Health Care (London)

Mary Macleod Excerpts

Wednesday 8th January 2014 Westminster Hall

[Mary Macleod (Brentford and Isleworth) (Con)]

I congratulate the hon. Member for Westminster North (Ms Buck) on securing this important debate. I will keep my comments brief because I want to be fair to other Members who want to speak, not because I do not care deeply about this subject. Previous speakers have talked ably about a lot of the statistics, so I do not need to go over them.

I was actually born in a London hospital, across the river in St Thomas’. I was pleased to go there again recently to visit my hon. Friend the Member for Bournemouth East (Mr Ellwood)—I hasten to add that I was visiting the maternity ward because his wife had given birth to their new son, Oscar. It was lovely to be back at St Thomas’, albeit after so many decades.

Some important issues have been raised in the debate. Health care is critical to all of us—it touches each and every one of us, our loved ones and our constituents. It is crucially important and we must get it right. In London, there are specific problems, as has been said.

I was pleased that in 2010 the Government made £2.7 billion extra available in real terms in the NHS budget across the UK. That has allowed us to have 440,000 more clinical staff, and we also have 23,000 fewer administrative staff, including 7,700 fewer managers. That was absolutely the right approach and what the NHS needed.

The average stay in hospital is shorter than in 2010, although that puts pressure on community care, so we must make sure that that is dealt with. The cancer drugs fund is also critical to the debate, and we have helped more than 38,000 patients through it.

The debate is about London and the issues specific to this great city. In my constituency, in west London, the key health care issues tend to be focused on tuberculosis, obesity—including in children—diabetes and alcohol-related harm. As Members might expect, we have above average problems with healthy eating, given the issues with obesity. Other issues include smoking during pregnancy, smoking deaths and skin cancer. There are therefore specific issues in west London, and I will focus on them.

In my constituency, we have one main hospital—the West Middlesex university hospital, where two thirds of my constituents go when they need to. My Chiswick residents—about a third of my constituents—tend to go to Charing Cross hospital. I want to reiterate what previous speakers have said: we have some excellent patient care and services across our London hospitals, but there are, absolutely, also areas we should focus on.

The West Middlesex has outstanding maternity and midwifery services. One of the best parts of our job as Members of Parliament is rewarding people who have done incredible work in the health service, whether they are clinicians or support staff, and I recently handed out awards at the West Middlesex, which is ably led by Dame Jacqueline Docherty.

I also want to pay tribute to London’s air ambulance service. During the Christmas period, there was a fire and a massive explosion in Chiswick, and the air ambulance was called. The service deserves as much support as possible, because it serves 10 million residents in London, and it has only one helicopter. It is world class, providing high-trauma, acute care. Everywhere else around the country has one helicopter for 1.5 million people, but the figure in London is 10 million, so there is an absolute need for another helicopter. I would push everyone to support the London air ambulance service, which has its 25th anniversary tomorrow.

[Stephen Pound]

I entirely agree, and I think most of us would associate ourselves with the hon. Lady’s comments on the London air ambulance, but does she not agree that it might be better if it were run by the state, instead of relying so much on charity?

[Mary Macleod]

The London air ambulance service is an amazing organisation, so I would not change its structure. It rightly gets some funding from the NHS, but it also derives funding from many other sources, and it is important that we support that. The service does an incredible job, so if the hon. Gentleman knows anyone who can give it a spare helicopter, it would really appreciate that.

My local CCG is chaired by Dr Nicola Burbidge. It started early, it has been absolutely focused on patients and it has been very responsive to any issues I have raised with it.

On reconfiguration, I was recently thankful when, after a lot of campaigning by my hon. Friend the Member for Chelsea and Fulham (Greg Hands) and others, the Secretary of State announced that the A and E at Charing Cross hospital would not be closed, thus helping residents in my part of London. Saving lives and improving patient care is paramount.

[Bob Blackman (Harrow East) (Con)]

I apologise for not being here for the opening speech. Does my hon. Friend agree that one challenge now facing London is the increasing complexity of diseases and the treatments that are required, which means that additional money and expertise are needed? Such diseases often cannot be dealt with at a local level; they must be dealt with nationally. Although we have supported those suffering from cancer and other diseases, much more complex diseases remain to be resolved.

[Mary Macleod]

My hon. Friend makes a good point. I hope the Minister will respond to the issue of how we take up such challenges in London and get the necessary funding.

I shall list some issues on which I would like more improvement. We heard how difficult it is to get appointments at general practices—we call up and know that the answer is going to be no before we say anything. There are also issues with getting to see a specialist as quickly as possible. We want an effective complaints process in hospitals, changing the culture to allow people, whether staff or patients, to complain. There is an issue with how patients are moved around London, and the hon. Member for Westminster North made an important point about having to use public transport to get home. Mental health and community public health are other important issues.

My final comment is about dementia, which is a growing concern in London, as it is across the country. About 30% of patients who go into the West Middlesex hospital have dementia. They do not go there because of dementia, but they have it. There is a lot to be done, and the West Middlesex hospital has just opened a new dementia ward. There needs to be a greater focus on dementia, given our ageing population nationally, and the size of the population in London. We must ensure that we work together to support those who really need and deserve care and support in London. That will improve the NHS for us all.

[Several hon. Members]

rose—

--- Later in debate ---

[Mr Andy Slaughter (Hammersmith) (Lab)]

Given the time constraints, I shall limit myself to one issue, which is the current threat to the emergency hospitals in my constituency, but I begin by congratulating my hon. Friend the Member for Westminster North (Ms Buck) on securing this timely debate. She made her arguments very well.

This morning, I received an e-mail from the Secretary of State that is pertinent to the debate. There was an agreement for him to meet the three Ealing MPs, two of whom—my hon. Friends the Members for Ealing, Southall (Mr Sharma) and for Ealing North (Stephen Pound)—are here, and me next Monday evening. The Secretary of State has withdrawn from that meeting, pleading other engagements, and asked us to meet officials instead. I hope that he will reconsider. The meeting is specifically about the threat to two of London’s major hospitals, Charing Cross and Ealing, and I hope that the comments I am about to make will lead the Minister to intervene and ask that the meeting go ahead. We understand that the Secretary of State has pressures on his time, but it is entirely unacceptable for him not to meet Members on an issue of such crucial and central importance.

It is sad news, but we know—

[Mary Macleod]

Will the hon. Gentleman give way?

[Mr Slaughter]

I would rather not because of the time. I am sorry.

We know what is happening with Hammersmith hospital because it has been announced that the A and E department there is going to close after the winter crisis—as if the crisis is not a continuing one. I have been told informally that it will close two weeks after the local elections to avoid any embarrassment to the Government. We were also told that there might not even be an urgent care centre there; it may be moving. That would mean no emergency access to Hammersmith hospital, unless it is still to receive emergency blue-light coronary cases. At least Hammersmith hospital will continue as a major specialist hospital, and a very fine hospital it is indeed.

The situation regarding Charing Cross hospital is far less clear. I will précis where we are and explain the matters that we wish the Secretary of State to deal with. In February last year, the decision, which is still extant, was made to close completely and sell off the Charing Cross hospital site, leaving an urgent care centre on 3% of the site. At the same time, there was to be an outline business case, to report in October last year, that might preserve 13% of the facilities and 40% of the site. That business case is now due in March, but we understand—through the Imperial College Healthcare foundation trust process, not any other process—that there will also be elective surgery on the site. That might mean there will be elective surgery as well as primary care and treatment facilities, and some form of emergency centre on the site, with perhaps 50% of the land preserved. That gain, in so far as it is a gain, is St Mary’s loss, because we understand that 50% of its site will be sold in any event. Of course, any amelioration in the position is to be welcomed.

I praise the cross-party Save Our Hospitals group for campaigning tirelessly in both my borough and Ealing on the issues I have mentioned. However, the point it would want me to make very clearly is that what I have described is not what we want. Of course we want good elective care, primary care and treatment services, but the issue of capacity must be addressed.

It is not feasible to close two of the largest emergency hospitals. I use the word “close” advisedly. As emergency hospitals, they are closing: there will be no emergency surgery, no blue-light A and E, no stroke unit and no intensive treatment on those sites. I am afraid that the Secretary of State’s intervention so far has been genuinely unhelpful and done for political reasons. We have invented a second-tier A and E, as it is called. A second-tier A and E is an urgent care centre. The only differences that clinicians could identify for me were that at a second-tier A and E there would be GP cover and X-ray services, and for elderly and vulnerable people there might be some beds for recuperation after minor treatment. Otherwise, it is an urgent care centre or a minor injuries unit.

Let us not play political games. I am not saying that we can keep politics out of the NHS—of course we cannot—but this is dangerous because it will mislead people. If people think that there is an A and E at Charing Cross or at Ealing when there is not, they will go there when they should have gone elsewhere. We will continue to campaign to save emergency services. It is not feasible for the Imperial family to go from three major emergency departments to one. All three are currently under pressure and overcrowded. The decision has to be taken by Ministers, so I implore the Minister to go back to the Secretary of State and ask that he meet us.

The level of politics is not acceptable. Politics comes into these matters all the time. Before the last election, when there was no threat to the hospitals, the Conservatives kept saying that there was—I have their election literature here. We now have taxpayers’ money being spent on campaigns saying that hospitals are staying open when, in fact, departments in them are not. Let us at least tell our constituents the truth. There may be unpalatable decisions to be taken, but as far as Charing Cross is concerned, the health service is clear that it will be a local hospital. It will not be an emergency hospital. That is not acceptable in any way to my constituents. It is not feasible to run a health service in west London on that basis.

I have made my points to the Minister clearly, and I look forward to her response. I also look forward to the meeting with the Secretary of State where I can put my points in more detail and more forcefully.