Accident and Emergency Departments

David Burrowes Excerpts

Thursday 7th February 2013 Commons Chamber

[Nick de Bois (Enfield North) (Con)]

I am not sure I can keep up with the pace of the hon. Member for Lewisham West and Penge (Jim Dowd), but I am delighted to follow him and I have some sympathy with one of his points. I felt compelled to write to the NHS medical director, Sir Bruce Keogh, having seen his comments about the role of politicians.

[Mr David Burrowes (Enfield, Southgate) (Con)]

It is 2-1.

[Nick de Bois]

It is true. As my hon. Friend says from a sedentary position, the Evening Standard claimed, “Nick de Bois 2, Sir Bruce Keogh 1”, so I hope I wrote on behalf of all Members. The medical profession is at the root of this issue. If it wants to win arguments based on evidence, so be it, it can win those arguments against politicians, but it also has to win the hearts and minds of the people it serves. That is why we should not be taking lectures on the role of MPs and democrats.

I would like, unapologetically, to talk about my hospital, which has been introduced briefly by my neighbour, the hon. Member for Edmonton (Mr Love). As a hospital facing threats of change—not all good by any means—Chase Farm hospital must predate almost every Member present in the Chamber, perhaps with the exception of the hon. Member for Islington North (Jeremy Corbyn). Going back to the early 1990s, it was promised the proceeds from the disposal of the Highlands hospital. As my hon. Friend the Member for Newark (Patrick Mercer) said, the story I am telling crosses more than one Government, so I will try to tell it in a non-partisan way because my interest is in getting the best for my constituents.

After my constituents were let down by the promise of investment from the sale of Highlands hospital—now a pleasant residential area—no money was forthcoming, and in 1999 an administrative merger between Barnet and Chase Farm hospitals was proposed, which we were assured would lead to no clinical changes and have advantages. The effect of the merger was that the healthy balance sheet of Chase Farm was sucked dry to support a hospital that was bleeding payments—the hon. Member for Lewisham West and Penge may identify with that. Again, my constituents were let down.

Just before May 2005 we were told that we would have £80 million investment in our district general hospital. Sadly, that investment did not materialise, and shortly afterwards, in 2006, a programme of downgrade—reconfiguration, as it is known—was started, particularly in our maternity and A and E units. That was confirmed in 2008, but judicial review by the local council held it up. Hopes were just beginning to rise, and with the change of Government those hopes were raised again from the moratorium. I have said this before on the Floor of the House but I will repeat it for the avoidance of doubt: my constituents were utterly let down by the Secretary of State when we were again downgraded.

Hon. Members will therefore understand why my constituents—I am sure this resonates with hon. Members on both sides of the House and their constituents—and the public the acute hospitals serve are so sceptical when they are on the receiving end of advice and recommendations. It is a question of trust and transparency.

Like every hon. Member, I understand the full implications of the strategic drive for, and some of the benefits of, centralisation. However, I oppose the reconfiguration because of the inconsistency in what we have been told. There has been a clinical case for change, and a clinical and safety case for change, and yet in 2011, the Care Quality Commission said that Chase Farm hospital was running up to standards.

At that point, the PFI situation emerged. The PFI deal sealed for North Middlesex hospital—a neighbouring hospital in the south of the constituency—meant an investment of £129 million over 31 years, meaning a total repayment of £640 million. That £2 million a month comes off the operational budget. On 22 November, the then Secretary of State was quoted in the very reliable Daily Mail as saying that the recent downgrade was partly because of unsustainable PFI debt.

One reason often cited for the proposed downgrade of my hospital is that GPs support it. Three hospitals—Barnet, North Middlesex and Chase Farm—were part of the downgrade plan, and GPs from Haringey, Barnet and Enfield were asked about the proposals. The vote was organised like a communist meeting. If we ask people in Haringey or Barnet whether they have a problem with the downgrade in Chase Farm, I suspect they will say no if it benefits their hospital. The figures show that only 44% of Enfield GPs approved, but of 129 GPs asked, only 48 responded, so only a positive 16% recorded their support. I hope the Minister asks her officials to reflect on that point.

I oppose the reconfiguration but recognise that I need to fight for the best possible deal for Enfield. It is therefore important to examine the so-called pre-conditions of implementation of the strategy that we were promised —we were guaranteed that they would be put in place.

[Mr Burrowes]

I commend my hon. Friend for his continuous efforts, although perhaps he should take his seat since he has given way.

[Mr Deputy Speaker (Mr Nigel Evans)]

That is my job, not the hon. Gentleman’s.

[Mr Burrowes]

My hon. Friend has continuously stood up, not just in the House but in his constituency, against the closure of the A and E in Chase Farm and for securing health improvement in Enfield. He has secured a cross-party delegation meeting with the Secretary of State, at which we want an assurance that the £10.6 million being invested in primary care in Enfield ensures we get effective primary care improvements before the reconfiguration.

[Nick de Bois]

That goes back to my point—it is a question of trust. It is vital that that promise is delivered, but it is already some four years since the change was envisaged, and very little has been put in. It is therefore right that we press the case for implementation and delivery on the ground if the strategic review goes ahead.

I welcome the opportunity to meet the Secretary of State—I hasten to add that a cross-party delegation will meet him—but I have some questions to put to the Minister on the Floor of the House. Is she aware of the growing health inequalities in the borough, which have increased since the original 2008 assessment? According to the latest census, the population is far removed from the original assessment—there are 40,000 more people.