King George Hospital

Andrew Gwynne Excerpts

Tuesday 8th November 2011 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

I welcome you to the Chair, Mr Brady, and congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this important debate on the issues facing his local hospitals. I know that he, my right hon. and hon. Friends, and other Members across the party divide have campaigned extensively for their local health services, and I commend them for it.

The Government are implementing a number of much wider changes in the health service—I will touch on those later—but my hon. Friend must be disappointed with the recent decisions made about the hospitals in his area and the health services used by his constituents. He and others have mentioned the recent Care Quality Commission report on the standard of care received by people under Barking, Havering and Redbridge University Hospitals NHS Trust. The report had immediate concerns in relation to maternity services, identified failings in emergency care and radiology, and demanded widespread improvement.

As Members have mentioned, Queen’s hospital had the most serious concerns, including poor clinical care, verbally abusive and unprofessional behaviour by staff towards patients and colleagues, and a lack of learning from maternal deaths and incidents. The report states:

“Despite some signs of improvement in recent months, patients remain at risk of poor care in this trust”.

It also notes that the trust addresses issues on a short-term basis, under instruction, rather than proactively looking for longer term solutions. The report also states:

“There is past and current evidence of poor leadership from some managers and a culture among some staff of poor attitude and a lack of care for patients, especially in maternity.”

That is of extreme concern, and those views have been reinforced in this debate. The report also confirmed that attempts to cut the financial deficit at Barking, Havering and Redbridge trust led to reductions in the quality of care.

About three hours after the CQC report was published, the Health Secretary made an announcement about King George hospital, which now looks set to lose its A and E and maternity units. We know that the Health Secretary backed the IRP’s proposal for services to be expanded at nearby Queen’s hospital in Romford. That raises the question why, when the report on King George hospital was presented to the Secretary of State on 22 July, it then sat on his desk for more than three months and he chose to release its conclusions and recommendations on the same day, three hours after the CQC report.

From articles in the Ilford Recorder, in the constituency of my hon. Friend the Member for Ilford South, I see that there is a great deal of concern and consternation about that decision. Indeed, my right hon. Friend the Member for Barking (Margaret Hodge) described the decision in the press as “sheer madness”, outlining how Queen’s hospital is already having difficulty dealing with existing pressures—an issue which she raised today. My hon. Friend the Member for Ilford South previously described the decision as a disaster and is quoted in the Ilford Recorder as saying that the decision on King George hospital showed an

“absolutely contemptuous attitude to local people’s wishes and concerns”.

The proposed changes will not take place until the Barking, Havering and Redbridge University Hospitals NHS Trust, which runs both sites, tackles the issues raised by the CQC. The Minister went into a little more detail about that in the debate. However, it is not just the disruption, but the uncertainty of local people, who will no longer have access to A and E and maternity services on their doorstep, that should be of concern to all hon. Members.

Yes, we need to acknowledge that reconfigurations are unpopular. We went through that a few years ago in Greater Manchester. Nevertheless, given public opposition and the views of the overview and scrutiny panel, local MPs and members of the local authorities across party, will the Minister say what account has been taken of the level of local opinion on the local health services by the IRP? My hon. Friend says that it was in its report, but what weight did the IRP and the Secretary of State give to that level of opinion?

[Mr Simon Burns]

May I help the shadow Minister? The consultations—not on the IRP level when it was doing its work, but on the proposals themselves—have, since 20 March 2010, had to fulfil the four conditions for reconfigurations set out by my right hon. Friend the Secretary of State, which include consulting local people within the health economy and local opinion.

[Andrew Gwynne]

I appreciate that, but we heard today that there is a great deal of concern across local authorities and the communities, and I would like to know what weight was given to their views.

[Margaret Hodge]

Does my hon. Friend agree that it appears that money has been the key factor in forming the decisions, and not the care of people? The views of bureaucrats have taken precedence over the views and experiences of local communities.

--- Later in debate ---

[Andrew Gwynne]

Absolutely. We recognise that reconfiguration is sometimes necessary in parts of the country for reasons of financial efficiency, safety and better health outcomes. However, people are rightly disappointed by the way in which the nature of the debate changed in the run-up to the general election. As hon. Members rightly said, the general election was fought with a pledge about hospital closures and reconfigurations that is not being met. Back in 2010, the now Prime Minister clearly promised a moratorium to stop closures. Indeed, in opposition both he and the Secretary of State toured the country making promises to overturn some very difficult reconfiguration decisions taken by the previous Labour Government. Yet, as we have seen, the moratorium has not materialised, and there is now evidence of major changes to hospital services across the country.

I do not want to stray too far from the subject, but it is worth remembering that the Prime Minister gave a firm pledge not to close services at Chase Farm hospital, but in September 2011 the Secretary of State accepted the recommendations of the IRP and approved the downgrading and closure of services at Chase Farm. Similarly, at the Fairfield maternity department near Bury, we were told on a visit by the now Secretary of State that the service would be kept open. We now know that the maternity department at Fairfield general hospital is scheduled to close in March 2012.

My hon. Friend the Member for Ilford South raised concerns about the ability of Queen’s hospital to improve when the NHS faces tough financial challenges in the years ahead. That is fair comment. At the general election, Labour promised to guarantee to maintain NHS front-line funding in real terms. In contrast, the Prime Minister offered real-terms increases. We can debate that another time, but I would suggest that that was just an electoral gimmick. The Treasury figures show that in 2009-10 health spending was £102,751 million in the last year of the Labour Government. In 2010-11, actual health spending was £101,985 million.

[Mr Simon Burns]

Will the hon. Gentleman be kind enough to tell hon. Members that the health spending figures for the financial year 2010-11 were set by his own Government, and that, for the lifetime of this Parliament and thereafter, we are increasing health spending in real terms, albeit a modest increase because of the financial mess we inherited, which needs to be sorted out?

[Andrew Gwynne]

I said that that was the actual health spend for the first year of this Government, which represents a real-terms cut of £766 million, according to Treasury figures. That includes the GDP deflator, which so excited the Minister during the Opposition day debate when my hon. Friend the Member for Leicester West (Liz Kendall) tried to raise this issue. That is the first cut in health spending for 14 years. Indeed, that is the first real-terms cut since the last year of the previous Conservative Government in 1996-97. The Government promised a real-terms increase in health spending; they have delivered a real-terms cut.

There are wider concerns about how the Health and Social Care Bill will impact on local health services. The extensive reorganisation of the NHS was not put forward by either party in government in their manifestos, or in the coalition agreement. Clearly, such a massive reorganisation will make it harder for the NHS to tackle the sorts of problems identified at Barking, Havering and Redbridge University Hospitals NHS Trust, and the wider issue of social care for older people by the CQC. The Prime Minister has clearly gone back on his promise on NHS reorganisation. The coalition agreement could not have been any clearer:

“We will stop the top-down reorganisations of the NHS”.

It is difficult to see how the coalition Government could have said that, when only weeks later they published a White Paper outlining the biggest reorganisation of the NHS since 1948. It is clear that such a change on this scale is the last thing that the NHS needs right now.

Returning to the more specific question about Barking, Havering and Redbridge trust and the future of King George hospital, given the CQC report and what hon. Members have said today, what consideration has the Minister given to the ability of Queen’s hospital to deal with the added pressures on its services when King George hospital closes its A and E and maternity services? On the face of it, no consideration has been given to the local support for keeping A and E and maternity services at King George hospital. If services are to be transferred—the Minister says within two years—does he recognise that people need certainty and that NHS staff need proper expectations to plan and manage those changes? If those time scales are not met, what plans are in place for NHS services in that part of London?

The concerns expressed by Members today are right and need to be addressed by the Minister. Also, the wider changes to the NHS will make it much harder to identify such failures in care in future and to deal with them effectively. That is why we are so against what the Government are doing to our national health service.