Hospital Services (West London)

Baroness Bray of Coln Excerpts

Wednesday 11th July 2012 Westminster Hall

[Angie Bray (Ealing Central and Acton) (Con)]

I congratulate the hon. Member for Hammersmith (Mr Slaughter) on securing this important debate. He is right to extend its scope to hospital services across west London because the proposed imminent reorganisation of services—the “Shaping a healthier future” programme, led by NHS North West London—will affect all hospital users in the area. It is a hugely ambitious and, I am sure, well-intentioned programme, but none the less it presents perhaps more questions than it answers. It raises serious concerns, especially for my constituents in Ealing and Acton.

[Mary Macleod]

I thank my hon. Friend and neighbour for giving way. My constituents use the West Middlesex university hospital and Charing Cross hospital, and I was glad to see that the aim is to retain the West Middlesex as a major acute hospital with A and E and its award-winning maternity provision. Does my hon. Friend agree that the ultimate aim of what is happening, whatever decision is made—any constituent would find the closure of any part of a hospital a difficult thing—is better clinical outcomes, and the key issue is whether they are achieved?

[Angie Bray]

Of course, we all want better clinical outcomes for all our constituents. The question is how to get to that result, and how to provide services for residents. An unfortunate aspect of the way things have been done is the pitching of one hospital against another, with everyone being asked to decide on one or another. That has been a divisive process.

My constituents face the real possibility of Ealing, Central Middlesex, Hammersmith and Charing Cross hospitals all having their A and E departments downgraded —a result that would surely be disproportionately negative for them and that threatens to destabilise health care provision across my constituency. In making its three key recommendations for the current consultation, NHS North West London seems to have completely overlooked their needs. While the consultation document does at least mention the full list of eight possible options, the pressure on people to support one of its three main recommendations leaves the impression that minds have already been made up. Minds should not be made up when my constituents in Acton—a place with a rapidly expanding population—look set to be left without any local emergency cover.

The consultation and pre-consultation business case documents make bold predictions when calculating travel times to justify recommendations. One document even states that the

“geographic distribution is proposed to apply to the remaining sites to minimise the impact of changes on local residents”.

Tell that to the people of Acton, as they battle their way through traffic to Chelsea and Westminster hospital, or the people on the western edge of my patch doing the same to get to Hillingdon hospital, in the event of downgraded services at Ealing hospital. With London’s transport infrastructure as it is, I remain unconvinced that those bold predictions stack up.

The current recommendations take all my constituents further away from access to emergency health. That is why I am encouraging all constituents who get in touch with me on this issue to contribute to the ongoing consultation, regardless of my concerns. That seems to be the best way forward. After all, we all know that, for many people, their local hospital is more than just a physical structure. Attachments to hospitals are often incredibly emotional. Quite naturally, people want to know, when or if they or their loved ones fall ill, that they can access the care that they need in good time. It is all very well presenting a case for change based on facts, figures and statistics in a hefty document, but it is clearly important that local people—the people who use these hospitals—are given a proper chance to have a proper say on their future.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

Does the hon. Lady agree that it is very important that the many people in our constituencies who do not have a car are able to get to a hospital quickly? Relatives also need to travel to hospital in a way that has a minimal impact on their families, particularly those with caring responsibilities.

[Angie Bray]

I agree. It is always important to bear in mind the impact on families who want to visit, because that is all part of the healing process. That is an important consideration.

The consultation is not made easy when the options to choose from are buried in such a heavy document. I have concerns about how that will affect the consultation process. The consultation document is itself a barrier to participation, as it is so huge and bulky as to be virtually impenetrable.

It would be helpful if NHS North West London were to encourage the GPs that it says support its proposals to actually speak out in support of them. The public are much more inclined to listen to their doctors than their politicians—we all know that, unfortunately—and I have urged those behind “Shaping a healthier future” on numerous occasions to do exactly that. So far, however, there has been a deafening silence. If the case for change is so strong, why are we not hearing more local GPs coming out publicly in support of the recommended options?

It is, of course, important to acknowledge that the NHS is set to undergo a series of improvements. The health reforms will fully kick in in April next year, crucially putting GPs in charge of decision making. It therefore seems extraordinary that, after the lengthy process of getting legislation through Parliament, we are now seeing a last-minute, top-down reorganisation of local health care pushed through by NHS North West London, instead of waiting for the GPs to take charge.

The “Shaping a healthier future” programme is a bureaucratically-led initiative by NHS North West London. As such, I urge my neighbouring MPs to accept that this is not about Government cuts. In fact, the Government are putting extra funding into the NHS in real terms year on year, and the Conservatives were the only party to pledge to do so in their 2010 election manifesto.

[Mr Slaughter]

I entirely respect the position that the hon. Lady is speaking from today, and I accept that the NHS locally is behaving very badly. However, does she not agree that the Government must take some responsibility and that, as local MPs, we all ought to be talking to the Government as well?

[Angie Bray]

I spend quite a lot of time talking to Ministers, who have been very generous with their time on this and other issues. Finance is at the root of the problem, but I suspect that the Government have decided to make the NHS a major spending priority; rather more so than some other Departments. We have to accept that there was a problem with funding relating to NHS London for a long time before the Government took power—a point that I was going to come on to in a moment.

As I said, we were the only party to make a pledge on extra funding in its 2010 election manifesto. Furthermore, any efficiency savings do not go back to the Treasury, but are instead ring-fenced for reinvestment in the health service. The latest figures from the Department of Health show that by 2014-15, there will have been funding growth of £12.5 billion across London. The problem is that NHS North West London has been struggling in the face of a huge £5 billion or £6 billion deficit in the past five years or so.

Clearly, we cannot stand against every proposal for change. All institutions occasionally need refreshing and reforming. The key to “Shaping a healthier future” is to work with local communities to establish clinical need that works for those who use the hospitals. This clunky consultation does not do the trick. Nevertheless, I urge people to persevere and wade through the massive document. My message to the Minister is that for my constituents to have all four of their nearest A and Es downgraded is absolutely disproportionate. I hope that, should the consultation go the way that I suspect is intended, the decision will be then called in and a fairer way forward will be found.