Barts Health NHS Trust

Mike Gapes Excerpts

Thursday 19th March 2015 Commons Chamber

[Jane Ellison]

I thank my hon. Friend for that—[Interruption.] We are hearing a lot of chuntering from a sedentary position, but I refer the right hon. Member for Leigh (Andy Burnham), who asked the urgent question, to a quote from Roger Davidson, former head of media at the CQC, who said in evidence to the Francis inquiry that

“there were conversations between the CQC and ministers to the effect that the CQC would not cause any trouble in the run up to purdah. The message that we don't want bad news infected the whole organisation.”

However much of a small discomfort it might be to Ministers to come and answer an urgent question on such an important matter for patients, people should be reassured that it is far more important that these issues come out transparently, whatever the timing, even if it is ahead of a general election.

[Mike Gapes (Ilford South) (Lab/Co-op)]

Both trusts that serve constituents in the London borough of Redbridge—Barking, Havering and Redbridge, which serves King George hospital in my constituency, and Barts, which serves Whipps Cross—are in special measures. In 2013, the Government forced the closure of maternity services at King George hospital, and as a result some of my constituents had to go to Whipps Cross. I am therefore shocked by what I have seen in the report. It is about time that the Government ruled out their plans to close the A and E at King George, because I do not want constituents of mine dying as a result of inadequate provision in north-east London.

[Jane Ellison]

The hon. Gentleman and I have debated these issues in Adjournment debates in this House, so I know that they are of great concern to him. All these issues in that part of London’s health economy need to be considered.

NHS Major Incidents

Mike Gapes Excerpts

Wednesday 28th January 2015 Commons Chamber

[Mr Hunt]

That is it, and that is why it is not working for the Opposition politically when they try to put the NHS centre stage. They can see people who downgraded or closed 12 A and E departments across the country during their time in office now coming to Prime Minister’s questions and trying to criticise this Government when similar things have happened. The answer on all these occasions is to put patients first, do the right thing for patients, be honest about the problems and sort them out, and that is what the Government are doing.

[Mike Gapes (Ilford South) (Lab/Co-op)]

The hard-working and dedicated staff at Barking, Havering and Redbridge trust, at King George hospital in my constituency and Queen’s hospital in Romford, know, because their trust is in special measures, that there has been a lot of reputational damage. On 5 January, elective operations were cancelled—in my personal case, at two hours’ notice; I was not the only constituent who had to go through that—because of A and E pressures in the trust. Can the Secretary of State explain whether hospitals in special measures have a special requirement so that they do not need to declare that they are in the position of hospitals that have made the decision to say that there is a major incident, or is it just coincidental that although operations were cancelled on a large scale on 5 January no major incident was declared at Barking, Havering and Redbridge?

[Mr Hunt]

I can confirm that there is no difference in any guidelines issued for hospitals in special measures and for hospitals not in special measures. This is a good example of a trust with deep, pronounced problems over many years. There was a terrible tragedy in 2007, I think, when someone gave birth sitting on a toilet seat. This Government have said that we are going to tackle those problems and put the trust into special measures. It has more doctors and nurses: 230 more hospital nurses in the past four years in that trust. We are making a real difference—we have a new management team—and I think that things are beginning to get better in that trust in a way that has not been the case for many years. I hope that the hon. Gentleman would welcome that.

Special Measures Regime

Mike Gapes Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

I am happy to do that. I agree with the right hon. Gentleman. I would like to see a lot more innovation. Even in the best care homes, which deliver good care by today’s standards, there is room for much more innovation and imagination in seeing how we can make people’s last years ones that they really enjoy. I have seen some amazing dementia care homes that break the mould. I am very happy to look at the work of that organisation. I am sure that there is a lot we can all learn.

[Mike Gapes (Ilford South) (Lab/Co-op)]

The Secretary of State said that 16 trusts are in special measures, but he mentioned only 11 of them. As he knows, Barking, Havering and Redbridge University Hospitals NHS Trust includes King George hospital in my constituency. Will he take this opportunity to explain why he has not said anything about that trust? Is it because the plans to close the A and E this year or next year are in total disarray, but he does not want to admit it publicly? Will he take this opportunity to clarify—yes or no—whether it is still his intention that King George hospital’s accident and emergency will close?

[Mr Hunt]

First, let me reassure the hon. Gentleman on the last point. The trust has made it absolutely clear that the change in A and E will not happen until it is safe. It is very unlikely that it will happen in the near or medium term. The reason I did not mention his trust is that the statement was about the 11 trusts that were put into special measures exactly a year ago and his trust was not put into special measures until just before Christmas. It, too, is making progress. It has employed 31 additional nurses, it has an excellent chief nurse, whom I have met on a number of occasions, it has had a new chief executive since April and there is an increase in patient satisfaction. However, there is still a long way to go because it is a very challenged trust with some deep-seated problems. We need to support it at every step of the way.

Health

Mike Gapes Excerpts

Monday 9th June 2014 Commons Chamber

[Mr Hunt]

I am aware of those shocking figures, and I am also aware that the Royal College of Surgeons says that 152 people died on waiting lists in Wales at just two hospitals because they did not get their treatment in time. I gently suggest to the shadow Health Secretary that the Labour party might want to fix what is going on in Wales if it is really serious about patient care, because how Labour is running the NHS in Wales is an absolute disgrace.

[Mike Gapes (Ilford South) (Lab/Co-op)]

rose—

[Barbara Keeley (Worsley and Eccles South) (Lab)]

rose—

--- Later in debate ---

[Mr Hunt]

Perhaps the hon. Gentleman would like to look at the facts relating to the actual cost of the reorganisation. The net saving as a result of it has been more than £1 billion a year, and we are now employing 7,000 more doctors and 3,000 more nurses than when his party was in office. Last year, as a result of this programme—

[Mike Gapes]

rose—

[Mr Hunt]

I am going to make some progress.

Last year, as a result of this programme, this Government put 15 trusts—

[Mike Gapes]

rose—

[Mr Hunt]

This might not be something the Opposition agree with, but they should listen. I need to tell the House that we have put 10% of all acute trusts into special measures, and that in each and every one of them the warning signs were there under the last Government. The George Eliot hospital, for example, had one of the worst mortality rates in the country back in 2005. Tameside had to pay £9 million compensation for mistakes in just two years, and at the Queen’s hospital in Romford in 2006, a lady gave birth in a toilet, leading to the tragic death of her child.

[Mr Hunt]

The hon. Gentleman mentioned to me earlier that he was going to raise that point. I will look closely at the issue, as it sounds like an extremely important one.

I want to look at what has changed under this Government. One of the trusts that has been in special measures is the Basildon and Thurrock University Hospitals NHS Foundation Trust. When the right hon. Member for Leigh was in office, inspectors at the hospital found blood stains on floors and curtains, blood spattered on trays used to carry equipment, and badly soiled mattresses. When the Care Quality Commission published those findings, it was allegedly leant on to tone down its press release. This Government put Basildon into special measures, and it now has 183 more nursing staff. I asked one of those nurses what the difference was. She said:

“It’s very simple. When we raised a concern before, they weren’t interested. Now, they listen to us.”

It gives me great pleasure to inform the House that the chief inspector of hospitals has today recommended that Basildon should be the first trust to exit special measures, and that Monitor has ratified that decision. The hospital has received an overall rating of “good” and has been praised for its excellent leadership. The chief inspector found that the trust had made significant improvements in a number of areas, including maternity services, which were rated as “outstanding”—[Interruption.] The Opposition might not care about what is happening at a trust in special measures, but we on this side of the House do.

[Mike Gapes]

On a point of order, Mr Speaker. The Secretary of State knows very well the issue I am trying to raise, because I raised it during the business statement last week. I want him to respond to an important fact. A leaflet was circulated in my borough on 20 May, two days before polling day. It was quoted in the local papers, and it related to the A and E department at King George hospital in my constituency. I simply want to ask him to confirm whether the announcement from the Secretary of State for Health referred to in the leaflet was made with his authority, or by him, during the week before polling day.

[Mr Speaker]

The hon. Gentleman is an ingenious and indefatigable Member. He probably knows that I can best describe that as an attempted point of order, because it is not a matter for the Chair. That said—[Interruption.] Order. That said, the hon. Gentleman has made his point forcefully, and it would certainly not be in any way disorderly for the Secretary of State to respond to it if he wished to do so.

[Mr Hunt]

I am most happy to respond to what—I agree with you, Mr Speaker—is a thinly disguised point of order. I will happily say this: what I said was completely in order because I was simply restating information publicly available on the trust’s website.

I want to go back to talk about Basildon hospital, because of the remarkable turnaround there. Chief executive, Clare Panniker, and her team deserve huge credit for the changes that they have made, which will truly turn a corner for patients who depend on their services.

[Mike Gapes]

On a point of order, Mr Speaker.

[Mr Speaker]

Order. I ask the hon. Gentleman to calm himself for a moment. I accept the great importance of these matters, but I hope that this is a point of order rather than of frustration.

[Mike Gapes]

indicated assent.

[Mr Speaker]

The hon. Gentleman is nodding with great vigour and intensity. Let us hear the attempted point of order.

[Mike Gapes]

I want to be clear about what the Secretary of State just said. He said, “What I said was”. I seek your advice, Mr Speaker. How can I get clarification from the Secretary of State about whether he made an announcement during the purdah period in the days just before the election or whether it was a previous statement rehashed and reissued from weeks before?

[Mr Speaker]

The short answer to the hon. Gentleman is that he must use his best devices, both in this debate, where he might have an opportunity to catch the eye of the Chair later, and in Health questions, which, if memory serves me right, are coming up very soon—

--- Later in debate ---

[Mike Gapes (Ilford South) (Lab/Co-op)]

For the first time in my life, I live in a majority Labour council in the borough where I was born. On 22 May, Redbridge—

[Chris Ruane (Vale of Clwyd) (Lab)]

Aptly named.

[Mike Gapes]

Yes, it is now. That is true.

In a borough established in 1964, for the first time we have 35 Labour councillors, with 25 Conservatives and the Liberal Democrats declining to just three.

I want to highlight an issue that I had hoped the Secretary of State for Health would have been on the Front Bench to hear in person. I do not think that he appreciates its seriousness, given that this leaflet might have changed the result in the ward where it was distributed. The leaflet said:

“Official announcement from the Health Secretary

Whilst calling on residents over the last few weeks it has become clear that the most important issue is the proposed closure of King George Hospital A&E. Lee Scott MP together with the Conservative Councillors have pressured the Health Secretary into clarifying the situation. Please read his statement overleaf. The position is now very clear:

KING GEORGE HOSPITAL IS NOT CLOSING

KING GEORGE A&E IS NOT CLOSING

Ruth Clark, Vanessa Cole, Thane Thaneswaran”.

They were the candidates of the Aldborough ward of Redbridge borough in the Ilford North constituency. On the other side is a statement issued by the Secretary of State for Health.

I heard about the leaflet because the local newspaper, the Ilford Recorder, put on its website a story with the heading, “King George A&E to remain open beyond 2015, says Health Secretary”. That was published on 20 May. Members know the rules about purdah very well. I immediately phoned the Department of Health and asked whether a press statement had been issued by the Secretary of State that day. I was eventually referred to somebody in the press office—it took a little while—who said, “We have made no statements of any kind today.” I said that it had been reported by the Ilford Recorder that there was a statement by the Secretary of State for Health. I had not seen the leaflet at that point, but I got a copy of it later.

The press office said that it would refer me, if I so wished, to somebody in the private office who would call me back. I did not get a call from the private office—I did not really expect one—but I decided to get to the bottom of the matter. I have written to the permanent secretaries in the Cabinet Office and the Department of Health to ask for an inquiry into whether any officials, civil servants or Ministers were involved in the leaflet issued in Redbridge.

I hope that the Minister will convey to the Secretary of State that I give notice that I shall write directly to him after this debate to ask, under freedom of information legislation, for all the information about what contacts, if any, there were between officials, advisers or SpAds—special advisers—in the Department with councillors in Redbridge or anybody else about the publication of the leaflet before the election. As it turned out, Labour won all three seats in Aldborough ward and it was successful in winning control of the council, but it is clear that the leaflet was designed to influence the result of the election.

When I raised this matter in the business statement last week, I was told by the Leader of the House that there “was no announcement”, and that the leaflet was just a restatement of existing policy. When I made a point of order earlier, I could not quite hear what the Secretary of State said, which was why I raised it again. I will have to read tomorrow exactly what he said, but I think that he said that the leaflet was a statement of existing policy. If so, why was a leaflet put out that said:

“KING GEORGE HOSPITAL IS NOT CLOSING”?

Under the existing policy, enunciated on the Government Front Bench in 2011, both the maternity and accident and emergency departments at King George hospital were to close in about two years’ time. Maternity services closed last year. The A and E closure was supposed to be by 2014, and then it slipped to 2015 because of the chaos, the deficit and the fact that the Barking, Havering and Redbridge University Hospitals NHS Trust, covering both Queen’s and King George hospitals, has been put in special measures, and we now have yet another chief executive to add to the litany of chief executives over recent years who were supposed to have solved the problem. It is a shame that the hon. Member for Monmouth (David T. C. Davies) is not in the Chamber, but perhaps he could come to Redbridge to appreciate what services are under a Conservative Government.

The reason the A and E department has not been closed is that it cannot cope with the existing pressures, and it would not be safe to close it. We have a growing population in north-east London, with very large numbers of young people and children, and a large migrant population. There are therefore enormous demands on services. We have relatively poor GP services—we still have single-handed GPs in some areas—so we cannot expect people to go to a GP. Many people are not registered or are temporary, and they therefore turn up at the hospital. These fundamental and deep-seated problems must be resolved before we can start to take away services. The people of Redbridge understand that, which is why there is a campaign to save our A and E at King George hospital.

I will continue to pursue this issue until I get to bottom of the complicity of someone in the Department in issuing the leaflets that were designed to mislead the public in the few days before the election. I assure the Minister that this will continue until I get the whole truth.

Barking, Havering and Redbridge NHS Hospitals Trust

Mike Gapes Excerpts

Thursday 9th January 2014 Commons Chamber

[Mike Gapes (Ilford South) (Lab/Co-op)]

Madam Deputy Speaker, I would like to ask you to convey my thanks to Mr Speaker for selecting this Adjournment debate today. On the last sitting day before Christmas, I asked for this debate because of what I considered to be the bad behaviour of the Secretary of State for Health. I was informed on 17 December that an announcement would be made the following day—embargoed until 2 pm—that would have profound implications for my constituents and the many other people in the London boroughs of Barking, Havering and Redbridge. That announcement, by the chief inspector of hospitals, Professor Sir Mike Richards, was that the Barking, Havering and Redbridge University Hospitals NHS Trust was to be put into special measures following inspections by the Care Quality Commission.

I attempted to raise the matter by intervening on the Secretary of State during a debate that took place following the announcement. I waited until after 2 o’clock so as not to break the embargo. I stood several times, but he did not accept my intervention. I therefore thought that the least I could do was to put in for an Adjournment debate on the subject, and I am grateful that it has now been chosen. I have also raised a point of order about this matter.

That was not the first time that I have found Ministers reluctant to engage with me directly on the question of the NHS trust that covers the King George hospital in my constituency as well as the Queen’s hospital in Romford. Nearly a year ago, on Thursday 7 February, I took part in a debate on accident and emergency provision in London. I asked the then Minister, the hon. Member for Broxtowe (Anna Soubry)—who has since been moved away from Health—to respond to my request to set aside the decision of the previous Secretary of State, the right hon. Member for South Cambridgeshire (Mr Lansley), in 2011. I also asked for the decision to plan for the closure of the accident and emergency department at King George hospital within two years of October 2011 to be reconsidered. The then Minister failed to respond or even to mention the King George or the Queen’s hospitals in her response to the debate.

I have tried on several occasions to get ministerial responses to my requests to reconsider that decision. It was clearly a strange decision, given that we are now in 2014 and that—for reasons I shall outline—the timetable and the absolute chaos of this failing NHS trust make it absolutely impossible to close the accident and emergency department at the hospital in my constituency. Sadly, in 2013, we lost our maternity services, which have been transferred to Queen’s hospital.

I asked the Secretary of State to reconsider this issue, but on 15 January 2013 he said:

“The decision has been taken”.

However, he also said that

“we have made it absolutely clear that we will not proceed with implementing it until there is sufficient capacity in the area, particularly at Queen’s hospital in Romford, to cope with any additional pressures caused by it, and that undertaking remains.”—[Official Report, 15 January 2013; Vol. 556, c. 734.]

I asked him again in May, and I got a similar answer. I was told that it

“will not be closed until it is clinically safe to do so.”—[Official Report, 21 May 2013; Vol. 563, c. 1064.]

What is the current situation? The Care Quality Commission published its report in December. That report does not just deal with accident and emergency; it also raises issues relating to other departments in both Queen’s hospital and King George hospital. On Queen’s hospital’s accident and emergency department, it states:

“The service is not responsive enough to people’s needs. People were waiting too long to be either discharged or admitted. The trust is not dealing with enough people within the national four-hour target. The initial care pathway for children does not meet their needs, and unnecessarily delays their initial assessment.

Queen’s Hospital has consistently failed to achieve the 95% NHS target for the number of attendees that were discharged, admitted or transferred within four hours of arrival. Between the 1 April 2013 and 8 September 2013, 9,359…out of 59,038 patients were not seen within four hours of arrival. The department struggles to meet the target at all times, however, Mondays and Sundays provide the greatest difficulties. The A&E at Queen’s…performs significantly worse than at King George Hospital. These delays mean that patients are more likely to have poor outcomes.”

So the report said that there was “significantly worse” performance at Queen’s hospital, yet the Government are still planning the closure of the A and E at King George hospital, even though they know that Queen’s hospital has been failing, is failing and will continue to fail unless massive investment is made there, and that the King George is the better performing of the two hospitals in the trust. My constituency has a very young population with a large number of children. Some 30% of the people who go to A and E at the two hospitals in my local trust are children, yet the children in my constituency will have to move, with their parents, to the Queen’s hospital to attend A and E, rather than be treated in the better performing of the two hospitals in this failing trust.

The CQC report is absolutely damning. It points out:

“The trust faces significant difficulties in recruiting medical staff for A&E, and has done since 2011.”

Of course, October 2011 was when the Government decided that King George hospital would be run down and that this trust would have only one hospital in around two years. I do not think that date is a coincidence. The reality is that there is a damaging impact on morale and on the future of the services in my borough and the neighbouring ones as a result of this decision.

The report also states:

“The College of Emergency Medicine recommends that, for the number of patients seen in the A&E at Queen’s Hospital, it should have 16 consultants to provide cover 16 hours a day, seven days a week.”

A separate part of the report reveals that about 10 consultants would be needed at King George hospital, yet:

“The trust has eight consultants in post out of an establishment of 21 to cover both A&E departments at Queen’s and King George Hospitals. The heavy reliance on locum staff is putting patients at risk of receiving suboptimal care. Joint work with other trusts has not achieved the desired results and additional work is underway, including recruiting staff from overseas.”

Will the Daily Mail, the Daily Express, the UK Independence party and Ministers please note that the suggestion is to recruit staff from overseas to deal with the crisis caused by a lack of consultants in NHS trusts in north-east London?

The report criticises the inadequate record-keeping. It talks about the need for significant management improvements. I do not have time in this short Adjournment debate to go into the great detail that is in the report, but I will say that there are hard-working and dedicated members of staff and good practice in some departments in the trust.

I must declare an interest. This week, I was an out-patient in the ear, nose and throat department at King George hospital. I was seen quickly and before my appointment time and I was dealt with in an efficient manner. I want to place it on the record that the morale of the staff in the two hospitals remains remarkably high, but they are to some extent lions led by donkeys. They are suffering from years, perhaps decades, of problems in the health service in north-east London. I have been an MP for 21 years and have seen a succession of chief executives and significant reorganisations, and yet the fundamental problem is that the trust has a deficit of £100 million, which is clearly one of the driving forces in the reorganisation, and, at the same time, it has a massive catchment area of between 700,000 and 800,000 people. It is one of the largest trusts in the country with a huge, diverse population, a lot of churn and movement of people, and, as a result, some inadequate GP and primary care services and problems at the A and E. The fundamental issues are not being solved by whatever reorganisation is happening.

Let me make a few more remarks before the Minister responds. The report says:

“There was widespread concern from staff that the trust has not fully supported the A&E”

when concerns were raised. One member of staff said:

“We never see any of the management over here and all the important meetings are held at Queen’s.”

The larger of the two hospitals, the hospital built for 90,000, now has 140,000 admissions in a year. The report went on to say:

“The staff also felt that they were not kept up to date on the planned closure of the A&E at King George Hospital by senior management in the trust. One nurse told us, ‘There is a lot of unrest about the closure; we feel they are doing it by the back door. It makes it more difficult to recruit and keep staff.’”

The problems we face at the King George and Queen’s hospitals cannot be resolved even by a change of management. I understand that the current chief executive has indicated that she will be leaving in a couple of months. Having been involved in the reorganisation and running down of Chase Farm, she has now done her job at King George hospital and will no doubt be moving on to some other unfortunate trust. I also understand, although it is not yet quantified, that there will be some form of special new management structure and things associated with special measures. Perhaps the Minister can clarify what special measures mean as regards the day-to-day running of the organisation.

Will there be additional financial support? Will there be additional resources? The Barking, Havering and Redbridge clinical strategy document—I have the presentation for stakeholders, patients and the public in my hand, as well as the document itself—contains interesting phrases. For example, it says that areas of King George hospital will be “liberated” for use by other services and facilities. I thought when I read that that it was some sort of Maoist cult trying to have a people’s liberation army of consultants and NHS bureaucrats coming in to seize the stable base areas in the centre of my constituency. The NHS bureaucracy’s jargon sometimes amazes me. What is being talked about is running down services in Ilford and transferring facilities out of other buildings in the borough or elsewhere that will then be sold off, presumably for use as housing to add to the population demanding services from the trust while the total number of beds is run down drastically from 1,250 to about 800 to 900.

King George hospital serves a population that includes some of the poorest people in north-east London. I worry about the long-term implications. We were told—this has been repeated in various trust documents—that the original plan was to wait for about two years, until new facilities had been established at Queen’s hospital, for the A and E at King George to be run down. That has obviously slipped, as we are now two and a half years on. I was told informally a few months ago that they were talking about the end of 2014 to the early part of 2015, yet the clinical strategy reveals that the new facilities at Queen’s hospital will not be ready until the middle or the autumn of 2015. One document says that the plan is to:

“Move all emergency medicine and surgery to Queen’s Hospital by mid 2015”,

whereas another says that that will be done by early 2016.

The whole process is still uncertain. Given the uncertainties, the problems, the management issues that have arisen and the poor morale of the staff, there should be a moratorium with a review. My ideal solution would be to go back to having a trust that would run the hospital in Ilford—the better performing of the two A and Es—and keep an accident and emergency department in Redbridge, as we have had since 1931. That would mean that the people of my borough, which at that time had a population of 85,000, would today, with a population approaching 300,000, have a hospital to serve them when they need it to meet their emergency needs.

I hope that the Government will seriously reconsider the situation, given the unprecedented action of the CQC—this is the first time an NHS trust has been put into special measures in this way—recognise the serious problems and recognise the dysfunctional nature of the Barking, Havering and Redbridge trust.

Accident and Emergency

Mike Gapes Excerpts

Wednesday 18th December 2013 Commons Chamber

[David Wright]

rose—

[Mike Gapes (Ilford South) (Lab/Co-op)]

rose—

[Mr Hunt]

I am going to make some progress.

--- Later in debate ---

[Mr Hunt]

My hon. Friend raises an important point. Again, we would not hear this from the Opposition spokesman, but ambulance services across the country are making great strides. For example, in the past year there has been a 10% increase in the number of patients that ambulance services do not take to A and Es, and an 8% increase in the number of patients that ambulance services and paramedics are able to treat and discharge on the spot. Those kinds of things can make a huge difference.

[Mike Gapes]

rose—

[Mr Hunt]

I am going to make some progress.

I want to move on to what we have been doing. As I said, every Health Secretary deals with difficult winters in the NHS. However, this year is different because we have taken unprecedented steps to relieve the pressure in the short and the long term. For this winter, we have distributed more financial help—£400 million in total—than ever before. So far, that money has paid for 2,900 additional staff, 1,100 more hospital beds, and 1,200 more community beds. It has also paid for additional support for ambulance services and 111 centres. We distributed that money earlier than ever before. [Interruption.] The hon. Member for Copeland (Mr Reed) says that we should not have cut the money in the first place. We did not—we protected and increased the NHS budget, which the shadow Health Secretary still wants to cut, as he reaffirmed today and on Monday. We distributed the money in August, earlier than ever before. We extended the winter flu campaign to two and three-year-olds. Patients who require emergency treatment this winter can be assured that they are getting high-quality and speedy care despite the pressure that we all recognise A and E departments are under.

We have gone further. This year, we have started to tackle the root causes of the long-term pressures in A and E, which are the result of the ageing population, yes, but also, sadly, the disastrous mistakes made by the previous Government, including the 2004 GP contract changes and the 48-hour GP appointment target that did not work.

--- Later in debate ---

[Mike Gapes]

rose—

[Barbara Keeley (Worsley and Eccles South) (Lab)]

rose—

--- Later in debate ---

[Mr Hunt]

My hon. Friend is absolutely right. This year we have extended flu jabs to two and three-year-olds because we think that prevention is better than cure.

We have been looking at other causes of the long-term pressure on A and E, such as Labour’s 2004 GP contract. The right hon. Gentleman spent the past year telling this House that that contract, which scrapped named GPs, has nothing to do with the problems in A and E. This is despite what nearly every A and E department in the country is talking about—namely, the pressure being caused by poor primary care alternatives, particularly for the frail elderly. What did he tell Sarah Montague on the “Today” programme when we reversed that GP contract and brought back named GPs for the over-75s? He conceded to her, as he never has in this House, that our changes which reversed that contract would help A and E, so he is finally accepting on the radio what he does not accept in this House and what A and E staff have been saying for months—that having someone in the community responsible for frail elderly will help.

[Mike Gapes]

rose—

[Clive Efford (Eltham) (Lab)]

rose—

[Mr Hunt]

I am going to make some progress.

Our plans go much further than simply reversing the 2004 contract. GPs will offer the most vulnerable guaranteed same-day telephone consultations, which never happened under Labour. There will be a dedicated telephone line so that A and E doctors, ambulance paramedics and others can get advice from GPs about treatment in urgent situations. GPs will co-ordinate care for elderly patients discharged from A and E to try to ensure they get proper wrap-around care to minimise the chance of needing to go back.

We have done something else that the right hon. Member for Leigh never did to tackle long-term pressure on A and E. One of the biggest problems has been not being able to discharge people from hospital because of poor links between the health and social care systems. Through our £3.8 billion better care fund, this Government are doing something that Labour talked about a lot but never actually delivered: we are merging the health and social care systems. Gone will be people being pushed from pillar to post, because in order to access this fund, clinical commissioning groups and local authorities will have to commit to joint commissioning and joint provision.

Finally, we have looked at the long-term structure of A and E. The previous Government were battered by a succession of failed reconfigurations. We, too, have had challenges over decisions, such as those with regard to Lewisham. Sir Bruce Keogh’s recent review of urgent and emergency care has changed the terms of this debate by setting out a 21st-centruy vision of emergency care. Sir Bruce rightly said there should be more extensive services outside hospital, and this, too, will help to reduce A and E queues. He rightly said that while the number of A and Es is not expected to change, the services offered by all of them should not be identical if we are to maximise the number of lives saved. Our duty to patients is to make that a reality and we will not hesitate to drive that vision forward.

A and E and the ambulance services are performing well under unprecedented pressure. I cannot speak highly enough of the hard-working staff who are working around the clock to deliver vital services. They share our overriding commitment to putting patients first this winter. Unlike Labour Members, we do not seek to turn a tough winter into a political football. If they want to make the comparison between our record and theirs, we are happy to do so: more people being seen within four hours, shorter waiting times, and long-term problems being tackled—not posturing from the Opposition, but action from the Government, and a commitment to do what it takes to support hard-working front-line staff over Christmas. We should get behind them and not undermine their efforts.

[Mike Gapes]

On a point of order, Madam Deputy Speaker. This information was embargoed until two o’clock today, but following an investigation the Care Quality Commission has put King George hospital Ilford and Queen’s hospital Romford into special measures. I tried several times to intervene on the Secretary of State in order to raise the matter, but he refused to take an intervention from me. I therefore seek your advice: how can I draw attention to the matter and the fact that the previous Secretary of State said that King George’s A and E department would close within two years? That is clearly not happening. There is chaos in my local A and Es, yet the Secretary of State did not let me intervene.

[Madam Deputy Speaker (Dawn Primarolo)]

Mr Gapes, in terms of getting your argument on the record, you have just done so, although it was not a point of order, as I think you know. As you are fully aware, it is up to the Secretary of State, or any Member of this House, whether they give way to another Member or not. I am sure you will find ways to pursue this matter over the minutes, hours, days and months ahead.

I inform Members that there is a five-minute time limit on all Back-Bench contributions in order to ensure that as many Members as possible can participate in the debate.

A and E Departments

Mike Gapes Excerpts

Tuesday 21st May 2013 Commons Chamber

[Mr Hunt]

Because, I am afraid, the Labour party is completely failing to take responsibility for some catastrophically bad decisions that it made when it was in power. Labour Members might want to talk not only to people such as the King’s Fund, but to their own constituents, who say that traditional family doctoring is something they would like to see return.

[Mike Gapes (Ilford South) (Lab/Co-op)]

How does the decision to close the A and E unit at King George hospital in Ilford, which was taken by the Secretary of State’s predecessor, who is sitting next to him, and confirmed by him recently, help to take the pressure off Queen’s hospital in Romford?

[Mr Hunt]

As the hon. Gentleman knows, the decision has been taken, but the A and E department has not been closed and will not be closed until it is clinically safe to do so.

Accident and Emergency Departments

Mike Gapes Excerpts

Thursday 7th February 2013 Commons Chamber

[Mike Gapes (Ilford South) (Lab/Co-op)]

It is a pleasure to follow the hon. Member for Enfield North (Nick de Bois). He and I have something in common. He said that he had been let down by the Secretary of State after 2010. Sadly, I have to say that my constituents and I, and my neighbour, the hon. Member for Ilford North (Mr Scott)—unfortunately, he cannot be here today, but he asked me to mention the fact that he has been in Committee—also felt let down because of a decision that was taken. Eight Members of Parliament from north-east London campaigned together on a cross-party basis to save the A and E at King George hospital, yet in 2011 the Government announced that, after the previous decision, they were going to go ahead with a recommendation to close the A and E and the maternity unit at King George hospital in Ilford. There will be no more births there at the end of March. We will no longer have children born in Ilford, unless they are born in the back of taxis or cars that are trying to get through traffic jams to take them to Queen’s hospital Romford. However, I want to concentrate on the A and E.

This afternoon, a risk summit is being held between Barking, Havering and Redbridge University Hospitals NHS Trust and the commissioners to consider the implications of the absolutely damning Care Quality Commission inspection, one of a series of inspections of Queen’s hospital, which was published on 30 January, which is last Wednesday. Among other things, the report stated:

“The accident and emergency department…has not met most of the national quality indicators as a result of extensive delays in the care of patients. Five percent of patients who need to be admitted to the hospital are waiting for more than 11 hours in the department. The Trust should be aiming to transfer 95% of patients who are being admitted to wards within four hours of their arrival.”

Many patients are waiting much longer than four hours, and 5% are waiting for more than 11 hours. That was from an inspection in December. The report also says that there is

“poor care for patients in the ‘Majors’ area”

and that the

“environment is unsuitable for patients to be nursed in for long periods of time,”

because of a

“lack of privacy/dignity, no washing facilities, no storage space for personal belongings and no bedside tables.”

I could go on—there are complaints about other A and E services and facilities at Queen’s hospital.

Queen’s is a new, PFI-built hospital that was designed for 90,000 admissions. Last year it had 132,000, as my right hon. Friend the Member for Barking (Margaret Hodge) mentioned in an intervention. It is in a joint trust with the King George hospital in Ilford, which has fewer admissions, but there was a proposal—the then Secretary of State and his Health Minister said this was the intention—to close the A and E at King George hospital in about two years from October 2011. Patients would then have had to go to the A and E at the already over-pressed and stressed Queen’s hospital. Frankly, that policy was always insane and foolish. We fought against the first such proposals in 2006—the misnamed “Fit for the Future” proposals—right the way through, in cross-party unity with neighbouring MPs, under the last Government. We managed to get implementation halted for reconsideration and review, but sadly this Government have given the go-ahead to closure of the King George A and E unit.

[Nick de Bois]

I hope the hon. Gentleman will benefit from the time he gains by giving way to me. He is right about the documents—as he will recall, we had “Healthy hospitals”, which was the last thing being sought. Let me remind him that we have another thing in common: the merry-go-round of chief executives, from my former chief executive to his hospital’s chief executive. It worries me that the administrators are in control, not the people or the politicians.

[Mike Gapes]

I do not personally blame Averil Dongworth, the new chief executive at Barking, Havering and Redbridge University Hospitals NHS Trust, for the current situation. She has not been there long enough. There are a number of predecessors who were party to the proposal. I also blame Ruth Carnall and the people in NHS London who were behind the original proposals. They and Heather Mullin, along with others in the NHS in London, have been determined for six or seven years to close the A and E unit at King George regardless of the petitions, the protests or the fact that the public overwhelmingly rejected their proposal, even in their rigged consultation.

[Jim Dowd]

On the malign influence of NHS London, let me tell my hon. Friend that its policy director—one Hannah Farrar—was appointed as number two and chief assistant to the special administrator of South London Healthcare NHS Trust, precisely to achieve what had always been wanted: the closures at Lewisham.

--- Later in debate ---

[Mike Gapes]

Where are we now? Last year saw a 22% increase from 2011, with 26,859 additional attendances in the A and E unit at Queen’s hospital. In addition, there were 73 patients a day more than in the previous year, with 23 days on which there were more than 470 compared with only three days in the previous year. The pressure on Queen’s hospital today is getting bigger and bigger, yet the plan is still to close the A and E unit at King George hospital. Where are all the patients supposed to go? Presumably not to Queen’s hospital, because it cannot cope. What is already happening? Although the figures are not being made public, I am told that on a number of occasions over recent weeks, in December and January, ambulances have been diverted to other hospitals from Queen’s hospital, including Whipps Cross hospital, which is part of the Barts Health NHS Trust—and it has its own problems. We are facing a real crisis.

I also understand that performance at Queen’s hospital has fallen off drastically. Only 65% of patients have been seen within four hours since the end of last year. The figure at King George hospital was much better, yet it is King George—the better-performing hospital in this trust—that is supposed to be run down. I spoke to the Care Quality Commission this afternoon, which is now proposing a potential cap on the numbers of patients in the “majors” area at Queen’s, because of the problems and lack of safety that will arise.

This is not just a question of resources. It is also, of course, a question of management, but ultimately it is not possible to get a gallon into a quart pot, which is what we face in north-east London. The trust’s board meeting on 9 January looked at these issues in detail. It has already got McKinsey in and it already has the so-called reset programme running. It also says that it has been making improvements for the past few months. Well, it made big improvements on maternity, but it has failed on A and E.

There is a real problem as long as the proposal to close A and E at King George is on the agenda. There is a problem of morale, motivation and, potentially, recruitment. The CQC report is absolutely damning about the shortage of consultants, the reliance on temporary locum staff and many other issues that are part of a fundamental problem in the trust’s culture that has been going on for a long time.

It is not very easy for my constituents to go to other hospitals. If the problems at Queen’s continue, it would be insane to go ahead with the proposals to close King George’s A and E. Last month I asked the new Secretary of State to reverse his predecessor’s decision; unfortunately he refused, but please will the Minister give me that commitment today?

[Several hon. Members]

rose—

Oral Answers to Questions

Mike Gapes Excerpts

Tuesday 15th January 2013 Commons Chamber

[Mr Hunt]

My hon. Friend makes a very important point, putting his finger on a key issue: the 24-hour availability of GP services. That is going to be crucial as the NHS goes forward. The NHS medical director, Bruce Keogh, is looking at the whole issue of seven-day working in the NHS and will certainly be examining what flexibility needs to be given to local areas to make that possible.

[Mike Gapes (Ilford South) (Lab/Co-op)]

T4. On 30 December, ambulances in north-east London were diverted from the Whipps Cross, Queen’s and Homerton hospitals, with only the accident and emergency units at the Royal London hospital and the King George hospital in Ilford being open. Last week, on 8 January, Queen’s hospital in Romford was again diverting ambulances. Will the new Secretary of State look at the decision of his predecessor, whom I see on the Bench near him, and cancel the insane decision to close the accident and emergency unit at King George hospital?

[Mr Hunt]

The decision has been taken, but we have made it absolutely clear that we will not proceed with implementing it until there is sufficient capacity in the area, particularly at Queen’s hospital in Romford, to cope with any additional pressures caused by it, and that undertaking remains.

Oral Answers to Questions

Mike Gapes Excerpts

Tuesday 10th January 2012 Commons Chamber

[Mr Lansley]

Yes. My hon. Friend makes an important point, and it is something the NHS must focus on. There are considerable opportunities through new technologies substantially to reduce the extent of missed appointments, including through things such as text messaging. What is frustrating is that, sometimes, appointments are missed because patients have not been adequately contacted by hospitals. As for people who abuse the NHS, I hope we will give them no excuses for not meeting their obligation to attend appointments.

[Mike Gapes (Ilford South) (Lab/Co-op)]

Can the Secretary of State intervene with those involved with the health for outer north-east London programme to get them to allow the Barking, Havering and Redbridge University Hospitals NHS Trust to use the births and maternity capacity at King George hospital to take pressure off Queen’s?

[Mr Lansley]

As the hon. Gentleman knows, following the independent reconfiguration panel report, which I accepted in full, the Barking, Havering and Redbridge Trust is looking to manage safely its maternity services, while improving the quality at Queen’s. It is doing that in close co-operation with NHS London and, indeed, with the advice of the Care Quality Commission, following the commission’s inspections. I will continue to be closely involved in that, and we will continue to support the Barking, Havering and Redbridge Trust in improving services for the hon. Gentleman’s constituents and others.