Karin Smyth

I will move through some of these points for the moment. For providers with the most entrenched financial, operational, leadership and structural challenges that impact patient care—that is what these trusts are about—we are taking a more holistic approach to that enhanced support because, as the shadow Minister asked, how do we choose? They are the most challenged long-term systems. At a national level, the intensive recovery programme is providing short-term, intensive support for organisations to help strengthen their immediate operational and financial stability while developing an organisation-owned plan for long-term sustainability. We cannot keep going round in this circle; at the end of the day, these organisations need to be well run and well led, and local systems need to own that problem. That is also part of our wider devolution agenda. I think I outlined that in my letter to the hon. Member for Chelmsford in September, but I am very happy to meet again and go through that in more detail if that is helpful. The first IRP cohort includes Hull, Northern Lincolnshire and Goole, East Kent, North Cumbria and Mid and South Essex. Each faces very different circumstances, so there is not a one-size-fits-all response. I will touch on some of them, for hon. Members have raised their own issues with them. There is interest in Hull and Northern Lincolnshire and Goole. Following an independent review, the decision has been taken to dissolve the Humber health partnership arrangements. In Hull, the focus is on strengthening core hospital services, making the best use of specialist services, improving productivity and reinforcing clinical leadership and accountability. For Northern Lincolnshire and Goole, the priority is to move more care into neighbourhood and community settings, reflecting the demands in those areas. There are good signs of progress. The hon. Member for Chelmsford and others who intervened highlighted Mid and South Essex. The 2020 merger of those three trusts has not delivered the planned benefits for 1.2 million people. Staff culture and morale remain a serious concern, with little improvement, as was highlighted in those terrible survey results over the past five years. We have heard those. The trust has long-standing performance problems linked to how demand is managed across the wider health system in that part of Essex. Work is under way to improve the long waits, improve patient flow, strengthen governance and make better use of the estate. I shared the analysis in productivity packs with everybody earlier in the year, and I am sure that everybody looked at them in detail, but I am very happy to go through them again. It identified more than £122 million of productivity opportunities. It is not simply about saving money. Better organisation across sites and stronger clinical integration should improve patient experience, reduce delays and raise quality for patients. The clinical strategy will make greater use of neighbourhood and community care in line with our 10-year plan and focus on maternity and planned care treatment. This is backed by £80 million for Southend hospital’s long-standing structural estate problems and support for a neighbourhood health centre in Maldon. I will touch on North Cumbria because, for the hon. Members for Westmorland and Lonsdale (Tim Farron), for Honiton and Sidmouth (Richard Foord) and for Yeovil (Adam Dance), the work going on there really highlights what can and needs to be done in rural healthcare. I remind hon. Members that hospitals in some of those areas are additionally funded to cope with some of those rurality issues. We highlighted that in our 10-year health plan. We absolutely understand that across the country, there are different issues with regard to rurality. I will not talk about Kent, because it has not been raised, but again, it has very different issues. That is why those areas have been chosen. They have long-standing and deeply entrenched problems. My hon. Friend the Member for Stoke-on-Trent South (Dr Gardner) raised ambulance handover delays. I did not know she was going to raise that today, but to assure her, the continued problem with the ambulances was raised with me in my oversight meeting with the team yesterday. Those issues are flagged by NHS England and its operational management across the country. They are long-standing issues, as she knows, but I gently disagree with her. She is absolutely right in her assessments of history, but this issue is not a failure of oversight and accountability. Good co-operation, collaboration and management are the responsibility of the services locally. The oversight has worked. We know that this is a problem. We and her constituents can see that. We very much want the services to work together to resolve that flow so that the ambulance handover works much better. My hon. Friend the Member for Salford (Rebecca Long Bailey) highlights, sadly, her constituency’s downward improvement trajectory. She asked to meet me, and I am very happy to do that. My hon. Friend the Member for Darlington (Lola McEvoy) did the incredibly difficult job of raising the terrible distress for women in her constituency. She highlighted a terrible case, and I will make sure that she has a meeting with the Minister to go through how that can be supported on behalf of her constituents. I know that she will work closely to make sure that they are served better. We are seeing early improvements through the IRP, but we need to demonstrate progress through safer care, better operation and financial performance. We have clear milestones and credible plans for stronger organisations. Support nationally is time-limited but proportionate, because trusts ultimately have to stand on their feet. Intensive oversight is not about naming and shaming. Staff in challenged trusts are working in exceptionally difficult circumstances. As we need to encourage people to work there, we must show them that it can be better. The purpose is to remove barriers to improvement, provide the right expertise and hold boards and NHS leaders to account for results. The Government will continue to work with NHS England. I am committed to keeping Parliament informed of significant developments. We will judge our approach by its effect on patients and staff, not by the creation of more processes. The oversight framework and the intensive recovery programme provide a clear route from identifying the risk to taking targeted action. There is much more to do. It can only be done in local circumstances with co-operation and transparency, including working with Members of Parliament. Where we hear examples of trust chief executives not doing that, I am prepared to call it out. It is not acceptable. There is more to do, but we want practical, safer and more timely care, and stronger organisations. I am pleased to have had the opportunity to debate this issue today. It is important for MPs to be part of the discussion. We want to improve all trusts, but we are focusing on those with long-term issues, sometimes having been affected for decades. The people in those areas deserve better, and we are determined to make sure they get it.