NHS: London

Debate between Earl Howe and Lord Tomlinson

Wednesday 30th October 2013 Lords Chamber

[Earl Howe]

The noble Lord is absolutely right. These solutions should not be imposed from above. Indeed, the Shaping a Healthier Future proposals were designed by local clinicians in consultation with their patients. It was not a prescription dreamt up in Whitehall. We are very clear that the local NHS should continue to feel local ownership of these ideas as it takes them forward. I have no doubt that, if it feels it necessary, it will turn to the royal colleges for particular kinds of advice. It is free to do that as it wishes.

[Lord Tomlinson (Lab)]

Is the noble Earl aware that on this side of the House he is very highly regarded as a model of clarity? However, in the second part of his answer to the noble Lord, Lord Hunt, today, he was somewhat equivocal in relation to the future of Lewisham Hospital. I hope that he will accept an invitation to visit Lewisham Hospital. I declare an interest as somebody who lives in that area and has opposed the closure. Does he also realise that such is the strength of feeling in Lewisham, he had better have read the whole judgment carefully and cleared all his lines before he goes there? The threatened closure created such community anger as I have never seen before and he would be most unwelcome unless he were able to give a clear and unequivocal response about its future.

[Earl Howe]

My Lords, I certainly understand the noble Lord’s strength of feeling on this. It is certainly my intention to read the judgment when we receive it in full. Nothing is closing in Lewisham. The service remains as it has been. There is nothing that Ministers intend to do to change that situation. However, as I mentioned earlier, there is an issue to be addressed in Lewisham and indeed in Greenwich. It is a pressing financial issue that commissioners as well as the hospitals themselves have to face. I have no doubt that a visit to Lewisham would benefit me enormously and I shall await an invitation to that effect.

NHS: 111 Telephone Service

Debate between Earl Howe and Lord Tomlinson

Monday 13th May 2013 Lords Chamber

[Earl Howe]

I am very glad that my noble friend has raised that issue. Sir Bruce Keogh is indeed looking across the piece at urgent and emergency care services, and that will include the way in which 111 is working.

[Lord Tomlinson]

Does the Minister accept that Sir Bruce looking at these questions is not necessarily a comfort? Sir Bruce looked at accident and emergency services in south London but, based on what the Minister has said today about the pressure on accident and emergency services, Sir Bruce came to the wrong conclusion about Lewisham accident and emergency.

[Earl Howe]

My Lords, I hope the noble Lord will understand that I cannot comment on Lewisham because it is sub judice. I do not accept that the advice that Sir Bruce gave was ill founded.

South London Healthcare NHS Trust

Debate between Earl Howe and Lord Tomlinson

Thursday 31st January 2013 Lords Chamber

[Lord Tomlinson]

My Lords, I join in the thanks offered to the noble Earl for repeating the Statement. One has the feeling that, for someone so highly respected in this House, his heart was not really in the repetition.

Lewisham hospital is a local hospital which produces excellent local care—and I declare an interest as someone who uses its services. What the Minister has announced today is that he is not going to make the cuts quite as bad as they were—not quite as extensive. But, in effect, we are still having a very good service penalised in order to provide resources for the failures. Can I ask two specific questions arising from the Statement? At one point it states that,

“a non-admitting Urgent Care Centre at Lewisham may not lead, in all cases, to improved patient care”.

How does the Minister square that with some of the other statements made about the principles on which this reorganisation is based? With two further tranches of money—£36 million and £37 million—provided to the other sites which need to be improved, I ask him to comment on what the Secretary of State said at the end, namely that,

“there is a significant level of risk associated with achieving the identified savings. I recognise that the additional clinical safeguards I have put in place will marginally increase these financial risks but on balance”—

basically, “I think it might be all right”. Is this not another example of wishing being given a higher priority than factual decision-making?

[Earl Howe]

My Lords, perhaps I may put on the record my own recognition that Lewisham hospital is an excellent hospital. There is no question about that and there has never been any question about it. The hospital provides good care for local people and it is highly valued. Only this afternoon I had one noble Lord from my own Benches telephoning me to tell me of his personal experience of Lewisham hospital and its excellent maternity care.

The noble Lord asked me two specific questions. He quoted the Statement where at one point it was made clear that a non-admitting urgent care unit at Lewisham would not improve patient care. That is the precise reason why Sir Bruce Keogh recommended something different; namely, an admitting A&E unit with 24/7 cover. He looked at the recommendation and was not satisfied with it in terms of risks to patients. I hope that that is helpful to the noble Lord because I think he misconstrued what I was saying.

On the question of risk, any set of assumptions that relies on hypotheses around patient flows in the future and clinical referral decisions has to be, by its very nature, uncertain. It is the view of the trust special administrator and the review of my right honourable friend that the assumptions underpinning these decisions are reasonable, and that was backed up by Sir Bruce Keogh. But the noble Lord has a point because the implementation of these recommendations is going to be key, and that is why the TSA has recommended a programme board to oversee the implementation of these recommendations over the next few years. It is absolutely essential that commissioners and the providers in that area buy in to these proposals. We believe that they will, but it is important that if the financial risk is to be minimised, we get as close as possible to the forecast and predictions that the TSA has set out.

NHS: Hospital Beds

Debate between Earl Howe and Lord Tomlinson

Thursday 6th December 2012 Lords Chamber

[Earl Howe]

My Lords, it is questions of that kind that we expect the clinical commissioning groups to examine because they will become responsible for out-of-hours primary care. Therefore, it is incumbent on them to ensure that that service not only is a good one but does not lead to unwanted consequences in terms of unplanned admissions to hospital.

[Lord Tomlinson]

My Lords, does the Minister accept that his usual clarity has deserted him somewhat today as he has indicated that money which is underspent is returned to the Treasury but on the other hand he has said that it is not lost to the National Health Service? Does he agree that this gives a completely new meaning to double-entry bookkeeping?

[Earl Howe]

I shall be happy to write to the noble Lord to explain why my answers have been absolutely correct and the situation that I have described is nothing new. However, we are in a new situation in the sense that it appears that the supplementary questions can be extended at will over any other Question on the Order Paper, but I am happy to take questions from the noble Lord at any time.

Health and Social Care Bill

Debate between Earl Howe and Lord Tomlinson

Thursday 19th January 2012 Lords Chamber

[Lord Tomlinson]

Is the Minister aware that his message about the imperatives of health service reform does not appear to have reached the Royal College of Nursing and the Royal College of Midwives, based on statements that they made yesterday? Does he share the view of his right honourable friend the Secretary of State in another place, who has stated that these are not disputes about the health service but politically motivated strikes?

[Earl Howe]

I do think that the objections that the Royal College of Nursing has raised have very little to do with the Health and Social Care Bill. They are much more about what may or may not be happening in certain hospital trusts, which are matters that, in general, the Bill does not affect.