Accident and Emergency Departments

Gareth Thomas Excerpts

Thursday 7th February 2013 Commons Chamber

[Mr Sharma]

I thank my right hon. Friend for putting that case so strongly. I do not think anyone—inside or outside the House—would fail to agree with that suggestion.

In North West London NHS, the proposal translates into a £1 billion cut to budgets over the same time scale. The medical director of North West London NHS said that it would

“literally run out of money”

unless the closures proceeded. The scale of change driven by this financial pressure is unacceptable. It is targeting the poorest and most vulnerable, and it is unfair on the hospitals that have been financially solvent. That last point was graphically illustrated last week at Lewisham hospital, whose A and E was unjustly proposed for closure because of a neighbouring trust’s financial insolvency. That brought tens of thousands of incensed protesters on to the streets.

Sadly, this is happening in Ealing, too, whose hospital is faced with losing its A and E department, yet it is financially viable and has been for many years. It is being sacrificed on account of financial problems in other neighbouring hospital trusts. This threat of closure in Ealing exists even after the Prime Minister assured me, in a response to my question, that there was no such threat.

[Mr Gareth Thomas (Harrow West) (Lab/Co-op)]

Although this is a debate about the closure of A and E departments across the country, does my hon. Friend accept that it seems particularly unfair that London, with nine accident and emergency departments apparently set for closure, is being hit so hard in losing vital NHS services?

[Mr Sharma]

I agree with my hon. Friend, and I shall definitely cover that point later in my speech.

As in Lewisham, the people of Ealing took to the streets in huge numbers last autumn in protest at the proposals from North West London NHS whereby if the preferred option A is chosen on 19 February, it would mean the closure of four A and E departments in west London: in Ealing, Central Middlesex, Charing Cross and Hammersmith hospitals. The campaign to save our hospitals has been broad and deep, bringing together MPs and councillors of all political parties, and organisations and individuals from all segments of society.

--- Later in debate ---

[Mr Gareth Thomas (Harrow West) (Lab/Co-op)]

I greatly enjoyed the speech of the hon. Member for Ealing Central and Acton (Angie Bray) and share many of her sentiments, but I hope she will forgive me for saying that her contribution lacked a sense of regional and national context. Despite the pretence of a national review, to which my hon. Friend the Member for Ealing, Southall (Mr Sharma) alluded, closing substantial numbers of A and E units is clearly now Government policy. Professor Matthew Cooke has been advising the Department of Health on A and E issues—he did so last year, at least. He has spoken to NHS North West London, supporting its plans to close four of our nine A and E departments, and he was reported in the Daily Mail as saying that those plans were in line with national Government policy.

At the 2010 general election, the Conservative party manifesto promised to stop the closure of A and E departments. Indeed, I think the Prime Minister insisted there would be a moratorium to stop further A and E closures. If I remember rightly, during the election campaign the Prime Minister visited Chase Farm A and E department in London and Queen Mary’s A and E department in Sidcup, promising to stop their closure.

[Siobhain McDonagh]

And Kingston, too.

[Mr Thomas]

Yes, and Kingston, too. Both Chase Farm and Queen Mary’s A and E have either closed already or are earmarked for closure this autumn.

My hon. Friend the Member for Ilford South (Mike Gapes) referred to the planned closure of A and E services at King George hospital in Redbridge, and Epsom and St Helier hospital in Sutton, which has also been mentioned, is also set for closure.

We have all heard about the scandal of the events in Lewisham, where doctors do not support the closure of the A and E department, but it is still going to close. I thought the whole point of the recent NHS Act was to give doctors control over service delivery. That has clearly gone out of the window now.

[Heidi Alexander (Lewisham East) (Lab)]

My hon. Friend mentioned the hospitals the Prime Minister visited before the election whose A and Es he promised to retain. Of course, in 2007 he also said that he would get into a bare-knuckle fight over the future of Lewisham hospital. Does my hon. Friend agree that the Government’s A and E policy seems somewhat hypocritical?

--- Later in debate ---

[Mr Thomas]

There certainly seems to be little obvious sign of any bare-knuckle fighting on the Prime Minister’s part to stop the closure of Lewisham A and E or, indeed, the other eight departments set for closure in London.

I want to concentrate the rest of my speech on the plans at North West London Hospitals NHS Trust. As the hon. Member for Ealing Central and Acton said, there are plans to shut Ealing, Charing Cross, Hammersmith—it is good to see my hon. Friend the Member for Hammersmith (Mr Slaughter) here—and Central Middlesex A and E departments. My constituency is served by Northwick Park hospital A and E department, and my constituents are worried about the pressure that the closure of the four other A and E departments in the area will put on Northwick Park when all the extra people turn up there needing treatment.

Clinical teams at the north-west London trust have noted that the strategy behind the proposed closure of the four A and E departments assumes that thousands of people can be persuaded not to go to A and E but instead to use their GPs and other community services. I am a little sceptical about the idea that that will work, not least because the numbers using Northwick Park A and E are already significantly greater than before the 2010 election.

One element of the strategy, to prevent the possibility of patients who shift to Northwick Park not getting the services they need, is, as I said, to use community services. The decision to downgrade the Alexandra Avenue polyclinic, a walk-in service open 8 am to 8 pm, 365 days a year in the south Harrow part of my constituency, to just Saturday and Sunday opening, 9 am to 3 pm, has led to greater use of Northwick Park hospital A and E, as a number of doctors have said. So the decision to close that polyclinic, supported, incidentally, by the Conservative party in Harrow, seems particularly surprising, given the appetite for community services to solve the problem of lots of people potentially going to Northwick Park A and E.

[Nick de Bois]

To put this in context, it is clear, having read Hansard, that both this Government and the previous Government supported reconfiguration on the basis of more people being served in the community, and that is probably not a bad thing. However, it is not just a question of having the infrastructure, the buildings and the clinical staff, but of imploring people to make a cultural change. One cannot do that easily and quickly, particularly between generations. So although both this and the previous Government agree that reconfiguration is important, my concern is that they have not taken the people with them.

[Mr Thomas]

On that very specific point, I agree with the hon. Gentleman. What feels different about the context in which we are having this debate is the sheer number of A and E departments whose closure is envisaged.

If the hon. Gentleman and others will forgive me, I will return to the issue of Alexandra Avenue polyclinic and how it helped to divert people from using the A and E department at Northwick Park. I urge the new Harrow clinical commissioning group to reopen Alexandra Avenue as a proper walk-in service, or to find an alternative site for such a facility in order to reduce the pressure on Northwick Park. The last figures that I saw showed that in fewer than 12 months, from April 2011 to February 2012, the number of people waiting more than four hours at Northwick Park and Central Middlesex hospitals’ A and E departments had risen to more than 9,000. A total of 9,137 people in that 10-month period had waited more than four hours for treatment. What is far from clear is whether there is a clear clinical strategy across London that has the confidence of doctors and of the public—that point was raised by the hon. Member for Enfield North (Nick de Bois)—to really drive down the pressure on A and E departments in the future.

Already, too many people in London have had to wait in ambulances for longer than 30 minutes; that happened to 42,248 people in 2011-12, a rise of almost 50% on the previous year. Some 10,000 people had to wait more than 45 minutes to get into the A and E departments across London; they were sitting in the ambulance waiting. As my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) said, the UK Statistics Authority has pointed out that the Prime Minister has broken his promise to protect NHS spending. It is clear that the NHS in London is under unprecedented pressure, because of the Conservative party’s squeeze on NHS funding. A Prime Minister who once promised to stop A and E closures is allowing nine to go ahead across London. Once again, that old adage is being proved true, “Same old Conservatives. You can’t trust the Tories with the NHS.”

[Several hon. Members]

rose—