The Rt. Hon Alan Milburn MP
The Secretary of State for Health
Department of Health
Richmond House
Whitehall
London
SW1A 2NL

30 January 2001

Constituency Survey Results & the Kingston NHS Challenge

I would like to highlight a number of issues that have been raised during my local campaigning for better NHS services and ask you to include these in your national and local strategies. The ‘headline’ finding is the need for more investment, especially in NHS staff and pay.

Background
Between March and June last year, I undertook a constituency wide survey of my constituents. I have received over 4,000 replies which includes a detailed section devoted to NHS services. These were returned by constituents from all ages groups and socio-economic backgrounds. Clearly the diversity of respondents provides a representative insight into how highly residents value the NHS and where they feel resources should be focused.

Furthermore, in order to complement these views I have also been collecting ‘real life’ examples from local residents of their experiences whilst accessing local health services. When these results are combined, they provide a clear indication of some of the national and local issues that still need to be addressed. I am also copying this to the local Health Authority and Trusts for their interest.

Constituency Survey Results

Please find a copy of the relevant section of my survey enclosed for your interest. The survey results are as follows:

Hospitals

When asked how long they waited between being seen by their GP and being seen for the first time by a hospital doctor (if they were referred by their doctor to a hospital during the past three years):

• 27% had waited up to four weeks to receive any treatment
• 22% had waited between 1 and 3 months.
• 34% waited between 4-10 months.
• 17% waited longer than 10 months.

GPs & Dentists

When asked how busy their GP’s surgery seemed:

• 43% stated that their GP’s surgery was very busy.

When asked if there should be more NHS dentists:

• 87% thought that there should be more NHS dentists.
• only 56% said that they had a local NHS dentist.

NHS Funding

• 82% of respondents when given a choice between better NHS funding and income tax cuts felt that the nation’s top spending priority should be on NHS funding.
• When asked about the NHS’s spending priorities; 50% felt that recruiting doctors and nurses should be given top priority.

Kingston NHS Challenge Campaign - Priority Areas Identified

Kingston Hospital serves the majority of my constituents. As you would expect, this has generated the largest number of cases from constituents. Rather than supply you with the over 300 individual cases which I have where necessary already raised with the hospital, I have summarised the problems, with examples, where applicable, for your interest.

A&E & Bed shortages -
Too many patients are still waiting for over 6 hours to receive treatment. A lack of cubicles exists and patients are kept waiting on trolleys, when they are available, whilst a spare bed is found.

• In one instance, a patient had to lie across a number of chairs in the waiting room because no trolleys were available.

While the new Accident and Emergency Unit will help solve the problems, this will not open till Autumn 2001, and the Casualty Unit is therefore still under severe pressure.

Waiting Times/Lists -
I have had a number of examples of the problems caused by delays whilst waiting to been seen by a consultant or for treatment. A few examples are as follows:

• An elderly patient left waiting for hours at an outpatient clinics, without refreshments or food, or being informed when they will be seen by the consultant.
• A professional in the health service working on the merger of local medical services was unable to reschedule an appointment for an operation and therefore was placed at risk of being unable to oversee the completion of this important project.
• A young self employed family man, in pain, and unable to take further time off work after many months waiting for an appointment, was forced to borrow money to have a private operation.
• An engineer’s appointments for two checkups with consultants were both cancelled and postponed for a total of 4 months.
• An elderly lady with advanced cataracts was given an appointment in August 2000 to see a consultant about her condition in June 2001.

Ward Cleanliness -
This has been of particular concern amongst patients and visitors. Toilets have been reported in an unpleasant condition. Floors and surfaces appear not to have been washed for days. I have also noted an increase over the last year of patients who contracted MRSA whilst recovering from operations. The most upsetting of these was a Chelsea pensioner who eventually died as a result of his infection. His family had complained bitterly about the cleanliness of the ward on which he was being treated.

Hospital Equipment -
Where equipment is loaned to patients to take home with them, this equipment is then not monitored and no arrangements are made as standard for its return. As you will appreciate all available staffing resources have been directed to patient care. As a result, there are no staff resources available to monitor the return of publicly financed equipment. Clearly, this is a leakage of resources from the Health Service that needs to be addressed.

Conclusion

I am sure you would agree that the results of my survey are not surprising given these ‘real life’ case examples.

The Government’s backing for my campaign for a new Accident & Emergency Unit was welcome and will in time address many of the problems and delays patients currently encounter at the current A & E department. However, the Hospital themselves have warned that they require an immediate increase in funding for additional acute and critical care beds. Bed occupancy at Kingston Hospital is often running at over 95% and the hospital have indicated that this needs to be reduced to a level of 85%. The current level does not permit any capacity to respond to peaks in demand. The Trust have indicated that they need an additional 30 acute beds to reduce their occupancy rates. The situation, as it stands, will continue to have a knock on effect on waiting times in the new A&E unit and on waiting lists.

According to the figures published by your own department, at Kingston Hospital, 1.31 % of operations were cancelled on the day of or after admission in 1999/2000. According to the Government’s annual report, the number of people on out-patient lists rose from 563 to 782. Thankfully, Kingston Hospital’s Ordinary & Day case admissions from 30 Sept 1990 to 30 Sept 2000 fell by 2% or 121 patients. From your colleague’s answer to my written parliamentary question (PQ4484), I am aware of the measures being pursued to try and reduce these waiting times; however clearly further investment in additional beds and staff at Kingston Hospital is still required.

The hospital have made numerous attempts to recruit more nurses. This has been successful to a point; however staff shortages still exist and hamper the level and quality of services provided to patients. You may already be aware of the research carried out by my colleague, Paul Burstow MP, which highlights the fact that 150,000 or nearly one-quarter of registered nurses are over the age of 50, of which nearly 80,000 are over the age of 55 and will retire in the next 5 years. These figures suggest worse is yet to come unless staff receive far better pay and conditions and recruitment levels can be significantly increased. From my survey results, this is a solution that my constituents would prefer to see enacted rather than receiving small tax cuts.

I trust that the above summary will provide you with a useful insight into the problems that exist in my constituency. Clearly, many of these problems will not be solved by simply reorganising existing resources. I hope the information I have supplied will convince you of the need to channel additional resources to local health services in Kingston & Surbiton to counteract these long standing problems.

I look forward to receiving your views on this information at your earliest convenience.

Yours sincerely

Edward Davey MP

cc. John Langan, Chief Executive, Kingston Hospital Trust
Dr Richard Gibbs, Chief Executive, Kingston & Richmond Health Authority

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