pressure on the Home Office to step up its support.  In a letter sent last week, Sir Michael said: “Kent continues to support more young asylum seekers than any authority in the country.

This is a national cost being covered by Kent residents.  Current grant funding from the Home Office is not adequate.”

Michael has pressed the Home Secretary Amber Rudd for an additional £8.6 million.

Seeking Stronger Ties with Swanley

Michael has recommended that the town of Swanley be formally recognised in the name of his constituency in his response to the Revised Boundary Proposals 2018.  Should his request be granted, the official name of the Sevenoaks constituency would become Sevenoaks & Swanley.

Revised proposals for all the parliamentary seats were published in October by the Boundary Commission for England.  Under the new proposals, the Sevenoaks constituency remains largely the same, but would gain the Wrotham, Ightham and Stansted ward from Tonbridge, increasing the size of the Sevenoaks electorate to 72,561.

The review aims to make constituencies more equal in size.  Parliament has also approved the principle of reducing the size of the House of Commons.  If the majority of MPs support the detailed plans, the proposed changes will take effect at the next election.

Happy with the boundary proposals, the local MP took the opportunity to recognise Swanley as a key part of his constituency.

He said: “My constituency is special because it is diverse.  The town of Swanley is very different from the town of Sevenoaks, and each contributes equally to the character of the constituency.  I refer to my constituency as Sevenoaks & Swanley, and I believe that now is the time that Swanley be recognised in its formal name.”

Fast-Service Delay ‘Not Good Enough’

Michael has pressed the government for answers following news that the new Thameslink fast service from Maidstone East, Otford and Swanley to London due to start from December 2018 has now been postponed until at least December 2019.

The local MP submitted a series of Parliamentary Questions to the Rail Minister about the matter.  The Rail Minister answered the questions last week, writing:

“Learning lessons from previous major changes and to enable the industry to reduce the risk of disruption to passengers from too much change on the network at any one time, the Secretary of State for Transport asked Govia Thameslink Railway (GTR) to propose options to reduce the risk of disruption to passengers from the introduction of the Thameslink timetable and operational changes. GTR’s proposal increases the number of services through central London more gradually than had been planned, beginning in May 2018 and ending in December 2019.

The changes have been selected as the best option to benefit the most passengers across the wider south east network. The new Thameslink services from Maidstone East will now be delivered in December 2019.”

Michael has also written to the Transport Secretary for an explanation, demanding he provide reasons for not having consulted on proposals before having taken the decision.

Before writing to the Transport Secretary, Michael was informed by GTR that the decision had been taken by the Department for Transport.

Michael said: “This is not good enough.  We need confirmation that operators will still achieve full capacity on this route, as planned, in 2018.  I await the Transport Secretary’s explanation for not having consulted with stakeholders before taking this decision.”

Local MP Joins Kent Campaign for New Medical School

Michael has signed a joint letter by 16 MPs across Kent to support the bid from Canterbury Christ Church University and the University of Kent to establish a medical school in the Kent and Medway area.

As Christmas approaches, local health services are preparing for the challenges the winter period brings.  Having discussed these challenges with many NHS and health organisations, Michael is aware that one of the main reasons local providers struggle is because they cannot recruit enough doctors.

Kent is one of the largest areas in the UK without a medical school.  The letter therefore raises awareness of issues surrounding recruitment in the health sector.  It also outlines the benefits a medical school would bring to the region, such as improving local people’s access to high quality healthcare.

The group of MPs add that a local medical school will attract newly qualified and senior doctors, thereby improving health outcomes for patients in Kent:

‘We face serious health inequalities across Kent & Medway, with life expectancy for males up to eight years lower in the most deprived areas […] we firmly believe that a medical school would be transformative for our local health services.’

Michael Celebrates Super-HERO Officers

Michael has officially launched Sevenoaks District Council’s new Super-HERO service in a ceremony at the Housing Forum.

The Sevenoaks District Council’s current Housing, Energy and Retraining Options (HERO) service has received national recognition for its work.  According to the Council, its HERO service has helped thousands of people with issues relating to housing, debt, mortgage and further education and employment options.

Super-HERO extends the decade-old HERO service to offer a more holistic approach to providing support.  It will help people to live independently in their own homes, offering small home adaptations such as grab-rails and stair lifts to more technologically-based devices such as remote health monitors.

HERO officers will now work closely with GPs and provide relief such as a maternity package covering benefits, housing and debt service to vulnerable parents and people fleeing domestic violence.

Michael awarded the Council’s HERO officers with certificates as a mark of their achievement.

He said: ‘I’m pleased that HERO has evolved into a service that will now look beyond just housing, with health at its core.  I refer hundreds of my constituents to Sevenoaks District Council services every year, and I see at first-hand the commitment and professionalism of its officers.’

New Housing Strategy Launched

Michael has officially launched Sevenoaks District Council’s newly adopted Housing Strategy at this year’s Sevenoaks Housing Forum.

The launch, which took place on Friday (3), follows the completion of the Housing Needs Survey in winter 2016.  The Housing Strategy document is the response to this survey.

The Strategy aims to tackle the shorter life expectancies associated with poor quality housing, using HERO officers to combat homelessness at an early stage and develop suitable housing options for young professionals and an ageing population.

With a focus on health, the document outlines a plan to support vulnerable people with mental or physical health issues, older people and military personnel re-adapting to civilian life.

In his address, Michael highlighted the ‘chronic issues poor housing causes’, particularly to individual wellbeing.  He asserted that ‘growing up or getting stuck in unsuitable housing are injustices that we must address in order to build a country that works for everyone’.

Michael hopes the Strategy will stand the test of time.  He said: ‘I’m delighted to support Sevenoaks District Council’s hard work to ensure our residents can access the housing that is right for them.  I hope their strategy will become an example that is followed by other councils across the country.’

Remembrance Sunday

Yesterday, Michael attended two services commemorating those who lost their lives in conflict as Sevenoaks and Swanley marked Remembrance Sunday.

He said: “I was proud to have laid wreaths in honour of those who lost their lives defending our country and our values.  It was a very moving day and a time to reflect on the freedom we enjoy because of their sacrifice.”

Pressing Rail Execs for Answers

Michael recently pressed railway executives for more improvements to local services sooner rather than later.

In a meeting held in Parliament, the Sevenoaks MP sought answers from the Managing Director of Southeastern, David Statham, and Route Managing Director (South East) at Network Rail, John Halsall, about a range of issues.

Having been underwhelmed by the May 2018 Southeastern Timetable, Sir Michael was pleased to hear that there are now 14 extra services and 37 extra quicker trains at peak times through his constituency.  Further, every train will now be at maximum capacity.

Mr Statham and Mr Halsall reported on the progress of planned regeneration at Bat & Ball station and Swanley Station, the rollout of on-board Wi-Fi and new fleet upgrades including carriage air-conditioning.  Sir Michael also raised specific concerns about smart ticketing and was reassured that the range of tickets available on The Key will increase.

The executives committed to remaining in close contact with the local MP and thanked him for his help in pressing the Government to help tackle these issues.

Michael said: ‘My constituents want to see improvements now, not later.  That’s why getting Southeastern and Network Rail in a room together was important.  I will keep in close contact with Southeastern and Network Rail to ensure commuters in my constituency get the best deal.’