NHS Sustainability and Transformation Plans

Debate between Andrew Gwynne and Diane Abbott

Wednesday 14th September 2016 Commons Chamber

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

My hon. Friend is making a very important point. She has already touched on the financial problems in the NHS, but allied to those are the financial problems in adult social care. We shall not have the truly integrated health and social care that we all desire when these STPs are being swept under the doors without people knowing precisely what they will mean for public services in their areas.

[Ms Abbott]

My hon. Friend has made an important point.

The danger is that, in a blizzard of apps and Skype, patients—particularly the elderly—will find it harder to access one-to-one care, and that those who can afford it will find themselves forced into the private sector.

Let me now say a word about the increasing private sector involvement in the NHS.

Health Care (London)

Debate between Andrew Gwynne and Diane Abbott

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.

Horsemeat

Debate between Andrew Gwynne and Diane Abbott

Tuesday 12th February 2013 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

We have heard a lot in this important debate about producer interests. I want to detain the House for a few minutes to talk about the interests of consumers and to remind the House that, even as we speak, there are mums—and dads, too—hovering over the frozen food cabinets of their corner shops, supermarkets or favourite frozen food stores, looking at their favourite processed meat product and saying, “Is this what it says it is? Is it even safe?” For those ordinary mums and dads up and down the country, it is not enough for Ministers to hide behind this or the other quango, as this horsemeat scandal has clear public health implications—possible implications, but implications none the less. There is a public health dimension, so responsibility falls fairly and squarely on Government.

We are relieved in the House today to understand that at this point there is no evidence that antibiotics or other drugs have entered the food chain. That is what we know today, but we know from previous food scandals that what we know this week may change week on week. It is the public health aspect that makes this an issue for Government. It is the public’s belief—it is a belief as old as the Chamber itself—that when it comes to the adulteration of foodstuffs, whether it is watered-down milk in the Victorian era or horsemeat in lasagne in 2013, they can look to Government to take some responsibility.

The other point to make is that we should not forget that this scandal affects the very poorest in our community and their children. Who, really, is eating £1 lasagne and so-called value burgers? Who buys those things, except the very poorest in communities such as mine? Often they feed them to children. I hear people saying, “Oh, you’d have to eat an awful lot of these things for there to be any discernible effect on your health,” but I put it to Ministers, who might not be aware of this, that there are families in communities such as mine who eat an awful lot of cheap, processed food. They deserve absolute assurances about its quality, not Ministers hiding behind quangos.

It must concern anyone taking an interest in this debate that the whistle was blown not by the Food Standards Agency in England, but by the Food Safety Authority in Ireland. What does that say about the processes and procedures in the British Isles? There are issues with the break-up and reorganisation of the FSA and the loss of trading standards officers locally. Serious issues have also been raised for some time about the cuts to the Meat Hygiene Service, so for Ministers to say that the ultimate responsibility lies somewhere else is not something that the British public accept or believe for a second. It is no coincidence that this issue has been headline news for some days in the British media, whether they ostensibly support the Government or not. I believe that it will continue to be headline news until it plays itself out, because historically there has been no issue of greater concern to British families than the quality of the food that they eat.

A fundamental issue arising from the horsemeat scandal is the price of cheap food. All along the food chain, relentless pressure has been exerted for decades to drive down costs at the farm gate, and at production, manufacturing and retail levels. There are obviously sections of the British community who cannot afford expensive products, but the main pressure on costs comes from the massive retail chains.

[Andrew Gwynne]

My hon. Friend is making a powerful point. The consequence of driving down costs has been to drive down quality as well. Is it not invidious that some products being sold as beef have never come into contact with a cow?

[Ms Abbott]

I entirely agree. The pressure on costs inevitably means pressure on quality. Instead of cutting back institutions such as the Meat Hygiene Service and reorganising and destabilising the FSA, the Government should be putting more resources and effort into guaranteeing the quality of food, right down to the cheapest products being bought by the poorest members of our communities.

Finance (No. 3) Bill

Debate between Andrew Gwynne and Diane Abbott

Wednesday 4th May 2011 Commons Chamber

[Andrew Gwynne]

It was not my intention to speak in the clause 35 stand part debate. Having listened to my right hon. Friend the Member for Delyn (Mr Hanson) and my hon. Friend the Member for Easington (Grahame M. Morris), however, I have decided that it is important for me to do so.

As has already been said, the clause introduces schedule 8, which introduces changes to the higher rate taxpayer relief for child care. That was first announced by the Government and, as my right hon. Friend the shadow Minister said, Labour does not oppose it, except for the important point—I bear in mind your earlier strictures on not extending the debate too widely, Mr Evans—that the measure has a wider impact on the Government’s child care policy and how it fits in with the Budget measures.

I have some sympathy with the notion of expanding child care places for two-year-olds. The previous Labour Government made greater provision for early years education, which has been incredibly beneficial to those children. I declare an interest in that all three of my children went through early years education under a Labour Government and, thanks to that Government’s investment, they are doing brilliantly at primary and secondary school.

[Ms Abbott]

Would my hon. Friend care to share with the Committee the name of the primary school?

[Andrew Gwynne]

I am happy to say that all three of my children went to St Anne’s primary school in Denton, where my wife, who is up for election tomorrow, is a chair of the governors. My eldest son goes to Audenshaw high school, which is also in my constituency, and all my children are getting a first-class education in those schools.

Let me return to clause 35, Mr Evans, for fear of being told off by your good self for straying too wide of the issue. The issue, for Labour Members, is this. We support the extra investment in child care for two-year-olds, especially in constituencies such as mine. Denton and Reddish is quite a deprived constituency, which covers five wards in the Tameside metropolitan borough—which is, I believe, the 52nd most deprived local authority in England—and the two Reddish wards in Stockport, which, although Stockport itself is a much more prosperous borough, are the two most deprived wards in the constituency. Investment in early years education has made a big difference to young people in constituencies such as Denton and Reddish. I would particularly welcome extra investment in nursery education in those deprived communities and, indeed, the Labour party proposed to provide it. I am pleased that the present Government are pressing ahead with a change that we proposed when we were in government.

Where we differ is in our approach to targeting. My hon. Friend the Member for Easington made a valid point about that. Although I understand the arguments for targeting as a way of ensuring that communities such as his and mine receive the benefit of extra early years provision, some constituents who are better off than the average in my constituency tell me—and it is difficult to argue against what they say—that they pay considerably higher taxes and pay into a welfare state system, and that they expect to get at least something in return. Those payments are their buy-in to the universal welfare system. I take on board your strictures, Mr Evans, but I also take on board the points made by my hon. Friend.