NHS in London

Debate between Heidi Alexander and Bob Blackman

Thursday 24th March 2016 Westminster Hall

[Bob Blackman]

I will come on to a CQC report on the Royal National Orthopaedic hospital in my constituency in a minute. The reality is we can pick and choose from CQC reports, but I want to ensure that the brilliant doctors, nurses and support staff who work in Northwick Park hospital are recognised for the work they do and not the fear, uncertainty and doubt created by Opposition Members about the performance of an outstanding hospital.

I will move on to the Royal National Orthopaedic hospital in my constituency. The Minister knows about this subject extremely well. The reality is shown in the most recent CQC report, which I will quote directly. It said that the hospital has

“Outstanding clinical outcomes for patients”

in premises that were—and are—

“not fit for purpose—it does not provide an adequate environment to care and treat patients.”

I could not have put it better myself. The reality is that, over the past 30 years, under Governments of all persuasions, we have heard promises to rebuild the Royal National Orthopaedic hospital. The medical and support staff there do a brilliant job; if I took you to that hospital, Mr Turner, you would see for yourself. They are treating patients in Nissen huts created during the second world war. It is an absolute disgrace that staff have to operate in such dreadful facilities. They do brilliant work to rehabilitate patients who come in crippled and leave much better able to live a decent-quality life.

That is why I am concerned about national health service bureaucracy. Previous Governments have committed to funding. The Chancellor stood up at the Dispatch Box during the emergency Budget in June 2010 and agreed and confirmed funding to rebuild the hospital. None the less, we still drag on. It is nothing to do with the Government; it is NHS bureaucracy. I will not go through all the details of everything we and the board have had to do to get to the point where the hospital can be rebuilt.

We have a plan. The hospital will be completely rebuilt. We will have a private hospital alongside the NHS hospital, so that consultants and medical staff will not have to leave the site to do their excellent work. We will sell off part of the land for much-needed housing. Instead of selling it off as a job lot, we will sell it off in tranches to ensure that we get the best value for money, and then the money can be reinvested in the national health service, in the hospital itself.

One would think that, if someone came up with a plan like that, the NHS bureaucracy would be leaping to say, “Yes, let’s get on with it.” Instead, we have had report after report, and business case after business case. I will not, as I did once in the Chamber, describe the 11 stages of the business case that a hospital must go through to get approval for finance. More money is spent on management consultants producing reports than on hospital consultants delivering health services.

[Heidi Alexander (Lewisham East) (Lab)]

I think I agree with the hon. Gentleman on that last point. In last week’s Budget, the Government shifted more than £1 billion within the NHS from the capital budget to the revenue budget. How does he think that helps deliver the kinds of building that we need to provide health services in the 21st century?

[Bob Blackman]

Clearly, the Government must balance the capital and revenue budgets and ensure that they and the national health service are fit for purpose. I believe passionately that it is wrong to expect our medical professionals and brilliant staff across the health service to operate out of substandard buildings. The more that we do to improve them, the better.

As the Minister will know, I have been agitating on this issue for the past six years. I will not stop until we get what we deserve—a rebuilt hospital of which we can all be proud. The reality is that the NHS Trust Development Authority, which seems to dictate finances within the national health service, is holding up this prestigious project. The hospital now has planning permission, and we are ready to go. Immediately on approval by the TDA, demolition of the existing buildings will start, and work will begin on the new hospital in June or July this year. However, the TDA has yet to approve. We now have a further eight-week delay while the TDA looks again at the business case to see whether it is justified. The staff, patients and everyone connected with the hospital are growing frustrated as a result of what has happened over not just the past six years but the 30-odd years before it as well.

We seek assurances from the Minister that the prevaricating TDA will be leaned on to give a decision, which will be to the benefit of the hospital, the patients and the health service in London and nationally, so that we can ensure that this brilliant hospital continues with its great work. I apologise that I will not necessarily be here to hear the Minister confirm the good news that she will do all that she can to make that happen, but I will sit down—

Regeneration

Debate between Heidi Alexander and Bob Blackman

Thursday 19th April 2012 Westminster Hall

[Bob Blackman (Harrow East) (Con)]

It is a pleasure to serve under your chairmanship for the first time, Mr Howarth, and to contribute to this important debate, the topic of which has been the subject of detailed consideration by the Select Committee. It is pleasurable that eight members of the Committee have been able to be here and that other MPs have chosen to participate. I remind Members that we are debating the Select Committee’s report in response to the Government’s published strategy. We have had the opportunity to hear of a great bid for funding for Erewash, and of greater reviews of Northampton and Cleethorpes, but I want to bring us back to the strategy and to what I believe should happen.

A problem in the past has been that with every change of Minister—whatever the Department has been called—there has been a new initiative. In my view, there has never been a proper evaluation of what succeeded and what failed, what was good and what was bad, and whether we could learn lessons. Historically, when Governments have succeeded one another, they also have failed to do that. I am a strong supporter of the Government and of almost everything they do, but I believe that there has been a missed opportunity with the strategy, and I hope that we can persuade my right hon. Friend the Minister that there needs to be much more of a proper strategy for regeneration.

As a veteran of local government, I go back—beyond some others—to the urban programme and the damage that it did, with small amounts of funding that had huge strings attached. It was not really successful, and we still bear the scars across the country. There has been a whole series of schemes, but time does not permit me to go through them all, and I would lose everyone to boredom were I to do so.

The problem is that regeneration is not just about replacing people’s houses. Someone can be given a decent place to live and that will be an improvement, but have they been given a job? Have they been trained to get a job? Has their health been improved? Have the life chances of young people been improved, so that they can get a job in their environment? Has it been ensured that the education system is right and that we have true equality of opportunity, so that people can aspire to be the best they can? Has there been the opportunity for the private sector to invest and create jobs? Without all that, spending on any single strand—whether housing, training or education—is almost wasted money. We need what I call wholesale regeneration of areas, rather than the picking off of little bits and pieces. That is one of my greatest concerns about the position regarding the Government’s strategy.

During the Select Committee inquiry, we considered successful and less successful regeneration schemes, and drawing strengths from the successful ones will start to lead us to what the strategy should be. There are limited resources, and I gently remind Opposition Members that the Government inherited a huge deficit, with one in four of the pounds that they spent having to be borrowed. There is no pot of gold to be handed out willy-nilly. However, it should be clear that if we have a regeneration strategy and Government funding is provided, competition is needed. Ministers should not simply dole out cheques for an area; people should come together as communities in partnership with the private sector and others to compete for the money that is available.

In addition, given the economic position faced by the Government, there is no doubt whatsoever that it will be extremely difficult to make revenue funding available, but the Government gave a commitment before the election to continue to fund the capital programmes and not to cut capital funding in the way that the previous Government planned. My hon. Friend the Member for Erewash (Jessica Lee) mentioned infrastructure, which is a key point. Often, the private sector wants to invest, but things—blockages—prevent it from doing so, and I well remember an example. On the site of Central Middlesex hospital in the London borough of Brent, 80 acres of prime industrial land were not going to be invested in. By using regeneration money, a new road was created and suddenly huge amounts of investment came in. Hon. Members can go and see that today. That investment dwarfed the amount of public money that came in. Therefore, a relatively small spend on an infrastructure project produced large-scale private sector investment.

[Heidi Alexander]

The hon. Gentleman is talking about the limited availability of money. I should like to ask him the question that he asked us earlier. With limited funds available, does he believe that they should be spent in the areas that are most likely to grow or in areas where the need is greatest?

[Bob Blackman]

That is a key point in the whole regeneration debate. My hon. Friend the Member for Rugby (Mark Pawsey) mentioned the evidence that we received from the London borough of Newham, where investment has been made in regeneration schemes for 30 years. When we forcefully asked the mayor of Newham whether that should continue and when we should stop public sector investment, he said, “We’d all dearly love to see it end, but just not now.” The view seemed to be that we will still invest in Newham for another 30 years and nothing will change. The housing will be nice, but the indices of deprivation will hardly have shifted.

My view is that if there are limited resources, they should be applied where the maximum gain can be achieved. We have to be honest about the situation and say that certain areas will not get funding because we will not get the most gain from them in terms of growth and opportunities. We have to concentrate the resources, as opposed to saying, “We’ll spread it thinly for everyone,” because by doing that nothing is achieved.

Local Government Finance Bill

Debate between Heidi Alexander and Bob Blackman

Wednesday 18th January 2012 Commons Chamber

[Bob Blackman]

The key is not that local authorities turn away business or prosperity; I am pointing out that there is an in-built presumption that areas of deprivation follow extra grant from Government. As a direct result, there has been hardly any change in areas of deprivation across the country. Despite the fact that local authorities—of all political persuasions—with areas of deprivation have had huge amounts of money put in over 30 or more years, those areas of deprivation remain the same.

[Heidi Alexander]

I am interested in what the hon. Gentleman is saying, because the implication is that local councillors and local authorities want to maintain deprivation in their areas because they get more money into their coffers. Is he really saying that? In my experience, local authorities and local councillors do the jobs they do because they want to make the lives of the people whom they serve better; they are not interested in getting money into their coffers to serve their own purposes.

[Bob Blackman]

I am not saying that councillors, council officers or local authorities of any persuasion deliberately decide that they want their areas to be deprived. I am saying that there is a perverse incentive for those areas to be deprived. The Bill changes that presumption. It will be for every local authority where there is deprivation to encourage and promote prosperity and businesses to set up in their areas, so that there is a deliberate move to create economic growth in areas that have been unfairly deprived for far too long.

--- Later in debate ---

[Bob Blackman]

That, of course, is local democracy—if people want to pay higher taxes, they are welcome to do so. I am personally a great advocate of annual elections to local authorities instead of referendums, so that if councillors want to raise local taxes exorbitantly they will be voted out at the ballot box. I therefore take the hon. Gentleman’s point.

[Heidi Alexander]

The hon. Gentleman has argued that incentives have not previously existed for local authorities to stimulate economic growth in their area. He is a distinguished former leader of a large London local authority, Harrow. Given that those incentives did not exist, did he not do anything in his time as leader to stimulate the local economy in Harrow?

[Bob Blackman]

I was actually the leader of Brent council, not Harrow, but I thank the hon. Lady for making that point. I was the chairman of a city challenge company that was part of the London borough of Brent, and for five years we had Government money flowing in. We retained every job that we had and expanded the number of jobs in the area, but by the end of the five years unemployment in the area had increased, not reduced. We had had huge amounts of money but, perversely, unemployment had risen, which meant that we could go back to the Government and say, “We need more money.”

Local Government Finance

Debate between Heidi Alexander and Bob Blackman

Wednesday 9th February 2011 Commons Chamber

[Bob Blackman]

My hon. Friend makes a good point. The reality is that the councils that planned ahead, knowing that reductions would take place, however draconian, are coping best. The councils that put their heads in the sand and said that it would never happen are being caught out. They are now being called to account. If councils have not planned ahead, they will suffer.

[Heidi Alexander (Lewisham East) (Lab)]

Like the hon. Gentleman, I represent a London constituency. My local authority faces cuts of £87 million over the next four years, out of a budget of £271 million. It is finding that difficult, having decided to protect care for the elderly and child protection, which amount to £109 million of the budget. It is a disgrace for him to suggest that it is a political choice for councils to look at other front-line services. Does he not agree that the scope for finding savings is limited, should councils choose to protect essential services for the vulnerable?

[Bob Blackman]

I thank the hon. Lady for that intervention. It leads me on to my menu of what councils should do. Have they eliminated unnecessary monitoring? Have they eliminated duplication and multiple handling of applications for grants and other such services? Have they reviewed senior officer pay? Have they co-operated with other local authorities to reduce costs by combining back-office services? Have they cut their communications budgets, or have they chosen to send out publications to the community on a regular basis? Have they removed vacant posts that are unnecessary? Have they rationalised their office space and found office space that is no longer required? Have they taken their efficiency savings seriously and delivered them year after year, or have they continued on the same basis as before? Have they got into smarter procurement and come together with other local authorities to use their buying power to reduce their costs? Have they considered a long-term plan anticipating all the reductions? If authorities have done all those things and still have problems, then it is right that they approach the Secretary of State for help and advice on how to construct their budget at local level, but not until then.

This Government and our Front-Bench team have produced a set of figures and budget proposals that can be supported and that will be recognised in the years to come as a dramatic step forward in ensuring that people get proper value for money in the local services that are delivered to them. I ask that we consider how more money can be raised locally through the transitional business rates and in other such ways, and I ask that we consider how to deal with deprivation in future. It is a disgrace that has gone on for far too long that the deprived areas of the country have consumed more and more money, yet continued to be the deprived areas. That cannot be right, and we have to put it right.

I also urge Ministers to continue the process of helping councils to freeze council tax not just for one or two years but on a continuous basis, so that hard-pressed tax payers do not suffer any penalty as a result of the actions of the councils that operate their services. We can all applaud our Front-Bench team for the work that they are doing.