Oral Answers to Questions

Andy Slaughter Excerpts

Tuesday 1st April 2014 Commons Chamber

[Paul Blomfield (Sheffield Central) (Lab)]

12. What progress has been made on achieving parity of esteem between physical and mental health.

[Mr Andy Slaughter (Hammersmith) (Lab)]

15. What progress has been made on achieving parity of esteem between physical and mental health.

[The Minister of State, Department of Health (Norman Lamb)]

The mandate to NHS England requires measurable progress in achieving parity of esteem by March 2015. “Closing the Gap”, which was published in January 2014, contains a reinvigorated system-wide drive to deliver parity of esteem and to hold services to account. That includes programmes in NHS England, Public Health England and Health Education England.

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[Norman Lamb]

We want to make sure that there is complete transparency in the availability of data and to ensure that in future it will be possible to draw those comparisons. I suspect that there is agreement across the House that mental health must not lose out. In the last decade, when the NHS was financially squeezed mental health lost out, as the Health Committee confirmed. It has happened again this time, but I am absolutely determined that we will change the levers to ensure that mental health gets its fair deal. I am delighted to confirm today that we are ending the exclusion of mental health patients from the legal right of choice. It is extraordinary to me that when the Labour Government introduced a legal right of choice in the NHS, they inexplicably left out mental health patients. We are ending that today.

[Mr Slaughter]

Last week, I hosted a reception in Parliament to celebrate the outstanding work of the West London Centre for Counselling and its tireless support for my constituents with mental health issues, and I thank my hon. Friends the Members for Liverpool, Wavertree (Luciana Berger) and for Copeland (Mr Reed) for attending. Organisations such as the centre are, in the words of Mind, “straining at the seams” because demand so far outstrips resources. Why does not this Minister take responsibility for being in government and do something about mental health being a Cinderella service?

[Norman Lamb]

That is precisely what I am seeking to do, but we have to address what I have often described as an institutional bias against mental health in the NHS. For example, when the previous Labour Government introduced a maximum waiting time of 18 weeks, inexplicably, they left out mental health again. What possible justification can there be for that? We are ending that and ensuring that when commissioners determine where funding goes they will have to take into account waiting time standards in mental health for the first time.

NHS

Andy Slaughter Excerpts

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

My hon. Friend is absolutely right, and I would love the Government to explain that everything is fine and that there is no problem at all to more than 100,000 people who have waited more than four hours on a trolley this year, or almost 1 million people who have waited more than four hours in A and E. The complacency is not justified, and if those people were to read the Government’s motion, I am afraid, quite frankly, they would be astonished.

[Mr Andy Slaughter (Hammersmith) (Lab)]

Perhaps I may help my right hon. Friend by saying that the campaign in North Norfolk began on the Minister’s website after the excellent campaign run by the Labour prospective parliamentary candidate, Denise Burke, who pointed out how deficient local services were—[Interruption.]

[Mr Speaker]

Order. I have been watching carefully. Dr Coffey, I fear that you are catching what I can describe only as Gove-itis. You are normally regarded as a rather cerebral soul, and I invite you to try to contain your irascibility for a period, if you can.

[Mr Slaughter]

Will my right hon. Friend join me in condemning the Government for still classing A and Es as such when, like the one at Charing Cross, they are in practice closing and turning into GP-run clinics? The Government are still calling them A and Es, and people are misled. That will lead them to go to the GP-run centres when they should be going to properly staffed A and Es, and we will get tragedies such as the one at Chase Farm.

[Andy Burnham]

I am afraid that under the coalition, NHS treatment for “Gove-itis” is being rationed, like everything else, unfortunately. As my hon. Friend said, the Government claim they are keeping A and Es and call them “local” A and Es, but they are actually downgrading A and E units all over the country. How can it make sense to close and downgrade A and Es in the midst of an A and E crisis? In west London, as my hon. Friend knows, incredible changes are being introduced without proper regard for the evidence I am presenting to the House today of a change in A and E and of sustained pressure on A and E units. The Government must go back and consider their plans for my hon. Friend’s constituency and the rest of London.

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[Mr Hunt]

The hon. Lady is right to highlight the fact that there has been a long-standing issue with recruitment into A and E. We have made some good progress. We have 350 more consultants in post than at the time of the election, but we need to do even better, so we are looking at the training process for A and E consultants. We are also looking at the contractual terms for A and E consultants, particularly as they relate to things such as shift work, to try to make it a more attractive profession. I am confident that these issues are now being addressed—in fact, I have had some encouraging feedback from the College of Emergency Medicine saying that it, too, is confident about that.

[Mr Slaughter]

Will the Secretary of State give way?

[Mr Hunt]

I will give way in a minute, but this is an Opposition day debate, so I want to return to the central motion. Let me remind the right hon. Member for Leigh that he told this House—in fact, he had an Opposition day debate to do it—that the NHS budget had been cut in real terms. It had not: it rose. He also claimed that the number of nurses was being cut, when actually it went up. His attempts to talk up a winter crisis have been disproved time and again. That is important, because we have not had a proper apology to this House in relation to the letter he received from the chief executive of the south-western ambulance trust complaining about his spinning, which stated:

“information provided to your office in response to a Freedom of Information request…has been misinterpreted and misreported in order to present a grossly inaccurate picture for the purposes of apparent political gain.”

The right hon. Gentleman should not be playing politics with the pressures in A and E; he should be getting behind front-line staff, who are working extremely hard and who find that kind of tactic extremely demoralising.

[Mr Hunt]

I will tell the right hon. Gentleman exactly what the facts are. The other word I heard him use several times in his speech was “complacency”. I will tell him what complacency is: it is complaining about an English NHS that is hitting its A and E targets and completely ignoring Labour-controlled Wales, where the NHS has been missing its A and E targets since 2009. Something else that is complacent is this idea Labour has that, almost a year after the Francis report, the lessons of Mid Staffs stop at the border of England and Wales—that Wales has nothing to learn and does not need to do a Keogh report into excess mortality rates, which the Welsh Labour Government have consistently refused to do. People in Welsh hospitals are suffering because the Welsh NHS has refused to bite the bullet on excess mortality rates.

[Mr Slaughter]

Tonight, at a “Save Our Hospitals” meeting in west London, I shall be speaking to A and E doctors and GPs about the largest-ever closure programme: four NHS emergency departments are to close in west London. Eight west London MPs, including me, have asked the Secretary of State to meet us and discuss the issue. Shall I tell those who attend tonight’s meeting that the Secretary of State is still refusing to meet eight MPs who collectively represent nearly a million people in west London?

[Mr Hunt]

As the hon. Gentleman knows, I must follow a strict legal process in relation to such decisions, and we have had an extensive consultation. However, let me say this to him. When he talks to those MPs, he should tell them the facts about the proposals for north-west London which I approved—proposals for three brand-new hospitals in which seven-day working is to be introduced, 24/7 obstetrics, 16/7 paediatrics, seven-day opening of GP’s surgeries, and a range of other services which will help to address precisely the issues raised by the right hon. Member for Leigh in connection with transforming out-of-hospital care, which I support. As a result of those proposals, the services that I have listed will be available in north-west London before they will be available in many other parts of the country. I hope that the hon. Gentleman will inform the MPs whom he is meeting of those important facts.

Health Care (London)

Andy Slaughter Excerpts

Wednesday 8th January 2014 Westminster Hall

[Mr Andy Slaughter (Hammersmith) (Lab)]

Given the time constraints, I shall limit myself to one issue, which is the current threat to the emergency hospitals in my constituency, but I begin by congratulating my hon. Friend the Member for Westminster North (Ms Buck) on securing this timely debate. She made her arguments very well.

This morning, I received an e-mail from the Secretary of State that is pertinent to the debate. There was an agreement for him to meet the three Ealing MPs, two of whom—my hon. Friends the Members for Ealing, Southall (Mr Sharma) and for Ealing North (Stephen Pound)—are here, and me next Monday evening. The Secretary of State has withdrawn from that meeting, pleading other engagements, and asked us to meet officials instead. I hope that he will reconsider. The meeting is specifically about the threat to two of London’s major hospitals, Charing Cross and Ealing, and I hope that the comments I am about to make will lead the Minister to intervene and ask that the meeting go ahead. We understand that the Secretary of State has pressures on his time, but it is entirely unacceptable for him not to meet Members on an issue of such crucial and central importance.

It is sad news, but we know—

[Mary Macleod]

Will the hon. Gentleman give way?

[Mr Slaughter]

I would rather not because of the time. I am sorry.

We know what is happening with Hammersmith hospital because it has been announced that the A and E department there is going to close after the winter crisis—as if the crisis is not a continuing one. I have been told informally that it will close two weeks after the local elections to avoid any embarrassment to the Government. We were also told that there might not even be an urgent care centre there; it may be moving. That would mean no emergency access to Hammersmith hospital, unless it is still to receive emergency blue-light coronary cases. At least Hammersmith hospital will continue as a major specialist hospital, and a very fine hospital it is indeed.

The situation regarding Charing Cross hospital is far less clear. I will précis where we are and explain the matters that we wish the Secretary of State to deal with. In February last year, the decision, which is still extant, was made to close completely and sell off the Charing Cross hospital site, leaving an urgent care centre on 3% of the site. At the same time, there was to be an outline business case, to report in October last year, that might preserve 13% of the facilities and 40% of the site. That business case is now due in March, but we understand—through the Imperial College Healthcare foundation trust process, not any other process—that there will also be elective surgery on the site. That might mean there will be elective surgery as well as primary care and treatment facilities, and some form of emergency centre on the site, with perhaps 50% of the land preserved. That gain, in so far as it is a gain, is St Mary’s loss, because we understand that 50% of its site will be sold in any event. Of course, any amelioration in the position is to be welcomed.

I praise the cross-party Save Our Hospitals group for campaigning tirelessly in both my borough and Ealing on the issues I have mentioned. However, the point it would want me to make very clearly is that what I have described is not what we want. Of course we want good elective care, primary care and treatment services, but the issue of capacity must be addressed.

It is not feasible to close two of the largest emergency hospitals. I use the word “close” advisedly. As emergency hospitals, they are closing: there will be no emergency surgery, no blue-light A and E, no stroke unit and no intensive treatment on those sites. I am afraid that the Secretary of State’s intervention so far has been genuinely unhelpful and done for political reasons. We have invented a second-tier A and E, as it is called. A second-tier A and E is an urgent care centre. The only differences that clinicians could identify for me were that at a second-tier A and E there would be GP cover and X-ray services, and for elderly and vulnerable people there might be some beds for recuperation after minor treatment. Otherwise, it is an urgent care centre or a minor injuries unit.

Let us not play political games. I am not saying that we can keep politics out of the NHS—of course we cannot—but this is dangerous because it will mislead people. If people think that there is an A and E at Charing Cross or at Ealing when there is not, they will go there when they should have gone elsewhere. We will continue to campaign to save emergency services. It is not feasible for the Imperial family to go from three major emergency departments to one. All three are currently under pressure and overcrowded. The decision has to be taken by Ministers, so I implore the Minister to go back to the Secretary of State and ask that he meet us.

The level of politics is not acceptable. Politics comes into these matters all the time. Before the last election, when there was no threat to the hospitals, the Conservatives kept saying that there was—I have their election literature here. We now have taxpayers’ money being spent on campaigns saying that hospitals are staying open when, in fact, departments in them are not. Let us at least tell our constituents the truth. There may be unpalatable decisions to be taken, but as far as Charing Cross is concerned, the health service is clear that it will be a local hospital. It will not be an emergency hospital. That is not acceptable in any way to my constituents. It is not feasible to run a health service in west London on that basis.

I have made my points to the Minister clearly, and I look forward to her response. I also look forward to the meeting with the Secretary of State where I can put my points in more detail and more forcefully.

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.

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[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.

Care Bill [Lords]

Andy Slaughter Excerpts

Monday 16th December 2013 Commons Chamber

[Andy Burnham]

The Secretary of State may remember that when he came into government he stood on a manifesto promising real-terms increases. He and the Prime Minister have stood at the Dispatch Box every week since the election saying that I said that we would cut the NHS, but that is not the case: I stood on a manifesto promising protection for the NHS in real terms. I said that if there were to be real-terms increases they should be given to social care instead, because it would be “irresponsible”—that was the quote—if the Government overfunded the NHS only to let social care services collapse: it would be a false economy, because it would push more and more older people into hospitals, and hospitals would stop functioning.

Do you know what? That is happening right now. The Secretary of State’s cuts to social care are forcing more and more older people into hospital. That is why he has an A and E crisis—because hospitals are full. On his watch there has been a 66% increase in people aged over 90 going into A and E via blue-light ambulances. If he is proud of that, that is up to him, but I certainly would not be.

[Mr Andy Slaughter (Hammersmith) (Lab)]

I am not surprised that the Secretary of State wants to change the subject, because if that decision is confirmed tomorrow my clinical commissioning group will lose £29 million—13% of its budget for hospital care. It has some of the poorest health outcomes, but that money will go to places where life expectancy and health outcomes are much better—in other words, Tory-controlled areas. That is a disgrace, coming on top of the closure of fine hospitals such as Charing Cross and emergency hospitals. That is the truth about what this Secretary of State is doing and I am afraid that all we have heard today is political spin.

[Andy Burnham]

The Secretary of State began by quoting the principles of the NHS. I was always led to believe that one of the principles is that the NHS should respect need—that funds should follow those in greatest need. [Interruption.] The Secretary of State says, “Absolutely.” In constituencies in parts of London, the midlands, the north-west, Yorkshire and the north-east, male life expectancy is 10 years lower than in other parts of the county. There is real need in those communities, but they will be the biggest losers if the change goes ahead. I believe that it is immoral to take money out of those communities to hand it to areas where life expectancy is already longer.

I hope that NHS England is listening to this debate. Quite apart from the morality of whether the change should be made, how is it that a quango can distribute about £80 billion of public money to our constituencies while we seemingly have no locus whatever in such a decision? Should not the Secretary of State be at the Dispatch Box either to defend changes that he makes or to say that such changes will not go ahead, so being accountable to this House? Instead, a quango—the biggest in the world—seems to be about to take money out of some of the most deprived parts of the country.

Urgent and Emergency Care Review

Andy Slaughter Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

I am in regular contact with the Northern Ireland Minister for Health, Social Services and Public Safety about good practice in Northern Ireland, and I am delighted to hear that they are doing some good things in urgent and emergency care. We should be open to all good practice, not just in our country but all over the world.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The Secretary of State may have seen the report in The Sunday Times at the weekend about the dispute between the medical director for London, who said that 20% to 30% of blue-light A and Es should close, and Sir Bruce Keogh, who said that less than that should close. Disgracefully, the Secretary of State has not told us what is in Sir Bruce Keogh’s report, but we know that it is below that figure, so why did he announce to the House two weeks ago that four out of nine—45%—of blue-light A and Es in west London would close, pre-empting the Keogh review?

[Mr Hunt]

Because it is going to save the lives of the hon. Gentleman’s constituents; it will mean that 800 more people are employed in out-of-hospital care; it will mean three brand-new hospitals for the benefit of his constituents; it will mean seven-day working; and it will mean seven-day opening of GP surgeries. That is why.

Changes to Health Services in London

Andy Slaughter Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

My hon. Friend speaks wisely. It is disappointing that we are not having a more intelligent debate. When Labour was in power, it closed or downgraded 12 A and E units in 13 years. The then Government realised that there were problems. He is right that they started the problem in Chase Farm. That is why, when we are facing such difficult decisions, it is important to have a responsible debate. I accept that MPs have views on their constituencies, but we have to start looking above the parapet to the wider interests of patients. That is a difficult thing to do, but I would have hoped for more leadership from the shadow Secretary of State, who used to be Health Secretary.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The Secretary of State is destroying services in four great London hospitals, two of which are in my constituency, in the biggest closure programme in the history of the NHS. Why is he closing A and Es in two of the most deprived communities in London—Brent and White City—and why, rather than certainty, is he installing chaos into Ealing and Charing Cross hospitals? What is happening to the 500 beds at Charing Cross? What is happening to the best stroke unit in the country? What does he mean by A and Es that are different in size and shape? When will he answer those questions? This is a cheap political fix. How can anyone have confidence in the Secretary of State—

[Mr Speaker]

Order. We understand the general drift of the observations—[Interruption.] Order. I understand how strongly the hon. Gentleman feels, but he should really ask one question. The Secretary of State is a man of dexterity and no doubt will meet the hon. Gentleman’s needs as he sees fit.

Hepatitis C (Haemophiliacs)

Andy Slaughter Excerpts

Tuesday 29th October 2013 Westminster Hall

[Mr Andy Slaughter (Hammersmith) (Lab)]

Thank you, Mr Dobbin, for calling me to speak. It is a pleasure to be here in Westminster Hall under your chairmanship.

I, too, thank my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) for securing this debate and for his speech. I welcome the Minister, the hon. Member for Battersea (Jane Ellison), to her post. This is the second Westminster Hall debate in two weeks that I have taken part in and she has responded to, so she has a very full in-tray. Nevertheless, I urge her to study her brief on this issue and, as my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) said, to meet the victims of the contaminated blood scandal and their MPs.

Most importantly, the Minister should come up with a proposal for resolving the remaining injustices on this issue. I am sure that she will; she has a reputation for being thoughtful and open-minded on such subjects, but she will have heard from right hon. and hon. Members today that this problem becomes more pressing with every year that passes.

I am afraid that, as my hon. Friend the Member for Kingston upon Hull North said, the cause was somewhat set back by the meeting that the previous Minister, the hon. Member for Broxtowe (Anna Soubry), had with the all-party group on haemophilia and contaminated blood earlier this year. It is no exaggeration to say that it is the worst meeting I can remember in eight years of going to such meetings. The previous Minister was completely unprepared in her brief; she shared the all-party group’s concerns but had no solutions whatever to address them. That meeting was attended by 20 MPs and peers, with 20 others giving their apologies. The number of Members who take part in the frequent debates on this issue shows the level of concern among all parties about it.

This is a great injustice, which successive Governments have failed to address; in so far as they have attempted to address it, they have done so in a miserly and bureaucratic way. An inquiry has been refused, and responsibility has been refused, by Government, and those things are to be deplored.

In the very few minutes that I have to speak, I wish to introduce one additional topic. My right hon. Friend the Member for Wythenshawe and Sale East has rightly framed this debate in terms of contaminated blood and hepatitis C; understandably, the good briefing from the Haemophilia Society has done the same. However, the briefing also refers to co-infection with HIV.

When the Minister looks at these issues, I urge her not to forget those who have been infected, or co-infected, with HIV as a consequence of contaminated blood products. Of the 1,252 people who have been infected with HIV in this way, 932 have died so far. Among the 322 of those people who are still living, one of them is my constituent, Andrew March, who was contaminated at the age of nine. He is now 39, so his entire life has effectively been ruined. He has been a staunch campaigner. He was the applicant in the judicial review proceedings on this matter, and yet after 30 years he is still waiting for any proper redress.

I feel strongly that this issue is the responsibility of Government, and the hon. Member for North Devon (Sir Nick Harvey) was also clear on that. To some extent, the admission of liability is not the central question. The previous Minister wrongly said that the reason why proper payments were made in the Republic of Ireland was that there was an admission of liability. In fact, payments were being made there before the admission was made, as the hon. Member for Foyle (Mark Durkan) pointed out very clearly, having a clear knowledge of what happened; the hon. Gentleman is not here today, but he has done a lot of work on this issue.

We do not need to get tied up in those matters of liability, but personally I would like an admission of responsibility from the Government, because, for some of the reasons that have already been given, much more could have been done. In the 1970s and 1980s, there was a delay because of a failure to see what medical knowledge was showing about contamination. Even when that contamination was known, there was a failure to treat products so that they were no longer harmful.

My final point is about funding. Reference has already been made to the Skipton Fund in relation to hepatitis C, but there are similar problems with the Macfarlane Trust. I have been told that it is effectively falling apart; that the review of its probity, of its success, has been ignored; that there is very poor communication between it and sufferers; and that it is underfunded.

The result of all that is that people die. People die because they are not getting sufficient treatment or sufficient medication that they need to deal with their conditions. HIV is a treatable condition, but for those who have serious health problems it can still be fatal and that issue is not being addressed. In the short term, I ask the Minister to look at both the lump sum and ongoing support payments, but in the longer term what we need is a full and final settlement.

I suspect that many Ministers, particularly junior Ministers, wonder how much difference they have made on a lot of issues when they finally leave their posts. However, I also suspect that this is one discrete area, with a defined number of victims, where the Minister could make a difference if she chooses to put her mind to it, in a way that some of her predecessors have not.

[Jessica Morden (Newport East) (Lab)]

A Welsh member of the all-party group on haemophilia and contaminated blood recently told me that every meeting and correspondence that it has with the Government ends with the words, “The Minister will look into this.” Does my hon. Friend agree that a promise really to get to grips with this issue now would be incredibly important, not least for Colin—aged seven, from Newport—who died in my constituency from having contaminated blood? We must also remember the very young victims whom we are campaigning for.

[Mr Slaughter]

I am grateful to my hon. Friend. I know that those views are shared by many Members on both sides of the House.

We are probably not looking for answers today, although we will listen to what the Minister has to say. She has heard clearly that we can do more than just look into the issue: we can achieve results for the remaining victims of these terrible diseases and their families.

Health Services (North-West London)

Andy Slaughter Excerpts

Tuesday 15th October 2013 Westminster Hall

[Ms Karen Buck (Westminster North) (Lab)]

I am grateful for the opportunity to raise some issues in this short debate, and I welcome the Minister to her role. It is good to have a London colleague here to respond to the debate, which deals with my serious concerns about the management of the delivery of health services in north-west London.

I asked for the debate with considerable sadness. I have been involved with health care delivery in north-west London for decades, on the community health council, when it existed, and as a member of the health authority for the same area; and for many years I enjoyed positive relationships with hospital management and primary care trusts, so it is of concern to me that I shall be describing a diversion away from such good relationships and communications, and the serious implications of that.

The debate is not about individuals, although I have concerns arising from the communication of some individuals’ views about health care delivery in recent months. The problem is structural, and it is not fixable just by improvements in the exchange of e-mails. It goes to the heart of trust and clarity in the way health care is provided. I am not alone in my concerns—I know other elected officials feel the same; but this is not just about politicians having our noses put out of joint when communications are not handled effectively. It is about some fundamental questions that have arisen, to do with how care is and will be provided to my constituents, and residents of the London borough of Westminster, where St Mary’s hospital is situated.

Because the challenges are so great in north-west London, as they are, indeed, in many parts of the health service, it is even more incumbent on those who deliver and manage health care to ensure that communications are clear, that there is a shared strategic approach to planning, and that there are common assumptions. As the Minister knows, the backdrop to the issue is important changes in the provision of hospital care and the “Shaping a healthier future” strategy for north-west London. That, of course, proposes the closure of several accident and emergency units in north-west London.

Fortunately, from my point of view—because it something about which we all care very much—A and E will not be closed at St Mary’s hospital in Westminster. It is good to see my hon. Friends the Members for Hammersmith (Mr Slaughter) and for Ealing North (Stephen Pound) here for the debate; I know that my colleagues have concerns about how emergency services will be provided in their areas when A and E units close.

[Mr Andy Slaughter (Hammersmith) (Lab)]

My hon. Friend shares my pain. Four out of nine accident and emergency units are designated for closure, and two of those are in my constituency; but the point that she is making is that every MP in north-west London shares the pain, because there is simply no capacity in the system to cope with such a decline in emergency services. The sooner the Government and the NHS realise that, the better.

[Ms Buck]

I agree with my hon. Friend. Of course, the proposed closures and the “Shaping a healthier future” strategy are themselves set against a financial context that puts extreme pressure on delivery. North-west London hospital services must accommodate a £125 million reduction in service between 2011 and 2015. At the same time—and this is pertinent to the core of my comments—local authorities have imposed dramatic cuts in their social care budgets. That is particularly germane to the issue, because the work of local authority care services relates to prevention and hospital discharge arrangements, and needs to be integrated with those areas, so that the highly pressured hospital service can work effectively.

Of course, another factor is the impact of the top-down NHS reorganisation that we were told would never happen, and the £3 billion that it cost, which has taken valuable resources and a great deal of energy away from the planned delivery of services. The slow death of the primary care trusts and the slow emergence of clinical commissioning groups during a time of massive changes has been part of the problem.

Colleagues such as my hon. Friend have legitimate concerns about the effect of the proposed A and E closures on their communities. St Mary’s hospital was not scheduled to lose its A and E unit, and we were pleased about that. I and others were briefed about ambitious plans for the development of a new, improved emergency care service, to be built at St Mary’s hospital. During the discussions and briefings there was no suggestion that there would be any specific consequential changes in the pattern of hospital services at St Mary’s. Therefore, when, at the invitation of my hon. Friend, I attended the independent review panel called to consider the A and E closures in other parts of west London, I was somewhat taken aback to be asked by the chairman how I felt about the closure of up to 200 beds at St Mary’s, and the movement away of most or all elective surgery, as part of the consequential changes resulting from “Shaping a healthier future”.

I immediately contacted the chief executive of the Imperial college health care trust, to ask whether that was accurate, what the implications were, and why I and others had not been told. That was not because I am automatically totally opposed to consequential changes in service delivery. We must be grown up about such things, and it is right that hospitals evolve and change. Things should not be, and never have been, set in stone. Good clinical reasons and financial necessity may drive change. However—and this is my theme today—to make that change work there must be clarity and partnership, and everyone must understand what is being proposed and how decisions are to be taken.

First, the Imperial trust referred me back to the “Shaping a healthier future” proposals, and to a slide pack that was shown to me and the hon. Member for Cities of London and Westminster (Mark Field) in the spring. That set out very broad headings for how services at the three hospitals in the Imperial group—Hammersmith, Charing Cross and St Mary’s—would develop. There was nothing in it that would have led me to conclude that St Mary’s would lose the bulk—or all—of its elective surgery.

I checked with Westminster council, to see whether I was missing the blindingly obvious. I am grateful to the excellent health strategy officer at the council, who has been a model of clarity in explaining how things worked. He told me, with, I believe, the full agreement of local authority members, that the authority—a statutory partner, which there is a requirement to consult about major changes in hospital services—

“did not receive any indication that there would be significant consequential changes to elective surgery at St Mary’s Hospital as a result of Shaping a Healthier Future. Furthermore, Westminster City Council has not been informed of any proposals to re-locate much or all elective surgery currently performed at St Mary’s Hospital to Charing Cross and any developments in this area would be submitted to both the Cabinet Member and Chairman of Health Scrutiny to investigate.”

He said the authority would consider the assumption by the chief executive of the Imperial hospital group

“that these proposals were in the Decision Making Business Case to be incorrect”,

and continued:

“At Imperial College Healthcare NHS Trust’s Board meetings on 24th July and 25th September, we were informed that Imperial were considering their options.”

Indeed, the chief executive of Imperial verbally, when I met him, and in writing indicated that no decisions had been taken and that the timetable for such decisions was for conclusion in the New Year. On 23 August, he wrote:

“I can assure you we are very much in the modelling and evaluation stages of any changes so are yet to consider whether we should propose moving any clinical services between our sites”—

note the use of “any”. That letter was widely circulated, so clarification could have come from other members of the local health service family, but no such clarification was received—to coin a phrase.

Meanwhile, a quick look at Hammersmith council’s website showed me that it was promising its community a reinvigorated Charing Cross hospital, but on a basis that did not appear to have been explained by Imperial to anyone in Westminster. Hammersmith announced in September:

“News that elective surgery is now on the list of possible future services would further boost the amount of expertise at the site, meaning patients in the local community benefit from the care it gives, and giving it greater status as a teaching hospital.”

[Mr Slaughter]

My hon. Friend is making a good case for the second of our concerns, which is not the closures themselves, but the chaotic, shambolic and amateur way in which they are being carried out. In the past six months, I have been told that Charing Cross hospital will close and be a clinic, a local hospital, a specialist social care hospital—whatever that is—or an elective surgery hospital. The person who told me most of those things, the chief executive of Imperial, has just left, suddenly, after only two years in the job. That is typical of the utter chaos in the hollowed-out NHS in north-west London and, no doubt, elsewhere.

[Ms Buck]

I totally endorse my hon. Friend’s words.

To return to my point about how Hammersmith council is presenting its achievements in winning services for Charing Cross that no one in Westminster or at St Mary’s hospital knows about, Hammersmith continued:

“Charing Cross will also become a specialist centre for community services which means that the many thousands of older and chronically ill patients, who need regular visits to hospital, will have less far to travel. It will mean local people will be better supported to live independently at home”.

It was good of Imperial to share that vision with Hammersmith and around Charing Cross, but it is a great shame that it chose not to share a single word with Westminster city council.

Reinforcing my hon. Friend’s point about chaos, however, I am not sure that even that is the true picture, because when I showed the press releases on Charing Cross from Hammersmith council to the chief executive of Imperial in September, I was told that it was spin on Hammersmith’s part and that what was proposed was only a 23-hour ambulatory care model, with no new beds at all. It is hard to square that with Hammersmith council’s vision and harder still to know what is true.

I do not begrudge Hammersmith residents their hospital—quite the reverse—but I am concerned about any sense of deals being done to secure their future, at the expense of local residents in Westminster and, critically, without so much as an opportunity for Westminster council even to consider the matter or to think about support services or the community care dimension, which Hammersmith so rightly talks about as important in a local hospital context and which can be applied to Westminster. If Hammersmith council can proudly claim that its new hospital means that

“the many thousands of older and chronically ill patients, who need regular visits to hospital, will have less far to travel”,

surely that cannot mean that older and chronically ill Westminster residents, who also need regular visits to hospital, should have further to travel—with no debate and no chance to put in place social care support or travel arrangements.

Things get worse. Four weeks after my meeting with the chief executive of Imperial, all my follow-up questions about what that means, whether decisions have been made or what services will be located where still remain unanswered. That is no doubt partly a consequence of the unexpected departure of the chief executive, who has been replaced in what is clearly a holding operation, in a manner that does not indicate a smooth and planned transition.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

This is the first time I have served under your chairmanship, Mrs Riordan—in fact, under anyone’s chairmanship, because it is my first Westminster Hall debate. It is good to start off with such a straightforward and easy subject.

I congratulate the hon. Member for Westminster North (Ms Buck) on securing the debate. I am a London MP and I know that this matter is important to her and her constituents, to the constituents of her hon. Friends the Members for Ealing North (Stephen Pound) and for Hammersmith (Mr Slaughter) as well as to those of other MPs who are not here today.

Before I turn to the issues raised, I put on record my thanks to the staff of the NHS for their commitment and dedication in providing a first-class service, particularly as they enter a period of change. We know that that is sometimes not easy, but they are maintaining a first-class commitment to patients throughout.

The debate around aspects of the north-west London reconfiguration has been going on for some time, but it is fair to say that the hon. Lady discussed a slightly new feature of it. Today is the first time I have heard in detail directly from her about these important issues. I will give her a response, but I will look at the detail of what she said, reflect on it and come back to her more fully after the debate. It is not possible to do that instantly, because until now I had not heard directly from her about some of the problems on communication and so on in the past year that she said illustrate some wider issues.

My understanding is that the joint committee of primary care trusts agreed in February this year that further work was needed to bring about improvements to services at both Charing Cross and Central Middlesex hospitals. I am aware that Imperial College Healthcare is developing its clinical and site strategy based on the principles set out in “Shaping a healthier future”. The trust has put forward a case for some elective surgery to be carried out at the Charing Cross site and has developed a vision for each of its three main sites becoming centres of excellence for the service they provide.

It is right that hon. Members and local authorities should expect openness and transparency when discussing local health issues and changes, and the hon. Lady has vividly put across that she does not feel that that has happened. It is regrettable that she feels she has encountered, in her dealings with Imperial, a lack of clarity around its clinical and site strategy and, in particular, around planned care and elective surgery.

The hon. Lady rightly stressed the need for partnership working through periods of difficult change such as these. Her comments on the overall exercise and the expressed clinical priorities were balanced, and I take seriously what she said about wishing to work in partnership and her point that we can clearly do a lot better. I have been assured by NHS England that a real effort will be made by the new leadership team at the trust and the local clinical commissioning group to engage more fully with her, other local MPs, local councillors and the local NHS as the site strategy is developed.

I am aware that the hon. Lady met the chief officer and the GP chair of the central London CCG to discuss her concerns about the changes to planned care and surgery in north-west London. As a result, she will know that under “Shaping a healthier future”, St Mary’s will continue to provide out-patient services, diagnostics, therapies and appropriate follow-up. I understand that work is under way to agree the best locations across north-west London for planned care surgery services.

[Mr Slaughter]

I hear what the Minister is saying—it is reasonable and I know that she is sincere—but we constantly meet these people and they are, frankly, hopeless. The issue is now becoming political. So far, we have had political unity across the board and we now know that the issue is on the Secretary of State’s desk. I implore the Minister to talk to him about these proposals—in the interests of her party, if none other.

So far, apart from Hammersmith and Fulham council, which is supporting the closures, everyone across west London is united on this: it does not matter what party they are or what position they hold. This issue is moving from the local to the national. Will the Minister please look—it is in her interest as well as ours—at what is going wrong in north-west London before we take steps in closing hospitals that we will not be able to correct?

[Jane Ellison]

I am not sure that describing NHS colleagues as “hopeless” is a particularly helpful contribution to future partnership working, but the hon. Gentleman has chosen his words in his own style, as he always does. He is right to say that the matter is on the Secretary of State’s desk. I will report back to the Secretary of State after this debate, specifically on the new concerns expressed by the hon. Lady on the dialogue and the relationship she has had. Beyond that, I cannot comment further on the reconfiguration, because of its status.

Accident and Emergency Departments

Andy Slaughter Excerpts

Tuesday 10th September 2013 Commons Chamber

[Mr Hunt]

I congratulate my hon. Friend and his Milton Keynes colleague on their assiduous and regular conversations with me on the pressures on their A and E. I recognise that it is operating way above its original planned capacity and hope that today’s announcement will make some difference, but we will continue to look at long-term solutions because we recognise that there are long-term pressures.

[Mr Andy Slaughter (Hammersmith) (Lab)]

In view of the continuing and worsening crisis in A and E, will the Secretary of State concede that closing four out of nine A and E departments and 500 beds at Charing Cross hospital is now unsustainable? Will he abandon those plans, or at least suspend them until the crisis is over?

[Mr Hunt]

I take issue with the hon. Gentleman’s suggestion that this is a worsening crisis in A and E. We have hit our A and E target for the last 22 weeks. We recognise that there are real pressures and are seeking to address them. On the proposals for north-west London, he knows that I cannot comment until I have received the Independent Reconfiguration Panel’s advice. I will look at it very carefully, but obviously, considering the pressures on A and E departments across the country, I will want to ensure that any proposed solution makes sure that his constituents get the service they need when it comes to urgent and emergency care.