NHS Services (Hertfordshire)

I almost do not know where to begin. Many of us share services; we do not all have our own hospitals or clinics. As a result, many of the cuts to services in other constituencies will affect my constituents. I was particularly touched by the tale of a nurse who lives in my constituency. She works in a thrombolysis unit in Hemel Hempstead. She told me that if that unit is relocated to Watford, nobody, including the staff, will have any confidence that the target of getting treatment within the target time of half an hour will be met. People who need to get there on a match day will not have that life saving injection into the heart, whereas the system works in Hemel Hempstead. Other shared services include podiatry and sexual health services. I have a number of letters from my constituents listing the cuts that they have been asked to face, some in my constituency and some just outside it. For example, there are the cuts in mental health services. I am sure that the Minister is only too aware that Hertfordshire has one of the highest incidences of mental health problems. We read about the amount of cuts for the adult care services—learning disability services, drug and alcohol services—and it beggars belief that that could be care in the community. Drug care services do not even bother tendering any more; they were being asked to provide so much that backed up the Government, even though they involve charities. People with mental health problems often use homeless services, and they have been cut back—for example, funding has been cut for the Open Door project in Bricket Wood. Funding has been cut to Grove House, the hospice in my constituency. Budgets for the elderly and mentally ill have been cut—£7.55 million. I have letters about the cuts from all the different services. Those are genuine cuts for my constituents, who do not understand how there can be extra care in the community and investment in health. As far as they are concerned, there is no investment in their health, just a hope that they will go away into a corner and not create a fuss about what are seen as some of the Cinderella services of our health service. I have a letter about staff shortages in the foot health service that states:"““Dear Colleague…I am writing to let you know about the staffing problems the Foot Health Service is currently experiencing…In addition, our current financial position has also exacerbated the problems and has necessitated the taking of other remedial action…This equates to a 35 per cent. reduction in the department’s staffing.””—" that is, not caring in the community, but an actual reduction in department staffing. It continues:"““The net result of the staff shortages is that all podiatrists are now having to accept an increase in their workload and therefore are having to be more rigorous in prioritising their workload””—" that is, rationing health care. I have written to the Minister about the issue of county sexual health promotion advisers. There used to be five in Hertfordshire; they went into schools, dealing with the issues at the sharp end, talking to pupils before they became sexually active. Such pupils may have had queries about sex or their relationships. We were then down to one last sexual health adviser post. Unfortunately, it seems that if we try to convince people that they can access services elsewhere, everybody says that somebody else is providing them and the post can be cut. The last post holder lost his job, despite active lobbying by his union and my writing on his behalf. The gentleman in question met the Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint) at a chlamydia screening conference. She said that sexual health promotion was a core part of the Government’s choosing health initiative. We do not see that in Hertfordshire, where there is no longer a single sexual health promotion adviser. People might say, ““Well, go to your local sexual health clinic.”” That would be interesting in St. Albans; people queue outside the door and into the car park. As I am sure the Minister is aware, sexual health clinics do not see only immediate constituents; people, for whatever reason—privacy, embarrassment or anonymity—will often travel across borders to go to clinics. My clinic in St. Albans and the clinic in Watford will serve the majority of people in Hertfordshire. I have raised our belief that sexual health services in Hertfordshire are severely underfunded, despite a 1,500 per cent. increase in HIV infections, as well as other sexually transmitted diseases. As a result, a MedFash—Medical Foundation for AIDS and Sexual Health—review was undertaken; reluctantly, it seemed, but paid for by the Government. We were all terribly hopeful that it would deliver what we wanted to happen, but it was not to be. In fact anyone who knows the well respected Dr. Pat Mundy should be aware that she resigned because she was being asked to ration patient care and preside professionally over a service that was unsafe and subject to cuts. Is sexual health one of the Government’s top six priorities in my constituency? I do not believe so. The trouble is that people wanting to use the services will not understand when they turn up and doors are locked against them. Are we really condemning people to an expensive, long illness of HIV/AIDS, for which we will eventually have to pick up the tab? Are we saying that young women may end up infertile and perhaps should seek the services later in life? Are we saying that we do not really care? Today I was pleased to read in a letter from Dr. Mundy that the 48 per cent. rationing that was to have been asked for in Watford has been put on hold. I am sure that the Minister has seen the MedFash report; I urge her to stress that that is not a temporary political hold for political expediency and that it is a recognition of the cuts and shortages that have been going on year on year in health service provision in Hertfordshire. As I said, we all share many of the services, so when a birthing unit closes at Hemel Hempstead or a thrombolysis service moves from somewhere else, or when the cancer services at the QEII hospital go, I care. I shall not take up too much time, because I know that my right hon. and hon. Friends feel passionately about the issues, but there is one thing I really care about. Unfortunately, my constituency, along with that of Hemel Hempstead, seems to have a cash cow. I regarded it as an excellent local hospital, but unfortunately it is seen as a wonderful building site, which may well be used to pay off deficits. I am not talking about people being put in other areas to make best use of the system. We have just opened—I know it was not long ago, because I opened it—a brand new breast cancer unit in St. Albans, but we do not know whether we are going to keep it. During a hearing for a report of the Select Committee on Health, David Law was closely questioned by my hon. Friend the Member for Hemel Hempstead (Mike Penning). He was asked about where he was going to find his money and replied:"““We shall have some redundant estate””—" he was talking about my hospital—"““We have a good facility in St. Albans with five theatres and beds and that will become redundant.””" That facility is going to pay off someone’s debts. I do not want some bean counter, who has been told to live within his budget, to ration health care. We are being asked to operate at 90 per cent. below national average, and we cannot do it. St. Albans may be seen as a wealthy area, because it has high house prices, but I can point to areas of recognised deprivation, such as London Colney, in my constituency. They are on my council website. They have high immigrant populations and poor outcomes on health and cancer—many of the factors that this Government would accept indicate poverty. However, because they are in small localised pockets, St. Albans does not attract the funding as a whole, although the people need the services just as much. I shall hand over to my hon. Friends now, but we are suffering huge cuts in our local services. People are not going elsewhere in the constituency, nor being cared for nicely at home. In St. Albans, we do not have a single NHS nursing care bed within our age care system—not a single one. I urge the Minister, please, to renegotiate the funding formula to take into account the fact that if we in St. Albans tried to meet our deficits, we would have no services. That is how it looks in my constituency.