NHS: North-West London

Debate between Julie Cooper and Christopher Chope

Wednesday 24th April 2019 Westminster Hall

[Julie Cooper (Burnley) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this debate. I know that he is a passionate advocate for the NHS in his area. Although I am pleased to respond on behalf of Labour, it is with sadness that hon. Members have to come here over and over to explain the impact on their constituents of the crisis in the NHS.

We have heard a mixed message of plans made and abandoned. It is a story of a shambles, and declining and reducing services, including the loss of services for children, maternity and stroke care. It is no secret that the NHS is under extreme pressure. After nearly a decade of stagnant investment, coupled with a recruitment crisis and a retention time-bomb, the cracks are really starting to show, as we have just heard. The King’s Fund notes that during the Labour Government, budget growth in the NHS was an average of 3.7% a year. It has dropped to an average of 1% a year during the Conservatives’ time in office. The recent announcements of additional funding are of course welcome. However, the British Medical Association and the King’s Fund acknowledge that the promised £20.5 billion, which equates to an increase of 3.4%, is simply not enough after nine years of severe underfunding. It is not even enough to wipe out hospital deficits.

Where is the funding to guarantee sustainable health services in the face of ever-increasing demand from a complex and changing demographic? Where is the funding to renew NHS infrastructure or outdated hospital equipment? Just repairing the dilapidated hospital buildings will cost in excess of £3 billion. We have heard from my hon. Friend the Member for Westminster North (Ms Buck) about the state of the buildings at St Mary’s Hospital and the urgent work that is needed. My hon. Friend the Member for Ealing, Southall (Mr Sharma) outlined the refurbishment work that is urgently needed.

Of course, it is not all about money. I was brought up to believe that you get what you pay for. It is clear that if we do not invest much, we will not get much. Is it any wonder that we have a staffing crisis in the NHS? The Conservative Government’s failure to provide adequate resource and support has created problems in both staff recruitment and retention. The Government continue to exploit the good will of dedicated NHS staff, many of whom are pushed to breaking point. As my hon. Friend the Member for Brentford and Isleworth (Ruth Cadbury) pointed out, staff morale is at an all-time low.

It is inconceivable that more and more hospitals should constantly face the threat of closure. I commend my hon. Friend the Member for Hammersmith and the committed grassroots campaigners for their extensive work over many years to save these vital hospitals. These victories are really welcome, but the Hammersmith and Fulham CCG faces cuts of £30 million. Is it not disgraceful to hear, in the light of that, that £72 million was wasted on private consultants? It is astonishingly incompetent, above all else.

Of course, the cuts to the CCG forced it to reduce urgent care, local GP hours and access to primary care, which is short-sighted as it causes suffering for constituents and often leads to more expensive or hospital treatments. It seems that the Health Secretary’s only answer is to focus on technology. I agree that technology has a role to play in the future delivery of NHS services, but we must proceed with caution. Patients’ needs are paramount, and we must ensure that their safety is never compromised.

I share my hon. Friend’s concern about the use of online GPs. It is clear that the app providing access to such services, GP at Hand, will be very convenient for some people, and is likely to appeal to younger patients. Indeed, Ipsos MORI found that 87% of all GP at Hand patients are aged between 20 and 39. It is also likely that online GPs will prove attractive to patients with less complex medical needs, leaving the providers open to the accusation of cherry-picking. They are undoubtedly delivering a service for which there is demand, but the fact remains that many patients need to attend a traditional GP consultation.

Of course, many patients do not know when they register with an online GP that they are deregistered from their GP surgery. That has serious consequences for the financial viability of the traditional surgery. Hammersmith and Fulham CCG has paid £10 million to GP at Hand. That money is no longer paid to local surgeries, which are as busy as ever catering for patients with multiple complex needs, and their overheads are still as great as they ever were. It is imperative that the funding model for the delivery of GP services is adjusted to reflect the fact—

[Sir Christopher Chope (in the Chair)]

Order. I have interrupted the hon. Lady, because we must hear from the Minister and time is very limited.

[Julie Cooper]

I will sum up, Sir Christopher.

Patients are suffering. We want assurances from the Minister about future hospital closures, sustainable funding and the role of technology in the modern NHS. We want to know the direction of travel of the NHS in north-west London and the country as a whole.

Hospital Parking Charges (Exemption for Carers) Bill

Debate between Julie Cooper and Christopher Chope

Friday 30th October 2015 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

I beg to move, That the Bill be now read a Second time.

I am pleased to have the opportunity to introduce the Bill and facilitate this debate in the House. I thank Members who have given up their valuable Friday constituency time to take part.

This is an important subject and it is essential at the outset to outline the context. The Bill raises, not for the first time in this place, the controversial subject of hospital car parking charges. Other hon. Members have made the case for free hospital car parking. In 2012, the hon. Member for Kingswood (Chris Skidmore) ran a prominent campaign against hospital car parking charges. In 2014, the right hon. Member for Harlow (Robert Halfon) ran a high-profile campaign on free hospital car parking, arguing that charges represent a “postcode lottery stealth tax”. The hon. Member for Wellingborough (Mr Bone) then chose the abolition of hospital car parking charges as the subject of his private Member’s Bill. I am grateful to them all for their work, which has provided a valuable foundation for my Park the Charges campaign.

No one likes to pay to park, full stop. To pay to park at a hospital, when sickness is involved, seems to add insult to injury. The majority of people in Scotland and Wales enjoy free parking when visiting hospitals and other medical facilities. During the course of my research for the Bill, many people contacted me to express the view that all hospital users in England should enjoy the same privileges as their Scottish and Welsh counterparts and be able to park for free when attending hospitals. That may well be desirable, but it goes beyond the scope of the Bill, which focuses on providing support for carers.

The Bill makes provision for carers who are entitled to carer’s allowance to park free of charge in hospital car parks in England. The duties in the Bill would also apply to walk-in centres, GP practices and private hospitals. The Bill, if passed, will require health authorities to put in place a strategy to exempt a broader range of carers from paying parking charges within one year of the Act coming into force.

I chose this subject for my Bill because about 18 months ago, I had a taste of what it is like to be a carer. My mother was seriously ill in hospital. So serious was her condition that we were not sure what the outcome would be. It was a distressing time. I was, by and large, the only visitor and I visited every day for nine weeks, often staying for long periods to provide comfort and support. I spent a lot of time sitting in hospital corridors, waiting to speak to medical staff; I had read every notice on the walls. Each night when I left, tired and distressed, I queued up to pay for my parking. It was costing me £40 a week, and on one of those days, driving out of the car park, it occurred to me that I was lucky, because I could afford to pay that charge. I reflected on the matter and wondered about those people who could not afford to pay—not those who would rather not pay to park, but those who could not afford to. I was distressed and worried about my mum, but I thought how much more distressing it must be for those in financial hardship that is made worse by hospital car parking charges.

There are currently 5.5 million carers in England providing unpaid care for people who have specific support needs. More than 700,000 of them receive carer’s allowance at a rate of £62.10 a week. A further 400,000 are entitled to the benefit. Those are the carers who will benefit if the Bill is successful.

[Mr Christopher Chope (Christchurch) (Con)]

The hon. Lady makes a compelling case, but do hospitals not have discretion to respond in the way that she wants them to, without the need for the Bill?

[Julie Cooper]

I am grateful to the hon. Gentleman for raising that point, and I will come to it later in my comments, if he will bear with me.

--- Later in debate ---

[Mr Chope]

My hon. Friend is absolutely right. That brings home the point that this Bill has not really been thought through. To what extent has it been discussed with GP practices? I doubt whether it has been discussed with them at all.

If one wanted to bring forward a Bill under the private Members’ Bill procedure and give it a good chance of success, I would have thought that one would ensure that it was very narrowly focused, specific and precise. If the hon. Member for Burnley had discussed her Bill with me before she presented it, I would have given her the same advice that I have given to many other hon. Members from both sides of the House who have aspired to make progress with their Bills: it is better to have a small, modest measure that is carefully thought through than something that is general and easily open to different interpretations, which makes it unlikely to make progress.

On that theme, the inclusion in clause 1(2)(b) of private hospitals is completely absurd. Why do we want to drag private hospitals into the issue of whether to impose car parking charges on carers? I am happy to give way to the promoter of the Bill so that she can explain why she wanted to bring private hospitals into the Bill. Most of the discussion has been about NHS provision. Why does she want to interfere in the private sector? In my experience, most private hospitals do not have any charges for parking.

[Julie Cooper]

To clarify that point, NHS patients have the opportunity to use private hospital services. The carers who transport them there may well still need access to free car parking.

[Mr Chope]

So the hon. Lady is saying that this provision would apply to private hospitals when they were treating NHS patients and that it would only affect the carers of NHS patients, rather than the carers of private patients.

--- Later in debate ---

[Julie Cooper]

indicated assent.

[Mr Chope]

Of course, it does not say that in the Bill. That is a point of detail that I am sure was just overlooked in the drafting. I am grateful to the hon. Lady for making that clearer.

The provision applies to

“car parking spaces provided directly or indirectly, including under contract, by or on behalf of a health care provider…for patients and other users to whom car parking charges would otherwise apply.”

Again, my submission is that that goes far too wide because it drags in contractual provisions in the private sector and could impose directly on hospitals that have contracted out by agreement to private providers. They might have said, “Please build this car park and provide spaces for our patients, and in return we will allow you to charge patients,” and a business plan will have been drawn up accordingly. Clause 1(3) would effectively drive a coach and horses through that contractual arrangement. It could result in a compensation bill being payable by the hospital concerned to the private provider because of a breach of contract. That is another example of why clause 1 is far too wide.

On clause 2, which is about qualification for the parking charge exemption, I am indebted to my hon. Friend the Member for Bury North (Mr Nuttall) for explaining the number of people who have an underlying entitlement to carer’s allowance. In my constituency, where there are a large number of pensioners, a significant number would be subject to the overlapping benefit rule and would therefore be included as carers under the Bill by reason of having an underlying entitlement.

The bigger problem is that the Bill would not help unpaid carers. The vast majority of the 6 million carers in this country do it voluntarily and do not get any help from the state or the taxpayer, yet the Bill would not help them at all. Indeed, it could perversely make them worse off.