Oral Answers to Questions

Siobhain McDonagh Excerpts

Tuesday 29th October 2019 Commons Chamber

[Mr Speaker]

Not just a champion but doughty!

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

This plan could see two A&Es reduced to one and two maternity units reduced to one. Have the Government taken into account the need for extra capital funding for both St George’s and Croydon university trust should St Helier place this new hospital on the Sutton Hospital site?

[Edward Argar]

The hon. Lady will know that the plans that will be brought forward will be clinically led and delivered and constructed by the trust itself, so I would encourage her to engage with the trust and with neighbouring trusts, but surely she would welcome this significant investment by the Government in her health infrastructure.

Health Infrastructure Plan

Siobhain McDonagh Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

As he said, my hon. Friend showed some dexterity in asking that question, but I am happy to reassure him. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is looking at this matter, and I am sure that she will be happy to discuss it with him further.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I would always welcome more money for our NHS, but as always the devil is in the detail. The “Shaping a healthier future” programme proposed the closure of four A&Es in north-west London, at a cost of £76 million, but just six months ago the Health Secretary stood at that Dispatch Box to declare the scheme scrapped. The author of that scheme, Daniel Elkeles, is now the chief executive at St Helier, where he is plotting to use these latest funds to reduce two A&Es to one—away from those most in need—which would place intolerable pressure on nearby St George’s. Does the Minister not see a pattern here?

[Edward Argar]

I always think it a little unfair in this House to name or attack individuals where they do not have the ability to answer back. The Government have made it clear that the announcement today and yesterday is about putting more money into our NHS, which will improve services for the hon. Lady’s constituents and for those across the capital and indeed the country.

Acquired Brain Injury

Siobhain McDonagh Excerpts

Thursday 9th May 2019 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I praise the remarkable work of the APPG on acquired brain injury for its dedication to this issue and for securing this particularly important debate. Research from Headway, the brain injury association, shows that every 90 seconds someone in the UK is admitted to hospital with an acquired brain injury-related diagnosis. That is approximately 350,000 people a year. If this debate lasts for an hour and a half, another 60 people will have been struck by brain injury while we are in the Chamber. The majority of those people will need at least some form of short-term support or long-term rehabilitation to help them rebuild their lives, re-learn lost skills and regain a degree of independence.

Excellent work is done in the charity sector to support people with acquired brain injury. I am sure that many colleagues across the House will want to join me in congratulating Headway on reaching its 40th anniversary this year. I am proud to say that the charity is based in my constituency and led by my friend and colleague, Peter McCabe, as chief executive. For four decades, it has been supporting brain injury survivors and their families and carers, to ensure that lives saved by significant advances in neurosurgery are lives worth living.

When a brain injury strikes, it is usually without warning. Put simply, it can happen to anyone, at any time. The support provided by Headway starts from the moment brain injury strikes and continues for as long as it is needed. With the introduction of major trauma centres, the chances are that a patient with a significant brain injury will be quickly transferred to a unit that is better equipped to provide specialist emergency care. That can be many miles from the family home. I am sure we can all agree that, if a loved one were involved in an accident or suddenly became seriously ill, we would want to be at their bedside, but for some people—particularly in low-income families—that can be a challenge if the patient is transferred to a unit many miles away.

That is why I would like to raise the importance of the Headway emergency fund, which provides grants to families to ensure that they can be by the bedside of a loved one in a coma. To date, the charity has distributed more than £369,294 to 1,783 families across the UK. In addition, families can receive emotional and practical support to help them to cope with the overwhelming situation and to make sense of what is happening. They can also rely on the charity’s nurse-led helpline, which has seen an increase in demand of 131% over the last 10 years.

Given that there will be many people watching the debate who are working on this issue, I would like to raise the Headway brain injury identity card, which is endorsed by numerous agencies in the criminal justice system, including the Police Federation and the National Police Chiefs’ Council. The House has previously discussed the high prevalence of brain injury among the offender population. This new initiative from Headway is helping the police to identify brain injury survivors at the earliest opportunity, to ensure that they receive appropriate support.

We should all be proud of our national health service, particularly when it comes to emergency and acute care, but a life worth saving has to be a life worth living. Many of my hon. Friends here today will be aware of the excellent work being done by Headway groups and branches in their constituencies. Whether through rehabilitative therapies to improve speech and language skills or facilitate a return to work or education, or social interaction to prevent isolation, the work being done in our local communities by these groups and branches can be a lifeline to families affected by brain injury, helping people to rebuild their lives and become less dependent on costly state support.

[Dr Julian Lewis (New Forest East) (Con)]

May I add briefly to that catalogue of virtues the fact that Headway has been reaching out to parliamentarians like ourselves? The reason I am here for this debate is that Jo Hillier of Southampton Headway got in touch with me and asked me to be here. That is why I am learning so much more about this condition than I would otherwise have had the possibility of knowing.

[Siobhain McDonagh]

That is my experience as well. Had Peter McCabe not called me, I might not be here, and I would know so much less about the volume of people who experience brain injury and the sort of problems they and their families and carers have.

We are very grateful for Headway’s intervention. However, Headway cannot do this alone. Local charities are under incredible pressure. Funding cuts are causing harm to the lives of some of society’s most vulnerable people, who are being cut out of society due to a lack of access to vital support services. For many people, Headway provides a route back to independent living, further education or employment. The reality is that, aside from Headway, most people—particularly those who cannot afford private healthcare—will receive insufficient support or rehabilitation after leaving hospital. Unless action is taken to enable people to access the vital support needed to ensure that these services survive, more and more people will be cut out of society and taxpayers will be left footing the bill for the longer-term care of those without the means to care for themselves. Considering that another four people will have been struck by brain injury during my speech, there simply is no time to delay.

St Helier and St George’s Hospitals

Siobhain McDonagh Excerpts

Tuesday 19th February 2019 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Let me start by putting on the record my respect and admiration for every single doctor, nurse, clinician and staff member at both St Helier and St George’s hospitals for their outstanding service and dedication to the health and welfare of my constituents. These remarkable individuals go above and beyond, despite facing extraordinarily testing circumstances—nine years of austerity have left our treasured NHS desperately short of staff, services and supplies.

For my constituents, however, the biggest threat to our local hospitals is far closer to home. It is in the wild west of south-west London’s NHS, which is once again pursuing desperate attempts to close all acute services, including the major A&E unit and the consultant-led maternity units at St Helier hospital. The impact that that would have on St George’s hospital, would, I believe, be devastating.

This evening I want to outline the reality behind the latest threat to St Helier, branded “Improving Healthcare Together 2020-2030”. I want to challenge every foundation on which that programme has been built, and I want to appeal to the Minister to step in before we see the decomposition of health services that are vital to my constituents. However, I want to start with some history.

For nearly two decades, the NHS in south-west London has pursued several irresponsible attempts to close the acute health services at St Helier hospital, on the border of my constituency, and move them to leafy, wealthy Belmont in Sutton. Under different titles and brands, and in the guise of countless NHS-funded marketing consultants, the proposal is on repeat, and an estimated £50 million has been wasted on almost identical consultations and programmes. Each one starts afresh, portraying to the public a neutral outlook when it is being decided where acute health services should be placed in south-west London.

The Minister may remember that, back in 2015, secret proposals to close St Helier and build a new super-hospital in Sutton were overheard by a BBC reporter on a train, which brought those plans to an embarrassing end. Fast-forward to 2017 and the programme was repeated, this time entitled “Epsom and St Helier 2020-2030”, and once again professing to assess the pros and cons of where to base acute health services. The public support expressed by chief executive Daniel Elkeles, the man running the programme, for moving the services to Sutton somewhat clouded the neutrality of the process.

[Paul Scully (Sutton and Cheam) (Con)]

Does the hon. Lady not agree that the proposal that immediately preceded this was to close facilities at St Helier and move them to St George’s in Tooting, which was universally unpopular? The proposal that is now on the table, on which I certainly hope there will be a public consultation, refers to one of three sites, and includes a reference to locating a new facility at St Helier hospital.

[Siobhain McDonagh]

My recollection of that particular consultation was that that was really the scorched earth strategy of deciding that St Helier and Epsom were going to close and St George’s would take the strain. I thank God that that never happened, because we could be in an extraordinarily difficult position had it ever happened.

I might sound cynical when I talk about the NHS and its bias against my constituency and against services being at St Helier Hospital, but I have been here several times before. A freedom of information request revealed that those running the programme only distributed consultation documents to targeted areas around their preferred site and to just a handful of roads in my constituency. But my constituents care passionately about their local health services and will not be ignored, and 6,000 local residents responded to the programme by calling for St Helier to retain all its services on its current site.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Lady for giving way. I sought her permission to intervene beforehand because I am always very interested in health issues, and I am here to support her as well. Centralising the health service means that the ill and the vulnerable and pregnant women are expected to travel for miles to get medical assistance. That is totally absurd. Surely the health of the patient must always be put first and foremost.

[Siobhain McDonagh]

I agree with the hon. Gentleman, but it is about not just distance travelled but who is travelling that distance: do they have access to a car, or do they have public transport? The NHS constitution requires that equalities legislation is taken into account, particularly looking at disadvantaged people who are in poor health and how they access services, because they access services differently.

As I said, my constituents care passionately about local health services, and when they responded to the consultation 6,000 of them sent in cards explaining how they felt and saying that they wanted St Helier to retain all its services on its current site. Can you imagine the anger when I found out that their responses had been discounted by the programme? Why? Because they were not on the official documentation—the same documentation that had been disseminated in those targeted letterboxes far away from my constituency.

To the public, the trust portrayed a neutral stance whereby a suitable site across south-west London would be selected for their acute services. To the stakeholders in Belmont, it confessed its desire to move the services to their wealthy area, and to mine, it pretended that the consultation would genuinely seek the views of the public. But as my mum always says, much gets more. I would like to put on record that while I fundamentally disagree with the desire to take services away from my constituents, I do recognise Mr Elkeles’ hard work and dedication in leading St Helier Hospital.

We now fast-forward to the present day and the latest brand, “Improving Healthcare Together 2020-2030”, a programme built upon the unstable and unscrupulous foundation of its predecessors and that once again considers the pros and cons of moving St Helier Hospital’s acute services 7 miles west to Epsom or south to leafy Belmont in Sutton. The programme was launched last summer—they always choose the summer—undertaking an initial public engagement that is expected to transition to a public consultation this coming summer. But just 837 people responded to the public engagement, and that is including hundreds of NHS staff and 169 comments on Twitter or Facebook. That is an utterly abysmal response considering the £2.2 million of taxpayers’ money squandered on the programme already. Does the Minister agree that this is a complete misuse of taxpayer funds at a time when our NHS is under such overwhelming pressure?

This is about more than just the future of St Helier Hospital. My constituents tell me that if St Helier Hospital were to lose its acute services, they would turn not to Epsom or Sutton but east to Croydon University Hospital or north to St George’s. That is a completely terrifying prospect. Before Christmas, my constituent, Marian, was left queueing outside St George’s Hospital with her left leg badly infected, because the A&E was full. And that was the calm before the storm, with St George’s A&E facing its busiest ever week just a fortnight ago. We all remember the winter crisis last year, but the first full week of February this year was 16% higher than last year’s equivalent, with a simply staggering 600-plus visits every single day. This is a hospital that already relies on St Helier as its safety valve. The maternity unit at St George’s had to close temporarily in 2014 and 2015, directing women who were already in labour to St Helier Hospital.

That is why a letter sent in November from the chair of the St George’s trust to those running the programme is completely astonishing. In the letter, the chair expresses her concern that

“there is no formal requirement to take account of the impact on other providers”

when deciding where to relocate acute health services across south-west London. It is hard to put into words just how dangerous that disregard is. I should like to pause briefly to thank the chief executive of St George’s Hospital, Jacqueline Totterdell, for her hard work and tenacity in steering one of London’s largest hospitals at a time of such difficulty.

St George’s is a hospital already under immense pressure. The plumbing, ventilation and drainage facilities are at breaking point, leading to a bid for £34 million of emergency capital from the Treasury. Does the Minister agree that a recent outflow of sewage in the hospital A&E is a clear sign that such emergency funding is justified and, more importantly, urgent? How busy does she think the same A&E would be if the local NHS were to get its way and move St Helier’s major A&E to wealthy, leafy Belmont? Will she step in today and require any proposal to reconfigure health services to wholeheartedly take into account the impact that such a decision would have on all other nearby health providers?

Merton Council recognises the devastating impact that these proposals could have, and I would like to put on record my thanks to leader of Merton Council, Stephen Alambritis, the cabinet member for social care, Councillor Tobin Byers, and the director of community and housing, Ms Hannah Doody, for their unflinching support. It is so disappointing that those at Sutton Council can stand so idly by.

By law, when deciding where acute services should be based across a catchment area of this size, it is fundamental that the level of deprivation and local health needs are accurately understood and thoroughly assessed. So I read from cover to cover the deprivation and equality analysis produced by a range of external consultancy services as part of their £1.5 million programme fee. At a time when the NHS is so strapped for cash, it is extraordinary that my local NHS seems to have carte blanche to employ so many consultants on such extraordinary rates. But even I was absolutely astounded by the monumental gaps in the analysis that these consultants have delivered.

In the pieces of analysis on deprivation and equality, areas that rely on St Helier Hospital are either absent from the documents or actively described as falling outside the catchment area. Take Pollards Hill in my constituency, an area that would be considered deprived in comparison with much of Sutton or Epsom. Wide Way Medical Centre is the largest GP surgery there, and it directs 34% of its patients to St Helier Hospital, but Pollards Hill is deemed to be outside St Helier’s catchment area. Why does this matter? Because if areas that rely on St Helier Hospital are not even considered in the analysis, how can the potential impact of moving acute services from the hospital be adequately assessed? Pollard’s Hill is not alone. The report does not mention Lavender Fields despite almost a fifth of Colliers Wood surgery patients and Mitcham family practice patients being directed or referred to St Helier from the ward.

I urgently brought the gaps in the analysis to the attention of those operating the programme and Jane Cummings, the NHS’s chief nursing officer. I was pleased that everyone agreed that such significant analysis shortfalls would be addressed and rectified.

[Paul Scully]

The hon. Lady is being generous in giving way. Does she agree that Colliers Wood is pretty much smack-bang next to St George’s and that the proposal on which last year’s public engagement was based was that 85% of current patients would still be treated in their current hospital, whether St Helier, the proposed Sutton site or Epsom?

[Siobhain McDonagh]

There is no reason why the hon. Gentleman should know this, so I am not trying to be tricky, but Colliers Wood surgery is the title of a split-site GP surgery. One site is on Lavender Avenue off Western Road—the hon. Gentleman probably knows Western Road from driving up and down it a lot—in the heart of one of the most deprived areas in my constituency, and many people there go to St Helier hospital. The idea that we could remove an A&E and a maternity unit and keep what is left is complete nonsense, because all the blood and testing facilities and all the talented doctors and nurses simply would not stay there. Chase Farm Hospital, which is in the constituency of my right hon. Friend the Member for Enfield North (Joan Ryan), is a wonderful example of such a situation, and Members may want to have a look at it.

I pointed out that areas in my constituency and large surgeries had not been included in the analysis, and I was promised that they would be. However, months have passed, and the process has proceeded unscathed, with no indication of when such significant gaps will be remedied.

The icing on the cake came in December when three behind-closed-doors workshops based on the deficient evidence were run by the programme. They were designed

“to inform the Governing Bodies decision making process about how the community and professionals ranked each of the three potential sites for acute hospital services”.

Let me be clear: hand-picked professionals and members of the public used incomplete evidence to rank Sutton as the preferred site for acute services. The Minister will not be surprised to hear that more participants in the workshops were from Sutton than from Merton or Epsom. How can a fair, balanced and rounded opinion be accrued from workshops based on flawed evidence and disputable criteria and with an unrepresentative group of people? For the findings to be used in any capacity in the decision-making process would be completely unacceptable.

Of course, I understand that figures and analysis can always be skewed in one direction or another. Someone wanting to disguise the 76.5-year life expectancy of men in Mitcham West in my constituency could include the 84.4-year average in Wimbledon Park and classify the figures by the borough of Merton as a whole. They could count cancer rates, stroke rates, mortality rates by borough rather than by ward or lower super output area. They could ignore deprived parts of the catchment area and proceed full steam ahead with the programme.

When will the gaps in the analysis be completed? When will taxpayers’ money stop being splurged on flawed and biased consultations? When will the madness end? Here is the reality: there are over twice as many people with bad or very bad health within a mile of St Helier than there are living within a mile of the Sutton site, and almost four times the number within a mile of Epsom. Around St Helier, the local population is significantly larger, with considerably more dependent children and more elderly people. Furthermore, the population local to St Helier is far more reliant on public transport, with residents statistically less likely to have access to a car.

Despite all that, when I secured—I can hardly believe it myself—£267 million from the Department of Health and the Treasury under both the Labour Government and the coalition Government to rebuild St Helier Hospital, guess what happened? The local NHS sent the money back. Can the Minister confirm whether the hospital will again receive its funding this time round?

It is time for some accountability and for the Government to step in before even more money is wasted and the future of both St Helier and St George’s is thrown into jeopardy. Leave these vital services where they are most needed: at St Helier Hospital, on its current site.

--- Later in debate ---

[Caroline Dinenage]

My hon. Friend makes an excellent point, and that is why it is important that no significant changes are made without consultation so that local people’s views can be taken into consideration. The CCGs will need to consult the public fully before making any decisions about a new hospital or changes to the configuration of acute services, but clearly any form of investment is welcome.

[Siobhain McDonagh]

Lists of NHS capital programmes in London have appeared in various newspapers, with Imperial College Healthcare NHS Trust at the top of those lists—Charing Cross and other hospitals are in that group. St George’s is desperate. Sewage came through the sinks and toilets in its A&E only a few weeks ago. It is not sure whether the electrics are going down, or whether the plumbing, the water and the water systems have caused considerable health problems to patients. Who is getting the money? Is it all going to south London? It would certainly all have to go to south London if there were to be a brand-new hospital anywhere.

[Caroline Dinenage]

The hon. Lady asks an excellent question. The CCGs are working closely with NHS England and NHS Improvement to develop the programme’s capital scheme prior to the next spending review, with a view to NHS England and NHS Improvement presenting the scheme for funding. They expect the public consultation on their proposals not to take place until after the next round of capital bids is concluded, which is likely to be after the autumn. There is a duty to carry out a travel times analysis when developing proposals, and this will be included in the consultation. CCGs also have duties to reduce inequalities. She spoke a lot about the inequalities in her area, and an impact analysis of that has to be done.

I understand that the hon. Lady is also concerned that any potential changes could increase pressure on St George’s hospital, and she is absolutely right to raise that important point. The Department is clear that NHS England and local NHS organisations must think about potential impacts on other services, which is why we are developing a more strongly regional approach in designing NHS services. CCGs must consider the impact on neighbouring hospitals close to the CCG boundary, such as St George’s. Changes to A&E services at any one hospital potentially have an impact on a number of surrounding hospitals, so the three CCGs have to engage with their neighbours throughout this process. In addition, the neighbouring CCG can respond to any public consultation and its response must be taken into account.

On the next steps, the hon. Lady will be aware that the reconfiguration of services is a matter for NHS England and local NHS bodies. Such matters have to be addressed at local level rather than in Whitehall because local organisations understand the needs of their community. No changes to the services people receive can be made without formal public consultation. They must have support from GP commissioners, demonstrate strengthened public and patient engagement, and have a clear clinical evidence base. They must also be consistent with the principle of patient choice. The NHS England test on the future of use of beds requires assurance that the proposed reduction is sustainable in the longer term. The Department is very clear that throughout the service change process local NHS organisations have to engage with the wider public and with the local MP on these issues, so I am sure that she and her constituents will take part in any local engagement as plans move forward.

The challenges facing the health economy in south-west London have been widely understood for a number of years. I recognise and appreciate that potential changes to local health services are often a cause of great worry and that they inspire impassioned debate among those involved. It is time for local partners to work together to find a solution which, as the hon. Lady said, has to be right for the people of south-west London and will secure a sustainable configuration of health services in the future. I thank her again for her continued dedication to these health matters.

--- Later in debate ---

[Siobhain McDonagh]

Will the Minister unequivocally put on the record that any consultation document has to go everywhere or nowhere, and that some consideration must be given to how much things cost? I am amazed that the NHS gets so few people to turn up to events that it spends so much money on.

[Caroline Dinenage]

The hon. Lady makes an excellent point. It always amazes me how few people engage in some of the consultations, which are often discussing huge sums and affect really important day-to-day provision of essential care services in their area. Yes, consultation has to go to the whole area—indeed I have already spoken about how it needs to go beyond the area and look at the impact on other local services and the people who use them. She is absolutely right to say that consultation has to be effective and it has to ask everybody who might be affected by any changes. With that in mind, I thank her again for her continued dedication to her constituents.

Question put and agreed to.

NHS Reorganisation

Siobhain McDonagh Excerpts

Wednesday 12th December 2018 Westminster Hall

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gapes; I love saying that, particularly to our current Chair. I thank my hon. Friend the Member for Warrington South (Faisal Rashid) for securing this important debate.

I am here today to put on record the wild west of the NHS in south-west London, which will be well known to the Minister. It is a branch of the NHS that has spent the past two decades desperately trying to close the A&E and maternity unit at St Helier hospital on the border of my constituency and move those services to leafy, wealthy Belmont in Sutton. I will describe the geography for any hon. Members unfamiliar with my constituency. St Helier hospital is based in the deprived area of Rose Hill. Further south is the Royal Marsden in the wealthy area of Belmont, and seven miles west is Epsom hospital. The local CCGs are proposing to move all their acute services to just one of those sites.

This is about accountability. Over the past 20 years a staggering £50 million has been wasted on almost identical consultations to reach the obvious conclusion: acute health services must be placed in the area where people are most deprived and most in need, and have the greatest health issues. They must be placed at St Helier hospital’s current site. It does not matter how many brands or names the local NHS gives these proposals or how many marketing consultants are hired. Moving these health services would be catastrophic for my constituents, and catastrophic for south-west London.

What my local NHS fails to consider is this: if St Helier hospital loses acute services, my constituents will not turn to Belmont. The Minister will know Lavender, Cricket Green, Figges Marsh and Mitcham town centre. They will turn north to St George’s or east to Croydon, both hospitals that are already under extraordinary pressure. I told the Prime Minister only today of the case of my constituent who had to queue outside St George’s hospital last Monday because the A&E was simply full. Two weeks ago, St George’s was on black alert. It had no beds. The managers had to cancel all meetings and walk around wards, attempting to get people discharged. Those pressures exist even before the winter bad weather starts and before the flu epidemic that we are anticipating.

I could not possibly have emphasised any more strongly to my local NHS that its statistics and suggestions that people will move from London and parts of my constituency to Belmont are simply not going to happen. In all the years I have been fighting this, nobody in the NHS has ever said anything publicly to support my view, until the week before last. I could not believe it when the chair of St George’s NHS trust wrote a letter that argued:

“There is no formal requirement to take account of the impact”

of its proposals on other providers.

Let me make this clear. Moving acute hospital services from St Helier to Sutton could bring St George’s hospital to the point of collapse, yet those consulting on these proposals were not even taking the inevitable impact on other hospitals into account. Is there a code of guidance on consultation in the NHS? It does not seem that people in south-west London have read it. Take last year, when the same consultation was run, this time by the hospital trust itself, and was called “public engagement”. To the public, the trust portrays a neutral stance and says a suitable site will be selected across south-west London for its services. To the stakeholders in Sutton, it confesses its desire to move the services to their wealthy area. To me, it pretends that the consultation will genuinely seek the views of the public, before it happens to ignore the fact that the consultation receives six times as many negative responses as positive ones.

I was not surprised, given that—this is hard to believe—Epsom and St Helier University Hospitals Trust delivered the consultation document to most parts of Sutton and most parts of Epsom, but not a single street in my constituency; and that is called a consultation. I ask the Minister whether he thinks it is appropriate for an NHS body to run a consultation or an engagement and simply exclude part of the catchment area. Better to deliver no leaflets at all than not to include everybody.

Fast-forward to the latest attempt, where flawed consultation documents are created so that boxes can be ticked and the process can move along more and more quickly. The latest versions argue that Belmont is the deprived area locally, but, staggeringly, the same documents suggest that Pollards Hill is outside the catchment area for the Epsom and St Helier trust—something that will come as news to Wide Way, the largest GP surgery in Pollards Hill, which sends 35% of its patients to St Helier hospital. The trust claims to be neutral about sites, but when I secured £267 million from the Department of Health and the Treasury under both the Labour Government and the coalition Government to rebuild St Helier, guess what happened? The local NHS sent the money back; it did not want to use it.

It seems that every step forward comes up with a new consultation involving closed meetings that unswervingly fails to take account of health inequalities, which I understand is a legal requirement for the NHS. The trust ignores access to the site, public transport and percentage of car ownership, and we make no progress. For me, the last 20 years as the MP for Mitcham and Morden has been like being in the film “Groundhog Day”. Every month there is something, and we can absolutely rely on the fact that every July some bit of the south-west London NHS will want to come up with a consultation to move acute services from St Helier hospital. I simply want to put a stop to it. I want the staff at St Helier to know they have a future, and I want my constituents not to be worried about how they will access an A&E.

Nursing: Higher Education Investment

Siobhain McDonagh Excerpts

Wednesday 21st November 2018 Westminster Hall

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Last month my mum celebrated her 95th birthday. Like many Irish nurses of her age, 75 years ago she travelled to London from Ireland to start her career in the very first generation of NHS nurses by qualifying as a state enrolled nurse at Warlingham Park psychiatric hospital. Growing up, I saw at first hand just how vital a dedicated, passionate and happy nurse was for the welfare of the patients. That is why I am incensed when I see the treatment of trainee nurses today. Let us be clear. Nursing students are exceptional. Their courses are complex, their training is tough, and they spend significant amounts of time on clinical placement, working all hours of the day and night. They deserve a tuition and living cost funding model that recognises their extraordinary efforts and the importance of those efforts.

England is now the only country in the UK without some form of bursary for the nursing degree. That has crumbled the number of nursing applications and fostered an environment that is utterly unfair to nursing students and completely unsafe for patients. The Government promised that reforms would provide up to 10,000 additional nursing and health professional training places but, since the loss of the bursary, nursing applications in England are down by a third and falling fast. In fact, the 2018 figure was the lowest since nursing courses were first included in the UCAS system.

Nursing must be made an attractive profession for all groups, and restoring the bursary is a fundamental step to achieving that. Now is not the time to experiment with funding models for nursing students. One in three nurses is due to retire within the decade. Ensuring the long-term recruitment of new nurses must be a Government priority. That, of course, is before we take account of the Brexit impact: 75% of NHS trusts have done nothing to prepare for the UK’s departure from the EU. Meanwhile, there is an alarming trend for nurses and midwives to leave the profession before retirement, citing intolerable working conditions. However, it is not a numerical conundrum. It is a national crisis. A fall in student numbers is simply exacerbating our current recruitment shortage and it is patients who are being put at risk.

Ms H, a student nurse in London, contacted me this morning:

“I’ve felt completely unsafe on many occasions because of short staffing, not just because of my personal protection but more so because of the safety of the patients that I care for”.

Her colleague, Ms Y, found a young patient on an adolescent ward with a ligature tied around her neck. Short staffing meant that there was no one to debrief, and in fact no one even realised that it was a student who found the young patient. Ms H said:

“Most weeks of my final year as a student nurse I have cut out sleeping an average of 2 nights per week. Staying awake for 36 hours is the only way I can afford to train, study, and work to sustain a living.”

And yet her main grievance is not about the present, but the future:

“It just doesn’t feel like there is really light at the end of the tunnel. Instead, we will just enter a longer tunnel of a career completely unsupported by Government.”

The warning signs are loud and clear. The conditions described today are unfit for those who selflessly care for our most vulnerable. The devastating consequences of leaving the system broken would be felt for decades to come.

Budget Resolutions

Siobhain McDonagh Excerpts

Tuesday 30th October 2018 Commons Chamber

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

This was a Budget for

“the strivers, the grafters and the carers who are the backbone of our communities and our economy.”—[Official Report, 29 October 2018; Vol. 648, c. 653.]

Or so we were told—I would like to extend an invitation to the Chancellor to come to my weekly advice surgery and say that to the dozens of families I meet every single week who are trapped in insecure gig economy work, who are being failed by universal credit and who cannot afford to put a private rented sector roof over their head. I will talk about each of those issues in turn.

Let us start with workers’ rights. The Chancellor stated that delivering higher wages for those in work is core to his mission, yet our national living wage is littered with loopholes and used by some of the biggest organisations to cut terms, conditions and take-home pay. Those organisations should be named and shamed—I am referring to the likes of Marks & Spencer, Zizzi, Ginsters, Le Pain Quotidien, Caffè Nero and countless others that have sought legislative loopholes, against the spirit of the law.

Only this morning, I heard from one of the thousands of B&Q staff members being forced to move from nights to days. Just two years ago, one lady lost her annual bonus and her Sunday premium. She works the twilight shift to enable her to care for her two children. If she keeps her job, by the end of the month she will earn £1.50 an hour less than she currently does, but she cannot work the new shift because she cannot care for her children as well. She is not being offered redundancy. I ask those on the Treasury Bench to use their influence to encourage B&Q to offer redundancy to the 441 twilight shift workers who cannot at the moment take the hours that are being offered to them.

The Chancellor talked about protecting employment for lower-paid workers. Does that mean that the Government will follow the lead of British Telecom and the Communication Workers Union by calling for the abolition of exploitative “pay between assignments” contracts that keep agency staff on low pay for years at a time, even though they lack a gap between assignments?

On housing, which is a supposed Government priority, I was expecting a little more than the few lines that we heard yesterday. I welcome the proposed measures and money, but they are simply not of a scale that will make the difference that is so desperately needed. Solving the housing crisis is the politics of “and”: we should lift the housing revenue account cap, for sure, but is it not time to argue that all public sector sites that have been disposed of should be used first for the purposes of social housing, to introduce more punitive action for empty properties and to increase the surcharge for the one in six over-55s who own a second property? What about councils such as Merton that do not have a housing revenue account? In the past year, Merton has had one four-bedroom property to offer, and there are 441 families chasing that one four-bedroom property.

What about the green belt? The Budget states that revised planning reform ensures

“more land in the right places…for housing.”

Do Treasury Ministers agree that we should de-designate the 19,334 hectares of unbuilt green-belt land within a 10-minute walk of London train stations? This supposed green belt includes a car wash, a waste plant, a disused airfield and even a lap dancing club. At no environmental cost, that is enough space for almost 1 million new homes.

Finally, I turn to universal credit. I appreciate that I do not have much time left to speak, but I must ask those on the Treasury Bench for their help with Mr C, who applied for universal credit at the beginning of September. As the result of a routine operation, he had an artery severed, and the likelihood is that his foot will now have to be removed. He lives in one room above a shop, which he shares with his sister, who is in her 50s. Since the beginning of September, we have attempted to get a home visit for him so that he can claim the money he is entitled to. More than eight weeks later, in spite of getting the help of the local jobcentre manager, and in spite of numerous calls and letters to everybody we can think of, that man is still awaiting his appointment. Surely that is absolutely wrong.

This is a Budget with an absence of hope. The era of austerity is said to be coming to an end, but for now it continues to proceed, dragging almost a decade of damage in its wake, affecting people without homes for their children, people trying to claim benefits and people who just want a fair week’s pay for a fair week’s work.

Cancer Treatment

Siobhain McDonagh Excerpts

Thursday 19th April 2018 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I rise today to talk about some very special people with an Ilford North connection. Perhaps even more impressive than crossing the party political divide in this debate, Tessa Jowell crosses an even greater political divide in London— the River Thames. I say respectfully to my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) and her constituents that we actually had Tessa first, because, in 1978, a fresh-faced Tessa Jowell embarked on a by-election campaign there. She was defeated, obviously, by the great tides of national politics of the day but, undeterred, she persisted in 1979.

What was so remarkable when I shared the video of Tessa Jowell speaking in the House of Lords in that powerful debate on cancer was just how many of my constituents responded, not just with great love and affection, but with strong memories of meeting Tessa during that by-election 40 years ago. That speaks so strongly of the warmth, empathy and infectious personality that Tessa has brought to her politics. As so many people have said, that certainly made its mark in so many ways on public policy in this country, but anyone who has ever met Tessa has been personally affected by her, and that is why we are all here today, determined to carry forward her legacy in such an important area.

I also want to talk about my constituent Kaleigh Lau. Today is a very special day for Kaleigh and her family—her father Scott, her mum Yang and her brother Carson. Two years ago today, Kaleigh was diagnosed with a diffuse intrinsic pontine glioma, or DIPG, which is a brain tumour located in the pons of the brainstem, for which there is currently no cure. At the time, Kaleigh and her family were told that life expectancy with DIPG was just nine months and that they should focus on making memories. Well, last month, Kaleigh celebrated her eighth birthday, and two years on from that awful day Kaleigh, her family and her huge band of friends and supporters are determined to make history, not memories, as they battle to defeat DIPG.

Their journey during the past two years has not been easy. I have followed the family through their tremendous ups and downs: the 30 radiotherapy sessions that young Kaleigh experienced between April and June 2016; that awful moment in December that year when Kaleigh was in progression, eight months in; the closeness with which Kaleigh almost got on to the convection enhanced delivery treatment programme through the compassionate treatment route, only to be told at the eleventh hour that the tumour had spread and CED would no longer be possible; the 10 more radiotherapy sessions that she underwent in January and February 2017; and the moment when Kaleigh’s condition declined to such an extent that the family took her on what they thought would be her last holiday, in March 2017.

Today is also an important day for the family because things changed a year ago today when Kaleigh began experimental treatment in Mexico. By her second treatment, she had regained all her functions. Five other UK families followed her to Mexico. Kaleigh was the first European to receive this treatment. More than 50 people around the world have now undergone the same treatment. None of this has been easy and we do not yet know whether this experimental treatment will be successful, but we know one thing for sure: if Kaleigh had stayed in the UK, she would not be with us today.

Kaleigh’s family have spent over £250,000 to fund her treatment so far, and her ongoing treatment costs them £15,000 every four to six weeks. I pay tribute to Kaleigh’s remarkably resilient family, particularly her father Scott, with whom I speak regularly. Scott has a full-time job and is a full-time dad. He is an utterly selfless human being, to such an extent that every time I call him back, without fail his first words are always, “Thanks for calling. I know you must be busy.” I am nowhere near as busy as Scott is, as a father trying to look after and care for his family on top of everything else that they are dealing with. This is why I address my remarks to Ministers.

I thank successive Ministers—most recently Lord O’Shaughnessy—for engaging with Kaleigh’s case, but they will understand the family’s frustration. After three meetings with the Department of Health, two online petition campaigns and a huge fundraising effort to pay for Kaleigh’s treatment, they do not feel that things are really moving forwards. As Scott says:

“How is the UK government going to help Kaleigh now? Not in the future, but now? Without funding we have no treatment. Overnight we have been forced to become an expert on DIPG, a carer, a fundraiser, a counsellor, an adviser, a leader, a beggar. But ultimately we need help from our government to take the burden off us so that we can focus on Kaleigh.”

There are just a few things that I want to say to Ministers in the short time I have left. We need to become a global leader in tackling DIPG, which has already taken over 200,000 children. We can do this through research, spearheading clinical trials and ensuring earlier access to treatment. We need to do more to ensure financial support to access experimental treatment. I understand the ethical dilemmas, particularly where experimental treatment is concerned, but we have to place greater trust in patients and parents who are willing to take risks.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I am sure that everyone in the House is paying rapt attention to my hon. Friend’s explanation of Kaleigh’s care and determination, and that of her family. Will he conclude the story and tell us what is going on at the moment?

[Wes Streeting]

I am so grateful to my hon. Friend for that additional time.

If Ministers cannot fund treatment, let us at least look at funding the flights, accommodation and all the additional costs that families face. It was remarkable listening to the comparison between what Tessa has been through and what Kaleigh’s family have been through in this respect. We need better care plans, advice and guidance. Scott has to do it all himself, to such an extent that he has become an adviser to families around the world on top of looking after his own children. We need to do a lot more to ensure consistency.

--- Later in debate ---

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I cannot compete with some of the wonderful speeches that have been made today. My research would be perfunctory by comparison with some of the things that Members of the House have told us. I will leave this debate knowing so much more about brain cancer than I did when I arrived.

My purpose in speaking is simply to say to Tessa: we are with you. You know, Mr Speaker, that politics is a rough old trade, and sometimes you fall out with people—people you think the most of. I just wanted to be here to say to Tessa that whatever the arguments or disagreements, it counts for nothing by comparison with my admiration and my determination to do anything I can to support her in her campaign.

[Joan Ryan]

Let me grab this opportunity to say something, because I am sure that Tessa can see that she has got these three women here—me, my right hon. Friend the Member for Don Valley (Caroline Flint), and my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh). We entered this House in 1997 and joined Tessa Jowell on the Government Benches, and we served with her through three terms of the Labour Government. She gave us such fantastic support. I just wanted to leave a rounded picture of Tessa in this very serious debate. I bet she is really a little bit embarrassed at all the praise, but she deserves it. She is such a strong supporter of women coming into this place and getting them through the process to get here. She also has a very ready but very kind wit that we witnessed much of when she was at the Dispatch Box.

[Siobhain McDonagh]

I thank my right hon. Friend—my very best right hon. Friend in this House—and Members can see so many reasons why that is.

Sometimes we fall out, and perhaps we fall out harder on our own side than we do with parties on the other side. Tessa is extraordinary in her example, as are so many people, particularly in the NHS. At 7 o’clock tonight, I will be holding a reception in the Jubilee Room of the House of Commons for the winter heroes from Epsom and St Helier University Hospitals NHS Trust to say thanks to them. If anybody wishes to join us, there will be a glass of wine and a packet of crisps for them. Thanks to the NHS, thank you to Tessa, and thanks to everybody for their brilliant speeches today.

NHS Winter Crisis

Siobhain McDonagh Excerpts

Wednesday 10th January 2018 Commons Chamber

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

May I begin by disagreeing profoundly with the hon. Member for Wirral West (Margaret Greenwood)? As a health professional and as a doctor who has worked in the health service for 15 to 20 years, spending more than two hours listening to Opposition Members putting negative after negative on the NHS has been profoundly taxing, and it has been hard for me to remain in my seat.

I worked in the NHS in A&E in the Christmas and new year period. Yes, I saw people waiting much longer than we would like. I also saw a seriously injured child who came in and received the very best treatment. People and equipment were available, and all the necessary hospital staff were available for his treatment. At times there were a dozen people around his bed, and I am pleased that we could give him the treatment that he needed to survive. We need to get away from always picking out the negative points. We must remember that more people are being treated and survive, and that they are real, genuine people who go on to live long, healthy lives and are really pleased with the NHS treatment that they receive from people such as me and the millions of NHS staff working over Christmas and on new year’s day.

We have heard a lot of negatives from the Opposition, but we should look at what we can do to improve. I did not hear anything from the shadow Secretary of State about what he was going to do to make things better if he was in charge.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I will not take much time, but I have some suggestions. It is the over-75s who are mainly going to A&E. They are more unwell than they used to be. Why do we not get volunteers with medical experience to phone up people on every GP list and make sure that the over-75s are okay? They could urge them to turn up at the GP as soon as they become unwell, and not to wait until they reach a state in which they need intravenous drugs and have to go to A&E.

[Dr Johnson]

I thank the hon. Lady for her intervention, but I fear that she is mistaken because the people most likely to attend A&E are the under-19s. The over-65s represent about 20% of attendances at A&E but, following their attendance, the vast majority require admission to hospital, so they are in a slightly different category.

Those who are awaiting admission after they have been seen are the group who are waiting on the trolleys in A&E. People are waiting for those patients to be moved on to the wards so that the ambulances can be freed up and those patients treated. I have a solution to suggest, about which I met the Secretary of State earlier this week following my work in A&E over the winter period, when I observed ambulance crew waiting next to trolleys with their patients. They could not leave until they had properly handed over their patients.

It is really important that patients’ care is handed over properly, but equally we need those ambulances back out on the streets to collect the patients who are waiting at home. We could do much better if we cohorted the patients. For example, if three ambulances came in with six ambulance crew members on board, one ambulance crew could look after the patients while the other two went back out to see more patients. It is not all about money; some of it is about the inventive use of staff to create safe and efficient protocols.

I want finally to talk about the postponement of operations, which is very upsetting when someone has waited a long time for an operation and psyched themselves up for the pain and distress they know they will experience, and they may be nervous and fearful.

We have several choices. We could run hospitals at a very low capacity all summer—which is hugely expensive—so that there is a lot of free capacity ready for the winter; we could say that we will not do as much elective work over the winter, but then we might cancel operations that do not need to be cancelled—we may be giving more notice, but patients might have been able to have their operation; or we tell people that we will plan their operation but there is a possibility that if the winter is acutely busy, it will need to be postponed. None of those choices is ideal; all have pros and cons. We need an adult, cross-party discussion about the best way; otherwise, whichever option is chosen by the Government of whichever party is in power, the other side will criticise.

As many hon. Members on both sides of the House have suggested, we need to take the politics out of the health service, recognise that the vast majority of patients receive excellent care from the health service, which is doing more than ever, and consider together how we improve the areas that need improvement.

Autism Diagnosis

Siobhain McDonagh Excerpts

Wednesday 13th September 2017 Westminster Hall

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I congratulate my hon. Friend the Member for Enfield, Southgate (Bambos Charalambous) on securing the debate and all the parents and voluntary groups who have clearly been galvanised and got so many Members to be in the Chamber this morning. That is a real tribute to them.

I will write to the Minister with my local examples of families with difficulties, but I want to bring the particular attention of the House and the Minister to a decision of my mental health trust, South West London and St George’s, and of the Merton CCG. Under pressure from the doubling of the number of referrals for autism assessment, the trusts decided simply to restrict the ability to refer. To combat the demand for diagnosis, they suggested that only those children displaying mental health problems would begin the diagnostic process. As we have learned in the debate, however, 30% of autistic children develop no further mental health problems. Girls in particular do not display autism until much later.

If the proposal goes ahead, therefore, a large number of my constituents will be living with undiagnosed autism. On 21 September, the five CCGs—Merton, Sutton, Wandsworth, Kingston and Richmond—will meet to decide whether a formal public consultation is needed. I ask the Minister directly to work with my local mental health trust and CCG to ensure that all those with autism in my constituency are given the diagnosis they need to receive support. They should certainly be involved in any consultation on changing procedures. Furthermore, those procedures should not change in a way that would mean that girls are less likely to receive a diagnosis.

A reduction in the diagnosis of autism in Merton would leave so many of my constituents without the specialist support they need. Such a reduction would be in the interests of no one, whether the individual or the state.

--- Later in debate ---

[Jackie Doyle-Price]

We very much send the message that parents of children with autism are entitled to good services and that is what they should expect. We need to spread that good practice and collect those data, in order to highlight exactly where it is not happening. When we look at the work that the Care Quality Commission has done to highlight good practice, we should be able to get some messages. We are looking for transparency to drive performance and to have those conversations. The NHS mandate for 2017-18 sets a priority for the NHS to reduce health inequalities for autistic people, so that is very much part of NHS England’s conversations with local CCGs.

[Siobhain McDonagh]

On that point, will the Minister refer to the issue of South West London and St George’s Mental Health NHS Trust and the five CCGs in south- west London?