Hospital Services (West London)

John McDonnell Excerpts

Wednesday 11th July 2012 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I associate myself with the sentiments expressed by the hon. Member for Cities of London and Westminster (Mark Field), particularly about the Royal Brompton and its specialist services. I will focus briefly on the impact of what is happening on my constituency, but I follow what my hon. Friend the Member for Hammersmith (Mr Slaughter) said: there has been an attempt to divide and rule Members over whether to save some A and E units and close others. Yet it is healthy that all Members across west London are working on a common cause to try to get a long-term view of the health care needs of our areas.

I was reminiscing a few weeks ago with one of our chief executives, who has been dealing with this issue in our area for about as long as I have—almost 40 years. I think that this is our ninth reorganisation. On average, a reorganisation takes place over roughly a two-year period and operates for about 18 months, and then we start all over again. I started off in my area with a network of GPs, a community hospital, a district hospital and specialist services. In the first reorganisation, we lost the community hospital. After that, I was promised five GP centres; I got two. Then we had the wonderful idea from Lord Darzi about polyclinics, which looked awfully like community hospitals, but I did not get one of those. By the time that they had been discarded, it was decided there should be a walk-in centre. After that, we lost a lot of the capital investment in relation to GP improvements, so I am left with some GP centres, but many GPs still working out of converted houses and many single practitioners. Many of them are about to retire. The walk-in centre is about to be closed and relocated to Hillingdon hospital, where I am told that all the basic triage will be performed. We seem to have come full circle but have cut out some of the basic elements.

I am now told that, under the present consultation, the coming plan is to devolve services into the community, with more community care and improved GP services, which will then reduce the need and desire to go to accident and emergency and make it possible for specialist services to be concentrated into fewer units. The problem with that form of devolution is that the walk-in centre in central Hayes is being lost; no further capital investment in GP centres is planned; many GPs, although they have given good service over the years, are ageing, will soon retire and, as I have said, are working in poor quality settings; and there are, to be frank, cuts in community care support as well, particularly those that are happening in personal budgets. Some bizarre judgments are being made at local authority and other levels about qualification for community care. People are winding up in my office to attend my constituency surgery because the care that they have had for years has been withdrawn.

The next stage of the proposal is the closure of Ealing accident and emergency. Ealing dealt with 84,000 people in 2010-11, with 12,000 urgent care cases and 30,000 serious in-patient cases. If even half that number transfer to Hillingdon, it will be swamped. My fear is that in the next round of cuts A and E performance at Hillingdon hospital will be examined and criticised, because it has been swamped, and that it will eventually become a target for further closure. I worry also because it appears possible to extrapolate from the numbers in the consultation reports the cutting in the next 12 months of up to 1,700 NHS jobs, with the prospect of 5,000 being cut by 2015. That could be yet another reorganisation that exhausts staff, confuses patients and the community, and wastes large amounts of resources. In the end, it will reduce the quality of services and might result in further cuts. I predict that, within four years, we will be back here again if we continue on this path.

All that my community is pleading for is an element of stability. I agree with my hon. Friend the Member for Hammersmith that the consultation process has been tainted from the start, because information for the community and opportunities for engagement have been lacking and there has been a failure to disseminate information in a form that people can understand properly. I think that that has been done by what is now emerging in our sub-region as a group of elite GPs, who seem to control the process rather than engaging even with many of the other GPs. When, in our meetings with GPs, we ask whether they support the proposals, those at the grass roots say clearly they do not. They do not feel involved.

It is time to draw breath in the consultation, start a proper process of discussion and try to get some form of longer-term stability into the process. My hon. Friend the Member for Feltham and Heston (Seema Malhotra) is here, and there is a 17-year difference between life expectancy in some wards of our constituencies and in some wealthier constituencies represented by hon. Members present for the debate. It is clear to me that the eight or nine, or perhaps more, reorganisations of the past 40 years have not dealt with the real health care issues and needs in our area. What is happening will be another exercise involving abortive costs, which will frustrate the provision of real health care to whose who need it.