Accident and Emergency Departments

Andy Slaughter Excerpts

Thursday 7th February 2013 Commons Chamber

[Angie Bray (Ealing Central and Acton) (Con)]

I sympathise with the problems described by the hon. Member for Mitcham and Morden (Siobhain McDonagh).

It seems a long time since NHS North West London presented its “Shaping a healthier future” proposals and Members from across west London first came together to debate them. On that occasion, I explained why I opposed the plans, and put on record my fear that they would have a serious and negative impact on my constituents. Downgrading the four nearest A and E departments—at Ealing, Central Middlesex, Charing Cross and Hammersmith hospitals—would be completely disproportionate, and would leave the people of Ealing and Acton slap bang in the middle of an emergency care black hole.

Since that debate, a cross-party coalition—including the hon. Member for Ealing, Southall (Mr Sharma), who opened the debate, and the hon. Member for Hammersmith (Mr Slaughter), who is also present—embarked on fighting the plans. We have organised rallies, marches, petitions and leaflets, and pages and pages of coverage have appeared in the local as well as the national press. I am not a natural marcher, but I did attend the big rally on Ealing Common to oppose the plans, along with other local Conservatives.

We felt that the most constructive use of our time would be to encourage as many people as possible to fill in the consultation document provided by NHS North West London. We offered guidance on how best to navigate the bewildering and unnecessarily lengthy set of questions, and we helped about 600 people to register their views. That was a large contribution in a borough which returned the highest number of responses to the consultation, almost all of which opposed the plans, and it demonstrates the level of worry that exists in Ealing and Acton.

[Mr Andy Slaughter (Hammersmith) (Lab)]

Despite the biased nature of the questionnaire, efforts were made to fill it in, and a few thousand people did so. However, 80,000 people signed petitions which were then studiously ignored. Only the responses to the questionnaire were taken into consideration. Perhaps the hon. Lady would like to comment on that.

[Angie Bray]

I certainly think that a petition of that size cannot be easily ignored. However, as we pointed out when we encouraged people to take part in what was a massive and time-consuming process, I suspect that, technically and legally, the authority is obliged to register only the responses to the consultation.

Beyond what I have described, my role has been to make my objections, and those of my constituents, fully known to and understood by as wide an audience as possible in Government. After doing the rounds of meetings with the previous team at the Department of Health, I held meetings with the new ministerial team and the Health Secretary after last autumn’s reshuffle. I followed that up with a meeting with the Prime Minister, whom I left in no doubt that this issue was of the utmost importance to my constituents.

We all believe that the closure plan must be reviewed. None of us can believe that it is anything other than reckless. We wonder how the A and E departments that are left standing will be able to cope with all the extra pressure that will result from the closure programme. I explained to the Prime Minister in detail why the extra travel time to A and E departments further afield would be unacceptable. He listened carefully, asked a number of detailed questions, and told me that he would certainly discuss the issue this with Health Ministers.

Much of our campaigning has focused on the baffling way in which NHS North West London has chosen to present the proposals as a virtual fait accompli, without adequately explaining quite how they will work in practice. We are told that new “urgent care centres” will cater for everyone’s needs, but we have also learnt that there is a lengthy list of conditions, and that there are a number of possible problems with which they will not actually deal.

--- Later in debate ---

[Mr Andy Slaughter (Hammersmith) (Lab)]

May I first thank my hon. Friend the Member for Ealing, Southall (Mr Sharma) for picking up the baton and sponsoring the debate? It was first proposed to the Backbench Business Committee before Christmas by me and colleagues from other parties as a London debate, and it has had the feel of a London debate. However, colleagues from elsewhere in the country should not feel excluded, because a lot of what is being tried out in London will soon be spreading to the rest of the country if they are not careful.

I had to attend the Justice and Security Public Bill Committee, which meant that I was not here at the beginning of the debate, but I am grateful for the opportunity to speak. Balancing whether to oppose the Government’s attacks on civil liberties or the Government’s attack on the health service is difficult, so it is nice to be able to deal with both in one day.

I will not get involved in a hierarchy of misery. Many Members have spoken passionately about their own experiences, but I will say that both the A and E departments at the world-class hospitals—Hammersmith and Charing Cross—in my constituency are marked for closure. Charing Cross hospital, which in many ways has the best site and some of the best facilities in north-west London, is marked for almost complete closure. All 500 beds will go, the A and E will go and the specialist services will go, leaving an urgent care centre and other services high and dry, such as the Maggie’s cancer centre and the mental health services. To its shame, Imperial College Healthcare NHS Trust is supporting those closures because it will provide a very valuable piece of real estate for it to sell and thus improve other campuses.

As my hon. Friend the Member for Harrow West (Mr Thomas) said, it is not the case that community services have been improved before these closures will take place. Indeed, the White City collaborative care centre, which should have been the first polyclinic in the country is, thanks to a Conservative council, six years late and with a fraction of the services it should have. It is still not open and will not adequately replace any of those services.

What is happening in north-west London flies in the face of the facts. Most hospitals in the area do not meet the four-hour target, owing to the demand on their services. Ambulances are less safe and effective than A and E care. For patients, it is clearly better to be in A and E than in an ambulance. Longer journeys and journey times need to be avoided. There is no evidence that when a good A and E closes most cases get dealt with better via centralisation. There are good data suggesting the opposite is true, as local A and Es have the capability to select patients who require more specialised care, easing the pressure on large units, and to stabilise those patients in the critical intermediate period.

In a nutshell, my constituents are being offered a second-class service. There is no clear demarcation. The health service itself cannot tell us which conditions should go to an urgent care centre and which should go to an A and E. The majority of my constituents will have a worse health service, and that particularly applies to poorer constituents who do not have access to private transport.

Let us look briefly at the process we have gone through, which has been utterly scandalous. As soon as the coalition Government came in they started preparing these closures. They gave millions of pounds to McKinsey to draw up the plans, yet when I asked it about those plans I was lied to about the fact that hospital closures were being prepared and was even told that I had been consulted when I had not. We have heard already about the phoney consultation, the 80,000 signatures that were ignored and the 3,000 or 4,000—

[Mr Speaker]

Order. I am sure the hon. Gentleman was not suggesting for one moment that he was lied to in the House of Commons.

[Mr Slaughter]

Absolutely not. As part of the consultation process that was undertaken, it is on the record in the documentation that I was consulted. I was not consulted on those matters.

[Stephen Lloyd]

Will the hon. Gentleman give way?

[Mr Slaughter]

I am sorry; although I would love to give way, I have been asked not to.

That consultation was ignored. The body taking the decision has no stake in these matters whatever. The joint PCT council, NHS North West London, will not exist. The bodies that do have a stake, namely the clinical commissioning groups that are taking over—the puppet masters, as it were—have too much influence in my view and too much to gain personally. I wish I had time to go through the declarations of interest that members of the CCGs have made. They show that most hold shares in Harmoni, Care UK or other private interests that might benefit from the commissioning powers that the CCGs are about to get. I have not received proper answers from the health service about what those interests are or what they remain.

To conclude, the decision for north-west London will be taken on 19 February, so this debate is very apposite. I have no doubt that the decision will be taken to go ahead with most or all of the proposed closures, but the protests that have taken place—the demonstrations, marches and petitioning—will continue, because this now becomes a political decision for the Secretary of State. In the early-day motion that I tabled last June, I referred to the fact that the health service locally was saying it would run out of money if it did not make these cuts. Services are already being run down by sleight of hand. The buck stops with the Secretary of State and the Government. The ball is in their court. I hope the decision will be taken, first, by the independent panel and, secondly, by the Secretary of State. The Government cannot dodge this issue. This is about cuts, as it was in the 1990s, and the denigration of our local health service. The buck cannot be passed beyond this point. I call on the Minister in her reply to say how she intends to preserve the local health service in north-west London.