NHS: North-West London

Karen Buck Excerpts

Wednesday 24th April 2019 Westminster Hall

[Ms Karen Buck (Westminster North) (Lab)]

It is a pleasure to speak under your chairmanship for the second time today, Sir Christopher. I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this short but important debate. He was quite right to use the word “bittersweet” in the context of the collapse of the “Shaping a healthier future” strategy. It was sweet, in that it lifted a shadow from Charing Cross Hospital. There has been a continuing surge in A&E admissions over many years, during which we have consistently been told that a strategic approach to health services should be about reducing such admissions and replacing them with services in the community. That is a principle that I think everyone would agree with, and the lifting of the shadow is a good thing, but as we have heard from other hon. Members, it is clear that the strategic shaping of healthcare in north-west London remains very much in doubt.

I will focus on St Mary’s Hospital in Paddington, which is just outside my constituency but is the main hospital for it. It is the major acute provider for north-west London, and one of the four major trauma centres in London, with a 24/7 A&E department. It is a hospital very dear to my heart—it saved my life once, and I gave birth there—and it is held in very high regard among my constituents. Quite rightly, it has a terrific reputation for clinical care; we should never miss an opportunity to record our admiration for the staff, who deliver healthcare so superbly to the public.

None of that should blind us to a very grim reality, which is that St. Mary’s Hospital is very old. In some instances, it is quite literally falling down. It is now 14 years since the Paddington health campus proposal finally collapsed, which was the first vision of the redevelopment of St. Mary’s Hospital. Here we are in 2019, with the collapse of “Shaping a healthier future”, and we are still frozen in terms of a major redevelopment for St Mary’s.

In January 2018, Imperial College Healthcare NHS Trust gained full planning permission for the first phase of the redevelopment of St. Mary’s, which is a new eight-story out-patient and ambulatory service building on the site. The trust submitted the outline business case for the investment required to NHS Improvement, NHS England and the local commissioning groups. Under those plans, the trust is looking to house most of the St Mary’s out-patient and ambulatory services in the new building, but this has been on hold since January 2018. It is not an academic issue; the failure to gain funding and approval from key stakeholders for the redevelopment programme is a key risk on the trust’s corporate risk register, because the conditions of St Mary’s Hospital have deteriorated so much. Planning permission has only two years left.

While we are waiting for the funding to be put together for the redevelopment of the hospital within that timescale, the structural issues in the hospital have become absolutely and imminently challenging. The structural problems in the Cambridge wing at St Mary’s resulted in two wards being out of use, with no possible value-for-money structural solution. There is a £1.3 billion backlog maintenance liability across the five hospitals, including St Mary’s. As we have heard, the backlog is the biggest in the country, and St Mary’s has the largest in the trust. In fact, 30% of all high-risk backlog maintenance in the NHS in England is at Imperial College Healthcare.

I just mentioned one of the wards that has been out of action, and St Mary’s maternity services had to be temporarily relocated due to a lift fault in September 2018. The Grafton ward closed due to significant structural concerns, with the loss of 32 beds in May 2018 and no possible structural solution. A ceiling collapsed in the Thistlethwaite ward. The Paterson Centre was flooded and closed for two weeks, with the loss of activity and 20 surgical beds in 2017. Floods, electrical issues and drainage problems are commonplace across the buildings and services at St Mary’s. The hospital simply cannot wait, yet everything is now frozen.

We urgently need advice from the Minister on how we will proceed. Should there be a further structural problem of the kind that we have already seen, it would not only be an imminent risk to patients, but would take out chunks of capacity from an already highly stretched hospital, which will have repercussions across the whole of north-west London. We simply cannot go on like this. I hope the Minister will give us an indication of how the St Mary’s maintenance backlog, structural programme and redevelopment will proceed.