Urgent Care Centres: Hillingdon

Debate between David Simmonds and Karin Smyth

Wednesday 10th September 2025 Commons Chamber

[The Minister for Secondary Care (Karin Smyth)]

I am grateful to the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) for securing this debate. He mentioned that his wife works in the system, so I pay tribute to her for her service in the local trust.

As the hon. Gentleman alluded to, I am a Hillingdon girl; it is where I was brought up. My brother was born in Hillingdon hospital, some 59 years ago. It was a great pleasure to be there recently with my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales). Some years ago, I predicted that we might have a Labour MP there, so after being around the area for a long time, I am personally very pleased to see that.

The hon. Member for Ruislip, Northwood and Pinner tempted me to move into the wider areas of what are rightly a to-ing and fro-ing on some of the bigger pressures in that part of north-west London and into Hertfordshire. I will not go into that, but it is absolutely right that hon. Members use this platform to share their campaigning on behalf of their constituents.

Service changes such as these are always hard and they are rarely popular. I have been the Member of Parliament for Bristol South for more than a decade, and before that I was an NHS manager, so I have seen many service changes and reconfigurations over the years. Like the hon. Gentleman, I was also a non-executive director in a past life. All the changes that I have seen were done through good consultation, with strong clinical leadership and a good clinical case, and involved patients and the public.

I strongly believe that patients, public and staff are often ahead of the wider system and sometimes of politicians in knowing the balance of the money, the funding, the good value for taxpayers’ money, clinical outcomes and safety. If they are managed well, those conversations and the sorts of debates we are having tonight can often yield better results than maintaining the status quo or decisions made behind closed doors. I am familiar with such debates, as like many of us I often found myself standing where the hon. Member for Ruislip, Northwood and Pinner is, advocating for my constituents against changes that I thought were not in their best interest or not clearly communicated. He was right to secure this debate.

[David Simmonds]

I agree with every word that the Minister has said about how we get good decisions in the interests of local people, but does she share my concern that there has been no public consultation about this decision at all? There has been very limited engagement even with local residents’ associations about the process and, for the staff involved, there has been some—shall we say—degree of ambiguity about what decisions have been made at each stage of the process. Does she agree that it would be wise at this stage, as a very minimum, to pause, to think again and to undertake that public consultation, so that the NHS managers tasked with making the decisions fully understand the impact on the local community?

[Karin Smyth]

I will comment on that later. I understand that there is a meeting on Friday, to which I will allude.

In preparing for the debate, I met representatives of the trust, and I am grateful to those in the local NHS for their time in giving some further background. The trust is clear that it would be more efficient for urgent care services to be consolidated at the site in Hillingdon, bringing forward the urgent care nurse practitioner service at Mount Vernon into the urgent treatment centre at Hillingdon hospital. The rationale for having urgent treatment centres alongside A&E is well established clinically.

The hon. Gentleman referenced the 10-year plan—I am pleased he is such a fan—and the direction of travel. I am pleased to say that the trust also believes that people are better served by primary care hubs, so that more responsive care can be delivered closer to where people live. Three such hubs are being developed in Hillingdon, one of which will be in Ruislip. I am sure that he welcomed the announcement this week of the roll-out of the first of the 43 hubs, including the one in Hillingdon, which will deliver the neighbourhood health services model.

--- Later in debate ---

[Karin Smyth]

I understand what the right hon. Gentleman says. I have seen some of those promises made and not delivered over many years. It is important that Members of Parliament are involved and that there is a wide conversation with the ICB and the trust around those changes and the development that they make towards delivering the 10-year plan.

My right hon. Friend the Prime Minister announced that we would bring together NHS England and the Department for Health and Social Care precisely because we think that democratic accountability for £200 billion of taxpayers’ money is important. However, that accountability does not mean micromanaging, or intervening in every difficult decision that the ICB makes. We expect local NHS organisations to make changes and to reconfigure their services as best needed by the people they serve. That is in line with the direction outlined in the 10-year plan.

My right hon. Friend the Secretary of State for Health and Social Care has received several requests to intervene on a number of issues. Having looked at them thoroughly and assured himself that patient safety and access were guarded, he has decided not to intervene in nine reconfigurations. Getting our NHS back on its feet is a team effort, and we have to trust local NHS leaders to deliver. Decisions that affect the people of Hillingdon should be made in Hillingdon—it is not for someone sat behind a desk in Whitehall to make those decisions for them.

Having said that, I want to assure colleagues that that does not mean we will give local leaders a blank cheque to do whatever they like. Yesterday, we published a data tool and league tables that make NHS performance open and accessible, to inspire improvement and deliver a better NHS for all. Those NHS organisations that are doing well will be rewarded with greater freedoms, such as in how to spend their capital, and those that demonstrate the best financial management will get a greater share of capital allocation. We want to move towards a system in which freedom is the norm and central grip is the exception, in order to challenge poor performance.

Improving services for patients should be rewarded; the quid pro quo is that there will be no more rewards for failure. Undertaking the reforms we have set out to make as a Government will require a good deal of trust between central Government and local leaders, and we will build that trust only by showing those local leaders that we trust them to get on with the job and make difficult decisions where necessary.

[David Simmonds]

Will the Minister give way?

[Karin Smyth]

I am going to pursue this point, if I may. Debates about service changes and reconfigurations have gone on since the birth of our NHS. I understand that they are really important for local people, and I understand the level of discussion about this issue and—as the hon. Gentleman has outlined—the wider impact on areas such as Watford. It would be easy for this Government to make ourselves popular by sacking some managers and promising people that services are never going to change, or that they will never close in any part of the country, but we were not elected on a populist platform, and it would not be in patients’ long-term interests not to reform and modernise the system.

We are building an NHS that is fit for the future. That is what the 10-year long-term plan is based on—moving services from hospital into the community, from analogue to digital, and from sickness to prevention. We expect local NHS leaders to make that happen. They must do so with local clinical leadership in the best interests of the populations they serve, and they must do it with the public—we expect open and transparent communications going forward. Local politicians have an important role in that, which Members present in the Chamber have demonstrated ably, and will continue to do so. I would be very happy to maintain contact with the hon. Member for Ruislip, Northwood and Pinner. The wider implications of the issues he has raised need to be outlined to him, and I commit to writing back to him about the consideration that is being given to those wider implications. I note his concerns, and I am happy to continue working with him.

Question put and agreed to.

Health and Care Bill

Debate between David Simmonds and Karin Smyth

Report stage
Monday 22nd November 2021 Commons Chamber

[Karin Smyth]

I came to this place largely on the back of the disastrous Lansley Act, and I am pleased to see it banished to the dustbin of history, which is what this Bill essentially does. It also banishes to the academic shelves that example of how not to make policy. Lansley took a sledgehammer to our work in primary care trusts, to partnerships, to morale, and to our capacity to forward-plan. Along with the austerity funding that came with it, the Act directly led to the poor state in which we entered the pandemic, and that must be front and centre of any review of the pandemic.

This Bill is a seminal point in the history of the NHS, because it banishes again to the history books experimental competition as an organising principle and a driver of efficiency. The key issue is what replaces it. Now we have in its place local cartels dominated by hospital trusts, and the supreme power of the Secretary of State to interfere in all local decisions. There is no power here for local elected representatives, no power for primary care or community care or mental health, no voice for patients, no voice for the public, and no voice for the taxpayer, who is asked to pay ever more. As we move to an ever more costly health service, accountability and transparency of our NHS in this role has to be at front and centre in order to bring people with us on that journey of paying more.

I have tabled two amendments to this part of the Bill. One is on the need for the local boards to be cognisant of palliative and end-of-life care. The other is on local improvement finance trusts, the local public private sector bodies introduced under the last Labour Government that are instrumental in providing good primary and community care estate—something that this Government are allowing to wither on the vine. My own South Bristol Community Hospital needs more support through these trusts in order to thrive, so that people have decent, good-quality estate from which to receive their care.

I also draw hon. Members’ attention to my new clause 23 on a good governance commission, which will be discussed tomorrow. I genuinely offer it as a helpful way forward. If it were enacted by the Government, it would avoid the cronyism that we have become used to, and would ensure that local bodies are more democratically accountable to their populations and more cognisant of the needs of their local populations. It would ensure that the people leading the local bodies are fit and proper, meet basic criteria regarding what is expected of them and have crucial accountability to local populations. It is akin to the Appointments Commission, which was abolished in the abolition of the quangos; that was a huge mistake. If the Government took notice of it, the new clause would really help us to get around some of the real concerns about how our local health services are governed.

Let me finally address new clause 49 on social care. It is a disappointment and unexpected. We had six weeks in Committee. In that time, we could have looked carefully at the proposal and shone a bit of light on it. The right hon. Member for West Suffolk (Matt Hancock), who is no longer in his place, clearly tried to say what this provision is really about, in that one part of the state should not be subsidising another part of the state. He started to say that that was a true Conservative principle and he was absolutely right. This provision will remind people who are in receipt of benefits that they are in receipt of those benefits, and that anything they may have built up should not be counted towards their future. It is a punitive property tax. I am old enough to remember what happened to the last Conservative Government who introduced a regressive property tax; this Government really ought to think again.

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

I draw the attention of the House to my entry in the Register of Members’ Financial Interests in that I am married to an NHS doctor, who is employed by a hospital trust that serves my constituency.

Let me turn first to new clause 49. Those of us who have been in the world of local government for a long time will have seen the attempts by Governments of various parties to address the financial settlement around social care. I chaired a social services committee that pushed through the charging policies introduced by the last Labour Government in an attempt to address these costs. I also chaired a social services committee that had to balance the demands of the fair access criteria, and saw the last Labour Government drive a coach and horses through a lot of local provision.

I recognise that we should all seek to ask questions of Governments about how we address in particular the impact on working-age adults. In response to the people asking whether we are proud of what we are here to do tonight, I would say that we should be proud of the fact that we are willing to take what are sometimes difficult decisions to ensure that we balance the books and have a sustainable financial settlement that supports social care for our constituents. It is too late for my two grandparents, who went through the process and saw very modest assets consumed by the cost of long-term care, but I welcome the fact that my constituents, and people up and down the country, will benefit from what this Government are seeking to achieve.

I will move on, briefly, to new clause 55, which addresses the responsibilities for ICSs regarding the provision of services and planning for services for our youngest children. My right hon. Friend the Member for South West Surrey (Jeremy Hunt) made a helpful intervention, in which he pointed out the effectiveness of Ofsted-style regulation in ensuring the quality of provision at a local level.

We had an excellent debate in the Chamber just a few weeks ago, discussing the work done by my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), which was reflected in the budgetary decisions that were brought forward previously. Having had that debate, it seems clear to me that in tabling an amendment supported by more than 70 organisations in the field of children’s care, we have an opportunity—one which was debated and touched on through various assurances from Ministers in Committee. It is an opportunity to ensure the right level of rigour and accountability in what we ask of ICSs, so that we can make sure that our youngest children, babies, neonatal care, and indeed young people up to the age of 25 who are already covered by statutory provisions in respect of special educational needs and care leaving, are appropriately covered.