New Hospital Programme and Imperial College Healthcare NHS Trust

Karen Buck Excerpts

Tuesday 13th June 2023 Westminster Hall

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

I am grateful for the opportunity to contribute to this debate, and I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing it. It is a pleasure to follow the hon. Member for Cities of London and Westminster (Nickie Aiken). St Mary’s Hospital, which I will mainly concentrate my remarks on, is located in her constituency but is the main hospital serving my constituents in north Westminster.

There is a feeling that this is déjà vu all over again. In April 2019, my hon. Friend the Member for Hammersmith and I spoke in a very similarly titled debate on the Imperial hospitals programme. I said:

“In January 2018, Imperial College Healthcare NHS Trust gained full planning permission for the first phase of the redevelopment of St. Mary’s”

as part of the overall redevelopment of the trust. I said that the

“failure to gain funding and approval from key stakeholders…is a key risk on the trust’s corporate risk register, because the conditions of St Mary’s Hospital have deteriorated so much…the structural issues in the hospital have become absolutely and imminently challenging.”—[Official Report, 24 April 2019; Vol. 658, c. 354WH.]

That case has intensified in the intervening years, as I will come to in a moment.

That was four years ago. A couple of weeks ago, we had the announcement that the main funding for the Imperial hospitals scheme has been pushed back beyond the start date of 2030. Other hospitals have been prioritised. Many of the 40 hospitals have received their commitment to proceed on the original timescale, but not St Mary’s or the Imperial hospitals. As the chief executive of the trust board said, that is very disappointing news.

The 40-hospital building programme was a key feature of the 2019 general election. Conservative candidates took advantage of the opportunity to pose outside St Mary’s Hospital and put the pictures on social media and in their campaign literature. One enthusiastically announced:

“We are helping rebuild St Mary’s hospital…Great to talk to Matt Hancock”

—the then Secretary of State for Health—

“about what it means for local residents”.

The Conservative Assembly Member for West Central, even more enthusiastically, talked about how she looked forward to talking to the BBC about the plans to completely refurbish Charing Cross and Hammersmith Hospitals and rebuild St Mary’s. Four years on, St Mary’s is still the hospital with the largest maintenance backlog in the country, and it has been left behind in the programme. That goes far beyond being yet another example of a broken promise.

There are two key issues. The first, which my hon. Friends and the hon. Member for Cities of London and Westminster have alluded to, is the centrality of the St Mary’s and Imperial trust life sciences campus as a leading centre for biomedical research. This is an incredibly exciting project that is part of this country’s scientific renewal—it could not be more important for the locality or the country—but to be honest, it is hard to sustain the necessary investment or the recruitment and retention of staff in a project of that kind in a crumbling hospital building.

But even more important is the central question of the condition of the hospital—all three of them, as my hon. Friend the Member for Hammersmith said, but particularly, from my point of view, St Mary’s—and its implications for patient care and public money. Put simply, this is about wasting money on routine maintenance and repairs to patch up a building that has for many years been recognised as being in need of a transformative rebuild; indeed, the plans have been proceeding on that basis.

I spoke four years ago about the litany of floods, fires and ceiling collapses that we have had to deal with in our hospital estate. However, some recent examples include the closure of the gynaecology day services unit due to the failure of the air handling unit, and the flooding of the Paterson surgical centre—both of which led to two weeks-worth of clinical activities being suspended—as well as flooding in the main out-patient building caused by a sewage blockage, a partial ceiling collapse in an in-patient ward, and sewage leaks into the bottom of the Queen Elizabeth building and into the pharmacy. These problems not only inconvenience patients and delay treatment; they demand ever more ad hoc spending, which is running at an estimated £6 million to £7 million every year, and there is a long list of repair work that needs to be done.

We know that the new hospital cannot be rebuilt overnight, but it is essential that the hospital redevelopment stays within the framework of the timescale that we have been working to over the last few years, since the programme of 40 hospitals became such a key element of the Government’s planning. St Mary’s and the Imperial NHS trust need Government support, and they need it fast.

I have two questions that I would like the Minister to answer today. Will any slippage in the hospital building programme, from other hospitals in the scheme, enable any assistance to be carried over to help Imperial and St Mary? Will the Government also commit to adopting an alternative funding approach to help that scheme—which is being led by a highly skilled, highly experienced team of clinicians and advisers—as a matter of urgency? A scheme is ready to move, but it needs Government support, and the people of Westminster need that hospital to be delivered fast.

New Hospitals

Karen Buck Excerpts

Thursday 25th May 2023 Commons Chamber

[Steve Barclay]

I pay tribute to my right hon. Friend for her campaigning on this issue, together with other Members, including my hon. Friends the Members for Mid Norfolk (George Freeman) and for North Norfolk (Duncan Baker), who have also led that campaign. I can confirm that the new hospital will open by 2030. We accept in full the findings of the independent report. That is why the seven RAAC hospitals are being prioritised and why today’s announcement is such great news for staff and patients in King’s Lynn.

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

The Imperial College Healthcare NHS trust, including St Mary’s Hospital Paddington, has the largest maintenance backlog in the country. We have had floods, fires, sewage leaks and collapsed ceilings. I noticed that St Mary’s Hospital was not mentioned in the course of the statement. Can the Secretary of State confirm to me that it will be completed as one of the 40 hospitals by 2030?

[Steve Barclay]

St Mary’s is part of three aspects of the Imperial NHS trust: there is the work at Charing Cross in Hammersmith, where we are building the temporary ward to unblock the refurbishment, which will be floor by floor, and the work in Hammersmith with the cardiac—[Interruption.] The hon. Member for Hammersmith (Andy Slaughter) may want to chunter, but I am trying to explain the investment we are placing into the constituencies, so we have funding going into—[Interruption.]

Oral Answers to Questions

Karen Buck Excerpts

Tuesday 14th June 2022 Commons Chamber

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

The United States company Operose Health runs 70 GP surgeries across the country, including the Randolph Surgery in my constituency. Yesterday’s “Panorama” broadcast indicated serious concerns about its quality of service, staffing levels and patient safety. Since then, constituents of mine have approached me to reflect their concerns about the service. What steps is the Secretary of State taking now, urgently, to establish what has gone wrong? Will he meet MPs with those surgeries to discuss our concerns?

[Sajid Javid]

First, I will ensure the hon. Lady gets the meeting she requests. She will know that NHS GP services all have to meet the same requirements, the same regulations and the same standards across the country. Where patients are not getting that care and those standards are not being met, we expect local commissioners to take action.

Covid-19 Vaccine: Take-up Rates in London

Karen Buck Excerpts

Tuesday 9th March 2021 Westminster Hall

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

I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on introducing this very welcome and extremely timely debate. He has set out the arguments very comprehensively and I shall endeavour not to repeat too many of the key points.

I will repeat, and I am sure that everyone speaking this morning will also repeat, our grateful thanks to NHS and public health staff who are working so hard to deliver this vaccine. It has been a national success story; there is no doubt of that whatever. It is an extraordinary logistical achievement, of which the NHS can be extremely proud. I had my vaccine on Saturday at St Charles’ Hospital and it was an extraordinary, professional operation; swift and effective. I think everyone should be very proud of what they have done.

Of course, that does not mean that that we should not be able to focus on some of the outstanding questions that arise regarding the delivery of the vaccine in London. As has been stated, London as a city, as a region, is not achieving the same figures as other parts of the country, which should be a cause for concern. My particular concern is my own borough, my own constituency area, Westminster North. It is apparently the second-worst performing borough in the country with just 69% coverage of 65-plus. City of London and Westminster South are also performing very poorly.

This does matter very greatly, for reasons we all understand. It matters in terms of individuals and in terms of the public health of the borough, but I would also suggest to the Minister that it is a particular concern because the central London economy is so critical to our national economic revival. Therefore, being confident that we have good coverage in central London seems, to me, to have a significance even over and above the pure public health considerations.

I want to focus on two particular themes, the first of which I am afraid is going back to the question of data. For the reasons that my hon. Friend the Member for Hammersmith has outlined, inner London generally has a highly complex set of population characteristics. We need to understand the particularity of those circumstances to be effective in delivering to those populations. While it is useful, indeed, to have the national and regional—north-west London, in my instance—and some of the borough data, we need to be able to look at local data, understand it and know that it is accurate.

I have yet to see the information that is provided to the directors of public health. As of this point, the middle of March, nearly three months into the vaccination programme, it has not yet been shared with me. The fact that it has not been shared with me by my local authority reflects its concerns that the data is not accurate. The Minister will have heard, no doubt, from many other people, that there is a concern that building up from the basis of the local data to a larger picture and then expanding it out to a national picture will give different results, and people will start looking at variations in that data and asking questions about it. I understand that point and can see that it is indeed difficult to get those statistics all squared off. On the other hand, I am absolutely clear that unless we understand the difference between what is in happening in, for example, the Mozart estate area in the Queens Park ward, and in Belgravia and Knightsbridge, we will not get a proper understanding of where the priorities should be.

My local authority has told me that part of its anxiety is that there is a variance between the use of the Office for National Statistics data and the national immunisation management system data, which has led to a significant national population variant of, I believe, as high as 5 million. As my hon. Friend outlined, there is good reason to believe that the percentage variance will be greater in central London than anywhere else in the country. We have seen that in terms of the census and the population figures. I had a debate on the 2001 census because of my concerns about accurate recording of population. However, it is unclear to me, from discussions with people working in the local health service, what population denominators are being used locally. It is unclear who is using what data, and as a consequence it is unclear whether such local data as exists is even remotely accurate.

The question is: does that matter? I would say that it does, because if we are spending time trying to find people who are simply not present, to raise the vaccination rate, for good reasons, we are wasting time and effort on them, whereas at the same time—both phenomena are, I think, true simultaneously—there are wards, estates and communities in my constituency, as there will be in others, where we are failing to make contact with people who need to be contacted, because they are extremely hard-to-reach populations. My hon. Friend outlined some of the reasons for that. There is a high relative proportion of single people who will not necessarily have ties to communities, and links so that we can use the normal channels of communication. There is a high proportion of people with mental health problems, again, often living singly. There is the largest private rented sector in the country, with a high degree of population churn, which means that when talking to someone it is often unclear whether they are the same person who was living there six months before. Unless and until we can be sure of the granular data and understand the baseline population statistics on which it is based, we have a problem.

A secondary data problem concerns ethnicity and understanding some of the issues around both the take-up of the vaccine and vaccine reluctance, which are different components. The issue is that, in central London, we have the largest Arabic-speaking populations, a very diverse set of communities, but these are being recorded under “ethnic—other”, and therefore it is difficult for us to be able to focus in on those communities, which are important, in terms of delivery.

I have written to the Minister with some of these questions, but even since I wrote to him there has been new information from the local authority and from the clinical commissioning groups that raise questions for me about the data. We need to know whether the population that we are chasing is there, whether we are chasing hard-to-reach people or whether we need to focus in on people who have vaccine reluctance. I was told last week—

[Sir Christopher Chope (in the Chair)]

Order. I am sorry, but if the hon. Lady were participating physically, I would by now have been staring her down, because a lot more people wish to participate in the debate. I hope that she will bring her remarks to a swift close so that I can call the next speaker.

[Ms Buck]

Many apologies. I will conclude on that. I have concerns about the data and the investment in support for reaching hard-to-reach populations, and I hope the Minister will address those. My sincere apologies.

Covid-19: Vaccinations

Karen Buck Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

Information, information, information. I am working across Government to make sure that we communicate the benefits, both in terms of protecting the individual, but also in protecting the communities people come from. Working with black, Asian and minority ethnic communities is incredibly important as part of the overall strategy to focus our attention to make sure all those communities come forward, especially those who work in our care homes and care for residents. Many of those workers are from BAME communities. The more that they see people like themselves taking the vaccine and getting protected, the more effective our strategy is to deliver that protection to those communities.

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

Following on very closely from the previous question, does the Minister agree that one of the key ways in which we can counter some of the very virulent anti-vax and covid denial messages on social media, which are impacting particularly in some communities, needs to be through not just a myth-busting approach, but through peer-to-peer positive example messaging within local communities—within faith groups, between neighbours and in local social media networks? Can he make sure that he advises local authorities, clinical commissioning groups and others to promote examples of where people have had the vaccine, so that they can be shared to counter some of those more damaging messages?

[Nadhim Zahawi]

The hon. Lady makes a really important point. I pay tribute to the right hon. Member for Tottenham (Mr Lammy), who reached out to me with his concerns for his community. Sadly, I see among the community that my wife and I come from that there is a lot of disinformation, and not only on social media. There is the very clever and, I should say, evil use of platforms such as WhatsApp to share videos that scare people into not having the vaccine.

The hon. Lady is right that local government and local public health leaders have a central role to play. We are engaging with them and, of course, making sure that local leaders throughout the United Kingdom are telling the story. She is right that the most effective way is for people to see someone like them taking the vaccine and being protected. We are doing that as well.

Covid-19 Update

Karen Buck Excerpts

Monday 14th December 2020 Commons Chamber

[Matt Hancock]

I can absolutely give that commitment and say to the people of Stockport that they have been in restrictions for a long time and have done a great thing in bringing the case rate right down. Of course we have to remain vigilant, and today’s news only further amplifies that fact, but by doing the right thing, they have helped to protect life, and I will look very closely at their case on Wednesday.

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

People want to spend the Christmas holiday with their loved ones—of course they do—and the message of doing so with care is one that we all must stress, but given the very worrying statistics we have heard today, can the Secretary of State tell us if he has asked for or received any modelling on the likely impact of the suspension of restrictions over the Christmas holiday and the movement of people all around the country on the spread of infections and the hospitalisation rates in the middle of January?

[Matt Hancock]

The truth is that it all depends on how people behave, and it is very important that we all urge people to behave with great care and responsibility over the Christmas period.

Covid-19 Update

Karen Buck Excerpts

Monday 5th October 2020 Commons Chamber

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

Despite all the billions that have been spent on testing, we learned at the end of last week that the testing hours in London fell by 43% on the week before. There is also a staggering variation in capacity. My own borough, Westminster, has one of the lowest testing rates in London. Given that the limited capacity means that testing is being directed to those with the highest rates of infection, is there not a very real risk that this will mean that we do not know what is going on accurately across the country because areas that are not getting enough testing are not showing transmission, and therefore we cannot make good decisions? When will we have the testing capacity to allow us to make the right decisions for our people and our economy?

[Matt Hancock]

The hon. Lady makes a really important case. First, as she implies, we obviously have to put the testing capacity into the areas with the biggest outbreaks to tackle those outbreaks. I think everybody understands that. At the same time, we have to increase testing capacity, and we are doing that. But thirdly, if an area has lower testing than another area, we have to make sure that we take that into account when we look at how serious the problem is. We do that in two ways. The first is the positivity rate—what proportion of tests come through positive—and the second is the survey data, particularly the Office for National Statistics survey, which shows that rates in London are higher than in some parts of the rest of the country, such as the south-west, the south-east and East Anglia, but not as high as in the midlands and the north of England, or indeed in Scotland, Wales and Northern Ireland. We have to look at the surveys and the positivity, as well as the basic case rate.

Oral Answers to Questions

Karen Buck Excerpts

Tuesday 23rd June 2020 Commons Chamber

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

What assessment he has made of the effect of covid-19 on the health of people in BAME communities.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

There was a passionate debate on this issue last Thursday. As I said then, there is no doubt that covid-19 has upended our lives. The virus cruelly discriminates by many factors, including age, gender and ethnicity. There are still gaps in our understanding of occupational risks and co-morbidity that need attention. My hon. Friend the Minister for Equalities will be taking forward important cross-Government work with the Equality Hub, Public Health England and others.

[Ms Buck]

We now know the full extent to which covid and other health inequalities affect black and minority ethnic communities, and the extent to which that is reflected in regional inequalities, but does the Minister also understand how much such inequality prevails within boroughs? In my local authority, there is a 16-year life expectancy gap between the poorest communities and the wealthiest, which reflects the disparity with black and minority ethnic communities. Will she ensure that an equalities review tackles inequality within boroughs as well as between them, and will there be funding to support that?

[Jo Churchill]

We know that health inequalities are stubborn, persistent and difficult to change—we knew that before covid-19, but that is not a reason to accept them. We fully agree that more needs to be done to reduce the disparity in health outcomes within the BAME community and the broader community. That is why we will ensure that the work on health inequalities goes on at pace.

Covid-19 Response

Karen Buck Excerpts

Tuesday 2nd June 2020 Commons Chamber

[Matt Hancock]

The answer is “needs must”: whatever is necessary to bring any local outbreak under control. We will take local action with local directors of public health using all the information we have, whether at a highly localised level, more broadly or on an institution basis—for instance, around a school, care home or hospital—if that is what it takes.

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

The pandemic has exacerbated mental health conditions and made it harder for people to access appropriate mental health services in many cases. This morning, I received an email from a constituent whose child has a severe psychiatric condition exacerbated by covid. The child has been in our local hospital for six weeks waiting for a specialist bed and is now hoping that there might be a bed in Birmingham—they are in north Paddington. What can the Secretary of State do to make sure that such urgent mental health conditions are responded to?

[Matt Hancock]

The hon. Lady is right to raise this issue. Mental health services, especially for less severe mental ill health, have in some ways been strengthened by the crisis, because of the extent of psychiatric support online, which in some cases, we have discovered, has been more effective than face-to-face support, especially in paediatrics. That said, of course that is not the case in all areas, especially with some of the more severe conditions, such as the one she outlines, and I am happy to look into that individual case. We are doing everything we can to restore services, in a way that is safe and covid secure, so that people can get access to the services they need.

Covid-19

Karen Buck Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

I will look into that question and get back to the hon. Gentleman.

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

People without a home of their own have particular challenges when seeking to self-isolate, which puts their health at risk, as well as that of the wider public. Can the Secretary of State assure me of two things? First, will everybody who is street homeless be guaranteed the opportunity to self-isolate if they start showing symptoms? People are being turned away from shelters at the moment. Secondly, given that tens of thousands of people are evicted every year, will he take action now to ensure that more people are not added to the homelessness total?

[Matt Hancock]

That is a very important point that is being addressed by my right hon Friend the Communities Secretary, along with the mayors and local authorities, who lead in many cases on the provision of those sorts of services.