NHS in London

Debate between Andy Slaughter and Jane Ellison

Thursday 24th March 2016 Westminster Hall

[Jane Ellison]

We have been clear that we have given a large amount: £3.5 billion has been made available to local authorities for social care. Ditto on public health—we will spend £16 billion over the next five years. If I have time, I will come to the good point that was made earlier about the move to business rates retention. It is matter of record that the Government committed at the election to what the NHS had asked for in the five-year forward view, and we will continue to make that commitment.

The London health system—CCGs and provider trusts—has planned for a deficit in 2015-16 of about £350 million, and overall the system is expected to be in that position. Some recovery is expected during 2016-17, and I am sure we will debate that again. In addition, a £1.8 billion sustainability and transformation fund is available, designed to address provider deficits in 2016-17. However, I think all Members would accept that additional Government spending is not the only answer to the challenges faced by the NHS. We have taken action with our arm’s length bodies to support local organisations to make efficiency savings and reduce their deficits, but much of the change Members have talked about is driven by desire to get better healthcare rather than to make savings. If we can make savings as well, that is all to the good, because we can reinvest them in great healthcare.

In London, from early April, the new NHS Improvement body will be providing additional expert support and capacity to trusts experiencing particular financial challenges. That support will include identifying and implementing financial improvement and helping them to identify savings to put them in a stronger position to maintain those savings.

Let me talk about the pressures on urgent and emergency care. It is acknowledged that the urgent and emergency care system faces increasing pressure. More and more people are visiting A&E departments and minor injury units, which is stretching their ability to cope. Members listed some reasons for that in their speeches. A lot of visits are unavoidable, but some people are visiting because of inconsistent management of long-term health conditions, difficulty in getting a GP appointment or insufficient information on where to go.

Winter sees an even bigger rise in visitor numbers and pressure on staff. Although the debate inevitably dwelled on Members’ concerns about their local healthcare systems and problems in them, I am sure we all want to place on record our huge thanks and praise, as many have, to the staff of London’s NHS, who work extremely hard under a lot of pressure and delivering some really good results against that backdrop. I will come on to that.

London’s A&E units have been significantly challenged this winter, and that has been reflected in performance. However, despite those pressures, the capital’s urgent and emergency care system has proved its resilience, with fewer serious incidents declared than in previous years. This winter, London accounted for just three out of 625 serious incidents declared across England. It is important to praise the staff in saying that.

In January, London’s performance was significantly higher than all other regions, with 90% of patients seen within the four-hour A&E standard. London is also the highest-performing region in England this year to date, with 93.1% of patients seen within the four-hour standard. My thanks and congratulations on that improved performance go to the hard-working staff of London’s services.

Reconfiguration schemes have loomed large in the debate. The health needs of people in London are changing and demands on health services are increasing. The hon. Member for Ilford South in his excellent speech illustrated through his personal stories some of the reasons for the changes in the shape of our health service in terms of how we are investing in specialist services and centres of excellence. The work done to centralise stroke expertise was brought up earlier in the debate. I remind Members, although many will remember, that those changes were bitterly opposed by many people. I am not sure whether that includes anyone in the Chamber, but it certainly includes campaign groups. However, all our London clinicians now say with certainty that those changes, with centralised expertise and specialist care, have saved many lives. That is always worth reflecting on.

People are living longer, the population as a whole is getting older and there are more patients with chronic conditions. We often say that people are living longer, but we forget to say that they are living with chronic conditions for longer, and that presents a longer-term challenge than might be seen at first sight. Heart disease, diabetes and dementia will all increase as they are conditions associated with an ageing population.

We did not dwell on the prevention agenda, but I was delighted that the hon. Member for Edmonton (Kate Osamor) spoke about it. The shadow Secretary of State also touched on it when she mentioned dementia and the problems we all know of older people in hospitals. I urge her to look at the dementia implementation plan we published on 6 March, which is a detailed response to the Prime Minister’s 2020 challenge. Dementia has sat in my portfolio since the election, and that plan is a detailed look at how we deliver against that challenge and in particular at the joined-up care that is key to ensuring that people with dementia have safer and better care in our system and are kept out of the acute sector whenever that is possible.

In a number of areas across the capital, the local NHS has concluded that the way it has organised its hospitals and primary care in the past will not best meet the needs of the future. We are clear that the reconfiguration of front-line health services is a matter for the local NHS, tailored to meet the local population’s needs.

I was glad to hear that Members recently met with Anne Rainsberry. The Members who came to the cross-party “Shaping a Healthier Future” meeting last summer will know it is vital that officials at all levels and NHS managers engage with elected Members. I was therefore disappointed to hear what the hon. Member for Eltham (Clive Efford) said. I will ask my officials to look into that. A number of Members asked reasonable questions about why they could not have certain bits of information. I have some specific answers and it may be that we can take a moment after the debate and I will point them in the right direction.

[Andy Slaughter]

I am grateful for what the Minister has said. If she could give an indication to health officials that we must have an open review of where we are with “Shaping a Healthier Future”, look at the implementation of the business plan and consider the Mansfield commission report, which really just asks questions along those lines, it would be very useful indeed.

[Jane Ellison]

We have had the time, during a three-hour debate, to make inquiries, so I will perhaps give the hon. Gentleman an update afterwards.

There have been a lot of references to the interaction with Members. Members of any party may feel they are knocking their heads against a brick wall, but sometimes, to be fair, information cannot be shared for good reasons. There may be commercial confidentiality, or things may be at a particular stage where information cannot be shared. However, I am quite clear that all plans for the local populations that Members represent must be shared with the best level of detail possible, at the most opportune moment. I am always happy to hear from London Members if they feel that that is not happening.

Reconfiguration is about modernising the delivery of care and facilities. I recognise that proposals for those changes sometimes arouse concern. There has been a particular focus on “Shaping a Healthier Future” in this debate, but under that programme, many more community services are now in place across all eight boroughs, so more patients can be seen closer to home. Eleven new primary care hubs are now open. Improved access to GP services has meant an additional 32,000 appointments in Ealing since August 2015, while weekend appointments are now offered to more than 1 million patients across north-west London. Rapid access services in each borough are helping to keep patients with long-term conditions out of hospital where possible, which has already prevented 2,700 hospital admissions in Brent alone.

Oral Answers to Questions

Debate between Andy Slaughter and Jane Ellison

Tuesday 9th February 2016 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

4. What assessment he has made of the implications for his policies of the findings of the Independent Healthcare Commission on the NHS in north-west London.

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

It might assist the House if I were just to mention that this commission was commissioned by five Labour councils and was chaired by Michael Mansfield, QC. On the assessment of the commission’s findings, I can put it no better than the lead medical director for the “Shaping a Healthier Future” project, who said:

“The unanimous conclusion of the board’s clinicians was that the report offered no substantive evidence or credible alternative to consider that would lead to better outcomes for patients…above the existing plans in place”.

I concur with that judgment.

[Andy Slaughter]

Last July, the Minister held a constructive meeting with west London MPs and agreed that information on the review of our hospital services would be shared. We understand that a plan B is being considered that will still move hospital services from Charing Cross and Ealing but, because of rising costs, will retain and mothball existing buildings rather than redeveloping the sites. Can we see the current plans?

[Jane Ellison]

The hon. Gentleman rightly says that we had a constructive meeting but, as with everything in this area, it is time to move on. There is a grave danger of him appearing to be like one of those soldiers discovered on a Pacific island after the second world war still fighting the old war. Part of the reason for cost escalation in NHS projects is the constant challenge and delay, and “Shaping a Healthier Future” has complete clinical consensus across north-west London. The clinicians say that this

“will save many lives each year”.

It is time to get on with this project.

Infected Blood

Debate between Andy Slaughter and Jane Ellison

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

One or two of those questions are probably a little too detailed to comment on now, but it is worth reiterating what I said about the devolved Administrations. I have not been able to speak to the Welsh Health Minister; we offered the opportunity of a call with other Ministers, including the Scottish Minister, but the Welsh Minister knows that he can get in touch. One of his officials was on the call this morning, and our offices have been talking to each other. I am happy to pick this up with the Welsh Health Minister if he wants to do so.

This consultation is for the scheme in England, but we have been working with counterparts in the devolved Administrations. While everyone in the UK is welcome to respond to the consultation and say what they think, health is now a devolved matter—that is different from when the first schemes were set up—so the devolved Administrations are responsible for providing financial support for those affected from each country. Treatment within the NHS is obviously a matter for the NHS in Wales, and I will look at some of the other points the hon. Gentleman made. We are happy to talk to him about the devolved aspects and write to him afterwards.

[Andy Slaughter (Hammersmith) (Lab)]

I thank the Minister for the consultation, the additional money, the scheme consolidation and the work that both she and the Minister for Community and Social Care have undertaken. I also thank, of course, the all-party group and my hon. Friend the Member for Kingston upon Hull North (Diana Johnson). Will the Minister concede that, for those of us who have worked closely with individual victims for a number of years, the resolution has to be, as far as possible, to put them in the financial position they would have been in but for the grievous harm done to them, and that that may in some cases mean a bespoke solution for individual victims—we are not dealing with unlimited numbers of people here?

[Jane Ellison]

That is clearly the hon. Gentleman’s view and I invite him to submit it to the consultation. This is exactly why we are consulting. We have made some proposals, but some of the questions are very open, and we will look at what comes back from the consultation. I urge him and other Members to take part in the consultation.

Victims of Contaminated Blood: Support

Debate between Andy Slaughter and Jane Ellison

Wednesday 16th December 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

Let me challenge the Minister on the phrase “quieter voices”, which I have heard her use several times. It seems to be a code for addressing the important but less costly issues of treatment and reform of the current scheme rather than a full and final settlement to what Lord Winston rightly called the

“worst treatment disaster in the history of the NHS”.

We have a moral duty here, so simply saying “the Chancellor will not give me the money” will not wash.

[Jane Ellison]

Again, I have said here today and previously in Westminster Hall what I believe the position to be with compensation. I accept that the hon. Gentleman has a different view and we had an exchange when he contributed to the discussion in November. I think it would be wrong to dismiss the idea of listening to quieter voices, which I have had the opportunity to do over the last couple of years, and as a result it has become clear that a number of people want a number of different things from a reformed scheme. It will not be possible to do everything that everyone wants. We are going to try to respond as best we can with a scheme that is sustainable, fair to all and responds to many of the points made here today.

Oral Answers to Questions

Debate between Andy Slaughter and Jane Ellison

Tuesday 2nd June 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

8. What effect the implementation of the Keogh urgent and emergency care review will have on type 1 A&E departments in England.

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

The Keogh review is all about responding to the long-term challenges facing the NHS, many of which we have already discussed in this Question Time. The implementation of the recommendations of the Keogh review will improve urgent and emergency care services and ensure patients get the right care in the right place.

[Andy Slaughter]

The “Shaping a healthier future” programme in north-west London, which is seen as a prototype for Keogh in closing or downgrading A&Es, is causing great concern, from the tragic death of Guy Bessant reported yesterday to the more than £20 million spent on external consultants last year. Eleven west London MPs would like to meet the Secretary of State and, I hope, the Under-Secretary, to discuss those concerns. Will they agree to meet us?

[Jane Ellison]

I read of the tragic death of that gentleman, who was a Wandsworth resident. Our hearts go out to his family.

As the hon. Gentleman knows, “Shaping a healthier future” is a clinically led programme supported by all eight clinical commissioning groups in the area and all nine medical directors of the trusts involved. There are no plans to make changes to A&E services at Ealing hospital, contrary to what was put about during the election, but I recognise that this is the subject of ongoing concern. All the recommendations of the Keogh review are entirely driven by one thing, which is putting patients and patient safety first, but I am happy to meet him and his colleagues to discuss it.