Commonwealth Heads of Government Meeting

Debate between Lee Scott and Mike Gapes

Wednesday 6th November 2013 Westminster Hall

[Mr Scott]

Yes. Of course it would be wrong to impose any restrictions. If we truly are to move things along, there must be free access for anyone—not only the British delegation, but any other delegation—to go anywhere, see anything, hear anything and speak to the people without those people being scared to say what they want to say.

[Mike Gapes (Ilford South) (Lab/Co-op)]

I thank my constituency neighbour and friend for giving way. I suspect that he is aware that the Select Committee on Foreign Affairs has called on the Sri Lankan Government to assure the Prime Minister that anyone he meets, and their families, will not subsequently be harassed or intimidated. We know that that happens regularly in Sri Lanka. If the Prime Minister meets figures who are critical of the Government, there is a risk that the situation may be serious for them after he and other Ministers have left.

[Mr Scott]

I agree totally with my neighbour.

I know that many other hon. Members wish to speak, so I will not continue for long. I have raised my concerns, but I raise one final point. Those of us who have spoken out for justice, reconciliation and peace for all in Sri Lanka should not be targeted and accused of being terrorists or of being wrong. That is unacceptable. Hon. Members on both sides only want justice, peace, reconciliation and accountability.

Sri Lanka (Human Rights)

Debate between Lee Scott and Mike Gapes

Wednesday 22nd February 2012 Westminster Hall

[Mr Scott]

I agree with my hon. Friend. I will personally go to the Human Rights Council to try to ensure that that happens. I will be with other hon. Members from all parts of the House.

The Americans have explicitly stated that if the internal mechanism is flawed and accountability is not addressed, they will put pressure on an international mechanism to probe human rights abuses. I ask my hon. Friend the Minister whether we can support the Americans at the UN in Geneva.

[Mike Gapes (Ilford South) (Lab/Co-op)]

Does the hon. Gentleman agree that we should also look at other international channels apart from the United Nations, given that the Human Rights Council took a deplorable decision in the previous consideration not to support an international inquiry into the event? The British Government should also raise the matter within the Commonwealth and follow the lead of the Canadian Prime Minister, who said that unless the situation in Sri Lanka changes, he will not attend the Commonwealth Heads of Government meeting in Colombo in 2013.

[Mr Scott]

I thank the hon. Gentleman for his intervention. I agree that we need to pursue every avenue, including, if necessary, going to the Commonwealth.

King George Hospital

Debate between Lee Scott and Mike Gapes

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.

--- 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 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.

Health Services (North-east London)

Debate between Lee Scott and Mike Gapes

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.