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That, for the purposes of any Act resulting from the Local Government and Public Involvement in Health Bill, it is
expedient to authorise the payment out of money provided by Parliament of
(a) any expenditure incurred by the Secretary of State under the Act, and
(b) any increase attributable to the Act in sums payable out of money provided by Parliament under another enactment .[Mr. Heppell.]
That, at this days sitting, the Second Reading of the Income Tax Bill may be proceeded with, though opposed, until any hour. [Mr. Heppell.]
That, for the purposes of any Act resulting from the Income Tax Bill, it is expedient to authorise any incidental or consequential charges to tax which may arise from-(a) provisions restating, with minor changes, certain enactments relating to income tax, or(b) the exercise by the Treasury of a power to make provision for the purpose of returning the effect of the law to what it was immediately before 6th April 2007. [Mr. Heppell.]
That Mary Creagh be discharged from the Joint Committee on Human Rights and Mark Tami be added. [Mr. Heppell, on behalf of the Committee of Selection.]
That Michael Gove be discharged from the European Scrutiny Committee and Mr. James Clappison be added. [Mr. Heppell, on behalf of the Committee of Selection.]
Mr. Paul Burstow (Sutton and Cheam) (LD): I have sought this debate on the national health service in the London borough of Sutton in order to put to the Minister a number of questions to which my constituents want answers. I hope that, with the prior agreement of the Minister, my hon. Friend the Member for Carshalton and Wallington (Tom Brake) will also be able to address the House during this short debate.
What is the future of health care in the London borough of Sutton? What is the future of St. Helier hospital? Those are the questions that my constituents want answered tonight. St. Helier is a huge part of life in Sutton. It is a great white monolith that stands on Rosehill and dominates the south London sky line. It also dominates the lives of my constituents. Like all hospitals, it has formed the backdrop to some of the most significant events in the lives of the people whom it serveslives begun, lives ended and much else in between. I was born at St. Helier, as were all my children. I therefore make no apology for the personal stake that I hold in the future of my local hospital.
Does that hospital have a future? The events of the past six months lead to one conclusion: St. Heliers future is at risk. We reached that stage through a long and tortuous process of proposals, plans and policies, which amounted to nothing but empty promises. Only 14 months ago, St. Helier was to be the site of a new, high-tech critical care hospitala state-of-the-art facility at the centre of a network of local care hospitals: a hospital for the 21st century.
After years of planning and fruitless consultation, the Secretary of State for Health intervened on 19 December 2005 to direct the local NHS that St. Helier be the site for that hospital of the future. However, rather than actively seeking to implement that direction, local NHS managers attempted to thwart my constituents wishes and the Secretary of States clear instruction. They have succeeded.
Last August, the Secretary of State backed down and withdrew her direction, leaving the NHS, its staff and my constituents in limbo. Why? The answer is money. The trust that runs St. Helier has had to find £20 million in savings in two years. In September, the trust announced the first round of cuts. It called them quick winsmoney that could be saved without upsetting anyone: that is, anyone except patients who forgot to pack their pyjamas and found that the hospital no longer kept a stock, those who got fed up with the single limp sandwich that they were served for lunch but were told that hot food was no longer available, or those affected by the jobs that were frozen throughout the trust, causing huge pressure on the wards.
However, those cuts were as nothing compared with what came next. On 10 October, the trust announced plans to axe 200 hospital bedsthat is, one in four of those available at Epsom and St Helier University Hospitals NHS Trust. A week later, it announced plans to cut 470 jobsone job in 10 across the trust. Every single one was a front-line clinical job.
What impact will the cuts have on the quality of service, staff morale and patient care? Those are questions that my constituents want answered. Between the two announcements, my hon. Friend the Member for Carshalton and Wallington, the hon. Member for Mitcham and Morden (Siobhain McDonagh) and I met the Secretary of State for Health. During that meeting, 10 months after her decision to direct that St. Helier be the site of a new critical care hospital, she told usor at least gave the impressionthat there was little chance of that ever becoming a reality. We were told that there was no money behind the lofty aims of the better health care project. Never has it been less gratifying to be proved right.
For years my hon. Friend and I have asked the same question: where is the money to pay for the hospital and the network of local care hospitals? That question has been evaded by those in charge of the local NHS. We have had warm words, nudges and winks. They said that everything would be fine, but they never gave a straight answer. Now, years down the line, we are told that there is no money. Where are the people responsible? They are nowhere to be seen. They have gone, moved on or resigned. The disappearing managers and faceless board members promised more and delivered less. Where is the accountability? That is a question that my constituents want answered.
We are told that there are too many hospital beds in London and that hospital closures are a real prospect in south-west London. In the end, what have we got? We have a hospital that is falling apart at the seams, where patients recovering from heart surgery shiver because there is no money to fix a broken radiator; a hospital with a threat hanging over it. It is ripe for downgradingeven closureso that accountants can balance the books in London. How is that better health care, closer to home? It feels like less health care, further from home.
On 25 November, on a cold grey morning, in pounding rain, more than 2,000 people joined my hon. Friend and me on a march to protest against the cuts at St. Helier. Those peopleordinary local residents, former patients and disgruntled hospital staffwanted to send a clear message to the Government, as, indeed, do many Labour Members. They wanted to say no to cuts driven by financial pressure rather than clinical need, no to additional pressures on staff already working extra shifts to offer decent care, and no to the gradual downgrading of services at our hospital.
Since then, the situation at St. Helier has deteriorated further. Staff morale has fallen through the floor. With fewer resources, increased pressures and the threat of compulsory redundancies looming, that is hardly a surprise. Morale has been further damaged by the sudden and unexplained resignations of both the chief executive and the chair of the Epsom and St. Helier trust.
Morale is only part of the problem, however. The cuts are having an impact on patient care. St. Helier has the trusts full complement of surgical assessment beds. Those 26 beds are so oversubscribed that, on a single night in December last year, there were 23 breaches of the four-hour waiting time target. That means that 23 people in a single night were let down because the system could not cope.
I could go on. I could speak of the nurses who campaigned to have the axing of two special care baby unit beds reversed. I could speak of the specialist nurses who are being forced to reapply for their jobs, competing against people alongside whom they have worked for years, and who are now waiting for their redundancy notices. I could speak of the inevitable increase in emergency readmissions resulting from the aggressive bed-clearing policy. But I must press on.
In the midst of this chaos, I am here to ask the Minister to intervene. First, I want a simple assurance that the cuts, the closures and the chaos are not the first stage of a plan to downgrade and eventually close St. Helier hospital. More specifically, I refer the Minister to the ongoing review of the better health care project. The aim of that review is to establish whether the better health care proposals can proceed to the business case stage. The document states that if this is not possible, the requirements of south-west London will
need to be considered within the overall framework of the proposed Strategy for London.
financial positions of local commissioners.
It is clear that the health economy in south-west London is already in severe difficulties. It seems that the results of the review are a foregone conclusion. The financial positions of local commissioners lead to just one conclusion: more cuts and closures.
Siobhain McDonagh (Mitcham and Morden) (Lab): Is the hon. Gentleman aware that the list of public meetings to be held in conjunction with the consultation on better health care closer-to-home project are all timed for between 6.30 and 8.30 in the evening, which will exclude many people who work in the centre of London? Is he also aware that none of them is scheduled to take place in my constituencythat will not be so much of a problem for him as it is for mein spite of the fact that it has the worst health?
Mr. Burstow: The hon. Ladys point speaks for itself, and I hope that the Minister will be able to respond to it. My hon. Friend the Member for Carshalton and Wallington and I certainly share that concern. We need an open and full public consultation as the review goes forward.
The wave of hospital reconfiguration that is sweeping the country seems poised to break on St. Helier. My constituents have been led a merry dance for a decade or more. The prospect of a better health service and a new hospital is always on the horizon, but that horizon always moves further into the distance.
Mr. Andrew Pelling (Croydon, Central) (Con): Surely the prospect of the hon. Gentlemans constituents having to face a journey out of the borough of Sutton, possibly even to the Mayday hospital in Croydon, is entirely unreasonable, bearing in mind the travel times involved and the geography of south London.
Mr. Burstow: The hon. Gentleman makes a fair point. The difficulty is that those engaged in programming all this are not fully aware of the difficulties involved in moving around this part of London. That is why my constituents want to be reassured tonight that a full range of health care services will continue to be available in Sutton. They want a certain future for St. Helier hospital. I hope that the Minister will be able to give us some of the answers that my constituents want, because that is what they deserve.
Tom Brake (Carshalton and Wallington) (LD): I thank my hon. Friend the Member for Sutton and Cheam (Mr. Burstow)and, indeed, the Ministerfor allowing me to make a contribution to tonights crucial debate. Our constituents share the accident and emergency unit at St. Helier hospital. My hon. Friends children were born at the hospital, and so were mine. We received fantastic care from the doctors and midwives there.
St. Helier hospital is at the centre of the community on the St. Helier estate. It is a landmark both on the skylineit dominates any south London panoramaand in health and employment terms. It sits at the centre of one of Londons largest and least affluent estates, which is represented by my hon. Friend and me, by the hon. Member for Mitcham and Morden (Siobhain McDonagh) and by the hon. Member for Croydon, Central (Mr. Pelling) on the Greater London authority. Its loss would be a body blow to residents of St. Helier and surrounding areas. When the Minister responds to the debate, he can allay our concerns and give a simple yes in answer to the question, Is St. Helier hospital safe?
My hon. Friend has explained why he is worried about the future of St. Helier. I echo his concerns, and I shall add one other. In a letter dated 18 January, Steve Peacock, the programme director of the better health care closer-to-home project, states that the review will need to consider new health services and providers, and lists the independent sector treatment centre. My concern is the extent to which the ISTC may distort the local health economy, as it has a guaranteed income.
Let me seek one further assurance from the Minister about a subject that has not yet been mentioned in the debate: Orchard Hill. He will be aware that last week the Healthcare Commission published a report that was critical of the care provided by the Sutton and Merton primary care trust for adults with learning disabilities. The failing must be rectified by the PCT as a matter of urgency. Indeed. the PCT, which called in the Healthcare Commission, which I welcome, has started the work. The report recommends that external support and transitional funding is provided to the primary care trust so that services for people with learning disabilities can be brought into the 21st century. For the second time, I seek a simple yes from the Minister, in response to the following question. Will the external support and transitional funding recommended by the Healthcare Commission be provided?
The Parliamentary Under-Secretary of State for Health (Mr. Ivan Lewis): I congratulate the hon. Member for Sutton and Cheam (Mr. Burstow) on securing this debate on significant issues in relation to the NHS affecting his constituents. The contribution made by the hon. Member for Carshalton and Wallington (Tom Brake) was of equal importance and validity. I shall try to respond, where I can, to the points made.
I also pay tribute to the work and campaigning, undertaken privately and publicly, in support of the St. Helier critical care hospital by my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh). In response to her points, I will consider both the timing and the location of consultation events. If we are serious about making sure that consultation reaches all sections of the local population and is an authentic and genuine process, her point is valid.
Mr. Lewis: We certainly expect that those who conduct NHS consultation processes will do so in an authentic and genuine way. That is about listening to the local population and articulating the need for change in the context of rising patient expectations and advances in modern medicine.
It is important to say to the hon. Members for Sutton and Cheam and for Carshalton and Wallington that the portrayal of any reconfiguration of health services in any community as a cut is disingenuous and undermines confidence in the national health service. Of course it is important that any changes are made for the right reasons, are clinically led and are in the interests of the local population. The status quo, however, is not always desirable. In some circumstances, change is not appropriate, and maintaining the existing infrastructure of services is the best way forward. However, the presentation of any reconfiguration or need to engage with the local population about changing health care requirements or social and economic circumstances as always being about cuts is disingenuous, and is not in the best interests of constituents and the local community.
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