Accident and Emergency

Andy Slaughter Excerpts

Wednesday 18th December 2013 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

That is a familiar story to all of us. There are four A and Es closing in west London and two major hospitals are changing. Charing Cross hospital will no longer be a major teaching hospital and half the site is being sold off. In its place, there will be a local hospital that provides primary care services. The Tories said that those hospitals were closing under Labour when they were not. They are now going back on their promises. In many cases, direct promises were given on site before the last election.

[Clive Efford]

There is example after example of broken promises. The Conservatives accused people of planning to close hospitals when there was no plan to do so, and then came in and did it themselves.

We have a curious situation. The Secretary of State has been saying, “Crisis? What crisis?” Today, he read out a quote saying that the crisis is behind us. That is a little confusing. Of course, the crisis that he was talking about was a summer crisis. He did not mention that. He presided over a summer crisis. That is pretty unique. I do not think that even Virginia Bottomley achieved a summer crisis, but I could be wrong.

The crisis is of the Government’s own making. The Secretary of State talked about the need for services away from the hospital to protect A and E from being overwhelmed. However, one of the first things that they did was to do away with the 24-hour promise of a visit to the GP. They then introduced 111, which had algorithms and questions that all ended with the advice, “Go to your A and E.” There are now 850 fewer surgeries opening at evenings and weekends, and a quarter of walk-in centres have closed. Talk about reinventing the wheel—the Government are now saying that those are the sorts of things that we need to do. The crisis in A and E is of the Government’s making. It is their decisions that have created the situation.

To return to south-east London, the Secretary of State appointed the trust special administrator to oversee the merger of Lewisham and Queen Elizabeth hospitals. The local authority took on that decision because the powers that the Government took were not within their remit. The Government were challenged in the court and defeated. The Government are now moving the goalposts. Having said before the last general election that there would be no top-down reconfiguration and that they would not enforce closures if the local community did not agree with them, they are taking powers to impose closures on local communities.

In the minute that I have left, I want to say to the Minister that there has been a series of broken promises. It is fitting that a Liberal Democrat is summing up a debate on broken promises on the NHS.

--- Later in debate ---

[Kate Green]

Two pressures could be highlighted. The first is the way that funding fails to take adequate account of deprivation. Secondly, there will inevitably be a hump at the time of transition, as new arrangements settle down and people adapt to the changing service configuration. When providing resources to Manchester royal infirmary or Wythenshawe, no account seems to have been taken of the effect of that transition and the likely need for additional resource to take those hospitals through that period. Indeed, in a private meeting with the Secretary of State, after the reconfiguration was announced, he confirmed that there would be no additional transitional funding. I could, however, look forward to additional funding to enable greater integration of services, although not until 2015-16. Furthermore, it would not be new funding, but funding that had been moved from the NHS to social care.

I am as strongly in support as anyone of seeing funding directed as much as possible to preventive care and care that can be provided at home in the community, but we cannot take services from hospitals before we put that care in place in the community. Such care is simply not adequate in Trafford today.

The other matter I want to raise was alluded to by the right hon. Member for Sutton and Cheam (Paul Burstow). There is utter confusion among patients about what services they should access and when. As soon as Trafford was downgraded to an urgent care centre, Trafford patients believed they could not go there. That was not the intention of NHS managers, but the impact was undoubtedly to drive more traffic to neighbouring A and E departments.

[Mr Slaughter]

My hon. Friend makes an important point. A and Es and anything we would recognise as such are being closed. They are turned into urgent care centres, which deal with minor injuries with GP cover at best. They are called second-tier A and E units, which is incredibly damaging, dangerous and confusing for people. It is done simply as a political fix, so that Tory councils and others can distribute leaflets saying, “There’s still an A and E on this site.”

[Kate Green]

Whatever the motivation—NHS managers in my area have tried to communicate the changes and how patients should respond to them—there is huge patient confusion about where they should go, what time they should go and what treatment they will receive. The right hon. Member for Sutton and Cheam referred to Sir Bruce Keogh’s report, which highlighted patient confusion. During periods of transition, confusion is heightened as people become used to new configurations. What lessons are being learned on how to communicate effectively with patients so they have proper understanding of what services are available and where they ought to go?

Massive problems are piling up over this winter period, when we might expect additional pressures—we see them every winter. There is a failure of local planning and ministerial engagement in ensuring that those transition processes work smoothly for patients in Trafford. I hope the Minister comments on how transitions will be handled in future. I venture to suggest that Trafford is, I fear, an early example of how not to do it. I look forward to his response.