Accident and Emergency Departments

Mike Gapes Excerpts

Thursday 7th February 2013 Commons Chamber

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

It is a pleasure to follow the hon. Member for Enfield North (Nick de Bois). He and I have something in common. He said that he had been let down by the Secretary of State after 2010. Sadly, I have to say that my constituents and I, and my neighbour, the hon. Member for Ilford North (Mr Scott)—unfortunately, he cannot be here today, but he asked me to mention the fact that he has been in Committee—also felt let down because of a decision that was taken. Eight Members of Parliament from north-east London campaigned together on a cross-party basis to save the A and E at King George hospital, yet in 2011 the Government announced that, after the previous decision, they were going to go ahead with a recommendation to close the A and E and the maternity unit at King George hospital in Ilford. There will be no more births there at the end of March. We will no longer have children born in Ilford, unless they are born in the back of taxis or cars that are trying to get through traffic jams to take them to Queen’s hospital Romford. However, I want to concentrate on the A and E.

This afternoon, a risk summit is being held between Barking, Havering and Redbridge University Hospitals NHS Trust and the commissioners to consider the implications of the absolutely damning Care Quality Commission inspection, one of a series of inspections of Queen’s hospital, which was published on 30 January, which is last Wednesday. Among other things, the report stated:

“The accident and emergency department…has not met most of the national quality indicators as a result of extensive delays in the care of patients. Five percent of patients who need to be admitted to the hospital are waiting for more than 11 hours in the department. The Trust should be aiming to transfer 95% of patients who are being admitted to wards within four hours of their arrival.”

Many patients are waiting much longer than four hours, and 5% are waiting for more than 11 hours. That was from an inspection in December. The report also says that there is

“poor care for patients in the ‘Majors’ area”

and that the

“environment is unsuitable for patients to be nursed in for long periods of time,”

because of a

“lack of privacy/dignity, no washing facilities, no storage space for personal belongings and no bedside tables.”

I could go on—there are complaints about other A and E services and facilities at Queen’s hospital.

Queen’s is a new, PFI-built hospital that was designed for 90,000 admissions. Last year it had 132,000, as my right hon. Friend the Member for Barking (Margaret Hodge) mentioned in an intervention. It is in a joint trust with the King George hospital in Ilford, which has fewer admissions, but there was a proposal—the then Secretary of State and his Health Minister said this was the intention—to close the A and E at King George hospital in about two years from October 2011. Patients would then have had to go to the A and E at the already over-pressed and stressed Queen’s hospital. Frankly, that policy was always insane and foolish. We fought against the first such proposals in 2006—the misnamed “Fit for the Future” proposals—right the way through, in cross-party unity with neighbouring MPs, under the last Government. We managed to get implementation halted for reconsideration and review, but sadly this Government have given the go-ahead to closure of the King George A and E unit.

[Nick de Bois]

I hope the hon. Gentleman will benefit from the time he gains by giving way to me. He is right about the documents—as he will recall, we had “Healthy hospitals”, which was the last thing being sought. Let me remind him that we have another thing in common: the merry-go-round of chief executives, from my former chief executive to his hospital’s chief executive. It worries me that the administrators are in control, not the people or the politicians.

[Mike Gapes]

I do not personally blame Averil Dongworth, the new chief executive at Barking, Havering and Redbridge University Hospitals NHS Trust, for the current situation. She has not been there long enough. There are a number of predecessors who were party to the proposal. I also blame Ruth Carnall and the people in NHS London who were behind the original proposals. They and Heather Mullin, along with others in the NHS in London, have been determined for six or seven years to close the A and E unit at King George regardless of the petitions, the protests or the fact that the public overwhelmingly rejected their proposal, even in their rigged consultation.

[Jim Dowd]

On the malign influence of NHS London, let me tell my hon. Friend that its policy director—one Hannah Farrar—was appointed as number two and chief assistant to the special administrator of South London Healthcare NHS Trust, precisely to achieve what had always been wanted: the closures at Lewisham.

--- Later in debate ---

[Mike Gapes]

Where are we now? Last year saw a 22% increase from 2011, with 26,859 additional attendances in the A and E unit at Queen’s hospital. In addition, there were 73 patients a day more than in the previous year, with 23 days on which there were more than 470 compared with only three days in the previous year. The pressure on Queen’s hospital today is getting bigger and bigger, yet the plan is still to close the A and E unit at King George hospital. Where are all the patients supposed to go? Presumably not to Queen’s hospital, because it cannot cope. What is already happening? Although the figures are not being made public, I am told that on a number of occasions over recent weeks, in December and January, ambulances have been diverted to other hospitals from Queen’s hospital, including Whipps Cross hospital, which is part of the Barts Health NHS Trust—and it has its own problems. We are facing a real crisis.

I also understand that performance at Queen’s hospital has fallen off drastically. Only 65% of patients have been seen within four hours since the end of last year. The figure at King George hospital was much better, yet it is King George—the better-performing hospital in this trust—that is supposed to be run down. I spoke to the Care Quality Commission this afternoon, which is now proposing a potential cap on the numbers of patients in the “majors” area at Queen’s, because of the problems and lack of safety that will arise.

This is not just a question of resources. It is also, of course, a question of management, but ultimately it is not possible to get a gallon into a quart pot, which is what we face in north-east London. The trust’s board meeting on 9 January looked at these issues in detail. It has already got McKinsey in and it already has the so-called reset programme running. It also says that it has been making improvements for the past few months. Well, it made big improvements on maternity, but it has failed on A and E.

There is a real problem as long as the proposal to close A and E at King George is on the agenda. There is a problem of morale, motivation and, potentially, recruitment. The CQC report is absolutely damning about the shortage of consultants, the reliance on temporary locum staff and many other issues that are part of a fundamental problem in the trust’s culture that has been going on for a long time.

It is not very easy for my constituents to go to other hospitals. If the problems at Queen’s continue, it would be insane to go ahead with the proposals to close King George’s A and E. Last month I asked the new Secretary of State to reverse his predecessor’s decision; unfortunately he refused, but please will the Minister give me that commitment today?

[Several hon. Members]

rose—