Oral Answers to Questions

Nick Raynsford Excerpts

Tuesday 26th February 2013 Commons Chamber

[Dr Poulter]

I thank my hon. Friend for his question. He is right to highlight the very damaging PFI scheme signed by the previous Government for the St Helens and Knowsley NHS Trust. The percentage of annual turnover going on PFI payments at the moment is 14.2%. That is unsustainable, which is why this Government are trying to sort out the mess created by the previous Government’s signing up to too many PFI agreements.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

The Minister will be aware that support for excess PFI costs was an important element in the report of the trust special administrator in south-east London, to which the Secretary of State referred in an earlier exchange. That recommendation was widely welcomed. However, as I highlighted in questions a month ago, the Government have not accepted the financial recommendations of the trust special administrator for the capital costs and the transitional costs inherent in his recommendations. If the Government wish to proceed with these changes, will the Government agree to meet those costs as well?

[Dr Poulter]

The right hon. Gentleman is in dangerous territory talking about PFI schemes to which the previous Government signed up. No hospital operates in isolation. The South London Healthcare NHS Trust was paying out 13.9% of its turnover on the PFI. That was unsustainable. It has caused huge difficulties in the local health care economy and affected patient care, which was a very bad thing to do. The right hon. Gentleman needs to recognise that this Government are providing £1.5 billion-worth of support to many trusts that have struggled under these PFI agreements—

South London Healthcare NHS Trust

Nick Raynsford Excerpts

Thursday 31st January 2013 Commons Chamber

[Mr Hunt]

Of the six local clinical commissioning groups, five support these proposals. One group is against the proposals, but it accepts the principles behind them, including the idea that to deliver higher quality care, we must perform complex surgery at fewer sites. That will mean that more of the hon. Gentleman’s constituents have better care outcomes. I remind him that if his Government had resolved this problem when they were in office before 2010, none of us would be having this discussion today.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

The Secretary of State has accepted all Matthew Kershaw’s recommendations. He will know that the trust special administrator recommended a substantial investment package to support the changes that he recommended, including £161 million of capital funding and £55 million of transitional funding over three years. In his statement, the Secretary of State referred to just £36 million of capital spending for maternity and £37 million for A and E. That is £73 million lower than Mr Kershaw’s recommendation. There was no reference in the statement to the transitional funding of £55 million. Will the Secretary of State confirm whether Mr Kershaw’s funding recommendations have been accepted?

[Mr Hunt]

We accept that very detailed analysis was used by Matthew Kershaw to come up with those numbers. We will look at them very carefully. However, we need to have sensitive negotiations with the new partners who will be part of making this solution happen before the final numbers are agreed on.

Hospital Services (South London)

Nick Raynsford Excerpts

Tuesday 22nd January 2013 Westminster Hall

[Heidi Alexander]

I acknowledge that a decision has yet to be taken, and I take this opportunity to press the Minister to confirm that the decision will be taken on 1 February. If it will be taken before then, it would be useful to know. We are here to present the case for refusing the recommendation.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

My hon. Friend has been making a powerful case. I want to pick up on the Minister’s interjection to the effect that no decision has yet been made and to reinforce my hon. Friend’s point that if changes as fundamental as those proposed in the trust special administrator’s report are introduced but are not safe and do not have clinicians’ true support, we run the risk of repeating the very mistakes of the last reconfiguration, which created South London Healthcare NHS Trust, and which proved not to be as financially sound as was expected when it was proposed. That is a real risk, and I hope that the Minister will pay attention to it.

[Heidi Alexander]

My right hon. Friend has consistently made that point in the House, and I totally agree.

It is a fact that maternity services in south London are under enormous pressure. In the 20 months between April 2011 and November 2012 providers of maternity services across south-east London suspended services on 37 occasions. Women in labour were therefore turned away from hospitals and told that they would have to go elsewhere. Of those 37 suspensions, 26 were necessary because of lack of beds. King’s College hospital also tried to suspend services on a further six occasions, but was unable to do so as no other unit had capacity to accept the women it was trying to transfer.

South London Healthcare NHS Trust

Nick Raynsford Excerpts

Tuesday 8th January 2013 Commons Chamber

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

The Secretary of State will understand that I have not been able to read the entire trust special administrator’s report in the hour or so I have had access to it. However, while I was reading the report, it became clear that a great deal of concern was expressed during the consultation about the implementation of the proposals. Indeed, the report highlights the fact that following previous reorganisations, costs have increased rather than reduced as a result of the very process of reorganisation.

Given those worries, will the Secretary of State agree to meet representatives from other boroughs, who are equally concerned? I remind him that he declined my request for a meeting on the trust special administrator’s draft report; I hope he will not decline to meet now that we have the full report. In particular, will he consider the implications for patient care and services of a major reorganisation, which can be disruptive and fail to deliver the savings envisaged?

[Mr Hunt]

I heed absolutely the right hon. Gentleman’s warning that reorganisations are not always the panacea that they are made out to be. We need to be absolutely clear that, if we accept the proposals, they will deliver a sustainable, robust and clinically sound outcome for the right hon. Gentleman’s and neighbouring constituents, as the trust special administrator believes they will. I shall be delighted if the right hon. Gentleman attends the meeting with other MPs affected by the proposal. I shall hear what he has to say further at that meeting.

National Health Service

Nick Raynsford Excerpts

Monday 16th July 2012 Commons Chamber

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

This debate comes less than a week after the Secretary of State’s announcement that he is putting South London Healthcare NHS trust into administration. He will therefore not be surprised, and nor will the House, that I intend to focus on that issue.

Not surprisingly, this announcement has caused massive alarm and concern across south-east London. Staff working for the NHS in all three affected boroughs—Greenwich, Bromley and Bexley—are all worried about whether they will continue to have a job. Patients and their relatives are worried that the NHS services on which they have depended for years may no longer be available, as rumours abound about potential cuts and closures affecting hospital services. What is most regrettable is that all this is utterly unnecessary. Indeed, there is a strong suspicion that the whole process of putting South London Healthcare into administration is driven by politics—by the Government’s wish to send a message about being tough with trusts in deficit rather than by a rational assessment of what is most likely to help the trust to improve its clinical and financial performance.

Let us look at the facts. At the time when the Secretary of State made his announcement, briefings appeared in the media about South London Healthcare being a failing trust with poor standards of clinical care. On the contrary, the trust has shown significant improvement in clinical performance. It is one of the top five trusts in the UK in terms of low mortality, hospital infection rates are three times lower than the national average, and the four-hour target for A and E patients has been met month on month since February. For those of us who have been working with South London Healthcare to raise its performance, it is particularly galling to see the Secretary of State dismissing those achievements and incorrectly claiming, as he did on 28 June in a communication to MPs, that patients at the trust

“experience some of the longest waits for treatment”.

That is simply not true of South London Healthcare today. It may have been true a year ago, but, as I said, there has been improvement, and the Secretary of State has ignored that. Indeed, he himself appears to realise that his criticisms were wide of the mark, as just one week after he made that statement I received a letter from him, as did many other London MPs, starting with the following memorable words:

“Dear Colleague,

I wanted to write to you with a summary of the excellent performance of the NHS in your area”.

You couldn’t make it up; talk about the left hand not knowing what the right hand is doing.

What about the deficit? Yes, there is a deficit—about £70 million last year—but South London Healthcare has been implementing a series of service changes designed to reduce it over the next four years while at the same time improving the standards of health care. Ironically, its task has been made much more difficult by the Secretary of State, who knows only too well that two years ago, in summer 2010, he intervened to halt the implementation of a clinically led plan to reconfigure services in south-east London entitled “A picture of health”, which, after six months’ delay and a review that he imposed, was judged to meet all four of the necessary tests. His intervention merely delayed a reconfiguration process that was going to improve services and save money. Now, after a wholly unnecessary and costly delay, the plan is proceeding, with the consolidation of A and E services on two, rather than three, sites and similar moves to concentrate specialisms: stroke at Bromley; elective surgery at Queen Mary’s, Sidcup; and maternity at Queen Elizabeth, Woolwich. All those changes have helped to improve performance and have made savings. Ironically, the same Secretary of State who delayed the implementation of these improvements is now blaming the trust for the deficit without acknowledging his own part in the process.

South London Healthcare has been in existence for just three years. It came into being as a merger of three trusts, all of which faced deficits and needed support and help to get out of their problems. As the trust’s ex-acting chair, who was removed from office today, said in his letter to the Secretary of State on 9 July,

“We have been prepared to take strong action—we are the only Trust in London to successfully close an A and E department and move maternity services…What we have not been prepared to do is to promise more than is within our capacity to deliver; nor to mask structural issues that need to be addressed.”

It is a tragedy that, rather than supporting the trust in its really good work in improving patient care and reducing the deficit, the Secretary of State has acted in an arbitrary and unfair way and is trying to blame the trust for a problem for which he has a large measure of responsibility.

NHS Reorganisation

Nick Raynsford Excerpts

Wednesday 16th March 2011 Commons Chamber

[Mr Lansley]

In a moment.

Only yesterday, the Public Accounts Committee said that over the past 10 years the productivity of NHS hospitals had been in almost continuous decline, and that taxpayers were getting less for every pound invested in the NHS: Labour, leaving us to sort out the mess. The truth of the matter is that the NHS needs to change to meet the rising demand for and cost of health care.

The changes that the NHS needs are simple: more investment, less waste, power to front-line doctors, nurses and health professionals, and to put patients first.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

Will the right hon. Gentleman give way?

[Mr Lansley]

No. I will give way to the right hon. Member for Lewisham, Deptford (Joan Ruddock) first.

NHS White Paper

Nick Raynsford Excerpts

Monday 12th July 2010 Commons Chamber

[Mr Lansley]

Yes, my hon. Friend understands that GPs are often providers beyond their primary medical services responsibilities. One of the difficulties with fundholding was that there was an opportunity for that conflict of interest to arise and not be properly resolved, so we have made it clear that, in the commissioning framework that we will publish, we will set out consultation proposals on how we ensure that that conflict of interest is not allowed to arise. Where GPs wish to be providers, we do not constrain them, but how that contract is arrived at is transparent and open.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

How can the Secretary of State, with a straight face, say that he opposes the culture of top-down bureaucracy and decisions being taken by politicians, when he himself, in the past six weeks, has stopped the implementation of a clinically led and agreed programme for improving health care provision in south-east London, which was going ahead until he stopped it? Does he now accept that his words carry very little force for those of us who know what his actions indicate?

[Mr Lansley]

No is the answer. I set out on 21 May criteria on listening to patients and understanding what patient choice will be in future; on engaging the public, including local authorities, which are now following through on that accountability; on following the clinical evidence of what can best deliver outcomes; and on ensuring that GPs, as we have made clear, must be supportive and engaged. If any proposal in London is made at local level, such as the one the right hon. Gentleman refers to in Oxleas, that satisfies those criteria, which are bottom-up and locally led, there is no difficulty in its proceeding.

Oral Answers to Questions

Nick Raynsford Excerpts

Tuesday 29th June 2010 Commons Chamber

[Mr Burns]

I am extremely grateful to my hon. Friend for raising an issue that I know is of concern to many people. Although I cannot make promises about the outcome of any review, he has my assurance that we will be looking into this, and that we take on board the concerns that have been expressed over a number of years.

[Mr Nick Raynsford (Greenwich and Woolwich) (Lab)]

The Secretary of State has halted the reconfiguration of services in south-east London, which was clinically led, the subject of detailed public consultation and approved by the reconfiguration panel. The outcome is to leave my PCT and hospital trust acutely troubled about their ability to deliver the improved health services that were promised under “A picture of health” and to meet their financial targets. What does that say about the Government’s commitment to evidence-based policy making?

[Mr Lansley]

What we have done in London is to give those who would be most affected by decisions to reconfigure services the opportunity, where decisions have not already been made, to have a local say. That includes patients, the public and GP commissioners. The delay, in so far as there is any delay, need not be great if those proposals are fully subscribed to by local people and by their GPs as commissioners.