Princess Royal University Hospital

Debate between Jim Dowd and Robert Neill

Wednesday 25th March 2015 Westminster Hall

[Jim Dowd]

I was talking about the fabled meeting in July 2012—two and a half years ago. When the Secretary of State and the trust special administrator said that the answers to the problems of the then South London Healthcare NHS Trust did not lie within its own boundaries, I knew that what they had in mind was effectively the evisceration of Lewisham hospital. For reasons that have eluded me for decades and more—I used to be on the health authority of Lambeth, Southwark and Lewisham, and the district health authority for Lewisham and north Southwark—various elements of NHS London have always had Lewisham hospital in their sights. There was once a plan for there to be only four accident and emergency and general hospitals in south-east London: St Thomas’, King’s, PRUH and Queen Elizabeth; there was no room for Lewisham. I do not know why the various NHS powers think Lewisham is such an encumbrance. The service it provides to its residents and the pressure it relieves from the other hospitals around south-east London are proof positive of its value.

The morning of 5 March dawned—I was quite delighted about that, because it was my birthday. At 9.25 am, I received an e-mail from Monitor, explaining that,

“Monitor is opening an investigation at King’s College Hospital NHS Foundation Trust to find a lasting solution to long-standing problems at the Princess Royal University Hospital…The regulator is concerned that some patients are waiting too long for A&E treatment”—

nothing unusual there. Not one of the hospitals in south-east London—not St Thomas’, over the river, not PRUH, not Queen Elizabeth, not Lewisham, not King’s—is currently meeting the 95% targets for seeing attendances at A and E, so that is not surprising. The e-mail went on to say,

“and routine operations…the trust is predicting a deficit of more than £40m this financial year. This deterioration in its operational and financial performance follows the unexpected costs of making urgent improvements to the quality of care at the PRUH.”

Well, Princess Royal was taken over by King’s College hospital as a consequence of the trust special administrator’s recommendations, and that is the problem it has run into.

When the trust special administrator was appointed, the Secretary of State said in a statement to the House:

“The trust is losing well over £1 million of taxpayers’ money a week, which means that vital resources are being diverted from other parts of the NHS.”—[Official Report, 29 October 2012; Vol. 552, c. 3WS.]

The difference between the £1 million a week then and the predicted £40 million a year at PRUH alone now clearly demonstrates that the trust’s special administration process did not address the right problems. Clearly, the problem was predominantly at Princess Royal.

Queen Elizabeth is now part of a very successful partnership with University hospital Lewisham, and it is doing quite well. It is not without difficulties, but that is the case for any organisations that come together under difficult circumstances. However, it is making progress in clinical and financial affairs, and is well on the way to building a solid and reliable NHS entity in our part of south-east London. That demonstrates that the entire TSA process was substantially illegal, because as we know, the High Court—and subsequently the Court of Appeal—found the trust special administrator’s recommendation with regard to Lewisham hospital, and the current Secretary of State’s stubborn refusal to accept anything other than those proposals, to be illegal. The Secretary of State did not have the powers he assumed he had and could not reorganise in the way that was suggested. He even had the hubris to try and test it at the Court of Appeal, which found similarly that that was the case. Thankfully, sense prevailed at that stage and he left it there, deciding not to waste any more taxpayers’ money by going to the Supreme Court.

However, the Government introduced an amendment to the Bill that became the Care Act 2014, giving them the power that they thought they originally had to do whatever they liked by appointing a trust special administrator. This is where we come to the key worry about the future of Princess Royal and King’s. It is not just about the services that are provided there, which are critically important to all the constituents of Members here today, but about the fear that Monitor, using the powers that the Government put into that Act, will try to engineer another back-door reorganisation involving Lewisham hospital. As I say, that was originally declared illegal, but Lewisham could be dragged into it by other means, so the Government can achieve what they originally meant to achieve and were stopped from so doing.

[Robert Neill (Bromley and Chislehurst) (Con)]

I understand the hon. Gentleman’s point. Do I gather that his principal concern is the impact on Lewisham, and not the fact that Monitor is looking at accepted issues at the Princess Royal and King’s? From his point of view, it is the Lewisham dimension, rather than what it is necessary to do at the Princess Royal. Am I right in that?

[Jim Dowd]

I broadly agree with the hon. Gentleman’s point. Clearly, financial management is an important part of running the NHS. Everybody knows that, whether it is in our part of south-east London or more broadly.