Accident and Emergency Departments

Andrew Love Excerpts

Thursday 7th February 2013 Commons Chamber

[Stephen Lloyd]

I thank the hon. Gentleman for that intervention, and I agree. My point is that the four tests look good on paper but my anxiety, which I am putting to the Minister, is that they may not be so good in practice.

[Mr Andrew Love (Edmonton) (Lab/Co-op)]

Will the hon. Gentleman give way?

[Stephen Lloyd]

I will continue, as I have only two and a half minutes left.

In short, either the Government’s reconfiguration tests are not being properly adhered to, or trusts and PCTs are merely using them as a smokescreen to hoodwink local communities. I do not believe for a moment that this is what the Government originally planned, so what is going wrong and why? It is clear that many very experienced and expert clinicians believe that most areas must retain emergency departments, with co-located essential core services to manage the bulk of common emergency conditions, which I spoke about earlier, or to stabilise patients prior to transfer to specialist units.

In conclusion, I am far from confident that the current process to determine whether or not reconfigurations of health services or A and E are being done in the best interests of local people is working, irrespective of the four tests that I talked about earlier. This must be addressed and that needs to be done quickly because if we get it wrong, lives could quite literally be lost unnecessarily. The NHS is our most cherished institution, often referred to as the glue which binds our society together. I pay tribute to the coalition Government for protecting NHS funding at a far higher level than was the case in any other Government Department but—and this is a “but” laden with real anxiety—I fear we may be getting the reconfiguration elements wrong. I hope the Minister will address my specific concerns about the reconfiguration element and about specialism v. generalism, to ensure that the right and the best service is provided for my and all our constituents.

[Jim Dowd (Lewisham West and Penge) (Lab)]

I am pleased to follow the hon. Member for Eastbourne (Stephen Lloyd). I thank him, the hon. Member for Newark (Patrick Mercer) and my hon. Friend the Member for Ealing, Southall (Mr Sharma) for securing this debate and the Backbench Business Committee for agreeing to their representations.

I will return in a moment to a few things that the hon. Member for Eastbourne said, because he got to the thrust and the kernel of a lot of the problems with the four tests, although his attitude towards them is a good deal more generous than mine.

[Mr Love]

The four tests were invented for the reconfiguration of Chase Farm hospital, which predates everything that we are discussing today. If we look back at what happened there, it is clear that it did not matter what local opinion was, what local medical opinion was, or that everyone at Chase Farm was opposed—there was a determination to go ahead regardless. So the whole thing becomes a farce and a complete sham, and the four tests do not really add up to anything in terms of protecting local services.

[Jim Dowd]

My hon. Friend has it exactly. That is precisely our experience in Lewisham, which I will elaborate on in a few moments, where we have seen that the four tests are a fig leaf and entirely inconsequential, and, more than anything else, that the Secretary of State can blithely announce that he has decided that they have been met and that that is all that counts. There is no review, no appeal, no objective analysis, no consideration of alternative views: it is just a case of the Secretary of State saying yes. It is precisely as Humpty Dumpty said: “Words mean exactly what I choose them to mean, and that is it.” That is the position of the Secretary of State.

My right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) went over a lot of the ground that is concerning us in Lewisham regarding the outrageous proposals by the trust special administrator appointed in South London Healthcare NHS Trust. Let me emphasise that the reason for the anger, the outrage, the fury and the sense of seething injustice in Lewisham is not that people there are particularly prone to believe scare stories—it is that they know exactly what is going on. They know that they are being punished for the failings of others at a time when Lewisham hospital has made every effort to meet the financial targets and, more particularly, the service targets, and to retain the confidence of local people.

I would therefore say this to anybody whose local trust is performing badly: fear not, for under this Government you will be rewarded. What people really need to be careful of is being anywhere near a trust that is doing badly, because even though their local trust may be doing well, the Secretary of State will appoint his henchmen—and women, for that matter—to go in there, jackboot their way around the place, spend millions of pounds of public money, and then come up with a scheme that does not do much to achieve the purpose for which they were appointed but rather deals with others who have played the game and played by the rules: and under this Government, more fool them.