National Health Service Funding

Maria Eagle Excerpts

Tuesday 22nd November 2016 Commons Chamber

[Maria Eagle (Garston and Halewood) (Lab)]

I want to talk about the Cheshire and Merseyside sustainability and transformation plan and the documents relating to it, which were finally published last Wednesday, although details had been repeatedly leaked. The plans are every bit as full of unrealistic proposals and management newspeak as many of us feared. They amount to a catastrophic financially driven plan drawn up by managers in secrecy under pressure from the Secretary of State for Health. They are already being implemented, without any of the affected stakeholders or the people of Cheshire and Merseyside ever being asked what they think.

If fully implemented, the STP would involve the merging of the Royal Liverpool, Broadgreen and Aintree hospitals, with the Liverpool Women’s hospital being “reconfigured” and merged into the new organisation at a later date. It is planned to be rebuilt nearer the Royal, but there is no NHS money available for the new hospital building. The plans entail the downgrading of hospital A&E services at Whiston hospital, where many of my constituents go, or at Warrington or Southport hospitals, or some combination of all three. Details are not provided.

These shocking cuts and mergers have very little chance of being accepted by the people of Garston and Halewood, for a number of reasons. First and foremost, it is clear that the Cheshire and Merseyside STP is financially driven. This has been admitted by those who have drawn it up. Katherine Sheerin, chief officer of Liverpool clinical commissioning group, accepted this in an interview that she gave in the Liverpool Echo. When asked what would happen if these changes were not made, she said:

“If we did nothing, we would not have enough money to run the services. This is about managing that, rather than letting it happen.”

When asked if these changes were being driven by cuts, she replied:

“The financial component has been a strong driver”.

The King’s Fund agrees with her. In its report entitled “Sustainability and Transformation Plans in the NHS”, it says:

“The original purpose of STPs was to support local areas to improve care quality and efficiency of services . . . The emphasis from national NHS bodies has shifted over time to focus more heavily on how STPs can bring the NHS into financial balance (quickly).”

Quite so, and we can see this in Katherine Sheerin’s answers.

The Cheshire and Merseyside STP has to deal with the pressure of almost a £1 billion gap in its funding by 2021, so making cuts in spending to meet the Government’s financial requirement is at the core of these plans. The people of Merseyside are not daft— they can see this. The Cheshire and Merseyside STP requires £755 million of capital funding, which is now no longer available. In Liverpool alone, our hospitals’ deficit is estimated to be £276.5 million. In her Liverpool Echo interview, Katherine Sheerin suggested that Liverpool City Council would provide the missing capital funding.

[Ms Angela Eagle]

I thank my hon. Friend for giving way. The Wirral Borough Council was not asked to participate at all. Was the Liverpool authority asked to participate?

[Maria Eagle]

Neither Liverpool City Council nor Knowsley Borough Council has been consulted at all about the plans. However, when asked where she was going to get the money for the new hospital, Katherine Sheerin said:

“There’s limited capital available but there are options to explore. Councils tend to be able to access borrowing at a very cheap rate.”

There we have it: Liverpool City Council is expected to stump up the money to implement what is supposed to be a key part of the strategy—building a new women’s hospital. However, this is the same Liverpool City Council that has had 58% of its money from central Government removed—first by the Lib Dem-Tory coalition and then by the Tory Governments after 2010—and that relies for almost three quarters of its income on that Government grant. This is the same Liverpool City Council that already spends £151 million on adult social services for its ageing population, but that can raise only £147 million in council tax. This is the same Liverpool City Council that is expected to find another £90 million of savings over the next three years and that is facing some extremely invidious choices to balance its budget.

My second point is this: these plans have been drawn up in near secrecy by NHS managers, and without consultation with those who are now being exhorted to help. Neither Knowsley Metropolitan Borough Council nor Liverpool City Council has been asked what it thinks. Consequently, both say, unsurprisingly, that they are opposed to the plans. In Liverpool, the ruling Labour group has made it clear that it will oppose any STP that proposes cuts, and the Mayor of Liverpool has said publicly that he opposes the proposed closure of the Women’s hospital and will campaign to keep a women’s hospital in Liverpool. I agree with him. Labour in Liverpool will support any change to existing provision only if it improves services to women in Liverpool.

The current plans are already being implemented, and that is another thing we cannot allow to go ahead without proper consultation.

Community Pharmacies

Maria Eagle Excerpts

Wednesday 2nd November 2016 Commons Chamber

[Jonathan Ashworth]

I know that the hon. Gentleman works tirelessly as a champion for pharmacies, but he knows that these proposals will mean cuts in many services.

[Maria Eagle (Garston and Halewood) (Lab)]

Many pharmacies in Halewood deliver medication, up to 8.30 pm, to elderly and vulnerable people who cannot get out of the house, and to care homes. What does my hon. Friend think will happen if those pharmacies have to close?

[Jonathan Ashworth]

I do not need to say what I think; I need to say what the sector thinks, and the sector has made it clear today that it will have to cut services such as the delivery of medicines to some of the most elderly and vulnerable members of society.

--- Later in debate ---

[David Mowat]

I want to make some progress.

Secondly, we want to see an enhanced role for the community pharmacy network in providing value-added services. This is an aspiration that we share with the network and its representatives. To that end, NHS England has commissioned Richard Murray of the King’s Fund to produce an evidence-based report to determine which types of primary care services are best done by pharmacists over the next two or three years. The report, which will be published later this year, will inform NHS England’s decisions on how to use the integration fund of £42 million that I announced two weeks ago. There are many candidate areas, including long-term conditions, minor ailments, better care home support and more medicine reviews, as well as the work that pharmacists do in public health.

[Maria Eagle]

Many of the pharmacies in my constituency already provide such services, but they are now threatened by the Government’s proposals. Does the Minister not realise that, according to research carried out by Pharmacy Voice, in a constituency such as mine, which is No. 20 on the list of deprived areas, four in five people who cannot see a pharmacist will end up going to their GP? Does he not agree that that will achieve exactly the opposite of what he wants?

[David Mowat]

The impact review, which was published at the same time as my statement two weeks ago, estimated that the amount of extra time that people would have to spend going to a pharmacy would be a matter of seconds, even if we had, say, 100 closures. The impact review sets that out in some detail. Did someone sitting behind me wish to intervene?

Hormone Pregnancy Tests

Maria Eagle Excerpts

Thursday 13th October 2016 Commons Chamber

[Maria Eagle (Garston and Halewood) (Lab)]

I congratulate my hon. Friend the Member for Bolton South East (Yasmin Qureshi) on her work in this area and on securing today’s debate. I am here to speak on behalf of my constituents: Pamela Mawdsley from Garston and her daughter Louise; a constituent who lost a baby son; and Sonia Fitzpatrick from Halewood. All of them believe—I think correctly—that the disabilities with which they or their children live and the losses they have had to face were caused by Primodos being administered in pregnancy. This was not for any therapeutic reason, but simply as a test to determine whether or not there was a pregnancy.

Pamela’s daughter, Louise, is now 42. In 1973, Pamela visited her doctor to find out whether she was pregnant, and she was given Primodos. Her daughter was born in November that year with many severe disabilities. She has extensive brain damage, cerebral palsy, a right leg two inches shorter than the left and a right foot four sizes smaller than her left foot, spina bifida, scoliosis, partial deafness and significant special needs. She nevertheless lives a good life with her family at the age of 42, and her family obviously value her tremendously, but she has ongoing medical problems. My constituent Pamela had her medical records go missing when she became one of the people who tried, with other families, to sue in the early 1980s. The hon. Member for Livingston (Hannah Bardell) also raised that issue in respect of her constituent.

Sonia Fitzpatrick from Halewood is also 42, and in common with Louise Mawdsley, she believes—again, I think, correctly—that the disabilities with which she was born that affect her every day were caused by the Primodos given to her mother to see whether or not she was pregnant. She has spina bifida and other significant medical problems. Since being a young child, she has had a colostomy and a urostomy. She has significant ongoing difficulties with her feet, her hands and other joints. She, too, has lived for 42 years with the effects of that day when her mother went to find out whether she was pregnant.

I first met Pamela Mawdsley in 2011, and I had never heard of Primodos at that time. As a former lawyer who used to conduct product liability litigation and medical negligence cases, however, I rather wondered why I had not. I practised from 1990 to 1996, specialising in this field among others. Products that cause harm, especially medical products, were one of my focuses at that time; and seeking the truth and, where appropriate, compensation for those adversely affected was what I sought to achieve. Yet I had still never heard of Primodos, which is why I am participating in today’s debate.

The stories my constituents and others tell me are familiar to anyone who has practised as a lawyer in product liability litigation. From Thalidomide to Primodos and vaccine damage, there are some common themes: a lack of warnings about possible side-effects; being called a fussy mother when disabilities of a young baby are first noticed and raised with medical practitioners; denial of causality when there are reports of adverse effects; the sudden and inexplicable loss of medical records that indicated what was prescribed and when—often “just for the week” or “just for the month”. I have come across that many times in litigation. Then there are overt hostility and lack of transparency when doubts are finally expressed; no acceptance of liability by drug company or regulatory agency or prescriber, even after the withdrawal of the product in question; and a legal battle—it also happened in this case—usually with gross inequality of arms, when those at fault are utterly unwilling to concede any kind of liability or causation or to co-operate at all in finding some way through the difficulties that the victims have to suffer for many years.

The results are always the same. There are years of denial and agony for those affected, and a subsequent failure to help to alleviate the consequences or to understand the motives of the people who come forward. There is agony for parents, who invariably blame themselves for what has happened to their children, particularly in cases such as these in which there is no therapeutic reason for taking the drug. There are also extremely long, frustrating and often fruitless campaigns for truth and justice, many of which involve failed litigation, as in this case. The litigation usually fails on the basis of causation, or, effectively, because there is no real co-operation or willingness to discover the truth but merely a defensive attitude on the part of medical authorities, scientists, and frequently—I hesitate to say it—Governments. That is what I see going on here.

I think there is little doubt that hormonal pregnancy tests caused the birth defects about which many of the families affected have complained. There was significant disquiet, and evidence from the 1960s, that there were adverse effects that led to the kind of disabilities that Louise and Sonia now live with, but there were no warnings. Obviously proving causation in individual cases is difficult, particularly when the medical records have gone missing, but why should these families have to prove it? Drugs containing such hormones in such doses were banned elsewhere. The fact that existing drugs contain them in much smaller doses does not mean that the large-dose versions could not cause the problems that we are discussing now.

Survivors such as Louise and Sonia have significant and ongoing serious health problems, and they and their families deserve the truth about what happened, in addition to the further help that they need. We have the so-called independent review that the Government established in October 2014, and I think that they were right to establish it, but it does not seem to be going well. I am not sure that it has the confidence of the families, or the confidence of those who have been fighting for so long to get to the bottom of what happened. There seems to be a failure to work with the families who are affected by this scandal.

I have seen independent reviews that work. The Hillsborough independent panel springs to mind: I had a long association with that campaign, and I know what works and what does not. Independent reviews that work are not based on expecting campaigners to sign confidentiality agreements before they can even observe proceedings. They are not based on appointing experts who are suspected by some families—rightly or wrongly—to have a conflict of interests. They are not based on proceedings being so slow and opaque, with so little information emerging, that those affected become suspicious, or do not know what is going on behind the closed doors of the review. They are based on proper consultation and obtaining the full confidence of those affected.

If that does not happen, the end result, whatever it is, will make matters worse. It will make the affected families feel that there has been another establishment whitewash, that their hopes have been raised only to be dashed, that things have been swept under the carpet, and that the authorities, whoever they are, do not really want to find out what happened because it is inconvenient.

In view of the debate and in view of the concern that many of the families are expressing, the Minister must get a grip on the process and ensure that it works. He must take steps to secure the confidence of the families. He must be much more transparent about what is going on, and he must have a proper understanding of what the process is seeking to achieve. I can tell him that if there is another whitewash—if the review does not work—those families and their Members of Parliament, whether that means us or our successors, will not go away. We will be coming back to the Minister and to the Government, and we will make sure that our constituents— those families—are given the truth, the information, and the acknowledgement and help that they deserve.

--- Later in debate ---

[David Mowat]

There is nothing in that intervention with which I disagree. We all want the inquiry to work. The Government have not established an inquiry in order for it to fail. We have not established an inquiry for it not to have the confidence of the association. We need to get to the truth, but that is a scientific process, and because it is a scientific process, it can be frustrating and long-winded; it can take a long time.

I want to talk about some of the concerns that have been raised. There were three types of concerns. The first was that the independent group of experts is not reviewing the regulatory concerns or the delays that took place at the time, in particular the failures of the then Committee on Safety of Medicines and the five or eight-year delay, which we have heard about. The UK was not the first country to ban the drug, but it was not the last either. The second concern, which I will talk about at some length, was that members of the expert group might not be independent and might not have fully declared their conflicts of interest. We have heard words like “colluding” and “cover-up” from some Members. The third concern was that not all the available evidence is being considered by the group, and we heard about the German material not being translated. I will address all three points.

On the first issue, we have heard that there was a regulatory failure and that the inquiry should look at it. I say to the House that if, when the expert group reports next spring, it finds a clear causal link, that will be the time to take further action on issues such as regulation and liability, and everything that goes with that. The first step we are taking is to establish the science. The group that has been set up is an expert group. It is science-led. It is important to make it clear in the House that we are not criticising individual members, because they are striving to get to the truth. It is a group of eminent people.

It would be quite wrong if we conflated the possible eventual need to look at the regulatory actions that were taken, the legal liabilities and everything that goes with that, with the first step of the process, which is to establish whether the science leads us to that link. In spite of some of the comments that have been made today, that has not been done yet in any country. The first serious attempt to do it is the one that is going on now.

The second concern is that the expert working group is not impartial. The MHRA has taken a vigorous approach to evaluating and handling potential conflicts of interest. No member of the expert working group can have any interest in any of the companies that were involved or their predecessors. Members should not have publicly expressed a strong opinion, favourable or unfavourable, about the possibility of birth defects arising from these drugs. We heard that one of the members had tweeted. If there is evidence of that, we will follow it up. It is true that one member not of the expert group, but of the advisory group was removed because it was felt that he had a conflict of interest that was not properly declared. Action was taken very quickly in respect of that.

The inquiry is chaired by a consultant gynaecologist from the Chalmers centre in Edinburgh. The group has 14 scientists drawn from some of the best universities in the UK. We have no reason to believe that any of them have any more reason not to want to get to the truth than Members on both sides of this House.

[Maria Eagle]

Does the Minister not realise how important it is that, whatever the rights and wrongs of this and whatever the qualities of the members of the panel, the families need to have confidence in it? There is no point in saying that they are all wonderful people. The families have concerns and if they are not assuaged, in one way or another, the outcome will not have their confidence.

[David Mowat]

I said at the start of my remarks that the learning point I have taken from this debate is that, whatever we think about the truth, the science and whether we are doing the right thing, the families are not happy. I also said that we will do what we can to amend that.

As well as that, Members on both sides of the House need to accept that we need to get to the scientific truth. In order to do that, there needs to be a scientific process. That has to happen and that is why some of this is time-consuming and difficult, even though we wish that it was not.

NHS Sustainability and Transformation Plans

Maria Eagle Excerpts

Wednesday 14th September 2016 Commons Chamber

[Sir Simon Burns (Chelmsford) (Con)]

Will the hon. Lady give way?

[Maria Eagle (Garston and Halewood) (Lab)]

Will my hon. Friend give way?

[Ms Abbott]

I give way to my hon. Friend.

[Maria Eagle]

I am grateful to my hon. Friend for giving way. We have a leak of the STP for Merseyside and Cheshire, which states that there is an “appetite for hospital re-configuration” because the existing set-up is “currently unaffordable”. Given that it also says that almost a £1 billion gap is to be expected by 2021, and that the public have not yet been consulted, does my hon. Friend agree that when the public are consulted, there will be an absolute outcry?

[Ms Abbott]

That is the reason for the secrecy thus far. The Government know that if the public understood what STPs meant, there would be an outcry.

--- Later in debate ---

[Mr Dunne]

I am going to continue my remarks, as I have already been quite generous in taking interventions.

As part of its annual planning round in 2015, NHS England published planning guidance last December—nine months ago—calling for clinical commissioning groups to come together with their providers across entire health economies to develop a collective strategy for addressing the challenges in their area. Those are the sustainability and transformation plans. There are 44 areas, which were agreed six months ago in March. They cover the whole of England, bringing together multiple commissioners and providers in a unique exercise in collaboration. Their geographies have been determined not by central diktat but by what commissioners and providers felt made the most sense locally.

Each area has also identified a strong senior leader who has agreed to chair and lead the STP process on behalf of their peers. They are well respected, credible figures in their local health economies, and we and NHS England are committed to supporting them to bring people together to agree a shared plan for how best to improve and sustain health services for their local populations. Local authorities, too, are fully engaged in the development of the plans. In some cases, local NHS organisations have agreed with local authorities that a senior council leader will lead the STP for their area. I think that is happening in Birmingham—I see a number of Birmingham Members present.

[Maria Eagle]

It is clear from the leaked document that Merseyside and Cheshire are looking to save £1 billion by 2021. In that context, does the Minister not agree that there will be an outcry when the secret proposals—which have now been leaked—to merge much-loved hospitals and cut services in Liverpool, for example, are finally consulted on? Does he acknowledge that they will have no chance of receiving any support?

[Mr Dunne]

The hon. Lady is leaping much too far ahead. There are no proposals at this point—[Interruption.] I will explain the exact state of the STPs shortly. There are a number of draft ideas to try to improve the services that are delivered to patients. Looking to the future and the efficiencies that need to be provided, as part of the five-year forward view the NHS leadership asked the Government to fund £8 billion of additional cash for the NHS. We provided £10 billion; the Labour party refused to provide anything like it. In return, the NHS agreed to look for £22 billion of efficiencies up to 2020. We have assisted it through the efforts of Lord Carter, whom we asked to undertake a review of efficiencies across the NHS. He has identified 10 work streams in which clear efficiencies can be found—many of which, incidentally, have been identified by Opposition Members. The hon. Member for Hackney North and Stoke Newington herself has referred in the past to areas of the NHS in which there is waste, and a newspaper article this week by the former Chair of the Public Accounts Committee, the right hon. Member for Barking (Dame Margaret Hodge), referred to “absurdities” in the spending practices in the NHS. We are trying to put right some of the practices that have been swept under the carpet for too long.

Defending Public Services

Maria Eagle Excerpts

Monday 23rd May 2016 Commons Chamber

[Maria Eagle (Garston and Halewood) (Lab)]

I welcome the Minister for Culture and the Digital Economy to his place and look forward to hearing what he has to say, but it is extraordinary that the Secretary of State for Culture, Media and Sport could not be bothered to turn up to wind up his part of the debate on the Gracious Speech at the very beginning of this new parliamentary Session. What a dereliction of duty. Who knows whether he is otherwise engaged—no doubt on the vote leave battle bus—or whether the Prime Minister simply does not trust him enough to let him out of the Cabinet dog house to which he has no doubt been confined on the shortest of leashes because of his support for the leave campaign.

We have had a broad-ranging and excellent debate. We have heard from 31 Back-Bench colleagues, one of whom, my hon. Friend the Member for Sheffield, Brightside and Hillsborough (Gill Furniss), made an excellent and well received maiden speech. It showed quite clearly what a great MP she is going to be, rooted as she is in the community that she now represents. Sad though the circumstances are that have brought her to this place, it is quite clear from her remarks that she will do an excellent job.

This was the Queen’s Speech that was not supposed to happen ahead of the EU referendum, and it showed. As my right hon. Friend the Member for Leicester East (Keith Vaz) and my hon. Friend the Member for Stoke-on-Trent Central (Tristram Hunt) said, we were told in Government briefings in March that the Queen’s Speech was to be postponed until after the EU referendum, but the Prime Minister then changed his mind. Perhaps that explains the ill thought out programme, with a small number of Bills, many of which seek to do things that everyone agrees with, being cobbled together to give an impression that all is well with this relatively newly elected Government—except that it is not.

We can see clearly that the Prime Minister is not focused on this legislative programme because he is otherwise engaged. It is no wonder, given that his fractious, warring Cabinet members seem to have lost all mutual respect, denouncing each other in language more suited to bitter political enemies. I will give two examples. The erstwhile Welfare Secretary thinks that the Chancellor tells fibs—he has said today that Pinocchio,

“with his nose just getting longer and longer and longer”,

is

“very similar to the Chancellor. With every fib you tell, it gets longer. Who am I to judge how many there have been?”

Meanwhile, the Employment Minister has accused the Prime Minister of “concocting Armageddon scenarios”, calling some of his claims about what will happen if we leave the EU “fantastical”, “hysterical” and “incredible”. It was clear from the context that she did not mean it in a positive sense.

We have heard an echo of those debates on the Government Back Benches today, with the right hon. Members for Hitchin and Harpenden (Mr Lilley) and for Wokingham (John Redwood) being opposed by the right hon. Member for Arundel and South Downs (Nick Herbert) on EU issues. My hon. Friend the Member for West Ham (Lyn Brown) called it a Tory “Game of Thrones”, and the hon. Member for Glasgow South West (Chris Stephens) even went so far as to offer parallels with individual characters from that drama. It makes for an interesting spectacle, but not for good governance or an ambitious legislative programme.

[John Redwood]

Could the hon. Lady give us an up-to-date view on how the Labour party is getting on with the arguments on unilateralism and the nuclear deterrent?

[Maria Eagle]

Certainly not in 10 minutes.

The Government’s extraordinary decision to announce that they will accept an amendment to the Humble Address if necessary, clarifying that the NHS will be exempt from arrangements in the Transatlantic Trade and Investment Partnership, is highly unusual, not to say humiliating for them. That major concession before we have even got to the end of the debate on the Gracious Speech shows how desperate the Prime Minister is to avoid being defeated on the Floor of the House by his own Brexit-driven rebel Back Benchers, at least 25 of whom have signed the amendment—enough, along with all the rest of us, to defeat the Government. Without that retreat, this would have been the first vote on a Gracious Speech lost by a Government since 1924.

That also shows how willing Tory Brexit rebels are to inflict such a defeat on their own Prime Minister. Indeed, some reports over the weekend suggested that it would be followed by the rebels going on strike to block Government legislation after the referendum unless some of their number were promoted—an extraordinary state of affairs. Meanwhile, one pro-remain Minister is reported to be demanding that the rebels should all be kicked out of the Tory party; a Tory “Game of Thrones” indeed. No wonder this legislative programme is so slim. The Prime Minister will be spending all his time after 23 June on party management. I can only congratulate the right hon. Member for Hitchin and Harpenden, who spoke to his amendment with great cogency, and my hon. Friend the Member for Dewsbury (Paula Sherriff) on causing such Government turmoil. My hon. Friend has now secured Government concessions on both the Budget and the Queen’s Speech—she is really getting the hang of how this place operates.

I am sure the hon. Member for Blackpool North and Cleveleys (Paul Maynard) will be glad to hear that the Opposition agree with the aims behind some of the legislation that has been announced. In the case of the Department for Culture, Media and Sport, how could one object to the Cultural Property (Armed Conflicts) Bill, which will implement The Hague convention to which the UK has been a signatory for many years? We support it wholeheartedly. We also welcome the aims behind the digital economy Bill, as did the right hon. Member for Arundel and South Downs, the right hon. Member for Basingstoke (Mrs Miller) and the hon. Members for Harrow East (Bob Blackman), for High Peak (Andrew Bingham), for Mid Worcestershire (Nigel Huddleston) and for Rossendale and Darwen (Jake Berry).

We particularly welcome the proposed introduction of the universal service obligation for broadband, automatic compensation for customers deprived of good service, and enhanced transparency for consumers to make an informed choice. We will look carefully at proposals to introduce a new electronic communications code, protect intellectual property rights online, and introduce age verification for pornographic websites. It is extremely disappointing that the Government will break their promise to automatically roll-out broadband to all households, so perhaps the Minister will spell out the additional costs that many households and businesses will need to bear to get connected, and give us the total number that he expects will be adversely affected.

Despite their desperate efforts to appear uncontroversial in this legislative programme, the Government pose an underlying threat to all our public services—many of my hon. Friends referred to that during the debate. The Government seem to know the price of everything and the value of nothing, and their obsession with marketisation as a prelude to privatisation leaves them with a tin ear to the value of the public service ethos. As my hon. Friend the Member for Huddersfield (Mr Sheerman) said, they seem to believe that the public sector is automatically bad, and the private sector automatically good.

Unfortunately, the Government are developing that theme across Departments. As my hon. Friends the Members for Washington and Sunderland West (Mrs Hodgson), for Manchester, Withington (Jeff Smith), for Sheffield Central (Paul Blomfield), for West Ham (Lyn Brown), and for Merthyr Tydfil and Rhymney (Gerald Jones) said, the Government seem unable to accept the fact that public service broadcasting and the public service ethos—as exemplified by the BBC—makes a hugely positive contribution to our society, boosts the UK creative industries and creative economy, and is successful and massively popular, providing great value for money for licence fee payers and high-quality broadcasting for us all. Channel 4 fulfils its remit without any input from the taxpayer or licence fee payer.

However, the Secretary of State for Culture, Media and Sport has shown himself to be utterly committed to denigrating and diminishing the BBC, which he recently described as no more than

“a market intervention of around £4 billion by Government”.

He wants to privatise Channel 4—he said so just last month, although I notice that there is no Bill for that in this legislative programme.

The constant assumption that the private sector is better, and that the public sector should be diminished or sold off, is based on ideology, not evidence, and is out of step with public opinion. Just last week the BBC announced that it would start to do what the Secretary of State said he wants, which is to cease activity that duplicates what can be done in the private sector—something he calls “distinctiveness”. The BBC announced that it would remove its online recipes. The huge public outcry was instructive, and the Government should take note. So far 195,000 people have signed the petition asking the BBC to keep that trusted resource. The Secretary of State immediately said that the plan was nothing to do with him, but we all know that it was.

Some of our debate has been about the national health service—our most loved public service—and I tell this House and the Government that the Labour party will not stand by and watch the health service be denigrated, reduced or cut. This legislative programme will do nothing to deal with the real challenges facing our public services, whether our NHS or the BBC. We know the value of our public services, and we will make it our business to speak up for and defend them.

Royal Liverpool University Hospital

Maria Eagle Excerpts

Wednesday 9th June 2010 Westminster Hall

[Mrs Louise Ellman (Liverpool, Riverside) (Lab/Co-op)]

Thank you, Mr Betts, and let me say that I am glad to serve under your chairmanship. I am pleased to have this opportunity to raise a key concern facing the people of Liverpool—namely, the urgent need to build a new Royal Liverpool University hospital. The Royal is an excellent university teaching hospital and a leading regional centre for diagnosis and treatment, deploying cutting-edge technologies such as digital histopathology, interventionist radiology and PET-CT—positron emission tomography-computed tomography—advanced scanning.

The problem is that the existing hospital, which was built in 1972, has major structural defects. Its mechanical and electrical infrastructure has major faults, it has design flaws and its internal and external fabric is failing. The trust is rated excellent for clinical services and for financial management. It has a gifted and committed staff, but that cannot overcome the problems of a deteriorating building.

In March, following years of intensive scrutiny, the then Secretary of State for Health, my right hon. Friend the Member for Leigh (Andy Burnham) visited the Royal to announce a new £45 million replacement hospital, a private finance initiative, to be built on the same site. The possibilities of refurbishment had been costed and rejected on the grounds that they offered poor value for money. The approval was confirmed in writing by the Treasury and by the Department of Health, which issued an approval letter. The trust is to fund £130 million of the £451 million capital cost, so it is planned that most of the funding should come from the private sector.

The proposal has been assessed for many years. The outlined strategic case was approved in 2006. It has been subjected to intensive scrutiny again and again locally, regionally and nationally, including by the Department of Health and the Treasury. It has met stringent tests for affordability and for value for money. That process has indeed cut costs, by about 32%, and the current proposal for 637 beds constitutes a 34% reduction in the number of beds outlined in earlier plans. Construction at the hospital, which will lessen both the hospital’s energy use and its carbon footprint, is due to start in 2012 and be completed by 2016. A competitive process to identify a suitable private sector partner is now under way. All that planning has now been thrown into doubt by this Government’s current spending review and their threatened draconian cuts.

I want to make it very clear that replacing the Royal is about providing front-line health care for the people of Liverpool and the region.

[Maria Eagle (Garston and Halewood) (Lab)]

I congratulate my hon. Friend on securing this debate. Does she agree with me that many people from south Liverpool also rely on the Royal Liverpool University hospital for acute health services and that a failure, at this late stage, to agree to rebuild the Royal and to let that project go forward will leave the entire city—not just the north of the city—having to obtain its health services in a deteriorating building that is no longer fit for purpose in the 21st century?

[Mrs Ellman]

I agree with my hon. Friend and her intervention shows why this issue is so very important.

The city has taken major steps forward in recent years, yet Liverpool remains the poorest local authority; in total, 67% of its population live in the top 10% most deprived localities in the country. Ill health is related to poverty. Industrial diseases such as asbestosis and mesothelioma, which are connected with the shipping industry of the past, cause deaths and incapacity today.

Although health standards have improved significantly during recent years, there is still an unacceptable gap in life expectancy between Liverpool people and those in the rest of the country. Women in Liverpool, Warrington and Hull have the lowest life expectancy for women in the country, at 78.8 years. Women in England as a whole can expect to live until they are 81.9 years old. The longest-living women in England are to be found in Kensington and Chelsea, reaching 88.9 years—a disparity of 10 years with women in Liverpool. Liverpool men have the fourth lowest life expectancy in the country, at 74.3 years, compared with a life expectancy of 84 years for men in Kensington and Chelsea and of 77 years for men in England as a whole.

Mortality rates are too high. The number of deaths from heart disease in Liverpool is 31% higher than the national average; the number of deaths from cancer-related diseases in Liverpool is 36% higher than the national average; deaths from causes that are amenable to health care in Liverpool are 42% higher than the national average, and deaths from conditions attributable to smoking in Liverpool are 57% higher than the national average. It is a chilling fact that for every 100 new cancers diagnosed in the rest of England, 130 new cancers are diagnosed in Liverpool.

Although that situation is related to long-term poverty, deprivation, the city’s industrial legacy and individual lifestyles, the new hospital, with its proposed high-tech facilities and single rooms, which would help to reduce the spread of infection, is essential to improving people’s health.

Despite its high incidence of cancer, Liverpool is the only major UK city without a comprehensive cancer centre. Following the Cannon and Baker report, a cancer centre linked to Liverpool university’s department of cancer studies should be built at the Royal and that project should be progressed with urgency.

The new hospital will contribute to the alleviation of disease by building on Liverpool’s strengths in the biochemical sector, already a major contributor to the local economy, by adding £1 billion gross value added and employing 6,000 people. In doing so, the new hospital will help regenerate the city. It will enhance important diagnostic research and life sciences, with increased collaboration between the university’s leading medical school, the internationally renowned Liverpool School of Tropical Medicine and the biomedical industry.

Companies such as Eli Lilly, Novartis, MedImmune and Bristol-Myers Squibb already work with the Royal. A new biomedical campus is planned on site and it will be integrated with similar facilities, expanding research, improving diagnosis and developing new health-related products. That campus will create additional jobs in Liverpool, as Liverpool increasingly becomes a global leader in this sector. The new hospital will also make a major economic impact. Building the hospital itself will create 1,600 jobs, with the local economic benefits reaching £240 million.

It is very sad that, with the Government’s draconian spending axe hanging over us, we still await a decision on the Royal’s future. What is at stake? Primarily, the new hospital is about the well-being of the people of Liverpool and the region, too many of whom experience unacceptably poor health. Everyone, irrespective of wealth, is entitled to good health care. There has been a great deal of investment in health services in Liverpool in recent years, which is why we have seen improvements in people’s health. But the key issue of the need to replace this major hospital remains outstanding and it is acutely important. The developmental hospital is important for Liverpool’s ongoing regeneration. Liverpool is a city transformed, but too many of its citizens have not yet reaped the benefits. And now, in this fraught economic climate, new challenges have emerged.

A rebuilt Royal will bring all the people of Liverpool essential state-of-the-art health care, fit for the 21st century. Linked with primary care, it will make a real difference. The current proposal is mainly private finance initiative-funded. It does not lean heavily on the public purse. It has been subject to stringent scrutiny, ensuring value for money, and that process is continuing.

The city council has already made strong representations and I want to praise Councillor Joe Anderson, the leader of the council, and Councillor Paul Brant, an executive member of the council, who have taken the lead in speaking up for the health needs of the city. Any delays, cutbacks or cancellation would deal a major blow to the people of Liverpool, with consequences for the whole region.

On 31 March 2010, the Liverpool Daily Post reported statements made by the then shadow Secretary of State for Health, the right hon. Member for South Cambridgeshire (Mr Lansley). Following some general comments that he made about the proposed scheme at the Royal, the Liverpool Daily Post said:

“And he turned the tables on Labour, by insisting the Tories were committed to protecting NHS budgets, while the Government”—

that is, the Government at that time—

“was plotting to slash capital spending by half.”

Asked about the Royal development, the right hon. Gentleman, now the Secretary of State, replied:

“The Conservatives have been clear about the need to protect NHS budgets, including capital spending, so we can support this project.”

I ask the Minister to confirm that that pledge remains real. I also ask him to implement it without delay, give this front-line service the green light and enable the people of Liverpool to benefit from the first-class health facilities that are so important for their future.

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[Mr Burns]

The hon. Lady can rest assured that I will come to that in due course, during the latter part of my speech. In light of some of her comments, particularly about cancer services, I wanted to show the setting for reconfiguration in so far as it might affect that site and other parts of Liverpool’s health care provision.

Where local NHS organisations have already started to consider changing services, they will need to consider again whether their plans meet the criteria before continuing. It will be an opportunity for patients, local GPs and clinicians, and local councils to play a far greater role in how services are shaped and to ensure that the changes will lead to the best outcomes for patients.

The hon. Lady mentioned in an intervention the rebuilding of the Royal Liverpool. That will be reviewed in the light of the Secretary of State’s four tests. As she said in her speech, it is widely recognised that the hospital has a number of issues. Most significantly, the fabric of the building is deteriorating due to a serious case of concrete rot. The building’s condition contributes to high maintenance costs and a significantly poorer patient experience. The building is also inflexible, making it increasingly difficult for the trust to deliver modern, high-quality services.

[Maria Eagle]

I welcome the hon. Gentleman to his role. He is a reasonable man, and I am happy to see him in this job. Can he give all the Liverpool MPs here today some time scale within which the Government will take the decision on the review? We would be grateful for an approximate date.

[Mr Burns]

I thank the hon. Lady for her kind comments, which are greatly appreciated. I return the compliment by saying that when our roles were reversed, I found her an extremely helpful and sympathetic Minister when I brought problems to her concerning Chelmsford prison. She has anticipated me in her direct question. I assure her—I am choosing my words carefully, as she will discover—that I will answer her question later in my speech.

The programme to address the issues within the trust has been ongoing for some time, as all hon. Members present will know and appreciate. For the benefit of those hon. Members not present who will read the report of the debate, I shall set out the timeline of events.

Due to the sorry state of the buildings and the high cost of refurbishment, the trust decided fully to rebuild the Royal Liverpool and Broadgreen University Hospitals NHS Trust while refurbishing the site at Broadgreen. In July 2004, the Department of Health agreed the project’s strategic business case, enabling work to start on the outline business case and the process of obtaining planning permission from Liverpool city council. In March 2008, planning permission was granted. In September 2009, the strategic health authority, NHS North West, approved the outline business case. Then, in March this year, the project was approved by the Department of Health and the Treasury. On 14 April, an advertisement to tender for the project was placed in the Official Journal of the European Union. That is the scheme’s current position.

However, it is important to understand the changed context within which we now find ourselves. The most urgent task facing the Government is to tackle our record debt. As part of that, the Treasury is reviewing every significant spending decision made between 1 January 2010 and the general election on 6 May. As the hon. Member for Liverpool, Riverside herself said, the final approvals were given on 29 March—two weeks to the day before the general election was announced. As a result, the project has been included in the Treasury review of public spending commitments made by the previous Government.

I hasten to add, as delicately as I can, that we, as a nation, face tremendous difficulties due to the staggering debt left to this Government. My right hon. Friends have rightly decided that we must get to grips with the economic situation that we inherited, and the primary problem that we face in the immediate future is the debt.

--- Later in debate ---

[Mr Burns]

The hon. Gentleman makes a valid point, but everything has to be taken in the context of the changed circumstances—a change of Government and our overriding need to get the debt and the deficit under control. The context for that and the engine driving it is the review of all public spending commitments across the board. We are talking about not simply the health service, but commitments made across Government since 1 January. I cannot anticipate the outcome of any review, and I am sure that hon. Members would not expect me to. I can tell them that decisions will be taken by the spending review in the autumn, and I hope that hon. Members consider that helpful.

[Maria Eagle]

The Minister is being extremely generous in giving way and I am grateful. I understand the position that he is in—believe me. He gave an endpoint to the deliberative process, but the time scale he suggested might put the development at risk. Uncertainty can create difficulties with the funding arrangements for a PFI project, such that it is no longer workable or cannot be put together properly if the delay is too extensive because the private sector needs to raise money through the markets and in other ways.

Will the Minister undertake to do the usual thing that Ministers do, which is talk behind the scenes to his Treasury colleagues, as he will have to do anyway? Will he ensure, as far as he can, that the project is at the front rather than the back of the queue? The delay he indicated—through to the spending review in the autumn—could put the viability of the scheme at risk, whether or not the Government reaffirm the commitment made by the previous Government. For that reason, I urge him to do us a favour and discuss with the Treasury behind the scenes, as Ministers do, the urgent need to deal with this scheme as soon as possible.

[Mr Burns]

I respect the hon. Lady’s ingenuity and I can see where she is hoping I will go. I do not want to disappoint, but I understand the situation and all I can do is reiterate that the project will be reviewed, as a lot of other projects across Government will be reviewed, in line with the Treasury guidelines for the review of projects from 1 January.

A decision will be taken by or at the time of the spending review in the autumn. I cannot go further than that. However frustrating it is for the hon. Lady, I know that in her heart of hearts she understands what I am saying. If the roles were reversed, she would probably say the same thing. It would be wrong and irresponsible, and potentially misleading, to go any further.