Hospital Services (West London)

Debate between Andy Slaughter and Gareth Thomas

Wednesday 11th July 2012 Westminster Hall

[Mr Slaughter]

There has already been significant change in hospital services in north-west London. That has been for clinical and financial reasons. It has involved within Imperial the centralising of services, including renal, paediatric, oncology and vascular specialisms. More of that was anticipated. Other proposals for savings have been leaking out of Imperial for the past six months. Further moves away from hospital to community or GP services were expected—but nothing on the current scale.

This review is driven by the need to cut costs and is unrestrained because the chaotic reorganisation in the NHS, for which the Minister must answer, means that there is no accountability on the part of those who are making decisions. The Joint Committee of Primary Care Trusts, itself a body artificially created to make these cuts, is neither their author, nor will it survive to see their execution.

I would like to say a little about the history of hospital services in my part of west London, the scale of the changes proposed and the flawed process under which they are being made. I would then like to summarise the emerging public and professional views on the proposals, before finally asking the Minister for his response. Given that many in the NHS see the north-west London proposals as a prototype for what will happen elsewhere, it is not satisfactory for him to disown interest. He must either justify or be prepared to criticise the loss of front-line hospital services.

Each of the hospitals now under threat has a long and distinguished history. I am afraid I am old enough to remember when Charing Cross was Fulham hospital and when Chelsea and Westminster was St Stephen’s. Hospitals have stood on the Hammersmith campus since 1905 and at Charing Cross since 1884. Originally, these were workhouse infirmaries, fever hospitals or military hospitals. They have evolved into the world-class treatment centres that they are today. I do not want to take up a great deal of time with the history, but while preparing for the debate, I did come across this interesting paragraph on the opening of Hammersmith hospital:

“Immediately on opening, there was an outcry about the cost of the…building…£261,000…and its lavishness. The vestibule was paved with mosaic and was surrounded with a dado of the most expensive encaustic tiles. The dining hall was ‘of baronial splendour’. The press dubbed it the ‘Paupers’ Paradise’ and the ‘Palace on the Scrubs’.”

I did not know the Daily Express was going in 1905, but clearly it was. I am not sure that that was a completely accurate representation of the hospital, because its annual report for 1957 illustrated a granite block—part of the last consignment to the workhouse for breaking up by the inmates of the casual ward. I do not want to give the Minister any ideas about reintroducing rock breaking for out-patients, but that does show that we have come a long way over that time.

The Minister may say that I am being nostalgic in looking at the history of Hammersmith’s hospitals or that it is evidence that change in the health service is nothing new, but that misses the point. These hospitals have grown up on their current sites and changed in response to local need. These are some of the most densely populated parts of the UK. There is intensive residential development in the area: tens of thousands of new homes are planned for the next decade. This is a population with complex health needs and high turnover. This is an area with major transport infrastructure—air, road and rail—and with risks ranging from major trauma accidents to tropical and infectious diseases.

The accident and emergency departments under threat are always busy. They are trusted by my constituents. They have evolved to work side by side with GP practices, walk-in clinics and urgent care centres. However, they work, because the level of clinical expertise available can be adapted to cases ranging from the relatively minor to the very serious. I understand the debate about having fewer major trauma centres—the trade-off between travelling further and losing critical treatment time against the quality of care on arrival. I do not think that that argument is settled, not least because of the unpredictable and congested road system in west London, but also because of the conflicting opinions as to how crucial minutes can be in reaching specialist care in different trauma cases. What is unarguable is that the vast majority of patients currently attending A and E will potentially receive a worse service. They will not be sure whether their condition merits a longer trip to a hospital that still has A and E services, or whether seeing a GP at an urgent care centre will suffice. There will certainly be confusion and delay, and overall standards in quality of care will fall.

[Mr Gareth Thomas (Harrow West) (Lab/Co-op)]

I apologise for missing the first couple of minutes of my hon. Friend’s remarks. Does he accept that, notwithstanding the proposed closure programme, there is already growing concern about the length of waiting times in A and E? Many of my constituents will be worried that their wait at Northwick Park hospital A and E unit will increase as a result of this closure programme.

[Mr Slaughter]

My hon. Friend missed the point that I made at the beginning: this affects all MPs and all communities in north-west London, not only those expecting the closure of services. The closures go against the thrust of the changes in the health service over the past five to 10 years, which have seen the huge pressure on A and Es relieved by the addition of urgent care centres, not the replacement of A and Es by them.

--- Later in debate ---

[Mr Burns]

rose—

[Mr Thomas]

rose—

[Mr Slaughter]

I will not give way to the Minister again yet. I want to make some progress. We shall see what happens in a few moments, but after I give way to my hon. Friend, I really must move on.

--- Later in debate ---

[Mr Thomas]

I am grateful to my hon. Friend for giving way. I do not know whether the Minister’s intervention was prompted by the recent answers he gave to my parliamentary questions. He will be aware of the approximately 180,000 people who waited more than four hours from arrival in A and E to departure. Will my hon. Friend ask the Minister for an assurance in his final remarks that the figure is not likely to rise for the 2011-12 period?

[Mr Slaughter]

I am happy to trade statistics with the Minister, but the debate is not about incremental performance, but the fundamental change to services.