Child Care (London)

Debate between Heidi Alexander and Nick de Bois

Wednesday 19th March 2014 Westminster Hall

[Nick de Bois]

I will, as I said, come on to the issues that we are facing in my constituency. However, the work force, on the supply side, is equally as important as the facilities. If the numbers halve, the problem of servicing good quality child care provision will be increased.

I suspect that we would also agree that the quality of the work force is important. That is unquestionable. We do not want to create places just to dump a child in, so that people can go off and have some free hours; no one is into that. We need good quality care. I am sure that the Government’s aims and attentions in this regard would draw cross-party support, because Opposition Members would have said, and tried to do, the same.

We can do things to open up the supply side. I do not generally like to intervene in markets, but we should try to work up constructive ways for the Government to apply leverage to encourage schools to admit younger children. We have to deregulate the process of allowing schools to admit younger children. We made it easier for schools to teach children under three by removing requirements to register separately with Ofsted, a move that was well intentioned, but we do not want to make it difficult. So often, by liberating certain elements of the market, we can free it up and increase the supply side.

On helping schools to offer affordable after school and holiday care, I want primary schools to be open for more hours each day—so does the hon. Member for Lewisham East—and for more weeks a year, to better match the working family’s time table. That can be done locally and I am all for empowering people locally to take those decisions—and, boy, are they needed in my constituency.

We should also be helping good nurseries expand, not stopping them. I would be interested to know whether the Minister is working with councils to explore ways that we can expand the supply side in the boroughs, particularly those that are challenged.

[Heidi Alexander]

The hon. Gentleman is talking about the need to expand nurseries, some of which will, of course, be co-located with schools. Does he recognise that the crisis in primary school places in London, which we discussed earlier, means that the physical expansion of nurseries is even more difficult now than it may have been in the past, because sites are taken up with temporary classrooms and the space does not exist?

[Nick de Bois]

The hon. Lady takes me down a path that I am quite interested in, because we have faced an expansion in primary schools, which unfortunately was not planned in advance. I know that London has transition problems, so it is more difficult to plan in London than elsewhere, but some of the planning that we have done has been to meet an urgent, immediate need for the next year, and we could have used the space much better in some primary schools in my area. We need to free up the planning regulations to make sustainable expansion that much easier. We have seen that done actively in schools. The hon. Lady may have encountered the same problem that I have—that temporary expansion encourages complaints from residents—when we try to meet extra demand in our area.

I often feel that we have missed out on long-term planning. If we could free up planning regulations and look ahead, a strategic plan would allow us to expand provision for both the younger child and the schoolchild. I should add that the problem is not just with primary; we are now passing it on to secondary, and that will be the next challenge.

NHS Funding

Debate between Heidi Alexander and Nick de Bois

Wednesday 12th December 2012 Commons Chamber

[Heidi Alexander (Lewisham East) (Lab)]

It is a pleasure to follow the measured and thoughtful speech that the hon. Member for Stevenage (Stephen McPartland) has just given. May I also put on the record my tribute to my right hon. Friend the Member for Cynon Valley (Ann Clwyd) and the vital work she is doing, at what must be an incredibly difficult time for her, on putting the importance of care and compassion back at the heart of our NHS?

I wish to focus on the current threats to NHS services in south-east London. My right hon. Friend the Member for Lewisham, Deptford (Dame Joan Ruddock) has already spoken about the threats to Lewisham hospital and the plans on the table, and I am going to treat the House to my own concerns about that matter. We are rightly debating national expenditure levels on the NHS today, but the harsh reality in Lewisham is that my constituents are confronted with the fact that their local accident and emergency and maternity departments may have to close in order to deal with financial pressures elsewhere in the NHS.

The Government can claim all they like that they are investing in the health service, but it does not feel that way in Lewisham. Last Friday, along with local doctors, my right hon. Friend the Member for Lewisham, Deptford and my hon. Friend the Member for Lewisham West and Penge (Jim Dowd), I presented a petition against the closure of Lewisham’s A and E and maternity departments to No. 10 Downing street. As has been said already, in five weeks the petition has been signed by more than 32,000 people. The proposed changes at Lewisham hospital are not only unwanted, but arguably unsafe and unjustified.

Lewisham is a busy hospital. More than 120,000 people visit the A and E each year and last year more than 4,000 babies were born there. Lewisham is a place where average life expectancies for both men and women are below national averages. Sadly, it is a place where sometimes, admittedly infrequently, a stab victim will walk into the A and E from the streets and a place where many teenage girls will give birth to their babies.

The A and E and maternity departments at Lewisham hospital are a matter of life and death for many of my constituents. I am therefore not surprised that more than 32,000 people signed the petition to keep a full A and E and full maternity service there; I am also not surprised that more than 100 local GPs, including the chair of the new clinical commissioning group and the head of every single clinical group at the hospital, have written to the Prime Minister to express their concern about the proposals.

The question for the Minister today is: will the Government listen? Will the special administrator to the South London Healthcare NHS Trust, a man appointed to sort out financial problems in neighbouring hospitals, think again about his plans for Lewisham when he draws up his final recommendations to the Secretary of State for Health?

I do not think that anyone can be under any illusion about the degree of local opposition to closing the A and E and maternity departments at Lewisham. I recognise that trying to balance the books at the South London Healthcare NHS Trust is a hard job, but asking a hospital that is not even part of the trust to pay such a heavy price seems patently unfair.

The plans for Lewisham are based on inaccurate data and flawed assumptions. The size and nature of the caseload at Lewisham’s A and E have been misunderstood. The estimated additional journey times to neighbouring hospitals have been woefully underestimated, yet the speed with which it will be possible to reduce the need for hospital care seems to be hopelessly optimistic and based more on wishful thinking than on hard fact.

Those are not the only problems with the proposals. I also cannot see how the current plans make financial sense. In the past week, we have had—even though the Government dispute this—independent verification that there has been a real terms reduction in spending on the NHS in the past few years. Surely it then becomes all the more important that every pound spent is spent wisely and well. How can it be wise to sell off more than half the Lewisham site for £17 million only to have to reinvest £55 million in reconfiguring the remaining buildings on that site to do different types of work? Why sell off the existing buildings, only to shell out money at other hospitals to increase capacity to enable other parts of the NHS to do the work that Lewisham is already doing very well?

The 4,000 babies who are born to Lewisham mothers every year will have to be born somewhere. Where? There is no free capacity in the system at the moment, so that will require investment. Where are the people who use Lewisham’s A and E going to go? We have all seen the reports of more and more ambulances queuing outside hospitals, with patients waiting to be taken into A and E but being kept in the ambulance because of a lack of space.

It is asserted that in Lewisham, if the proposal to close the A and E went ahead, only one in four people would have to go to other A and Es, while the other 77% would still be treated in the urgent care centre that would remain. That figure is fanciful. The emergency doctors at the hospital say to me, based on their analysis of patient numbers and the nature of the work that they do, that just 30% of people could still be treated at the urgent care centre.

I accept that the NHS cannot be preserved in aspic and I understand that it must change to meet the demands and challenges of the 21st century. However, those changes must be driven by patients’ health needs, not an accountant’s bottom line. That is not what is happening.

[Nick de Bois (Enfield North) (Con)]

The hon. Lady may be aware that we have had a long fight against the downgrading of my hospital, Chase Farm. Many people think that that fight is over, but I do not. With the new demographic figures and population increases in London, it is important that we continue to press authorities and Ministers to take these things into account, even at this late stage, because where people go is even more of a priority than she assessed it was before the figures came out.

[Heidi Alexander]

The hon. Gentleman is completely right. Lewisham’s population is growing, and has increased by 10% in the past 10 years. All the indicators suggest that London’s population will continue to grow. It is a diverse population with varied health needs, so it is imperative that people in our capital city can access high-quality services close to home.

In conclusion, before the election, the Prime Minister told us that he would cut the deficit and not the NHS. In 2007, he promised a bare-knuckle fight over the future of services at Lewisham hospital. How times have changed. He has broken his promises on NHS spending and he has broken his promises about Lewisham hospital. If anyone needs proof that the Government cannot to be trusted with the NHS, they need look no further.