Barking, Havering and Redbridge University Hospitals NHS Trust

Jon Cruddas Excerpts

Wednesday 15th July 2015 Westminster Hall

[Jon Cruddas (Dagenham and Rainham) (Lab)]

I will be brief, given that I want to leave sufficient time for the shadow Minister and the Minister to respond. I congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this debate.

From the contributions so far, I think we would all agree on what politicians tend to call the challenging environment that the trust has existed in for many years—including the initial Care Quality Commission report, which contained a lot of criticism, specifically on A&E and maternity. A whole host of other issues were raised, leading to the placing of the trust into special measures in December 2013 and the improvement plan of 12 months ago.

We know that there are huge demographic pressures on the trust, reflected in the number of emergency patients, of which there were 220,000 across Queen’s and King George last year. That illustrates the pressure from footfall. All speakers so far have mentioned the huge budgetary pressures, in terms of both the debt overhang from the private finance initiative and the management’s ability to secure the in-year budget. The deficit was some £38 million last year, and it is estimated to be the same this year.

There have been huge management changes across the trust, and I, too, support Matthew Hopkins’s work. As my right hon. Friend the Member for Barking (Margaret Hodge) mentioned, there has been a squeeze on Barts, on the west side, and also on the Essex trust, on the east side, meaning that there is a danger in the distribution of resources: we could be squeezed between the two trusts on the western and eastern borders of our trust.

The CQC report was a bit of a mixed package. There were positive outcomes for radiotherapy, strokes, nurse-led oral chemotherapy and the humane end-of-life care service, and there was increased cleanliness and good infection control across the trust, which compares well with some of our experiences a few years ago. However, the report also consistently pointed to issues relating to clinical governance and waiting times, especially for A&E.

The in-patient survey results mentioned improvements in single-sex placements, the decline in changes to admission dates and the offering of alternative hospital placements to patients. It also mentioned the need for improvements in waiting times for beds, doctor communication and the number of nurses on duty. I acknowledge, however, that in 2015-16 there will be £5.8 million of extra spending on improved nursing care, which will amount to some 80 additional nurses.

On the broader issues that have been raised, I echo a number of points mentioned by colleagues about the pressures on primary care, the age profile of the GPs, the number of single-handed practices and the fact that we have waited for a promised new integrated health centre in Dagenham East for 10 years—it has still not been delivered. Similarly, the Rainham practices desperately need new facilities. Getting appointments is becoming more difficult, putting more and more pressure on the acute sector because of people rolling up to A&E.

Overall, there have been improvements—we all support the management—but there is a long way to go. As we, hopefully, move out of special measures, it is especially important that we remove what my hon. Friend the Member for Ilford South called the sword of Damocles that is hanging over King George. I hope for a positive response from the Minister on that specific point.