Changes to Health Services in London

Andrew Love Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

I assure my hon. Friend that the resources taken out of some acute services will be used to give better, safer and more high-quality services to his constituents. Northwick Park is one of the best examples of that. Stroke services in the north-west London area were centralised in Charing Cross and Northwick Park. As a result of those changes, which were introduced by the right hon. Member for Leigh (Andy Burnham), stroke mortality rates in London have halved. That is a very good example of why it makes sense to centralise certain more specialist and complex services if we are to get the best results for patients.

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

The Secretary of State talked about putting politics before patients, but I remind him that the Prime Minister, when he was Leader of the Opposition, went to Chase Farm to say that the Conservatives would stop all configurations. That simply has not happened, but yet the Secretary of State continues to have a role. Patients and local residents are firmly opposed to the reconfiguration at that hospital and he will end up in court very soon over the matter. There is still time for him to reconsider that decision.

[Mr Hunt]

We did not agree with how the previous Government went about reconfigurations. I have announced a better way of achieving them, with better public and clinical support. My predecessor as Health Secretary paused on reconfigurations because he wanted to introduce a better structure, including the four tests, one of which was the need for local clinical support, and another of which was the need for effective public engagement. That is why we are in a better place today than we were with the previous Government’s reconfigurations.

Accident and Emergency Departments

Andrew Love Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

My hon. Friend has campaigned assiduously for Kettering hospital, including by inviting me there to see it for myself. I think that its staff are working extremely hard. I am pleased to confirm that today’s announcement means that an extra £3.9 million will be given to the hospital to help it meet those pressures over this winter. I think that the people working in A and E would be the first to say that where there are alternatives in the community, they should be used. The long-term change we need to make is to reverse what has happened over the past decade, which is that it has become easier and easier to go to an A and E department and harder and harder to get an appointment with a GP. That was the profoundly wrong change made by the previous Government and that is what we have to put right.

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

The Secretary of State will be aware that the major reason given for the reconfiguration of services at Chase Farm hospital was the need to increase the number of consultants and specialist staff in accident and emergency, but we discovered over the weekend, as colleagues have indicated, that there is a massive shortage of specialist staff and consultants, particularly in outer London, where there are special pressures. The Secretary of State has indicated some of the short-term measures, but my constituents want reassurance that steps will be taken to bolster the number of A and E consultants and specialist staff to look after them.

[Mr Hunt]

The hon. Gentleman is right to say that that is one of the key issues in the underlying pressures on A and E departments. About a quarter of the money announced today will be used to increase the capacity of A and E departments, including increasing consultant cover. In the end, however, we need more trained consultants; we need more doctors who want to work in A and E departments. That is a longer-term challenge, but one of the ways in which we will make A and E more attractive is by convincing doctors that we have a long-term, sustainable strategy to make sure that it does not become an impossible job. That is what the measures on improving GP access, IT systems and the social care system aim to achieve.

Oral Answers to Questions

Andrew Love Excerpts

Tuesday 16th July 2013 Commons Chamber

[Anna Soubry]

We know that a third of GP appointments are mental health-related, so GPs have a lot of experience in tackling mental illness. We also know, however, that it is not covered extensively in GP training, which is why the Royal College of General Practitioners has identified improved care for people with mental health problems as a training priority—this is to be welcomed—through its enhanced GP training programme.

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

Yet mental health spending has been cut over the last two years and we find ourselves in a position where four in 10 mental health trusts do not have safe levels of staffing. What is the Minister going to do about the funding and the staffing levels in our mental health services?

[Anna Soubry]

Of course, the overall health budget will be rising by some £12 billion by 2015, and in relation to mental health, I have to say that I am exceptionally proud of this Government for making mental health such a priority, notably through the mandate. I think we are to be congratulated on at last recognising how important mental health is. In our view, it underpins almost all public health matters and so many of the troubles and conditions that people present to GP surgeries. Therefore, I think we are doing an extremely good job on this subject.

A and E Departments

Andrew Love Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

Yes, I will.

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

In 2009, long after the GP contract was introduced, accident and emergency units were hitting their 98% target. The Secretary of State has reduced that target to 95%, but we are now hearing that units around the country are not even achieving that. How can that possibly be? What steps is he going to take to deal with the situation?

[Mr Speaker]

The Secretary of State appears to have managed to make the hon. Member for Hammersmith (Mr Slaughter) smile. The occasion should be noted.

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.

National Health Service

Andrew Love Excerpts

Wednesday 26th October 2011 Commons Chamber

[Andy Burnham]

If that is the case and the people of Enfield are in control of the decision, would Chase Farm A and E be closing? What the hon. Lady describes is a complete and utter reinvention of the moratorium policy. She stood on an election manifesto that promised a moratorium. Where is it? It has not materialised. It is a mythical policy that was designed to win votes; it had nothing to do with the good stewardship of the national health service.

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

rose—

[Andy Burnham]

I give way to my hon. Friend, who has a nearby interest in Chase Farm.

[Mr Love]

I thank my right hon. Friend for giving way, and yes, I do have an interest because constituents of mine have been affected by the decision at Chase Farm. Not only did the Secretary of State come to Chase Farm immediately after the election, but he announced the change in policy on reconfigurations. He introduced the so-called four tests, none of which has ever saved any unit, in any part of the country. The reality is that he seriously misled the people of Enfield, who are now bearing down on their Member of Parliament, who also misled them on this policy. It is an outrage and they feel badly let down by this Government on health service reform.

--- Later in debate ---

[Mr Love]

Will the right hon. Gentleman give way?

[Mr Lansley]

Yes, I will, as I am interested to hear what the hon. Gentleman has to say.

[Mr Love]

A year or 18 months into this Administration, does the right hon. Gentleman regret the announcement he made on the steps of Chase Farm hospital? Does he accept that the four tests have seriously misled local people about the future of the health service in their area? Does he recognise the demoralisation that that has caused in the local health service in Enfield, and what steps will he take to try to recover the situation and move forward?

[Mr Lansley]

The hon. Gentleman also intervened on the shadow Secretary of State. I am afraid that I do not recognise his description. I said before the election that we would have a moratorium on top-down and forced closure programmes affecting A and E and maternity services—and that is exactly what we did. A moratorium means what it says; it provides an opportunity to stop, to take stock and to subject something to the right tests. I set out for the first time the tests that needed to be met—that proposals needed to be consistent with prospective patient choice, consistent with the views of the local community, not least as expressed through the local authority, consistent with the views of the commissioners in the area, especially the developing clinical commissioning groups, and consistent with clinical evidence of safety.

In the context of Enfield and Chase Farm, the hon. Gentleman knows—because he was a participant in these discussions—that that moratorium was applied, that the opportunity was given to the local authority and the general practice community in Enfield to come forward with alternative solutions. We should also remember that among those four tests is the one about clinical evidence and safety. However, when those community groups came back and said, “We don’t have a specific alternative, but we just don’t want things to change”, I had to ask the independent reconfiguration panel to examine it. Its view was that that was not clinically sustainable.

Oral Answers to Questions

Andrew Love Excerpts

Tuesday 12th July 2011 Commons Chamber

[Anne Milton]

I thank my hon. Friend for raising this matter. I understand that five GP surgeries in NHS Warwickshire use 084 numbers, and that the primary care trust has been assured that patients using those numbers are not charged more than the cost of using an equivalent local number. It is absolutely clear that there is no distinction between landlines, mobiles or payphones. The directions are very clear that patients should not expect to be charged any more.

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

I, similarly, have three GP practices that use those telephone numbers. I have made extensive contact with my local PCT about this, but it did not seem to know what to do. Can the Minister assure us that the clear advice she is giving here today will be distributed around the health service, so that we can put an end to this?

[Anne Milton]

The Department is very clear, and the general medical services contract makes it very clear, that GPs are not allowed to do it. There are a number of options open to GPs who already have such telephone contracts, such as calling patients back, altering the contract arrangements or, indeed, paying the costs themselves.

NHS (Public Satisfaction)

Andrew Love Excerpts

Wednesday 30th March 2011 Westminster Hall

[John Cryer (Leyton and Wanstead) (Lab)]

I would like to thank the Speaker’s Office for selecting the subject of public satisfaction with the NHS for debate. I will focus on three pieces of research, and on the Government’s attempts to prevent information getting into the public domain, to prevent scrutiny of policy and to cut funding for future sources of information, all while failing to inform Parliament. The three surveys are “Public Perceptions of the NHS and Social Care” by Ipsos MORI from March 2010, the general lifestyle survey by the Office for National Statistics, and the British social attitudes survey by the National Centre for Social Research.

The first survey, “Public Perceptions of the NHS and Social Care” by Ipsos MORI, has been carried out every six months since 2000. It recently emerged that the latest results, from last year, were being withheld from the public domain. Ministers were accused of burying good news because the information clearly shows increasing levels of public satisfaction. On 22 March 2011, the Secretary of State was questioned about that by the Select Committee on Health, and particularly by my hon. Friend the Member for Walsall South (Valerie Vaz). The Secretary of State’s defence was that as previous surveys had not been released, he would not release the information from March 2010. The reality is that the previous data were only ever released following questions by the Opposition. From March 2007, the then Opposition stopped asking for the information, and we can only assume that that was because the level of public satisfaction was increasing, and it did not exactly serve their purpose to draw that information into the public domain.

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

I want to emphasise what my hon. Friend says. I can recount a conversation I had with a local general practitioner, who told me that in the 1980s, a constituent of mine in need of a hip replacement came to see him. He could not get her a place anywhere within the health service. My constituency is deprived, and it was impossible for her or her family to get treatment privately, so she had to suffer in silence. That would not happen nowadays. My GP, who represents my constituents, told me that that has not happened to him since the early 1990s. Is that not the evidence we need to show that the health service has improved significantly in recent years?

[John Cryer]

I agree with my hon. Friend. I have had exactly the same experience. We were both elected in 1997, and when I became an MP, I regularly had people come to see me with orthopaedic problems who had been waiting for operations for two to two and a half years. Some of them were in serious pain and unable to work. In the past few years, the complaints I have been hearing are that people have not had an operation for four or six months. It is a completely different world.

[John Cryer]

If the Minister will calm down a bit, I will come to that. After the Secretary of State appeared before the Health Committee, it emerged that data until 2010 had been placed in the Library, and the results until December 2009 are on the Ipsos MORI website. I was granted this debate on 24 March and the data were released the following day, Friday 25 March, on the Department of Health website. Previously, the data had not been on the Department’s website. It might be a coincidence, but it struck me that that was a fairly good time to bury good news: it was the day before 500,000 people tramped through central London on the TUC march in opposition to the cuts. The fact that the data were not initially released is unsurprising, given that polling showed a 72% satisfaction rating. Ipsos MORI concluded in the report:

“This level of satisfaction has now been recorded for over a year…suggesting that there has been a…positive shift in the public’s perceptions of the NHS. Pride in the NHS also continues to climb and is at its highest recorded level”.

Pride in the NHS is at its highest ever recorded level—an interesting statistic. We might hear a comment from the Minister about that.

[Mr Love]

The report has some very good news about public attitudes to the NHS. Why would Government, who are in control of the NHS, not want to publish such a report?

[John Cryer]

I will leave that to the Minister to answer, because I have not finished my comments about the suppression of statistics.

My story does not end with the original survey on public perceptions of the NHS. The second of the three surveys is the general lifestyle survey, carried out every year by the ONS on behalf of Government Departments, but that has had its funding withdrawn by the NHS information centre, for reasons best known to the Government. However, Sir Michael Scholar, head of the UK Statistics Authority, has warned that the decision may break the Government’s rules on consultation. I should point out that the general lifestyle survey provides statistics on public health and does not involve NHS satisfaction rates. It produces figures, information and statistics for testing Government policy and holding Governments to account; it is important that the information be available for holding Ministers to account. If the decision to withhold funding for the general lifestyle survey stands, the information will not be available to us in future.

The Department of Health also intends to withdraw funding for health and NHS satisfaction questions in the British social attitudes survey. The survey will be familiar to many Members. It is carried out annually by the NCSR, which is a pretty respected body, both nationally and internationally. The withdrawal of funding was not announced to the House of Commons, but was leaked over the weekend to Health Policy Insight, which published an interesting editorial that condemned the decision to withdraw funding in fairly colourful language.

The British social attitudes survey charts how NHS satisfaction started at 55% in 1983, which was the year the first survey was published. That plummeted to 35% by the time the Conservative Government left office in 1997. The latest satisfaction rate is 64%, which, according to John Appleby from the King’s Fund, is the highest level of satisfaction since the survey began in 1983, and part of a continuous upward trend since 2002. He said:

“The NHS must have been doing something right to earn this extra satisfaction”.

There is also an interesting quote from the director of the Nuffield Trust, Jennifer Dixon:

“I suspect that public satisfaction will decline because the pressurised financial climate will result in staff unrest, cuts, and the spectre of rationing but also because of the relaxation of some of the process targets that the public hold dear, such as waiting times.”

She continued:

“To overload reform on top of that is the problem and to do both at the same time is very risky.”

I emphasise “very risky”.

The reason for killing off such research is fairly clear. The aim is to obscure the results of Government policies so that they cannot be exposed to the proper scrutiny that we all want, and to prevent comparisons with the records of previous Governments—Labour and Tory. If the information is not available, the records of previous Governments cannot be compared with the record of this Government.

There are a number of questions that I should like the Minister to answer. Will the “Public Perceptions of the NHS and Social Care” survey by Ipsos MORI continue to be funded and to be reported on? If it is not to be continued, will the research be replaced? The research is very detailed and heavyweight. I can provide it to the Minister, although I assume he already has it. I do not intend to imply that Ministers intend to cut funding for that research, but because of other decisions, we start to wonder whether that might be the conclusion.

The Government have decided, apparently without telling Parliament, to axe funding for two other crucial pieces of independent research: the British social attitudes survey, which I mentioned, and the general lifestyle survey, conducted by the ONS, which I also mentioned. Ministers have sneaked out the information that funding is to be cut in a fairly underhand way. Many Labour Members suspect that it is being done so that we cannot draw comparisons with previous Governments. The information will not be available to allow us to say, “Government policies were working but funding has been cut, which is having an effect on public perceptions and services.”

Public perception is crucial. My impression and that of piles of research is that public perceptions are improving and are at an all-time high, but that does not satisfy Ministers, who are engaging in the biggest reorganisation of the NHS since Nye Bevan created it in 1947. If information is in the public domain showing that the public are very happy with the NHS, particularly acute and GP treatments, it does not serve the purposes of a Government who are committed to the wholesale reorganisation of one of the most beloved institutions of British society. I look forward to what the Minister has to say.

Oral Answers to Questions

Andrew Love Excerpts

Tuesday 8th March 2011 Commons Chamber

[Paul Burstow]

My hon. Friend is absolutely right to draw attention to that, and it is interesting that a number of Opposition Members are saying that they do not see it as making any contribution whatever to the quality and extension of life. Yes, the funds that the Government provided very early on will be available to ensure that people get access to drugs that have hitherto not been available to them.

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

The Minister has indicated several times that diagnosing cancer earlier is the solution to the difficulties that we face. What is he going to do to bring that about?

[Paul Burstow]

Just a few weeks ago we started a pilot of a national advertising campaign on bowel cancer, with the key message being that people should never feel embarrassed about talking about their poos, so that they get the diagnosis that they need at the earliest opportunity. We are ensuring that such messages get across, even in the Chamber today. We are taking steps to raise awareness so that people get earlier diagnoses.