A&E Services

Andy Slaughter Excerpts

Wednesday 24th June 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

I hope, Madam Deputy Speaker, that you and the House will indulge me if I spend my six minutes giving an update on the “Shaping a healthier future” programme, which afflicts west and north-west London. I have done so several times during the three years since—to the consternation and disbelief of 2 million people in those areas—the programme was announced, although there was something of a hiatus over the election period.

I do not want to be self-indulgent, but I think that the subject of “Shaping a healthier future” is one to which all Members will wish to pay attention, because it is the biggest closure programme in the history of the NHS. Four out of nine A&E departments and two major hospitals have been substantially downgraded. Many see the programme as a prototype for the Keogh review of urgent and emergency care. I wonder what has happened to the latest stage of that review; we heard nothing about it from the Under-Secretary of State. It was put on ice last year because a proposal for the downgrading of most of the type 1 A&E departments in the country was seen as political suicide, but it now seems to have disappeared completely. I hope that there are good clinical reasons for that.

Reference has already been made to the excellent briefing with which Members were provided yesterday by the Royal College of Emergency Medicine. Here are three of the statistics that the college came up with. The increase in A&E attendances last year was equivalent to the workload of seven large A&E departments; only 2% of A&E attendances involve major trauma, stroke and heart attack patients; and a maximum of 15% of patients who attend A&E departments could be seen in a non-hospital setting. Even that must be subject to a caveat, because I suspect that a fair number of the people who go to A&E departments are not knowingly accelerating their symptoms or time-wasting, but have genuine concerns, perhaps for a child with a fever that might be a symptom of flu but, again, might be due to meningitis.

The solution proposed by the Royal College of Emergency Medicine is co-location. Its briefing states:

“Costly and time-consuming efforts to encourage patients to seek advice on urgent care by telephone or to attend elsewhere…have not reduced A&E attendances. Rather than blaming patients for attending A&E, when we know they have great difficulty accessing supposed alternatives, RCEM advocates a completely new approach. We believe that the issue should be dealt with by collocating”.

However, many hospitals in west London are already co-located, so that cannot be a solution for them.

There have been a number of developments in the past three or four months. Chelsea and Westminster hospital is about to take over West Middlesex University hospital. That new trust will believe that it can maintain two fully functioning type 1 A&E departments—unless another is to close in the area. Why, then, is Imperial College Healthcare NHS Trust expected to manage with only one major A&E service in its three hospitals?

Ealing hospital’s maternity unit will close on 1 July. My hon. Friend the Member for Ealing, Southall (Mr Sharma), who could not stay for this part of the debate, asked me specifically to mention that, because it is a matter of great concern, not least because it will have an impact on other maternity services in the area.

We are still suffering the effects of the closure of the A&E departments at Hammersmith and Central Middlesex hospitals last September, including four-hour waiting times at other hospitals such as Charing Cross hospital in my constituency, which is persistently below target. At the same time, stroke services are being centralised at Charing Cross for at least the next five years, having been transferred from St Mary’s hospital, although the plan is to move them away in due course.

In the last two years, £33 million has been spent on consultants just for the purposes of the “Shaping a healthier future” programme, of which £12.5 million was spent on a single consultant, McKinsey. That is £27,000 a day, and it could pay for 300 new nurses. Imperial College Healthcare NHS Trust is spending one eighth of its staffing budget on bank and agency staff, and the most recent figures show that it had an £18.5 million deficit.

Against this crisis—and it is a crisis—in A&E, the proposal in relation to Charing Cross, a major emergency hospital in my constituency, is that all its buildings be demolished, that its beds be reduced from 360 to 24, and that it lose all consultant emergency services. The population of London, and of west London in particular, is going to go up massively over the next 10 years. That is unprecedented. This is a very poor scheme, not just clinically for the reasons that the Royal College of Emergency Medicine gives, but logistically, spatially and financially.

I am grateful to the Minister and the Secretary of State for the opportunity, at last, before the summer recess to meet and discuss these matters in depth. I will therefore say no more about them today. I look forward to that opportunity, and I know the Minister will attend in good faith and look at the concerns we all have about the “Shaping a healthier future” programme. These are not idle concerns. It is obviously in the Whips’ brief for Government Members to say, “Let’s not make the NHS a political football,” but I do not think any Opposition Member is doing so. We are not in an election period.

[Wes Streeting (Ilford North) (Lab)]

It is a bit rich for Government Members to accuse us of using the NHS as a party political football, when prior to the 2014 local elections the Ilford North Conservative Association put out a leaflet claiming that King George hospital’s A&E would not close, when before the general election we were told its closure would be reprieved, and when the NHS trust chief executive has now told us that the closure plan will be published in the next six to nine months. That was playing party politics with the NHS, cynically.

[Andy Slaughter]

My hon. Friend makes a very good point. I make sure that every time I refer to what is happening in my local NHS now, I look into the voluminous papers on “Shaping a healthier future”, or what the Imperial College Healthcare NHS Trust actually says, so that I am clear that I am describing what is happening, not giving my opinion or saying something that has come from a party political standpoint. I simply wish that the Government would listen and respond in kind.

[John McDonnell (Hayes and Harlington) (Lab)]

I apologise for coming late to my hon. Friend’s speech. The reason why is that outside Ealing hospital there are currently 200 people demonstrating because of the maternity unit’s closure, which will put undue stress on the local community. He has listened to many of the arguments regarding its closure, and none of them stacks up. Perhaps those 200 people will be listened to.

[Andy Slaughter]

I am very grateful to my hon. Friend for his intervention. No one does more than him, directly and positively, to draw attention to the crisis in the NHS in west London. His local hospital, Hillingdon, is not closing, but throughout the process over the past three years he has been absolutely steadfast in defending and supporting those of us whose local NHS is being downgraded, not just because he is a good comrade, but because he knows that the knock-on effect of hospital closures will make it impossible for any of the 2 million people throughout north-west and west London to receive a decent health service.

I shall say no more today, as other Members wish to speak. I again thank the Minister for the opportunity we will have to make our case. I hope the Government are listening on this matter, which is the most urgent matter that I have dealt with in my 30 years as a councillor and as an MP. It is about the preservation of the NHS for a substantial part of London’s population. These are genuine and legitimate concerns, and I hope the Government will listen to them.