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Westminster Hall
Tuesday 8 November 2011
[Mr Graham Brady in the Chair]
King George Hospital
Motion made, and Question proposed, That the sitting be now adjourned.—(Michael Fabricant)
9.30 am
Mike Gapes (Ilford South) (Lab/Co-op): I want to raise the issue of the Care Quality Commission report on the Barking, Havering and Redbridge University Hospitals NHS Trust in north-east London, the related independent reconfiguration panel report and the recent decision by the Secretary of State for Health to endorse the recommendations in the panel’s report and, as a result, significantly to downgrade services at King George hospital in Ilford. It is not the first time that the problems in north-east London health services and hospital provision have been debated in Westminster Hall or the House. Indeed, I introduced debates in 2006, 2009 and 2010, and my right hon. Friend the Member for Barking (Margaret Hodge) introduced a debate in June about maternity services.
Members of Parliament throughout north-east London have been very concerned, and there has been cross-party consensus, in very unusual circumstances, involving eight Members of Parliament: myself, my right hon. Friend the Member for Barking, my hon. Friends the Members for Leyton and Wanstead (John Cryer) and for Dagenham and Rainham (Jon Cruddas), the hon. Members for Ilford North (Mr Scott), for Hornchurch and Upminster (Angela Watkinson), and for Romford (Andrew Rosindell), and the Secretary of State for Work and Pensions. We have had massive support in the community. Decisions have been made by local authority health overview and scrutiny committees and there is wide public concern, with huge petitions and public meetings, about proposals that were initiated in 2006 to downgrade services at King George hospital, the smaller of the two hospitals in the trust.
That trust, in the words of the first paragraph of the Care Quality Commission’s summary,
“had a history of poor performance under the previous regulatory framework. It has long-standing and escalating debts (in 2005/06 this was just under £16m; by 2009/10 it was close to £117m). There have been numerous changes at executive level.”
Queen’s hospital, Romford is the newer of the two hospitals, having opened towards the end of 2006. It cost a huge amount of money and is run under a private finance initiative arrangement, which has led to certain difficulties. There was high-profile publicity, particularly about deaths in maternity services, and the CQC began a series of investigations, as a result of which it decided to carry out a full investigation of the trust as a whole, encompassing both hospitals and all services. That investigation went on throughout this summer, and its report was published at 10 am on 27 October.
At the same time, there have been proposals from the NHS London region bureaucracy, driven by the people within it, who have a vision of reducing the number of
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hospitals in north-east London from six to five, transferring services to large hospitals and reducing facilities in the Redbridge and Barking and Dagenham areas. We have ended up with a series of proposals that, when they were initially put forward, were deemed by Professor George Alberti to be clinically unsound. Later, they were revamped, tweaked and remodelled, and they became known as the health for north-east London proposals.
Those proposals envisaged principally getting rid of the accident and emergency department at King George hospital, Ilford. There has been an accident and emergency department in the district general hospital there since 1931, when the population was 85,000. Now it is 264,000 in the London borough of Redbridge, and the hospital also serves Barking and Dagenham, with a population approaching 200,000. The proposals also included getting rid of King George hospital’s maternity services, which serve young mothers in an area with a growing, diverse, predominantly ethnic minority population. Many of those young mothers have come recently to the United Kingdom, or at least have recently moved to Ilford. At the same time, it is proposed to increase the number of births taking place at Queen’s hospital in Romford—the one about which there were particular concerns—to make it what some people have called a baby factory. Those words were used in the reports by the CQC and the independent reconfiguration panel.
In March 2010, following concern and a campaign against the proposals, the then Secretary of State for Health referred the matter to the independent reconfiguration panel. The IRP then decided not to carry out an investigation, but to allow the consultation process to continue. That process led to final proposals, which were published towards the end of 2010, and then went through the so-called consultation and decision-making process, based on the primary care trusts. The joint committee of primary care trusts rubber-stamped the proposals despite overwhelming public opposition: aside from the tens of thousands of people who signed petitions against the proposals, within the committee’s own limited, and rigged, consultation procedure the public were opposed by a two-to-one majority—and an eight or nine-to-one majority in areas that were directly affected—to what was put forward.
We were told, however, that there was clinical support. There was no ballot of GPs, or system to ascertain what ordinary GPs thought.
Margaret Hodge (Barking) (Lab): My hon. Friend says that there was no ballot of GPs, but does he accept that I undertook a survey of GPs in Barking and Dagenham, and there was unanimous support for retaining the two A and E departments, at both King George hospital and Queen’s?
Mike Gapes: Yes, I should have said that there was no official ballot of GPs, because, of course, the view of the NHS bureaucracy was that the clinical leadership and the practices should make the decision; therefore, there was a strange kind of managed democracy and consultation.
Mr Lee Scott (Ilford North) (Con): Does the hon. Gentleman also agree that it is possible that a number of the GPs who were spoken to were too concerned for their own futures to give their real opinion?
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Mike Gapes: I suspect that that may be the case. A number of others were also on the payroll in one way or another—including many who were the lead GPs in the consortia that endorsed the proposals.
It is important to get the chronology right. Following the decision of the joint primary care trust meeting in December to endorse the proposals, all the councillors from all the parties in the London borough of Redbridge made a unanimous referral to the Secretary of State. The joint overview and scrutiny committee for all the boroughs in outer north-east London also made a referral to the Secretary of State. The Secretary of State then decided—the Minister will recall a previous debate in the main Chamber, in which we had an interesting exchange on the matter—to refer the case to a new independent reconfiguration panel investigation.
The IRP spent a lot of time talking to Members of Parliament and councillors, and it worked hard; I have no criticism of the consultation process. In its analysis, although it tended to group us all into one paragraph called, “Save King George Hospital” campaign, which covers many interviews and consultations, the community’s opposition was reflected. The view was expressed, if tucked away, that the local community was overwhelmingly against the proposals.
The IRP published its report internally, but not publicly, and put it on the desk of the Secretary of State on 22 July, and there it sat. Two or three weeks after that, the CQC decided to carry out a full, no-holds-barred look at Barking, Havering and Redbridge trust. Understandably, I guess, the Secretary of State decided to hold back until he had received the CQC report before he published the IRP report and gave his official response; Members of Parliament expected something like that to happen.
Then, interestingly, everything went quiet. We originally thought that we were going to get an announcement in September, but September came and went. Then we thought that we would get an announcement in early October, but that did not happen. Eventually, three hours after the CQC report was made public, the Secretary of State published his response.
There is a little bit of history here. As a local Member of Parliament—I know that other MPs feel the same—I was not appropriately informed about the matters. BBC London news on television at 6.30 pm on Wednesday evening ran a story saying that the Secretary of State was going to announce at 12 o’clock the following day the closure of A and E and maternity services at King George hospital. I raised a point of order in the Chamber that evening with Madam Deputy Speaker, who had no knowledge of the matter—there was no statement or announcement to come.
The following morning, telephone calls to the private and press offices of the Department of Health ascertained that, yes, the news was true: there was going to be an announcement. To be fair, I was phoned back eventually, at 11.15 am, and told that the announcement would be made at 1 pm, and that I would be told in advance of it. That is true: I received an e-mail at, I think, 12.46 pm. Attached was a letter from the Secretary of State with a link to the IRP report, but the report was not available on that link; the link did not work until 1.10 pm. Other people had a similar problem, by which time the announcement was already up and running. Therefore,
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we knew what the decision was—to endorse the report—but we did not know the content of the report. That is a matter of concern.
Nevertheless, the essence of the proposal is that Barking, Havering and Redbridge trust will be completely reorganised, because the IRP recommended going ahead with the downgrading of services at King George hospital, despite public opposition and deep concerns.
I have a question. The CQC report was published at 10 o’clock. Is the CQC report consistent with the IRP report and the Secretary of State’s decision? The Secretary of State, having read the CQC report, should have thought hard about whether to endorse the IRP report. The CQC report is absolutely damning about services at Queen’s hospital. It contains some criticisms of King George, principally because that hospital is in the same trust as Queen’s, with the same management, which the report is also strongly critical of. However, of the 73 recommendations in the CQC report, concerning maternity, A and E, children’s services, dealing with complaints from MPs, quality of care, cleanliness and all kinds of other issues, the vast majority relate to the new, five-year-old, private finance initiative-built Queen’s hospital in Romford. The report explicitly says on occasion that the recommendations do not apply to King George and that at King George, there is a different case. We have a series of absolutely damning recommendations relating to the larger hospital in the trust.
I do not wish to go through the report in great detail, as it is a long document. If people are looking for horror reading at Christmas, I recommend taking the report away and reading it. Apart from criticising poor management, it says that some staff, particularly in the maternity services at Queen’s, have very poor attitudes to the patients whom they are treating. It also confirms that attempts to cut the deficit at Barking, Havering and Redbridge trust over the years have led to reductions in the quality of care.
The IRP report also flags up concerns, saying that if the trust drove on with the deficit reduction programme and reduced the number of staff and beds, there could be an issue with quality. Damningly, the report makes it clear that although services at King George were reduced over the years, it has not led to efficiency savings. All it has done is reduce the quality of care in a hospital that serves my constituents and those of a number of other MPs. The cost of doing that has not led to improvements in efficiency; on the contrary, it has contributed to the ongoing deficit problems in the dysfunctional trust.
There we have it. The Secretary of State receives a report from the IRP recommending the endorsement of NHS London’s vision to downgrade services at King George hospital in Ilford. He then receives a report saying that there are two hospitals in the trust, covering 750,000 people in the community in the three boroughs, one of which is doing badly and there are criticisms of the other. He therefore endorses the recommendations to cut the services at the hospital that is doing better, on the aspiration, but with no evidence, that it will lead to a miraculous Stakhanovite improvement in the services at the bigger, supposedly better and more expensive hospital in the long term. You really could not make it up.
The Secretary of State could have delayed his decision on the IRP report. He could have said, “I am concerned about the CQC report and the damning indictment of
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what is going on at Queen’s hospital. I have waited three months with the report sitting on my desk, and I will wait another year to see whether I am satisfied that the improvements at Queen’s hospital are happening and have happened, that the quality of services provided is sufficient and that there has been an improvement in primary care services, which is also called for in the IRP report.” He could have waited, or he could have said, “I have made an announcement. I am minded to support the recommendations unless there is a significant improvement at Queen’s hospital and other services.”
The Minister of State, Department of Health (Mr Simon Burns): I am grateful to the hon. Gentleman for giving way, and I hope this reassures him. As he will know from the decision, nothing to do with the IRP proposals will come into effect until the problems highlighted in the CQC report have been remedied, and the time scale for that in many ways fits in with the hon. Gentleman’s point.
Mike Gapes: I am sorry, but that is not good enough. The Minister gives the impression that the Secretary of State has somehow not “fully supported”—to use his own words—the recommendations. The letter that I have from Heather Mullin of the Health for north east London programme states that the Secretary of State fully supports the recommendations of the IRP.
Mr Burns: The hon. Gentleman is making a fallacious point. I have never said that at all. It is quite clear from the letter that my right hon. Friend the Secretary of State sent to him and to other hon. Members that he does. The point that I was making in my intervention is that he said that the IRP proposals should not come into effect until the problems have been sorted out at the two hospitals. I am saying that it has already been accepted that those improvements have to be made prior to the IRP proposals coming into effect, which is what I understood that the hon. Gentleman was saying should happen.
Mike Gapes: I am saying something different; I am saying that the Secretary of State could have delayed his decision or that he could have said that he was minded to—the words that I used—support the proposals, but would not make a final decision until he was satisfied.
I spoke to people within the Health for north east London programme last week. I asked them what the timetable for the implementation of the proposals was, and they could not tell me. I asked them whether babies will be born at King George hospital, Ilford, in five years’ time, and I was told, “Almost certainly not.” I therefore asked whether babies would be born there in two years’ time, and I was told, “They may be. We have not yet worked out the detail of these proposals. There is still a lot of work to do.”
Mr Burns: There is no secret about this. The improvements to care must first be achieved at the hospitals before the IRP proposals are enacted. It is anticipated—one can never be 100% accurate—that the time scale will probably be about two years.
Mike Gapes: I give way to my right hon. Friend.
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Margaret Hodge: Perhaps the Minister will be able to help us in his reply, but my understanding is that the business plan put forward by NHS Outer North East London at the end of the summer suggested that, for the finances to stack up, the proposals will have to be implemented by April 2012. If that has been superseded, that is welcome news, but the local information is that the NHS ONEL business plan suggests the closure of the A and E and maternity services by April 2012.
Mike Gapes: There is obviously some uncertainty, because I was not told that when I spoke to NHS ONEL. Perhaps it is having a rethink in light of the report.
Mr Scott: If it is helpful, I have also received a letter from Heather Mullin stating exactly what the Minister has said, which is that two years is the minimum time scale for things to be looked at.
Mike Gapes: I am happy to keep giving way.
Mr Burns: To respond to the hon. Gentleman and the right hon. Member for Barking (Margaret Hodge), I will repeat what I said before, which is that it is of paramount importance that the recommendations and demands of CQC are met before anything happens with the IRP recommendations, because patient safety is paramount. As far as can be assessed, it will probably be two years to get patient safety to the required levels and to address all the problems highlighted in the CQC report. Whatever the hon. Gentleman or the right hon. Lady may have heard from other people, we estimate that the time scale will probably be about two years, because the CQC’s requirements are paramount.
Mike Gapes: I would like to move on to what the CQC actually said, because it has made several criticisms and expressed deep concern. It will prove difficult for the management of the trust and the present configuration of Queen’s hospital to meet the required improvements within a two-year timetable. My right hon. Friend the Member for Barking and I have visited the hospital, and there are, for example, bottlenecks where people are on trolleys around the corner where they cannot be seen, which is pointed out in the report. There are design faults, and it is a bit like Eros at Piccadilly circus with trolleys suddenly coming from both directions. This newly designed hospital has a level of chaos. Whoever was responsible for signing off the design must have decided that it was an airport rather than a hospital, because the design has big issues—
Mike Gapes:
Before the Minister intervenes, I am criticising the previous Government, the private finance initiative and the people in the consultancies and the private sector who run the PFI and make a huge amount of money from it, for designing a hospital that does not work well. The reports state that. They criticise the bad signage, the design and the way that wards are structured. Queen’s hospital has, for example, areas where children cannot be seen and areas where people wait for more than an hour before being attended to by a nurse or
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doctor. There is a whole litany of things that relate partly to design, partly to management, partly to staff shortages and partly to other issues at the hospital.
I do not believe that Queen’s hospital can be turned around in the suggested time scale, and that raises wider questions. The CQC wrote to me after I asked for an update following the publication of its report, and I received it yesterday. The update confirms the reasons why it had to intervene, which included the poor performance of the trust in the past and the fact that long-term problems prevented offering care that consistently meets CQC’s essential standards. To be fair, the CQC refers to both hospitals. It continues by saying that they have taken action to mitigate the risk of immediate harm in the short term, which includes reducing births at both Queen’s hospital and King George hospital and transferring caesareans out of the area. When they will be transferred back is an interesting question, which we can perhaps come to later. The update also states that the CQC met many staff and patients and that their concerns were made known, but the nub of the issue is that if improvements are not forthcoming, the CQC is prepared to restrict access to or close services that appear to be basically unsustainable. It then states that the CQC is not responsible for service reconfiguration.
The CQC, therefore, is not yet convinced that the 74 improvements that it has requested will be met. The final paragraph in the letter to me states that the CQC has set out 16 key recommendations that must be fulfilled by the trust and that it will monitor their implementation, but it admits that the trust needs help from organisations in the local health economy such as NHS London and commissioners and that the necessary significant changes are likely to challenge both clinical flows and trust finances.
There it is. We have problems with capacity and money, and we have a decision from the IRP and the Secretary of State to downgrade King George hospital, but serious concerns remain about Queen’s hospital. Are we confident that within two years those problems will have been addressed sufficiently well, at a time when there are financial problems; that Queen’s hospital will suddenly have been turned around, so that it is such a fantastic place that my constituents and the constituents of my neighbouring MPs—my right hon. Friend the Member for Barking and my hon. Friend the Member for Dagenham and Rainham—will feel happy to go into it to give birth to their children? I already have constituents expressing concerns because of the media reports and other things that are going on.
The CQC report points out that in the past there were more than 2,000 births a year in the King George hospital; at one time, there were 2,500 births a year. However, those numbers were deliberately run down by the trust to around 1,300 births a year. Then, a few months ago, the trust began to push the numbers up again, because Queen’s hospital could not cope. Within two years of now, the capacity for births at King George hospital—a capacity of around 2,000 births a year—will go. We are told that some of that capacity will go to a midwife-led birthing unit on the Barking hospital site, where there are currently about 10 births a week, or about 500 births a year. I am told that that figure is the maximum for that unit, although I do not
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know whether that is accurate. There is no proposal to have a similar unit on the King George site. That idea was floated in the consultation, but it was ruled out.
We have had a maternity hospital in Ilford since 1926; children have been born in that hospital since 1926. But from 2013 there will be no children born in that hospital, even though we have a young population. People in Ilford will be forced to go to the Queen’s hospital, where there is capacity for 9,000 or 10,000 births a year. It will be one of the largest maternity units in the country and it has been described as a “baby factory” in one of the documents that I have referred to this morning. Alternatively, they can go to Newham hospital or Whipps Cross hospital. Apparently, the facilities for babies to be born at Newham hospital or Whipps Cross hospital will be increased, although the cost of doing that is undefined. That will happen, while the perfectly good maternity service that exists in Ilford at King George hospital is being run down. My constituents will have to travel to Havering or to Whipps Cross. It is not easy to get to Whipps Cross from Ilford lane; the route is complicated and there are sometimes lots of traffic problems. There will be concerns about that.
Interestingly, Havering has the oldest population of any London borough; that is pointed out in the IRP report. The boroughs with the youngest populations in London are Barking and Dagenham, and Redbridge. So we have this huge increase in young people in north-east London, but their hospital will not be in the communities where they live. I could understand it if we had had a hospital at Queen’s hospital that provided long-term care for people suffering from long-term illnesses, mental health problems and so on, and if we had our maternity hospital in the area where most of the births were taking place. But oh no—the IRP, Health for north east London and the Government do it the other way round. We pointed that out in the consultation and the local MPs and councillors kept making these points, but we have been ignored.
Mr Brady, I am conscious of the time and that other Members wish to speak, so I simply want to get back to the CQC. I have been told that the CQC will review in March 2012 whether or not the Barking, Havering and Redbridge University Hospitals NHS Trust is delivering improvements. The CQC says:
“If we do not see improvements, we are prepared to take further action to restrict and ultimately close services that do not deliver care that meets our essential standards of safety and quality, and that present risks to people using services.”
That review is due to take place in March 2012, which is not very far away. It is not two years away; it is just a few months away.
I hope that the quality of care at Queen’s hospital improves sufficiently; I hope that services at King George hospital are not run down by surreptitious salami-slicing cuts in preparation for the implementation of Health for north east London’s plans, as they have been for several years now; and I hope that quality of patient care and treatment for my constituents is put ahead of the bean-counting desire to reduce the deficit at the Barking, Havering and Redbridge University Hospitals NHS Trust.
However, I am not confident that those things will happen. I am extremely angry at the betrayal of my constituents by the bureaucracy in Health for north east London; by the Minister, who said before the general
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election last year that there would be no top-down reorganisation; and by others, who said that they would keep district general hospitals open and that those hospitals should not close. The Prime Minister said that in 2007. In 2009, he promised “a bare-knuckle fight”. That was in the context of Chase Farm hospital, but the principles involved are the same. I feel that we have been betrayed and that our services are going to be reduced, and I fear the consequences of that for my constituents.
Mr Graham Brady (in the Chair): It may be helpful for right hon. and hon. Members to know that I anticipate taking Front-Bench contributions from 10.40 am. Colleagues can work out for themselves that we may be able to get everyone in to speak if speeches are reasonably short.
10.5 am
Mr Lee Scott (Ilford North) (Con): I am grateful for the opportunity to speak in this debate.
Before I talk about anything to do with the hospitals that we are discussing today, we should praise the doctors, the nurses and the back-up staff at Barking, Havering and Redbridge University Hospitals NHS Trust. After everything that has happened in these last few weeks, particularly the reports on the trust, morale must be pretty low. I do not believe that those staff are to blame for the problems at the trust. I believe that criticisms of staff can be made and that there are things that need to be learned, but I also believe that the fault for the problems lies much more with the previous senior management at the trust than with the doctors, nurses, back-up staff and front-line staff. Of course, recommendations for improvements have been made, but those staff took their orders from others and we should try to build morale rather than knock it down. That is what I genuinely feel.
I, along with other right hon. and hon. Members in our local area, thought that the Care Quality Commission report was going to be bad, but I did not think for one moment that it would be quite as bad as it turned out to be. It was damning of just about everything. It was probably easier to see what was right than what was wrong, because the good points were fewer than the bad ones.
I will talk about the CQC report in depth, and at this point I want to mention that I am talking on my own behalf and that of my hon. Friend the Member for Hornchurch and Upminster (Angela Watkinson), who is a Government Whip and therefore is unable to speak in this debate. If she disagrees with anything I say, I am sorry but that is too bad. The damning report by the CQC was ostensibly of Queen’s hospital, but it also points the finger at King George hospital. As with the independent reconfiguration panel report, I was disappointed, upset and angry that the decision that was made had been taken.
I will begin with accident and emergency. In my own constituency of Ilford, North, I believe that a large additional burden will be placed on Whipps Cross hospital. My guess is that in an emergency, people from wards such as Woodford Bridge, Fairlop and Fullwell will go to that hospital, rather than cross the A12 right the way through to Queen’s hospital, so there will be a major problem at Whipps Cross.
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The CQC report and the letters that I have received say that, that owing to the pressure of our one-paragraph “Save King George Hospital” campaign, the urgent care centre will now be manned by doctors, nurses and some specialists 24/7, 365 days a year. I acknowledge that, and I am grateful for it. However, in his response to the debate, will the Minister say whether we can look at taking the next step and going a bit further to make that urgent care centre an A and E department.
Regarding maternity services, during the consultation I had a meeting at Barking, Havering and Redbridge University Hospitals NHS Trust, and I believe that the hon. Member for Ilford South (Mike Gapes) had a similar meeting, although we were not allowed to have meetings together, for whatever reason. It was hinted—quite strongly—that a birthing unit would remain, in some shape or form, at King George hospital. I do not know what happened to that idea, but I would like it to be considered, because it came through loud and clear at the meeting that I attended.
Mike Gapes: I recall the conversation that I had very well. I was told that the local trust wanted to have the birthing unit, but that they had to get the approval of NHS London and that, as usual with regard to services in Ilford, NHS London’s bureaucracy was less inclined to go along with it.
Mr Scott: I thank the hon. Gentleman for that intervention.
I want to praise the hospital’s new management. Averil Dongworth is doing a good job with her staff. She inherited a difficult situation, with a £117 million deficit and low morale, and she should be praised for doing her utmost to turn things around. The CQC report stated that things had improved over the past months.
The hon. Gentleman said that there are 265,000 people in the London borough of Redbridge alone and, given the amount of new build that has outline or detailed planning permission, the population is going to grow considerably. I understand that the situation is similar in Barking and Dagenham, and it is estimated that the area could grow by about 50,000 people in the next five years or so. When I met with the independent reconfiguration panel and the CQC, I mentioned that issue in relation to my own constituency, and I am sure that colleagues have also done so.
On the ballot of GPs that did not take place, GPs were consulted and the report says that they gave their blessing to what was happening. However, that seems to contradict what I heard from a number of GPs who contacted me in private, as they made it clear that although they did not feel confident enough to make their views public they had grave concerns. I know that that is anecdotal, but I want to put it on the record. It certainly happened with me; I know not whether it happened with other Members, but I would be surprised if it had not.
I think that it is fair to say that the private finance initiative at Queen’s hospital has been a failure. It was badly negotiated—the hon. Gentleman acknowledged that that was done by the previous Government and not the current one—it was a bad deal; it was badly set out and there are grave concerns. I understand that the
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planning applications for the new units that would need to be built at Queen’s have not even gone in, and are unlikely to do so before the new year. The time scale for the build ties in with the two years the Minister mentioned earlier, so that would obviously be a constraint.
In a letter to the hon. Gentleman, we heard that the CQC would undertake a re-evaluation in March 2012. I urge it to make a full report before any changes are made—in two years’ time or whenever—to say, “Yes, we are satisfied that our 73 points of concern have been rectified.”
Mr Simon Burns: As my hon. Friend will appreciate, the CQC is independent of the Department of Health, because it is a regulatory body that is concerned with standards of quality. Knowing how it works, however, I have no doubt that on an ongoing basis it will look closely at ensuring that its recommendations are implemented and the required standards for people in that community are reached.
Mr Scott: I thank the Minister. I am sure that the CQC will take note of what the Minister, other colleagues and I say in this debate. I have presented petitions signed by a total of 39,000 people, and other Members have presented petitions directly to Downing street; via our local Ilford Recorder, to which I pay tribute for its continued campaign; and in other ways. I am sure that it is an underestimate to say that there must have been a total of 50,000-plus signatures.
Mike Gapes: I presented 25,000 signatures, which became 28,000, to NHS London on the initial proposals, and another 32,000 in the latest round. Adding all those together with the ones that went in from other groups, I would guess that it was more like 100,000.
Mr Scott: My arithmetic shows why I will probably never be in the Treasury. None the less, a huge number of people have signed petitions.
I ask the Minister to take on board the fact that there is cross-party support for keeping the services that our constituents need at King George’s, and to consider upgrading the urgent care centre by renaming it an A and E and adding a little to it—I do not ask for a lot in life—and a birthing unit at King George’s.
10.14 am
Margaret Hodge (Barking) (Lab): I congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this debate and on giving us the opportunity to comment on something that impacts on all constituents of all hon. Members participating today.
I am really disappointed, because I feel that the Minister and his Secretary of State have reneged on promises that he gave to my constituents before the election. First, he said that he would never close the A and E, and we all know that the closure of such a department means the closure of a hospital over time, because most patients who go through a hospital come in that way. Secondly, he said that there would be more money in real terms for the NHS. Sadly, that is not true either, and it is impacting dreadfully—[
Interruption.
]
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The Minister can reply if he wishes. A 0.1% increase in cash terms is not real-terms growth, especially when inflation is running at about 5%. Thirdly, he promised no more top-down reorganisation. In north-east London, we are suffering from his reneging on those three promises. He must listen to that, because it has a terrible impact on the quality of the health service offered to my constituents. I have said to him privately, and will say to him publicly, that that will grow health inequalities in London.
I do not want to repeat what others have said about the Care Quality Commission. What I will say is that a lot of emphasis has been placed on confidence in the new management at Queen’s. I am on my fifth chief executive there, and every time a new one arrives, I think, “Perhaps this one will be a little better.” The new chief executive has been in place for six months, and so far I am not sure about that confidence. If one looks at the maternity services, why in September did we suddenly see elective caesareans being transferred from Queen’s to the London hospital? None of us knew why; none of us could understand it; none of us was told the reason, but it was because the CQC went back into the maternity unit because it was so bad and threatened to close the entire unit. The only way for the hospital to maintain the unit was for it to accept that caesareans should be transferred. The teams were not talking to each other; people were not taking responsibility, and no one was putting the patient at the heart of care, but the required cultural change has not occurred. Yes, new midwives are being recruited, but not at the right grade and not to manage the unit. The Minister is putting too much on Averil Dongworth, because she will not be able to turn around those cultural issues. The record so far shows that she does not share information freely, particularly with Members of Parliament, and that she has not done much.
The most recent case that I have had at the unit is an anonymous one—the woman does not want to reveal her name, although the case will be investigated. This mother was left for hours without being checked on, and it was her mother—the grandmother—who had to look after her. She was almost lifeless and delirious, and she was discharged without anyone checking her scar from the cuts she was given or changing her dressing. She was asked to give water samples, but they were left in the bathroom and were still there when she left, which is just not on. Queen’s provides facilities for 7,000 births, and if the proposals go ahead that will increase to 9,000, making it the biggest single maternity unit in the country. Given the quality of care, the problems faced and the population growth, it is sheer madness to go ahead with a proposition that closes a hospital in this area of London.
Perhaps the Minister will give us some words of comfort about the finances. The trust’s finances have been in a mess for ever, since well before the Labour Government came into office. I assure the Minister that when I became a Member of Parliament in 1994 there was already a deficit in the trust. David Varney, a well-respected and talented man with a lot of experience, was chairman of the trust although for a very short time, and I breathed an enormous sigh of relief that at last we had someone there who could sort the trust out. He went to NHS London and said, “Write off the debt, give me a blank sheet of paper and I’ll provide you with a decent health service within budget.” NHS London
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refused, so David Varney walked away. That was a tragedy for the people of that part of London, and such tragedies will continue to be repeated. The problems will not be sorted out until somebody grasps them properly and says, “Right, we will do something about the finances,” enabling the trust to run a decent service within budget rather than always chasing a deficit.
One thing about the CQC report that has not been raised is that it is about not only maternity but accident and emergency. One of the most shocking things, for me, involves radiology. The results of scans are just sitting around. Some scans show a possibility of cancer, but individuals are seen so late that the cancer has grown. People’s lives are being threatened and death warrants are being written simply because the hospital has no systems to transfer knowledge from a scan to a consultant who can quickly pick up on the symptoms and deal with the patient.
That is awful, as is the fact that people sit in theatre all the time. The fact that A and E is bound to be bad again this winter is awful. The fact that proper records are not kept of who has had cannulas inserted for treatment is awful. The culture throughout the hospital is awful, and it seems to me that it will take a heck of a lot more than Averil Dongworth, whose only record is the closure of Chase Farm hospital, to turn that around.
I am conscious of time. I campaigned for years to reopen a birthing unit at Barking hospital, for all sorts of reasons, including pressure on Queen’s, population growth and the fact that I wanted babies to be born in Barking again. I was grateful when it was finally built. Those hospital beds have been ready for occupation since March this year, but they are still not occupied. When I last asked NHS London what was happening, I was told that the unit would be open by March next year. That is a 12-month wait. If the hospital is kept empty, £1 million in costs for security, electricity, heating and so on will go down the drain each year. Now the deadline has changed from next March to next spring.
That is absolute madness. There is pressure on Queen’s. Queen’s is failing to deliver, so people are being sent to London, while a brand-new facility that could provide for many more births than my hon. Friend the Member for Ilford South has suggested stands empty. Will the Minister give us an assurance that the unit will be open not next spring but by Christmas, so that people in my constituency can have hope?
The decision whether to close the A and E at King George hospital was predicated on the idea that fewer people should go to A and E; I agree. If and when the Minister can demonstrate to me and other Members of Parliament that fewer people are actually going to A and E, maybe we can have a serious conversation about whether that part of north-east London has too many hospital places. The reality is that we have a mobile and transient population, many of whom have not registered with a GP and who, if they want to access health care, go first to A and E.
Another reality is that GP and community services also have issues. Before taking a decision, is the Minister willing to do a comprehensive inspection of GP services in my area to ensure that they can fulfil the demands on them, as the decision to close assumes they can? If GP services prove to be up to scratch, again, I am willing to enter into conversation with him about whether there are too many hospital places. However, at present, he is letting down the people in my borough.
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Time and again people say to me, “I rang the GP at 6.30 in the evening. He said to ring back the following morning. I rang at 8 o’clock in the morning, and I couldn’t get through. By that time, I felt that the only way to be seen was to go to A and E.” [ Interruption. ] The Minister looks at me in amazement. That is the reality on the ground.
Mr Simon Burns: I am fascinated to hear the right hon. Lady say that. Does she know who the authors were of the GP contract that ended evening and weekend work for GPs? It certainly was not my Government.
Margaret Hodge: Making a political point does not get at what is happening in practice. It is not about the contract; it is about the practice, attitude and culture in the whole NHS economy in our part of north-east London. That is the problem that the Minister must tackle. Making a cheap political point does not help make any advances in the quality of health care in my quarter of London, for which he is responsible.
Finally—I have said this to the Minister privately, and I will say it publicly—there is inequality in health care across London. The teaching hospitals in the heart of London take away necessary resources from outer London, whether north-east or south-east. If Queen’s becomes the only hospital in our part of London, it will have to meet the health needs of 500,000 people, according to the CQC. The catchment area in inner London has a population of about 200,000. It is completely different.
I have spent my whole adult life bringing up my children in north London. The catchment area where I live has four hospitals that I can reach within 10 minutes and that provide excellent health care for me and my family. In north-east London, where I work, if King George hospital closes, it will take those who live on the Thames View estate an hour and a half on three buses to get to Queen’s hospital. People with weekly hospital appointments will not go. With the greatest respect to the Minister, that means that they will die earlier. His Government have said that they want to tackle health inequalities. Our Government tried to tackle them, but did not make much progress. Those health inequalities will grow.
Why does the Minister not take a bold move and consider the configuration of teaching hospitals in inner London? For example, the Royal Free hospital is not a good hospital. The physical building is terrible, and it sits on an extremely valuable site that would do a lot to sort out the financial situation faced by the NHS, but some talented and good people with the right culture and attitude work there. Those people ought to be working in areas of health need, such as our bit of north-east London. They should be operating out of the brand-new Queen’s hospital on the Romford site. If he did something radical and sensible like that, it would improve health outcomes for people in my constituency. It would also help him tackle some of the financial problems that he faces, and it would make sense in terms of tackling health inequalities across the capital.
10.28 am
Jon Cruddas (Dagenham and Rainham) (Lab):
I echo every point made by my right hon. Friend the Member for Barking (Margaret Hodge) in her powerful speech,
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which I think will resonate with the local community. I congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this debate and on the extensive speech that he made, as did the hon. Member for Ilford North (Mr Scott). There is total agreement across the aisle on issues of local concern about the provision of health care in north-east London and the sub-region. I will not repeat the points made, but I will emphasise a couple of them, especially about the pressure on Queen’s hospital if the King George closes. Those points are echoed in the report, and I will touch on them.
I welcome the Care Quality Commission’s investigation of Queen’s hospital. I recognise that it must have been a stressful and worrying time for many people involved, but it is definitely a process that we needed to go through. The report has 16 key recommendations for the future, and I, like my colleagues, will support the chief executive and her staff in trying to meet them. I have major concerns, however, about how the two reports will affect each other, specifically in relation to Queen’s hospital. Many of my constituents are extremely worried about the proposals to close the A and E and maternity services at King George hospital, especially when the only alternative for them is to go to Queen’s hospital.
Some figures have not been cited this morning, but they are worth rehearsing. According to page 26 of the independent reconfiguration panel report, planned activity for 2011 for Queen’s hospital is 885,511 people, while for King George hospital it is 284,459. The combined total of 1,169,970 people simply cannot be treated by Queen’s hospital alone. A 24% increase in patient numbers will result in havoc in a hospital that is struggling to cope with its current intake of patients. The estimated increases from 2010 to 2017 of 12.5% in the Barking and Dagenham primary care trust and of 5.7% in Havering PCT demonstrate that the acute sector in the sub-region has a serious structural problem, and closing the services at King George hospital will do nothing to help.
The question of the structural debt has been raised throughout the debate. The trust is clearly suffering from its escalating debts. From 2005-06 to 2009-10, the trust debts rose from £16 million to £117 million. Those levels will only increase and make any future improvements very difficult to sustain. That takes us back to the changes in the staffing of people who were keen to remove some of the structural debts to resolve some of the health problems that we have seen over the past few years, but who have since departed because they did not receive the support that they desperately needed to secure that.
I want to touch on the four general issues in the CQC report. First, capacity at Queen’s hospital is already too high for hospital staff to cope. The report states:
“An independent review of maternity services at the trust was undertaken at the beginning of 2011, which concluded that ‘Capacity at Queen’s is of major concern to the review team’. The recommendations from this review included the need to develop measures to ease the capacity at Queen’s, including ‘an impact assessment of the changes at KGH. It should also include an updated Escalation Plan, with clear indicators relating to capping numbers at Queen’s and temporary closure if required in the interests of patient safety’.”
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Nevertheless, the Health Secretary is looking to increasing capacity further. Does the Department not understand what multiple panels are recommending to it?
Secondly, on demographic changes, which have also been mentioned, the IRP’s decision to transfer maternity services to Queen’s hospital seems peculiar, given that the CQC report states that
“King George Hospital is geographically located for the populations of Barking and Dagenham and Redbridge,”
an area with an expanding, multicultural and relatively young population and a high level of teenage pregnancies. Under the IRP’s recommendations, however, provision of maternity services would be predominantly from Queen’s hospital. Moreover, as has been mentioned, a third of the population of Havering is over the age of 65, which means a different health profile and different needs in the sub-region that cannot be catered for solely by Queen’s hospital. With people living longer and the population growing at an ever-increasing rate, the number of patients presenting at Queen’s hospital will increase year on year, and it is very unlikely that it will be able to manage these levels in five, 10 or even 15 years’ time.
Thirdly, on travel, it does not help the fears of local residents that, historically, transport links between the hospitals have been incredibly poor. My right hon. Friend the Member for Barking has mentioned the Thames View estate. It can easily take someone living on the other side of Ilford up to an hour and a half to get to Queen’s hospital, as opposed to 20 minutes or less to get to King George hospital.
Mike Gapes: I travel to Queen’s hospital by public transport. If people get the train from Ilford to Romford and come out of the station, they will see that two buses on one side of the road go in one direction to Queen’s hospital, and that two buses on the other side go in the other direction. I have been pressing for years for proper signage at Romford station, and, while various chief executives of the trust have said that they will do it, they still have not done so. The links for people who have to rely on public transport to get to Queen’s hospital are appalling.
Jon Cruddas: I agree. The point has been made in Havering, Barking and Dagenham, and Waltham Forest, as well as Redbridge.
The fourth point relates to evidence of no gains from the previous transfer of services in the sub-region. There has already been a long, ongoing transfer of services form King George hospital to Queen’s hospital, but the efficiency gains that were predicted have not occurred, as my hon. Friend has said. What are the guarantees that any future transfer of resources will lead to such efficiency gains? What is the correct move for both hospitals and the wider trust to see a rise in standards and for the faith of local residents to be restored in their local NHS trust? If that is to be achieved, King George hospital’s A and E and maternity services simply cannot close. It would go against all logic suggested by the CQC report and cause no end of damage to the confidence of residents in their local hospitals. I urge the Government to step in and implement the CQC report and hold back the IRP report, until we can re-evaluate after the CQC has been able to see whether its initial recommendations have been met.
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My right hon. Friend the Member for Barking has talked about one case that was recently brought to her attention. All local MPs have a series of cases that are equally dramatic and heart-rending. A few hours after the two reports were published on 27 October, I received this e-mail:
“Just wanted to give an example of what could happen if the above A&E is closed.”
The correspondent is referring to King George hospital. They continue:
“Two weeks ago I had to take my eldest daughter to Queens as she thought she was having an early miscarriage. All the spaces in the Early Pregnancy Unit were full, (apparently they even called in the consultants), we had to wait in the A&E department for approximately 7 hours before she was seen by a doctor, she could not have a scan as there were 15 women in the unit which meant it was full, so she was sent away and told that there was no point in returning at 9am as they had a full unit to clear before they could see her. We tried to arrange a private scan but were unable to do so (not that we are awash with money but she was distraught). Homerton agreed to see her and scan her and we are returning there tomorrow, unfortunately we are almost certain that she has lost a much wanted baby.
How is Queens going to cope if King Georges is closed as they are not coping now?”
Overall, such reports confirm what all the local MPs have known for years about the standards of care throughout the sub-region. The pressures are growing. Extra capacity is needed and should not be cut.
10.37 am
Andrew Gwynne (Denton and Reddish) (Lab): I welcome you to the Chair, Mr Brady, and congratulate my hon. Friend the Member for Ilford South (Mike Gapes) on securing this important debate on the issues facing his local hospitals. I know that he, my right hon. and hon. Friends, and other Members across the party divide have campaigned extensively for their local health services, and I commend them for it.
The Government are implementing a number of much wider changes in the health service—I will touch on those later—but my hon. Friend must be disappointed with the recent decisions made about the hospitals in his area and the health services used by his constituents. He and others have mentioned the recent Care Quality Commission report on the standard of care received by people under Barking, Havering and Redbridge University Hospitals NHS Trust. The report had immediate concerns in relation to maternity services, identified failings in emergency care and radiology, and demanded widespread improvement.
As Members have mentioned, Queen’s hospital had the most serious concerns, including poor clinical care, verbally abusive and unprofessional behaviour by staff towards patients and colleagues, and a lack of learning from maternal deaths and incidents. The report states:
“Despite some signs of improvement in recent months, patients remain at risk of poor care in this trust”.
It also notes that the trust addresses issues on a short-term basis, under instruction, rather than proactively looking for longer term solutions. The report also states:
“There is past and current evidence of poor leadership from some managers and a culture among some staff of poor attitude and a lack of care for patients, especially in maternity.”
That is of extreme concern, and those views have been reinforced in this debate. The report also confirmed that
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attempts to cut the financial deficit at Barking, Havering and Redbridge trust led to reductions in the quality of care.
About three hours after the CQC report was published, the Health Secretary made an announcement about King George hospital, which now looks set to lose its A and E and maternity units. We know that the Health Secretary backed the IRP’s proposal for services to be expanded at nearby Queen’s hospital in Romford. That raises the question why, when the report on King George hospital was presented to the Secretary of State on 22 July, it then sat on his desk for more than three months and he chose to release its conclusions and recommendations on the same day, three hours after the CQC report.
From articles in the Ilford Recorder, in the constituency of my hon. Friend the Member for Ilford South, I see that there is a great deal of concern and consternation about that decision. Indeed, my right hon. Friend the Member for Barking (Margaret Hodge) described the decision in the press as “sheer madness”, outlining how Queen’s hospital is already having difficulty dealing with existing pressures—an issue which she raised today. My hon. Friend the Member for Ilford South previously described the decision as a disaster and is quoted in the Ilford Recorder as saying that the decision on King George hospital showed an
“absolutely contemptuous attitude to local people’s wishes and concerns”.
The proposed changes will not take place until the Barking, Havering and Redbridge University Hospitals NHS Trust, which runs both sites, tackles the issues raised by the CQC. The Minister went into a little more detail about that in the debate. However, it is not just the disruption, but the uncertainty of local people, who will no longer have access to A and E and maternity services on their doorstep, that should be of concern to all hon. Members.
Yes, we need to acknowledge that reconfigurations are unpopular. We went through that a few years ago in Greater Manchester. Nevertheless, given public opposition and the views of the overview and scrutiny panel, local MPs and members of the local authorities across party, will the Minister say what account has been taken of the level of local opinion on the local health services by the IRP? My hon. Friend says that it was in its report, but what weight did the IRP and the Secretary of State give to that level of opinion?
Mr Simon Burns: May I help the shadow Minister? The consultations—not on the IRP level when it was doing its work, but on the proposals themselves—have, since 20 March 2010, had to fulfil the four conditions for reconfigurations set out by my right hon. Friend the Secretary of State, which include consulting local people within the health economy and local opinion.
Andrew Gwynne: I appreciate that, but we heard today that there is a great deal of concern across local authorities and the communities, and I would like to know what weight was given to their views.
Margaret Hodge: Does my hon. Friend agree that it appears that money has been the key factor in forming the decisions, and not the care of people? The views of bureaucrats have taken precedence over the views and experiences of local communities.
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Andrew Gwynne: Absolutely. We recognise that reconfiguration is sometimes necessary in parts of the country for reasons of financial efficiency, safety and better health outcomes. However, people are rightly disappointed by the way in which the nature of the debate changed in the run-up to the general election. As hon. Members rightly said, the general election was fought with a pledge about hospital closures and reconfigurations that is not being met. Back in 2010, the now Prime Minister clearly promised a moratorium to stop closures. Indeed, in opposition both he and the Secretary of State toured the country making promises to overturn some very difficult reconfiguration decisions taken by the previous Labour Government. Yet, as we have seen, the moratorium has not materialised, and there is now evidence of major changes to hospital services across the country.
I do not want to stray too far from the subject, but it is worth remembering that the Prime Minister gave a firm pledge not to close services at Chase Farm hospital, but in September 2011 the Secretary of State accepted the recommendations of the IRP and approved the downgrading and closure of services at Chase Farm. Similarly, at the Fairfield maternity department near Bury, we were told on a visit by the now Secretary of State that the service would be kept open. We now know that the maternity department at Fairfield general hospital is scheduled to close in March 2012.
My hon. Friend the Member for Ilford South raised concerns about the ability of Queen’s hospital to improve when the NHS faces tough financial challenges in the years ahead. That is fair comment. At the general election, Labour promised to guarantee to maintain NHS front-line funding in real terms. In contrast, the Prime Minister offered real-terms increases. We can debate that another time, but I would suggest that that was just an electoral gimmick. The Treasury figures show that in 2009-10 health spending was £102,751 million in the last year of the Labour Government. In 2010-11, actual health spending was £101,985 million.
Mr Simon Burns: Will the hon. Gentleman be kind enough to tell hon. Members that the health spending figures for the financial year 2010-11 were set by his own Government, and that, for the lifetime of this Parliament and thereafter, we are increasing health spending in real terms, albeit a modest increase because of the financial mess we inherited, which needs to be sorted out?
Andrew Gwynne: I said that that was the actual health spend for the first year of this Government, which represents a real-terms cut of £766 million, according to Treasury figures. That includes the GDP deflator, which so excited the Minister during the Opposition day debate when my hon. Friend the Member for Leicester West (Liz Kendall) tried to raise this issue. That is the first cut in health spending for 14 years. Indeed, that is the first real-terms cut since the last year of the previous Conservative Government in 1996-97. The Government promised a real-terms increase in health spending; they have delivered a real-terms cut.
There are wider concerns about how the Health and Social Care Bill will impact on local health services. The extensive reorganisation of the NHS was not put forward by either party in government in their manifestos,
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or in the coalition agreement. Clearly, such a massive reorganisation will make it harder for the NHS to tackle the sorts of problems identified at Barking, Havering and Redbridge University Hospitals NHS Trust, and the wider issue of social care for older people by the CQC. The Prime Minister has clearly gone back on his promise on NHS reorganisation. The coalition agreement could not have been any clearer:
“We will stop the top-down reorganisations of the NHS”.
It is difficult to see how the coalition Government could have said that, when only weeks later they published a White Paper outlining the biggest reorganisation of the NHS since 1948. It is clear that such a change on this scale is the last thing that the NHS needs right now.
Returning to the more specific question about Barking, Havering and Redbridge trust and the future of King George hospital, given the CQC report and what hon. Members have said today, what consideration has the Minister given to the ability of Queen’s hospital to deal with the added pressures on its services when King George hospital closes its A and E and maternity services? On the face of it, no consideration has been given to the local support for keeping A and E and maternity services at King George hospital. If services are to be transferred—the Minister says within two years—does he recognise that people need certainty and that NHS staff need proper expectations to plan and manage those changes? If those time scales are not met, what plans are in place for NHS services in that part of London?
The concerns expressed by Members today are right and need to be addressed by the Minister. Also, the wider changes to the NHS will make it much harder to identify such failures in care in future and to deal with them effectively. That is why we are so against what the Government are doing to our national health service.
10.50 am
The Minister of State, Department of Health (Mr Simon Burns): It is a pleasure to serve under your chairmanship today, Mr Brady.
I congratulate the hon. Member for Ilford South (Mike Gapes) on securing the debate because, from personal experience in a previous debate and from meetings, I know that he and other right hon. and hon. Members have a tremendous interest in, and concern about, securing the highest-quality health care for their constituents. I share their desire for excellent health services in hospitals and in the community, whether in Barking, Dagenham, Ilford or elsewhere in London and the country. That is why it is so important that the issues raised by the Care Quality Commission’s investigation into Barking, Havering and Redbridge University Hospitals NHS Trust are acted on immediately and that safe services are realised and sustained.
Before I go on, I extend my sympathies to anyone who has experienced poor care at the trust. We can all be united in our concern and, in certain cases, even horror at what the CQC report showed. It is unacceptable in this day and age for services to deteriorate to that level, with such low-quality patient care. The improvement of the quality of care in that area and throughout the NHS is crucial—it is imperative and a priority. I can assure right hon. and hon. Members that the Secretary of State, my ministerial colleagues and I take such issues every bit as seriously as they do.
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Although the CQC report identified some risk of poor care throughout the trust, it is the maternity service that requires immediate action and where the biggest risk of poor care was identified. The local NHS has taken immediate action at the trust to ensure that services are safe. NHS London and the Outer North East London PCT cluster have been working in collaboration with the trust to manage capacity and demand, to support its clinical leadership and to address the gaps in capability.
Margaret Hodge: Will the Minister therefore ensure that the unit at Barking hospital is open before Christmas?
Mr Burns: Since the right hon. Lady has specifically mentioned it, I will discuss that now, instead of later as I had intended. There is a plan to move the midwifery-led unit services into Barking hospital; that is a continuing, high priority for the hospital, and currently I believe that capacity is about 50%. [Interruption] She ought to have waited until she had heard the end of my answer. If she wants to intervene again, I point out that I have only been left seven minutes and there is a lot to deal with. However, it is not for me in Whitehall to micro-manage decisions; services and the speed at which services are provided must be a local decision by the local health economy. The only assurance that I can give—it is an assurance—is that the MLU is a priority for the hospital. I am advised that the whole service is expected to be provided at Barking hospital by April 2012, which I think is the date given to the right hon. Lady.
NHS London continues to monitor closely the actions taken in the local NHS, including twice-weekly discussions with all key stakeholders, as well as regular meetings with the PCT cluster, the trust and NHS London’s performance and chief nurse’s teams. Some concrete actions, which I hope reassure right hon. and hon. Members, have already been taken. To ensure safety, NHS London, PCTs and the trust decided to cap the number of deliveries to 20 a day at Queen’s and seven a day at King George from the beginning of October. In collaboration with the South West Essex commissioning cluster, a number of women with Essex postcodes due to give birth at Queen’s or King George will give, and have given, birth in hospitals in Essex instead. Additional, part-time professionals are being brought in—including the well-respected head of midwifery from the Royal Free hospital—to support the maternity unit until substantive leadership can be appointed.
Five supervisors of midwives from surrounding trusts have agreed to support the team at Queen’s. A senior obstetrician has been recruited and will begin working with the trust shortly. Given CQC concerns about the number of vacancies and the skill mix in the maternity work force, NHS London’s chief nurse has set up a
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midwifery leadership scheme to attract 12 experienced midwives to the trust. For an initial period of eight weeks, Caesarean sections have been transferred from the trust to Homerton university hospital in Hackney. All such actions are having an immediate impact on the ground and protect patients.
In February of this year, the trust gained a new chief executive, Ms Dongworth. The CQC and NHS London have confidence in her and have given her their full support. The CQC reported:
“Almost without exception, staff were positive about the impact the new Chief Executive is having at the Trust. They have embraced the Chief Executive’s inclusive style and believe, for the first time in many years, that there is a real opportunity for positive change.”
It is my belief that such positive leadership can help the trust to move forward from the report and to continue to make the improvements that are so badly needed. A recruitment drive has already brought in an additional 72 midwives, enabling the trust to have one of the best midwife-to-birth ratios anywhere in London, and one of the highest levels of senior doctor cover. There is now regular, independent monitoring of performance every week. The trust has made it absolutely clear that continuing to improve is its top priority. All local NHS partners are committed to making that happen. The Secretary of State will also actively monitor developments.
I now pick up on a point made by my hon. Friend the Member for Ilford North (Mr Scott) which, to be fair, I think was a special plea about his urgent care centre. The urgent care centre at King George’s will see the majority of patients who already attend. I must advise my hon. Friend that few blue-light cases are actually taken to that unit. He might have been hoping that I would do something to upgrade the centre to an accident and emergency unit, but I am afraid that that is not within my remit. However, under the modernisation of the NHS, nothing prevents the clinical commissioning group, when commissioning care for its patients, from looking at the situation if it is so minded. If it wants to commission enhanced care in an urgent care or A and E centre, it has the powers to do so if it wishes. I cannot prejudge what a local CCG might or might not want to commission in the future, but the opportunity is available.
Owing to the shortage of time in the debate, I have not been able to answer all the points made by the hon. Member for Ilford South, or by the right hon. Member for Barking (Margaret Hodge) and the hon. Member for Dagenham and Rainham (Jon Cruddas). I commit to writing to them with the answers to their specific points, made during this interesting and in many ways traumatic debate. I appreciate, as they do as constituency MPs, that it is totally unacceptable to have poor-quality health care for our constituents and for patients within the NHS.
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Grammar Schools
11 am
Gareth Johnson (Dartford) (Con): It is a pleasure, Mr Brady, to serve under your chairmanship, the irony of which will not be lost on hon. Members who are present. I know that you take a keen interest in education matters.
I applied for this debate because grammar schools are an important and integral part of the education system in the United Kingdom. They provide social mobility and opportunity for thousands of children every year and are hugely popular with pupils and parents alike in the areas where they are found and beyond. It may help if I give a brief history of how they were established.
Grammar schools were created during the second world war and promoted by the Labour Government that was formed in 1945, but it is fair to say that subsequent Labour Governments have had a less enthusiastic approach to them. In 1965, Harold Wilson declared an end to selection in schools—a diktat that was withdrawn by Ted Heath in 1970, after which date the matter was left to local education authorities. That was again changed in 1974 by the re-elected Harold Wilson, who obliged LEAs to close grammar schools, a situation that was repealed in 1979 by Margaret Thatcher. The Government’s recent announcement allows an expansion of existing schools, and I congratulate the Minister on that announcement.
Mark Field (Cities of London and Westminster) (Con): Before my hon. Friend finishes his history lesson, which is timely—I congratulate him on obtaining this important debate—surely one problem in the post-war era and one reason for the hostility on one side of politics to the grammar school system was the failure of the plan to build up technical schools and colleges as part of the 1944 Butler Act settlement. Will he congratulate the Government on their tremendous work in the past 18 months in developing technical schools, which I hope will work in tandem with a strong and thriving grammar school system well into the future?
Gareth Johnson: My hon. Friend makes a pertinent and correct point. Having a range of options available for children is undoubtedly the key to a good and successful education system. We should not try to pretend that all children are alike and that they have the same needs and desires in the education system. The Minister’s recent announcement is a huge step towards the goal that I would like to reach—new grammar schools where parents and local authorities want that option.
Mr Andrew Turner (Isle of Wight) (Con): Does my hon. Friend accept that it is not only those at grammar schools who like grammar schools and secondary modern schools? Rugby, where I used to live, had both sorts and they were very welcome.
Gareth Johnson: Yes. Grammar schools have a positive effect on non-selective schools in the areas where they are found. Boroughs where there are grammar schools tend to have some of the best exam results, which is evidence of the positive impact that grammar schools may have not just on their own environment, but beyond.
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I do not claim that grammar schools are for everyone. It is a case of horses for courses. Some children flourish in academic surroundings, and others do not. We must cater for all children, and grammar schools play a vital role in that diversity. A one-size-fits-all education system must never be our goal. Such a system can only help one sort of child. Children have different needs, talents and capabilities, and our education system should reflect that.
I make no secret of my support for selective education. It gave me the opportunity to specialise in academic work within the state system, an opportunity that tends to be available elsewhere only in the private school system. I do not claim to be part of a rags-to-riches tale—I never wore rags and, unfortunately, I am not rich—but I come from a modest working-class background. My father was a milkman. I went to the local state primary school, and I was fortunate to pass the 11-plus and to go to Dartford grammar school. I used that opportunity to become a solicitor and now a Member of Parliament. The social mobility that that education gave me would be difficult to find outside the grammar school system. It is wrong to suggest that only comprehensive schools provide equal opportunities for children.
Kevin Brennan (Cardiff West) (Lab): If it is hard to find social mobility outside the grammar school system, how does the hon. Gentleman account for my social mobility as a comprehensive school pupil?
Gareth Johnson: I am not saying that there are no examples of social mobility among non-selective schools, but in my experience it is common for children who go to grammar schools to benefit enormously from the social mobility that they offer.
What is unique about grammar schools is that they enable specialisation in academic work, which is not always available, not should it be, in other schools. In some areas with exclusively comprehensive schools, the catchment area around good non-selective schools experiences higher house prices than in areas around less-well-performing comprehensive schools, which leads to poorer families being unable to send their children to the best performing schools in the area.
To return to the point made by the Gentleman, social mobility may suffer in areas without selective education. Grammar schools provide an equal chance for children from poorer backgrounds. Common sense suggests that children will learn more when placed with children of similar academic ability.
Jim Shannon (Strangford) (DUP): Grammar schools clearly push academia, and push pupils to achieve above what they may think they can do. An example in my area is Regent House school in Newtownards, where one young fellow achieved six A-levels, four of which were 100% passes. That proves that if children are in the right school and are pushed hard, they do well.
Gareth Johnson:
The hon. Gentleman makes an important point. I think I am right in saying that Northern Ireland has a completely selective school system. I have taken the liberty of obtaining some figures on exam success in Northern Ireland compared with England.
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I do not doubt that there are caveats attached, and I will give him the figures after the debate. According to the Library, in England, just under 70% of GCSE entries were awarded a grade C or higher, compared with just under 75% in Northern Ireland; and 76% of A-level entries in England were awarded a grade C or higher compared with 84% in Northern Ireland. That is the proof of the pudding. Northern Ireland has a completely selective process and, with caveats attached, it has improved exam success as a result.
Kevin Brennan: Is the hon. Gentleman aware that Andreas Schleicher, statistician at the OECD, who is often cited by the Secretary of State as being the most important man in education, makes it clear in his pronouncements that the best and most effective education system for all pupils is non-selective?
Gareth Johnson: Education will always provoke differences of opinion. Some academics disagree with other academics, but common sense seems to dictate that it is right to have different types of schools because we have different types of children. What is inherently wrong with the comprehensive system is that it is a one-size-fits-all system. It tries to put all children, of all types and varieties, into one bag. Common sense dictates that that surely cannot be right.
Common sense also suggests that children learn more when they are placed with other children with similar abilities, and that has been shown in the streaming that takes place more and more often in non-selective schools. I cannot understand why some people believe that it is acceptable to stream within a school, but not between schools. That simply does not make any sense whatever. Grammar schools are generally good schools, and heaven knows we need to look after good schools. We need them to ensure that we educate our population and that the country’s future is secure.
More than 98% of children who attend a grammar school achieve five GCSEs or more compared with 80% in comprehensive and independent schools. I concede that those figures may not cause surprise, because selective schools are, by their nature, full of children with a record of academic achievement. However, when we look at A-level success where there has already been a record of achievement at the GCSE stage, grammar schools again out-perform all other forms of schooling. In addition, boroughs with grammar schools tend to out-perform boroughs with none, so grammar schools help all the schools in the area to perform better.
In my constituency of Dartford, we have four grammar schools: Dartford grammar school, where I was a pupil; Dartford grammar school for girls, where I am a governor; Wilmington grammar school for boys; and Wilmington grammar school for girls. Each offers something different, and each provides academic specialisation, which is highly sought after in the area, particularly by children from modest backgrounds. My neighbour and hon. Friend the Member for Bexleyheath and Crayford (Mr Evennett) is a passionate supporter of grammar schools in his constituency. I know that his constituents enjoy the benefit of grammar schools in my area, and vice versa.
It is a myth that non-selective schools in selective school areas inevitably suffer. In Dartford, we have first-rate non-selective academies, one of which is the
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most over-subscribed school in Kent. They form as crucial a part of the educational system as the grammar schools and benefit from the existence of grammar schools.
Mark Field: We all know that the existence and indeed excellence and elitism of grammar schools have been a matter of dispute in our party. Does my hon. Friend agree—I hope the Minister will discuss this later—that if we can commit to making academies the grammar schools of the 21st century, places of great elitism and excellence, the culture war that has existed within the Conservative party can come to a close and we can look firmly to the future?
Gareth Johnson: I very much hope that that will be considered in due course by the Department. I have spoken about the benefit that grammar schools offer children from poorer backgrounds. Children who receive free school meals in grammar schools achieve almost an equal success those who do not have free school meals—95.6%, compared with an overall figure of 98%. However, pupils in non-selective schools who have free schools meals achieve far less in examinations—30.9%, compared with an overall figure of 55%. That confirms my point that pupils from the poorest backgrounds have most to gain from the grammar school system.
My hon. Friend highlights the potential for academies, and I welcome the freedom that the Government have given to schools to become academies. The new freedoms allow schools to become flexible in their approach to education. The Department for Education has wisely allowed grammar schools to continue to select on academic ability when they convert to academy status. I hope that the Department will soon consider allowing academies that did not previously select on academic ability to do so. Grammar schools are popular. They provide excellent education, offer social mobility and enable many children to reach their maximum potential. We need to allow them to flourish.
11.13 am
Mr Rob Wilson (Reading East) (Con): I congratulate my hon. Friend the Member for Dartford (Gareth Johnson) on securing this extremely important debate. His commitment to grammar schools is well known. I note that he is a distinguished alumnus of Dartford grammar school, along with Sir Mick Jagger.
Reading school, in my constituency, can boast my hon. Friends the Members for Cities of London and Westminster (Mark Field) and for North East Hertfordshire (Oliver Heald) as Old Redingensians. While not easily described as rock stars, they have equally made their mark in the world of politics.
Mark Field: My hon. Friend has missed out the black sheep of the family: the right hon. Member for Oxford East (Mr Smith) was also an alumnus of Reading school. Despite the disadvantage of a grammar school education, he still managed to go to Oxford and become a Cabinet Minister, although in a Labour Government.
Mr Rob Wilson: That is an excellent intervention. I recall that his hairstyle back in those days was very much like a rock star’s.
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As a keen supporter of grammar schools, I have campaigned vigorously to protect them in my constituency, and I am delighted to contribute to the debate today. Grammars have played a significant part in the important role of social mobility. Through selection, grammars offer our most academic young people and constituents across the country excellent educational opportunities. Academic selection in secondary education is often the focus of rigorous debate, and we are getting a flavour of that this morning. Some have argued that grammar schools are an impediment to social mobility, but that view is profoundly wrong. Our 160-odd grammar schools continue to offer fantastic opportunities to gifted pupils from more disadvantaged backgrounds, thus unlocking all the potential that an academically rigorous education can provide.
Far from impeding social mobility, our grammar schools encapsulate the driving principle of aspiration and ambition. The Prime Minister has said, when staving off class-based attacks from the left about his educational background, “It matters not where you come from, but where you are going.” Grammar schools reflect that ethos. They are precisely about where someone is going, not where they are from. They provide a ladder of opportunity, and I fail to see how that is an impediment, as some have described.
If we take social mobility seriously, as I do, it is fundamentally important that our grammar schools are safeguarded and that threats to their future are taken seriously, but those who wish to threaten and destroy our grammar schools do not rest. Their commitment to vandalising some of the best schools that state education provides continues undiminished, as I recently found in Reading.
Reading is on the front line of the battle to protect our grammar schools. Reading East is fortunate to have two excellent grammar schools: Reading school, which I have already mentioned, and Kendrick school, which is a girls’ grammar school. Both schools feature at the top of the nation’s league tables for educational attainment, a fact of which I am enormously proud. Despite their excellence, Reading’s grammar schools find themselves firmly fixed in the crosshairs of those who seek to kick away the ladder of opportunity that they offer by removing their ability to select pupils. This year, a mere 10 Reading residents formed an anonymous group to put a petition together to trigger a ballot to end grammar school education in Reading.
Without wishing to suck this debate into the realm of legal complexities, the law pertaining to a ballot was confusing and flawed, because the grammars had converted to academy status, as they had been encouraged to do by the Government. A lack of synergy was exposed between annex E of the academy funding agreements and the provisions of the School Standards and Framework Act 1998, the legislation that sets out the regulations pertaining to grammar school ballots. The confusion focused on the 20% petition threshold of local people eligible to vote in the ballot—namely, parents at feeder primary schools.
It is also worth noting that the ballot itself, should it have gone ahead, was undemocratic, because it comprised only parents from primary feeder schools and not the parents of pupils currently in grammar schools. Why
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should parents of children attending a grammar school be disfranchised in decisions about the school’s future, as parents and their children will be affected by the outcome of any ballot?
Is it right that 10 faceless people can cause huge instability at local schools that have served the people of Reading so well for so long? Recently, when those faceless individuals started that ballot process, it caused huge problems. How does a school cope with a threat to its future? The uncertainty it causes for staff, parents and pupils is significant. Enormous effort and expense have to go into administering the ballot and putting the case for the school, taking time away from the important teaching effort that has to go on. It was both wrong and unfair, and it should never have been allowed to happen.
In short, the episode in Reading exposed a gaping democratic deficit whereby a tiny, unrepresentative part of Reading’s community managed to unsettle two schools along with their staff, pupils and parents. Because of the disruption and potential expense to our grammar schools, I hope that the Minister will look at the initial trigger point for initiating such a ballot, which should surely be well above 10 anonymous people. Working closely with Reading school’s head teacher, Mr John Weeds, we lobbied Ministers in the Department for Education. As a result, we have an undertaking from the Minister that amendments will be made to the funding agreement, which I hope will achieve greater clarity.
For now, the threat to Reading’s grammar schools has been temporarily beaten back, but it could return at any time. If they wish, the same 10 people in Reading could return with their protest year after year, and the Government must change the rules so that, if a ballot attempt fails one year, it cannot be constantly repeated. Such a strategy could become a device for destabilising grammar schools all over the country, and I would have grave concerns for the remaining grammar schools in England should it be repeated elsewhere. In defending the few grammar schools that we have left, it seems that the price of their retention will be constant vigilance, unless the Government make significant and necessary changes to the legislation. I am therefore encouraged to see that so many determined hon. Members are participating in this important debate.
To remove grammar schools would be to remove a specialist part of our state education system that seeks to maximise a pupil’s academic potential. Critics of grammar schools—usually, although not exclusively, from the left—say that those who do not pass the selection criteria for a grammar school education will in some way be left behind by the system. That argument, however, is flawed. Not every pupil is academic in orientation, but that does not mean that their potential should be left unfulfilled. Too often, our state education system has let down technically gifted as well as academically gifted pupils, and we need schools that reflect the abilities of all pupils.
That is why I am delighted that university technical colleges are growing in number and strength, and last week I joined Lord Baker of Dorking in celebrating and promoting the success of such colleges at a parliamentary reception with rest of the UTC community—a community which now looks more like a movement. By departing from a one-size-fits-all approach to education, both types of school serve the interests of social mobility.
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It is about being holistic, serving pupils in the system and reflecting their needs accordingly. Our grammar schools do precisely that, and they deserve our unwavering support.
11.23 am
Laura Sandys (South Thanet) (Con): I thank my hon. Friend the Member for Dartford (Gareth Johnson) for securing the debate. He has said many things that I agree with, particularly on the Kent grammar school system.
When I arrived in Kent as a parliamentary candidate, I had no great understanding of the grammar school system, although I did have an open mind. I wanted to find out what parents felt about the issue, and when knocking on doors I came across families in which one child went to a grammar school and the other to the high school. Sometimes the child at the high school went on to sixth form at the grammar school. I found that Kent had an integrated system and that it was impossible to knock on a door and say, “That is a grammar school house,” or, “That is a high school house.” Perhaps that has something to do with the number of grammar schools in Kent. In my constituency, as in that of my hon. Friend, there are four grammar schools. Therefore, 30% of young people in my constituency go to a grammar school, and it also allows children who have finished their high school education to attend sixth-form college at a grammar school. People can access that excellence at any time.
One thing that struck me very starkly was social mobility. We look for excellence in education, and no one disputes that grammar schools provide that. There is always, however, a big question about whether grammar schools attract only children from middle-class families. One school in my constituency, Chatham House, surveyed its pupils’ parents and found that only 20% had been through higher education. Therefore, 80% of children at that school will be the first generation to go into further education or university. For me, that provided a stark understanding of the issue, and it sounded a clarion call that we are talking about a route into higher education for a first generation of children.
In one of the richer areas of east Kent—an interesting thing to say, because the area has high deprivation— Sir Roger Manwood’s grammar school in Sandwich has an average number of children on free school meals. Again, that reasserts the message coming across from teachers.
Kevin Brennan: I am sure that the statistics that the hon. Lady has quoted are correct, but is she aware that overall, the ratio of state to grammar schools is 25:1? There are 158 pupils on free school meals in non-grammar schools for every one in a grammar school. The ratio is 158:1, rather than 25:1, which is what it should be. Is the grammar school mentioned by the hon. Lady highly unusual?
Laura Sandys:
It is not unusual for me or for parents who send their children to grammar schools in my area, but different counties have different systems. Kent has a high number of grammar schools that are attended by between 25% and 30% of children. That offers a huge opportunity for young people from diverse backgrounds to access the grammar school system. Other counties
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have few grammar schools. That is a pity, because the schools attract only a small number of children, which may not include a representative percentage of the population as a whole. In many ways, that supports my advocacy of the need for more grammar schools to create a proper mixed environment and educational system that is appropriate for different children with different abilities at different ages.
As my hon. Friends and I have said, grammar schools do not work in isolation, and when seeking excellence in our grammar schools, it is crucial that we also seek it in our high schools and other schools in the area. We cannot promote grammar schools without promoting a mixed educational environment.
Kent is lucky to have very good high schools, and I ask the Department to look at how they are judged during Ofsted reports. It is important that the system in which those schools operate is understood by Ofsted and that the 30% of children in my area who enter the grammar school system is understood in the context of what those high schools have achieved in that mixed and selective system.
I wish to be clear on three points. First, we must not undermine excellence. I was concerned to hear about the campaign in Reading, because if we end up with a situation in which grammar schools, which are excellent schools, are threatened or put under pressure by parents, we will do our education system a big disservice. Secondly, I would like the Department to be clear about the opportunities and social mobility offered by grammar schools, when there are enough of them in an area to enable them to increase their intake. Thirdly, I will always be dedicated to my high schools, and I am clear that they need to achieve a huge amount. The Government must understand the selective nature of the system in which they operate.
We are looking to increase opportunities for schools to expand, extend their interests and attract parental choice, and that will be the same for grammar schools, high schools and technical colleges. At the same time, we must maintain and sustain the excellence that currently exists in our grammar school system.
11.29 am
Mr Robert Syms (Poole) (Con): Like other hon. Members, I know how dear this subject is to you, Mr Brady. No doubt you are having occasion to bite your tongue, to be an impartial Chair.
I start with the usual caveat that I enter in such debates. The vast majority of children go to comprehensive schools, and if we are to remain a first-class economy, we must raise education standards for all children in the United Kingdom, in whatever sector they are being educated. However, that does not mean that we should not value and cherish the 160-odd grammar schools. Looking around the Chamber, I see a smattering of the geography of Britain where parents banded together in the bad old days and managed to maintain their grammar schools, as we have done in the Poole and Bournemouth area. These schools have suffered hostility and sometimes indifference. I am glad that at last we have a Government who appreciate the value that these 160 schools bring to the UK and the chances that they give to the children who go to them.
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One of the saddest things over the past 20 or 30 years because of the changes is that a bigger divide has developed in the UK, in that those from a middle-class background who can afford to pay for education have more opportunities, whereas some of those from more disadvantaged backgrounds have found that, with the demise of grammar schools in many areas, their opportunities have not expanded as much as they might have done 10, 20, 30 or 40 years ago. It is still amazing to me to see the people whom this country has produced who make a major contribution to business, to universities and to the media who came from a grammar school background.
We must cherish and support the grammar schools that we have. They provide a beacon for the academy programme. I understand why the Government have focused more on academies than on grammar schools. Clearly, everyone is in favour of grammar schools, but not everyone is in favour of the 11-plus. Rather than arguing about that, it was probably right and proper to get on with the academy programme, which seems to be building up a head of steam. The existence of grammar schools will allow many academies to look at the way in which they teach their pupils. I am thinking of the streaming, the uniforms and the whole ethos of those schools. If the expansion of the academy programme sees many academies adopt those things, that may be a quicker way of ensuring that the widest possible number of pupils get a better chance in life.
We come into politics to make a difference, or at least we hope to make a difference. Of course, it is terribly difficult for any of us to measure what difference we make. However, the changes that the Government are making to school admissions, particularly as they relate to grammar schools, really are a major difference, because the presumption against expansion is to go, which means that good schools will be able to expand. I have no doubt that one of the most important announcements made by the Government is the one that will allow grammar schools to expand, because they are popular and more people will wish to go to them, providing that they meet the standards. That is the first staging post on the way to cherishing and perhaps expanding this sector in the future as a major beacon for educational standards.
I do not intend to say much more, but the number of colleagues present for the debate says something about how strongly they feel. The Minister and I are old friends, and I am pleased with and proud of what he is doing in the Department to improve standards and opportunities not only for those from prosperous backgrounds, but for those from poorer backgrounds.
11.33 am
Eric Ollerenshaw (Lancaster and Fleetwood) (Con):
Like other hon. Members, I am the product of a grammar school—Hyde County grammar school, which was destroyed in the grammar school wars. On the other side of things, I went into teaching in 1973, in the heyday of comprehensivisation, with a genuine desire for comprehensives to succeed, because there was, in a sense, no golden age. I think that it was my hon. Friend the Member for Cities of London and Westminster (Mark Field) who remarked on the failure of the tripartite system, because there was not a tripartite system in
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most of the country. To be fair, in the 1950s and ’60s, although the grammar schools were successful, both parties were worried about the failure across Britain in terms of skills and attainment of those who did not have the chance to go to grammar schools.
As I have said, I entered teaching at the time of comprehensivisation. The phrase used at the time was that it would be a grammar school education for everybody. My first comprehensive school was in Tottenham—Northumberland Park school, just behind the Spurs ground. In a sense, that was my education in how political education is.
I congratulate my hon. Friend the Member for Dartford (Gareth Johnson) on securing this debate. It is a pity that there are no Labour Members present other than the shadow Minister, the hon. Member for Cardiff West (Kevin Brennan), but I hope that we will hear from him that this will be the end of the grammar school wars.
Kevin Brennan: Would the hon. Gentleman also like to hear from the Liberals on this issue?
Eric Ollerenshaw: Well, there you go. What I am trying to say is that I hope—my hon. Friend the Minister has already indicated this—we will see the end of the grammar school wars. I think that all parties have learned from the mistakes that we made and the destruction of good schools that took place in the genuine attempt to create all-purpose comprehensives for everybody.
Let us consider what happened in the ’70s and ’80s. I shall give a personal example. I remember as a teacher in Tottenham at the time trying to bring in an A-level course—France under Louis XIV—and being challenged by other teachers who said, “Do you think they’re good enough for this, Eric?” The penny then began to drop that somehow there was a dumbing down in the system. No teacher in that comprehensive sent their child to it. Most moved to the higher reaches of Hornsey to get near the comprehensive there. There was a classification of comprehensives, but only the middle-class, trained professionals knew the distinctions.
My family background is that I was the first one who passed the 11-plus and all that stuff, but my parents and grandparents did not understand the system. I just went to a school where I managed to pass the 11-plus and ended up in a grammar school. Hon. Members can imagine that loads of parents in Tottenham did not understand that there were distinctions between the schools. We must remember that that was the day and age when schools did not publish their results. There were huge battles to get schools to publish results, so people had to be really in the know, to know which comprehensive produced better results than the other comprehensives.
Then there were all the other things that we tried. I started off teaching mixed ability. Then we tried setting and then, as has been said, streaming. Then we had social priority schools and social priority staff, which meant that we got extra money. I managed to keep that extra money until 2000, when I finished, but that was another problem with the bureaucratic system. In addition to all those different attempts to do things, there were new subjects, including integrated humanities, cross-curricular studies and sociology—I think I happen to be the only Conservative in education who ever taught sociology to A-level. We made all those attempts to do something with the system, having destroyed the previous
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system, even though, as hon. Members have said, every school and every area are totally different. If results can be measured, people can understand those results, and if the schools are achieving, let them get on with it.
One of the bravest things that we did in opposition was finally to stop the wars and say that we support the academies programme. I hope that that will be reciprocated and that we can pull out of the political wars about education. I now find myself the Member for Lancaster and Fleetwood, where there are two grammar schools. One is Lancaster royal grammar school, which claims a history going back to the 13th century. It is a boarding state grammar school. I thank the Minister, who had a meeting with some of us who represent state boarding schools. I hope that that is another area in which we might see an increase now that we are in the era of free schools—let them get on with it. My area also has Lancaster girls’ grammar school, which dates back to 1907. Those schools are very successful. They are outstanding schools that provide outstanding opportunities for children. Alongside them, my area has Church of England schools, such as Ripley St Thomas school, which has been rated outstanding by Ofsted. Central Lancaster high school, a comprehensive school, is just about to get its first sixth form. That school provides a very good education for those who do not want a grammar school education or a religious school. In a sense, everything is there. There are no problems in my area—touch wood—with choice in education, simply because there is huge variety, which is the key. As I have said, we must pull the politics out, let schools get on with it and allow them to prove by their results what they can do.
I welcome the announcement that grammar schools will be allowed to expand, but I ask the Minister to go further. On selection criteria, the school admissions code specifically mentions selective schools and
“designated grammar schools that rank children according to their performance in a test and allocate places to those who score highest”.
It then has some rules about siblings who can or cannot go to such schools. If we are to go the whole hog on free schools—if we are letting 100 flowers bloom and all that—let us start pulling out the regulation and discrimination that have been built up against grammar schools, which hon. Members say provide a successful education for children in their patch.
Beyond that, grammar schools that have gone for academy status are raising the issue of the possible impact of funding still being under the control of local education authorities and school forums, where there is a predominance of non-academies. There is still work to be done on that. As my hon. Friend the Member for Reading East (Mr Wilson) has said, there is also discrimination because people can call for a ballot over which school they get. Let us put an end to all that.
The debate is about grammar schools. As my hon. Friend the Member for Poole (Mr Syms) has said, they make up a minority of schools, but they are still very successful. Let us put an end to these arguments about which kind of schools we have, which should be up to the local area and to parents. We should enable people to have the education that they want for their children. The Government’s responsibility should simply be to measure success and to build on it, and grammar schools have been one part of that success.
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11.41 am
Esther McVey (Wirral West) (Con): I congratulate my hon. Friend the Member for Dartford (Gareth Johnson) on raising this issue. All of us are saying that grammar schools provide excellent education for all children from all backgrounds. As my hon. Friend the Member for South Thanet (Laura Sandys) explained most powerfully, we would not necessarily know what schools people’s children go to when we are knocking on doors while out canvassing.
For me, the debate is about acknowledging grammar schools and the excellent work they do. It is also about acknowledging the part that they play in the educational system. There are a number of different kinds of schools, and grammar schools are just one, but we cannot run away from the fact that they do an excellent job. They need to be supported, and I am delighted that the Government are backing them, which will enable them to flourish.
Grammar schools produce consistent, successful results and well-rounded citizens and adults. I say that as a previous governor of Calday Grange grammar, which is 365 years old this year. I was most impressed by the way in which the parents there came together to support not only the school, but the pupils in it. I was also impressed by the community engagement there. If parents want grammar schools and support them—this one has been going for 365 years, and there are many more like it, not just in Wirral West, but right across Wirral—we must keep hold of them. Parents know what is right for their kids and they want these schools to keep going.
The successful results of grammar schools in Wirral West speak for themselves, so let me give just a couple of examples. On the average point score per student, Calday Grange grammar gets 34.5% above the average in the country, Upton Hall school for girls gets 37% above the average and West Kirby grammar gets nearly 40% above the average. On the five A to C grades at GCSE, Calday Grange grammar is 44.5% higher than the average, Upton Hall is 35.5% higher and West Kirby grammar school is 43.5% higher. That is outstanding, and it is part of the grammar school system. Why try to mend something that is not broken? Why take away something that is unbelievably successful?
Wirral grammar school for girls had a 100% pass rate for A-level students, with 43% of its pupils getting A* and A grades and 73% getting between A* and B grades. The school is unbelievably successful. It is ranked in the top 100 state schools in the country in The Sunday Times list.
My area desperately needs great schools—I can say that because I am from Merseyside. In fact, every area could say the same. That really is key when we look at the future generation we are creating and at social mobility. Grammar schools have to be the engines for social mobility in communities.
Grammar schools are academic schools, and our top universities look to them. More than 1,000 grammar school pupils went to Oxford and Cambridge after taking A-levels in 2008. In areas such as mine, grammar schools provide an outlet for academic potential.
We all watch BBC and ITV and select excellence in dancing, singing or some other kind of performance—nobody has a problem with that. We all vote on these things and say that someone can win because they are
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the best. Why do we have a problem with looking at academic excellence and selecting people in that way, when the whole country is quite happy to send in a text to vote in these shows?
Jim Shannon: Why do people vote for Russell Grant in “Strictly Come Dancing” if this is about excellence? I cannot understand that.
Esther McVey: To be fair, I think that man has got move and groove and slinky hips, and I will be voting for him. As an ex-dancer, I was taken by his dancing abilities.
I welcome what the Government are doing. I welcome free schools and academies, because I believe in choice. The grammar schools in Wirral West are moving to become academies and following the academy route. As they progress towards becoming academies, I hope they will remain true to their beliefs, aims, aspirations and founding principles. I hope they will remain the same when they become academies. I hope that our support for them will allow them to flourish, that we do not change a winning formula and that we ensure that these excellent schools remain in our community.
What the coalition Government are doing is a refreshing change. They are offering choice, pushing for discipline, looking to support and encourage all sorts of schools and looking for achievement in every area. Yes, there must be academic achievement, but there must be achievement and fulfilment for every child. What some might do in academia, others might do through practical skills, while others might provide for their community in a very different way. I support all those kids, because they all have a talent; we just have to find out what theirs is and nurture them.
11.47 am
Mark Pawsey (Rugby) (Con): I am grateful for the opportunity to speak in this important debate. Like everyone who has spoken before me, I am a strong supporter of grammar schools. Like my hon. Friend the Member for Dartford (Gareth Johnson), whom I congratulate on securing the debate, I am a product of the grammar school in the constituency that I represent.
Rugby retains grammar schools, but we have the best of both worlds because we also have non-selective schools. We have a non-selective school in Ashlawn that has a grammar stream, and we have two high-class, selective, single-sex grammar schools—Lawrence Sheriff school for boys and Rugby high school for girls. I should declare an interest, in that my daughter is a pupil at the girls’ school.
As I say, Rugby has grammar schools, and I am a product of Lawrence Sheriff. My hon. Friend the Member for Isle of Wight (Mr Turner) was there a few years before me, and I came to this place with my hon. Friend the Member for Warrington South (David Mowat), who also went to the school. The school therefore has a proud tradition of producing Members of Parliament.
At the school, I was in a class with the sons of cement factory workers and scrap metal merchants, each of whom was the first member of their family to go to university. I therefore have a good understanding of the role of grammar schools in providing social mobility.
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We retain grammar schools in Rugby because of the hard work and diligence of an earlier generation of politicians, who fought to retain our selective schools in the face of the comprehensivisation of Britain. The fact that we have grammar schools is a major asset for the community that I represent. Our schools are in high demand. Parents move into our area to provide their children with the opportunity to attend a grammar school, and they also apply from substantial distances—20 or 30 miles away—to secure that kind of education for their children. We know the schools are popular, and it is because of the high standards and excellence that a grammar school provides. My hon. Friend the Member for Dartford gave a full account of the academic qualifications secured at most grammar schools.
I am pleased that the Government recognise the strengths and qualities that grammar schools can bring the country, and that they have brought forward a policy that will enable them to expand. In Rugby, we have been looking forward to the expansion of our grammar schools in the past few years, because of our party’s policy to permit them to grow where there is population growth. Rugby has a very positive approach to new housing development. We have a site that is expected to take 6,200 new homes in the next 20 years, and we are expecting the grammar school provision to increase in proportion. It is great news that we may be able to go further.
I am anxious to ensure that our grammar schools should be available for the broadest possible number of children in our community. I have one or two anxieties about the selection process that will take place in an era of academies. Until now, the selection arrangements for our existing grammar schools have been run by the local authority, and I have two concerns about the process to which the authority has moved in recent years.
The first concern is about the need for parents to opt in. That came home clearly to me much as it did to my hon. Friend the Member for South Thanet (Laura Sandys). I was on a doorstep talking to parents who had a bright and gifted young child, who had been denied the opportunity of a grammar school place because they had not filled in the necessary form in time for the child to take the exam. I was horrified that there was a system in which parents must opt in rather than opting out. I should like the Minister to comment on an opt-out system. I recognise that there will be parents who decide that a selective education is not right for their children, or who do not want to put their children under the burden of taking a selection exam. However, if we are to make our grammar schools the engines of social mobility that they should be, we should make certain that a child’s ability to sit the selection exam is not determined by their parents’ ability to get a form filled in on time, and sent back to the school and local authority.
Laura Sandys: Another issue in my constituency is that fewer girls than boys apply to grammar school. There is no reason for that, other than parents’ not necessarily looking at their girls, and their potential to go to grammar school, in the same way. My hon. Friend’s system would be extremely interesting, in many ways, in relation to opening that up and perhaps increasing the number of girls who apply.
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Mark Pawsey: My hon. Friend’s intervention is profound. The essence of my support for grammar schools and, I am sure, of the support of other hon. Members present, is that they should be available to all children. We want them to be vehicles of social mobility. We want children from less privileged backgrounds to go to them; so my heart went out to the parents I met whose daughter had been denied the opportunity of a grammar school education.
Mr Rob Wilson: Why are not primary schools encouraging parents to put their children in for the examinations, and opting in on behalf of the children? Does my hon. Friend agree that primary schools do not do enough to get their children into grammar schools?
Mark Pawsey: Absolutely. I share my hon. Friend’s view. One of the difficulties is that in certain primary schools there is an expectation that children will sit the selection exam, whereas in other schools, perhaps in less well-off areas, the expectation may not be present; but it should be. Those schools should put all their children forward, to give them the opportunity to participate in a selective education.
I have a second point about the selection process on which I would like the Minister to comment. I have mentioned my daughter, who is currently at grammar school. My other daughter, who is older, sat the exam 10 or 12 years earlier, when the entrants sat several practice papers in school and then took the actual paper in school—an environment that they were all entirely comfortable with. I am sure that that enabled each child sitting the paper to do their best. By the time my younger daughter took the exam, it had been moved to a separate examination centre. At the age of 11, with the entire cohort of other children of that age, she was taken to a foreign environment—a school they were not familiar with. They sat in rows in the same way we would have sat our GCSE and A-level exams. For many children, the move from the comfortable environment to somewhere completely different was distressing. They are youngsters of 11 years old. Sure, the selection exam should determine which children are the most capable, and who will benefit—
Kevin Brennan: I am very interested in the experience that the hon. Gentleman describes, but is he entirely comfortable with categorising children in that way at the age of 11?
[Jim Sheridan in the Chair]
Mark Pawsey: Absolutely comfortable. I know as a parent that it is possible to identify at the age of 11 the children who will benefit from the more rigorous academic education that would come through a grammar school. However, I do not want children to be assessed in an environment in which they are not entirely comfortable at such a tender, early age. I urge the Minister to do his utmost to ensure that the process of selection is put on a more even footing and that the system is better able to identify those with the ability and skills to benefit from a grammar school education, rather than those who perform particularly well in an exam on a given day in an unknown environment.
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I am very supportive of what the Government are doing in increasing the role of grammar school education, and I look forward to many children benefiting from the changes that we will make in the years to come.
11.57 am
Kevin Brennan (Cardiff West) (Lab): Welcome to our proceedings, Mr Sheridan. We have had a very interesting debate, although I feel somewhat as though I am intruding on a private argument.
Mr Andrew Turner: What argument?
Kevin Brennan: I think that there is an argument, because I agree with the Minister that more grammar schools should not open, and I sense an undercurrent among the hon. Members who have spoken that they would like more to open. Perhaps if I am wrong about that, one of them will intervene and tell me so, but no one is standing up to speak, so we can take it that they do not agree with the Minister and that they have an argument with his policy—
Esther McVey: Will the hon. Gentleman give way?
Kevin Brennan: In a minute. I will finish and let the hon. Lady intervene in a second, if she will contain her slinky hips, as she said in her speech earlier. I apologise—I should not have said that: I was simply quoting what she said about “Strictly Come Dancing”.
The Minister’s policy is not to open more grammar schools, and I understood from the speeches of other hon. Members that they want to open more, so perhaps the hon. Lady will clarify matters.
Esther McVey: I think that if the hon. Gentleman was listening to what I was saying, he would know that I gave full acknowledgment to the grammar schools that we have and the fact that parents want to keep them. My speech was not about increasing them, or making alterations; I was saying that they are an important part of the education system, for which they must be acknowledged.
Kevin Brennan: I accept that one hon. Member in the debate agrees with the Minister’s—and the Government’s—policy that more grammar schools should not be opened. The hon. Lady has made it clear that she agrees with that. I am looking around the Chamber to see whether other hon. Members want to tell us they agree with the Minister, but I do not see any.
Stephen McPartland (Stevenage) (Con) rose—
Kevin Brennan: Ah! I am very grateful to the hon. Gentleman for intervening on me.
Stephen McPartland: I did not speak in the debate, but I understood my hon. Friends to be saying that they were very proud of the grammar schools in their areas and that they wanted them to have the opportunity to expand. I believe that it is Government policy that all good schools should have the opportunity to expand.
Kevin Brennan:
I am grateful to the hon. Gentleman for that clarification. I shall take it then that all Government Members present do not wish to see more grammar schools opened across the country, which is
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the Government’s policy, although they support the Minister’s move to allow existing grammar schools to expand their numbers.
Mr Andrew Turner: I would say that it would be a good idea to have grammar schools in areas in which they do not currently exist, but I would need to consult my electors before I decided which way to vote.
Kevin Brennan: I take from that that the hon. Gentleman has some doubts about his own Government’s policy in not allowing more grammar schools to be built; that is the logical conclusion of his statement.
We now know that there is a mixed bag of views among Government Members about the matter. I agree with the Minister that we should not build more grammar schools, because selection at age 11, in my view, does not work and is wrong. I will expand on that in a moment.
Mr Syms: As the hon. Gentleman is speaking for the Opposition, if he believes that selection at age 11 is wrong, is he in favour of abolishing the 160 grammar schools?
Kevin Brennan: Our policy on the matter is unchanged. It should be up to local parents, via the ballot mechanism described earlier, to decide whether they want to keep the grammar schools that are in their area. Our policy is unchanged from what it has been for many years.
I congratulate the hon. Member for Dartford (Gareth Johnson) on securing the debate. When he opened the debate, he talked about a one-size-fits-all education. He told us his story of social mobility, which he attributed to his attendance at grammar school. He seemed to indicate that that kind of social mobility would not be possible without grammar schools, but I have to tell him that that is not correct.
I think that I come from a background similar to the hon. Gentleman’s. My parents both left school at 14. My father worked in the steelworks and my mother was a dinner lady. I attended a comprehensive school and ended up here via various other institutions along the way, including teaching in a comprehensive school, which the hon. Member for Lancaster and Fleetwood (Eric Ollerenshaw) also did. Social mobility is not dependent on attendance at a grammar school. There is conflicting evidence regarding the impact of grammar schools on social mobility, when looked at in the round, and the evidence that the hon. Member for Dartford cited was circumstantial rather than conclusive.
Gareth Johnson: No one here has suggested that it is impossible to have social mobility in non-selective schools. What we are saying is that there is a high degree of social mobility in grammar schools, which we are all proud of.
I hope that the hon. Gentleman will clarify something for me. He says that he is against selection at 11, yet his party has a policy of continuing selection at 11 for the 164 remaining grammar schools. Does he want a policy with which he disagrees to remain?
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Kevin Brennan: We have made our position clear. Although I am not in favour of selection, it is up to the parents in existing areas, via the ballot mechanism described by the hon. Gentleman, to decide whether they want to keep grammar schools. That has been our policy for many years, and the decision has always been taken in that way at a local level, previously by local authorities.
The hon. Gentleman said that no one is suggesting that social mobility is possible only through the grammar school route. Perhaps that is not what he wanted to suggest, but he made a remark—and I intervened on him, as the record in Hansard will show—that might have implied that that was what he believed. However, I accept the explanation that that is not the case. I will come on to the evidence that says that non-selective systems are more effective than selective ones.
The hon. Member for Reading East (Mr Wilson) objected to the mechanism available to parents, should they seek to trigger a ballot, to change a selective system in their local area to a non-selective one. There was only one part of his argument that I did not understand. If the presence of grammar schools benefits all children and parents in an area, as many of his hon. Friends say is the case, why is he concerned about parents of children in the feeder schools to grammar schools having a vote on keeping a selective system? After all, according to him and his hon. Friends, all those parents would benefit massively from the gravitational pull of a selective school in their area.
Mr Rob Wilson: My concern is not about parents of children in feeder schools voting—they should be able to do so—but about parents of children in grammar schools not being able to vote and about the fact that ballots may be triggered by 10 anonymous people collecting a petition.
Kevin Brennan: Leaving aside the trigger, which the hon. Gentleman raised with the Minister—I am sure that the Minister will respond to it—the logic of his argument suggests that he would want parents from all secondary schools in an area to be able to vote in a ballot, because they, too, would all benefit hugely, as described by his hon. Friends, from the presence of grammar schools that their children do not attend. By his own logic, all parents in an area should have a say in whether the local system should be selective or non-selective. However, the current system allows parents of children in feeder schools to vote in that way. If he is afraid that they will vote differently, clearly he is saying that they might not feel that their children are benefiting from having a selective school in their area. That was not the point that his hon. Friends were making.
The hon. Member for South Thanet (Laura Sandys) mentioned the high schools in her area and spoke with passion and persuasiveness about the school system there. It was interesting to hear that non-grammar schools in the area are now referred to as high schools. Why do we never hear the term “secondary modern” any more? Why are non-grammar schools referred to as high schools, comprehensive schools, sometimes community schools or a variety of other appellations? It is for the reason pointed out by the hon. Member for Lancaster and Fleetwood—the tripartite system that existed across
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the country condemned the vast majority of children to second-class schools. That is the truth and the reality of what the system was like.
Eric Ollerenshaw indicated assent.
Kevin Brennan: The hon. Gentleman is nodding, because he taught in that system and knows what secondary modern schools were like, as a whole, across the country. They provided a second-class and extremely poor education to the children who failed their 11-plus and were unable to attend other schools.
Mr Andrew Turner: I have no experience of grammar schools or secondary modern schools on the Isle of Wight, because that has not happened to the schools there. Both grammar and secondary modern schools are doing well in places such as Thanet, the rest of Kent and Rugby, where grammar schools remain. They are good schools; it does not matter what one calls them.
Kevin Brennan: I am not disputing the fact that there are many good schools within a selective system that are not grammar schools. I completely accept the point made by hon. Members about good schools in their local areas; they will know far better than I the quality of education offered in those schools. I am simply pointing out that when the system was scaled up right across the country in the 1950s and 1960s, the reason why the comprehensive movement came along was because of the failure of that system to cater for the needs of the vast majority of children.
The hon. Member for Lancaster and Fleetwood brought to the debate the benefit of his experience as a teacher in a London comprehensive school, and he made some valid points about the kind of social selection that can also take place in a comprehensive school. I taught in a comprehensive school for 10 years, and in my experience in schools, what counts is not whether a school is selective, but the quality of its leadership, the teachers in the school and the relationship created with parents and the effective enforcement of good standards of behaviour in the classroom. Those are the sorts of issues that count in giving a good education to a child. That is perfectly possible—I witnessed it in many comprehensive schools. With the right leadership and the right quality of teaching, we can offer an educational experience for all children in a comprehensive school, including those who are academically gifted.
Eric Ollerenshaw: I agree with the hon. Gentleman on that, but I just wonder why his party still pursues the line of antagonising the remaining grammar schools and why it would prefer to see even them abolished at some point. On his party’s strictures, if the schools are good with good teachers and good results, should they not be allowed to continue?
Kevin Brennan: I am not in the least antagonistic towards any school. As I have made clear, our policy is that the parents of children in the feeder schools to such schools should have the decision as to whether a system is selective or not. Let us be clear. When discussing grammar schools, it is not just a case of one school, but a selective system in an area. That is the consequence of having selection. It is quite right that parents should have a choice on that.