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Whipps Cross Hospital
Motion made, and Question proposed, That this House do now adjourn.--[Mr. Jon Owen Jones.]
10 pm
Mr. Harry Cohen (Leyton and Wanstead): I congratulate my hon. Friend the Minister on his appointment. I know that he has considerable abilities and his appointment is well deserved, but he is in a tough job, especially after 18 years of damage to our health service by the Tories. I wish him success. I also congratulate you, Mr. Deputy Speaker, and thank Madam Speaker for granting me this debate.
In the election, the most common complaint raised by my constituents was: "Do something about Whipps Cross." [Interruption.]
Mr. Deputy Speaker (Mr. Michael J. Martin):
Order. Would hon. Members leave quietly? An hon. Member is addressing the House.
Mr. Cohen:
Thank you, Mr. Deputy Speaker.
Seven to eight-hour waits in the accident and emergency department are commonplace, with regular reports of 24-hour and longer waits. The impression is that Whipps Cross resembles a war zone, and that local people fear going there. My mailbag bulges with complaints confirming the findings of a table showing that Whipps Cross was second in the whole country for complaints; last year, there were 1,170 complaints.
Local newspapers regularly catalogue the dismal stories of long waits in the A and E department for patients on trolleys in corridors. For elderly people, left without regular nourishment, medical or nursing attention, physical deterioration is rapid, with the risk of pressure sores. There should be fast-track admission for elderly patients directly referred to the hospital by their general practitioner. They should not be repeatedly queuing for admission. [Interruption.]
Mr. Deputy Speaker:
Order. The hon. Member for Buckingham (Mr. Bercow) had better be silent. I have heard some comments from Opposition Benches. He is in an Adjournment debate on an important matter.
Mr. Cohen:
There has recently been the tragic death of 11-year-old Neil Askew from meningitis. Among the many unsatisfactory aspects surrounding his death is the suspicion that, if he had not endured a wait of many hours before his condition was identified, and if he had been transferred to the specialist hospital more quickly, his life might have been saved.
I draw the Minister's attention in particular to the long waits for treatment, especially on trolleys, that were particularly bad last winter. To prevent a recurrence, I ask him to accept that action needs to be taken before next winter.
In addition to the unacceptably high level of complaints, two separate performance indicators point to persistent chronic under-performance at Whipps Cross. The Government's official national health service performance guide, analysed by The Guardian on 3 July
last year, showed Whipps Cross second from bottom of all acute hospitals in England. Most recently, the Audit Commission report said:
Those three indicators show that Whipps Cross is not delivering the same quality services as comparable hospitals elsewhere. That is unfair to local people. Waiting lists for hospital treatment have slipped back to 18 months, and a recent trust report shows that they will slip further. Staff tell me that some patients are actually being kept off the waiting lists. About 14,000 people are waiting for non-emergency operations.
The community health council said:
Some of the elderly acute wards are in a dreadful state without adequate toilet and washing facilities. The majority of those who die do so in ordinary wards, where the level of palliative care is inadequate.
Whipps Cross hospital is in deep financial crisis. Forest Healthcare NHS trust and Redbridge and Waltham Forest health authority, which are responsible for that, are in a financial mess. On 7 May, a report on the deficit said that the
On top of that, a £10 million reduction to Redbridge and Waltham Forest is proposed in the latest unfair funding formula adopted under the Tories. Last week's Wanstead and Woodford Guardian and Waltham Forest Guardian reported a "£20 million black hole" in health finances, quoting David Avis, the health authority's director of finance. The Ilford Recorder lists £13.1 million of debts on the health authority's loans.
I and fellow Members of Parliament for the area, some of whom wish to catch your eye, Mr. Deputy Speaker, have met local health officials month after month and year after year, only to be told that things are under control and getting better. Only Nick Leeson could believe that.
The management is in a state of permanent crisis. The top managers are not on top of the situation, and are disinclined to take responsibility. Middle managers struggle to cope with costly, repeated reorganisations. Some staff have had to apply three times in three years for their own jobs. Expensive outside consultants have been used, but their recommendations have not always been implemented, and then new consultants are appointed.
The trade union talks of "destabilisation" of the work force, which puts the blame on the staff who have left and creates a climate of fear so that employees cannot speak their mind. The hospital staff, to whom I pay tribute for keeping the service going in awful circumstances, have been treated unfairly. Their morale is at rock bottom.
The privatisation contract with Tarmac Servicemaster, for cleaning, portering, transport and switchboard services, has been disastrous. There has been a failure properly to appreciate basic hospital hygiene. For example, initially one mop was used to clean toilets, wards, treatment rooms, sluices and kitchens--what a risk of cross-infection and MRSA, or methicillin-resistant staphylococcus aureus. This is the madness of privatisation, which ends up costing a lot more. I have photographs to pass to the Minister showing the shambles of that contract.
New Labour's election promise was that the internal market will go and that 100,000 more patients will be treated by cutting £100 million from the bureaucracy budget. We will also act on the scandal of long waits on trolleys. From the case that I have outlined, I am sure that the Minister will agree that Whipps Cross sorely needs the benefit of that programme.
There are huge funding deficits in the health authorities and trusts across London. I ask the Minister to re-examine swiftly the capitation formula, of which a quarter is not weighted for deprivation. A full weighting for deprivation is recommended by the Select Committee on Health, and by the King's Fund. Out of 402 boroughs, Waltham Forest is 23rd from the bottom and Redbridge is in the bottom third, according to the Jarman indicators of deprivation.
The health authority and the trust have adopted a joint strategic change programme with transitional funding of £4.4 million, dependent on cash efficiency savings of £3.7 million being achieved. Because of the scale of the deficit, however, the programme will simply spread the debts and cuts over a number of years. As the Audit Commission confirmed, new disinvestments--many of which are desperately short-term--will exacerbate the appalling problem of delays in the accident and emergency ward.
A recent trust report on acute services recommended a reduction of 183 posts and 27 beds, and downsizing theatre sessions by 10 per cent. On 7 May, Lister ward--the female surgical ward--closed, despite the trust's assurances in April to the Waltham Forest Guardian that no changes would be made in the 1997-98 financial year. Cost-effective programmes, such as interim care, have been abandoned, and have resulted in higher readmission levels. Quality of care, best practice and good ideas have been jeopardised.
Currently available money could be better spent, and wasteful spending on inefficient private contractors and consultants must be ended. The joint strategic change programme must be drastically improved, because it is currently the only game in town. The local health authority and trust managements have failed to take effective action and assume responsibility for the various on-going crises and for the overall crisis.
Department of Health monitoring and support is necessary. I ask the Minister to scrutinise and reorganise the structure and personnel of the trust and the health authority. There should be local authority staff representation.
The health authority and the trust have failed to agree on this year's contracts, in which there is a £6.5 million gap. Redbridge and Waltham Forest health authority costs more than £4.8 million per annum, primarily in managing
the internal market. That sum could be slimmed down considerably, in line with Labour policy. Management of patient care is our primary objective.
"Waiting times are a serious problem at Whipps Cross Hospital, and are the result of a combination of factors. In addition to the increasing workload and inadequate staffing levels, a shortage of specialty beds and problems with current admission policies need to be addressed."
The report found that Whipps had the worst waiting times out of the 17 London and south-east accident and emergency departments that it examined.
"Health services in Waltham Forest are worse than in other areas."
For example, elderly patients currently have to wait six to nine months for a hearing aid as priority is given to the dying and the over-90s.
"health authority is in a position where it has an underlying recurrent deficit of £3 million . . . It could be exposed to a £6.5 million deficit".
The trust overspent by about £4 million.
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