NHS Services (Access)

Gavin Shuker Excerpts

Wednesday 15th October 2014 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

I make no apologies for addressing my comments to the latest developments in the “Shaping a healthier future” programme, the comprehensive reorganisation of health services that is affecting 2 million people in west and north-west London. It constitutes the biggest hospital services closure programme in the history of the NHS, and I believe that it will be the prototype for similarly draconian cuts if the current Government are, by some misfortune, re-elected.

The programme was two years in planning—in secret—and was announced in June 2012. It involves the closure of four of the nine accident and emergency departments in the area, and the closure, effectively, of two major hospitals. It affects both A and Es in my constituency and, indeed, the complete demolition of Charing Cross hospital, one of London’s major hospitals. At the time, all but 3% of the land on which that hospital stood was to be sold off.

There followed two years of confusion, phoney consultation, buck passing and false information, and decisions were taken by primary care trusts that were then abolished the following month. The original scheme was so incompetent that the business case was delayed for more than a year. It emerged last month, and now requires 50% of the Charing Cross land to be sold, as well as 50% of the land at St Mary’s, Paddington. However, it still requires £400 million of borrowing to be approved by the Treasury, despite the fact that the trust—Imperial College Healthcare NHS Trust—cannot manage its finances from one month to the next.

Exactly a year ago, the Secretary of State announced in the House that the Hammersmith hospital and Central Middlesex hospital A and Es should close as soon as was practicable, and that in fact happened on 10 September this year. Two A and E departments closed in one day, with people who attended them being told to go to Northwick Park and St Mary’s hospitals. Four days later, The Mail on Sunday reported in relation to Northwick Park:

“An accident and emergency unit criticised in an official report for being unsafe and unable to cope with demand is set to be swamped with thousands of extra patients—thanks to emergency department closures elsewhere. The Chief Inspector of Hospitals painted a picture of chaos at ‘very busy’ Northwick Park Hospital in Harrow, North-West London, after a recent visit. But its A&E will soon have to deal with at least 8,000 more patients a year due to the controversial closure of two London units last week.”

How that can be said to be a practicable and safe decision, I do not know. At the trust’s annual general meeting two weeks later, the chief executive—newly arrived from Australia—told people that they should not rely so much on A and E departments. Well, they do not have a great deal of choice in my constituency.

Is closing two neighbouring A and E departments enough? Clearly not, despite the fact that GP and community services are also being cut—I wish I had the time to go into that in more detail—because the closure of Charing Cross hospital A and E is being persisted with. That hospital is still due for demolition and downgrading. The current plan is for it to lose all but 24 of its 360 in-patient beds, its emergency surgery unit, its intensive therapy unit, its stroke unit and of course its A and E, which will leave only primary care treatment and day surgery on site.

[Gavin Shuker (Luton South) (Lab/Co-op)]

My hon. Friend, alongside his local party, has mounted a truly impressive campaign to protect those services. Government Members say that they are the defenders of the NHS. What action has been taken locally by other political parties to support him?

[Mr Slaughter]

The Conservative party fully supports the closures of the A and E departments. When it ran the local authority—fortunately, it no longer does so—it simply put out disinformation about whether the service closures would or would not take place. It is only because of the actions of local residents that my constituents know exactly what is happening.

Worse than that, on 15 May the Prime Minister came to my constituency for one purpose and one purpose only—to go into the basement of the Conservative party offices and give an interview to a local journalist, in which he said that Charing Cross hospital would retain its A and E and other services, and he then left. That was of course one week before the local elections. On 7 September, The Mail on Sunday, which I now regard as the paper of record on this issue and which has fought a strong campaign on behalf of A and E departments, reported the following:

“A casualty unit that David Cameron personally promised would stay open is due to be closed, The Mail on Sunday can reveal. Days before council elections in May, the Prime Minister visited Hammersmith in London and stated that Charing Cross Hospital in nearby Fulham ‘will retain its A&E and services’. But the organisation that runs the hospital intends to close the department and replace it with an ‘urgent care centre’, NHS papers show. Urgent care centres can be run by GPs and nurses rather than A&E consultants, and have far fewer facilities to care for the seriously ill or injured.”

I do not think that I need to explain that any more. The Prime Minister, for the purely party political reason of supporting a Conservative local authority that he has described as his favourite, did not say what was factually correct.

If they were not so disingenuous and incompetent, I might have some sympathy for those at the trust because, under instruction from their political masters, they have to argue against themselves. On 7 October, they came to answer questions from the scrutiny committee of the local council. They were asked about Charing Cross hospital and said that, in future, it will have

“emergency services appropriate for a local hospital”.

They were cross-examined on that issue and could not amplify their position, so we are none the wiser. However, we do know that a hospital that has only primary care and treatment services cannot sustain an A and E department. In the interests of safety, as well as honesty, it would be better if that was admitted to my constituents.

I will end with the beginning of a letter that is in the Evening Standard today. It is from Anne Drinkell, who is the admirable secretary of the “Save our hospitals” campaign in Hammersmith and a former community matron. She says:

“You highlight the pressures that closing A&Es at Hammersmith and Central Middlesex hospitals put on surrounding emergency departments. God help us if plans to close Charing Cross A&E go ahead. Imperial NHS Trust’s management seems in chaos, with leaked internal memos detailing cuts in acute beds and a mounting deficit. It has been unable to provide a clear description of what future ‘emergency’ care at these sites would look like. A notice on the back door at Hammersmith still advises patients to take sick kids to the now-closed Central Middlesex A&E”.

She ends by saying:

“We ask North West London NHS for a moratorium on closures until they consult on plans for change based on clinical need, not budget cuts.”

Is that an unreasonable request?

--- Later in debate ---

[Gavin Shuker (Luton South) (Lab/Co-op)]

Many hon. Members on both sides of the House have talked about their personal experiences of the NHS, and movingly about the care that they and others have received. It might not have escaped the House’s notice, but I am statistically one of the least likely Members to access NHS services, being under the age of 40—[Interruption.] I hear disparaging remarks about my size coming from my left, but I will ignore them.

I was extremely grateful to receive incredible care for my wife and child when Ruby, my daughter, was born last year, and got to see, incredibly and movingly, the dedication of NHS midwives, doctors and other staff as well.

I am hugely moved as well by the fact that locally in the seat I represent in Luton we receive fantastic NHS care. We have Luton and Dunstable hospital, and we were pleased to welcome the Darlington mums who had marched down to Whitehall to protest about the changes to the NHS when they came through Luton. They made many of the points I want to make today. They, as members of the general public, were able to articulate what I do not believe many Members across this House could: the depth of passion people feel for the NHS.

I would just say this. A number of different contributors today have talked at length about statistics and churned out figures, but for me there is one stand-out statistic from this Parliament: the level of patient satisfaction in the NHS. We can talk until we are blue in the face about which target should be met and which target should be missed, but it speaks volumes to me that the highest ever level of patient satisfaction was in 2010 when this Government came to power and it has dropped since then. That should cause us to ask profound questions, because we understand that a new top-down reorganisation of the NHS can only do one thing, which is distract from patient care. That is the experience in this Parliament.

People forget that the NHS is not a series of services that can easily be bolted together. It is more a network or a system, and just as Beeching wielded his axe and chopped up different parts, compartmentalising and fragmenting the railways, so we must be aware of the lessons of history when it comes to fragmentation in our NHS system. It is the role of us in this Parliament not just to protect our own local services or seek to move forward with the amazing new treatments that exist now, but to protect the legacy of the NHS over the last 70 or 75 years.

Will this Government talk about the massive error that was the reorganisation of the NHS in this Parliament and allude to two others? The starvation of funds by the Tories in the ’80s and ’90s that had to be put right by a Labour Government in 1997, who saved the NHS, is the second, and opposing its creation in the first place was the Tories’ original sin on the NHS, but they seem not to have learned that lesson. They continue to make this mistake, and it has led to 440 new organisations in the NHS, tying up hospitals in competition law, with 4,000 staff laid off and then rehired. Is this not the waste we have talked about in our system—the waste that could be repurposed for better patient care, and a rise in patient satisfaction as well?

We need a clear plan for putting this system back on track, because of the many shortages and the rationing we have seen in the system. The first plank of that plan, advocated by my right hon. Friend the Member for Leigh (Andy Burnham), is to be clear about our plans to repeal this damaging Tory NHS Act that has done so much damage in this Parliament. I am glad to hear that in five weeks each of us in this Parliament will be asked to cast our votes for the repeal of the most damaging aspects of this legislation, and I pledge to my constituents that I will not be found wanting when that comes. We must also exempt the NHS from the transatlantic trade and investment partnership, make sure the extension of competition law that has led to a massive acceleration in privatisation is curbed, increase NHS spending by £2.5 billion a year in a sustainable way to make sure the NHS has time to care, and hire 36,000 new nurses, doctors and midwives.

That is the expectation that will fall to us in the next Parliament, but in this Parliament there is also something that needs to be done. Government Members must admit publicly, not just privately, their error in going about this reorganisation, and commit to the funding that is going to be required. We all accept that there are no easy solutions, and politicians can sometimes get wound up in all sorts of knots trying to defend services that should be reconfigured. I fully accept that. But, fundamentally, we are the custodians and the guardians of the greatest mechanism against social inequality and the greatest mechanism to attack health inequality head on. The national health service is an institution rightly held in high regard by the people who believe they own it, not those who are asked to be its custodians. It is the crowning achievement of the 1945 Labour Government. It needs to be rescued by successive Labour Governments after Tory Administrations. The NHS demands nothing less.