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The Parliamentary Under-Secretary of State for Health (Jane Ellison)
This is the first time I have served under your chairmanship, Mrs Riordan—in fact, under anyone’s chairmanship, because it is my first Westminster Hall debate. It is good to start off with such a straightforward and easy subject.
I congratulate the hon. Member for Westminster North (Ms Buck) on securing the debate. I am a London MP and I know that this matter is important to her and her constituents, to the constituents of her hon. Friends the Members for Ealing North (Stephen Pound) and for Hammersmith (Mr Slaughter) as well as to those of other MPs who are not here today.
Before I turn to the issues raised, I put on record my thanks to the staff of the NHS for their commitment and dedication in providing a first-class service, particularly as they enter a period of change. We know that that is sometimes not easy, but they are maintaining a first-class commitment to patients throughout.
The debate around aspects of the north-west London reconfiguration has been going on for some time, but it is fair to say that the hon. Lady discussed a slightly new feature of it. Today is the first time I have heard in detail directly from her about these important issues. I will give her a response, but I will look at the detail of what she said, reflect on it and come back to her more fully after the debate. It is not possible to do that instantly, because until now I had not heard directly from her about some of the problems on communication and so on in the past year that she said illustrate some wider issues.
My understanding is that the joint committee of primary care trusts agreed in February this year that further work was needed to bring about improvements to services at both Charing Cross and Central Middlesex hospitals. I am aware that Imperial College Healthcare is developing its clinical and site strategy based on the principles set out in “Shaping a healthier future”. The trust has put forward a case for some elective surgery to be carried out at the Charing Cross site and has developed a vision for each of its three main sites becoming centres of excellence for the service they provide.
It is right that hon. Members and local authorities should expect openness and transparency when discussing local health issues and changes, and the hon. Lady has vividly put across that she does not feel that that has happened. It is regrettable that she feels she has encountered, in her dealings with Imperial, a lack of clarity around its clinical and site strategy and, in particular, around planned care and elective surgery.
The hon. Lady rightly stressed the need for partnership working through periods of difficult change such as these. Her comments on the overall exercise and the expressed clinical priorities were balanced, and I take seriously what she said about wishing to work in partnership and her point that we can clearly do a lot better. I have been assured by NHS England that a real effort will be made by the new leadership team at the trust and the local clinical commissioning group to engage more fully with her, other local MPs, local councillors and the local NHS as the site strategy is developed.
I am aware that the hon. Lady met the chief officer and the GP chair of the central London CCG to discuss her concerns about the changes to planned care and surgery in north-west London. As a result, she will know that under “Shaping a healthier future”, St Mary’s will continue to provide out-patient services, diagnostics, therapies and appropriate follow-up. I understand that work is under way to agree the best locations across north-west London for planned care surgery services.
Mr Slaughter
I hear what the Minister is saying—it is reasonable and I know that she is sincere—but we constantly meet these people and they are, frankly, hopeless. The issue is now becoming political. So far, we have had political unity across the board and we now know that the issue is on the Secretary of State’s desk. I implore the Minister to talk to him about these proposals—in the interests of her party, if none other.
So far, apart from Hammersmith and Fulham council, which is supporting the closures, everyone across west London is united on this: it does not matter what party they are or what position they hold. This issue is moving from the local to the national. Will the Minister please look—it is in her interest as well as ours—at what is going wrong in north-west London before we take steps in closing hospitals that we will not be able to correct?
Jane Ellison
I am not sure that describing NHS colleagues as “hopeless” is a particularly helpful contribution to future partnership working, but the hon. Gentleman has chosen his words in his own style, as he always does. He is right to say that the matter is on the Secretary of State’s desk. I will report back to the Secretary of State after this debate, specifically on the new concerns expressed by the hon. Lady on the dialogue and the relationship she has had. Beyond that, I cannot comment further on the reconfiguration, because of its status.
Ms Buck
The Minister is kindly referring to my sense of the communication problems. To reinforce the point, I should say that at the heart of this problem is a local authority that is meant to be a statutory partner. It has a duty to be consulted and that has clearly not happened. That is what matters, because it is through that consultation that decisions are made on how a local authority performs its role on supporting care. I want that message to go back to the Secretary of State. It is not a matter of opinion; it is a matter of absolute fact that the local authority has been ignored by Imperial for probably two years.
Jane Ellison
I hear that. I believe in the role that local authorities have to play in shaping health outcomes for their residents; as the public health Minister, one of my jobs is to champion their role. Like Members of Parliament, they care so deeply for the health of their local population and are so close to them that they are well placed to shape the future of health care in their area, and we take that seriously. I will take the hon. Lady’s concern back, reflect on it and talk to the Secretary of State about it.
There is a limit on what more I can say on the detail that the hon. Lady has given me. We have a lot to look at and talk to health partners about. I can only assure her that I take it seriously. The role of hon. Members in periods of enormous change such as this is critical, as it is for key local authority partners, too. That message is fully taken on board.
I will use my remaining time to give a little background on the reconfiguration. I know hon. Members will be familiar with it, but it is worth putting on the record. The reconfiguration of NHS services is a matter on which the local NHS is taking the lead, hence the importance of engaging local partners. The hon. Lady has already made reference to the fact that we do not believe that these things can be shaped only in Whitehall. They have to be influenced by enormous local input. I cannot agree with the description of the service as “hollowed out”, which is neither accurate nor fair.
Individual health overview and scrutiny committees, and the joint overview and scrutiny committees, made up of democratically elected members of all the councils concerned, have the power to refer the reconfiguration to the Secretary of State if they believe that the consultation has not been conducted appropriately, or that proposed changes are deemed to be not in the best interests of the local health service. We know that one council has exercised that power.
As the hon. Lady is aware, the proposals were referred to the Secretary of State by Ealing borough council in March this year; the hon. Member for Ealing North referred to that. The Secretary of State has sought and received advice on that referral from the Independent Reconfiguration Panel. I fully understand the importance of the Secretary of State’s decision to the hon. Members present and to others who have been prominent in this debate. The Secretary of State is actively considering the panel’s report and that decision will be made public shortly. Although I have not been pressed on when that might be, it is imminent. I cannot say anything further about the IRP’s report.
The one thing I want to stress is that all the changes are being driven by clinical need and a desire to get better outcomes for patients. They are not driven by a desire to save money. In that regard, I reject the comments made by the hon. Member for Hammersmith. The hon. Lady acknowledged that the driving force behind the reconfigurations is looking at whether we can get better outcomes for all our constituents through greater specialism.
Ms Buck
The Minister is being generous. She refers to decisions made by Ealing council and Hammersmith and Fulham council, but Westminster council was not even told about some of these changes, so it could not exercise its powers on overview and scrutiny in this case. While that is absolutely true, I do not think that anyone is setting out to change these things deliberately. They are, however, doing it without telling anybody.
Jane Ellison
As I said, I have heard the hon. Lady’s points. All relevant CCGs and trusts supported the overall shape of the reconfiguration. Local authorities have been key partners in that as well. She has rightly made specific points on some specific aspects that affect her constituents. We will reflect on those points and come back to her.