Princess Royal University Hospital

Heidi Alexander Excerpts

Wednesday 25th March 2015 Westminster Hall

[Heidi Alexander (Lewisham East) (Lab)]

I am very grateful for the opportunity to make a short contribution today, and I congratulate my hon. Friend the Member for Lewisham West and Penge (Jim Dowd) on securing the debate. I also thank him for sharing his time with me so that I can put on record my concerns about the challenges facing the Princess Royal and other hospitals in south-east London.

When I first learnt about the Monitor investigation into the PRUH a few weeks ago, I was worried, like my hon. Friend, that we might be witnessing the start of another process that would end up with Ministers or NHS officials wanting to close Lewisham’s full A and E. I was worried because, as he has said, we have been here before. Problems in a neighbouring hospital trust, of which the PRUH was then a part, resulted in NHS bureaucrats casting around, on the look-out for ways to save money.

It is understandable that my constituents might be suspicious about the latest investigation, given their experience a few years ago with the trust special administration process, which, as we all know, had at its heart an ill-judged and illegal attempt by the Government to close services at Lewisham in order to sort out problems at the PRUH and the Queen Elizabeth hospital.

The Minister may tell us today that this process is entirely different, but it would be helpful if she could set out exactly what the process is limited to, the time scale of the process and what change could come about as a result of the investigation. Is it about giving King’s and the PRUH more money to adequately provide the services that are needed? Is it about changing leadership at the hospital or providing specific types of support? When the investigation is concluded, how will local people know what has been proposed? Will we, as local Members of Parliament, get a copy of Monitor’s full report? Could another trust special administration process be triggered?

I am keen to get answers to those questions. Although we successfully fought the Government’s proposals for Lewisham hospital last time around, the Government have since changed the law. They can now use a rushed and chaotic process to force service closures at any hospital in the country as long as they deem the neighbouring hospital trust to be failing. Given that cynical move by the Government, it is little wonder that among my constituents there is considerable anxiety that the proposals to take services away from Lewisham will rear their head again.

I tell the Minister, for the sake of clarity if nothing else, that the people of Lewisham are adamant: no matter what the problems in neighbouring hospitals are, our full accident and emergency and maternity departments are essential local services that we cannot do without. I am not saying that everything is perfect, but when there are such huge pressures on the system, such as those we saw in the winter, my constituents are right when they say to me, “Just think how much worse it would have been if they had closed Lewisham.”

There are enormous pressures on London hospitals, and the situation is getting worse. At the PRUH, according to the chief executive’s January board report, one in four people who attended the A and E there in December were not seen within four hours. The latest weekly figures for both the PRUH and Lewisham hospital show a much lower percentage of patients seen within four hours than this time three years ago. We know that the PRUH is heavily reliant on nursing agency staff because of recruitment difficulties. That has resulted in an overspend on its staffing budget. I could list other problems, but time is short.

Suffice it to say, the system is under increasing pressure, and that has happened on this Government’s watch. When I first stood to be a Member of Parliament five years ago, the NHS hardly ever came up on the doorstep. It now comes up time and again. When I get an e-mail from a constituent telling me about their elderly neighbour being left waiting hours for an ambulance to turn up, waiting hours on a trolley to be seen in A and E and then waiting hours to be given a bed, I know that something is seriously wrong with our health service.

Will the Minister give us her honest assessment of the state of hospital services in south-east London? Will she set out exactly what her Government are doing to resolve the problems and give us categorical reassurance that the latest investigation into the Princess Royal hospital is not just another attempt to come after services in Lewisham?

--- Later in debate ---

[Jane Ellison]

I have just made clear for the record what Monitor’s powers are and are not. I hope that that gives Members on both sides of the Chamber greater clarity than they had when we started. Monitor is in the process of concluding its investigation. It will announce in due course the outcome and whether it will take any further action. Key findings and any next steps will be announced by means of a press notice. Colleagues from Monitor are here in the House, and I would like to put them on notice that I expect—I am sure that they also expect this—Monitor to engage fully with local Members. Clearly, we are entering a more tricky period from that point of view, but on the other side of the election I expect there to be full engagement with local Members, particularly as the solution lies, as I think it will in other health economies that are challenged, in the whole local health economy coming together to understand how to work through the problems. That is laid out in NHS England’s “Five Year Forward View”.

[Heidi Alexander]

The Minister talks about further support that may be available to King’s and the PRUH when Monitor has concluded its investigation. Will she give some examples of the form that that support may take?

[Jane Ellison]

If it is acceptable to the hon. Lady, I will write to her to provide some clarity on that. It might be helpful, for example, for Monitor to give examples from other investigations of the sorts of things that it undertook and the changes that it requested through the formal process. I will write to her with some examples to give her a sense of that. I have sought to give a degree of reassurance to Members, and I hope that I have managed to do so.