Health Care (London)

Andrew Gwynne Excerpts

Wednesday 8th January 2014 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mrs Main. I congratulate my hon. Friend the Member for Westminster North (Ms Buck) on securing this very important debate about health care in London. I hope that hon. Members will forgive this Mancunian for gatecrashing the debate to respond for the Opposition.

The future of health services and especially accident and emergency services across London is an important issue of genuine concern to a great many of the constituents of hon. Members present. It is definitely an issue of real significance right across our capital city. I pay tribute to all the hon. Members who today have made contributions, long and brief, on a wide variety of matters.

Let me take this opportunity to pay tribute to the staff working in the national health service for their commitment in providing a first-class service to patients in what has been a very trying period for the NHS. As we know, there have been important changes in the provision of hospital care in London. We have had “Health for North East London”, “Shaping a healthier future”, the Barnet, Enfield and Haringey clinical strategy, the trust special administrator’s review of South London Healthcare NHS Trust and the NHS in south-east London and “Better Services, Better Value” in south London, to name a few of the reconfigurations that have taken place in the capital.

My hon. Friend the Member for Westminster North is right to point to extreme financial pressures on hospital services. North-west London hospital services must accommodate a £125 million reduction in service between 2011 and 2015. The people who use hospitals in London are rightly concerned about the changes to the services on which they rely. We have heard about the proposals that will lead to the loss of accident and emergency departments at Charing Cross, Ealing, Hammersmith and Central Middlesex hospitals.

However, it is not only my hon. Friends who are concerned about the future of A and E departments in London; local authorities are, too. Local authorities such as Ealing have voiced their concerns about the downgrading of their A and E services. As we have heard from my hon. Friend the Member for Hammersmith (Mr Slaughter), A and E facilities that both the Prime Minister and the Secretary of State had promised to save across north-west London and elsewhere in the capital will be closing. I hope very much that the meeting between the Secretary of State and the hon. Members who represent Ealing and Hammersmith can be reconvened as requested.

Of course, all this is in direct contradiction to what the Prime Minister said during the general election, when he promised to halt the closures of hospitals, accident and emergency departments and maternity units. Why does the Minister think that there is such widespread concern about the lack of leadership in the health service in London at a time when the NHS is dealing with unnecessary upheaval?

Frankly, it was a disastrous decision on the part of the Government to spend billions of pounds on an unnecessary top-down reorganisation, which has led to a loss of financial grip in the NHS. Now, more than 6,000 nursing posts have been lost, waiting lists are getting longer and we are seeing the return of patients on trolleys in corridors. Indeed, we are now seeing A and Es not just in London but across the country facing a winter crisis after an unprecedented summer A and E crisis. At the same time, local authorities are having a huge cut to their social care budgets. More and more elderly people are therefore ending up in A and E, because there is no one at home to care for them, adding even more pressure to a pressured system.

Labour Members warned Ministers repeatedly during the passage of the Bill that became the Health and Social Care Act 2012 that the legislation would lead to the break-up of the NHS. The public rightly expect to have easy access to health services, and Ministers have a heavy responsibility to show leadership and to act to prevent people’s lives being put at risk. Ministers must also tell the House today what action they propose to take to ensure that London’s growing population will continue to have good access to hospital and other health service provision in their local areas. Those points were made eloquently by a number of hon. Members, but I have to mention my hon. Friend the Member for West Ham (Lyn Brown) in relation to Newham.

Of course, Labour Members do not oppose all the changes to local health services. Surely, it is right that hospitals and services evolve and change. However, it must be change based on good clinical reasons and not just financial necessity.

[Ms Abbott]

Does my hon. Friend agree that the issue in London is not just provision for its size of population, but the extreme diversity and complexity of the population? It is a very mobile population. There are large numbers of refugees and asylum seekers, and London has the largest lesbian, gay, bisexual and transgender community in the country. That is what people have to pay attention to if they are reconfiguring services.

[Andrew Gwynne]

My hon. Friend is right. London is a global city. It has people coming in from all over the world, not just from elsewhere in the United Kingdom. It is a diverse city. It is an exciting, vibrant city—I am probably over-egging it for a Mancunian, but it is a great place. Those complexities are what makes London fantastic, but they are also what makes delivering health services a real challenge.

To make the change work, there must be clarity and partnership. Everyone must understand what is being proposed and how the decisions are to be taken. That brings me on to the issue of Lewisham and clause 118 of the Care Bill. We saw in Lewisham the power of an effective campaign in the face of unpopular change to health services and what that can achieve.

I pay tribute to the Lewisham MPs and to the campaigners, who fought tirelessly for their local hospital. The proposal to close their A and E department was rightly met by a strong local campaign, which included protest marches and a successful legal challenge to the closure. Indeed, the Court of Appeal ruled that the Health Secretary did not have the power to implement the cuts at Lewisham hospital. If only he had listened to my hon. Friends in Lewisham—they had been arguing that beforehand.

Clause 118 should give very real concern to all hon. Members in the debate, because in future it will give carte blanche to the Secretary of State and the Department of Health to reconfigure services right across the country as they sought to in Lewisham, disfranchising the communities that have spoken out very loudly across London against some of the changes. Labour Members are rightly concerned about that measure and we will be opposing it during the next stages of proceedings on the Care Bill.

In conclusion, I pay tribute to my hon. Friend the Member for Westminster North and to all my right hon. and hon. Friends who have taken part in the debate. Hospital services are very important to the capital. We must make sure that there is proper strategic planning across London, not the piecemeal approach to reconfigurations of services that we have seen, so that the complexities in health needs—including mental health, which my hon. Friend the Member for Hampstead and Kilburn (Glenda Jackson) mentioned—are taken on board fully for the betterment of people living in London.