Physical Inactivity (Public Health)

Lee Scott Excerpts

Tuesday 18th November 2014 Westminster Hall

[Justin Tomlinson (North Swindon) (Con)]

It is an absolute pleasure to follow the hon. Member for Blaenau Gwent (Nick Smith), who made a very good, thoughtful speech on a very important topic. I have highlighted it a number of times previously in Westminster Hall and the main Chamber.

I am speaking partly as a vice-chair of the all-party group on heart disease, but also because of my own background. My school was bottom of the league tables in Kidderminster. My group of friends replicated whatever was on television, so predominantly we played football, but if Wimbledon was on, out came the tennis rackets; if the Tour de France was on, out came the bikes; and if the Ashes was on, out came the cricket bats. The importance of that was both that I was active and that I kept out of trouble. Two of my friends ended up spending time at Her Majesty’s pleasure, but the rest of us did not follow that path, because frankly we were just too tired at the end of the day, although I remember that when I phoned my old headmaster to say that I had got into Parliament, he said, “You know, the last time someone from our school got into the press, it was because they had gone to prison, but I’m not sure which is worse.” We will all make a judgment on that.

The hon. Member for Blaenau Gwent made a very important point. This debate is not just about sport; it is about the opportunity to be active. That is the part that I want to concentrate on—that opportunity. Before I became the MP for North Swindon, I represented for 10 years as a councillor a new build housing estate. It went from 1,800 to 10,000 houses. I was horrified once to be told that I was very lucky that my ward had the greatest proportion of open space of any ward in Swindon. I knew, as I lived there, that that was complete nonsense, so I did a bit of digging and it turned out that hedges, heritage sites and grass verges counted as open spaces. The last time I put down jumpers for goalposts to play football, none of those counted as usable open space, so it is a welcome move that the Government have removed the higher density rule, but I still think that more needs to be done in planning terms for new development to provide usable open space. That is incredibly important because garden space for one’s own home is now one third smaller than it was in the 1960s and front gardens for new builds are often just an aspiration rather than a reality.

We do not need premier league-standard open spaces for people to be active. When I used to play football during the whole of the summer holidays, we played on an almost vertical pitch, which was very handy, because Matthew and Paul Gilbert, the twins, were considerably better than me and my teammates. We got to kick downhill all day and they got to kick uphill—that was only fair.

We also need to look carefully at how we organise opportunities. I was a big fan of the school sports partnership. The Government looked at that when they first came to power, because there was the worry that in the previous years, even with £150 million being spent, only two out of five children ever took part in competitive sport.

[Mr Lee Scott (Ilford North) (Con)]

Does my hon. Friend agree that competitive sport, whatever sport it might be, in school leagues and various competitions is beneficial in getting young people involved and stopping some of the obesity problems that this country has?

[Justin Tomlinson]

I thank my hon. Friend for that very good point. I am about to come on to that issue, so I shall just pause my response, but I will cover it.

To return to the school sports partnership, there was the worry that after the £150 million had been spent year on year for a number of years, still only two out of five young people were involved in competitive sport. The reality is that if someone is good at sport, that is probably because their parents have encouraged them, and they have probably already signed them up to competitive teams. What the figures did not show was what was happening with the other three out of five children; it was probably the only opportunity that they had to be active. Therefore, the figures were not telling the full story and it was absolutely right for the Government to continue that provision.

Leading on from that was the desire to reinstate the school games, which was competitive sport. I speak from the experience of invariably being on the losing team—that set me up well for being involved in politics later in life. But I think that it is important for children not always to win. My hon. and learned Friend the Member for South Swindon (Mr Buckland) and I visit the Swindon school games every year, and they are a fantastic success. Huge numbers of sports clubs are engaged, as are volunteers; and schoolchildren of all abilities are getting involved.

I also welcome the moves to encourage more troops to become teachers. There is a chronic lack of PE-confident teachers in primary schools. That is a real challenge. I have visited a number of primary schools, and they have said that it is one of the biggest challenges that they face.

I am very proud that when I was a councillor, I set up the Swindon sports forum, which brings together about 60 different sports clubs. They are not necessarily competitive sports clubs. They could be walking clubs or clubs aimed at those aged 60 and above. However, the forum brings clubs together to share best practice and to talk about how they can secure funding from external bodies and how they can sometimes share facilities. There have been a number of major successes in that respect.

We face another big challenge. We talk about the Olympic legacy, and straight after the Olympics or any major sporting event on the television, young people are inspired and want to go and replicate the success that they have seen on the television. Sports clubs are then overwhelmed, in the short term, by huge numbers of new participants. The problem is that the number of children who can benefit is capped by the number of volunteers who are available. Sports clubs are no different from charities, political parties or other organisations when it comes to the real challenge of finding sufficient volunteers. I am a big fan of the Government’s National Citizen Service programme, because it is training young people to be good, constructive citizens. I think that we should look to channel more of those volunteers, in the summer, to go on to become sporting volunteers to help sporting clubs.

There also needs to be a lot more work among youth services, leisure centres and traditional sports clubs. I remember that when I was a councillor, the three would never talk to one another, but I also remember pointing out that on a Friday night there was the ice skating disco. That was not technically sport, but it involved 650 teenagers going round very quickly in a circle chasing after people they found attractive, so I argued that it was probably the most beneficial way of getting young people active.

Finally, there is the big plea that I have made as an MP. We have amazing facilities in this country. Whether it is schools, sports centres or community facilities, they are fantastic facilities. However, we charge an absolute fortune for voluntary groups to come and provide constructive activities, whether for older people or for younger people. It is very hard to get volunteers, and I think it is unacceptable to charge them for the privilege of helping people to be active. In my utopian world, between the hours of 4 o’clock and 6 o’clock, all school buildings would be available free of charge to groups that provide constructive activities for young people. That would help busy parents. It would help to tackle the obesity crisis. It would provide constructive engagement, which stopped me going down a very different path. I make that plea for all parties. There is good cross-party support on the wider principle, and I think that that is the most tangible way in which we could make a big difference.

Hospices (Children and Young People)

Lee Scott Excerpts

Wednesday 18th December 2013 Westminster Hall

[Stuart Andrew (Pudsey) (Con)]

It is nice to serve under your chairmanship, Mrs Osborne. I am pleased to have secured the debate on an issue that is important for me personally.

I have mentioned on a number of occasions that it was my privilege to work in the hospice movement for some 16 years, mostly in the children’s hospice movement. Although being elected to this place was one of the proudest days of my life, it was tinged with a little sadness, because it meant that I had to leave Martin House children’s hospice. Through my time there and at Hope House children’s hospice, I got to see and hear at first hand the incredible stories of so many children, young people and their families. I got to witness people offering care and support not only because it was their job, but because they cared passionately about the families they were caring for. I got to see some remarkable courage and resilience on the part of children and of families living with the constant prospect that their child would not live into adulthood.

Many of my friends often said that they could not understand how I could work in such a place. Their perception was that a children’s hospice was a depressing place, filled with sadness and despair. For someone who walks into any children’s hospice in this country, however, that preconceived idea simply disappears. Of course there are sad days, when a child has deteriorated or come to the end of their life, and there are moments of pain, but for the most part it is rare to visit a children’s hospice and not to hear the sound of music in the background and children laughing, and an atmosphere of warmth and support, not to mention the wonderful smell of cooking and baking by the volunteers.

Martin House hospice is not only the hospice that I worked at, but it serves the children in my constituency. When it opened its doors for the first time some 25 years ago, it was only the second children’s hospice in the UK and it served most of the country. As time moved on and more hospices were built, so its catchment area changed. Today, Martin House offers practical help and support through a range of services to some 400 children and their families. That is the critical bit: it is not only about caring for the child.

When I spoke to many of the families, they would try to describe their feelings on learning that their child was going to have a short life. The most memorable reply that I ever heard was from someone who described it as the loss of hopes and dreams. At the birth of their child, they had dreamt about the child’s first steps, first words and first day at school, about the child going to university, getting married and eventually having children of their own. The family said that they had to make new dreams when they realised that their child would not be able to do those things. Martin House was there to do just that: to help them to build a life for their child.

The hospice offers a host of services that have developed over 25 years through knowledge, experience and listening. The impact on a family in which there is a child or young person with a life-limiting illness is difficult to imagine, but Martin House—like all hospices around the country—is committed to being alongside the children and their families. Such close work has helped Martin House to develop and fine tune what it has to offer, providing truly family-led care and support. The ongoing day-to-day care of a child with a life-limiting illness, which may go on for a number of years, can be a physical and emotional strain on the whole family. Martin House shares that care with them, and it can take various different forms from symptom control, through emergency and respite care to terminal care.

Respite care offers the opportunity for a short stay to give the family a break. I spoke to one father who said that if he got up eight times in the night he would consider it a good night’s sleep. His daughter was eight years old at the time. Imagine doing that for more than eight years—it is no wonder that they need respite and support. Sometimes they may all stay together as a family, or sometimes they leave the child at the hospice, but it is an opportunity for them to recharge their batteries. Many a time I saw them looking exhausted when they arrived on a Friday, but was pleased to see them looking much more relaxed on Monday morning after a weekend of not having to think about feeding the child, doing the ironing, washing or cooking—all of that was taken care of by the wonderful staff.

Emergency support is there for when the families hit those everyday problems that we all experience. If a relative falls sick or there is a problem at home, it is difficult enough for us to deal with, but for someone with a child with a life-limiting illness such things are much harder. Knowing that there is someone at the end of a line, in a hospice, who is able to help is a great relief.

We must also think about the terminal care. No one really wants to think about a child or young person dying, but to be able to think about or, where possible, plan for that time is something that those care teams do with great skill and compassion.

[Mr Lee Scott (Ilford North) (Con)]

I congratulate my hon. Friend on securing the debate. Does he share my admiration for the way in which staff deal with parents, such as at my own local children’s hospice, Haven House, which serves the young people of my constituency in that terrible situation. The care, the passion and the compassion that they show to the parents enables them to deal with something that, in honesty, no parent would want or should ever have to deal with.

[Stuart Andrew]

I certainly agree. I got to know Haven House through my time working in various hospices. It and the other hospices do tremendous care—even at the most difficult and challenging times, they manage to do it with a great sense of dignity, which we should all be proud of.

Ensuring that the families are supported through the most difficult period is paramount, but also beyond that, through bereavement support. What is good about many of the hospices, Martin House included, is that the services are offered not only at the hospice, but in the family home, to ensure that as much as can be done is being done. The first head of care at Martin House was an inspirational lady called Lenore Hill. I remember that her phrase to the families was: “The answer is yes; now, what is question?” Such a philosophy is what makes the hospices so wonderful.

Time has gone on and medical advances have been achieved, so many of the children are now living longer. For example, when I joined Hope House children’s hospice in Oswestry, boys suffering from Duchenne muscular dystrophy would invariably live to about 18. By the time I left Martin House, however, some 14 years later, some sufferers were living into their mid- and late 20s. Naturally, that is good and wonderful news, but it presents new problems.

Urgent and Emergency Care Review

Lee Scott Excerpts

Tuesday 12th November 2013 Commons Chamber

[Mr Hunt]

The number of people waiting more than a year for an operation has gone down from 18,000, when the hon. Gentleman’s Government were in power, to fewer than 1,000 now. We have reduced long waits at a time of great pressure on the NHS, so I do not recognise the hon. Gentleman’s figures at all, I am afraid.

[Mr Lee Scott (Ilford North) (Con)]

My right hon. Friend will have seen the disastrous reports that have come in about Barking, Havering and Redbridge University Hospitals NHS Trust, with some of the most alarming things including a report of a baby being put in a stationery cupboard. I am sure that, as he said in a recent debate, he will conduct a full review of King George hospital. Can that be done urgently, as we are now in a very serious situation?

[Mr Hunt]

I pay tribute to my hon. Friend for raising both publicly and privately his concerns about the hospital provision that his constituents face. We shall of course make sure that there is a proper review before any service changes are made. I hope that he will be reassured by the big change that happened this year with the introduction of an independent chief inspector of hospitals, who is going round the country rooting out poor care, not sweeping it under the carpet, as happened so often under the Labour Government.

Changes to Health Services in London

Lee Scott Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

I understand why the hon. Lady is rightly representing the concerns of her constituents, but she must also understand that I have to look at their interests as patients, as well as at the interests of the broader south London population. It is important to make that amendment to the Care Bill because hospitals are not islands on their own. We have a very interconnected health economy, and what happens in Lewisham has a direct impact on what happens in Woolwich and vice versa. If we are to turn around failing hospitals quickly—something that the last Government sadly did not do—we need to have the ability to look at the whole health economy, not at problems in isolation.

[Mr Lee Scott (Ilford North) (Con)]

Will my right hon. Friend look again at Barking, Havering and Redbridge trust? As he knows, the difficulties that Queen’s hospital has had simply meant that, in its own admission, it would not be able to cope without an A and E at King George hospital for many years to come.

[Mr Hunt]

I commend my hon. Friend for raising this issue with me consistently. I know his very real concern is to make sure that when those changes are made they do not have an adverse impact on his constituents. I will go back and make absolutely certain that no changes will be made until it is certain that they are clinically safe.

Epilepsy

Lee Scott Excerpts

Tuesday 29th November 2011 Westminster Hall

[Steve McCabe]

Absolutely. Young Epilepsy is very effectively carrying out a pilot project, with more than 20 schools, to develop and test a model of best practice that can be replicated in any school. Although there might well be the usual problems of time and finance, I understand that the pilot is now at a stage where it could be rolled out across the country. That would go some way to addressing fellow pupils’ concerns and to preparing staff much better in what to do in particular situations. I am extremely grateful to Young Epilepsy for its work in that area.

The figures suggest that there has been a general increase in epilepsy, but that could be due to better diagnosis. There certainly seems to be a suggestion that greater attention to the recording and monitoring of people with the condition has been a factor, due to the GP outcomes framework and the introduction of the National Institute for Health and Clinical Excellence guidelines, and similar ones for Scotland. Misdiagnosis remains a significant problem: a rate of between 20% and 30% of people being misdiagnosed could equate to something like 138,000 people without the condition receiving anti-epilepsy drugs, at a cost of about £220 million a year.

There is evidence that epilepsy is more prevalent in the most socially deprived parts of the country than in the better-off ones. There is a particular problem, with which the Minister will be familiar, in the allocation of residential care for some people who suffer from epilepsy, with the local authority describing epilepsy as a health condition, but most other people saying that a combination of health and social factors are involved. A particular group to mention in that respect is prisoners. A number of studies have been done, not least by the all-party group, that show that the NICE guidelines are not followed in the vast majority of prisoner cases, and that there are problems with prisoners having access to the proper drugs and, significantly, with diagnosis. There also seems to be a problem with how some PCTs determine access to services, with some using referral and funding panels rather than relying solely on clinical judgment. I would have thought that that is not necessarily in people’s interests.

All of that leads to a picture of a treatment gap. About 70% of the population with epilepsy in this country could be seizure-free if they received optimal treatment, but only about 52% are seizure-free. Too few children are offered or referred early enough for surgery that could cure their epilepsy or at least significantly reduce seizures. I understand that there is a backlog of more than 2,000 children who could benefit from such surgery.

The Prime Minister himself has acknowledged that there is a need for improved services. More than 10 years have passed since the then chief medical officer, Sir Liam Donaldson, said in his annual report that epilepsy services suffered from a lack of interest compared with the management of other chronic conditions such as asthma. Although national initiatives such as the NICE guidelines and inclusion in the GP contract have raised awareness of epilepsy, and although there are patches of excellence across the country, overall service provision in most communities has not translated into sufficient effective interventions. One purpose of today’s debate is to ask the Minister to meet with some of the epilepsy organisations, particularly Epilepsy Bereaved, to discuss what else we can do to prevent avoidable deaths.

I do not want to take too long because I want to let other people speak, but I should mention that there are recurring stories about the deaths of young people. A young boy of nine who experienced frequent seizures had benefited from excellent care from his paediatricians, but he died following a transfer of care during an overnight stay in hospital when his history was not adequately updated. In another case, a young woman died suddenly in her sleep, leaving behind two sons. She had had infrequent seizures but had never been given adequate advice. Some five years ago, two famous cases, those of Erin Casey and Christina Ilia, led to a fatal accident inquiry in Scotland, with which the Minister might be familiar. In summarising, the sheriff was absolutely clear that the risk of sudden death might have been reduced by access to a night monitor or much better information about the particular risk at that point in the evening.

I will not dwell on the number of things we need to do. I take the view that there has been progress in our understanding of epilepsy and that there is probably less stigma attached to the condition these days. I think that the previous Government and the present one have made efforts to improve the quality of care, but we know that significant problems remain. We need to think about whether we can set up a dedicated research fund to look much more closely at epilepsy. General practice needs to be much clearer about risk management, about the potential benefits of technology—for example night monitors—and the need to flag up injuries, A and E visits and missed prescriptions. Good medicines management is needed because, as I said earlier, about 70% of people could be seizure-free if prescribed the right medicine. Much more active monitoring of epilepsy deaths is also needed, so that we know what is happening and can draw up plans to help people to manage the condition.

The depth of the subject tempts me speak for much longer, but as I said at the outset, my purpose is to flag up some of the central issues involved in avoidable deaths and the actions that could be taken to help people who suffer from epilepsy. I will allow sufficient time for other colleagues to contribute and for the Minister to reply to the debate.

[Mr Lee Scott (in the Chair)]

Before I call the next speaker, let me say that I intend to start the winding-up speeches at approximately 10.40.

King George Hospital

Lee Scott Excerpts

Tuesday 8th November 2011 Westminster Hall

[Mike Gapes]

Yes, I should have said that there was no official ballot of GPs, because, of course, the view of the NHS bureaucracy was that the clinical leadership and the practices should make the decision; therefore, there was a strange kind of managed democracy and consultation.

[Mr Lee Scott (Ilford North) (Con)]

Does the hon. Gentleman also agree that it is possible that a number of the GPs who were spoken to were too concerned for their own futures to give their real opinion?

--- Later in debate ---

[Mike Gapes]

There is obviously some uncertainty, because I was not told that when I spoke to NHS ONEL. Perhaps it is having a rethink in light of the report.

[Mr Scott]

If it is helpful, I have also received a letter from Heather Mullin stating exactly what the Minister has said, which is that two years is the minimum time scale for things to be looked at.

[Mr Burns]

rose—

--- Later in debate ---

[Mr Lee Scott (Ilford North) (Con)]

I am grateful for the opportunity to speak in this debate.

Before I talk about anything to do with the hospitals that we are discussing today, we should praise the doctors, the nurses and the back-up staff at Barking, Havering and Redbridge University Hospitals NHS Trust. After everything that has happened in these last few weeks, particularly the reports on the trust, morale must be pretty low. I do not believe that those staff are to blame for the problems at the trust. I believe that criticisms of staff can be made and that there are things that need to be learned, but I also believe that the fault for the problems lies much more with the previous senior management at the trust than with the doctors, nurses, back-up staff and front-line staff. Of course, recommendations for improvements have been made, but those staff took their orders from others and we should try to build morale rather than knock it down. That is what I genuinely feel.

I, along with other right hon. and hon. Members in our local area, thought that the Care Quality Commission report was going to be bad, but I did not think for one moment that it would be quite as bad as it turned out to be. It was damning of just about everything. It was probably easier to see what was right than what was wrong, because the good points were fewer than the bad ones.

I will talk about the CQC report in depth, and at this point I want to mention that I am talking on my own behalf and that of my hon. Friend the Member for Hornchurch and Upminster (Angela Watkinson), who is a Government Whip and therefore is unable to speak in this debate. If she disagrees with anything I say, I am sorry but that is too bad. The damning report by the CQC was ostensibly of Queen’s hospital, but it also points the finger at King George hospital. As with the independent reconfiguration panel report, I was disappointed, upset and angry that the decision that was made had been taken.

I will begin with accident and emergency. In my own constituency of Ilford, North, I believe that a large additional burden will be placed on Whipps Cross hospital. My guess is that in an emergency, people from wards such as Woodford Bridge, Fairlop and Fullwell will go to that hospital, rather than cross the A12 right the way through to Queen’s hospital, so there will be a major problem at Whipps Cross.

The CQC report and the letters that I have received say that, that owing to the pressure of our one-paragraph “Save King George Hospital” campaign, the urgent care centre will now be manned by doctors, nurses and some specialists 24/7, 365 days a year. I acknowledge that, and I am grateful for it. However, in his response to the debate, will the Minister say whether we can look at taking the next step and going a bit further to make that urgent care centre an A and E department.

Regarding maternity services, during the consultation I had a meeting at Barking, Havering and Redbridge University Hospitals NHS Trust, and I believe that the hon. Member for Ilford South (Mike Gapes) had a similar meeting, although we were not allowed to have meetings together, for whatever reason. It was hinted—quite strongly—that a birthing unit would remain, in some shape or form, at King George hospital. I do not know what happened to that idea, but I would like it to be considered, because it came through loud and clear at the meeting that I attended.

[Mike Gapes]

I recall the conversation that I had very well. I was told that the local trust wanted to have the birthing unit, but that they had to get the approval of NHS London and that, as usual with regard to services in Ilford, NHS London’s bureaucracy was less inclined to go along with it.

[Mr Scott]

I thank the hon. Gentleman for that intervention.

I want to praise the hospital’s new management. Averil Dongworth is doing a good job with her staff. She inherited a difficult situation, with a £117 million deficit and low morale, and she should be praised for doing her utmost to turn things around. The CQC report stated that things had improved over the past months.

The hon. Gentleman said that there are 265,000 people in the London borough of Redbridge alone and, given the amount of new build that has outline or detailed planning permission, the population is going to grow considerably. I understand that the situation is similar in Barking and Dagenham, and it is estimated that the area could grow by about 50,000 people in the next five years or so. When I met with the independent reconfiguration panel and the CQC, I mentioned that issue in relation to my own constituency, and I am sure that colleagues have also done so.

On the ballot of GPs that did not take place, GPs were consulted and the report says that they gave their blessing to what was happening. However, that seems to contradict what I heard from a number of GPs who contacted me in private, as they made it clear that although they did not feel confident enough to make their views public they had grave concerns. I know that that is anecdotal, but I want to put it on the record. It certainly happened with me; I know not whether it happened with other Members, but I would be surprised if it had not.

I think that it is fair to say that the private finance initiative at Queen’s hospital has been a failure. It was badly negotiated—the hon. Gentleman acknowledged that that was done by the previous Government and not the current one—it was a bad deal; it was badly set out and there are grave concerns. I understand that the planning applications for the new units that would need to be built at Queen’s have not even gone in, and are unlikely to do so before the new year. The time scale for the build ties in with the two years the Minister mentioned earlier, so that would obviously be a constraint.

In a letter to the hon. Gentleman, we heard that the CQC would undertake a re-evaluation in March 2012. I urge it to make a full report before any changes are made—in two years’ time or whenever—to say, “Yes, we are satisfied that our 73 points of concern have been rectified.”

[Mr Simon Burns]

As my hon. Friend will appreciate, the CQC is independent of the Department of Health, because it is a regulatory body that is concerned with standards of quality. Knowing how it works, however, I have no doubt that on an ongoing basis it will look closely at ensuring that its recommendations are implemented and the required standards for people in that community are reached.

[Mr Scott]

I thank the Minister. I am sure that the CQC will take note of what the Minister, other colleagues and I say in this debate. I have presented petitions signed by a total of 39,000 people, and other Members have presented petitions directly to Downing street; via our local Ilford Recorder, to which I pay tribute for its continued campaign; and in other ways. I am sure that it is an underestimate to say that there must have been a total of 50,000-plus signatures.

[Mike Gapes]

I presented 25,000 signatures, which became 28,000, to NHS London on the initial proposals, and another 32,000 in the latest round. Adding all those together with the ones that went in from other groups, I would guess that it was more like 100,000.

[Mr Scott]

My arithmetic shows why I will probably never be in the Treasury. None the less, a huge number of people have signed petitions.

I ask the Minister to take on board the fact that there is cross-party support for keeping the services that our constituents need at King George’s, and to consider upgrading the urgent care centre by renaming it an A and E and adding a little to it—I do not ask for a lot in life—and a birthing unit at King George’s.

Maternity Services

Lee Scott Excerpts

Wednesday 22nd June 2011 Commons Chamber

[Mr Lee Scott (Ilford North) (Con)]

I congratulate the right hon. Member for Barking (Margaret Hodge) on securing this debate. I would like to follow what she said by outlining the position of myself and my hon. Friend the Member for Hornchurch and Upminster (Angela Watkinson), who, as a Government Whip, cannot speak in this debate. She has met the new chief executive and has been given assurances about the changes happening to improve the dreadful situation we have just heard about.

I would like to speak briefly about the King George hospital. As the right hon. Member for Barking said, it cannot make sense for maternity services at King George hospital to cease, not only because Queen’s hospital is not giving as good a service as King George at the present time, but because, with the birth rate rising, it simply will not be able to cope.

We have heard of the tragic, unnecessary loss of life over the past 18 months, and of the high level of medical negligence payments that have had to be made and that are a drain on already strained NHS resources, as the trust has one of the highest deficits in our country. The situation will only get worse if King George hospital ceases to operate maternity and A and E services, and that would be unacceptable. Were that to happen, I fear that there will be further tragic loss of life. Whichever side of the Chamber one sits on, and whatever one’s political views, we are elected to stop that occurring. That is why hon. Members from both sides of the House have united to try to save the services. I hope that the review panel and Ministers are listening, and I am pleased that the matter was sent to a review panel, with a view to overturning this ridiculous recommendation by the NHS. As Members, we will unite to save the services for our constituents. If we do not do so, it will be a regrettable event.

Carmel Bloom

Lee Scott Excerpts

Tuesday 29th March 2011 Westminster Hall

[Mr Lee Scott (Ilford North) (Con)]

I start by thanking everyone involved in allowing me this debate. Many times in the six years in which I have been honoured to be a Member of Parliament, when people have come to me with a case of a medical nature, I have regrettably had to say that I could not assist them because there was no way to take the case forward. I want to make it clear that this case is not one of them.

I shall start with a brief case history, and the family’s attempt to understand how a normally fit woman went from being perfectly healthy to tragically losing her life during an everyday, routine procedure from which, I am told, no one has ever died. Carmel Bloom, a healthy 54-year-old woman, walked into Bupa Roding hospital on the evening of 27 August 2002. She was found to be suffering from pain in her left side, and was therefore admitted as an in-patient. Earlier that evening, she had gone to the accident and emergency department at the King George national health hospital in Ilford, but because there was a 14-hour wait, she had gone on to the Bupa hospital.

The following day, 27 August, a scan and blood test showed that she had a urinary tract infection and that a stone may have lodged in her lower left urethra. The following evening, exactly 24 hours later, an everyday procedure was commenced in an effort to bypass the blockage and enable the free flow of urine. That was done by inserting a JJ stent—a small J-shaped rubber tube—into her urethra.

Seven hours after the procedure, Carmel was transferred by emergency ambulance to the intensive care unit at the NHS Whipps Cross university hospital. During the transfer, Carmel collapsed into an irreversible coma; she never regained consciousness. Tragically, 10 days later, on 8 September 2002, her life-support machine was switched off, and she was certified dead. Carmel’s family has spent nearly nine years trying to discover what happened on that fateful night, and to understand how a normally fit and healthy woman could die of an everyday complaint with which, I am told, no fatality statistics are associated if it is properly treated in a hospital environment.

The family told me that following Carmel’s admittance to Whipps Cross university hospital’s intensive care unit, it quickly became apparent that the doctors and nursing staff were ill at ease, and I am told that they became quite agitated when asked for further particulars of Carmel’s condition by Carmel’s sister-in-law. I should explain that she is a qualified medical doctor; she resides in Canada, which is why that had to be done by telephone. Which one of us, if we had a qualified doctor in the family, would not ask that person to request information? However, the doctors refused to accept any further calls from her after she requested further details of Carmel’s condition and treatment. I cannot say why that happened.

On 9 September 2002, Carmel’s death was referred to the Walthamstow coroner, as it had become apparent that her death was anything but straightforward. The following time line demonstrates the due process that the family were obliged to follow in their quest to find out how and why Carmel died. As you will hear, my involvement came seven years down the line, as I was not Member of Parliament for Ilford North at the time. Nearly nine years after Carmel’s death, the evidence shows that questions about the causes of her death have still not been properly answered. A number of agencies come into play, but today I shall restrict my comments to the health aspects of the case. At a later date, I shall seek to revisit other justice matters.

In 2002, the first inquest was adjourned; coroner Dr Stearns stood down because of a conflict of interest. In 2003, the inquest was adjourned again; Dr Dolman, the second coroner, stood down but refused to disclose his reasons. In 2003, the third coroner, Andrew Walker, brought in a verdict of death by natural causes. In 2003, the Home Office suggested that application be made for a new inquest.

In 2003, Lord Goldsmith, the Attorney-General, intervened. In 2004, he granted consent for the High Court to quash the inquest verdict of natural causes. In 2004, in the High Court, Lord Justice Tuckey quashed coroner Andrew Walker’s verdict, and ordered that a new inquest be held with a jury. In 2005, the inquest jury overturned the natural causes verdict, finding that a series of failures had contributed to Carmel’s death.

In 2006-07, the Healthcare Commission investigated Bupa Roding hospital. I should say that it is no longer a Bupa hospital. The commission found a series of shortcomings and a serious lack of training and equipment in the hospital, together with false reports being given to them following Carmel’s death. The commission brought no charges against the hospital, stating that it had no power to act in retrospect. Following the investigation, Bupa sold its 26 hospitals.

In 2007, the General Medical Council started an investigation into the conduct and fitness to practise of Mr John Hines and Dr Paul Timmis. In 2007, the London ambulance service disclosed previously withheld evidence—the AS/1 emergency call receipt document and Bupa Roding Hospital’s 999 tape recording. I have seen the transcripts and heard the tape, and there is a gap of approximately 15 seconds in the recording; to the best of my knowledge, it remains unexplained to this day.

In 2007, the police began an investigation into Carmel’s death and looked into Bupa’s alleged false report to the Healthcare Commission on the events that led to her death. As I said earlier, I shall not speak about the police at this stage, except to say that, between 2007 and 2009, the Ilford criminal investigation department referred the case to the Metropolitan Police Service’s homicide and serious crime command unit, following the discovery of new evidence. In 2008 and 2009, the homicide unit referred the case to the Crown Prosecution Service. In March 2008, Bridget Matthews, the night sister on duty at Bupa Roding hospital on 29 August 2002 and the nurse in charge, was interviewed under caution by the Met’s homicide and serious crime command unit, SCD1.

In 2009, the Ministry of Justice investigated a complaint against the 2005 coroner. It was said that the coroner withheld key evidence from the inquest jury. Unfortunately, however, no inquiry took place; the judicial review office cannot investigate coroners’ non-disclosure of evidence to a jury. The non-disclosure of evidence enabled the court to understate Carmel’s condition, but that issue is not the object of today’s debate. I became involved in 2009, when my constituent’s family came to see me. I intervened, and approached the right hon. Member for Blackburn (Mr Straw), then the Secretary of State for Justice.

In 2010, the General Medical Council’s fitness to practise hearing against Bupa doctors Mr John Hines and Dr Paul Timmis commenced. At that stage, I wrote about the case in my newspaper column and in articles, and I thank the Ilford Recorder and the Wanstead and Woodford Guardian for printing them. In my writings, I asked if anyone had information relating to Carmel’s tragic death. I pay tribute to Julie Moody, who came forward as a whistleblower. She made a statement, which caused her great difficulty; that was done at great cost to her personal and professional life, and I record my gratitude for her bravery. She displayed enormous courage and compassion. She was a senior nurse and an ex-employee at the Bupa Roding hospital. She contacted me with vital new evidence about Carmel’s treatment during the night following her operation. I provided this new evidence to the Ministry of Justice and the Met borough commander, but it was withheld from the GMC’s fitness to practise panel hearing against Mr Hines and Dr Timmis. The GMC decided to proceed with the hearing, even though a whistleblower had come forward, casting new light on Carmel’s treatment at the Bupa Roding hospital, with evidence of serious negligence during Carmel’s operation. Entirely inappropriate post-operative treatment was also alleged.

Let me read out the remit of the General Medical Council:

“Our statutory purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.”

It is vital, not only in this case but a number of cases, to decide whether the GMC is a union for doctors—if it is, fine—or whether it is there to represent patients’ interests.

In 2010, the Council for Healthcare Regulatory Excellence considered an appeal to the High Court against the GMC hearing’s decision not to prosecute or even issue a warning against the two doctors, even though, between them, they pleaded to, or were found guilty of, 79 charges, including one where the doctors’ conduct was so serious that it increased the risk of Carmel suffering hypoxia—I apologise for any mispronunciations of medical terms; I know that the Minister is medically qualified, but I am afraid that I am not—cardiac arrest, brain damage and/or death.

In 2010, there was an unsuccessful appeal against a decision of the Independent Police Complaints Commission. The Metropolitan Police Service’s homicide and serious crime unit interviewed the night sister. In an extraordinary development that has still not been explained, the night sister said in her statement that she had been given the whistleblower’s highly confidential statement. That statement had been given only to me—I immediately put it in a solicitor’s safe in north London—the police and the Ministry of Justice. I cannot explain how that could have possibly happened.

In 2010, the Crown Prosecution Service was approached for the third time by homicide detectives who were considering instituting a criminal prosecution, but the CPS failed to reopen the case. In the same year, the GMC referred the Bupa nurses to the Nursing and Midwifery Council for misconduct in relation to the care and treatment of Carmel, leading to her death. Bupa’s resident medical officer, Dr Darko, was also referred to the General Medical Council. Further evidence from the whistleblower—Julie Moody—and a 500-page report were provided to: the Met’s homicide unit; my right hon. Friend the Secretary of State for Work and Pensions; my right hon. and learned Friend the Lord Chancellor and Secretary of State for Justice; the General Medical Council; the Nursing and Midwifery Council; and myself.

All the way along the line, the family, who have suffered great distress over a prolonged period of time, have said that they simply want to know what happened, and want closure. That is why they asked for my assistance, and I have been trying to help to the best of my ability. We are awaiting a number of key developments: the Attorney-General’s consent to apply to the High Court for a fresh inquest; the outcome of a Nursing and Midwifery Council action against the two Bupa nurses; a decision to call for a full police investigation into the death of Carmel Bloom; the GMC’s decision to recharge the two doctors involved; and the decision by the health service ombudsman regarding the London ambulance service’s actions and the part that it played.

I have a number of questions for the Minister. I appreciate that she will not be able to answer them today. I let her see a copy of what I was intending to say last night, but it was too late for her to get any replies to me. The family are concerned that the GMC, the Nursing and Midwifery Council and the Healthcare Commission did not investigate the causation of death. I am not making any accusations against anyone; I am neither a lawyer nor a doctor. None the less, there are so many questions that need to be answered before the poor family can move on and have closure.

The coroner at the 2005 inquest wrongly withheld key evidence—I cannot give any reasons for that; I am not making accusations—contained in the London ambulance service’s emergency 999 call receipt document, to which I referred. That evidence was introduced into the inquest’s rule 37 bundle as an exhibit, but the detail and significance of this document was never pointed out to the jury. The information in that 999 call, which was made by the Bupa Roding hospital to the ambulance service, is significant.

The fact that there is a two-tier legal system is clearly demonstrated by the shocking and disproportionate lack of prosecutions. I am not saying who should or should not be prosecuted, or even whether anyone should be prosecuted. As I have said, I do not have the ability to go into that. However, there are so many conflicting reports and unanswered questions.

Before a fresh inquest for Carmel can be held, some medical personnel must be questioned and a number of medical documents must be disclosed. The X-rays taken during Carmel’s procedure, which would have shown the condition of Carmel’s kidney, have been removed from the hospital’s notes. The chest X-rays taken on Carmel’s arrival at the intensive care unit would show the condition of Carmel’s lungs. The hospital notes state that on her arrival, Carmel had a maximum four-star pulmonary oedema—fluid in her lungs—and no heartbeat. She was cold to the touch, had shut down, and her pupils were fixed and dilated. Forgive me—I am a layman—but those symptoms suggest to me someone who is, sadly, deceased. The operating department assistant anaesthetist who was present during Carmel’s botched operation needs to be questioned, and we need to know the identity of the radiologist who took the X-rays during Carmel’s operation. An investigation is also needed properly to establish the true identity of the anaesthetist who accompanied Carmel in the ambulance.

Let me stress again that Carmel was not suffering from a life-threatening condition. It was a regular occurrence that could happen to any one of us in this Chamber today. If a person dies unexpectedly in a hospital and relatives suspect wrongdoing, negligence or criminality, there is no Government body or organisation— apart from the police, who refused to get involved—willing to assist.

One of the difficulties that I have found with this case is that it falls under the remit of a number of Departments, which is why I have not included certain aspects of the case in my speech. The Minister could not be expected to respond to them, so I will have to revisit them at a later date. I will wind up, because time is moving on and I want the Minister to have the opportunity to reply. Let me, in a removed way, make my own comments. During this case, I have been moved by the dignity of the family and the whistleblower. There have been times when the family have been under great pressure and stress, and I have had to explain that there are things that I can do, and things that I cannot.

When I first met the family more than two years ago, I pledged that I would stick with the case to try to get the answers and the closure that they need and deserve. I pledge again today that I will stay with the case. When this first started, I received a phone call warning me off the case. To this day, I do not know who that was or what their reason was. I do not pretend to be a remarkably brave person, but if I give my word, I stick to it. I brought this case before the Chamber today, and I feel honoured to have done so. I thank you, Miss McIntosh, for your time and await the Minister’s response.

[The Parliamentary Under-Secretary of State for Health (Anne Milton)]

It is a pleasure to serve under your chairmanship, Miss McIntosh. I congratulate my hon. Friend the Member for Ilford North (Mr Scott) on securing this debate. He has set out, with considerable passion, some of the detail that led to the death of Carmel Bloom following her operation to remove a kidney stone. It was a moving speech and I commend him for the support that he has given to Ms Bloom’s brother, Bernard, who has worked tirelessly to try to establish the sequence of events that led to his sister’s death.

My hon. Friend has worked tirelessly to give support not only to Ms Bloom’s brother but to the family. I should like to take this opportunity to extend my sympathies to the family. Being unable to find out the circumstances of Ms Bloom’s death or to get any closure is a terrible burden to live with.

As my hon. Friend has eloquently said, there have been numerous investigations and inquiries into the treatment that Ms Bloom received. I know that in 2002 there was a coroner’s inquest that recorded a verdict of death by natural causes. The second post mortem did not provide conclusive statements and a further inquest in the presence of a jury found the cause of death to be

“progression of pre-operative infection following surgery, to which the absence of post-operative intubation, ventilation and monitoring contributed.”

However, none of those investigations or inquiries has brought the closure that is required by the family, or a feeling that they have found out the true circumstances of what happened.

As my hon. Friend has said, there were fitness to practise hearings into the behaviour of two clinicians, but those hearings found that the failings of neither clinician amounted to misconduct. The hearings came to the judgment that it was not necessary to issue a warning in either case. As I say, none of those investigations or hearings has resulted in an explanation that has satisfied my hon. Friend or indeed Ms Bloom’s relatives.

I have nothing but admiration for people who pursue answers to questions, sometimes, sadly, in the face of considerable adversity. Unfortunately, it is really down to their tireless efforts that we learn more and more about the failings of systems. What is important is that we ensure that we learn lessons and that those failings do not happen again.

As my hon. Friend said, Mr Bloom has taken up his case with the Metropolitan Police Service and so my hon. Friend will appreciate that, in the light of ongoing inquiries, I cannot comment further on any police action. I know that that might be a disappointment to Mr Bloom, but it is essential that due process is allowed to take its course free from interference from the influence of Government Ministers.

I also want to commend my hon. Friend for his tribute to Julie Moody. Whistleblowers, for want of a better word, are an important part of this process and we have strengthened the protection of people who have information that we feel is important. That information, when it reflects on the safety and efficacy of treatment, is absolutely vital and it is important that those people are protected.

Services provided by independent hospitals such as the Spire Roding hospital are subject to regulation and inspection. All health care providers in England, whether they operate in the independent sector or in the NHS, are subject to both professional regulation and system regulation. It is important that those things work and are effective.

Health care professionals are required to be registered with their relevant professional regulator. As my hon. Friend knows, in the case of doctors, that is the General Medical Council. He is absolutely right that the GMC’s purpose is not to act as a trade union—the British Medical Association is the trade union for doctors—but to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. It does that by controlling entry on to its register, and by setting standards for medical schools and postgraduate education and training. The GMC registers doctors to practise in the UK and, where necessary, it has the power to issue warnings, remove a doctor from the register, suspend a doctor or place conditions on a doctor’s registration.

Interestingly, in preparing for this debate, I got out some figures about the GMC. In the last year that we have figures for, the GMC undertook 270 fitness to practise hearings, which resulted in 68 instances of doctors being struck off the register and 77 instances of doctors being suspended. I think that those figures give my hon. Friend some idea of the sort of activity that the GMC is engaged in.

At the time of Ms Bloom’s death, independent hospitals were registered with the then Commission for Health Improvement, but since that time a new system of registration has been introduced, which focuses on the outcomes of care that matter most to patients. Although I will not be able to respond to all my hon. Friend’s comments and questions today, it is perhaps important for me to set out some of the changes that have been made.

All health care providers are required, as part of their registration with the Care Quality Commission, to have an effective complaints mechanism that will enable them to learn from the experience of patients. That is an important point to make. Often we cannot change what has happened and we cannot always correct mistakes. People want to know what happened, but most importantly they want to know that things have changed as a result of what has happened to them or to their family and that lessons have been learned.

In the first instance, a complaint would be considered by the provider itself. In the case of the Spire Roding hospital, if a complaint is not resolved to the satisfaction of a patient at the hospital level, I understand that an independent review can be requested from Independent Healthcare Advisory Services. On 1 October last year, the registration of independent health care providers was transferred to the new registration system operated under the Health and Social Care Act 2008. Under that new system of registration, all providers of a regulated activity—whether they are privately or publicly funded—are legally required to register with the CQC. Providing a regulated activity without being registered is indeed a criminal offence and in order to be registered a provider has to meet and must continue to meet 16 registration requirements. Those requirements set out the essential levels of safety and quality for the provision of health care and adult social care in England. Those are essential levels of safety and quality, and as I have said already they focus on the outcomes that matter to patients and all service users.

Where a provider provides services that do not meet those essential levels of safety and quality, the CQC now has additional enforcement powers that were not available in 2002. For example, it can now issue a warning notice for non-compliance and a new financial penalty notice can be issued in lieu of prosecution through the courts. In extreme cases, the CQC has the power to close down a specific service or ward, or to cancel a provider’s registration and/or to bring a prosecution for non-compliance. If the CQC does bring a prosecution, the courts are now able to impose a larger fine of up to £50,000 where a provider has failed to meet essential levels of safety and quality. Those powers should provide some assurance to patients and service users that wherever they access health and adult social care they will receive a service that at the very least meets essential levels of safety and quality.

The CQC is risk-based and it should be a transparent regulator. That transparency is very important. Its inspections are informed and guided by the intelligence that it gathers about providers, and its inspection reports are publicly available on its website. I understand that there have been three inspections of the Spire Roding hospital in the last few years and that there were two inspections in 2009.

I can assure my hon. Friend that we want robust and effective regulation of health care providers and that we want to improve current arrangements. The health reforms that are currently before Parliament will strengthen the role of the CQC, by giving it a clearer focus on regulating the essential levels of safety and quality. In addition, we have also set up HealthWatch as a new and powerful consumer champion for users of health and social care services. It is very important that that voice for patients and the public is heard. HealthWatch will be established as a committee of the CQC and it will provide a direct route for the views of service users to reach the regulator.

[Mr Scott]

Would the Minister be willing to get back to me on the points that time obviously has not permitted us to cover today?

[Anne Milton]

I know that time is running out on us and I will certainly get back to my hon. Friend. My door and the doors of other Ministers are always open if it would be useful to have a meeting to clarify some of the issues that we have discussed. Of course, as I have said we cannot necessarily interfere in processes that are already under way.

I know that what I have said today will not change things for Ms Bloom’s brother and the rest of her family and friends, and I also know that the ripple effect of a case such as this one goes far and wide. Sadly, what I say today cannot provide the closure that they want, but hopefully I can work with my hon. Friend to give him and Ms Bloom’s family and friends some of the answers that they so desperately seek.

Health and Social Care Bill

Lee Scott Excerpts

Monday 31st January 2011 Commons Chamber

[Mark Simmonds (Boston and Skegness) (Con)]

It is always a pleasure to follow the right hon. Member for Rother Valley (Mr Barron). Although I did not agree with much of his speech, I strongly agree with his last point about the importance of keeping the foot on the accelerator to try to narrow health inequalities. That is right at the top of the priorities of Health Ministers. This is a very important and complex Bill. We all want to see high-quality care and value for the taxpayer in the provision of health care. I think it is fair to say that there has never been a better-informed, more knowledgeable and better-prepared incoming Secretary of State than we have at the moment.

The opening speeches by my right hon. Friend and by the shadow Secretary of State stood in stark contrast to one another. I feel rather sorry for the shadow Secretary of State. He is clearly an intelligent man, but he is cornered by the supplicatory role that his leader is playing to the trade union movement. I am sure that the shadow Secretary of State agrees with the Government’s introduction of independent treatment centres. I am sure that he also agrees with the previous Government’s introduction of the independent sector into provision and into commissioning, “any willing provider”, practice-based commissioning, payment by results—although it was payment by activity then—and national tariff ceilings within quality standard frameworks. However, he could not say so because he is cornered.

Listening to some Labour Members, one would think that there were no improvements to be made—that the national health service was a utopian structure prior to the last general election. Let me point to 10 things that I sketched out this morning: too much money spent on administration and bureaucracy and not enough on front-line patient care; too little patient-centric information to inform decision making; too little innovation; too little clinical input into decision making; too much inertia and hostility to reform, as we have seen today; too much process-driven target culture distorting clinical decision making; falling productivity; poor outcomes across a range of clinical indicators; too often, weak commissioning of servicing; and widening health inequalities in the past 10 years, in addition to the scandals that occurred in Staffordshire and Kent. That is hardly a situation that makes the status quo desirable.

[Mr Lee Scott (Ilford North) (Con)]

At the risk of being accused of management-bashing, may I point out that somebody in my own trust who worked up a deficit in excess of £100 million was rewarded with a large pay-off when he left the NHS? Can that possibly be right?

[Mark Simmonds]

My hon. Friend is absolutely right. I remember him fighting tirelessly and vociferously to try to prevent those in the health service and the then Health Secretary from allowing that to happen.

Another thing that Labour Members have to understand is that we must move the NHS towards being a service that is centred on the patient, not one where the patient revolves around the system. To enable that to happen, we must measure and improve outcomes on a continuing basis, and we must do it with patient-centric information that will enhance patient choice, not only about the choice of the provider and the location of their treatment, but about the treatment that they receive for their ailment. This Bill deals with all the failings that were present when the Labour party was in charge.

There are three or four areas where the detail still needs to be discussed, and I want to make some suggestions. There must be an opportunity for integrated care and for improved patient pathways. I would very much like acute clinicians, pharmacists and others who deliver patient care to be involved in GP consortia and the commissioning process. Some of the more forward-thinking consortia are already involving acute clinicians, and this needs to be implemented across the board. We need to find a non-prescriptive architecture to enable consortia to work together to collaborate where appropriate, not only in the all-important area of cancer, as appropriately highlighted by my hon. Friend the Member for Basildon and Billericay (Mr Baron), but in acute stroke services. This has been done successfully, and it must continue to be done.

Performance management is absolutely critical. The Bill seems to make no specific mention of out-of-hours care. My right hon. Friend the Secretary of State will remember only too clearly the terrible case of Mr Gray, who was killed by Dr Ubani, the out-of-hours doctor who flew in from Germany and prescribed him the wrong dose of a drug. That was a performance management failure. The SHA failed to monitor the PCT, which was failing to monitor the provider. We must ensure that GPs are involved in driving improvements in out-of-hours care as well as in-hours care.

We need to look at GPs’ contracts. It is rather perplexing that a PMS—personal medical services—contract could be held by a national commissioning board. Who will be in charge of revalidation, training and performance lists? We must move GPs’ quality and outcomes framework towards one that is outcome-based rather than process-based.

Health Services (North-east London)

Lee Scott Excerpts

Thursday 21st October 2010 Commons Chamber

[Mike Gapes]

It may be a new Labour term, but it is still being used by the current Government, so if the Minister can do something to stop that, I would be grateful.

There was a report back to “stakeholders” in September. I shall come to that in a moment, but let me first give a flavour of the responses that were received as a result of the whole exercise. For instance, the responses from the local authorities have been listed. The London borough of Redbridge sent in a clear response, which was a resolution adopted unanimously by the council that said:

“having taken account of the need to provide a wide range of health services in Redbridge which are able to meet the needs of our growing and diverse population, we express our strong opposition to the Health for North East London ONEL proposals to downgrade services at King George Hospital which would include (a) closure of the Accident and Emergency department (b) the ending of critical care support and acute surgical and medical treatment; (c) the ending of Children’s surgery and (d) the ending of maternity delivery in the Borough”.

That was the unanimous Redbridge position, supported by all parties and councillors among the 63 members of Redbridge council.

Barking and Dagenham council took a similar position, writing in its covering letter that it was “concerned about the proposals”. In particular, it was concerned that Queen’s hospital in Romford, which is the larger of the two hospitals in the Barking, Havering and Redbridge trust, would not be able to cope with the increased pressures, including the increased pressures on A and E, and maternity services. Interestingly, Waltham Forest council, which, in a previous incarnation in 2006, had come out in favour of the Fit for the Future proposals, said in 2010 that it would not comment on the A and E position. However, the council was critical that concerns about mental health had been neglected, saying that alternative services were needed. Waltham Forest council also said that Health for North East London needed to

“spell out what will be involved in reducing the number of A & Es from six to five especially in terms of impact on the remaining A & E departments”,

adding that the proposals were not clear. Newham council said that it was not convinced by the proposals either:

“We also note the significant changes to service provision at King George’s hospital. It will be necessary to closely monitor any resulting impact on our local Newham Hospital… Our expectation is that any increase in activity will be matched by appropriate resource levels.”

That was a conditional position. Tower Hamlets did not want to comment on the proposal either. Among the borough councils—these are representative bodies, the people who represent the community—there was either a clear opposition or at least indifference or ambivalence.

What about other organisations? I have already mentioned the Newham trust. It said something very important in its documents:

“experience with the Gateway Surgical centre supports the model of locating elective care in a separate building but on the same site as acute provision, allowing easier access for staff.”

The whole thrust of the proposals is to separate the two out, whereby the elective and the acute are in different places, yet this has been questioned even by one of the hospitals that could benefit by receiving the transferred patients.

The position adopted by other organisations is also significant. The Ipsos MORI documents make it clear that very strong views were expressed. The essence of my debate is captured by an important sentence, which states:

“The views opposing the reduction… from six to five hospitals providing accident and emergency, critical care and maternity services…came from organisations representing the public (elected local authorities and patient representative groups such as LINks)”.

It continues:

“It should also be noted that some opposition was also expressed from representative groups associated with NHS staff, notably some Local Medical Committees.”

Who, then, is in favour of these proposals? Not a lot of people, it seems. Within the local community in Redbridge, it is very hard to find anybody in favour of the proposals. Perhaps some people in other boroughs might be found, but it is certainly true that in Redbridge it is very hard to find anybody of any authority or any representative political role who is prepared to speak out.

[Mr Lee Scott (Ilford North) (Con)]

Does my constituency neighbour agree that of the people who seem to be in favour of this proposal, none have actually lived in the area? Indeed, if I am not mistaken, some of the doctors involved in it were from Newham.

[Mike Gapes]

The clinical director behind these proposals is Dr Mike Gill, who is based at the Newham General hospital, and the general practitioners involved come from Waltham Forest. I think we can safely draw the conclusion that they have other interests in these matters.

On the proposals to end maternity services, I remind the House that we have had a maternity hospital in Ilford since 1926 and there are presently about 3,000 births a year at King George hospital. The Ipsos MORI summary of the conclusions states:

“On maternity services specifically, there were detailed submissions that made specific comments”,

some of which are cited. It notes that the Royal College of Obstetricians and Gynaecologists—a not insignificant organisation—had

“changed its view of maternity service provision”

and cites the royal college as saying:

“The trend towards a rising birth rate in this area over the next decade cannot be ignored, which will have a direct bearing on the capacity of a large unit at Queen’s Hospital.”

It made the following recommendation:

“Both units (King George V Hospital and Queen’s Hospital Romford) should be developed and sustained as fully-fledged maternity units.”

Those, it said, should be accompanied by “midwife-led units”. That was directly contrary to the position taken by Heather O’Meara and the outer north-east London organisation.

The document quoted the Royal College of Midwives as saying that the proposal for King George V Hospital and Queen’s raised concerns about

“the ability to deliver the configuration of services in such a way as to not result in a high volume of births at Queen’s Hospital.”

It also said that there were

“challenges in relation to…capital investment and workforce planning…in achieving the recommendations.”

The team of midwives from Barking, Havering and Redbridge University Hospitals NHS Trust, who work at the two hospitals, said:

“Geographically, there will be no obstetric unit in Redbridge to serve the women of this area. Residents of Barking will need to travel further for obstetric led care… Although women will have greater choice for low risk birth there will only be one option for hospital birth in three boroughs.”

I could produce more quotations. There are so many in the document. But what has been the outcome? A meeting was organised on 30 September, of which neither the hon. Member for Ilford North nor I was given notice. I only received the information about it because one of my local councillors managed to get hold of the slide presentation. It was advertised as a “stakeholder discussion event”, and was held not at West Ham football ground but at the Holiday Inn, Newbury Park, in the constituency of my constituency neighbour, the hon. Member for Ilford North.

The “stakeholder discussion event” document is very interesting. Anyone reading it might assume that the recommendation was done and dusted. It contain presentations by Heather O’Meara, who is now the chief executive of all the outer north-east London primary care trusts; by Helen Brown, who works for NHS London; and by leading figures in the process. They spoke of “proposals”.

There has been a consultation, which has revealed serious concern among professional organisations in the area, and strong opposition from the local authorities. It might be assumed by anyone believing that consultation and public involvement really matter that something would have changed. On Friday morning, my neighbour and I had a meeting with Heather O’Meara, who described the outcome of the consultation as “some caveats”. She also said that the stakeholder discussion event had been based on clinical working groups where the ideas had been tested, and that there had been consultation with GPs and a huge number of public events. I had not noticed those huge events. Perhaps they happened in big places.

[Mr Scott]

Is it not fascinating that neither of the two local Members of Parliament most closely affected by the proposals was informed about the events and consultation that were allegedly happening, or was invited to take part? Is that not slightly strange? It might give us a complex: we might imagine that they did not want us there.

[Mike Gapes]

Why on earth could that be? I do not know.

On Friday morning, we discovered that the stakeholder discussion document and other proposals would be put before a meeting on 15 December of the joint committee of primary care trusts for outer north-east London. We asked questions. We asked what the process is before then. We asked whether there will be a role for the health overview and scrutiny committees of the local councils—we were told that there would not be. We asked what would happen to the role of the London region NHS and we were told that the meeting on 15 December will make the decision. So we asked who is to be consulted about these proposals before that meeting. That is when the statements that have been made and the positions of the Minister were quoted to us; what we were told is in line with the guidance from the Government since the election.

The Minister wrote to me on 12 October about a complaint I had received from a constituent. He stated:

“In May, the Secretary of State for Health announced a review of all service change proposals. He has outlined new, strengthened criteria that he expects decisions on NHS service changes to meet…proposals must have support from GP commissioners; arrangements for public and patient engagement, including local authorities, must be further strengthened; there must be greater clarity about the clinical evidence base underpinning proposals; and proposals must take into account the need to develop and support patient choice.”

Let us leave aside the last two of those. We have been given a clear view from our local authorities about the original proposals and we have been given a clear view of the public attitude to those proposals. What we have now been given is a slight tweaking of the consultation document. Three or four minor modifications have been made to the proposals and, as a result, those involved now intend to go ahead with the essence of the original proposals.

To confirm what I am saying, I wish to quote from a document produced by Helen Brown as part of the stakeholder consultation. On page 48 of the stakeholder presentation, under the title “Activity and capacity”, is a table describing the

“Proposed shift of activity to hospital sites”.

The figure for the row headed “Non-elective”, which relates to people admitted to the accident and emergency department for King George hospital, is minus 25,937 or minus 100%. That hospital’s figure for “A&E” is minus 59,565, or 100%, and its figure for births is minus 2,910, or minus 100%. Its elective activity is increasing, with some 18,000 being transferred from the Queen’s hospital, so that is a partial shift. Originally this was to be limited, but now some facilities are being moved in. However, the essence of the proposals—to get rid of the A and E department, the children’s surgery and births at the King George hospital site—remains.

So what does this mean? It means that the consultation that has been engaged in at great cost—the public stakeholder engagement—is a sham, a charade and a waste of money. The people behind the proposals, who tried and failed in 2006, and who tried in 2009 only to have this dragged out for longer, are now absolutely determined. This is a juggernaut being driven by unelected people in the NHS bureaucracy. They are disregarding the views of the local community and disregarding the Members of Parliament and the local councillors, and they are not going to be stopped because as far as they are concerned they are right.

My neighbour, the hon. Member for Ilford North, will doubtless wish to comment on the fact that on Friday morning we got into the essence of the issue, when we heard the argument that clinicians know best. In which case, what is the point of pretending that a public consultation is being carried out? What happens if the consultation comes up with a conclusion that these people do not like? I recall the old quote of Bertolt Brecht, “The electorate has made the wrong decision, so change the electorate.” Joseph Stalin’s 1936 constitution was adopted and the result was announced the day before the referendum was held in the Soviet Union. Are we moving that way with certain people in the professions believing that they know best, disregarding the wishes of the community?

King George hospital is not perfect. We have a lot of problems, but we also have a lot of problems with the other hospital in the trust, Queen’s hospital. The two together have a big ongoing deficit that they have had for five years and, despite promises to get rid of it, they have not done so. There is a real difficulty and I believe that an element of this is financially driven. As I pointed out in 2009, getting rid of the A and E at Newham general hospital would save £28 million a year, whereas getting rid of the A and E at King George hospital—according to the figures provided by those behind the proposals, not mine—would save only £19 million. Nevertheless, the decision has been made to go ahead with getting rid of the A and E at King George.

We are facing a very important time. We need a decision that is in the interests of the people, not in the interests of the people who run the bureaucracy of the national health service. There are strong arguments, but I want to finish with a quotation of the Prime Minister. In answer to a question yesterday from my hon. Friend the Member for Ealing, Southall (Mr Sharma), the Prime Minister said:

“The whole point of the reform of the NHS is to put power in the hands of patients and doctors, so decisions about hospitals will be made on the basis of what local people want”.—[Official Report, 20 October 2010; Vol. 516, c. 947.]

Interestingly, last Friday morning we asked, “How will the doctors be consulted?” We were told, “We will take soundings,” so we asked, “How do you take soundings? Is there a ballot? Do the GPs vote on whether they agree to the proposals?” We were told, “No, we will take soundings of health practices.” So we asked, “What is a health practice?” My GP is part of a health centre and there are eight or nine GPs. We were told that each practice would have one vote. So a single-handed GP could be equivalent to eight or 10 GPs in a group practice or health centre. That is a very strange way to find something out. It is perhaps like the Hong Kong Legislative Council or the estates in pre-revolutionary France, but if we are talking—as the Prime Minister said—about decisions made on the basis of what local people want, we need to be clearer about who is making those decisions.

I fear that at the meeting on 15 December these proposals will be pushed through regardless, and the running down of the accident and emergency—which is already beginning, with salami-slicing—and of the maternity services will start, so that in future no one will be born in Ilford except in the back of a car or taxi rushing them to the Queen’s hospital in Romford. People who need to go to the local hospital will not have that hospital facility, because they will have to go several miles away.

These matters are so important to my community and my constituents that I hope that I will not have to come back to this House for a fourth time with a debate on the future of my hospital—but if necessary I will do so. I hope that when the Minister responds he will reassure me that this process will not be allowed to be driven in the interests of people who are disregarding the wishes of the local community and their elected representatives.

[Mr Lee Scott (Ilford North) (Con)]

I congratulate my constituency neighbour, the hon. Member for Ilford South (Mike Gapes), on securing the debate. We must both be feeling déjà vu, because we have found ourselves on many previous occasions debating and saying exactly the same things about this issue. However, the situation now is totally different.

I will try not to repeat anything that the hon. Gentleman has said, although the events of last Friday were a little surreal, to say the least. We sat down and were told about all the consultation that had been taking place, which was surprising news to us. I had received an invitation that was posted the day after the meeting had taken place—so my hosts were obviously desperate for me to be there! I realise that they might have been unhappy with me because of my views about Redbridge NHS, but not inviting me to the meeting until after it has happened was, perhaps, a step too far. The hon. Gentleman has compared that to a rigged Afghani election, but I think that is being unkind to rigged Afghani elections; it was far worse than that.

This House has been presented with a petition of about 9,000 signatures from my constituents in Ilford North and another from the hon. Gentleman that brings the total of signatures to about 27,000. Our local paper, the Ilford Recorder, has also presented petitions to Downing street, of a further 16,000 signatures. In my past five and half years as Member of Parliament for Ilford North, not once has anyone e-mailed, phoned, come to my surgery or written to me to say, “We think it would be a wonderful idea to carry out these proposals,” and all these thousands of people are opposed to it.

I shall now turn to the process. Two weeks ago I received a phone call from the Ilford Recorder asking what I thought of these proposals, which, as the hon. Gentleman said, are virtually identical to proposals we have previously seen on various occasions over the past number of years. I said that these proposals could not be proposals because they had not undergone any independent review, which we had clearly said would take place if we became the party of government and which was clearly stated during the last days of the previous Government. Miraculously, by the time the press phoned Redbridge NHS back, they were no longer proposals; they were now just a possibility or an option—although, funnily enough, I did not see too many other options in the document. Like the hon. Gentleman, I found that my copy of the document turned up three weeks after the meeting—which I admit was not held at West Ham United football ground. It turned up in my office late—after the meeting—so I could not possibly have commented on any of its contents as I had not known about them at the time of the meeting.

It seems to me that the previous leader of Redbridge NHS, who is now in a much more exalted position, had decided that, come rain or shine, she wanted to push through the proposals. In the past, both the hon. Gentleman and I as the local Members of Parliament were called in for a meeting or a briefing separately, not together. I should say here that even though we clearly disagree on a number of political matters, it is not possible to put a cigarette paper between us on this matter; we are in total agreement on it. Those at Redbridge NHS have, without any question, tried to change that by briefing us separately. The people briefing us have come from Newham and a practice that is serviced by Waltham Forest, so would obviously not be affected by any changes at King George hospital. They would say what a wonderful idea it was, yet in all the conversations and meetings I have had, not one GP has said that; they have all said that they are concerned about its impact .

If, God forbid, someone were to be involved in an accident or have a heart attack in my constituency, they could die before they got to Queen’s hospital accident and emergency unit. I am not over-dramatising; that would sometimes happen, and that is why there has been such an outcry against this plan from the whole of Redbridge—not from one part of it or from one political party, but from the whole of Redbridge.

I go back to one freezing cold day last year when I, the hon. Member for Ilford South and hundreds of others marched through sleet to protest against proposed closures to the accident and emergency, maternity and other services at King George hospital. We did the same again—admittedly in much more clement weather—this year. The message was loud and clear: the results of this lack of consultation that are going forward to the meetings on 15 December are absolutely null and void and do not meet any of the criteria, because there was no proper consultation.

I and the hon. Member for Ilford South have held meetings in our respective constituencies and invited members from Redbridge NHS. I want to state clearly that in no shape or form were they political meetings, because they were open to the general public and I have no idea of the allegiances of those who attended them. None the less, the message was loud and clear: we need to maintain our accident and emergency and maternity services at King George hospital. They cannot be closed by stealth. They cannot be salami-sliced and closed. They must remain.

I would like to thank my hon. Friends the Members for Hornchurch and Upminster (Angela Watkinson) and for Romford (Andrew Rosindell) for their help and support. Their areas are serviced by Queen’s hospital. People might not think, because that hospital is not under threat, that the proposals would affect my hon. Friends’ areas, but of course it would, because the pressure of 250,000 extra people using Queen’s hospital will have a knock-on effect for their constituents.

I do not intend to detain the House further. However, like the hon. Member for Ilford South, I tell the Minister that this consultation is wrong. If those concerned try to railroad through the suggested closures on December 15, we will resist.

--- Later in debate ---

[Mr Burns]

I agree that we do not need to get into to-ing and fro-ing about what exactly was written. My point was that some of the questions—I am not saying all of them—on some of the petitions were not directly relevant to what was being consulted on. Having said that, it has been recognised that they will be considered as part of the consultation process.

[Mr Scott]

My own petition did not say anything like “Lee Scott’s petition”; it talked purely about the proposals to close A and E and maternity services, and made no reference to anything else. I therefore trust that those 8,000 names will also be taken into account.

[Mr Burns]

I have no doubt that they will, as part of the ongoing consultation and evaluation of responses to the consultation process.

Before 15 December, the London strategic health authority will assess north-east London’s readiness against the four tests that my right hon. Friend the Secretary of State introduced in May this year to ensure more local engagement in the proposed reconfigurations of services throughout the country. In certain previous consultations, there was a long-held view that although lip service was paid to local people and medical practitioners—clinicians and GPs—the views of the local community did not matter because, in effect, a decision had been taken at the launch and things would end up in exactly the same state at the end of the process.

To give greater credence and importance to local views, my right hon. Friend the Secretary of State announced his changes to the criteria that had to be conformed with for reconfigurations to take place, to empower people to take part in the discussions and to ensure that their views would be fully considered before decisions were taken. To achieve that, he has said that reconfigurations and consultation processes that are already in progress will have to be checked against the revised and strengthened criteria to ensure that they have been carried out under the new format. I can assure the hon. Member for Ilford South that that will happen prior to the meeting on 15 December.