NHS in London

Debate between Jane Ellison and Andy Slaughter

Thursday 24th March 2016 Westminster Hall

[Jane Ellison]

We have been clear that we have given a large amount: £3.5 billion has been made available to local authorities for social care. Ditto on public health—we will spend £16 billion over the next five years. If I have time, I will come to the good point that was made earlier about the move to business rates retention. It is matter of record that the Government committed at the election to what the NHS had asked for in the five-year forward view, and we will continue to make that commitment.

The London health system—CCGs and provider trusts—has planned for a deficit in 2015-16 of about £350 million, and overall the system is expected to be in that position. Some recovery is expected during 2016-17, and I am sure we will debate that again. In addition, a £1.8 billion sustainability and transformation fund is available, designed to address provider deficits in 2016-17. However, I think all Members would accept that additional Government spending is not the only answer to the challenges faced by the NHS. We have taken action with our arm’s length bodies to support local organisations to make efficiency savings and reduce their deficits, but much of the change Members have talked about is driven by desire to get better healthcare rather than to make savings. If we can make savings as well, that is all to the good, because we can reinvest them in great healthcare.

In London, from early April, the new NHS Improvement body will be providing additional expert support and capacity to trusts experiencing particular financial challenges. That support will include identifying and implementing financial improvement and helping them to identify savings to put them in a stronger position to maintain those savings.

Let me talk about the pressures on urgent and emergency care. It is acknowledged that the urgent and emergency care system faces increasing pressure. More and more people are visiting A&E departments and minor injury units, which is stretching their ability to cope. Members listed some reasons for that in their speeches. A lot of visits are unavoidable, but some people are visiting because of inconsistent management of long-term health conditions, difficulty in getting a GP appointment or insufficient information on where to go.

Winter sees an even bigger rise in visitor numbers and pressure on staff. Although the debate inevitably dwelled on Members’ concerns about their local healthcare systems and problems in them, I am sure we all want to place on record our huge thanks and praise, as many have, to the staff of London’s NHS, who work extremely hard under a lot of pressure and delivering some really good results against that backdrop. I will come on to that.

London’s A&E units have been significantly challenged this winter, and that has been reflected in performance. However, despite those pressures, the capital’s urgent and emergency care system has proved its resilience, with fewer serious incidents declared than in previous years. This winter, London accounted for just three out of 625 serious incidents declared across England. It is important to praise the staff in saying that.

In January, London’s performance was significantly higher than all other regions, with 90% of patients seen within the four-hour A&E standard. London is also the highest-performing region in England this year to date, with 93.1% of patients seen within the four-hour standard. My thanks and congratulations on that improved performance go to the hard-working staff of London’s services.

Reconfiguration schemes have loomed large in the debate. The health needs of people in London are changing and demands on health services are increasing. The hon. Member for Ilford South in his excellent speech illustrated through his personal stories some of the reasons for the changes in the shape of our health service in terms of how we are investing in specialist services and centres of excellence. The work done to centralise stroke expertise was brought up earlier in the debate. I remind Members, although many will remember, that those changes were bitterly opposed by many people. I am not sure whether that includes anyone in the Chamber, but it certainly includes campaign groups. However, all our London clinicians now say with certainty that those changes, with centralised expertise and specialist care, have saved many lives. That is always worth reflecting on.

People are living longer, the population as a whole is getting older and there are more patients with chronic conditions. We often say that people are living longer, but we forget to say that they are living with chronic conditions for longer, and that presents a longer-term challenge than might be seen at first sight. Heart disease, diabetes and dementia will all increase as they are conditions associated with an ageing population.

We did not dwell on the prevention agenda, but I was delighted that the hon. Member for Edmonton (Kate Osamor) spoke about it. The shadow Secretary of State also touched on it when she mentioned dementia and the problems we all know of older people in hospitals. I urge her to look at the dementia implementation plan we published on 6 March, which is a detailed response to the Prime Minister’s 2020 challenge. Dementia has sat in my portfolio since the election, and that plan is a detailed look at how we deliver against that challenge and in particular at the joined-up care that is key to ensuring that people with dementia have safer and better care in our system and are kept out of the acute sector whenever that is possible.

In a number of areas across the capital, the local NHS has concluded that the way it has organised its hospitals and primary care in the past will not best meet the needs of the future. We are clear that the reconfiguration of front-line health services is a matter for the local NHS, tailored to meet the local population’s needs.

I was glad to hear that Members recently met with Anne Rainsberry. The Members who came to the cross-party “Shaping a Healthier Future” meeting last summer will know it is vital that officials at all levels and NHS managers engage with elected Members. I was therefore disappointed to hear what the hon. Member for Eltham (Clive Efford) said. I will ask my officials to look into that. A number of Members asked reasonable questions about why they could not have certain bits of information. I have some specific answers and it may be that we can take a moment after the debate and I will point them in the right direction.

[Andy Slaughter]

I am grateful for what the Minister has said. If she could give an indication to health officials that we must have an open review of where we are with “Shaping a Healthier Future”, look at the implementation of the business plan and consider the Mansfield commission report, which really just asks questions along those lines, it would be very useful indeed.

[Jane Ellison]

We have had the time, during a three-hour debate, to make inquiries, so I will perhaps give the hon. Gentleman an update afterwards.

There have been a lot of references to the interaction with Members. Members of any party may feel they are knocking their heads against a brick wall, but sometimes, to be fair, information cannot be shared for good reasons. There may be commercial confidentiality, or things may be at a particular stage where information cannot be shared. However, I am quite clear that all plans for the local populations that Members represent must be shared with the best level of detail possible, at the most opportune moment. I am always happy to hear from London Members if they feel that that is not happening.

Reconfiguration is about modernising the delivery of care and facilities. I recognise that proposals for those changes sometimes arouse concern. There has been a particular focus on “Shaping a Healthier Future” in this debate, but under that programme, many more community services are now in place across all eight boroughs, so more patients can be seen closer to home. Eleven new primary care hubs are now open. Improved access to GP services has meant an additional 32,000 appointments in Ealing since August 2015, while weekend appointments are now offered to more than 1 million patients across north-west London. Rapid access services in each borough are helping to keep patients with long-term conditions out of hospital where possible, which has already prevented 2,700 hospital admissions in Brent alone.

Oral Answers to Questions

Debate between Jane Ellison and Andy Slaughter

Tuesday 9th February 2016 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

4. What assessment he has made of the implications for his policies of the findings of the Independent Healthcare Commission on the NHS in north-west London.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It might assist the House if I were just to mention that this commission was commissioned by five Labour councils and was chaired by Michael Mansfield, QC. On the assessment of the commission’s findings, I can put it no better than the lead medical director for the “Shaping a Healthier Future” project, who said:

“The unanimous conclusion of the board’s clinicians was that the report offered no substantive evidence or credible alternative to consider that would lead to better outcomes for patients…above the existing plans in place”.

I concur with that judgment.

[Andy Slaughter]

Last July, the Minister held a constructive meeting with west London MPs and agreed that information on the review of our hospital services would be shared. We understand that a plan B is being considered that will still move hospital services from Charing Cross and Ealing but, because of rising costs, will retain and mothball existing buildings rather than redeveloping the sites. Can we see the current plans?

[Jane Ellison]

The hon. Gentleman rightly says that we had a constructive meeting but, as with everything in this area, it is time to move on. There is a grave danger of him appearing to be like one of those soldiers discovered on a Pacific island after the second world war still fighting the old war. Part of the reason for cost escalation in NHS projects is the constant challenge and delay, and “Shaping a Healthier Future” has complete clinical consensus across north-west London. The clinicians say that this

“will save many lives each year”.

It is time to get on with this project.

Infected Blood

Debate between Jane Ellison and Andy Slaughter

Thursday 21st January 2016 Commons Chamber

[Jane Ellison]

One or two of those questions are probably a little too detailed to comment on now, but it is worth reiterating what I said about the devolved Administrations. I have not been able to speak to the Welsh Health Minister; we offered the opportunity of a call with other Ministers, including the Scottish Minister, but the Welsh Minister knows that he can get in touch. One of his officials was on the call this morning, and our offices have been talking to each other. I am happy to pick this up with the Welsh Health Minister if he wants to do so.

This consultation is for the scheme in England, but we have been working with counterparts in the devolved Administrations. While everyone in the UK is welcome to respond to the consultation and say what they think, health is now a devolved matter—that is different from when the first schemes were set up—so the devolved Administrations are responsible for providing financial support for those affected from each country. Treatment within the NHS is obviously a matter for the NHS in Wales, and I will look at some of the other points the hon. Gentleman made. We are happy to talk to him about the devolved aspects and write to him afterwards.

[Andy Slaughter (Hammersmith) (Lab)]

I thank the Minister for the consultation, the additional money, the scheme consolidation and the work that both she and the Minister for Community and Social Care have undertaken. I also thank, of course, the all-party group and my hon. Friend the Member for Kingston upon Hull North (Diana Johnson). Will the Minister concede that, for those of us who have worked closely with individual victims for a number of years, the resolution has to be, as far as possible, to put them in the financial position they would have been in but for the grievous harm done to them, and that that may in some cases mean a bespoke solution for individual victims—we are not dealing with unlimited numbers of people here?

[Jane Ellison]

That is clearly the hon. Gentleman’s view and I invite him to submit it to the consultation. This is exactly why we are consulting. We have made some proposals, but some of the questions are very open, and we will look at what comes back from the consultation. I urge him and other Members to take part in the consultation.

Victims of Contaminated Blood: Support

Debate between Jane Ellison and Andy Slaughter

Wednesday 16th December 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

Let me challenge the Minister on the phrase “quieter voices”, which I have heard her use several times. It seems to be a code for addressing the important but less costly issues of treatment and reform of the current scheme rather than a full and final settlement to what Lord Winston rightly called the

“worst treatment disaster in the history of the NHS”.

We have a moral duty here, so simply saying “the Chancellor will not give me the money” will not wash.

[Jane Ellison]

Again, I have said here today and previously in Westminster Hall what I believe the position to be with compensation. I accept that the hon. Gentleman has a different view and we had an exchange when he contributed to the discussion in November. I think it would be wrong to dismiss the idea of listening to quieter voices, which I have had the opportunity to do over the last couple of years, and as a result it has become clear that a number of people want a number of different things from a reformed scheme. It will not be possible to do everything that everyone wants. We are going to try to respond as best we can with a scheme that is sustainable, fair to all and responds to many of the points made here today.

Oral Answers to Questions

Debate between Jane Ellison and Andy Slaughter

Tuesday 2nd June 2015 Commons Chamber

[Andy Slaughter (Hammersmith) (Lab)]

8. What effect the implementation of the Keogh urgent and emergency care review will have on type 1 A&E departments in England.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

The Keogh review is all about responding to the long-term challenges facing the NHS, many of which we have already discussed in this Question Time. The implementation of the recommendations of the Keogh review will improve urgent and emergency care services and ensure patients get the right care in the right place.

[Andy Slaughter]

The “Shaping a healthier future” programme in north-west London, which is seen as a prototype for Keogh in closing or downgrading A&Es, is causing great concern, from the tragic death of Guy Bessant reported yesterday to the more than £20 million spent on external consultants last year. Eleven west London MPs would like to meet the Secretary of State and, I hope, the Under-Secretary, to discuss those concerns. Will they agree to meet us?

[Jane Ellison]

I read of the tragic death of that gentleman, who was a Wandsworth resident. Our hearts go out to his family.

As the hon. Gentleman knows, “Shaping a healthier future” is a clinically led programme supported by all eight clinical commissioning groups in the area and all nine medical directors of the trusts involved. There are no plans to make changes to A&E services at Ealing hospital, contrary to what was put about during the election, but I recognise that this is the subject of ongoing concern. All the recommendations of the Keogh review are entirely driven by one thing, which is putting patients and patient safety first, but I am happy to meet him and his colleagues to discuss it.

Penrose Inquiry

Debate between Jane Ellison and Andy Slaughter

Thursday 26th March 2015 Commons Chamber

[Jane Ellison]

All relevant matters will need to be considered by the next Government. By the time the next Government are formed, and the next Parliament is assembled, Members will have had more chance to look at Lord Penrose’s detailed narrative of these tragic events.

[Mr Andy Slaughter (Hammersmith) (Lab)]

The Minister says she regrets that more has not been done in this Parliament. The main reason for that was that we were waiting for the Penrose inquiry—so that is doubly disappointing today. She says that much of the work has been done. I appreciate that her writ is about to run out, but has she or the Government formed the opinion that there should be a comprehensive financial settlement, of which what the Prime Minister announced should be just the downpayment?

Oral Answers to Questions

Debate between Jane Ellison and Andy Slaughter

Tuesday 24th February 2015 Commons Chamber

[Jane Ellison]

I can only reiterate this Government’s complete commitment to openness when it comes to patient safety and say again that confidentiality agreements cannot be used to prevent individuals from making a protected disclosure in the public interest.

[Mr Andy Slaughter (Hammersmith) (Lab)]

22. What plans he has for the NHS in west London.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

Clinicians in west London are leading a process that is very much aimed at improving services for people in west London. As the hon. Gentleman is well aware, the local NHS is pressing ahead with the implementation of service improvements as part of the clinically led reconfiguration programme, “Shaping a healthier future”.

[Mr Slaughter]

The Minister does not sound very convinced by that herself. I wonder whether she saw the comments from the College of Emergency Medicine yesterday, which said that attempts to dissuade people from going to A and E have been a dismal failure and that what we should do is locate primary care services alongside A and E. That is the model we have at Charing Cross hospital and in the rest of west London, and it is succeeding. What is failing is the closure of emergency departments, which is creating an intolerable strain. Will the Government look again at the issue? Will you stop closing A and Es in west London?

[Jane Ellison]

I am afraid that the hon. Gentleman has a dismal track record of campaigning on this issue. We have all seen the leaflets being put out in west London. I can only say to his constituents that in the run-up to the election they would glean more from reading their tea leaves than from reading his leaflets if they want to know the truth about the NHS in west London.

Contaminated Blood

Debate between Jane Ellison and Andy Slaughter

Thursday 15th January 2015 Commons Chamber

[Jane Ellison]

I will come on to why I do not entirely agree with the hon. Gentleman, but my concern is essentially that after families have endured so much, I would hate to tell them the way forward only for that to be unpicked and revisited in the light of any recommendations by Penrose. I am afraid that I do not agree with him, because it is important to consider the report.

[Mr Slaughter]

A moment ago, the Minister said that, given the late reporting of Penrose, she would have to consider the scope of the Government response. Will she be a little more specific: what are the Government likely to say and how far will they go before the election?

[Jane Ellison]

I will come on to that. Although I cannot be as specific as I would like, I will try to give the House some sense of the way forward.

I stress that the support currently provided is over and above any other state benefits that infected individuals and their families may receive, and moneys paid under the schemes are not subject to tax. Some hon. Members have raised issues relating to the DWP, and I will of course bring those concerns to its attention.

I am aware that many hon. Members have concerns, which they have expressed in some detail, about the way that support for those affected is delivered. During the past year, I have listened to and actively considered the thoughts of all colleagues about how to improve the system. I have met the officers of the all-party group, and spoken a number of times to my right hon. Friend the Member for North East Bedfordshire.

I acknowledge that there is scope for reviewing the support system. I have been open with hon. Members about the fact that I share their concerns about the charitable basis of that support. I thank my right hon. Friend and the all-party group for the survey on which they recently collaborated. This is the first large-scale effort to consult beneficiaries, their families and the wider public on the current system. I will certainly consider its findings—I have looked at the executive summary of the report, which was only published yesterday—and all the other sources of information. From my conversations with Members over the past year, I have a good sense of the report’s direction of travel and of their concerns.

As I have said, in considering possible reforms to the current system, we must take into account Lord Penrose’s findings and recommendations before any specific proposals are made, but I have been ably supported by my civil servants in looking at possible reforms. His report is likely to be lengthy: to give the House some sense of that, the interim report published in 2010 exceeded 600 pages.

If Penrose does not publish until shortly before the House rises, it will be challenging, as Members have recognised, to provide a considered and thoughtful Government response in such a short time. I want to give due respect and consideration to Lord Penrose and his report, not least because it matters so much to so many individuals and families. As I have said, after all they have been through, it would be terrible for us to announce measures that then had to be unpicked or revisited. I reassure the House that however late in the Parliament Penrose reports, we will make a response, although that will inevitably have to be an interim response.

Having acknowledged that not everyone is satisfied—far from it—with the current system of support, it is extremely important to remember that the system makes an enormous difference to the lives of many beneficiaries. To date, more than £365 million in support has been paid to more than 5,000 people in the UK affected by HIV and hepatitis C and their families. Through the reforms made in January 2011, which some Members have mentioned, the Government have improved the system of support. Since they were introduced, more than £70 million in extra funding has been made available in England.

Something that is new since the House last debated this issue is the therapies that are coming through. Members have spoken about the side effects and impacts of existing therapies. Many of the new therapies have a much higher cure rate than existing ones, with far fewer side effects. We understand that cure rates for new therapies are between 90% and 95%, and that the courses of treatment are much shorter. Those figures are based on clinical trials. New data from the early access programme will be evaluated to confirm the robustness of that finding, but it is obviously encouraging news.

I am encouraged by some of the improvements that we can make to the quality of life of those who have suffered from their infections for so long. New treatments for hepatitis C are becoming available through the NHS. While we have been waiting for NICE to publish its final appraisal of the first of the new drugs—Sofosbuvir and Simeprevir—NHS England has taken two important steps to ensure that eligible patients with late-stage hepatitis C can expect to have received treatment by the end of 2015. In April 2014, it published an interim clinical commissioning policy statement to provide access to the new therapies for patients with liver failure. More than 700 patients have already been treated through this policy, at a cost of £38 million. Specialist centres were procured to deliver this early access treatment around the country.

The NHS is developing a further interim clinical commissioning policy for patients with compensated cirrhosis to reduce the risk of their developing decompensated cirrhosis or liver cancer. Subject to its internal approval processes, the NHS is aiming to have that in place from this April. I have confirmed with the clinical director that if any hon. Members are approached by constituents with hepatitis C, they should advise them to consult their GP about a referral to a hepatology specialist to determine whether they have developed cirrhosis.

Medical advances continue to improve the ways in which HIV and hepatitis C can be treated and managed, and I want to take this opportunity to assure the House that the UK now has one of the safest blood supplies in the world, and independent experts continually review current safeguards.

This debate has again allowed me to hear about the issues with which many of those affected live daily. I of course recognise that improvements must be made to the system that provides financial assistance, and I have given considerable thought to that over the past year. Together with those we represent, we need to be realistic about the challenge of making changes that are fair and sustainable. It is very welcome that we can work on a cross-party basis—that is absolutely vital—and it is most reassuring that several hon. Members have emphasised that.

I am hugely frustrated that the much longed-for closure cannot realistically be achieved in this Parliament. Nevertheless, a new Parliament is imminent, and it will provide an opportunity for the next Government to provide closure.

Late Stage Hepatitis C

Debate between Jane Ellison and Andy Slaughter

Tuesday 6th January 2015 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

It is a pleasure to serve under your chairmanship, Mr Gray. I thank the hon. Member for Ealing North (Stephen Pound) for his kind words and congratulate him on securing this important debate. Hepatitis is a significant health issue that has been overshadowed by others for too long, in part because of many of the people who are most affected, so I welcome this opportunity to discuss it. In nine minutes I cannot possibly respond to all the points that have been made, so I will say straight away that I am going to put the issue of contaminated blood to one side as there will probably be another debate on that at some point. Work is ongoing with regard to previous problems with contaminated blood in the NHS. We are still awaiting the findings of Lord Penrose’s much delayed inquiry, which, as it addresses pre-devolution issues, is highly relevant. Nevertheless, I must put that issue to one side.

[Mr Slaughter]

Will the Minister give way?

[Jane Ellison]

I cannot take an intervention on that point because I must deal with the rest of the debate.

On presumed consent, within the past year we have had two good, thorough debates in this Chamber on issues of organ donation and consent. It is a very interesting area of discussion. I am watching the Welsh experience with interest; I do not dismiss it, but it is very complex. I would be happy to debate it at any time with any Member because it is a topic to which I have given quite a lot of thought and consideration.

I pay tribute to the Hepatitis C Trust for its work. More recently, I have met the Hepatitis C Coalition, which has impressed on me with great force some of the issues that it wishes to see addressed—issues that were picked up by the hon. Member for Ealing North.

The NICE appraisal of the first of the new hep C therapies is due very soon, so this debate is timely. Understandably a lot of the focus is on the new therapies, but focus on prevention runs right through the NHS long-term strategy. That is highly relevant because if people are to be treated with good, new and expensive therapies, it is important to address issues such as re-infection rates and good public health prevention. Members should be in no doubt about the Government’s commitment, which I suspect would be shared by any Government, to reducing the big killers—the main reasons for premature mortality in our country—one of which is liver disease. We cannot tackle the big killers if we are not tackling hepatitis C. We are clear that the contribution that tackling hepatitis C can make to reducing current rates of end-stage liver disease is an important part of any premature mortality strategy.

Oral Answers to Questions

Debate between Jane Ellison and Andy Slaughter

Tuesday 15th July 2014 Commons Chamber

[Jane Ellison]

We have discussed this with the FSA and we will respond in more detail when we have the final Elliott review. But it is worth noting that the FSA is supporting local authorities financially and with expertise, but is also very much encouraging people to work smarter so that a lot of inspection is based far more on risk. That is right, as we do not want businesses with excellent records of compliance being subjected to the same regime of testing and inspection as those who give rise to greater risk. I hope my hon. Friend would agree that an intelligence-led approach is the right thing to do.

[Mr Andy Slaughter (Hammersmith) (Lab)]

4. What plans he has for hospitals in west London and their A and E services.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

The NHS is, as the hon. Gentleman knows, implementing the plans for hospitals in west London under the “Shaping a Healthier Future” scheme. This will include 21st-century health care facilities for the local community, and it is very much led by local clinicians to provide better care for patients in the hon. Gentleman’s and other west London constituencies.

[Mr Slaughter]

Is the truth not that two west London A and E departments will close eight weeks tomorrow? Although the local NHS is paying M&C Saatchi to spin that decision, so far no one has told the 300,000 people in the catchment area for the Central Middlesex and Hammersmith hospitals that their A and Es are going to close and no evidence has been produced to show that it is safe to do so?

[Jane Ellison]

Unsurprisingly, that is another example of the hon. Gentleman putting politics before patients. We have had a slew of information put out to people in his area and surrounding areas, much of which did not highlight the new facilities that are being introduced. I would love to hear the hon. Gentleman talk up the new facilities coming into that area. Charing Cross hospital will be redeveloped as a 21st century health care facility, in line with my right hon. Friend’s decision based on the independent reconfiguration panel’s advice. Charing Cross and Ealing will have a local A and E with 24/7 access to full diagnostic support, consultant advice and specialist care—and it would be really refreshing if the hon. Gentleman, rather than following his usual line, could tell some of his constituents the good news about health care in his part of London.

Health Services (North-West London)

Debate between Jane Ellison and Andy Slaughter

Tuesday 15th October 2013 Westminster Hall

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

This is the first time I have served under your chairmanship, Mrs Riordan—in fact, under anyone’s chairmanship, because it is my first Westminster Hall debate. It is good to start off with such a straightforward and easy subject.

I congratulate the hon. Member for Westminster North (Ms Buck) on securing the debate. I am a London MP and I know that this matter is important to her and her constituents, to the constituents of her hon. Friends the Members for Ealing North (Stephen Pound) and for Hammersmith (Mr Slaughter) as well as to those of other MPs who are not here today.

Before I turn to the issues raised, I put on record my thanks to the staff of the NHS for their commitment and dedication in providing a first-class service, particularly as they enter a period of change. We know that that is sometimes not easy, but they are maintaining a first-class commitment to patients throughout.

The debate around aspects of the north-west London reconfiguration has been going on for some time, but it is fair to say that the hon. Lady discussed a slightly new feature of it. Today is the first time I have heard in detail directly from her about these important issues. I will give her a response, but I will look at the detail of what she said, reflect on it and come back to her more fully after the debate. It is not possible to do that instantly, because until now I had not heard directly from her about some of the problems on communication and so on in the past year that she said illustrate some wider issues.

My understanding is that the joint committee of primary care trusts agreed in February this year that further work was needed to bring about improvements to services at both Charing Cross and Central Middlesex hospitals. I am aware that Imperial College Healthcare is developing its clinical and site strategy based on the principles set out in “Shaping a healthier future”. The trust has put forward a case for some elective surgery to be carried out at the Charing Cross site and has developed a vision for each of its three main sites becoming centres of excellence for the service they provide.

It is right that hon. Members and local authorities should expect openness and transparency when discussing local health issues and changes, and the hon. Lady has vividly put across that she does not feel that that has happened. It is regrettable that she feels she has encountered, in her dealings with Imperial, a lack of clarity around its clinical and site strategy and, in particular, around planned care and elective surgery.

The hon. Lady rightly stressed the need for partnership working through periods of difficult change such as these. Her comments on the overall exercise and the expressed clinical priorities were balanced, and I take seriously what she said about wishing to work in partnership and her point that we can clearly do a lot better. I have been assured by NHS England that a real effort will be made by the new leadership team at the trust and the local clinical commissioning group to engage more fully with her, other local MPs, local councillors and the local NHS as the site strategy is developed.

I am aware that the hon. Lady met the chief officer and the GP chair of the central London CCG to discuss her concerns about the changes to planned care and surgery in north-west London. As a result, she will know that under “Shaping a healthier future”, St Mary’s will continue to provide out-patient services, diagnostics, therapies and appropriate follow-up. I understand that work is under way to agree the best locations across north-west London for planned care surgery services.

[Mr Slaughter]

I hear what the Minister is saying—it is reasonable and I know that she is sincere—but we constantly meet these people and they are, frankly, hopeless. The issue is now becoming political. So far, we have had political unity across the board and we now know that the issue is on the Secretary of State’s desk. I implore the Minister to talk to him about these proposals—in the interests of her party, if none other.

So far, apart from Hammersmith and Fulham council, which is supporting the closures, everyone across west London is united on this: it does not matter what party they are or what position they hold. This issue is moving from the local to the national. Will the Minister please look—it is in her interest as well as ours—at what is going wrong in north-west London before we take steps in closing hospitals that we will not be able to correct?

[Jane Ellison]

I am not sure that describing NHS colleagues as “hopeless” is a particularly helpful contribution to future partnership working, but the hon. Gentleman has chosen his words in his own style, as he always does. He is right to say that the matter is on the Secretary of State’s desk. I will report back to the Secretary of State after this debate, specifically on the new concerns expressed by the hon. Lady on the dialogue and the relationship she has had. Beyond that, I cannot comment further on the reconfiguration, because of its status.

Housing Benefit (Under-occupancy Penalty)

Debate between Jane Ellison and Andy Slaughter

Wednesday 27th February 2013 Commons Chamber

[Jane Ellison]

I am glad the hon. Lady has given me an opportunity to respond on that point. It was always predicted that debt would rise for most of this Parliament. It is true that that period has had to be extended, but that is not a surprise. The structural deficit is being reduced. To return to an intervention I made on the right hon. Member for Birmingham, Hodge Hill, who spoke for Labour, if Labour had begun to address some of the structural deficit problems when the financial crash hit in 2008, the current Government might not have had to take some of the difficult decisions they are taking now. Housing benefit is a classic example.

[Mr Slaughter]

rose—

[Jane Ellison]

I will be delighted to give way to the hon. Gentleman if he can tell the House why the Labour Government did not introduce measures to bring the housing benefit bill down from 2008 onwards.

[Mr Slaughter]

I understand the hon. Lady’s point—she, like the Conservative party, believes that the poor should pay and the rich should get away with it. Like me, she represents an inner-London constituency. More than 2,000 families in my constituency will be unable to pay their rent because of the measure. At the same time, councils such as Wandsworth and Hammersmith are refusing to build social housing and are selling it off. What is that if not destroying communities? How does she defend it?

[Jane Ellison]

I do not know how the hon. Gentleman can begin to criticise Wandsworth council, which has just set the lowest council tax in the country—it has done so for many years in a row. The difference between Wandsworth council’s band E tax and that of many surrounding councils, and particularly that of many high-spending Labour councils, is enormous—it is the equivalent of a family holiday, a new car or a new three-piece suite. That illustrates the benefit of low tax and leaving people with more of their own money to spend on what they will. I am glad the hon. Gentleman gave me the opportunity to pay tribute to Wandsworth council’s low council tax policy.

Some of my constituents will be affected by the measure—[Interruption.] I realise that other hon. Members want to speak, but if Labour Members want to make every general economic point and make endless reference to tax cuts for millionaires and that sort of thing—[Interruption.] Well, I made the point earlier that the Labour Government had several years after the financial crash and after financial reality had dawned to do something about the upper rate of tax, but they did nothing. The higher rate was in effect for, I believe, 37 days before the election. A lot of nonsense is spoken about that.

As I have said, we could look at aspects of the measure. The Minister’s speech was helpful because he clarified concerns and misunderstandings. The measure draws attention to the fact that subsidised social housing is a scant and important public resource. The fact that subsidy is built in to the rent for social housing means that social housing is often not appreciated as a valuable resource, and we should aim to provide access to it for as many taxpayers as possible.

I would like to make a point on behalf of the many people who come to see me who are over-occupying. No one claims that this policy will free up all of the 1 million rooms, but it might well encourage people to look at being in appropriate-sized accommodation. Many housing directors tell me that if they could match people to the correct-sized accommodation, they could resolve much of their waiting lists—that is what I have been told by people with many years’ experience in this field. This is not a panacea, but there are people in wrong-sized accommodation. If this measure starts to get people thinking and encourages them to move into right-sized accommodation where it is available, that is a good thing.