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10.12 pm

Mr. Mike Gapes (Ilford, South): I welcome you, Mr. Deputy Speaker, to your new position. I am also very grateful to have an opportunity to say something about Whipps Cross hospital, because many of my constituents depend on it for services in some specialisms.

Over the past five years, some of my constituents have waited 30 hours in hospital, and others have had operations cancelled several times. It is quite clear, however, that the situation facing both trusts--Forest Healthcare NHS trust, at Whipps Cross hospital; and Redbridge Healthcare NHS trust, at King George hospital, which is in my constituency and within the Redbridge and Waltham Forest health authority area--is now very serious.

My hon. Friend the Member for Leyton and Wanstead (Mr. Cohen) mentioned last week's reports in the local press. The Ilford Recorder reported a £13 million deficit, and explained the implications of that deficit for waiting times, cancelled operations and care for local people. It is perhaps ironic--given the leadership of Redbridge and Waltham Forest health authority--that, immediately after the general election, the authority announced that it had a problem and that it could not set a budget for this year until July, thereby deferring everything for two months.

It is interesting that the authority's management did not reveal the problem in April, or in any of the many meetings that we have had with them in recent months and years. They told us that us that everything was under control, and that any problems were completely the fault of the hospitals' inefficiencies.

The problems are deep-seated, and they need radical solutions--one of which will be to restructure the health authority and to clean out many of the people working for it, so that we can replace them with people who are more responsive to local communities and to the needs of my constituents and those of my hon. Friend the Member for Leyton and Wanstead.

I hope that, when he replies, the Minister will recognise the wider issues that threaten our part of north-east London, one of which is the potential knock-on consequences for Whipps Cross and King George of the closure of the accident and emergency unit at Oldchurch hospital. I believe that all those issues are linked, and that it will be disastrous for us all if the Tory closure programme for London hospitals continues. I thank my hon. Friend the Member for Leyton and Wanstead for allowing me to make this contribution.

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10.14 pm

Mr. Neil Gerrard (Walthamstow): I am grateful to my hon. Friend the Member for Leyton and Wanstead (Mr. Cohen) for allowing me to take part briefly in this debate.

I have no doubt that my hon. Friend the Minister will hear from many hon. Members throughout the country about problems in their local hospitals. It is, however, important to emphasise that I and all the Members of Parliament for the area around Whipps Cross--this is true irrespective of party--believe that there are particular problems in this trust and this district health authority.

I do not trust the league tables we have had over the past few years. They measure things that are measured easily, such as how long people wait before their name and address are taken in accident and emergency. On that basis, Whipps Cross meets the patients charter standard, although we know that there are immense waiting times. What the tables do not, of course, measure is quality of outcome, and there are many concerns about Whipps Cross in those terms. Whatever the league tables measure, there is something wrong when a hospital is at the bottom of every league table except the league table of complaints, in which it is up at the top.

My hon. Friends the Members for Ilford, South (Mr. Gapes) and for Leyton and Wanstead have mentioned the problem of the budget being deferred and of the deficit, so I do not want to go over that point. One of the most important points, however, for Members of Parliament has been the difficulty we have all had in trying to establish exactly what is going on. As a result of the internal market, the trust and the district health authority blame one another, and, from one meeting to the next, it is extremely difficult to pin down what has happened to the budget. Horrendous figures suddenly appear about which we have not been told before.

There is a strong case for looking at the question of openness--at the way in which budgets are decided, when they are decided and how open that process is. There is no doubt about what is happening to services, irrespective of the true figures for the deficit.

I know that the trust has historical problems. The original application for the trust to be set up was a disgrace. With such financial information, it would have been impossible to borrow anything from a bank, yet, on the basis of that totally inadequate information, a large chunk of national health service assets was handed over to the trust. I also believe that creating a trust covering not just a hospital but all the services in the area was a big mistake. All that is history, but it has left the present management, who are making serious efforts to address the problems, with an impossible job.

I ask the Minister, when he looks at solutions for the hospital and at the review of the health service in London, to consider special assistance, particularly special management assistance, for trusts that are having such problems.

I heard yesterday that my hon. Friend the Minister for School Standards has decided that one of the schools in the Waltham Forest area should be on the list of those that are to be the subject of special measures. For most of my constituents, putting Whipps Cross hospital rather than a very small school on such a list would be of far greater interest. We need to consider how we can take hold of hospitals, trusts and district health authorities that

21 May 1997 : Column 818

are clearly failing their communities, and do something to turn them around. On that there would be unanimous support from local Members of Parliament.

10.19 pm

The Minister of State, Department of Health (Mr. Alan Milburn): It is a pleasure to reply to the debate, and to congratulate you, somewhat belatedly, on taking up your new post, Mr. Deputy Speaker.

I thank my hon. Friend the Member for Leyton and Wanstead (Mr. Cohen) for his kind remarks, and the courteous way in which he presented his concerns. I know that he takes a keen interest in local health service issues, and that he and my other hon. Friends who have spoken this evening have some pressing concerns about the state of the NHS in their part of London.

What I have heard this evening is saddening, but perhaps not surprising. It shows how much needs to be done to rebuild the health service in this city and throughout the country. I was particularly pleased to hear my hon. Friend's positive comments about the service provided by the dedicated staff who work so hard at Whipps Cross hospital. The problems faced by the local health service are no reflection on such people, who work tirelessly to provide patient care.

Whipps Cross is not alone in facing such difficulties. I know from the discussion that I have had with many colleagues during my brief time as a Minister that such problems are repeated all too often in hospitals up and down the country. The legacy that we inherit is profoundly challenging.

As my hon. Friend took us through the litany of problems at Whipps Cross, I was struck by two trends in his remarks: the unnecessary pain and suffering caused to vulnerable individuals by problems in the national health service, and the extent to which improving the situation finds common ground with our manifesto commitments for restoring our national health service and the work that we have already started to put things right.

I appreciate my hon. Friend's serious concern about the financial plight of Forest Healthcare NHS trust. Despite the staffing reductions that he described, and other measures to contain costs and improve efficiency, it is a real concern that the trust is ending the financial year 1996-97 with a forecast £4.4 million deficit. Of equal concern is the continuing gap between the trust and the health authority in the current financial year.

A joint strategic change programme has been agreed between the trust and the health authority to redress the deficit over two years. The plan includes further efficiencies and cost reductions, but it is not all bad news. For example, there are programmes in place to improve accident and emergency services by recruiting additional consultants. Plans are in train to deal with the frail elderly population when they enter hospital. I hope that my hon. Friend will welcome those developments.

The quality and timeliness of the care delivered to patients are crucial. I hope that my hon. Friend will take some reassurance from the fact that improvements in

21 May 1997 : Column 819

patient quality standards are a declared principle of the Government--a principle shared with the programme being implemented by the trust. I shall ensure that the NHS executive monitors progress on the programme extremely carefully.

Mr. Iain Duncan Smith (Chingford and Woodford Green): I apologise to the hon. Member for Leyton and Wanstead (Mr. Cohen), but I should like to make a very brief intervention on a non-party political basis as one of the Members for the area who uses Whipps Cross hospital.

I associate myself with the request of the hon. Member for Walthamstow (Mr. Gerrard) that the executive examine the problem. Before the election, I had conversations with the Minister's predecessor about this. If he could ensure that and publish the results, at least to establish some confidence locally that things are being done, it would help tremendously to improve relations with local people.

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