Oral Answers to Questions

Debate between Rupa Huq and Andy Slaughter

Thursday 14th March 2024 Commons Chamber

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

5. What discussions she had with her Israeli and Palestinian counterparts on compliance with international humanitarian law during her visit to the middle east in February 2024.

[Andy Slaughter (Hammersmith) (Lab)]

7. What discussions she had with her Israeli and Palestinian counterparts on compliance with international humanitarian law during her visit to the middle west in February 2024.

New Hospital Programme and Imperial College Healthcare NHS Trust

Debate between Rupa Huq and Andy Slaughter

Tuesday 13th June 2023 Westminster Hall

[Andy Slaughter (Hammersmith) (Lab)]

I beg to move,

That this House has considered the New Hospital Programme and Imperial College Healthcare NHS Trust.

It is a pleasure to see you in the Chair this afternoon, Sir Mark. I understand that our proceedings may be interrupted for some time, but let us make a start. I am delighted to see my west London colleagues here—my hon. Friends the Members for Westminster North (Ms Buck), for Ealing Central and Acton (Dr Huq) and for Brentford and Isleworth (Ruth Cadbury)—and indeed the hon. Member for Cities of London and Westminster (Nickie Aiken), my hon. Friend the Member for Reading East (Matt Rodda), and, of course, the hon. Member for Strangford (Jim Shannon), without whom no debate would be complete, perhaps to remind us that although this is to some extent a local or regional issue, it has much wider implications.

To be clear, this debate is about one thing specifically: the defunding and removal from the 2030 new hospital programme of three major hospitals—Charing Cross, Hammersmith, and St Mary’s—all of which form part of the Imperial College Healthcare NHS Trust. They are teaching hospitals, major emergency and trauma hospitals, research hospitals, academic hospitals, tertiary hospitals—hospitals with a huge national and international reputation—but they are also local hospitals for my constituents and those of many other Members.

In the Secretary of State’s statement on the new hospital programme on 25 May, seven of the schemes that had previously been in the 40 hospitals scheme were removed from that programme with respect to completion by 2030—we must be careful in our words here. I need to deconstruct what has happened since that time, because there has been some misleading presentation of the facts. In order to clarify this, I sent some rather key questions to the Minister in advance of this debate.

Essentially, looking at the statement that was made, the Secretary of State said, in respect of those seven schemes:

“The work will start on those schemes over the next two years, but they will be part of a rolling programme where not all work will be completed by 2030.”—[Official Report, 25 May 2023; Vol. 733, c. 479.]

That is the key change, as far as we are concerned, in relation to that statement.

The questions that still sadly remain unanswered are these: what works will be done at each of the three hospitals before 2030? How much will the budget be for that, and will it come out of the £20 billion new hospitals by 2030 programme? What is the total budget for the rebuild schemes at each of the three hospitals? Is this secured funding, and when will it be allocated? By what date or dates will the works for each hospital be completed?

I have put together what I think are the answers—I have done my sleuthing—but I really need to hear it from the Minister’s own mouth, this afternoon if possible, or in a follow up if he needs to use that. I might also add a sort of meta-question to that: when will I receive a response to the email that I and my hon. Friend the Member for Westminster North sent to the Secretary of State on 28 May, which raised those same issues?

I understand that there is confusion associated with the new hospital programme—as would be true of any scheme that came in under the aegis of the former Member for Uxbridge and South Ruislip—about whether those were new hospitals or not. Almost a year ago, I asked the then Prime Minister about the new hospitals—the “new” hospital at Hammersmith that opened in 1902, and the “new” hospital at Charing Cross that opened in 1818—but I will not focus on that point today. This is about the funding and the timetabling of the scheme; frankly, the Minister can call them whatever he likes.

There have been a number of schemes moving in and out. At one stage there were going to be 48 new hospitals. I think 128 bids came in for the extra eight places and five were successful. We are told there is £20 billion, which sounds like a lot of money—it is a lot of money—but it is not the £32 billion to £35 billion that the Health Service Journal says would be needed to complete all the schemes that have at one time been put forward for the new hospital programme. Those are legitimate grievances, but I do not have time to deal with them all today. I have time only to deal with the one matter that I have already raised.

I need to give a little bit of background. As I have indicated, the hospitals have a long and illustrious history, going back more than two centuries in the case of Charing Cross. In 2012, an Orwellian programme called Shaping a Healthier Future, which had been the product of two years’ secret work by the consultants McKinsey, said that several A&Es should close, including the one at Hammersmith, and that Charing Cross should be demolished and replaced by primary care and treatment services on the site. It was the biggest closure programme in the history of the NHS.

Sadly, we did lose the A&E at Hammersmith in 2014, but after a herculean battle fought over seven years by community groups, such as Save Our Hospitals, and by Labour local authorities, particularly that in Hammersmith, that battle was won and Charing Cross had a reprieve and would go on being a major hospital. That happened in 2019.

It was rumoured that the money that would have been gained by selling most of the land at Charing Cross might have gone into the St Mary’s scheme, which, by common consent, is the hospital that most needs emergency work. But although the bill for essential repairs on the three hospitals is about £350 million—far and away the biggest repair bill of any hospitals in the country—if we want to make those hospitals fit for the 21st century, the actual cost, which I believe is accepted by Department of Health and Social Care officials, will be about 10 times that, between £3 billion and £4 billion. If that seems an unspecific figure—my hon. Friend the Member for Westminster North will say more about this—it is because it depends to some extent on what receipts can be received from land value and moneys at Charing Cross. It is a significant sum of money, but it is to make those essential and world-class hospitals fit for purpose for decades going forward, not just to patch them up.

It was always going to be difficult, and it was disappointing that the hospitals were in cohort 4 and would just squeak in by 2030—that is when the work would be completed. We would have a newly built hospital at St Mary’s and refurbished hospitals at Charing Cross and Hammersmith over that time. That is why it was so disappointing when they were moved out of that without any further future date being given.

What is at stake here? Because there has been so much information, I do not want to use my own words, but the words of the trust itself. In preparation for this debate today, it said:

“the main funding for our schemes has been pushed back beyond the original commitment of 2030 as other schemes have been added to the programme and prioritised. We had two schemes in the original list of 40 hospitals to be built by 2030: a complete rebuild of St Mary’s Hospital in Paddington; and extensive refurbishment and some new build at both Charing Cross Hospital and Hammersmith Hospital”—

confusingly, the Department of Health classifies the two hospitals of Hammersmith and Charing Cross as one scheme, but it certainly affects the two hospitals. The trust goes on:

“It is clearly very disappointing that we will not now be funded to complete these schemes before 2030.”

It also states that

“some funding to progress to final business case approval and to support enabling work”

should be provided, and

“we are awaiting a response in terms of a decision and a funding allocation.”

It then talks about the business plans that it is going to put forward. In rather more emotive but absolutely accurate language, it says:

“If we waited until 2030 to start building works at St Mary’s it would become impossible to patch up our oldest facilities, many of which house key clinical services. As the provider of London’s busiest major trauma centre and host of the NHS’s largest biomedical research centre, that would be hugely damaging for the health and healthcare of hundreds of thousands of people”.

That is the statement from the chief executive officer at Imperial, Professor Tim Orchard, and those words should resonate with the Minister.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I am aware that the Division bell will probably start ringing as soon as I stand up, but I am familiar with that quote from Tim Orchard. My hon. Friend is making a really powerful speech. I am familiar with all these hospitals, as are all my constituents. I was born at Queen Charlotte’s, my little sister was born at Hammersmith, and both my parents were under Charing Cross. I went to the Western Eye Hospital last year when I had shingles, and I have an auntie who has retired but was a consultant professor at St Mary’s.

Does my hon. Friend agree that it is really sad that, in the 75th year of the NHS, we are talking about crumbling estates and all these issues? The backlogs at these hospitals existed long before covid. The Government like to throw up that smokescreen and say, “It’s covid’s fault.” I have just written to Tim Orchard because a constituent told me that there is only one temporary scanner at Hammersmith at the moment. Is that not scandalous? Does my hon. Friend agree that, to paraphrase the Sex Pistols, who were formed on the Wormholt estate, which borders both our constituencies, this is the great NHS scandal?

[Andy Slaughter]

I thank my hon. Friend for that contribution, and I entirely endorse what she said.

I want to deal briefly with the misinformation—I accept that it was wholly unintentional—in the Secretary of State’s statement, or rather in his responses to questions following his statement, because it is important. A ministerial correction was made following a point of order that I made arising out of that. In response to my hon. Friend the Member for Westminster North, the Health Secretary said:

“We recognise the importance of the Imperial bid; that is why we are starting to build the temporary ward capacity at Charing Cross and the first phase of work is under way on the cardiac elective recovery hub, to bring cardiac work on to the Hammersmith site.”—[Official Report, 25 May 2023; Vol. 733, c. 485.]

There are 47 words in that statement, and four errors had to be corrected in the ministerial correction. That may be an all-time record; I do not know. Some are more important than others. There are bids, not one bid. We are not starting to build; we will start to build at some time in the unspecified future. There is no cardiac elective recovery hub; there is a cardiac catheter lab. The idea that we are just moving cardiac services to the Hammersmith Hospital site would be a surprise, given that St Mary’s is a world-leading cardiac hospital at the moment.

I accept that mistakes happen, but there were other errors in that statement. It implied that works are under way, whereas it is common consent now that they have not yet started. The cardiac work is nothing to do with the new hospital programme; it is part of the ordinary work, as is the refurbishment of wards. The temporary ward at Charing Cross will be necessary, but not until the main funding for the floor-by-floor hospital renewal refurbishment is ready to go. Some greater clarity would be helpful on those very contentious matters.

My first question is: what are the enabling works? What does that mean? We have heard several definitions. The trust says:

“We do not yet know when we will be able to start work.”

There has been mention of surveys. Of course there will have to be surveys before the works, which are estimated to cost several billion pounds, start. We are hoping to get a significant sum of money for the business case—perhaps as much as £200 million. This is about rebuilding the three main hospitals.

An energy centre is mentioned. There will need to be a new energy centre, partly because we have major supply issues in west London, and the existing energy supply would not supply modern, state-of-the-art hospitals. All that is true, but what is not true is that this is somehow the beginnings of the major works of the scheme. That is a fig leaf to cover the fact that the major works have been postponed beyond 2030. The fact is that they are not in the 2030 programme or the current spending review. I ask the Minister again: when will the work be done and what funds have been assigned? Yes, there has been preparatory enabling work, but does that come out of the £20 billion? What is the Government’s commitment to the major work of rebuilding those hospitals? There has been some work, with £20 million spent on preparing plans so far, but we are in limbo at the moment. We are suffering repeatedly from misinformation.

I understand that this is a highly contentious political area. The chairman of the Conservative party will, if the Boundary Commission proposals go through, be the MP who covers Charing Cross Hospital. That is no excuse for putting forward matters that are simply misleading to my constituents and many other people. That does us a great disservice. We all want to see these hospitals thrive, in the interests of patients, staff, management, the trust and the hospitals themselves.

Therefore, I will end my comments, because I want to give others an opportunity to contribute. What I need from the Minister today is clarity and honesty about what is happening. We will live with the consequences of that, and we will continue to campaign as we have done for our wonderful hospitals and local NHS. The Government do a disservice if they are not straightforward and clear in the message they send out.

Charing Cross Hospital

Debate between Rupa Huq and Andy Slaughter

Wednesday 1st November 2017 Westminster Hall

[Andy Slaughter]

I am grateful for the clarity that my hon. Friend brings on that point. What is proposed is the loss of all consultant-led emergency services—type 1 A&E services. The site will therefore lose blue-light ambulances, emergency surgery and emergency consultant services. That is a very substantial change to the health facilities available.

The change came under the heading, “Shaping a healthier future”, which I am afraid my constituents regarded as a rather Orwellian title. That programme has now been subsumed within the sustainability and transformation partnership proposals, which are now nationwide, but essentially the meat of the proposal has not changed over that time. I do not deny—I look for points of agreement if I can—that some of the objectives are perfectly laudable, such as specialisation and the bringing together of expertise on a particular site, as has happened with stroke services, major trauma, renal services and so on, even within the three hospitals in the Imperial trust. That is to be commended. No one objects to improvement to primary, social and community care, which may in time lead to less pressure on acute services. If the consequence is not just better health outcomes but a saving for the public finances, we do not object. The problem, and the reason why there has been a breakdown of trust, is that the changes are being advanced before we know the consequences.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

Does my hon. Friend agree that the plans may be transformational, but they are certainly not sustainable, given that London is heading to a population of 10 million before long? It is projected that there will be 12,000 more people in his borough, Hammersmith and Fulham, between the last census and the next one in 2021. We were both at a meeting on Monday night, and he pointed out that the borough has a target of 20,000 new homes by 2035. Where are all those people meant to get treatment, given that we have lost A&E at Charing Cross and Hammersmith, and maternity and paediatrics at Ealing? Demographically, that is illiterate.

[Andy Slaughter]

My hon. Friend puts it very forensically. The difficulty is that however much the aspiration may be to relieve acute services, most independent analysis—whether from the King’s Fund or the Mansfield review, which specifically looked at west London—shows that that is not likely to happen in the foreseeable future. The precious little additional investment in primary and social care is barely keeping up with the pressure on those services. That is where the lack of confidence comes from. However pious and laudable the aspirations, what is hoped for is simply not happening in fact.

I welcome the announcement that nothing will happen in the current sustainability and transformation partnership period, which runs to 2020. That is an admission by the Government that the pressure on services is so great that one could not possibly think about the proposed downgradings at the moment, but that is simply to put off a wrong decision. It means that nothing can happen physically to the Charing Cross site, other than maintenance, until 2021. I have been told privately that it probably means a number of years beyond that, because the eastern part of north-west London, which includes the three Imperial hospitals, has now been put in the slow lane behind what is happening in the western half, so it is unlikely that any changes will happen before 2025. That is 13 years after the first proposals were put forward; that is a very long time in politics, but it is a very long time in the NHS as well.

I am looking for something of more substance from the Government. We have had virtually nothing in writing, or in terms of consultation or engagement with the public, since those announcements back in 2013. Substantial expertise in the community has sprung up in the vacuum that has been created by the health service simply not engaging—expertise through the hospitals movement, trade unions and local people generally. An independent survey conducted by a polling organisation recently showed that 90% of people in the west London area opposed the proposals—that has been borne out in every other survey that I have seen—and 82% think that they have not been involved properly in the decisions. I urge the Minister to listen to that, to turn over a page and to engage with the community on these matters.

Going back to the point made by my hon. Friend the Member for Ealing Central and Acton, last month the four-hour waiting time target was achieved only in 70% of cases for the two hospitals in Imperial. Figures are not disaggregated, so I cannot give them exactly for Charing Cross—only for St Mary’s and Charing Cross combined. That has been a regular pattern over the previous months and years, in particular since the closure of the A&E departments at the Central Middlesex and Hammersmith Hospitals.

The population is growing hugely—as are the health demands, because the area’s population is not only ageing, but mobile and diverse, and those are not on the whole people who do not need acute care. For many years Charing Cross has had good practice: people who arrive at that hospital and have something that can be dealt with by a nurse, a GP or an urgent care centre—in some way other than through consultant care—are simply filtered off, because all those services are available on site. This is not a case of unsuitable use; this is a case of growing demand, and lack of resources to deal with that demand.

I will sit down in a moment, because I want to give the Minister a proper opportunity to respond. I urge him not to read out the brief again because, with respect, I have heard it a number of times over the past five years. I genuinely wish to engage in reassessing what has happened. I welcomed the debate in the other place on 18 October, which was called by my friend Lord Dubs, a Hammersmith resident. More eloquently than I could, he too led a debate specifically on Charing Cross, in which a number of peers took part. The Minister there responded:

“there will be no reduction in A&E or acute capacity at Charing Cross Hospital unless and until a reduction in acute demand can be achieved”.—[Official Report, House of Lords, 18 October 2017; Vol. 785, c. 659.]

Those are very welcome words to have put on the record. I am sure that the Minister here will not resile from that today, but will there therefore be an assessment of whether the changes are likely to happen in the foreseeable future? If they are not going to happen for another four, eight or 12 years, or however long, I put it to him that the Government cannot persist in saying simply, “We will do this when the time is right.” That creates uncertainty, demoralisation among staff, and a motivation for management not to maintain or keep up services because they are in effect throwing good money into a building that they believe will not be there in the foreseeable future.

That is my first request to the Minister: that we have a proper assessment of whether those “Shaping a healthier future” proposals are still fit for purpose, as the Government believed in 2012—although I did not. My second request involves the land on the hospital site, because none of it has been designated as surplus land for redevelopment. I push the Minister to say what exactly is meant by that. In 2012 and 2013 we were told in terms that the land not used for health service purposes would be disposed of privately to subsidise the cost of building on the land that would remain within the health service. Will that not now happen, or is it simply that no formal proposals have yet been brought forward?

As I said, this has been a hospital site for well over a century, and the hospital has existed for two centuries. It would be a great pity if that were to change on my watch and the Minister’s, particularly when the hospital is needed most by people in my constituency and others who have used it throughout their life and their family’s lives.

Ealing Hospital

Debate between Rupa Huq and Andy Slaughter

Tuesday 3rd May 2016 Westminster Hall

[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to be here this afternoon under your chairmanship, Mr Stringer. Although the debate is difficult, it is a great pleasure to follow my two neighbours from the London Borough of Ealing, and I thank my hon. Friend the Member for Ealing, Southall (Mr Sharma) for securing this debate today. As the MP for Ealing hospital, no one has done more than he has to champion the cause of that hospital over the four years that it has been under threat. As we see from the petition that generated this debate—not the first petition of this size—he is admirably and clearly reflecting the view of the vast majority of people not only in Ealing borough but across west London.

Apart from their choice of Member of Parliament, the constituency of my hon. Friend the Member for Ealing Central and Acton (Dr Huq) may be one of the most unlucky in the country. To lose one A&E department may be considered unfortunate; to lose four must be an all-time record. Following the closures of Central Middlesex and Hammersmith and the downgrading of Ealing and Charing Cross to non-type 1 status, her constituents will be in a very difficult position, as will all our constituents.

I am here today for two reasons. I am not an Ealing MP, but I want to support my colleagues and I want to say—I think the Minister will accept this—that the proposals for Ealing hospital are inextricably linked, under the “Shaping a healthier future” programme, to the future of the eight other major hospitals in west and north-west London, four of which, as we have seen, will undergo substantial change and either closure or downgrading of services, or at least movement of services elsewhere.

As my hon. Friend the Member for Ealing Central and Acton said, we have debated this subject many times. I do not think that is surprising. I make no apology for that, given the importance of the issue. In the recent debate in March, which was an across-London debate, “Shaping a healthier future” was raised several times. One of the matters on which I and others pressed the Minister was when we would see the next developments. I was grateful when the Minister said that Members would have the next important document—the draft of the implementation business case—as soon as possible.

Since that debate we have also managed to fix a date, 25 May, for the 11 MPs to meet the health service management across north-west London. Unfortunately, I have been told by my clinical commissioning group that the document will not be available for the meeting, although it will be available later in the summer. The sooner we can see that document and have an update on what the proposals are for Ealing and the other hospitals, the better. I say that because this will be familiar not only to Members here, but to the many people in the Public Gallery. The difficulty we have had over the past four years is a lack of information.

We began with the bombshell proposals in the summer of 2012, which effectively proposed the closure of Ealing and Charing Cross hospitals, leaving just a primary care facility on the site. There was a modification when the final proposals were brought forward in February 2013. Those proposals—which most of us regarded as a fig leaf, albeit a very expensive fig leaf—were for the demolition and disposal of a substantial portion of the site, but with the building of new facilities, primarily for primary care and some other treatment, while still using the majority of emergency and acute services on the site. Since then, nothing. Indeed, we have been waiting a couple of years for the business case. In the place of factual information, rumours tend to spread. As was mentioned previously, nothing has changed.

As for Ealing hospital, the very strong rumour is that, given the poor financial condition of the NHS and the scepticism of the Treasury about the programme, it is likely that the service cuts and reconfigurations will go ahead, but also that the existing buildings will be retained. Those buildings were not designed for the purposes for which they will now be used and will not receive the funding to modernise them that was at least the mitigation in the previous proposals. The sooner we know one way or the other on that, the sooner we can have a proper discussion about it. The news that Imperial will have a £50 million deficit this year—I think the situation for north-west London hospitals is even worse—suggests that the financial imperative is continuing to drive this

Although the health service itself may have been quiet—certainly in what it has told Members and the public—my constituents and those of my hon. Friends have not been quiet over the past few years. As I say, the petition that generated this debate is not the first petition of more than 100,000 signatures that has been lodged. I hope that more attention is paid to this one than has been paid to previous ones. I pay tribute to the thousands of people who have not only signed petitions but been active in the campaign, which is going into its fifth year. The uncertainty is not helping anyone.

The public, the organised campaigns and the local authorities have acted responsibly. The local authorities commissioned the Mansfield report, a serious document that was not taken seriously enough by the NHS. The level of demoralisation is extremely high, and is combined with issues relating to the junior doctors’ dispute. Places such as the Imperial College school of medicine are centres of excellence for training junior doctors. I have spoken many times to the staff there and their morale is very low. All staff morale is very low because people do not know where they are going to be working or what job they will have. They do not know whether the facilities they are working in will survive, or whether they are going to be run down in the meantime. Consequently, we have a substantial overreliance on agency staff. That is not a good template for the NHS.

I appreciate the fact that there are financial difficulties throughout the country and that the situation in west and north-west London is not unique. Nevertheless, I do not think that any other areas have had to put up with this reorganisation—or whatever we want to call it—for as long as we have.

[Dr Huq]

When my hon. Friend made the point about the loss of four A&E departments, he reminded me of the saying, “Once is unfortunate, twice is a coincidence, but three times is beginning to look like a habit.” I do not believe that any saying even goes up to four. Does he agree that it is unprecedented to lose four A&E departments?

[Andy Slaughter]

Yes, I do. I anticipate that we are unlikely to get much by way of an answer from the Minister today, although I will be delighted if she does have some news to impart. I hope she will take the debate in the spirit it has been conducted, because there is genuine anxiety. What we are asking for and what will help is transparency. It may be that we do not like what we hear any more than we liked what we heard three or four years ago, but it is getting beyond a joke now.

We talk a lot about hundreds of millions of pounds of money and about people’s love for institutions such as hospitals, but if we are pragmatic about it, at the end of the day the important thing is whether individuals receive a good standard of care. By coincidence, this morning I spent half an hour on the phone to a constituent whose husband’s life was saved two years ago when he had a serious aneurism. They were told by the professor who operated on him that had they taken a few moments longer to reach Charing Cross hospital, which they live very close to, that would have been the end.

The rider to that is that last week the same gentleman was rushed to Charing Cross hospital again with a recurrence of that issue. He spent seven hours there before being transferred to St Mary’s in Paddington, where he again received very good treatment. I hear again and again that the system is beginning to break down and people are not necessarily taken to the right place at the right time or, when they do get there, they are not seen quickly enough. That is not a criticism of the staff, who are working extremely hard against the odds and are highly professional.

We are very lucky to have such world-class hospitals in west London. We do not take that for granted, but I have given just one example of the kind of story I could probably repeat every week. I worry about the future of the health service for my constituents and those of my colleagues if we do not get to grips with the situation quickly. We are drifting in a way that means that the excellent and superb levels of healthcare we have become used to over the years are no longer likely to be maintained.

NHS in London

Debate between Rupa Huq and Andy Slaughter

Thursday 24th March 2016 Westminster Hall

[Dr Huq]

I completely agree with my hon. Friend. We are trying to have a serious debate, but we are pooh-poohed at every turn. When my hon. Friend the Member for Hammersmith (Andy Slaughter) asked a question about the Mansfield report, he was told that he was living in a bygone age. I cannot recall the exact remark, but it was something like, “You’re an old soldier fighting a war that’s concluded.” Dismissing people in that way does not inspire confidence.

[Andy Slaughter (Hammersmith) (Lab)]

I always do what I am told by my hon. Friend—the dismissive comment was that the Mansfield report was commissioned by five Labour councils. I have actually had a slightly more considered response, but it was still dismissive. It was a very serious independent report, and I am sure my hon. Friend will agree that the Minister should take it a bit more seriously.

[Dr Huq]

My hon. Friend puts it very well. People’s concerns are serious and should not simply be dismissed.

I also agree with my hon. Friend the Member for Eltham (Clive Efford) that the community pharmacy network is a vital component of our country’s health and care system. Suddenly, the Government seem to be imposing arbitrary cuts in a high-value, easily accessed, community-based facility, which relies on private investment as well—pharmacists are small businesspeople. Hiten Patel of the Mattock Lane pharmacy opened my eyes when I spent a bit of time shadowing him there. I saw how the burden on the NHS and GPs is reduced by people having such pharmacies at the end of their street. For most people, they are much nearer than a hospital or even a GP service.

Hiten Patel and his staff help people to make lifestyle choices. They provide a range of services and information to promote health, wellbeing and self-care. They are a useful check on prescribing errors and are dedicated and trusted people. We have such pharmacies all over the country, and they form obvious back-up and support at a time of crisis for GP recruitment and retention. We should value those people, not make life more and more difficult for them.

Last Sunday, I collected my elderly mum’s meds from Harbs pharmacy in South Ealing Road. That pharmacist is open out of hours. I recall that one year he was open even on 25 December—I did not go past this year, but he was probably open then as well. That releases the Ealing Park surgery practice next door for more acute and specialist care, but the Government seem to do short-termism. The long-term impact of eroding the network will have a disastrous effect.

Another troubleshooting service that is located at the heart of the community and has hidden value is opticians. They, too, have a valuable role of social contact, with networks and support mechanisms, and they can contribute to signposting and safeguarding the vulnerable. As the right hon. Member for Carshalton and Wallington (Tom Brake) pointed out in connection with community pharmacists, opticians can also catch things early.

I visited the Hynes opticians in Northfield Avenue, where staff are worried about the continuity of their supply chain. Joint strategic needs assessments enable clinical commissioning groups and local authorities to work in tandem, and the Ealing Council assessment mentions effective eye services and sight loss, but the NHS Ealing CCG does not use the JSNA in its commissioning decisions. Will there be some guidance from the Minister about how to integrate CCGs and local authorities better?

I could go into mental health services, which are chronically underfunded and a huge cause for concern. The Prime Minister made a speech about them last month, but I would like to see more action. Labour has a shadow mental health services Minister. The chief executive of Central and North West London Foundation Trust, Claire Murdoch, has claimed in an interview that mental health can be an “easy target” at times of belt tightening, saying that

“during recessions mental health tends to be hit first and hardest and recover most slowly…There is an absolute anxiety that people are depressed and really are suffering as a result of some of the economic reforms. What we don’t know yet is the extent to which some of the welfare reforms are driving people to real, serious illness.”

I have the sense of morale taking a nosedive locally. My constituent Michael Mars, who is now retired but was a senior consultant at Great Ormond Street hospital, said:

“The essential problem is the feeling of impotence experienced by those at the coal face

because of an

“overwhelming management culture where clinical knowledge and experience is secondary to management.”

Such words echo, because we hear them from a lot of other public service professions such as teachers and the police. They all say that they are doing all the paperwork and are not allowed to do what they are supposed to do. Michael Mars talked about survival in the culture of management and worries that we might be in danger of forgetting what clinical consultants are appointed to do.

At the other end of the career scale are junior doctors, on whom there was a debate in this Chamber on Monday. I have had numerous representations from constituents who are junior doctors. The latest NHS staff survey showed that the percentage of junior doctors suffering from work-related stress has gone from 20% in 2010 to 34% in 2015.

High Speed Rail (London – West Midlands) Bill

Debate between Rupa Huq and Andy Slaughter

Wednesday 23rd March 2016 Commons Chamber

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I rise to support new clauses 26 and 32. Paradoxically, I agree with most of what has been said today, because I do think that it is possible to be pro-infrastructure investment, pro-progress and pro-brand new trains. I am pro the concept of high-speed rail, but I am not pro-HS2 Ltd and, as the right hon. and learned Member for Beaconsfield (Mr Grieve) said, the rather cavalier way it operates. In the Select Committee its QC called my residents tedious, which I thought showed complete contempt for them.

New clause 26 is about protecting vulnerable businesses and the time given for relocation. I have spoken to some of the businesses in the Park Royal area of my constituency. The businesses there are quite mixed. Many of them deal with food preparation—for example, supplying olives to restaurants in the west end—and need to be close to the A40, which is a vital artery. They are family businesses. They have been told that when it happens they will be given three months to relocate. They have a combined turnover in the millions. They are all extremely concerned that they will be forced to close because three months is not enough time for them to start again.

I spoke with a prop hire company. It occupies thousands of square feet of warehouse space, with antiques and big fat televisions behind wooden veneer cabinets. It supplies props for films such as “Star Wars”. It would find it very difficult to find alternative premises quickly. Those companies would also like an assurance of 100% compensation for their sites, not the 90% on offer.

The Conservative party is the party of business, surely. It is the party of small and medium-sized enterprises. [Interruption.] I think this new clause has genuine cross-party support, judging by the Members who have signed it. It is deeply worrying that those firms are being forced to move towards what is called extinguishment, because apparently their balance sheets do not show enough turnover, so HS2 considered their financial value to be too small to warrant relocation. That is a slap in the face and an insult to hard-working, small family businesses.

[Andy Slaughter (Hammersmith) (Lab)]

My hon. Friend is doing a brilliant job of representing her constituents, as she always does. Does she agree—I think this is the purpose of her new clauses—that it is often the businesses in urban areas that are the most fragile and therefore the worst affected, but the levels of compensation and concern shown to them is the worst on offer—[Interruption.]

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. We do not have time for long interventions.

Prisons and Probation

Debate between Rupa Huq and Andy Slaughter

Wednesday 27th January 2016 Commons Chamber

[Andy Slaughter]

The cuts in staff lie at the root of many of the problems I am identifying. The fact that in many cases prisoners now spend 22 or 23 hours in their cell, and have restrictions on work, education and association, is leading to increased violence and poor behaviour in prisons. That is a very short-sighted development. I think the Government realise that, but perhaps too late.

Turning to probation and reoffending, figures I obtained last month revealed that almost one in 10 offenders are convicted of an offence within 18 days of release. HM inspectorate of probation’s fourth report on the implementation of transforming rehabilitation was published on 15 January. It highlighted the disparity in performance between the national probation service, which is still part of the National Offender Management Service, and the 21 community rehabilitation companies managed by private providers. For CRCs, one quarter of the offenders sampled had been convicted of a further offence, whereas for the NPS the figure was less than one fifth. On child protection and safeguarding on home visits, the NPS again outperformed CRCs. Earlier this month, the Lord Chancellor’s Department stopped publishing figures relating to staffing figures at CRCs. Why was this, except to conceal the hundreds of experienced probation staff being laid off across the country to promote the bottom line for the CRCs’ owners?

Let me turn to the youth estate, and in particular the role of G4S. We welcome the measures announced yesterday by the Lord Chancellor to effectively put Medway secure training centre into special measures. This is unsurprising, as they are exactly what I called for in an urgent question two weeks ago. I also welcome the decision by the director of Medway to stand down. However, individuals should not bear the entirety of the blame for what looks like corporate failure by G4S. I have now written to the Serious Fraud Office to ask that it investigates the allegations, made in the BBC “Panorama” programme on Medway, that instances of disorder were concealed to avoid G4S incurring fines under its contract. This is in addition to the ongoing SFO investigation into G4S and Serco’s manipulation of the tagging contracts for financial gain.

G4S has a truly dismal record of managing public contracts here and abroad. At Rainsbrook STC, six staff were dismissed and the contract was terminated last September, following an inspection report that said some staff were on drugs while on duty, colluded with detainees and behaved extremely inappropriately with young people. The company taking over the contract is MTCnovo. It is a name not well known in this country because, in origin, it is a US prison firm. As such, it presided over a riot in an Arizona state prison and ran a youth facility in Mississippi that a judge described as

“struggling with disorder, periodic mayhem, and staff ineptitude which leads to perpetual danger to the inmates and staff.”

It probably left that reference out of its application, along with the fact that its directors helped to set up Abu Ghraib prison in Baghdad.

The problems of the youth estate go way beyond G4S, however, which is why the chief inspector of prisons has called for an inquiry into the failings at Medway and the implications for the wider youth justice system.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

On the Justice Committee, we interviewed the chief inspector and found his answers on ministerial interference in his reports very interesting. Does my hon. Friend agree that, to the outside world, the fact that the chief inspector’s contract is not being renewed makes it look like he was doing an effective job in holding the MOJ to account, and is now being silenced?

[Andy Slaughter]

My hon. Friend makes an extremely good point, and one that I will come on to.

If the Lord Chancellor is a prison reformer, as he is now billed, we are prepared to work with him. He could start with the Prison Reform Trust report, “Correction or care? the use of custody for children in trouble”, published last year, which looked at successful models around the world. Successful prisons are becoming smaller, more focused and more rooted locally, which is why he is right to abandon his predecessor’s plans for a new borstal. Although he is also to be commended for wishing to close unsuitable prisons, if, as a consequence, prisons are built a long way from friends and family or we move from local to titan prisons, that will have its own drawbacks.

We need prison watchdogs with real teeth and independence. The outgoing inspector, Nick Hardwick, has done a great job in spite of, not because of the Government. This brings me to the point made by my hon. Friend the Member for Ealing Central and Acton (Dr Huq). The reports last week that the MOJ had tried to control or muzzle him were outrageous. I welcome the Lord Chancellor’s announcement yesterday that he will retain Mr Hardwick’s expertise as head of the Parole Board, but let us use this opportunity to shake things up. We need a stronger, more independent inspectorate that is able to produce reports with total independence from the MOJ and to conduct more frequent and unannounced inspections.