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1 May 2007 : Column 383WH—continued
Progress has already been made. Shortly after our previous debate last year, I visited the new renal centre at Hammersmith with the all-party kidney group, and that institution is fantastic, as are the other buildings that are going up on the Hammersmith and Charing Cross sites and, no doubt, on the St. Mary’s site. Impressive improvements have been made in care as a result simply of changes that have been made under the existing management and co-operation arrangements,
but the institution of the AHSC is a once-in-a-generation opportunity to make a sea change and to improve the health care of my constituents and those across west London.
9.55 am
Mr. John Randall (Uxbridge) (Con): I congratulate my hon. Friend the Member for Ruislip-Northwood (Mr. Hurd) on obtaining the debate. As the hon. Member for Ealing, Acton and Shepherd's Bush (Mr. Slaughter) implied, this might well become an annual event, which would be a good thing because nothing matters more to our constituents than the provision of good health care.
I echo my hon. Friend’s comments about the Mount Vernon site. Although it is not in my constituency, many of my constituents use the facilities there and are concerned about any potential move to take cancer services away from the site. My hon. Friend told us about the proposal to move to a fictitious hospital in Hatfield, although the site had not even been identified and there was no planning permission. Although such things happen, we must move on. It is self-evident to anybody who knows someone who has suffered from cancer or who has suffered from it themselves that the last thing a cancer patient needs to do is to make a long journey in terms either of mileage or, in the case of west London, travel time. Public transport is available to take people into central London, although it can be unreliable, as we all know, but the last thing that somebody who is having chemotherapy or other treatment wants to do is sit on a crowded train. The joy of Mount Vernon is that although it is in west London—I would say it is in Middlesex—it looks over some wonderful countryside and has excellent facilities for patients and for the family and friends who take them there. We should not lose what we have there.
My hon. Friend did not mention Hillingdon PCT, but it is involved in a rather sorry tale of deficits. The three Members of Parliament for the area have tried hard to help successive chief executives of the PCT. I have lost count of how many we have had—I think that we have had more than one a year so far under the revolving-door policy that we seem to have at the PCT. Indeed, we have just lost Mr. Sumara, who has gone off to be the chief executive of the London strategic health authority, NHS London. However, I get the impression that although chief executives come and go, the problem of the deficit remains to some extent. I still have not had the answer that I would like on that issue and I do not know exactly why such a large deficit has arisen. I do not want to indulge in party politicking on the issue because it is far too important, but there is a serious problem and I doubt that the ongoing debt—that is what it is—will benefit my constituents and their health care.
My hon. Friend and I have raised the issue of orthodontics, homeopathy and other services that seem to be affected. We are always assured that they are not affected, but I am afraid that I am becoming increasingly cynical as I get older, and I am not entirely sure that I quite believe what I am told these days. There was a time when I was fresh faced, young and slim that I might have believed it, but as you see today, Mr. Cummings, things have changed somewhat.
The Minister of State, Department of Health (Andy Burnham): Speak for yourself.
Mr. Randall: I am afraid it will come to the Minister too; I was young and full of hope, but I must tell him that life deals a bitter blow. His will come shortly because fate has given me a lot of time to speak in this debate and there are matters that I want to raise with him.
Hillingdon hospital, which is in my constituency and is close to where I live, still manages to provide a very good service, but, as I think is recognised, the building is not quite what it should be. I remember going there as an 11-year-old, having broken my wrist playing football; even today, although there has been a little refurbishment of accident and emergency, the X-ray department is identical to what was there 40 years ago, so it is probably recognised that change is needed. We have been talking about a rebuild, and there is also talk of the private finance initiative, among other things.
It is a slight shame that the ideal location for a new Hillingdon hospital should be the RAF site. There is a very large RAF station in Uxbridge that is being sold by the Ministry of Defence, but it seems that the time scale between the departure from the site of the Ministry of Defence and the potential financing of a new build at Hillingdon hospital makes the idea impossible. It has been explored, but I have promised those involved in the Hillingdon Hospital NHS Trust and the primary care trust that I shall not keep going on about it, for fear that we shall lose the rebuilding of Hillingdon hospital, which is so sorely needed. However, it seems incredible that two Government Departments cannot get their act together sufficiently to achieve something that would provide the whole of west London with the services of a remarkable facility in the future.
There is one matter concerning Hillingdon hospital for which, to be charitable, I probably cannot blame the Minister. It is the continuing problem going back many years of an incinerator on the site. Unfortunately, it was given planning permission many years ago, when there was Crown immunity—I think that the ruling about that has now changed. Subsequently, Hillingdon hospital sold some land and made an application for residential development. The local authority turned it down, but its decision was overturned on appeal. Anyone familiar with the area would have known that the new houses would be situated right up against the incinerator, although from talking to the residents it seems to me that they were given some sort of assurance by the people selling them the properties that there was nothing to worry about and it would soon go away. Sadly, that does not seem to be true.
I am greatly concerned about the matter. I have heard recently from residents about police escorting the waste lorries as they come in. One begins to wonder exactly what is being incinerated there. We have had meetings and I am assured that everything perfectly okay and there is nothing to worry about. None the less, there is a great deal of noise and a certain degree of pollution, and I am not convinced that what people in that area are breathing in is beneficial to their health. It is ironic that such an operation is on the hospital grounds and, although not run by the hospital—it has been put out to a company—is an integral part of it. We should think about that, because when we want public support for hospitals and the health economy it is important to deal with both sides of an issue.
My hon. Friend the Member for Ruislip-Northwood mentioned Harefield hospital, which, although it is not now in my constituency, was historically in the Uxbridge constituency. It does not only serve our constituents; it is world-renowned. I should say that Harefield has a healthy future. It has been refurbished and improved and has lately benefited from a most up-to-date 64-slice scanner, which is a brilliant diagnostic aid. It cost about £700,000, which interestingly was all raised by the public. After the scandal—that is one of the mildest words that I can use—of the Paddington health campus, it is reassuring that everyone is happy to invest in the Royal Brompton and Harefield NHS Trust.
I noticed yesterday on the HillingdonTimes website that Harefield hospital had just achieved another first. Mr. Brian Everard of Stanmore was
“spared the pain and trauma of open heart surgery—to replace his heart valves—and was instead operated on through a small incision in his chest.”
Harefield hospital, as it says in the article,
“has long been at the cutting edge of heart and lung treatments and earlier this month it was announced that scientists had managed to grow heart valves from stem cells, a world first.”
It is also making incredible advances in the treatment of cystic fibrosis. I do not think that I have to make a case for what is happening at the hospital.
My hon. Friend mentioned shenanigans about trust status and said that it was not time to revisit the Paddington health campus scandal. I disagree—but only because no lessons seem to have been learned. When that project finally came to its end, all the supporters of Harefield hospital greeted the news with delight, but there was great anger about the cost to the public purse of that over-ambitious and fatally flawed project. My hon. Friend rightly mentioned a voluntary organisation that has been mentioned before in such debates: Heart of Harefield. Its members are ordinary men and women led by a very energetic person, Mrs. Jean Brett, who has shown what determination, knowledge and great skill can do. I am not sure that the scandal would have been exposed without Heart of Harefield and Mrs. Brett. We might even have reached the point of having a white elephant that would have cost the public purse millions for years to come.
Unfortunately, the public anger remains. My hon. Friend referred to a meeting about this some time ago with the Minister, who was very generous with his time. One reason for the anger is that the chief executives who were involved remain unaccountable and the Royal Brompton and Harefield NHS trust is perceived as having been unjustly denied foundation trust status. I hope that hon. Members know that I do not engage lightly in polemics—I am a great believer in a consensual style of debate in this Chamber. However, much of what has happened seems to me to be down to the actions of one of those NHS chief executives, Gareth Goodier. I believe that he has been vindictive.
The chief executive of the North West London strategic health authority was humiliated at being proved wrong on the Paddington issue. The strongest contributing factor was the withdrawal from the project of the Royal Brompton and Harefield NHS Trust, under the leadership of its new chief executive, Mr. Bob Bell, for whom I have the highest regard. Shortly after his appointment, Mr. Bell, who had
experience of planning and completing a new hospital, realised that the Paddington project lacked sufficient land to make it viable. There is an obvious contrast with the inability of his supposedly senior colleague to grasp that point over a lengthy period of time.
I do not expect this place to be like a business, because they are different worlds, but I remember discussing the Paddington project in this Chamber in May 2004, when I set out, in what I thought was a calm and collected way, why the business arguments for continuing the Paddington health campus were flawed. The Minister who responded to that debate, who is now a little more senior—the Secretary of State for Work and Pensions—turned on me with a degree of unkindness and accused me of opportunism. He also accused the people who had helped and advised me and given me information of being vindictive and simply wanting to stop something that was going to be the most marvellous thing in the world. I protested that that was not the case and that I was using the little knowledge that I had acquired from 20 years in business to show that the project was a waste of public money, but I was not able to get a word in. I remember trying to make an intervention at the end but not being allowed to make it. However, but that is how things work in this place—let us be grown up about it.
Since that debate, the people who were responsible—NHS executives and Government Ministers—have never acknowledged that a mistake was made. No one has said, “Actually, you were right, and so were the people with you. A great deal of money has been saved for this country and the taxpayer, and we regret the waste beforehand.”
Mr. Andrew Lansley (South Cambridgeshire) (Con): My hon. Friend makes an important point about learning lessons from the collapse of the Paddington health campus scheme. I recall the debate that he secured back in May 2004, in which I was the Conservative Front-Bench spokesman. The responding Minister in that debate was indeed the present Secretary of State for Work and Pensions, who subsequently repeatedly refused ever to give direct evidence to the inquiries of the National Audit Office and the Select Committee on Public Accounts into why the Paddington health scheme collapsed. That was one of the more disgraceful episodes of Labour Ministers’ stewardship of the Department of Health.
Mr. Randall: I agree with my hon. Friend. Indeed, I was going to make that point. It was not only Ministers who acted in that way: NHS chief executives did not give evidence to the inquiries by the NHS and the Public Accounts Committee. If there had been a genuine desire to ensure that the same thing did not happen again, they would have given evidence. I should like to know what reasons they gave for not giving evidence. Were they trying to hide something? I shall give them the benefit of the doubt, but there is a strange smell about people refusing to give evidence to inquiries that are intended to sort out problems and ensure that they do not recur.
The North West London SHA chief executive, Mr. Goodier, was one of the strongest supporters of
the Paddington project. I remember discussing it with him. His support continued even after he was sent a letter by the Department of Health in January 2006 advising him in the strongest possible terms to write back disproving the points made in the letter. Again, nothing was forthcoming.
The Royal Brompton and Harefield NHS Trust has benefited greatly in the past six months from its association with Sir Magdi Yacoub, of whom the whole House and a great many of the public have heard. The Sir Magdi Yacoub heart science centre, which is on the Harefield site, has made groundbreaking, successful advances in the regeneration of the heart in last-chance cardiac patients using a combination of drug treatment and a ventricular-assist device. We have already heard something about what is being done at that centre. Its breakthrough in April in generating human heart tissue opened up a field that is so large in its scope to benefit patients that it is impossible for any of us to quantify.
The Heart of Harefield campaign has been mentioned a lot in this and previous debates. Before Jean Brett agreed to lead that campaign back in 2000, she had to be convinced that maintaining the bed-and-bench situation at Harefield hospital, in which the patient and research are in proximity, was of such importance that destroying that affinity would result in a loss of benefit to patients both nationally and internationally. Recent events have proved her decision to have been absolutely correct.
The trust is the UK’s largest cardio-respiratory centre. Due to its expertise and eminence it has been the largest recipient of NHS research and development funds, but recent Government changes in the allocation of such funds have caused problems. Monitor has suggested that all research funding might dry up after 2009 and has claimed that the trust’s strong financial position could therefore be jeopardised. That is a rather worrying thing for Monitor to say. The public, and probably the trust’s board, have had a surfeit of NHS organisations throwing spanners in the works while pontificating on matters that are beyond their remit. I am afraid that I hear echoes of the whole Paddington fiasco coming back to haunt us.
It is highly unlikely that the Royal Brompton and Harefield Trust or other specialist trusts will be so radically disadvantaged in respect of research moneys by the Government that all specialist trusts will therefore cease to be financially viable. It is rather more likely that the possible side effects of introducing a new research and development system were not thought through, but it is not acceptable for Monitor to take a disaster scenario approach when assessing the trust for foundation status.
In the most recent round of applications, 17 trusts applied for foundation status, of which only three were successful. Given that one of the trusts was the Royal Brompton and Harefield Trust, which is regarded by the chief executive of the SHA for London as one of the most successful, there are doubts about the efficiency of the system. The press releases at the end of March suggested that the decision had been taken some time before. The application was supposed to be under consideration at that time and the decision was to be made by 26 April, but it seemed to be a foregone conclusion. I want some openness about that decision,
and Members of Parliament, members of the public and members of the trust need answers about it.
Specialist trusts should not be unilaterally disadvantaged by Monitor as a result of Government policy on cuts in R and D moneys, particularly given that decisions remain in a state of flux. There is no objection to changing the system nationally so that R and D moneys are shared more equitably throughout the country and are monitored more strictly so that they do not leak into supporting deficits, but it is not acceptable for any organisation to use the change in Government policy as an axe to disadvantage specialist trusts. The improvement of patient care and the reputation of this country both nationally and internationally depend on the fruits of specialist trusts’ research.
I raise this matter because I am genuinely angry about what has happened, and not only because one of the best NHS trusts in the country—a real jewel of the NHS—has been affected. I am angry about the lack of openness, the twists and turns and the political manoeuvring. Things have gone on that would make a senior Whip blush—the sort of strange things that go on behind closed doors about which I can only dream. At least, that is how things seem to me, a young innocent out here. All that is bad for the NHS.
If we want to improve the NHS and its systems, as I believe everyone does, we cannot have the current system of NHS executives running roughshod over common sense and the evidence and then indulging in a vindictive war against those who have dared to cross them. I dare say that I shall have to watch out if I go to hospital in the next few months, certainly in some areas, but I lay down the marker now: I know where they are, I know where they live and they know where I live.
10.20 am
Susan Kramer (Richmond Park) (LD): I am conscious of the fact that my constituency is in south-west London, so I shall attempt to impose a self-restraining ordinance not to drift into that territory, because south-west London deserves a health debate of its own. I shall try to focus instead on west London issues, although as the two areas sit side by side and the boundaries are terribly unclear to most constituents anyway, many of the experiences and issues are inevitably shared.
This has been an incredibly high-quality debate, involving hon. Members who are able to talk in great detail about the particular circumstances of local trusts and hospitals. I shall therefore try to take a small step back, because lying behind our discussion is an absence of any sense of sustainable direction within the national health service. That has been the character of the past and we are all afraid that the situation may not be resolved in the future.
Many of us have been in conversation with a strategic health authority—I imagine that that is the case for all hon. Members present. I suspect that they have been excited by the basic work in Sir Ara Darzi’s “Healthcare for London: A Framework for Action”. There is a sense that perhaps there is now the possibility that someone is coherently examining the future situation across London. We are conscious of the fact that the work is being undertaken in the
context of a national health service that does not meet Londoners’ or west Londoners’ expectations. In addition, productivity levels in the NHS are lower in London than elsewhere in the country—for example, doctors in its acute hospitals see 24 per cent. fewer patients than those elsewhere. We are also conscious of the fact that London is perhaps in the almost unique situation of having overcapacity in many areas and the wrong capacity in many areas. We are concerned about how all this will be resolved.
May I say, because this is shared by people of west London and south-west London, that as we examined “Healthcare for London” and the core consultation document, we saw a worrying red flag? The consultation document talked constantly about the needs of north and east London, as if those areas were in competition with west and south London. On the distribution of GPs, the document said:
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