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Heidi Alexander
My right hon. Friend is right to highlight those issues. I would add that the close working between Lewisham hospital and Lewisham council on child protection has been recognised across the country, and I would not want that to be compromised in any way if the proposals go ahead.
I fear that other A and Es will end up hopelessly overstretched, resulting in worse care for my constituents and many other people in south London. I am also concerned that although clinical evidence exists for centralising some emergency care, such as that for those who are involved in bad traffic accidents or who have suffered a stroke, I have seen nothing showing that better outcomes can be achieved by centralising care for other medical emergencies.
When I was in my 20s, my brother got bacterial meningitis. When he arrived in hospital, after an initial incorrect diagnosis by a GP, the hospital doctors said he had got there just in time—a few more minutes and he might not have survived. He had to have a lumbar puncture taken, and it was only after getting the results that he could be treated. It was one of the worst days of my life seeing a grown man lying in a hospital bed. We were unable to do anything, and we did not know what the problem was. That is why I worry about how long it takes people to get to A and E.
Closing the A and E at Lewisham will mean longer journeys for people who need access to emergency care. It is said that, in a real emergency, people will be in an ambulance, and that may be so, but anyone who lives in south-east London and who has ever been stuck in a traffic jam on the south circular will know how hard it can be, even for ambulances, to get through.
I have spoken at length about the plans to shut the A and E at Lewisham, but may I also raise the impact of the proposed closure of the maternity department? The A and E and maternity departments at any hospital are intrinsically linked. Sometimes things go wrong in labour, even with supposedly low-risk births, and emergency support needs to be available there and then to sort out problems.
More than 4,000 babies are born each year at Lewisham. There has been an 11% increase in the number of births at the hospital over the past five years, and the birth rate is rising. Unlike other health services, maternity care cannot be rationed or restricted. Nationally, we are witnessing the highest birth rate for 40 years—it is particularly high in areas such as Lewisham—and the Government want to close a popular and much needed maternity department.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
Does the hon. Lady agree that the Government do not want anything at all at this stage, and that the Secretary of State has not made, and will not make, a decision until 1 February?
Heidi Alexander
I acknowledge that a decision has yet to be taken, and I take this opportunity to press the Minister to confirm that the decision will be taken on 1 February. If it will be taken before then, it would be useful to know. We are here to present the case for refusing the recommendation.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
As ever, it is a great pleasure to serve under your chairmanship, Dr McCrea. I congratulate the hon. Member for Lewisham East (Heidi Alexander) on securing this debate. I have about 10 minutes to respond to all the points. In the normal terms of any debate, there is an airing of conflicting views, different ideas and different points of views, but today there has been no such disagreement; we have had an outbreak of complete agreement among all the speakers and all those who have intervened. Everyone who has spoken this morning has done so with great passion and sometimes with ferocity in defence of the maternity unit and the A and E department at Lewisham hospital.
Let me make it absolutely clear that we are not in this position because of a Government decision or proposal, or as a result of some set of Government cuts. I made that same point a couple of weeks ago in an Adjournment debate that was called by the hon. Member for Lewisham West and Penge (Jim Dowd). I hope that those in the public domain who report these matters make that point very clearly, too. Anyone who seeks to make political capital out of this exercise does so at their peril, because, in many ways, this transcends party political divide and should not be used for party political advantage.
The trust’s special administrator published his report on 8 January, and a decision will be made by the Secretary of State for Health on 1 February.
Anna Soubry
Will the hon. Gentleman wait one moment, because it is extremely important that I put this on record? The Secretary of State will consider whether to accept the recommendations of that report and will reach a decision by 1 February. As a result of that, bizarre as it may seem to those who do not know the House, I am in some sort of peculiar purdah where I am not allowed to give any opinion of my own. It might be that that is a good idea, I know not, but those are the rules and I stick by them. I am not in a place, as the hon. Member for Denton and Reddish (Andrew Gwynne) well knows, to be able to say whether or not the four tests have been satisfied or, as I have said, to give my opinion. Sometimes, it is extremely difficult for an MP such as myself not to give an opinion.
Anna Soubry
I will give way, but please be brief, because I do not have much time.
Dame Joan Ruddock
Will the Minister confirm that the four tests are relevant? Will she also note that the Secretary of State has said, “on or before” 1 February? It would be good to have clarity.
Anna Soubry
I agree. In such cases, it is imperative that a decision is made sooner rather than later. What is most important—
Anna Soubry
I have not finished my sentence; do forgive me. What is most important is that the right decision is made after careful consideration. I am pleased that the Secretary of State was true to his word and had a meeting with Members who are rightly concerned about the future of Lewisham hospital on 14 January. I know that it was effectively a listening exercise, because he could not express an opinion. That meeting was held with Matthew Kershaw, who is the TSA, and his officials.
Jim Dowd
The Minister mentioned that a decision is to be made on 1 February, which is a sitting Friday. Statements can be made on a Friday, as we saw with the urgent matter last week. Sometimes, statements about issues relating to London can be made, but will the Minister accept that this is an issue of national import? Will she prevail on the Secretary of State to ensure that, whenever the statement is made, it is not on Friday 1 February? Will she give us that assurance now, or seek one from the Secretary of State?
Anna Soubry
That is a good point well made. I will ensure that the Secretary of State is fully aware of the hon. Gentleman’s views.
Why are we in this position? That was a question posed by the hon. Member for Lewisham East. Let us be absolutely clear about it. South London Healthcare NHS Trust has six PFI schemes. It is not as simple as putting all the blame on the PFI schemes, as some Members have suggested. The two largest schemes are at the Princess Royal university hospital in Bromley with a £30 million PFI scheme, and at Queen Elizabeth hospital in Woolwich with a PFI scheme of £29.1 million. The PFIs were signed off in 1998, but they certainly do not help the situation.
The trust is losing £1 million of public money a week. That £1 million could be better spent on improving and providing services to all whom these trusts seek to serve. This is a trust that has a £65 million deficit, the largest in the country, so doing nothing is not an option. No Government of whatever political colour would stand by and see the haemorrhaging of £1 million a week. When hon. Members gather again on Saturday for their protest, I hope that they make it absolutely clear to all the good people who attend to support their local hospital that that is the real financial situation. Often, when faced with such realities, difficult and tough decisions have to be made. The simple truth is—and I am sure that the hon. Member for Lewisham East will agree with me—that we cannot continue to have that haemorrhaging and a deficit of £65 million.
Heidi Alexander
No one disputes the existence of financial problems, but the closure of A and E and maternity departments affects people’s lives and health. Will the Minister confirm that, were the Secretary of State minded to agree to the proposals put before him, the four tests set by her own Government will be applied?
Anna Soubry
I am happy to remind us all of those four tests and principles; they remain as firm as ever. First, any reconfiguration should have the support of GP commissioners. Secondly, there should be full public and patient engagement and proper consultation. Thirdly, there should be a clear clinical evidence base. Fourthly, any reconfiguration should be in support of patient choice.
The hon. Lady comes to the House to represent her constituents and to put forward their views, which she undoubtedly shares, and their anger and concern about their hospital. In her speech, she understandably uses the words outrage and disbelief to say that those four tests, in all or in part, have not been made. She speaks with passion and with detail about the lack of support from GP commissioners and consultants at Lewisham and beyond. She says that this is a hospital that has had many successes and a long-standing investment. She makes the point that, given all the arguments that have been advanced by her and other hon. Members, the decision clearly has no merit.
Let me mention here the interventions by the right hon. and learned Member for Camberwell and Peckham (Ms Harman), my hon. Friend the Member for Dartford (Gareth Johnson), the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock), who speaks in accord with others in support of the hospital, and the right hon. Member for Greenwich and Woolwich (Mr Raynsford). There were speeches by the hon. Members for Lewisham West and Penge and for Eltham (Clive Efford) and by my hon. Friend the Member for Beckenham (Bob Stewart).
This is a very serious subject and I do not want to be flippant. The views of all are certainly taken on board. In due course, the Secretary of State will announce his decision. Therefore, as I said at the outset, I cannot be of great assistance in addressing the various comments that have been made, because I am not allowed to give my opinion. I should, however, mention the contribution of my right hon. Friend the Member for Bermondsey and Old Southwark (Simon Hughes)—I think that I missed him off my list. He gave a thoughtful and frank speech in which he talked about his concerns about the legislation that brought about the appointment of the administrator. He has looked at an alternative and he advanced that.
Finally, the hon. Member for Eltham calls for a review of A and E, but he should do so with great caution. There might be merit in that, but when one embarks on such a review, we have to make it clear that, in those circumstances, some tough decisions might be made, and everyone involved in that would have to sign up to it on that basis.