Accident and Emergency Departments

Baroness Hodge of Barking Excerpts

Thursday 7th February 2013 Commons Chamber

[Mr Virendra Sharma (Ealing, Southall) (Lab)]

I beg to move,

That this House has considered the matter of the closure of accident and emergency departments.

On behalf of all my Back-Bench colleagues who wanted time to be allocated for this important debate, may I put on record my thanks to you, Mr Deputy Speaker, and to the Backbench Business Committee for today’s scheduled parliamentary time? The closure of accident and emergency departments is a national issue and one that has profound impacts on the current and future provision of health care across the country. Concerns about the A and E closures and accompanying hospital reconfigurations have been voiced by members of all political parties including Back Benchers and Front Benchers on both sides of the House, so it is crucial that we have this debate.

Weighty decisions are being made about A and E closures across the country by NHS bureaucrats, under the guise of localism and clinically led decision making, without the democratic accountability that is vital for decisions of such importance. In order to bring these decisions to the Secretary of State for Health, local council scrutiny panels have to refer such decisions to the independent reconfiguration panel, which then reports its findings to the Secretary of State. Why are primary care trusts in their dying days making such critical decisions and not clinical commissioning groups? It is vital to have democratic accountability for these decisions and, although it is not sufficient, this debate will shine some much-needed light on these huge decisions that will have profound impacts on all our constituents. I am pleased that the Government have belatedly announced a national review of A and E services, but I am horrified that the review is planning to report by March this year. This is being done in an obscene rush, and it cannot be the considered review that we need.

There are proposed and actual A and E closures in my constituency and in those of other hon. Members. It is clear that this is an NHS-wide change that will affect every constituency in the land. The NHS needs to change and be fit for purpose in the 21st century, and I am not saying that there must be no change. Clearly, we have to provide health care in changed ways, but I am concerned about the pace of change, the impacts on the poorest and the financial drivers of the changes. The financial drivers are clear. The Nicholson challenge means that the NHS is seeking to cut spending by £20 billion by 2014-15.

[Margaret Hodge (Barking) (Lab)]

Does my hon. Friend agree that the care of patients must be at the heart of any changes in the NHS, and not finance? In my part of London, there is a proposal to close the A and E at King George hospital, but it would be madness to do so at a time when Queen’s hospital in Romford has far too many A and E patients and when a Care Quality Commission report has just condemned the quality of care for people who visit that A and E unit.

[Mr Sharma]

I thank my right hon. Friend for putting that case so strongly. I do not think anyone—inside or outside the House—would fail to agree with that suggestion.

In North West London NHS, the proposal translates into a £1 billion cut to budgets over the same time scale. The medical director of North West London NHS said that it would

“literally run out of money”

unless the closures proceeded. The scale of change driven by this financial pressure is unacceptable. It is targeting the poorest and most vulnerable, and it is unfair on the hospitals that have been financially solvent. That last point was graphically illustrated last week at Lewisham hospital, whose A and E was unjustly proposed for closure because of a neighbouring trust’s financial insolvency. That brought tens of thousands of incensed protesters on to the streets.

Sadly, this is happening in Ealing, too, whose hospital is faced with losing its A and E department, yet it is financially viable and has been for many years. It is being sacrificed on account of financial problems in other neighbouring hospital trusts. This threat of closure in Ealing exists even after the Prime Minister assured me, in a response to my question, that there was no such threat.

--- Later in debate ---

[David Morris]

I shall come to that in my speech.

A concerted Labour campaign has been mounted by local party members who actually work in the NHS to make people believe that the A and E department is likely to close. The campaign involves press briefings, an online petition, a Facebook group, and even people walking around the centre of Morecambe with clipboards inviting people to join it. I want the e-petition to be removed from Directgov, and I have written to the Cabinet Secretary asking him to intervene. We cannot allow a dishonest campaign to be fought on Directgov e-petition platforms. If the A and E department is not under threat, it must be concluded that people are being frightened for the purpose of political advantage, which, in my view, is morally wrong.

Perhaps it is time to admit the truth: the trust is getting better under the present Government. A new and better management was introduced by the former Secretary of State. Only a few weeks ago, the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) opened a new minor injuries unit in my constituency. A new health centre in Heysham, costing £20 million, was opened last year, and four new wards have just opened at Lancaster hospital. I pay tribute to my hon. Friend—for he is my hon. Friend outside the Chamber—the Member for Barrow and Furness (John Woodcock) for ensuring that maternity services in Barrow remained secure.

All that was paid for by a 2.8% increase in funding for the NHS under the present Government. This debate is part of a national campaign to scare people into believing that the NHS will be deconstructed.

[Margaret Hodge]

Will the hon. Gentleman give way?

[David Morris]

I will later.

This, I believe, started with a disingenuous story in Corby, which was used to great effect. It has now become the scare story in Lewisham and now, surprise, surprise, the scare story in Lancaster and Morecambe. Those A and Es are not under threat. They are not closing down. The public will see through this Labour campaign to start a fire and then claim to put it out, saving us all.

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

It is a pleasure to follow the hon. Member for Morecambe and Lunesdale (David Morris), who made what I must say was a quite extraordinary speech. I realise that I may be in danger of being a little ungracious, given that he was kind enough to thank me. I shall say a little about the University Hospitals of Morecambe Bay NHS Trust, which our constituencies share. However, I must first say to him—on behalf, I think, of several Members who are present—that to suggest that the impending closure of Lewisham A and E department is a scare story from the local Labour party does an incredible disservice to the many thousands of families who are deeply alarmed and worried about what is happening in the area.

[Margaret Hodge]

I congratulate my hon. Friend on managing to save his A and E department, but does he not agree that money should go to where patients are? In my area, north-east London, 132,000 patients currently attend the Queen’s hospital A and E department, and 100,000 attend King George’s hospital A and E. Closing an A and E department that serves more than 100,000 patients is unfair to patients and madness in terms of funding distribution.

[John Woodcock]

My right hon. Friend is right to speak of the crazy situation in which heavily used accident and emergency provision across the country is under threat. I intend to say a little more about the particular challenges faced by geographically isolated regions such as mine, but first let me say how grateful I am to the Backbench Business Committee for securing the debate, and congratulate my hon. Friend the Member for Ealing, Southall (Mr Sharma) on a very powerful opening speech.

I want to speak briefly about the accident and emergency department at Furness General hospital in my constituency, and, in doing so, stress the importance of ensuring that A and E provision remains accessible to the high-tech, highly skilled industries in which this nation must continue to lead the world. Barrow’s A and E department is not yet under immediate threat of closure, but there is grave concern about the impending review of services throughout the Morecambe Bay area, which has been driven at least partly by the trust’s need to make significant cuts in its operating budget in the years ahead.

A trust covering 300,000 people would often be served by just one A and E department, but in the Morecambe Bay area there are two. That is due to the particularly challenging geography of the area, and, in particular, the time that it takes to travel the 50 miles from my constituency to Lancaster with only a single road connecting Barrow to the M6.

The hon. Member for Morecambe and Lunesdale directed all his fire at the local Labour party, and in doing so highlighted—probably quite helpfully for the party—the excellent work that it is doing with its campaign on the streets. I was probably more disappointed than surprised that he made no mention of his hon. Friend the Member for Westmorland and Lonsdale (Tim Farron), who is campaigning hard to take A and E provision away from Lancaster and transfer it to Westmorland General hospital.

Let me make it crystal clear why no one should get the idea that Barrow’s A and E department could move. Not only would every single resident in the geographically isolated Furness peninsula suffer unacceptably long journey times if it were closed; its removal would be a significant blow to industry in the area, and would ultimately threaten our potential to become a national cradle for advanced manufacturing. The manufacturing companies on which our local economy depends—including shipbuilding, nuclear engineering and pharmaceutical companies—have enviable safety records, but they nevertheless carry a small but inherent risk of industrial injury. As responsible business men, local employers seek to mitigate and manage that risk, but part of their management includes access to a full accident and emergency service in the locality.

BAE employs 5,500 people in Barrow, representing the largest of the many sites in the nation’s critically important nuclear submarine supply chain. This is what the company’s submarine arm told me for today’s debate:

“BAE Systems Maritime Submarines is possibly one of the highest risk manufacturing sites in the UK with a broad spectrum of safety hazards. Although these hazards are effectively managed and the site has a strong safety record, the absence of locally provided A and E services would have serious implications for the business. The treatment administered within the first hour following incidents is critical. A number of minor incidents, particularly associated with foreign object ingress to eyes, are referred to Furness General Hospital per week. Therefore additional ambulances would be required to transfer injured personnel, significantly increasing the ambulance demand within the area. Decontamination of people would currently be provided by FGH Accident and Emergency following a major incident at the Barrow site. This may include the cleansing of chemicals or radioactive substances.”

If, God forbid, something like that were to happen, time would be of the essence. Here in Furness, as in several areas of the country, A and E closure could put at risk the lives of employees who perform a service to their country and would ultimately endanger key parts of the nation’s prized industrial base. It is vital that Ministers wake up to the full spectrum of risks posed by the approach they seem intent on imposing on our national health service.