Protecting the Public and Justice for Victims

Debate between Catherine West and David Lammy

Wednesday 9th June 2021 Commons Chamber

[Mr David Lammy (Tottenham) (Lab)]

I beg to move,

That this House regrets the unprecedented backlog of more than 57,000 Crown Court cases, as well as record low convictions for rape and a collapse in convictions for all serious crime; calls on the Government to set up more Nightingale Courts, to enshrine victims’ rights in law and to introduce the proposals set out in Labour’s ‘Ending Violence Against Women and Girls’ Green Paper; and further calls on the Secretary of State for Justice to update the House in person on progress made in reducing the court backlog by 22 July.

As always, it is good to see the Secretary of State for Justice in his rightful place.

In 1915, Franz Kafka wrote “The Trial”, which was about a young bank official, Josef K, who was arrested and prosecuted by a distant bureaucratic state, despite having done nothing wrong. The novel chronicles his lifelong struggle and frustrations with the invisible law and untouchable court. Readers of Kafka are shocked by the grindingly mundane frustrations of Josef K’s trial, which goes on for an entire year.

As has been repeated so many times, reality is often stranger than fiction. Today, in modern Britain, it can take multiple years before victims of crime and the accused finally get their day in court. Simon Foster, the new West Midlands police and crime commissioner, recently explained that he had seen court trial dates set for as late as 2024. He was right to pin the blame on the mismanagement and reckless neglect of the justice system over the past decade. Disturbingly, he warned that the delays would put domestic abuse, violence against women and rape cases at particular risk of collapse, due, of course, to the vulnerability of the witnesses.

I do not enjoy having to repeat the damning statistics that show that the Government are failing the survivors of violence against women and girls—frankly, they break my heart, and they should break all our hearts—but it is necessary for the House to recognise the scale of the problem that the Government have created if we are to have any chance of fixing it. In 2019-2020, the number of rape convictions in England and Wales fell to a record low: just 1,439 suspects in cases where a rape had been alleged were convicted of rape or another crime—half the number three years before. I am sorry to detain the Secretary of State, but I repeat that, because it is worth listening to: just 1,439 suspects in cases where a rape had been alleged were convicted of rape or another crime —half the number just three years before. Fewer than one in 60 rape cases recorded by the police last year resulted in a suspect being charged. The public have lost faith in those who are supposed to keep them safe: seven in 10 women say that the Government’s efforts to make the UK safer for women are not working.

[Catherine West (Hornsey and Wood Green) (Lab)]

My right hon. Friend is making an excellent point. Would he agree with me that behind all of these statistics is often a desperate young woman not knowing what her rights are, waiting months for an independent violence and sexual assault advocate, and just in desperate straits, and that the House has to push harder on this Government to get it right? It is completely unacceptable.

Minors Entering the UK: 1948 to 1971

Debate between Catherine West and David Lammy

Monday 30th April 2018 Westminster Hall

[Mr Lammy]

rose—

[Catherine West]

rose—

North Middlesex University Hospital NHS Trust

Debate between Catherine West and David Lammy

Tuesday 12th July 2016 Westminster Hall

[Catherine West (Hornsey and Wood Green) (Lab)]

It is an honour to serve under your chairmanship, Ms Vaz. I congratulate my right hon. Friend the Member for Enfield North (Joan Ryan) on securing the debate. It feels a bit like mark 2 for her, I think, given the earlier experiences with Chase Farm. I am pleased about the cross-party nature of the debate; it was interesting to hear the personal experience of the hon. Member for Enfield, Southgate (Mr Burrowes) of care at the hospital.

Like my right hon. Friend the Member for Tottenham (Mr Lammy), I am at a loss; I attended the annual general meeting a couple of weeks ago and have written letters to Ministers—indeed, the Minister present today has been kind enough to have a meeting with us. We have had press reports and urgent questions. We have asked questions at Prime Minister’s questions. We have had Adjournment debates, and the Mayor of London has raised the matter with NHS London. I am at a loss to know what we should do next, and which levers can be pulled.

I am pleased that management action has been taken, and that Mr Sloman has now taken an interest and is the accountable officer. I am equally pleased that Ms McManus has been brought in to take over on an emergency basis while the leadership of the hospital is being looked at. However, I have concerns for the long term about a situation in which decision makers in Hampstead would make decisions about a north London hospital whose area is Edmonton, Tottenham, Wood Green, Enfield and Haringey. I am concerned about how remote and out of touch they might be. I look forward to hearing in the spring what the management arrangements will be for the medium to long term. We must ensure that there is proper representation of local people at board level and a proper voice for our area in the hospital management and governance structure.

I will briefly raise two constituency cases. One is about medicines training, which was referred to in the Care Quality Commission’s report. I understand from a constituent that when her father was discharged from the hospital, somehow his name had got mixed up with another patient’s name, and when she got home she had the incorrect medicine for him. That is a basic error, and the wrong medicine could have been fatal for an elderly and frail man.

The second case arose after an anonymous phone call to my office reporting on the condition of an elderly patient. The caller was very distressed, as the patient was his elderly wife. He said, “I’m so worried to tell you, because I am afraid that they actually might kill her if I tell you her name.” There is a level of desperation, and that call was made not so long ago; it was within the last month.

There are some general lessons to be learned from this specific situation about the lack of leadership and lack of quality control in our public services. The first is about the recruitment and retention of properly qualified staff. We desperately need to tackle the low morale of staff, which has been exacerbated by the poor handling of the junior doctors dispute. Morale is low not only at senior level or consultant level but at the middle level, and even at the level of junior doctors. Once the hospital lost the contract for the training of junior doctors, everything went downhill from there. We need to get that training back, and we need to work very hard and very quickly to get back the doctors and experts who want to serve, learn and train in a university hospital.

The second lesson to learn is about the crucial issues in our health economy, one of which is the problems with primary care. I understand that there are immense problems with the current Enfield primary care arrangements. The clinical commissioning group is not in a good place. I would like to hear about any associated issues, and I would like to know what levers the Minister can pull to ensure that proper primary care arrangements are put in place for Enfield and that primary care in Haringey is strengthened.

I understand that Haringey has done some very good things, including putting some extra general practitioners into the accident and emergency department to educate people about where to go when they first come into hospital, and about how they can go and see their GP in the local community. I would be happy to hear about an evaluation of that programme and whether it has been helpful. Rather than rushing in with a band-aid solution, can we hear back about that programme? What has the evaluation been, and what do the experts think? Has that programme stopped the flow of people coming—perhaps incorrectly—to A&E, and has it helped the primary care health economy?

It is well known that Members including my right hon. Friend the Member for Tottenham secured a debate in the main Chamber on mental health in Haringey. At St Ann’s hospital in Haringey, the acute care places are really overloaded, which has led to greater demand for beds at North Middlesex hospital. Once the health economy becomes unbalanced, that can put more strain on A&E departments from general patients who do not have mental health problems.

Furthermore, there is an ambulance crisis. Police officers have told me that there are not enough ambulances and that they have to take patients to the North Middlesex hospital themselves because the ambulances cannot cope. Of course, we know that once the ambulances get to hospital, people are being treated inside the ambulances, which is completely unacceptable.

[Mr Lammy]

My hon. Friend will also appreciate that a major criticism in the CQC report was that after patients have left the ambulance, they are treated solely by nurses at grade 5, with no doctors in sight and no consultants available after 11 o’clock at night. How can there be an emergency department when there are no consultants available on a Friday or Saturday night?

[Catherine West]

My right hon. Friend makes an excellent point about an issue that must be monitored. I look forward to the Minister reporting back on the lack of the leadership and clinical excellence that we expect on behalf of our constituents.

The cuts to public health provision will have an extra impact. I will give just one example, which many Members here have pursued—basic HIV/AIDS care. We are not doing the preventive work, and we are unnecessarily cutting back the public health budget, which will eventually lead to more people turning up at A&E or acute care departments in crisis. These issues in the health economy are all linked, and we need to do much more about all of them.

We are all aware that litigation accounts for a quarter of NHS expenditure. Why do we not get better at doing the proper work first, so that the money we spend on lawyers and expensive court cases when we get things wrong does not add up to so much? The situation is absolutely desperate. We need more investment, and we need to stop making mistakes so that we do not have to pay for litigation and so that instead of litigation there can be front-loading of resources into prevention, mental health and good-quality primary care and basic services. People accessing the NHS could then have confidence that their local service is as good as we should expect it to be.

Finally, we know that in London, there are a number of issues with the cost of living, the cost of transport and the cost of childcare for medical practitioners and nursing staff. Those issues are linked to the others that I have mentioned, and I would like to see a more robust approach from the NHS around London to the needs of those working in our hospitals and our public services. London is not like other areas, where it is cheaper to rent homes and so on. We are unable to recruit the medical practitioners and nurses we need because they cannot afford to live in the area, and we should examine that issue more energetically and not just in a theoretical way.

Thank you very much, Ms Vaz, for calling me to speak. I look forward to hearing the Minister’s conclusions.

Primary Care: Tottenham

Debate between Catherine West and David Lammy

Wednesday 16th December 2015 Westminster Hall

[Mr David Lammy (Tottenham) (Lab)]

I beg to move,

That this House has considered primary care in Tottenham.

I am grateful, Sir Roger, for the opportunity to introduce the debate. It is now 67 years since my party introduced the national health service. At that time, living to 100 would have been a newsworthy event, but today more than half the children being born in our country can expect to reach that age. This is clearly a sign of great progress and the quality of our healthcare system. However, that progress has not been the same across the board. There remain in this country huge discrepancies and a postcode lottery that determines the quality of healthcare people can expect to receive. I am particularly worried that the life expectancy of many children in Tottenham is nowhere near the national average.

The current situation paints a worrying picture. Today, average life expectancy for a male in this country stands at more than 80 years, but in my constituency, in the wealthiest city in one of the richest countries in the world, a male can expect to reach an average age of just 74. That is some five years lower than the national average, lower than Cuba where the average wage is £15 a month, and lower than Slovenia, Colombia, Bosnia and Peru. Perhaps most worrying, it is more than eight years lower than the life expectancy of men just a couple of miles away in Crouch End, in a wealthier part of the London borough of Haringey. That is a troubling and stark difference within the same London borough, and the same is true for women.

Primary care is the first point of contact in the healthcare system. In this country, that usually means GPs. They are the very frontline of our health services, the entry point for all our healthcare needs and the means by which we access a whole array of treatments. Primary care is, therefore, the linchpin of our healthcare system. In fact, it accounts for 90% of patients’ interaction with the NHS. Because of that, NHS England’s five-year forward view stated that in future a much higher proportion of its budget would be spent on GP services.

Both this Government and their coalition predecessor claimed to understand the importance of primary care, and to some extent matched their words with funding. For example, £550 million was earmarked in March 2015 to improve GP access, to modernise facilities and to provide better care outside hospitals. Then in May 2015, the Prime Minister announced the “seven-day NHS”, proudly stating that by next April 18 million patients will be able to see a GP in the mornings, evenings and at weekends, with everyone being able to do so by 2020. One would therefore be forgiven for thinking that primary care provision on an average weekday is securely in place, given the £8 billion of extra funding earmarked in a time of austerity to provide additional services outside the current working week. That may be true in some areas of our country, but it is not true in mine.

Recent research paints a stark picture of primary care in Tottenham. The data come not from NHS England or from the Department of Health, which does not seem to be monitoring the situation adequately, but from a small local organisation, Healthwatch Haringey. With no extra funding or support, it went out and listened to local people about the problems they were facing in accessing primary care, and it found something quite disturbing. Some 86% of the patients at one GP surgery were either unhappy or very unhappy with their surgery. That surgery is ranked in the bottom 10 practices in England, with 41% of patients reporting they were unable to get an appointment.

That is apposite because, on Monday this week, Rob Clarke in my constituency tried to access his surgery, Bridge House surgery, with his three-year-old. He tried repeatedly for many hours and was ultimately told to go to A&E. That is not what we want in Britain, where A&E is always overrun, and it was appropriate in that circumstance for the child to be treated at the GP surgery.

Across Tottenham, there are currently 1,300 too few appointments a week, which equates to 52,000 appointments a year fewer than the NHS benchmark. In just one ward of my constituency—Tottenham Hale—there is a shortfall of 18,000 GP appointments a year. Tottenham Hale is undergoing significant regeneration and now has several large blocks of apartments, a sizeable retail park, 500 more properties under construction and a further 1,900 planned for the medium term. It is one of the Mayor of London’s designated housing zones, but despite the influx of thousands of new residents, no new GP surgery was planned. It was only when the desperate need was pointed out by Healthwatch that NHS England’s task and finish group eventually arrived to complete a planning exercise. I note that a final decision on a new surgery will be made on Friday 18 December.

Our treasured national health service has been fractured by this Government and their coalition predecessor, but even with the best will in the world and even when clear need is established, nothing can be achieved quickly. I want to press the Minister on how fast we can and need to move in the circumstances I am outlining. It will have taken over a year for a decision to be made and, if that decision is positive, nearly 18 months for the surgery to finally open. During that period—I put this starkly—people are dying as a result of not being able to get an appointment, and children are being born unregistered. They are the truly dispossessed in our city. Will the Minister look closely at the issue and do all in his power to make the process as swift as possible?

The issues surrounding primary care in Tottenham relate not just to the number of GP places, but to quality and accessibility. According to NHS England, three quarters of GP buildings there do not meet legal compliance, and there are not enough consulting rooms. Some of the facilities in use in the fifth largest economy in the world are shocking. Healthwatch found that 20% of young mothers were not registered with a GP at all.

The consequences of not being able to obtain a GP appointment are stark: more avoidable deaths from cancer, worse life chances for children, and a lack of antenatal and postnatal care when women and, of course, their infant children are at their most vulnerable. My constituency is where Victoria Climbié and Baby P met their tragic end. The ability to obtain an appointment is important if we want to safeguard children. If people cannot do so, it raises serious concerns for mothers and their unborn children, and has led to the grave situation of three unregistered births in my constituency, one of which was of a disabled child whose mother gave birth at home with no one to help her.

Furthermore, Healthwatch discovered clear health inequalities between the west and the east of the Haringey borough, where my constituency is located.

[Catherine West (Hornsey and Wood Green) (Lab)]

My right hon. Friend is making an excellent speech with some good points about the disparity between those who live well and live long lives in the London borough of Haringey and those who do not. Does he accept that it is not solely Tottenham where there is a lack of primary health care? Parts of my constituency—for example, Noel Park—have similar problems with provision of basic, high-quality primary healthcare. Will he give that some consideration?

[Mr Lammy]

My hon. Friend is absolutely right. Her constituency includes Wood Green, and there are pockets of deprivation across Crouch End and Muswell Hill. She is absolutely right to make that point. In a way, this debate stands in both our names, because the crisis affects the borough of Haringey. It is not a coincidence that life expectancy of a male in the far west of the borough and the east correlates with the statistics that I have given, especially when so many mothers of infants are unable to register children in the constituency.

None of us should accept the situation. It is the sort of thing we associate with parts of urban America where there is no universal health provision. In the UK, we have a proud history of our national health service with its own constitution, which states clearly that people have the right to access NHS services. I fear that that is not the reality for many of my constituents.

These issues are not a reflection on the doctors in Tottenham, the vast majority of whom do an excellent job on behalf of the local community. I have recently met, for example, Dr Muhammed Akunjee of West Green surgery and Dr John Rohan of Lawrence House surgery, and I am very grateful for the work that they and their colleagues do in the constituency. As usual, the problems arise much higher up the chain of command. However hard GPs in Tottenham work, there are simply not enough of them and not enough facilities to serve our growing community. That leads me to wonder what it will take for the Government to address the crisis.

We know that there is a well documented link between poverty and ill health; we know that social conditions such as unemployment, overcrowding and inadequate housing make illness more likely; and we know that deprivation increases health problems and therefore pressures on the health system. Given that, I ask the Minister why one of the poorest constituencies in the UK receives significantly less health funding than wealthier areas nearby. Given the greater pressures, it should be receiving more. It is clear that the way to alleviate the GP crisis in Tottenham is to attract new GPs to the area and to retain the ones we already have. However, it is impossible to do that, because despite the huge workload, the urgent pressures and the ceaseless demand, GPs in my constituency are paid significantly less than those in wealthier areas just a few miles away.

For example, a GP in Holborn and St Pancras, the 126th most deprived constituency in the UK, receives £154.64 per registered patient, whereas their counterparts in Bethnal Green and Bow, the 36th most deprived community, receive less—£144.48 per patient. Despite the huge pressures on GPs operating in Tottenham, the 23rd most deprived constituency in the whole country, they receive only £124.94 per patient. That is a full 20% less than in Holborn and St Pancras. Clearly there are fundamental problems with the Carr-Hill formula, which is used to calculate GP funding. There are also real concerns about the impact that withdrawing minimum practice income guarantee payments has had on GP practices in deprived areas such as my constituency. I urge the Minister to look at what he can do to incentivise new GPs to come to areas such as mine.

If the GP situation in my constituency is to improve, GPs in Tottenham must be paid at least the same as their colleagues working nearby. That is an urgent need, given that one third of GPs in the borough are over 60 and therefore due to retire. Things could get considerably worse before they get better. Clearly, younger GPs are being attracted to work in other London boroughs because of the price differential.

It was this Government who wanted the NHS run on market principles, yet they have failed to grasp the obvious problem that for a GP to set up a business in Tottenham, he has to do more work, in worse facilities, for lower pay. Any 12-year-old fan of “The Apprentice” knows that that is not the way to run a successful business. It clearly demonstrates the inherent problem with trying to force a market on the health service, yet we are stuck with this Government’s NHS market framework, so I ask the Minister this: will market rules be applied so that GPs are given proper incentives to set up practices in Tottenham? Also, will he ask the chief executive of NHS England to finally take an interest? I am not clear whether it is Simon Stevens I should talk to or his London lead, but I would quite like the London lead at least to come down to the constituency for herself. I would have thought, given the work that Healthwatch has done, that she would have sought to do that.

I understand that following Healthwatch’s report, NHS England has started to take the problems in Haringey seriously and has produced a detailed 10-year capacity plan, which sets out how many full-time GPs and clinical and treatment rooms are required. Growth is predicted in four key areas: Green Lanes, Northumberland Park, Tottenham Hale and Noel Park, which is in the constituency of my hon. Friend the Member for Hornsey and Wood Green (Catherine West). Three of the four areas are exclusively within my constituency. NHS England has identified a need for five extra GPs in the Green Lanes area, six in Northumberland Park, 16 in Tottenham Hale and eight in Noel Park over the next 10 years. That is 35 extra full-time GPs, 27 of whom are needed exclusively on my side of the borough.

There are a few questions that I want to ask. Does the Minister agree that it is unacceptable that 20% of my constituents in Tottenham Hale do not have access to a GP? Is he concerned that the gaping holes in primary care provision in Tottenham have contributed to the fact that the average life expectancy of a man in Tottenham is just 74—below that of Cuba? Will he explain how, within the NHS market framework, he will attract more than 27 GPs to my constituency, where, despite the far higher workload, GPs are paid significantly less than those in leafy areas just a few miles away?

Will the Minister give me his word that there will be a transparent process to increase the funding per patient in Tottenham by 20%, so that it is brought up to the level of its far wealthier neighbour, Camden? Does he agree that it is disgraceful that the Government have committed themselves to providing a “seven-day NHS”, with weekend GP appointments for 18 million patients, many of whom are in the richest areas of the country, whereas in my constituency 20% of new mothers and their infant children have no access to a GP at all? I look forward to hearing what the Minister, the Government and NHS England, which I hope is paying attention, have to say.