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The Parliamentary Under-Secretary of State for Health (Jane Ellison)
Of course, Mr Stringer. It is a pleasure to serve under your chairmanship. I congratulate the hon. Member for Ealing, Southall (Mr Sharma), a fellow London MP, on securing this debate on an issue that is of concern to him, to his constituents, as we can see from the attendance in the Public Gallery, and, of course, to colleagues in neighbouring constituencies, who also contributed to the debate—not for the first time.
Before I address the issues raised, I would like to echo the words of others and pay tribute to those who work in our national health service. Despite the debates that we have in this place about reconfigurations and the like, all of us are united in praise of the dedication of those working on the frontline to provide first-class services to all in their care.
There is of course considerable ongoing interest in the changes in north-west London proposed under the “Shaping a healthier future” reconfiguration programme. It is worth stressing that those are not just changes to acute hospitals, but planned changes to the whole of that health economy. The aim has been to look at how it can best provide in the future for the local population.
Of course I acknowledge the concern expressed among local people and in particular by the Save Ealing Hospital Community Action Group. The hon. Member for Ealing, Southall will know that I responded in January to a petition by the action group, and I will respond in writing in due course to the latest petition that he has presented. But I want to make it clear that proposals and change on so large a scale as that taking place in north-west London are inevitably controversial. Major change is inevitably controversial, but we have always stressed, as did the shadow Front-Bench spokesman, the hon. Member for Ellesmere Port and Neston (Justin Madders), that the reconfiguration of services is a matter for the local NHS. That is best organised and shaped by those who know the communities best, and with local clinicians right at its heart, rather than being dictated from Whitehall.
Let me deal with the Mansfield Commission report. On Thursday 14 January, the North West London Clinical Board considered the report of the Independent Healthcare Commission for North West London, and the view of the clinicians on the board—local doctors and health workers—is that the current programme, which was designed by doctors and based on significant clinical data, evidence and experience, continues to offer the best outcomes, experience and equality of access to NHS services for all our patients. That is a direct quote from what they said. Having read the Mansfield report, I am not surprised that that was the conclusion of local health leaders. I take issue with a number of things said about that report, not least about its independence, but I want to use some of the time that I have this afternoon to deal with some of the substance of the concerns raised about services for people in Ealing. Some of the language used was very strong, and I want to try to set a few minds at rest by talking about some of the new services.
Before moving on to specifics about Ealing, though, let me deal with the implementation of the programme itself. The hon. Member for Hammersmith (Andy Slaughter), perfectly reasonably, exposed the case why it is important that people have certainty and transparency. Some colleagues referred to the meeting that I chaired last summer to try to reboot this process after the general election—with a degree of success, in terms of the contacts between Members. But on the proposals for capital works for both Ealing and Charing Cross hospitals, I have been assured that local health and social care partners are working together to produce a sustainability and transformation plan by the end of June 2016, and it is anticipated that details for those two sites will be included in that.
I have been honest enough before to say that I share hon. Members’ frustrations about delay. I quite understand why they want more certainty and I fully expect NHS England and the “Shaping a healthier future” programme to keep me abreast of developments as we move towards the summer. I want to hear if there are any problems with hitting that timetable, because Members have a right to expect to get that information, so that they can respond to it, so please rest assured that I will continue to ask those questions.
The hon. Member for Hammersmith also talked about morale, and it is vital that we put on the record some of the ways in which good progress is already being made as part of the “Shaping a healthier future” programme. As I have said, better healthcare is not just about the acute sector, important though that is. For example, good progress has been made in developing primary and community services, and there are examples showing patients benefitting. GP practices across north-west London now offer more than 1 million people in the area extended opening hours on weekdays, from 8 until 8, and weekend access. That is vital for families’ peace of mind, as has been mentioned. GPs in Ealing now provide 19 new services, including anticoagulation services, electrocardiograms and some mental health services. Many more community services are now in place across all eight boroughs, so more patients can be seen closer to home.
Those are just some of the reasons why I do not recognise the description of the plans given by the hon. Member for Ealing, Southall. He used expressions such as “risking lives” and that is not what local doctors want to do or what the plans are about.
Jane Ellison
I am sorry; I will not, because the hon. Lady made a long speech and I must respond to it.
At the heart of the plans is the fact that local clinicians want to provide more and better services, although delivered differently, it is true, from the way they may sometimes have been delivered in the past. That brings me to the focus on Ealing hospital. Of course I recognise the concerns associated with such significant changes as are proposed, and I take the point entirely that uncertainty, both for Members of Parliament and members of the general public, gives rise to concerns.
Ealing hospital will be redesigned as a 21st century facility for the local community. The hospital will have a local A&E and a 24-hour GP-led urgent care centre, with access to 24-hour specialist care, as well as a range of specialist services designed with the needs of the community in mind, such as a diabetes centre of excellence. The hospital will be a centre of excellence for other areas of care, such as elderly patients, those with long-term conditions and the most vulnerable members of the community, by integrating primary and secondary care with community and social care. It is common ground between all parties that that is how we will help to keep people healthier in the future. So good news for patients is already beginning, in the changes.
On maternity services, some strong language was used in the opening speech about concerns for local mums and their babies. As has been pointed out, maternity services were consolidated in July across north-west London into six maternity units. Women from Ealing now have a choice in maternity services, with 30 antenatal sites across Ealing, including Ealing hospital, and six sites for delivery across north-west London. As a result, there has been a 10% increase in choice of midwifery-led units. I am told that 778 women had their maternity care safely transferred from Ealing to a new maternity unit of their choice with no incidents reported.
What is the benefit to Ealing women from the changes? Before the changes, Ealing hospital was achieving 60 hours of consultant cover—lower than all the neighbouring hospitals. Across north-west London before the transition, the average was 101 hours. North-west London has set out to achieve 123 hours in 2015-16, and it currently has 122 hours of consultant cover. Also, 100 new midwives have been recruited across north-west London as a result of the changes. Antenatal and postnatal care are still available at Ealing hospital, and as I said, the number of community midwives has also increased locally at 30 sites across Ealing. It is clear that a complex service change has been managed safely, with benefits to patients—mothers and their babies. It is telling—Members need not just listen to my words—that Ealing Council’s health and adult social services standing scrutiny meeting on 26 April heard from the Royal College of Midwives. That is not the Government. It endorsed the transition and congratulated the NHS in north-west London on the model of care and the detail in the transition. Again, I do not recognise that service in the words of the hon. Member for Ealing, Southall, although I know that he meant them with due concern for his community.
On paediatric in-patient services, good progress is being made on the implementation of changes. I am informed that that will ensure that children in north-west London will receive consistently high-quality seven-day care, with more paediatric nurses and specialist doctors available. Paediatric in-patient services, which are for children who require emergency treatment or an overnight stay, will move on 30 June from Ealing hospital to five other hospital sites in north-west London. That will significantly expand capacity—more beds, doctors and nurses, seven days a week.
The changes do not mean that all children services are moving from Ealing. Nearly three quarters of existing children’s services will continue on the Ealing hospital site and elsewhere in the borough. Services remaining include routine appointments and treatments that do not require an overnight stay, such as day care unit activity, so most children will be seen in the same place as they are now. Urgent care for minor injuries and out-of-hours GP appointments will also remain at Ealing hospital. The majority of children who are brought to Ealing’s A&E by their family or friends are already treated in the urgent care centre. Services for children with long-term conditions, such as asthma and epilepsy, and child and adolescent mental health services will also remain unchanged.
To reiterate, 75% of existing children’s services will continue to be delivered by the dedicated staff of Ealing hospital, but—this is an important “but”—the sickest children in north-west London will receive better care as a result of the changes. That is what we all care about the most.
It is right that local people have the chance to hear from their parliamentary representatives in such debates, so I welcome the fact that we have had the chance to debate the subject again. I suspect that we will do so again at some point in the future. As the programme moves through its implementation, I encourage those with particular concerns to continue to engage with the local NHS. I thank colleagues for doing so, as they have been, because that is the right way to proceed. I have reiterated to local health leaders the need to share plans in a timely fashion. I only ask of hon. Members that they also share the positive changes that are already visible to people in their communities, as I have illustrated today. I look forward to hearing how the meeting later this month goes—it was referred to earlier—and I will continue to engage positively with colleagues as they handle this important issue, which matters so much, as we can see, to local members of the public.