Hospital Services (South London)

Lord McCrea of Magherafelt and Cookstown Excerpts

Tuesday 22nd January 2013 Westminster Hall

[Ms Harriet Harman (Camberwell and Peckham) (Lab)]

I thank my hon. Friend for giving way and I join the hon. Member for Dartford (Gareth Johnson) in congratulating her on securing this debate.

On the impact on neighbouring hospitals, my hon. Friend will be aware of the importance—not only to local people but to London as a whole—of King’s College hospital. Is she also aware that the effective closing of maternity and A and E services at Lewisham hospital will hit like a tidal wave at King’s College hospital, because of the numbers of people involved. The health service estimate is that the number of people at King’s College A and E will increase by 45%. The staff at King’s College A and E do a very good job, but they will not be able to cope with a 45% increase in patients. The additional emergency admissions from that increased number of people at A and E will create such a strain on in-patient beds that the proposal is that in-patients—non-emergency admissions—will have to be shipped off to Farnborough hospital, which is an hour away on a bus and a train from Camberwell.

As for maternity services, the situation is even more pronounced, with a 54% increase envisaged in the number of women giving birth at King’s College hospital. The staff there simply cannot cope with that increase. At the moment, many women are turned away and told to go—guess where?—to Lewisham hospital.

[Dr William McCrea (in the Chair)]

The right hon. and learned Member for Camberwell and Peckham (Ms Harman) will know that interventions must be short. Certainly, however, the point she makes is well made.

[Heidi Alexander]

My right hon. and learned friend encapsulates the issues in relation to King’s College hospital perfectly.

The fact of the matter is that millions of pounds will have to be spent at neighbouring hospitals to enable them to do the job that doctors and nurses at Lewisham hospital are already doing very well. Roughly £200 million has to be spent on making those changes happen, and that is not to mention the £12 million that has just been spent on Lewisham hospital’s A and E department.

In my view, this process is sheer madness. I do not think that there is any guarantee that money will be spent in the right places. If the predictions about where people will go after the closure of the A and E department and maternity department at Lewisham hospital are not right, we will end up spending money on the wrong hospitals. That could result in complete chaos. I cannot see the sense in the proposal, and neither can thousands upon thousands of people in south-east London.

The proposed closure of Lewisham’s A and E department and maternity department would also mean that two thirds of the building and land at Lewisham hospital would be sold off. These plans were hidden in an appendix to the initial proposals document, which was first published at the end of October last year.

I cannot overstate the opposition to these plans. More than 40,000 people have signed a petition against the closures; not one Lewisham GP is in favour of the changes; and the chair of the local commissioning group is also opposed to them. Put simply, these changes are unwanted.

--- Later in debate ---

[Simon Hughes]

I have no reason to disbelieve what the right hon. Lady says, but even more important is returning the decision to the people in the health service who are now meant to be leading it—the GP commissioners and others. That is what all of us, in different ways, believe needs to be done. She made an argument for the issue being London-wide, and that of course is the context, but the practicalities of travel and transport, whether buses, cabs, cars and trains, are such that south-east London works as a segment for health service use in a way that does not really cross over into other parts of London, other than to King’s. The only knock-on bits are the small amount of crossover to the London hospitals for specialist reasons, and some to King’s because it is so near—technically, it is south-east London, but it is in Lambeth.

Secondly, the precedent would be a bad one to set for those parts of the NHS that have been financially well managed, compared with parts that have been badly managed. Lewisham has been relatively well managed, being very nearly in balance. We rely on trusts to do their job locally and on people to manage local trusts, so we have to support those who do that job well and responsibly.

My last point is probably the most important. I have been to Lewisham A and E and visited patients there privately. It and the maternity services have developed a reputation for good clinical care of all who attend it. That was not the case some years ago, but it has been worked on, and not only physically. It has become a university teaching hospital, as well as being a local general hospital, and it has good community links—the point made by the right hon. Member for Lewisham, Deptford in her intervention. It has also built up a good reputation for integrating acute care, hospital-centred care, with community provision.

The Secretary of State could take the clinically easy decision to follow the trust administrator’s recommendation, saying, “This is what has been recommended, therefore I am following what I have been told”, but I hope that he realises the greater benefits to the local community and to the wider health economy and service of south-east London, as well as to the Government if they are seen to be listening to the people and to the GPs more than to the trust special administrator. I understand why the trust special administrator takes a hard line, because he is a health economist and his interest is finance. The Health Secretary, however, has a different job, which is to be responsible for the NHS in England, and that means making responsible decisions to secure a good NHS in all parts of south London and elsewhere.

[Dr William McCrea (in the Chair)]

I will be commencing the winding-up speeches at 10.40 am at the latest. Three Members are seeking to catch my eye, so I ask them please to be conscious of that in their contributions, because I would like to get as many Members in as possible.

Oral Answers to Questions

Lord McCrea of Magherafelt and Cookstown Excerpts

Tuesday 12th June 2012 Commons Chamber

[Paul Burstow]

The important point about the extension of any screening programme is that it is based on evidence. The most recent review of cervical smear and screening campaigns took place in 2009, and on the basis of all the available evidence at the time the Government’s advisory committee on cervical screening concluded that it would do more harm than good to extend screening below that age, but it is a standing item on the committee’s agenda. It looks at any new evidence and will continue to do so.

[Dr William McCrea (South Antrim) (DUP)]

Pancreatic cancer is greatly feared by many of our constituents. What funds are going to be made available to assist in its research, and how will the Minister measure improvements in that field?

Mental Health Care (Hampshire)

Lord McCrea of Magherafelt and Cookstown Excerpts

Wednesday 18th April 2012 Westminster Hall

[Andrew Griffiths (Burton) (Con)]

I will speak briefly in support of my hon. Friend the Member for New Forest East (Dr Lewis). We have joined together on many occasions to campaign on the provision of acute mental health facilities, and today I shall express my concerns about how these processes are being undertaken by primary care trusts across the country. If anybody wants to see why the health care reforms that the Minister has fought so valiantly to introduce are needed, PCTs’ actions and decisions to close mental health facilities are the perfect example and demonstrate how they are out of touch, need reform and need to change.

Sadly, three weeks ago South Staffordshire PCT took the decision to close Margaret Stanhope Centre, a unit of 18 acute mental health beds in my constituency. It took that decision not only in the face of huge opposition from local people—8,200 people signed a petition as part of a campaign run by my local newspaper the Burton Mail and the Friends of Margaret Stanhope campaign group—but in the face of the evidence. I am a new Member of Parliament, elected for the first time at the last general election, and I had always assumed that such decisions were based on fact and on evidence—that the PCTs that took such important and often life-threatening decisions would be able to stand up to defend their decisions by proving their case. However, in the closure of the Margaret Stanhope Centre the PCT acted irresponsibly, recklessly and had no factual evidence to back up its decisions.

We conducted some research and found an Audit Commission report: 46 PCTs across the country had taken part in a benchmarking exercise, and the report showed that the average provision of acute mental health beds in those 46 PCTs was 27.5 beds per 100,000. In my trust, however, provision was 14.5 beds—almost half that average. The PCT then prayed in aid the following report, produced during the consultation process. It claimed that, miraculously, its provision had shot up to 31 per 100,000, and that there was nothing to fear.

I tried to get the facts. I tried to get the information. I asked and I asked and I asked for independent data. When the data came, they showed that the PCT had got its figure wrong: provision was not 31 beds per 100,000, but 22. However, when analysing the raw data, the PCT had included such things as mother and baby post-natal depression beds, beds for eating disorders, and drug and alcohol rehabilitation, so actually the figure for provision came out at 13.2. The PCT then prayed in aid an independent report that it had commissioned from Staffordshire university. We asked for that report. When we received it—it took two and a half months to come—we found that the person who had conducted the independent report, Dr Eleanor Bradley, was being paid not only by Staffordshire university, but by the NHS trust. The independent report that it claimed demonstrated how safe it was to close the Margaret Stanhope Centre was actually conducted by somebody on its payroll.

One claim made in the report was that the PCT had been able, through a pilot scheme, to reduce the in-patient stay by a third, but when we managed to drag the report out from the PCT, we discovered a number of things. First, we discovered that for stays in Margaret Stanhope of more than 91 days, it had managed to reduce average stays beyond 91 days by more than a third, from 39 days to 23—a reduction of 41%. However, the vast majority of admissions—88%—were between two and 90 days, and there the reduction was just 1.1%. The PCT claimed to have reduced in-patient stay by a third, but had actually reduced it by just 1.1%. I could go on about how flawed was the evidence used by my PCT to justify the closing of a much loved and much valued unit that serves the most vulnerable in my community. The process began some four years ago, so this is not a party political point, but a point about the actions of the PCT.

We met three weeks ago to discuss the passionate campaign for the continued existence of the unit. The process used to make that decision—

[Dr William McCrea (in the Chair)]

Order. May I draw the hon. Member’s attention to the fact that we are having a debate on the closure of acute adult mental health beds in Hampshire? I am sure that he is building his case from his experience, but it must be linked directly with the situation in Hampshire.

[Andrew Griffiths]

Forgive me, Dr McCrea. I will do exactly that and draw my speech to a close.

What I have seen is that the processes are flawed. What I have seen is that PCTs cannot be trusted to make the decision in Staffordshire and they cannot be trusted to make the decision in Hampshire. It is essential that we reassure the most vulnerable in our communities and in society. It is essential that the Minister understands their concerns properly and reassures himself that the decisions being made in Hampshire, and the decisions made in Staffordshire, are correct and are based on fact and evidence. I urge the Minister to train his laser-like vision on this important issue and to reassure himself, so that he, we and our constituents can be confident that mental health provision in Hampshire and in the rest of the country is not being jeopardised by false decisions made by people who are unaccountable, unelected and are not making those decisions in the best interests of our constituents.

Obesity

Lord McCrea of Magherafelt and Cookstown Excerpts

Wednesday 9th November 2011 Westminster Hall

[Justin Tomlinson (North Swindon) (Con)]

I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this very important debate. I echo many of the points that have been raised this afternoon, but I want to concentrate mainly on the childhood obesity angle. It was mentioned that a third of children are overweight, and that 85% of those will then go on to be obese in adulthood. I want to cover four topics: planning, food, sport and youth provision.

Gardens are a third of the size they were in the 1960s. Front gardens are often more of an aspiration than a reality in new build areas. I am keen that we make greater use of accessible and usable open space. Before becoming MP for North Swindon, I was for 10 years a councillor for a new build estate. I used to complain time and again that there was not sufficient usable and accessible open space, and I was told, “You are wrong. You have more open space than anywhere else in Swindon.” It transpired that that is because the definition of open space includes hedges and heritage sites, neither of which is suitable for a child to play football on, and that is something that needs to be considered.

I am not asking for premier league, standard turf right across all housing estates. When I was growing up, our open space was an almost vertical hill. The twins, Matthew and Paul Gilbert, who were technically gifted at football, got to kick the ball uphill all day long and myself and my friends got the advantage of kicking it downhill. Such is the creativity of young people.

Open and accessible spaces are very important. As a child, I was very sporty. I grew up in the 1980s when children were fuelled with artificial colourings and flavourings—the sort of things that we are now worried about. None the less, I had the balance because I spent all day running around. We copied the television, so mostly we played football. If the Ashes were on, out came the cricket bats. When it was the Tour de France, the bikes came out. When it was Wimbledon, we brought out the tennis rackets. Normally, we brought them out for only two weeks or for one or two days if we were following our British hopes.

I was also the lead council member for leisure. People always said to me, “The emphasis is on creating lots of really good leisure centres.” The reality is that youngsters go to leisure centres only once or twice a year—normally for somebody’s birthday party. It is the jumpers-for-goalposts mentality that matters. It is really important that we build in to developments usable and accessible open space.

It became fashionable to build new public buildings under the private finance initiative scheme. Ignoring the advantages or disadvantages of the scheme, there was a particular problem for local communities in that they could not afford to access those community facilities. Again I know, from my time as a councillor, that we had some wonderful open spaces behind very big fences and the local community could not afford to hire the sports clubs, so that is another issue that requires consideration.

Local authorities are always under pressure on funding. One of the areas that I would like to see prioritised is investment in local country parks. Families would use them and we would see jumpers for goalposts, family walks, people walking their dogs and all sorts of different free activities to get people going.

Councils can be innovative in this area. Let me give three examples from my own local authority. First, £1 million has been invested in Mouldon hill through section 106 money—nothing new there. We had £5 million invested in Lydiard park, of which £4 million came from the Heritage Lottery Fund and £1 million from local private businesses and organisations. The best one of all was the £2 million investment in Shaw forest, which was a tip. We charged neighbouring authorities to put their rubble on top of the tip and then we planted trees and now it is a very enjoyable country park in which to walk the dog.

There have already been some very good contributions on food, so I will just mention my particular bugbears. First, basic cookery in schools should be compulsory. Nowadays, too many people’s idea of cooking is a three-minute wait and then the ping of the microwave. As an MP I have visited a number of schools to see how they provide cookery lessons. I am a big supporter of the £20 million national lottery-funded “Let’s get cooking” campaign, which is coming to the end of its five-year scheme. I hope that it will carry on. The main function of the campaign is to encourage cooking in schools. Last Friday, I visited a cookery session at Warneford secondary school in Highworth. Boys and girls from different backgrounds joined in enthusiastically. Cooking is not a bind for young people; they want to do it and they enjoy doing it. With “Junior Masterchef” and all the other cookery programmes on TV, they are inspired to cook.

The children themselves made another point to me. A lot of professional sportspeople are the role models for young people. Because professional footballers, for example, only train for a couple of hours a day, they have to do something with the rest of their time and a lot of them now are very good chefs, which has filtered through to a lot of young people, particularly younger boys.

I have also visited Haydonleigh primary school, which had what to my mind is the perfect example of cookery in schools. In Haydonleigh’s cookery sessions, the parents or grandparents of children were invited to come in, so that they were cooking with the children, who would then take their skills back home. However, there was also an allotment at the school, so the children got to see the full cycle: they planted the seeds; they grew the vegetables; they cooked in school with their parents or grandparents; and they went home and carried on cooking.

In my role as the vice-chair of the all-party group on heart disease, I fully echo all the points that have been made about the need for clear and uniform labelling of food, which allows people to make informed decisions.

[Dr William McCrea (South Antrim) (DUP)]

Does the hon. Gentleman believe that GPs have a greater responsibility and need to be more proactive in informing people about, and leading people in, healthy eating?

[Justin Tomlinson]

Yes, I absolutely do, but this is an area where the schools can lead, in terms of teaching the basic cookery and giving students the information they need, and I am covering that.

Then there is food labelling. I want to refer to labelling here in Parliament, because people often say, “Does labelling really make much of a difference?” Well, we have the “traffic light” system in our canteens in Parliament. As a general rule, anything that has a red sticker next to it is normally the most attractive thing, but we are able—even we MPs, with our limited intelligence—to say, “I can’t have too many of those,” although I confess that, as I was writing this speech earlier, I was eating a pork pie. So I failed by that rule myself.

I turn to organised sports now. I have already said that the most important element is the open, accessible and usable space on which kids will be creative. But organised sport also plays a very important role and there are a lot of opportunities that we can examine, in order to be more proactive.

I set up a sports forum when I was a councillor and that forum brought together about 60 different sports groups, who shared best practice. For example, there would be one group saying, “We’ve got a facility, but it’s underused,” and there would be another group saying, “We haven’t got the facility, and we need one.” We put those two groups together and between them they became experts at applying for external funding. There are lots of examples of external funding and I will talk about one in a moment.

I was quite an outspoken critic of the plan to scrap the school sports partnerships scheme and I was delighted when the Government changed their mind and delayed the scrapping of the scheme by nine months, to allow the good and successful examples of school sports partnerships to dig in and secure their existence. The principle of the school sports partnerships in schools was not to deal with those children who are already technically gifted, because by and large if a child is naturally good at sport—probably because their parents encouraged them—they are usually already involved in competitive sports clubs. Instead, it was to deal with the three out of five kids who were not naturally inspired to participate in sport and to provide them with a menu of alternative sports, because there is something for everyone.

It is not only a question of getting people to be active. One of the biggest challenges that sports groups tell me about is that they would like to provide lots of facilities but are struggling to do so because they are struggling for volunteers, for example to join the administrative staff and coaching staff who do all sorts of things, such as filling in forms to make all the bookings, to provide the organisation so that the kids can take part in activities.

I will touch on the point that my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart) has made today, and in previous speeches, which is the need to address the cost of insurance. One of the barriers for a lot of schools is that many teachers are very young and it costs a fortune to insure a teacher to use a minibus. I have pleaded with several Ministers to consider providing some national insurance scheme for all different schools, so that they can achieve economies of scale and make the cost of insurance cheaper. In addition, health and safety issues prevent a number of schools from taking up more opportunities.

Councils should also do more to open up facilities. It is a crying shame that many of our facilities are closed on Friday and Saturday evenings. We are talking about tackling antisocial behaviour and childhood obesity. Where there are leisure centres that are shut, surely we should open their doors and provide facilities.

A good example of how that process works is that we have just had an academy built in the last few years in Swindon; an old school was closed down to build it. However, just before the decision was made to do that, £4 million was invested in a fantastic new sports hall in the old school. Initially and regrettably, the council was going to bulldoze the new sports hall along with the old school, because there was no point in having a random, stand-alone sports hall. Through the sports forum, however, we managed to identify a sports group that could take over that sports hall. It was Esprit Gymnastics and Mark Hows, who runs it, is fantastic at identifying funding opportunities. He had about 250 kids a week in his old facility, but that was at full capacity. However, he had an income, so he could pay a rental income to the council, which is revenue-stretched, and he said, “Just don’t bulldoze it. I will rent it.” Now his group has more than 500 kids a week participating, including potential Olympic athletes, and they are a real jewel in the crown for Swindon. That is a good example of the council being proactive and working through the sports forum to identify other facilities that can be used.

One of the external bodies that provide funding is the Football Foundation, which provides funding through its “Grow the Game” scheme. That scheme aims not only to increase participation but the sustainability of it. I have seen a lot of funding come in and people will put on a one-off session. That is great, but it does not really make that much difference. The “Grow the Game” scheme slants its funding to ensure that it is not just used for one-off things. It targets things such as coaching qualifications to provide additional coaches so that more junior clubs can take part, and paying for facility hire if there is a group of volunteers, particularly in challenging areas where there may not necessarily be a huge amount of funding. Also, first aid provision is funded, as part of the process of ticking off the many items on the very long health and safety list that exists. Already the sports forum has increased participation by 12,000 new players and, crucially, by an extra 2,000 new coaches. That is just one of many, many schemes, but councils and the Government can do more to help sporting groups and volunteer groups to identify the different streams of funding that are available.

My final point is about youth provision. My suggestion is a little bit contentious, but I have road-tested it on a number of schools, youth clubs and colleges. In the past, there was a traditional divide, whereby children were either very sporty and they went to a sports club, or they might choose to go to a youth club, and the divide would never be crossed. But times have changed and when I talk to young kids they are all very keen, either on whatever sport is popular on TV or even on things such as cheerleading or street dance, which are not strictly “sports” but which get the heart rate going.

I think that the youth service and the leisure service in local authorities should be merged to become one service. The chief officer within those areas should be one person and they should not employ armies of youth officers with very expensive youth clubs attended by only a handful of children, where they do things that we may have liked doing when we were younger but which, I can assure hon. Members, these days kids are not particularly switched on by. Instead, we should open up schools, community centres and leisure centres. We would pay for football coaches, street dance instructors and so on, and say, “Right, it is 50p. You come along and for the next two hours you’re in a constructive environment, and you’re doing something that is active.”

That is not just some pie-in-the-sky thing. In Swindon, we have the ice-skating disco on a Friday night for teenagers and 600 kids chase around the ice after whoever they think is particularly good-looking. They are being very active for a couple of hours; they are off the streets; and the youth service could and should be parking its mobile facility outside. Those young children who need the traditional youth service, from which they can get advice and seek help, will find that that is available. For all of the others who might have been put off going to the youth club, because that was the only thing that was available, there is the enjoyable activity of ice-skating. I am very keen to push such projects and we could judge their success by the number of children who are engaged by them.

To conclude, it is for us—whether we are the local authority or the Government—to provide as many opportunities as we can: through the planning system, through making changes in teaching cookery and in food labelling, and also through the power of sport.

Coeliac Disease

Lord McCrea of Magherafelt and Cookstown Excerpts

Wednesday 7th September 2011 Westminster Hall

[Dame Anne Begg]

My hon. Friend may agree that if one tells an organisation that is providing a sandwich lunch that one wants a gluten-free sandwich, it always seems to provide the worst possible gluten-free bread, without the same filling as everyone else. One is given processed cheese or a bit of cold ham, and looks lovingly at the filling in everyone else’s sandwiches. Not only does one get the worst bread in the world, one gets the worst filling in the world, when it would have been easier to take out the original filling and put it on a plate to make quite a good salad.

[Dr William McCrea (in the Chair)]

Order. Time is passing, and the Opposition Front Bench spokesman and the Minister must make their winding-up speeches, so perhaps the hon. Gentleman will draw his comments to a close.

[Mr Jones]

I agree with my hon. Friend. When I was a Minister, it took at least six months to convince those in my private office at the Ministry of Defence that I did not want a salad whenever I went anywhere.

I congratulate the House authorities on the steps that they have taken in the House of Commons to provide gluten-free products, including meals, and to put the crossed grain logo on menus and so on to inform people. I hope that the House of Lords will eventually follow the same principle. That shows that it is possible for catering establishments to provide for people who need a gluten-free diet, and the House of Commons should be congratulated. There are some important issues to consider, and I hope that today’s debate has raised awareness about people who suffer coeliac disease, and provided some practical suggestions, which I hope the Minister will consider.

Health and Social Care (Re-committed) Bill

Lord McCrea of Magherafelt and Cookstown Excerpts

Wednesday 7th September 2011 Commons Chamber

[Nadine Dorries]

No.

I constantly speak to people at a high level across the abortion industry, and they always tell me that no woman goes through those doors wanting to be there. All women’s stories are the same; there is a theme that runs through every single one. The individual circumstances may be different, but the stories all start in the same way and with the same questions: “Will I lose my job or won’t I lose my job?”; “Will he leave me or won’t he leave me?”; “Will my parents kick me out or won’t they kick me out?” The questions are all the same; there are no surprises. Many women say that once they are referred—

[Dr William McCrea (South Antrim) (DUP)]

Perhaps this is not about this particular debate on the amendment, but I have to say that some of us in this House have the conviction that the emphasis seems to be on the right of the woman and that it is about time we spoke about the right of the unborn child. They have rights too.

[Nadine Dorries]

The hon. Gentleman is a man of great conviction and, I think, a lay preacher, and we all respect and honour his views. However, the amendment is not about the unborn child; it is about the woman accessing counselling.

Oral Answers to Questions

Lord McCrea of Magherafelt and Cookstown Excerpts

Tuesday 25th January 2011 Commons Chamber

[Anne Milton]

I thank my hon. Friend for his question and I know that he has a keen interest in this subject. I share his frustration that the previous Government spent a long time not doing anything about it. The Medicines and Healthcare products Regulatory Agency has identified the possibility of creating a national regulatory scheme, allowing authorised herbal practitioners to continue to commission unlicensed manufactured herbal medicines after 30 April. We are in discussions with the devolved Administrations, the Health Professions Council and the Complementary and Natural Healthcare Council about the feasibility of a statutory register. As I say, I share my hon. Friend’s frustration but we will make proposals shortly.

[Dr William McCrea (South Antrim) (DUP)]

Specialists in the field state that the figures that point to a more than 50% rise in young drinkers ending up in hospital are a gross underestimate of the serious problem. What further steps can the Department and the Government take to address this important problem?

[Mr Lansley]

As the hon. Gentleman will recall from earlier exchanges, it is absolutely right that we must have a series of measures to tackle alcohol abuse. Price is part of it, as is the enforcement of legislation. Community alcohol partnerships have been very promising. We must have better alcohol education, and I spoke at the first annual conference of Drinkaware yesterday, encouraging it in the work that it does. We must understand that we have to change people’s behaviour and that the damage that can be done is intense. As a consequence of chronic alcohol abuse, large numbers of people are coming in and out of intensive care units, presenting an enormous burden to the health service as well as doing great damage to themselves.