I would like to welcome the new Secretary of State for Health and Social Care, the hon. Member for Louth and Horncastle (Victoria Atkins), to her place.
I rise to raise the pressing situation facing the community hospital at Seaton in the part of east Devon that I represent. I am very grateful for the opportunity to outline why plans to strip away a whole wing of the hospital pose a serious risk to the long-term viability of the hospital, and how small actions by the Government can unlock this space and provide huge benefits for the local communities.
Seaton Hospital is one of 12 community hospitals that provide vital services in my corner of Devon which were given over to NHS Property Services in 2016. Seaton Hospital provides a range of services and clinics that enable people to be cared for closer to home in their own community. I would like to take a moment to give hon. and right hon. Members an idea of the range of services that the hospital currently provides. They include a dedicated Chime audiology service, aneurysm screening, bladder and bowel treatments, and child and adolescent mental health services—we heard a lot about that in today’s health debate—as well as access to a dietician, ear, nose and throat specialists, general medicine, orthoptists, support for those with Parkinson’s, physiotherapy, podiatry, retinal screening, speech and language therapy, and stoma treatments. I could go on.
The hospital also acts as a hub for the growing number of so-called at-home care services. We appreciate that community hospitals have been increasingly moving over to services provided in the community at home. That includes provision for those who are frail and need regular care, or are reaching the end of their life. Indeed, the Seaton & District Hospital League of Friends supports the hospice at home professionals, who provide care to people and their families in those most difficult times of a person’s life or in a family’s life.
I commend the hon. Gentleman for securing this debate. When someone evaluates what a community hospital does, they find that it is about much more than finance and making sure that the books balance. It is about all the things the hon. Gentleman has referred to. The community hospital in my constituency is where my three children were born some 30-plus years ago. It is where I took my youngest son when he broke his arm. It is where I took my other boy when he put his hand through a glass window and had to go to hospital for surgery. That is what a community hospital is about, and that feeling is replicated by every one of my constituents. When the hon. Gentleman speaks about his local community hospital, I am quite sure that he has the same passion, belief and commitment to that hospital, because it is part of the community, and that is how it is measured, not by finance.
I am grateful to the hon. Gentleman for his intervention. His anecdotes about what that hospital has done for his family and community are absolutely the same sort of thing as I hear from constituents every time I speak to them.
Seaton Hospital was built in 1988 to provide better local access to medical care and treatment for people across the Axe valley. It serves people not only in Seaton but in Colyton, Colyford, Beer, Axmouth and other villages dotted around the east Devon countryside. Originally, the plan was that people would not have to travel so far for their treatment. Given that the Royal Devon and Exeter Hospital is perhaps 30 miles away—20 miles at least—people felt that acute provision was on their doorsteps, which is what they wanted.
Simon Jupp (East Devon) (Con)
The hon. Member is making a stand for a community hospital used by people in both our constituencies, and I congratulate him on having secured the debate. I live less than 10 miles from Seaton Hospital. So many residents raised funds to build the wing, which first opened back in 1991. Does the hon. Member agree that it would be so wrong for local residents to have to pay twice for a building that they helped to fundraise for and build?
The hon. Member makes an excellent point. It is exactly right that Seaton Community Hospital was built by local people. Let me expand on that important point, because a lot of people have talked to me about this and I want to relay to the House the feelings they have spoken to me about at recent local community meetings.
The hospital was built over two storeys and updated in 1990 with an acute wing, which was funded not just 50% by the local community but 100% by local donations. The important thing to note is that the construction would not have been possible at all were it not for the contributions by local individuals. For example, the Seaton & District Hospital League of Friends had a scheme called “Be a brick: donate to Seaton Hospital”. People could make a small contribution—whatever they could afford—and get a little brick as a memento to demonstrate that they had contributed to Seaton Community Hospital. The charity is still a vocal champion of the hospital to this day. The project would not have happened had it not been for the generosity of the local people. What comes with that is a sense of ownership that I cannot really stress enough. There is a really strong feeling that the hospital does not belong to some amorphous NHS: it is their hospital. They paid for it, they were treated in it and it belongs to them.
Several weeks ago, I was contacted by the League of Friends charity after it learned from the Devon NHS that the plan is to hand over the two-storey wing from the Devon NHS to NHS Property Services. The charity was concerned that this could lead, eventually, to the selling off of the hospital wing, and even to its demolition. As soon as I heard that, alarm bells were set ringing for me. It is clear that Devon’s integrated care board is keen to wash its hands of the facility as quickly as it can. In essence, the facility is in special measures, and in a financially dire place. The wing is costing the Devon NHS about £300,000 a year, billed by NHS Property Services.
My hon. Friend is making a passionate speech on behalf of his community. What strikes me is that when the community came forward and made those contributions or bought those bricks, they did not do so to save the hospital at that point. I am pretty sure, like the hon. Member for Strangford (Jim Shannon), that they made that contribution to maintain the hospital for future generations. I am not surprised that it feels like a betrayal to my hon. Friend’s constituents.
I very much thank my hon. Friend for her contribution. She is exactly right. I point to two specific conversations I have had with constituents recently. The first was with someone who lives in Seaton, who was close enough to the hospital that she could walk there. Her husband died in the hospital and she was able to go and see him in his final days. She welled up—more than that, tears rolled down her cheeks—as she told me about her husband, who she was able to see in his final days.
Now we have moved to a situation in which patients are cared for at home. Of course, that means that some of the staff previously based out of the community hospital are driving to people’s driveways and providing that care in their homes. That works for some individuals, but the other day I had a lady in my surgery who was almost shaking with nervousness because her husband, whom she loved dearly, had just been discharged from the acute hospital in Exeter and she was charged with looking after him but did not feel able to look after his needs, as he was overcoming his operation towards the end of his life. We are putting some of our constituents in a really difficult situation that they do not feel equipped for.
The reason for the beds being removed from the hospital in 2017 related to so-called workforce issues. There was a substantial consultation of local people in 2017 when beds were removed from local hospitals, but I fear that following that consultation, which showed the outrage and indignation of local people, the NHS does not want to get involved such a consultation exercise again, hence the desire for the ICB to get shot of the building as soon as possible.
The ICB was talking about getting shot of it by the end of this calendar year, although that has gone to Devon County Council’s health scrutiny committee, so it may be pushed into next year. What we need tonight is an intervention from the Minister in relation to NHS Property Services, which is charging a clinical rate for a space that has not been used for acute medicine—it has not had clinical beds in it—since 2017. Organisations are coming forward with a desire to use it not for clinical use but as a care hub to provide other services.
Finally, when it comes to healthcare infrastructure in rural areas such as mine, it is so much harder to rebuild something once it has been removed than to maintain it. We saw in coastal and rural communities such as mine the damage that the closure of cottage hospitals caused, and the impact of removing beds from community hospitals. We must put a stop to that, before our rural healthcare centres are left empty skeletal shells of their former selves, where they were once hubs of love and care. I am looking forward to the Minister’s response and hope that she will agree to work constructively with me, as Seaton’s MP, to ensure a fair deal for local people and to protect our hospital for the people who bought and contributed to it.
I congratulate the hon. Member for Tiverton and Honiton (Richard Foord) on securing this debate. I appreciate his interest and concern about the future of Seaton community hospital. As he said, it was built only as a result of a huge fundraising campaign in the local community, which was matched pound for pound by the NHS. It therefore holds a lot of importance for the hon. Member’s constituents. I fully understand his interest in making best use of the facilities. I know that my hon. Friend the Member for East Devon (Simon Jupp) also wants to see this situation resolved, and I met him earlier to talk about it. I remind the hon. Member for Tiverton and Honiton that decisions about the use of NHS property such as this community hospital are taken at a local level—as they should be—and not by a Minister in Whitehall.
It may be helpful to recap some of the history, as the hon. Member covered in his speech. Between 2015 and 2017, the then NHS clinical commissioning group—CCG—undertook a recommissioning of community services in Devon. That was about introducing a new model of care—more integrated and more community based, with more people receiving care at home. I heard him raise concerns about that model and the shift to getting care closer to the community. My ministerial brief includes supporting the discharge of people from acute hospitals to try to care for more people in their own homes. Some patients spend longer in hospital than is good for their recovery, so for many people it is much better that, when they are declared fit for discharge, they recover and receive care at home.
Returning to the situation of this particular community hospital, as part of the commissioning change there was a change of lead NHS trust as the provider of services in local community hospitals. That meant that ownership of 12 community hospitals, including Seaton, was transferred from the former NHS provider trust to NHS Property Services, as the hon. Member spoke about. NHS Property Services’ model of charging a market rent for properties is to build an incentive to make good long-term decisions about the use of buildings. NHS Property Services then invests that income into those properties and the services that they provide.
10:00 pm
Motion lapsed (Standing Order No. 9(3)).
Motion made, and Question proposed, That this House do now adjourn.—(Gagan Mohindra.)
It is important to note that NHSPS operates on a cost recovery basis. That means any reduction in its charges counts as a loss to the health budget if it is not directly offset by actual cost reductions in the facilities. As the hon. Member mentioned, the annual charges for the vacant space in this facility are approximately £300,000, of which £140,000 is the rental charge. The rest is spent on a share of the utilities, business rates, maintenance and cleaning costs for the property.
I am grateful to the Minister for explaining the charge-back system. Could she explain why the NHS is charging the NHS and hence the NHS cannot have this space, and why it cannot be used for health purposes? Could she explain the charging mechanism a little bit more please?
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I was not all that familiar with NHS Property Services a year ago. I had heard of it, but I was under the impression that it was just another division of the NHS. I looked into it a bit further, and I found that it is responsible for the maintenance and support of most local NHS facilities. I was surprised to find that it is a Government-owned company, legally owned by one shareholder. The single shareholder for NHS Property Services is the Secretary of State for Health and Social Care. As of today, the hon. Member for Louth and Horncastle can congratulate herself on taking on NHS Property Services as her new holding. How can it be the case that a hospital built with the generous support of local people is now owned directly by NHS Property Services, rather than those local people?
In 2016, the Government transferred that facility over to NHS Property Services and implemented a consolidated charging policy to levy charges for rent, maintenance and service charges. Some of those charges are extortionate. We are talking about £300,000 a year, which is £247 a square metre. On paper, it might seem prudent to organise the NHS with some commercial expertise in charge of some of these facilities. However, we have to bear it in mind that the people running NHS Property Services are not necessarily thinking about it through the lens of health and social care; they are thinking about how they can maximise the utility of space and make savings to put money back into budgets.
That is worrying, because what I am hearing is that the offer being made to NHS Devon is, “If you wash your hands of this facility, you will receive 50% of the proceeds of the sale”—that will be to the NHS Devon integrated care board—“and 50% of the proceeds will go back into central coffers, back to Whitehall and back into the very large pot that is the NHS.” The House can imagine what that is like for an individual constituent in my part of east Devon, who has contributed perhaps tens or hundreds of pounds—as much as they could afford—in decades gone by, perhaps through a direct debit or regular payment, to maintain the facility. To hear that those decades of investment will be put back into a big pool in London, a long way away, is pretty sickening.
There has been an understandable backlash from people right across my corner of Devon. I have been to a couple of public meetings in recent weeks since the news broke. At Colyford Memorial Hall a couple of weeks ago, there were more than 200 people. It is a cliché to say there was standing room only, but there was no standing room—there was a long queue of people outside in the rain wanting to get into the meeting. People had one overriding feeling that they wanted to convey to me, and that they wanted me to convey to the Minister and to others gathered here this evening: they created this hospital and they are deeply offended by the idea that it might be taken away. What put salt into those wounds was the idea that that should happen with zero public consultation.
I want to make hon. Members aware of how those clinical beds got removed in the first place. In 2017, there was deep concern that the removal of the beds was an arbitrary decision made following a last-minute intervention by the then right hon. Member for East Devon, Hugo, now Lord Swire. In fact, it is revealed in a book by his wife, Sasha, that Seaton Hospital was to be kept open, with its beds maintained, but, because of that last-minute intervention by Hugo Swire, the bed closures moved to Seaton and the Sidmouth Hospital beds remained.
As a result of that decision, there was no additional funding to set up extra services at Seaton. Instead, the ICB began charging this exceedingly high rent for an empty space. What we really need to do is reduce that rental fee from its clinical rate to one that acknowledges that there are community alternatives. The palliative care nursing team can operate out of this space, and organisations such as Restore and hospice at home carers can work out of it, too. The friends of Seaton and District Hospital are coming up with a strong business plan, but they do need more time to develop it and a concessionary rate—not the clinical rate—to operate from it. If no solution is found, the ward is most likely to be either sold off or demolished. Again—I cannot stress this enough—we need to do this for the people who feel that they paid for the hospital.
There is a precedent for it, and I am grateful to the hon. Member for St Ives (Derek Thomas) for letting me know that the hospital in Cornwall was saved from the jaws of NHS Property Services. However, there is a big difference between what I am proposing for Seaton and what happened at St Ives. St Ives hospital was paid for by a single philanthropist. As we have heard, Seaton Hospital was paid for with contributions—or subscriptions —from thousands of people.
At the point of transfer, many community hospitals in Devon had a large amount of empty space. The transfer happened on the basis that the NHS commissioning body—now the ICB—would be responsible for the full cost of that space. The costs include the recovery of the market rent and service charges, such as energy, rates, cleaning and maintenance. Over the past seven years, progress has been made to identify sustainable, alternative healthcare uses for vacant spaces in other community hospitals in Devon, such as in Axminster and Ottery St Mary’s. However, I understand that Seaton and some others still have significant amounts of vacant space. In addition, the ICB and NHS Property Services have worked closely with the voluntary sector, and have supported local initiatives in some properties, such as the Waffle café at Seaton Hospital. However, it is for the local commissioners—not NHS Property Services—to determine the best use of the healthcare spaces that they are responsible for.
Despite sincere efforts from the ICB, I understand that no sustainable healthcare use has been identified for the former ward space at Seaton, which adds up to about half the hospital space. I know the hon. Member’s constituents are frustrated by this situation. Local community groups have expressed an interest in taking on some of the empty ward space, but they see the level of charges as an insurmountable barrier. The ICB has explored a range of potential healthcare uses with NHS providers, but the proposals have not yet come to fruition, so I know the situation is not satisfactory for them either.
The costs to the system of the vacant space are a pressure on the health budget. Clearly, having unused space is not a good use of resources and, ultimately, taxpayers’ money.