Accident and Emergency Waiting Times

Andy Slaughter Excerpts

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

I entirely agree, and I shall say more about that issue shortly.

Let me return to the subject of the 111 service. Will the Secretary of State review the contracts with the aim of negotiating changes so that more calls can be handled by nurses? The use of the computer algorithm should be reviewed as a matter of urgency, and the full roll-out of 111 should be delayed until the problems have been solved.

There are more general questions to be asked about the scale and pace of NHS privatisation. NHS Direct offers an illustration of what happens when services are broken up. Those who attended last week’s summit heard that in some areas there had been a huge increase in the provision of 999 ambulances by private companies. It was said that on a single day in Yorkshire, 50% of 999 calls had been responded to by private operators. I think that the public would be surprised to know that. It shows that there is no part of our NHS that cannot be put up for sale by this Government.

Is the Secretary of State satisfied that those private crews are appropriately trained and have the right equipment? Is there not a danger that because contractors are operating in isolation from the rest of the system, they will all too often simply transport people to A and E? Does the Secretary of State envisage any limits to private 999 services? Given that the issue raises fundamental questions about emergency services, should there not be a debate about it before this goes any further?

Fourthly—I come now to the point raised by my hon. Friend the Member for Harrow West (Mr Thomas)—there is good evidence to show that NHS walk-in centres have diverted pressure from A and E units. In 2010-11, there were about 2.5 million visits to such centres from people who might otherwise have gone to A and E. Analysis by the House of Commons Library shows that 26 of them closed in the last year alone, and that the number is down by a quarter. The Government have let that happen, but at least Monitor has intervened and set up a review of the loss of walk-in centres. Will the Secretary of State halt all further closures while the review is taking place?

That brings me to my fifth and final point, which concerns A and E closures and downgrades. At least 25 A and E units—one in 10—are under threat or have recently closed. The trouble with these plans is that they were drawn up in a different context, when A and E was not under the pressure that it is under today. Let me say this to the Secretary of State: if a clinical case can be made in support of closures—if there is evidence that lives can be saved—the Opposition will not oppose the plans. However, we cannot accept the pushing through of proposals that have not taken enough account of the latest evidence, and cannot show that extra pressure can be safely absorbed by neighbouring units. That is important, because the public will rightly ask this simple question: how can it make sense to close A and Es in the middle of an A and E crisis? To reassure people, will the Secretary of State personally review all the ongoing A and E closure or downgrade proposals on a case-by-case basis, in the light of the very latest evidence of pressure in the local health economy?

[Mr Andy Slaughter (Hammersmith) (Lab)]

rose—

[Kate Green (Stretford and Urmston) (Lab)]

rose—

[Andy Burnham]

I will give way one last time to each of my hon. Friends, but then I must finish my speech.

[Mr Slaughter]

What my right hon. Friend has been saying will be music to the ears of people in west London, where four A and E units are slated for closure. All of them are coping with dreadful circumstances. Will my right hon. Friend—and perhaps also the hon. Member for Enfield North (Nick de Bois), who seems to share his view—have a word with my local Conservatives, who are supporting all those closures?

[Andy Burnham]

I think that everyone needs to consider their position in the light of the evidence that is emerging about pressure on A and E, particularly in London. I pay tribute to the excellent and determined campaign run by my hon. Friend, and I noted what was said yesterday by the hon. Member for Enfield North. Perhaps one of the consequences of today’s debate will be agreement across the Floor of the House to delay any closures pending a personal review of the evidence by the Secretary of State.

--- Later in debate ---

[Mr Andy Slaughter (Hammersmith) (Lab)]

I am most grateful, Madam Deputy Speaker.

A report in the Evening Standard last Thursday revealed that a spot inspection of Charing Cross hospital in my constituency showed that it was

“so overcrowded that operating theatres were turned into makeshift wards”.

The hospital

“used the theatres when it ran out of critical care beds—with doctors caring for seriously ill patients because there were no nurses available.”

Charing Cross is one of the four hospitals that are to lose their A and E department—indeed, in the case of Charing Cross hospital, it is to be demolished, with 97% slated to go. I plead with the Secretary of State to accept the point made by my right hon. Friend the Member for Leigh (Andy Burnham) and to review all these closures. The services are in crisis. Please, do not go ahead with any closures of vital A and E services, particularly in north-west London, until a proper review has been carried out and the crisis has been seen for what it is.

A and E Departments

Andy Slaughter Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

All decisions on reconfigurations have to be taken on a case-by-case basis. The really important thing is to ensure that, when we reconfigure services, we have a good alternative in place and we are able to give the public the confidence that it is in place. As the hon. Gentleman knows, we follow the four tests before any ministerial approval is given for a reconfiguration to go ahead.

[Mr Andy Slaughter (Hammersmith) (Lab)]

Tomorrow is the 40th anniversary of the opening of the present Charing Cross hospital. The Secretary of State is welcome to come to the party, although he might be unpopular, as the A and E department there is one of the four in west London that he wishes to close. Three months ago, at Health questions, he told me that he would refer those decisions to the IRP, but he now appears to be telling my hon. Friend the Member for Ealing, Southall (Mr Sharma) that he is taking advice on whether to do that. Will he stick to his promise and make that referral for a full review?

[Mr Hunt]

Yes, I will.

Accountability and Transparency in the NHS

Andy Slaughter Excerpts

Thursday 14th March 2013 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

Two NHS stories were leading the news this morning, both of which are relevant to the subject of this debate. The hon. Member for North East Cambridgeshire (Stephen Barclay) and my hon. Friend the Member for Ealing, Southall (Mr Sharma) have talked about the important issue of whistleblowers. I want to talk about the other subject, which is the conflicted interests of clinical commissioning group members.

All hon. Members should be grateful for the British Medical Journal report that was the basis of this morning’s new stories. In case anyone has not seen it, let me read the headline points. It states:

“More than a third of GPs on the boards of the new clinical commissioning groups (CCGs) in England have a conflict of interest resulting from directorships or shares held in private companies”.

It continues:

“conflicts of interest are rife on CCG governing bodies, with 426 (36%) of the 1179 GPs in executive positions having a financial interest in a for-profit private provider beyond their own general practice—a provider from which their CCG could potentially commission services.

The interests range from senior directorships in local for-profit firms set up to provide services such as diagnostics, minor surgery, out of hours GP services, and pharmacy to shareholdings in large private sector health firms that provide care in conjunction with local doctors, such as Harmoni and Circle Health.

In some cases most of the GPs on the CCG governing body have financial interests in the same private healthcare provider.”

Yet the cheerleader for the privatisation, Dr Michael Dixon of NHS Alliance says:

“The priority is to move services out of hospital and into primary care. The reason this hasn’t happened to date is because of blocks in the system. It’s more important to remove those blocks than be preoccupied with conflicts of interest.”

I say that the British Medical Journal has done a good job, but it has only just scratched the surface. I shall refer to my own experience of trying to get to the bottom of this matter in north-west London.

On 10 November an article by the social affairs editor of The Guardian began:

“Five family doctors have this week become millionaires from the sale of their NHS-funded firm to one of the country’s biggest private healthcare companies in a deal that reveals how physicians can potentially profit from government policy in the new NHS.”

It went through the individual shareholdings of those doctors who had sold out to Care UK and it continued:

“Another winner seems to be NHS reform champion Ian Goodman. The north-west London GP chairs the Hillingdon clinical commissioning group and was also a board director of Harmoni. He could make as much as £2.6 million.”

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

This Dr Goodman chairs my local CCG and tried to force Hillingdon hospital to put £13 million of operations out to tender, which would have destabilised the whole hospital. I pay tribute to the Treasurer of Her Majesty’s Household, the right hon. Member for Uxbridge and South Ruislip (Mr Randall) and the Parliamentary Secretary, Cabinet Office, the hon. Member for Ruislip, Northwood and Pinner (Mr Hurd), who joined me in preventing that from happening. It would have meant Hillingdon hospital being financially destabilised in the long term.

[Mr Slaughter]

I am grateful for that. I did a company profile for Harmoni. It revealed that, although he might have sold his shares for that amount of money, Dr Goodman is still listed as head of clinical spine. A series of press articles deals with the failings of Harmoni—failures that have caused deaths through under-staffing or poor-quality staffing—and why it is under investigation.

Let me return in the time I have available to my attempts to get to the bottom of the matter. The same day as I read the article in The Guardian, I wrote a short letter to the chief executive of the NHS in north-west London. I said:

“I attach the front page article from today’s Guardian, which you may have seen, regarding the sale of out of hours GP service provider Harmoni to Care UK. The article states that a number of GPs will make substantial sums from the sale.

I note that four of the CCG chairs in NW London declare shareholding or directorship in Harmoni, as does your Medical Director. It would be helpful to know if they are beneficiaries of the sale and by what amount.”

I then asked for assurances as to the future.

A month later I received a non-reply reply, the most relevant sentence of which was:

“Any member who declares an interest in a meeting is expected to take no part in discussions and step out of the meeting.”

I wrote back a much longer reply, in which I pointed out that the chair of the Royal College of General Practitioners had said:

“it is not about excluding yourself from the room whenever there is a discussion; it is about how it will drive your decision-making overall”.

I pointed out that, as a consequence of hospital closures in north-west London, there had been a shift in funding from hospital to primary care, a greater involvement of private companies in the primary care sector, and an opportunity for those companies to increase their profits by cutting back on the level of service offered.

I principally raised the fact that the information that should be provided is not provided on declaration of interest forms, especially the scope and value of any interest. I listed doctor by doctor and CCG chair by CCG chair what those interests were and how they were not adequately declared. I dealt with seven out of the nine CCG chairs and the medical director. That was in a letter on 20 December.

I received a reply on 3 February which said:

“The Cluster does not hold this data.”

So three months on from my original inquiry, I am none the wiser in relation to these matters.

I advise any hon. Member to look at their CCG declarations of interest online—not Hillingdon, because it does not publish them online. I use Hammersmith and Fulham as an example here. The husband of one member is a partner of Drivers Jonas Deloitte. The first thing I found on the website of Drivers Jonas Deloitte was that it had been appointed to sell the Kent and Sussex hospital in Royal Tunbridge Wells when it closes in 2011. Another member is the owner of a provider of home care services. Another is the brother of the director of a design company that holds a number of contracts with NHS organisations. It might be that none of them has a direct financial pecuniary interest now or in the future, but it shows touching naivety, complacency or worse.

Before the 28 members of the joint PCT board made the decision to close the four A and Es in north-west London, I said at the public meeting that if any of them had or was likely to have interest of a pecuniary nature they should not take part in that decision. One of them rather touchingly volunteered the information that they had sold their shares. What world are we living in when a third of GPs on the new CCGs can hold financial interests in anything from land sales to an alternative provider?

I raised the question with the Prime Minister yesterday and mentioned Dr Goodman, although not by name, and his estimated minimum return of £2.6 million. Again, I got a non-reply in reply. Sooner or later the Government will have to address these matters.

There is another story in the Daily Mail today that states:

“In 1981 there were eight NHS press officers in Britain. Now there are 82 in London alone”.

It is not that there is a lack of spending on publicity in the NHS. Indeed, almost £1 million has been spent on a private consultancy firm simply to carry out the bogus and botched consultation on the closure of A and Es.

We are seeing the creation of a second-grade health service in north-west London.

[Barbara Keeley]

A number of months ago, I raised the case of a person who rejoices in the title “NHS head of brands”. There seem to be a whole set of units that keep cropping up.

[Mr Slaughter]

I am sure that all Members will have similar examples. It is an obscenity that millions of pounds are being spent on spin and disinformation while basic information is not being provided even to Members of Parliament after three months and persistent requests. Sooner or later, these issues will have to be addressed.

Of course, our main preoccupation is to maintain our first-rate health service—our blue light A and Es, our stroke centres and our major hospitals—rather than having it replaced by urgent care centres and minor primary care facilities. That is what we face in north-west London and, I am sure, around the rest of the country. It adds insult to injury if the individuals who are making the decisions to sell the land and to transfer services into the private sector are also the shareholders and owners or if they benefit in any other way. This is a corrupt act and it must be addressed by the Government. They cannot continue to turn a blind eye to it.

[Several hon. Members]

rose—

NHS Commissioning Board

Andy Slaughter Excerpts

Tuesday 5th March 2013 Commons Chamber

[Norman Lamb]

My right hon. Friend is right on all counts. As he says, the patient’s interest must trump everything else. One of the things that we will reinforce in the amended regulations is the paramount importance of integrated care. We legislated for that for the first time through the Health and Social Care Act, which the Care and Support Bill will reinforce and which, indeed, is reinforced by the mandate of the NHS. The Government’s whole intent is to drive a fundamental shift to integrated care for the benefit of the patient.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The Minister has been put up by the Secretary of State to explain the Government’s incompetence, which he may be ideally placed to do. Will he tell us what will happen if the four accident and emergency units in west London close and replacement services are taken over by companies, such as Harmoni and Care UK, which are unfit to run them? That can still happen under his redraft. Will he confirm that members of clinical commissioning groups who have financial interests in the private providers that are bidding should not decide what should replace public services when they are inevitably handed over to the private sector?

[Norman Lamb]

The regulations as currently drafted are absolutely clear about the importance of avoiding the conflicts of interests that the hon. Gentleman has described.

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 26th February 2013 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

Last week’s decision to close four north-west London A and Es, including Charing Cross and Hammersmith in my constituency, will shortly be on the Secretary of State’s desk, as he predicts. It was referred by Labour Ealing council because Tory Hammersmith and Fulham council supports the closures. Will the Secretary of State refer the matter for independent review? This is the biggest hospital closure programme in the history of the NHS. It will see a world-class hospital downgraded to 3% of its size.

[Mr Jeremy Hunt]

I am aware how concerned people are throughout north-west London about the proposals. If the matter is referred to me by Ealing council, I will indeed ask the independent reconfiguration panel for its independent view on the proposals.

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.

NHS Funding

Andy Slaughter Excerpts

Wednesday 12th December 2012 Commons Chamber

[Andy Sawford]

I will not give way; I want to make important points for my constituents. It is important that these things are put on record, so I shall not be giving way to the hon. Gentleman again. He has not done a great service to people in my constituency in the way that he has addressed these issues.

[Mr Andy Slaughter (Hammersmith) (Lab)]

I had the pleasure of visiting my hon. Friend’s constituency earlier this year, and I am sorry to hear about Kettering. Both the accident and emergency departments and one 500-bed hospital in my constituency are due to close. Neither of those A and E departments is PFI, and none of the four A and Es closing in west London is PFI, so is that point not a complete red herring?

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 23rd October 2012 Commons Chamber

[Anna Soubry]

This is an area that is important to the Government’s work. At this stage it is important to make sure that we do not over-regulate but that we work with industry and manufacturers. The four Governments across the United Kingdom will shortly issue a statement about front-of-pack nutrition labelling, and we expect to publish the formal response to this year’s consultation within the next few weeks.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The excellent children’s heart surgery unit at the Royal Brompton hospital will be pleased that a full review has been announced. Why does it have to report within four months, including the Christmas period, and why were previous referrals by both Brompton and Leeds refused? Will the review be full and impartial or not?

[Mr Jeremy Hunt]

It will be a totally impartial and very thorough review. This is an extremely important decision, and that is why I asked the Independent Reconfiguration Panel to take the time that it needs to do the review properly; that is the least that the hon. Gentleman’s constituents would want.

Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Lansley]

I would be grateful if my hon. Friend could convey my best wishes to the Countess of Chester hospital, which I visited just before Christmas, and my appreciation of the work of the West Cheshire CCG. I can confirm that discussions between officials in the Welsh Government, my Department and the NHS Commissioning Board are under way to extend and renew the protocol for cross-border commissioning for 2013-14 and beyond.

[Mr Andy Slaughter (Hammersmith) (Lab)]

If the Secretary of State believes that the reconfiguration of hospitals is clinically rather than finance led, will he ensure that NHS North West London publishes full risk assessments of its decision to close four accident and emergency departments and replace them with urgent care centres?

Health

Andy Slaughter Excerpts

Tuesday 17th July 2012 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

On 4 July, a committee of primary care trust chief executives made the extraordinary decision to end children’s heart surgery and intensive care at one of the best performing and largest centres in England: Royal Brompton hospital, a specialist heart and lung hospital that treats children and adults from all over the country who have some of the most severe forms of heart and lung disease. It was quite a surprise for the doctors and other staff at Royal Brompton to find out last year that they were earmarked for closure. The national review panel that made the recommendation, in February 2011, had previously specified that for children’s heart surgery centres to be viable they must have four surgeons each doing at least 100 operations every year, and they must offer round-the-clock care.

Royal Brompton has four surgeons, each undertaking more than 100 operations every year and it offers round-the-clock care. It also has a safety and outcome record of which any centre would be proud. Rates of patient satisfaction at the hospital are exceptionally high.

The national review of paediatric heart surgery set out to reduce the number of hospitals offering children’s heart surgery, because it was felt that in some areas surgeons did not have enough cases to maintain their skills in the longer term. London has three centres, although two of them, Royal Brompton and Great Ormond Street, are recognised national specialist centres and treat patients from all over the country. The decision was made to close a London centre, and divert its patients to the remaining two, once their facilities are improved and extended, at significant cost to the taxpayer. A proposed solution to develop a network in London that would mean closer collaboration between the three existing centres, but no closures, was ignored.

Time prevents me from going into detail about why Royal Brompton drew the short straw of closure; it came down to a complicated scoring mechanism that eventually ended up in the High Court. I must stress, because it is of utmost importance, that there was never any suggestion that Royal Brompton’s clinical services for children are anything other than first rate. A better insight may be provided by the comments of a civil servant at a meeting of the London specialised commissioning group on 26 April:

“It is likely that the rest of the country will take the view that London should take its share of the pain of closures and will seek to make one closure in the capital in order to make closures elsewhere more palatable.”

Removing children’s surgery and intensive care from Royal Brompton will have devastating consequences, and not just for the young patients who value the hospital’s cardiac care so highly. Losing its children’s intensive care unit will destroy Royal Brompton’s world-class paediatric respiratory service, which specialises in the treatment of children with cystic fibrosis, severe asthma and a number of severe and complex respiratory conditions. Without the back-up of intensive care and on-site anaesthesia, doctors will not be able to undertake the more complex specialist treatments they do now, because they will consider it unsafe to do so.

Royal Brompton’s respiratory teams also undertake groundbreaking research into important areas such as cystic fibrosis, severe asthma, lung disease, inflammation of the airways and neuromuscular conditions. That research can be carried out only at a specialist hospital, where the combination of clinical expertise and the type and number of patients seen provides the necessary conditions. Without an intensive care unit and provision for anaesthesia, research will simply not be possible.

[Greg Mulholland]

The hon. Gentleman makes a passionate case for the Royal Brompton unit. The chief executive of Little Hearts Matter says that, in the Glasgow case, a unit that does 300 operations can be made perfectly safe by other means, without closing units. Does the hon. Gentleman share my frustration at the fact that in the Royal Brompton, Leeds and other places, those involved are not prepared to do that? It does not make sense.

[Mr Slaughter]

I am grateful for that intervention, because, in case my comments are seen as special pleading from the hospital, I was just coming on to mention some independent recommendations and sources that support the argument that, if there is no opportunity for research, and if experts—in Leeds, as well as the Royal Brompton—are prevented from working to the level of their abilities, many are likely to seek work elsewhere, possibly outside the UK.

Dr Neil Gibson, a consultant in paediatric respiratory medicine at Glasgow’s royal hospital for sick children, wrote to the chair of the review as follows:

“The unit at the Royal Brompton Hospital from a paediatric respiratory point of view is truly one of the world’s leading centres with an already impressive track record…There is a significant potential for irreparable damage to be made to the only world class Paediatric Respiratory Research Unit in the United Kingdom.”

Professor J. Stuart Elborn, president of the European Cystic Fibrosis Society, wrote that

“high quality research is a key determinant of the ability of a centre such as the Royal Brompton to retain and recruit the world leading clinical and academic staff on whom its respiratory services depend. Adverse impact upon the ability of the clinical staff to carry out cutting-edge research will undermine the sustainability of the clinical services, to the detriment of its patients.”

Asthma UK, the Cystic Fibrosis Trust, the Muscular Dystrophy Campaign, and the Primary Ciliary Dyskinesia Family Support Group wrote a joint letter to the chair of the committee, saying:

“We have explicitly mentioned respiratory research because it is an issue of fundamental importance to each of our charities because of the excellence of the Royal Brompton’s paediatric respiratory research and clinical trials programmes and the importance of that work for improving patient outcomes in the future.”

Patients and staff at Royal Brompton are understandably deeply distressed at the prospect of losing their high-performing children’s heart unit, soon to be followed by their specialist respiratory services. They do not understand how such a decision can be made by bureaucrats who have never visited the hospital and have no specialist knowledge of the care provided there. They have written to their MPs and to the Secretary of State. Indeed, one resourceful mother brought the matter to the attention of the Prime Minister in Downing street last Thursday.

The Secretary of State for Health assures the parents of these seriously poorly children, and the dedicated teams that treat them, that this is a matter not for him, but for the NHS. For the sake of the thousands of children whose care will be damaged by the decision of Sir Neil McKay’s committee, the sake of the research programmes that will be destroyed, and the sake of common sense, I hope that the Minister of State will realise that the time has come for him to meet clinicians from the Royal Brompton and at least hear what they have to say. Perhaps he will be able to persuade them that destroying NHS services and research programmes that are viewed by international peers as among the best in the world is a good idea. I wish him luck in doing so.