A&E Services

John McDonnell Excerpts

Wednesday 24th June 2015 Commons Chamber

[Andy Slaughter]

My hon. Friend makes a very good point. I make sure that every time I refer to what is happening in my local NHS now, I look into the voluminous papers on “Shaping a healthier future”, or what the Imperial College Healthcare NHS Trust actually says, so that I am clear that I am describing what is happening, not giving my opinion or saying something that has come from a party political standpoint. I simply wish that the Government would listen and respond in kind.

[John McDonnell (Hayes and Harlington) (Lab)]

I apologise for coming late to my hon. Friend’s speech. The reason why is that outside Ealing hospital there are currently 200 people demonstrating because of the maternity unit’s closure, which will put undue stress on the local community. He has listened to many of the arguments regarding its closure, and none of them stacks up. Perhaps those 200 people will be listened to.

[Andy Slaughter]

I am very grateful to my hon. Friend for his intervention. No one does more than him, directly and positively, to draw attention to the crisis in the NHS in west London. His local hospital, Hillingdon, is not closing, but throughout the process over the past three years he has been absolutely steadfast in defending and supporting those of us whose local NHS is being downgraded, not just because he is a good comrade, but because he knows that the knock-on effect of hospital closures will make it impossible for any of the 2 million people throughout north-west and west London to receive a decent health service.

I shall say no more today, as other Members wish to speak. I again thank the Minister for the opportunity we will have to make our case. I hope the Government are listening on this matter, which is the most urgent matter that I have dealt with in my 30 years as a councillor and as an MP. It is about the preservation of the NHS for a substantial part of London’s population. These are genuine and legitimate concerns, and I hope the Government will listen to them.

Oral Hormone Pregnancy Tests

John McDonnell Excerpts

Thursday 23rd October 2014 Commons Chamber

[John McDonnell (Hayes and Harlington) (Lab)]

People often ask what an MP does. I think that my hon. Friend the Member for Bolton South East (Yasmin Qureshi) and the hon. Member for Enfield North (Nick de Bois) have demonstrated what a good MP does. They have taken an issue that has been brought to them by their constituents and pursued it until they achieve an end result. I hope that we will see such an end result today. I congratulate them on what they have done.

I was contacted by my constituent, Mr Kulvinder Sidhu, who asked me to attend and participate in today’s debate in order to secure the establishment of the panel and the full release of all the documentation. I do a radio show each week on Hayes FM, our local community radio, and I recently interviewed Mrs Valerie Williams, the former chair of the Association for Children Damaged by Hormone Pregnancy Testing. She succinctly explained the background to this scandal, and it was an extremely moving interview. She described some of the appalling human suffering that has taken place, and it was really shocking.

This seems to be a worrying hangover from the past. We thought, after the thalidomide inquiry, that we had put issues such as this behind us. We thought that in such issues, there would subsequently be full transparency, openness and decisive action by Governments. Today will test whether that is the case, and whether we will see decisive action. I do not think the general public would understand if there were a continued refusal to release all the papers, or if there were resistance to the establishment of an independent panel inquiry. My hon. Friend the Member for Bolton South East has already said that we are mopping up the scandals of the past, including Hillsborough and Bloody Sunday. The hon. Member for Enfield North said that we are now living in a different era, with more openness and transparency. This debate will test whether that is really the case.

It is difficult to understand how we have arrived at this situation. We have to address the issue of the pharmaceutical industry’s relationship with the medical profession and with the Government. Big pharma, as it is now called, has insinuated itself into the decision-making and policy-making processes of successive Governments for the past few generations, and I believe that it has had an undue influence not only on Government decision making but on some of the professional institutions that regulate the medical sector. Big pharma is one of the most powerful lobbies in government of any industrial sector. This case is another example of where one company has used the clout of its financial resources, through the legal system, to silence critics and even those who have researched the information and tried to publicise it. That was demonstrated by my hon. Friend the Member for Bolton South East in respect of the denial of not only access to information, but of someone even being able to publish or to produce a film that would have demonstrated to the wider general public exactly the scandal that is taking place. For too long, the pharmaceutical industry has dominated Government policy in a number of areas, including this one.

So I say to the Minister that this is a test case about who governs this country in the area of drugs safety and about the medical safety and security that we offer our constituents. I see no reason for the Government to deny the full publication of all the documentation and I also see no reason why we cannot have an independent panel inquiry. If such a panel is set up, I hope that not only will it be fully resourced, but those who will want to provide information to it will also be resourced, and that includes the campaigning organisation that has been fundamental to delivering today’s debate. Anything less than that will compound the scandal, because we now know much more than we did in the past about the cover-ups that have gone on, the sacrifices that have been made by individual families and the need for Government action today.

Ebola

John McDonnell Excerpts

Monday 13th October 2014 Commons Chamber

[Mr Hunt]

I thank my hon. Friend for her comments and her support for the statement. I want to pay particular tribute to the chief medical officer and Dr Paul Cosford at Public Health England, who have done an enormous amount to make sure we develop the right policies, which are both proportionate and enable us to prepare for the future. The Government are hugely grateful for their contribution.

We are satisfied that the testing arrangements at the PHE facility at Porton Down are adequate to the level of risk, but one of the reasons why I wanted to announce to the House the current estimate of the number of Ebola cases we are dealing with in the UK was to make the point that we will continually keep those arrangements under review should the situation change. We need to recognise in a fast-moving situation such as this that it might well change, and I will keep the House updated, but in such situations the resilience of all those very important parts of the process will be checked.

[John McDonnell (Hayes and Harlington) (Lab)]

In May the Government announced the closure of the health control unit at Heathrow airport in my constituency. It contained the staff who undertook the monitoring, screening and treatment of passengers who were sick. I believe many of those staff have now been made redundant, so can the Secretary of State tell me what the staffing arrangements will now be at Heathrow airport? Also, will a training programme be developed for airport staff themselves, including cabin crew and others?

[Mr Hunt]

The hon. Gentleman makes a very important point. In terms of the staffing arrangements, a total of about 200 people will be employed in the screening process, working at both Heathrow and Gatwick airports in the hours when they are open, and potentially at other airports if we expand the screening. It is a comprehensive facility.

The hon. Gentleman’s most important point is that we must make sure that those who might come into contact with people who might have Ebola—airport staff and people working on aeroplanes, and people working at receptions at GPs’ surgeries, at A and E departments and at hospitals—have basic information about how the virus spreads, so that we can avoid any situations of panic. The virus is transmitted through exchange of bodily fluids. It is not an airborne virus, so it is not transmitted as easily as something like swine flu. The advice is that those doing physical examinations of patients need to wear the protective equipment, but that that is not necessary when having a conversation with a patient, for example. That advice will always be kept under review, but the hon. Gentleman is absolutely right to say that we need to make sure everyone knows that advice.

Care Bill [Lords]

John McDonnell Excerpts

Tuesday 11th March 2014 Commons Chamber

[John McDonnell (Hayes and Harlington) (Lab)]

I apologise for arriving so late, Mr Deputy Speaker. I have been stuck in a meeting.

Let me begin by saying, without party rancour, that I shall vote against any measure that puts further power in the centralised hands of the Secretary of State. I apologise for going down memory lane as well, Mr Deputy Speaker, but 40 years ago, when I first represented my constituency as a local councillor, we had what I thought was a very effective health service consisting of local GPs’ surgeries, two cottage hospitals and a district hospital. In the 1980s the two cottage hospitals were closed, because a new Secretary of State—let us leave aside the party to which he belonged—decided that we did not need them, that all the services should be centralised in the district hospital, and that there should be some investment in the GPs’ surgeries. We occupied Hayes cottage hospital in an attempt to keep it open, but we lost the battle. However, it became a residential home in the end, so we had some success.

What happened next was that other Secretaries of State came along and moved some of the services from the district hospital to more centralised hospitals in central London. Then a new Government were elected and a new Secretary of State decided that we needed to devolve again, so we had Darzi polyclinics, which looked awfully like cottage hospitals to me. If you stand still for long enough, it all comes round again.

All that was basically a result of what we heard about from the hon. Member for Enfield North (Nick de Bois): a lack of trust in local people. I believe that local people supported the original model of GPs’ surgeries, cottage hospitals and a well-resourced district hospital. If they had been listened to at the time, we would not have gone round in a huge contorted circle to get back to what was virtually square one. As I have said, I am very anxious about any measure that puts further power in the hands of the Secretary of State and overrides the wishes of local people.

[Richard Drax]

In my experience, cottage hospitals are the gold standard of the national health service, and should be preserved at all costs.

[John McDonnell]

I entirely agree. There are still members of the community who, like me, deeply regret the fact that we lost two cottage hospitals in my constituency and another in the constituency of the right hon. Member for Uxbridge and South Ruislip (Sir John Randall). We lost a whole network of cottage hospitals. I do not remember who was Secretary of State in the 1980s under the Thatcher Government, but that Secretary of State was obsessed with closing them down, and they were closed down as a result of central diktat rather than listening to people.

As other Members have said, there were consultations, and, in every case, nearly 100% of local people wanted to keep the local cottage hospital. The hon. Member for Wycombe (Steve Baker) said that we were running a socialist health service. Well, my socialism is grass-roots socialism—community socialism—which means listening to local people and respecting their wishes. Local people often know intuitively what is right, and that is why I am so anxious about any further powers being put in the hands of the Secretary of State.

[Steve Baker]

Not for the first time, I find myself gently agreeing with the hon. Gentleman. I think that he has advanced a magnificently Conservative argument, and I look forward to his eventually matching the colour of his tie with the colour of his rosette.

[John McDonnell]

I will send the hon. Gentleman a few books about council socialism and the socialism of the grass roots.

Today’s debate is about trust, about listening to local people, and about not allowing any further powers to accrete in the Secretary of State’s hands and override local wishes. People do not trust central Government. That is not a party-political point; I think that people have been ill used over a long period by not being listened to at local level, which is why I urge Members to support the new clauses and the amendment.

Let us not denigrate organisations such as 38 Degrees which are merely expressing a view. Others may not agree with that view, but it has been expressed to me not just by 38 Degrees, but in e-mail after e-mail and letter after letter from people whose views I respect because they have gone through the same local experience as me. All that those people want is long-term stability and investment in a publicly funded and democratically accountable health service.

[Mr Simon Burns (Chelmsford) (Con)]

It is a pleasure to follow the hon. Member for Hayes and Harlington (John McDonnell). He said at the beginning of his remarks, and he kept to his pledge, that he was going to speak without party rancour. I, too, would like to do that because I think there is very little difference between my views on the health service and those of the right hon. Member for Leigh (Andy Burnham). We may perhaps have a divergence of view on how to achieve what we both passionately believe in, as does my right hon. Friend the Secretary of State, which is the finest health service for the provision of care for all people in this country, but on the core principle of a national health service, free at the point of use for all those eligible to use it, there is not one iota of difference, despite the speech I heard from the endearing hon. Member for Easington (Grahame M. Morris). I almost felt I had woken up from a nightmare. Having listened to the same speech in 39 of the 40 sittings of the Health and Social Care Bill Committee, I regarded it as my good fortune that during the 40th sitting, my right hon. Friend the then Secretary of State was giving evidence to the Health Committee which prevented the hon. Gentleman being in our Committee.

The point I want to make is this: the national health service has from day one constantly evolved in the delivery of health care, partly because of changing medical science, partly because of changes in the diseases that people have suffered from owing to improved and enhanced preventive care, and partly because many conditions that in the past one would stay in hospital for no longer need to be treated in hospital but can be treated in a GP surgery or elsewhere. We all—politicians, medical practitioners and others—have to recognise that the NHS is constantly evolving and revolving, and we have to adjust to those changes and meet those challenges.

I passionately believe that decisions within the NHS should be taken locally. I supported the Health and Social Care Bill so strongly because it devolved powers and decision making to the people who I think are best qualified to take commissioning decisions on behalf of patients—local GPs. I also welcome the fact that my right hon. Friend the Secretary of State is no longer micro-managing the running of the NHS on a day-to-day basis. However much admiration I have for my right hon. Friend, or even for the shadow Secretary of State when he was in post, I do not think he is best qualified to be running the health service on a day-to-day basis.

If we are going to evolve and meet the challenges, difficult decisions will have to be taken, and politicians in particular—politicians of all political parties; this does not apply simply to Opposition Members of Parliament or to Conservative Members or to Liberal Democrats—have got to be braver. When there is any consideration of a reconfiguration to meet new challenges or address problems, the knee-jerk reaction is to take the populist, easy route, say no and oppose for opposition’s sake, rather than look at the reasons behind any reconfiguration.

Care Bill [Lords]

John McDonnell Excerpts

Monday 10th March 2014 Commons Chamber

[Dr Wollaston]

I thank my hon. Friend for those comments and I welcome the mental health crisis care concordat, and what is being done to emphasise that prevention is by far the best way forward, but even with those prevention measures in place I think we would all accept there will still be circumstances where people will reach crisis, and unfortunately a police station is absolutely the last place anyone, let alone a child, would wish to be in crisis. In Devon and Cornwall alone, 27 children last year were taken to police cells for long periods of time. On three occasions those children were as young as 12 and 13. That is simply unacceptable. One of the reasons it is likely to continue is that there is no penalty currently for the NHS in continuing to use such facilities. It does not have to pick up any of the financial tab. That is putting enormous pressure on our police forces. They do not wish this to happen, of course. If we cannot at least have this sunset clause, which I think is eminently sensible, I hope the Minister will consider making sure that the NHS has to pay to use the police cells, and that there is a significant financial penalty, because that would be a driver. That would make it financially much more sensible for the NHS to put in place measures for these vulnerable people—who often have been found by the police at the point where they are about to take their own lives. It cannot be acceptable for this situation to continue.

Moreover, the variation in such use of police cells is extraordinary. There are some areas where that is not used at all and others where it is very heavily relied on. I hope the Minister will say in his response that he is prepared to consider a sunset clause, or at least a financial penalty, so we see drivers in place and we continue to move away from such a practice. However, I absolutely recognise the point made by my hon. Friend the Member for Enfield, Southgate (Mr Burrowes) that prevention is far better, and I know all areas are working towards that and that the Minister fully supports it.

New clause 9 is an extraordinary measure that is widely welcomed because of the principles to which the right hon. Member for Salford and Eccles (Hazel Blears) referred about well-being and prevention. These are at the heart of the Bill and everybody welcomes them. However, I think the Minister recognises that there could be unintended consequences if we were to introduce many new statutory obligations without their being funded fully. As he will know, we have two tests—a needs test and a means test—for people to pass in accessing social care, and 88% of needs tests are now set at a substantial level, which has been quite a considerable change. There is also the means test, which stands at £23,250. On many occasions as a GP, I remember coming across the absolute shock encountered by people when they realised that they would get no help whatever.

The change under the Bill will be extraordinarily welcome, although we should be under no doubt about the burdens that it will place on local authorities, in particular in my area. Devon has the third oldest demographic in the country, but funding of local authorities for health care does not have sufficient emphasis on the age structure of the population. There will be great impact on Torbay and on other areas in Devon, such as my constituency.

New clause 9 is a sensible measure about how we plan for the future and make an appraisal of whether we are fulfilling the important provisions in the Bill, ensuring that we have sufficient resources directed towards prevention and well-being. I hope that the Minister will see the new clause as helpful and as one that will assist us in planning for the future.

[John McDonnell (Hayes and Harlington) (Lab)]

I will speak to the amendments in my name. I share the view of the right hon. Member for Banbury (Sir Tony Baldry) that we should not have nodded the programme motion through blithely. Many of my constituents have contacted me about the Bill, because care in my area is on the edge of crisis, with the new threshold rolling it back for many people. That is why I support new clause 11; people need their human rights to be ensured in the Bill. New clause 2 is important, because we have a Children’s Commissioner and we need a commissioner for the elderly and other care services, so that there is someone to speak out for people. I support new clauses 7 and 9, because I agree that introducing legislation without funding is meaningless. We place local authorities in an impossible position, as they struggle to provide the services.

With regard to the work force, we need to ensure pay and adequate training, so that we fully professionalise the work force. In my area, we have a high turnover of care workers, which leads to distressing results. In one case, an elderly lady was burgled and on the next day a new carer came in, but she thought that she was being burgled all over again, because she did not recognise the person. That is the instability in the industry at the moment. That is why I support new clauses 17 and 18.

On the amendments in my name, new clause 31 is generated by one of my constituents called Jonathan Kay, who asked me to get the matter dealt with in the Bill. For many years, Jonathan has been funded by the local authority to employ a personal assistant to enable him to carry out his day-to-day tasks—he is a disabled person—but he has experienced serious problems with personal assistants in the past, even suffering abuse on more than one occasion. When employing personal assistants, Jonathan has found assessing the suitability of candidates extremely difficult, and he has not been able to obtain reliable recommendations from any public body, despite using public funds to employ them.

Part 3 of the Bill provides that the training and education —but no qualifications—of carers will be undertaken by Health Education England. The purpose of my new clause is for Health Education England to allow scope for the local education and training boards to do such work and to compile, publish and maintain a register of all persons who provide regulated social care for individuals under arrangements made by or paid for by a public authority. That would allow people such as Jonathan to access a list of trained professionals whom they can employ with confidence, we hope, in future.

With amendment 26, I am simply seeking to install into the Bill a provision on the right to live independently, as recommended by the Joint Committee on Human Rights, but dismissed by the Government. The Government might well have been concerned about the legal actions that were taking place with regard to the independent living fund, but the Committee’s report made its disappointment very clear that the Government had not taken the opportunity of the Bill to be explicit about their support for the convention on the rights of people with disabilities and article 19—“Living independently and being included in the community”—being a human right. It should therefore be included in the Bill. The Government have given assurances that the general direction of the Bill might achieve the same ends, but that is not good enough in that it does not enforce the rights in law.

My amendment 21 covers the same ground as new clause 15, so I will not dwell on it in any depth, but I will give an example. Whether with our parents or in our community, we all know about the uncertainty of charges for residential care. They cause real concern and anxiety among families. Yes, the ability of local authorities to negotiate rates influences the overall market, but that is why there is a need for some form of indicative price. A care funding calculator is used to set the care of people with learning difficulties, and that model has worked and saved public funds. We should at least be considering in the Bill that sort of process for care overall.

My proposals in amendment 20 would

“require the local authority, when carrying out the assessment, to capture an individual’s main and other disabling conditions”.

A whole group of organisations, including the Parkinson’s Disease Society, Sue Ryder, the Motor Neurone Disease Association, the Multiple Sclerosis Society, the Epilepsy Society, the Neurological Alliance and the Alzheimer’s Society, have all campaigned for this simple change in the assessment process, which merely requires local authorities to collect and record information about an individual’s main and other disabling conditions when they are conducting their social care assessments and arranging care packages. Why is that important? It is important for local authorities to be aware of the different conditions in their community, so that they can plan long-term services, but it is also important for us to be aware of the information nationally, so that care services and our investment can be planned in the long term. Taking that into account seems to be a minor amendment.

Amendment 22, which I also tabled, was proposed by the Royal National Institute of Blind People and lobbied for by a number of my constituents. In clause 76, the duty is placed on the local authority to establish

“a register of sight-impaired and severely sight-impaired adults who are ordinarily resident in its area.”

The existing provision relates only to adults and does not include children. My amendment simply ensures that the local authority is required to collect information on both adults and children. The reason for this is that, under the Children Act 1989, there is a requirement on local authorities to collect information with regard to blind and partially sighted children, but 20% of local authorities admitted failing to meet that legal requirement. Furthermore, 20% of local authorities have no register; three councils include just 1% of disabled children known to the authority on the registers; one in four authorities have whole registers with fewer than 2% of disabled children known to the council; and almost six in 10 councils include 10% or fewer of the disabled children. The RNIB therefore emphasises that in clause 76 we should place on local authorities a duty, when collecting information, to include children ordinarily resident in their area. Again it is the same mechanism; it is about the planning of services to ensure that they are properly invested in over the long term.

Overall, I welcome the Bill, but I fear that it will disappoint many as a result of the failure to address some of the considerable issues with regard to funding, rewards to the work force and professional training, and the appropriateness of the cap on costs.

[Sheila Gilmore (Edinburgh East) (Lab)]

I am pleased to have the opportunity to speak to new clause 5, which is in my name. I thank the many Members who have supported the clause.

I have been pursuing the issue since 2011, initially on behalf of a constituent, a Mr Kenny, who suffered an injury when he was serving in the Army and is paralysed from the waist down. He originally lived in the London area, but his family is from Edinburgh and he wanted to move back to his family. For four years, he got absolutely nowhere, because neither authority would take responsibility for him being able to move. They argued backwards and forwards. Eventually, his family helped him to move physically, but for a period none of his care costs was being met, until Edinburgh relented and began to meet those costs. By that time, he had incurred quite a lot of debt.

I first raised the issue in 2011. The right hon. Member for Sutton and Cheam (Paul Burstow), who was then the Minister, said that it should be covered in the White Paper, but when that came out it only related to portability of care within England and not to the devolved authorities. I kept raising the matter and I was assured that something would be in the Bill, but when it was published the measures related to the portability of residential care packages but not home care packages.

Care Bill [Lords]

John McDonnell Excerpts

Monday 16th December 2013 Commons Chamber

[John McDonnell (Hayes and Harlington) (Lab)]

First, may I apologise to the House? I was here for the early stages of the debate and listened to the Front-Bench speakers and others, but then had to leave. Tomorrow’s announcement on aviation, and the fact that we seem to have yet another Government who want to build over a third of my constituency, means I have been at other meetings to deal with that.

I will not take up much time, but I just want to raise a couple of issues that have been raised with me by constituents, and in particular by Jonathan Kaye. I would welcome an intervention by the Minister if I have got this wrong, but Mr Kaye’s first concern is about the regulation of carers who are recruited as a result of direct payments. In my constituency, the borough has moved progressively towards direct payments, where the individual recruits carers on the open market. That is extremely difficult, but at least they have some choice. I want to be clear about whether these carers are included in the regulation system of the Care Quality Commission, as set out in the Bill. Who will inspect them, and how will their performance be monitored?

[Norman Lamb]

Personal assistants are not part of the CQC regulatory system. That has always been the case, including under the previous Government. We would certainly encourage personal assistants to seek to secure the new care certificate qualification, however, so as to demonstrate their care skills, but they are not part of the formal system.

[John McDonnell]

I think Mr Kaye would like me to press that at some stage during the Bill’s progress. His view is that they should be regulated in the same way as others, and that there should be appropriate inspections as well. I understand the difficulties, particularly in terms of family relationships with regard to carers. I understand the subtleties of that, but there does seem to be a gap in the Bill as it stands. I might want to look at that in Committee, and certainly on Report.

The second point is that I believe that in the other place Baroness Greengross or Lady Greengross—I am never sure of the titles of the bourgeoisie—moved an amendment to cover the whole range of abuse. That was partly a response to the lobbying for abuse by carers to be properly covered by this Bill. I hope the Government’s attitude is that the amendment will remain in the Bill. I am happy to give way again to the Minister if he wants to respond; perhaps he will do so later.

The third point Jonathan wanted me to raise was about assessment and reassessment. I do not know what other Members find in their constituencies, but I find that the process of assessment can be extremely difficult—first, getting an appropriate person who can do the assessment, then getting that appropriately skilled person to do the assessment, and then the bizarre continual reassessment after reassessment that amounts almost to harassment. Some people with severe disabilities —with permanent conditions who, to get a cure, would need a trip to Lourdes, to be frank—get reassessed time and again. That becomes worrying for them, and some individuals can lose some element of their benefit through this process.

[Meg Munn]

I have a great deal of sympathy with what my hon. Friend is saying. In my experience there seems to be a tendency of wanting to assess people and then reassess them, rather than putting effort into providing services for them. If we quantified the time that goes into assessment as opposed to provision, I think we would see some way in which we could shift some of these very scarce resources into helping people properly.

[John McDonnell]

I was with a constituent last Friday and the issue under discussion was disabled facilities grant. Again, there seem to be more assessments and more spent on assessment than on getting the work done at times. There needs to be a clear understanding of the issue of permanent conditions and how we can make sure people do not have to go through the trauma of assessment

That brings me on to the issue that was raised by Age UK—I apologise if others have raised it before—which is about the individuals who will do the assessments and the level of their qualifications and of their specialisms. My whole community has been traumatised by what happened with the Atos assessments, and I would not want to see another process implemented in the same way under this Bill. Age UK wants us to ensure that appropriate assessments are carried out by appropriately skilled and qualified assessors.

That leads me to a further point, and I apologise if others have already raised it. Part of the issue for people who have to undertake the assessments is ensuring that they have the right advocacy support. In my area, we have DASH—the Disablement Association Hillingdon—which provides excellent support and advocacy, but it is struggling, as is every other voluntary organisation in the area, as a result of local government cuts and the demands and challenges that are placed on it. It is important that, as we introduce this legislation, we look at the role of advocacy and the importance of supporting it through appropriate funding from local government and elsewhere.

I want to talk briefly about the report from the personal social services research unit. It was mentioned by my hon. Friend the Member for South Shields (Mrs Lewell-Buck), whose superb speech set out, drawing on personal experience, exactly how many of us experience the services of carers. I am not sure whether other hon. Members have gone through this matter in depth in the debate today. If they have, please will they intervene to tell me, so that I do not need to go through it again?

The report has usefully confirmed all that we have experienced and understood anecdotally in our constituencies. Even I was shocked at some of the statistics that it contained. The report was produced by the personal social services research unit of the university of Kent and the London School of Economics, and it is an objective assessment of expenditure and of the numbers of people receiving services from local authorities between 2005-06 and 2012-13. Its findings confirm what most of us have experienced in our constituencies—namely, that there have been

“widespread reductions in the period 2005/06 to 2012/13 in both the observed and standardised estimates of number of adults receiving state-funded social care services”.

It also found:

“Across all user groups, approximately 320,000 fewer people received local authority brokered social care in 2012/13 than in 2005/06. This represents a 26% reduction in the number of recipients of care.”

If we look at the standardised assessment, we see a

“decrease of 453,000 (36%) individuals being served”.

That reflects what I am finding in my constituency. People who should be receiving a certain level of care and who would previously naturally have received it are no longer doing so. The report goes on to state:

“Reductions in the number of clients are particularly acute for older people; 260,000 or 31% fewer older people received services in 2012/13 than in 2005/06…The standardised estimate of reduction was greater: 333,000 or 39% fewer clients.”

That means nearly 40% fewer older people are receiving services now than five years ago. The report goes on:

“Approximately 37,000 or 24% fewer adults aged 18-64 with physical disabilities received social care support in 2012/13 than in 2005/06. The standard estimate showed a reduction of 50,000 or 33%. A reduction of 30,000 (21%) was observed in the number of service recipients aged 18-64 with mental health problems.”

I find that staggering but, at the same time, it reflects what is happening in our constituencies. Why is this happening? It is fairly straightforward, really. It is a result of the cuts that local government is experiencing.

Although the report covers the period between 2005-06 and 2012-13, it emphasises that the vast majority of the cuts have been made in the past two years. The coalition Government have brought forward this level of service withdrawal over a very limited period of time. According to the report,

“our analysis suggests a drop in need-standardised net social care expenditure between 2005/06 and 2012/13 of approximately £1.5 billion…Moreover, almost all reductions in expenditure are concentrated in 2010/11 and 2011/12.”

That is a cut of £1.5 billion overall. It goes on:

“The largest reduction in expenditure levels is concentrated on services for older people”.

That again reflects the anecdotal evidence that we can bring back from our constituencies. The report suggests that there has been a £1.6 billion cut in services to older people. This is not a party political point; this is independent, objective research, which we should all take on board in the debate as it goes forward.

The report continues:

“For adults 18-64 with learning disabilities”—

there has been—

“a significant increase in observed and standardised expenditure in 2012/13 relative to 2005/6 worth just above £1 billion”.

So there has been some increase in some areas but dramatic cuts in others. Worryingly, the cuts seem to be focused on older people and those with mental health problems. The interesting thing is the point made by my hon. Friend the Member for Edinburgh East (Sheila Gilmore) and others about how this is disproportionate; it is not being done right the way across the board, and the impact on areas is geographically uneven. It appears that the most deprived areas are being hit the hardest.

The report said:

“Approximately 95% of local authorities in England were observed to have reduced the number of older people receiving services in the period…Of these, the number of older people receiving services had fallen by 40% or more in approximately a third…of authorities.”

So this is focused on a limited number of local authorities, and again it appears that they are the most deprived. I find that extremely worrying.

Although we welcome the Bill as a first step, as others have said, Dilnot did make it clear to all of us that the social care crisis has to be addressed before we move on to other changes in legislation, or at least simultaneously. Introducing new legislation when the Government are introducing this scale of cuts will completely undermine the credibility of the new legislation. That is why I hope that as part of the debate as the Bill moves forward we can reach a consensus on not only the legislation—where I hope we can take on board some of the points made in the reasoned amendment—but on the level of investment required over the coming period if we are to support the most vulnerable in our society.

The study I mentioned is objective and it reflects what I am experiencing in my constituency surgery on a weekly basis—I believe it is the same for other Members of all political parties. The social care services in our areas are under intense stress and, as a result, people with even critical and substantial needs are not being addressed—those with moderate needs, which are still significant and should be within the system, are being ignored completely. We need to address this matter with some seriousness now and try to reach some all-party agreement on the way forward, not only on the Bill, but on the investment strategy for care needs.

Changes to Health Services in London

John McDonnell Excerpts

Wednesday 30th October 2013 Commons Chamber

[Mr Hunt]

The hon. Lady makes an important point. I accept that there will be changes in transport arrangements. I am happy to work with her and to talk to TfL about how improvements can be made in respect of the changes I have announced today.

I hope that the hon. Lady talks to her constituents about the positive aspects of the proposals. Hers will be the first part of the country in which all GP surgeries are open seven days a week—at least, there will be seven-day access to GP surgeries throughout her constituency and north-west London. North-west London will be the first part of the country where we have full seven-day working and we eliminate the fact that mortality rates are 10% higher if people are admitted in an emergency at the weekend. The positive aspects of the proposals will mean that her constituents find that they get better, safer care and live for longer.

[John McDonnell (Hayes and Harlington) (Lab)]

I represent wards with some of the highest morbidity and lowest life expectancy in north-west London. Clinical support for reform and restructuring was based on adequate funding during the period. Hillingdon clinical commissioning group has written to the Secretary of State to express its concern about the current funding formula, which could undermine service delivery unless there are additional resources. Will he meet representatives from the CCG and Hillingdon hospital, which he has denied additional winter money this year, to talk about the long-term future of our health economy?

[Mr Hunt]

Hillingdon CCG supports the changes because it recognises the profound impact they could have in addressing health inequalities. I know that that is precisely what concerns the hon. Gentleman. His constituents will be big beneficiaries of the changes we are announcing today. The funding formula is an extremely difficult issue. We have decided to depoliticise it by making it a matter for NHS England—it is decided at arm’s length from politicians because we believe it is very important that things are decided on the basis of an independent formula.

Accountability and Transparency in the NHS

John McDonnell Excerpts

Thursday 14th March 2013 Commons Chamber

[Mr Andy Slaughter (Hammersmith) (Lab)]

Two NHS stories were leading the news this morning, both of which are relevant to the subject of this debate. The hon. Member for North East Cambridgeshire (Stephen Barclay) and my hon. Friend the Member for Ealing, Southall (Mr Sharma) have talked about the important issue of whistleblowers. I want to talk about the other subject, which is the conflicted interests of clinical commissioning group members.

All hon. Members should be grateful for the British Medical Journal report that was the basis of this morning’s new stories. In case anyone has not seen it, let me read the headline points. It states:

“More than a third of GPs on the boards of the new clinical commissioning groups (CCGs) in England have a conflict of interest resulting from directorships or shares held in private companies”.

It continues:

“conflicts of interest are rife on CCG governing bodies, with 426 (36%) of the 1179 GPs in executive positions having a financial interest in a for-profit private provider beyond their own general practice—a provider from which their CCG could potentially commission services.

The interests range from senior directorships in local for-profit firms set up to provide services such as diagnostics, minor surgery, out of hours GP services, and pharmacy to shareholdings in large private sector health firms that provide care in conjunction with local doctors, such as Harmoni and Circle Health.

In some cases most of the GPs on the CCG governing body have financial interests in the same private healthcare provider.”

Yet the cheerleader for the privatisation, Dr Michael Dixon of NHS Alliance says:

“The priority is to move services out of hospital and into primary care. The reason this hasn’t happened to date is because of blocks in the system. It’s more important to remove those blocks than be preoccupied with conflicts of interest.”

I say that the British Medical Journal has done a good job, but it has only just scratched the surface. I shall refer to my own experience of trying to get to the bottom of this matter in north-west London.

On 10 November an article by the social affairs editor of The Guardian began:

“Five family doctors have this week become millionaires from the sale of their NHS-funded firm to one of the country’s biggest private healthcare companies in a deal that reveals how physicians can potentially profit from government policy in the new NHS.”

It went through the individual shareholdings of those doctors who had sold out to Care UK and it continued:

“Another winner seems to be NHS reform champion Ian Goodman. The north-west London GP chairs the Hillingdon clinical commissioning group and was also a board director of Harmoni. He could make as much as £2.6 million.”

[John McDonnell (Hayes and Harlington) (Lab)]

This Dr Goodman chairs my local CCG and tried to force Hillingdon hospital to put £13 million of operations out to tender, which would have destabilised the whole hospital. I pay tribute to the Treasurer of Her Majesty’s Household, the right hon. Member for Uxbridge and South Ruislip (Mr Randall) and the Parliamentary Secretary, Cabinet Office, the hon. Member for Ruislip, Northwood and Pinner (Mr Hurd), who joined me in preventing that from happening. It would have meant Hillingdon hospital being financially destabilised in the long term.

[Mr Slaughter]

I am grateful for that. I did a company profile for Harmoni. It revealed that, although he might have sold his shares for that amount of money, Dr Goodman is still listed as head of clinical spine. A series of press articles deals with the failings of Harmoni—failures that have caused deaths through under-staffing or poor-quality staffing—and why it is under investigation.

Let me return in the time I have available to my attempts to get to the bottom of the matter. The same day as I read the article in The Guardian, I wrote a short letter to the chief executive of the NHS in north-west London. I said:

“I attach the front page article from today’s Guardian, which you may have seen, regarding the sale of out of hours GP service provider Harmoni to Care UK. The article states that a number of GPs will make substantial sums from the sale.

I note that four of the CCG chairs in NW London declare shareholding or directorship in Harmoni, as does your Medical Director. It would be helpful to know if they are beneficiaries of the sale and by what amount.”

I then asked for assurances as to the future.

A month later I received a non-reply reply, the most relevant sentence of which was:

“Any member who declares an interest in a meeting is expected to take no part in discussions and step out of the meeting.”

I wrote back a much longer reply, in which I pointed out that the chair of the Royal College of General Practitioners had said:

“it is not about excluding yourself from the room whenever there is a discussion; it is about how it will drive your decision-making overall”.

I pointed out that, as a consequence of hospital closures in north-west London, there had been a shift in funding from hospital to primary care, a greater involvement of private companies in the primary care sector, and an opportunity for those companies to increase their profits by cutting back on the level of service offered.

I principally raised the fact that the information that should be provided is not provided on declaration of interest forms, especially the scope and value of any interest. I listed doctor by doctor and CCG chair by CCG chair what those interests were and how they were not adequately declared. I dealt with seven out of the nine CCG chairs and the medical director. That was in a letter on 20 December.

I received a reply on 3 February which said:

“The Cluster does not hold this data.”

So three months on from my original inquiry, I am none the wiser in relation to these matters.

I advise any hon. Member to look at their CCG declarations of interest online—not Hillingdon, because it does not publish them online. I use Hammersmith and Fulham as an example here. The husband of one member is a partner of Drivers Jonas Deloitte. The first thing I found on the website of Drivers Jonas Deloitte was that it had been appointed to sell the Kent and Sussex hospital in Royal Tunbridge Wells when it closes in 2011. Another member is the owner of a provider of home care services. Another is the brother of the director of a design company that holds a number of contracts with NHS organisations. It might be that none of them has a direct financial pecuniary interest now or in the future, but it shows touching naivety, complacency or worse.

Before the 28 members of the joint PCT board made the decision to close the four A and Es in north-west London, I said at the public meeting that if any of them had or was likely to have interest of a pecuniary nature they should not take part in that decision. One of them rather touchingly volunteered the information that they had sold their shares. What world are we living in when a third of GPs on the new CCGs can hold financial interests in anything from land sales to an alternative provider?

I raised the question with the Prime Minister yesterday and mentioned Dr Goodman, although not by name, and his estimated minimum return of £2.6 million. Again, I got a non-reply in reply. Sooner or later the Government will have to address these matters.

There is another story in the Daily Mail today that states:

“In 1981 there were eight NHS press officers in Britain. Now there are 82 in London alone”.

It is not that there is a lack of spending on publicity in the NHS. Indeed, almost £1 million has been spent on a private consultancy firm simply to carry out the bogus and botched consultation on the closure of A and Es.

We are seeing the creation of a second-grade health service in north-west London.

Hospital Services (West London)

John McDonnell Excerpts

Wednesday 11th July 2012 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I associate myself with the sentiments expressed by the hon. Member for Cities of London and Westminster (Mark Field), particularly about the Royal Brompton and its specialist services. I will focus briefly on the impact of what is happening on my constituency, but I follow what my hon. Friend the Member for Hammersmith (Mr Slaughter) said: there has been an attempt to divide and rule Members over whether to save some A and E units and close others. Yet it is healthy that all Members across west London are working on a common cause to try to get a long-term view of the health care needs of our areas.

I was reminiscing a few weeks ago with one of our chief executives, who has been dealing with this issue in our area for about as long as I have—almost 40 years. I think that this is our ninth reorganisation. On average, a reorganisation takes place over roughly a two-year period and operates for about 18 months, and then we start all over again. I started off in my area with a network of GPs, a community hospital, a district hospital and specialist services. In the first reorganisation, we lost the community hospital. After that, I was promised five GP centres; I got two. Then we had the wonderful idea from Lord Darzi about polyclinics, which looked awfully like community hospitals, but I did not get one of those. By the time that they had been discarded, it was decided there should be a walk-in centre. After that, we lost a lot of the capital investment in relation to GP improvements, so I am left with some GP centres, but many GPs still working out of converted houses and many single practitioners. Many of them are about to retire. The walk-in centre is about to be closed and relocated to Hillingdon hospital, where I am told that all the basic triage will be performed. We seem to have come full circle but have cut out some of the basic elements.

I am now told that, under the present consultation, the coming plan is to devolve services into the community, with more community care and improved GP services, which will then reduce the need and desire to go to accident and emergency and make it possible for specialist services to be concentrated into fewer units. The problem with that form of devolution is that the walk-in centre in central Hayes is being lost; no further capital investment in GP centres is planned; many GPs, although they have given good service over the years, are ageing, will soon retire and, as I have said, are working in poor quality settings; and there are, to be frank, cuts in community care support as well, particularly those that are happening in personal budgets. Some bizarre judgments are being made at local authority and other levels about qualification for community care. People are winding up in my office to attend my constituency surgery because the care that they have had for years has been withdrawn.

The next stage of the proposal is the closure of Ealing accident and emergency. Ealing dealt with 84,000 people in 2010-11, with 12,000 urgent care cases and 30,000 serious in-patient cases. If even half that number transfer to Hillingdon, it will be swamped. My fear is that in the next round of cuts A and E performance at Hillingdon hospital will be examined and criticised, because it has been swamped, and that it will eventually become a target for further closure. I worry also because it appears possible to extrapolate from the numbers in the consultation reports the cutting in the next 12 months of up to 1,700 NHS jobs, with the prospect of 5,000 being cut by 2015. That could be yet another reorganisation that exhausts staff, confuses patients and the community, and wastes large amounts of resources. In the end, it will reduce the quality of services and might result in further cuts. I predict that, within four years, we will be back here again if we continue on this path.

All that my community is pleading for is an element of stability. I agree with my hon. Friend the Member for Hammersmith that the consultation process has been tainted from the start, because information for the community and opportunities for engagement have been lacking and there has been a failure to disseminate information in a form that people can understand properly. I think that that has been done by what is now emerging in our sub-region as a group of elite GPs, who seem to control the process rather than engaging even with many of the other GPs. When, in our meetings with GPs, we ask whether they support the proposals, those at the grass roots say clearly they do not. They do not feel involved.

It is time to draw breath in the consultation, start a proper process of discussion and try to get some form of longer-term stability into the process. My hon. Friend the Member for Feltham and Heston (Seema Malhotra) is here, and there is a 17-year difference between life expectancy in some wards of our constituencies and in some wealthier constituencies represented by hon. Members present for the debate. It is clear to me that the eight or nine, or perhaps more, reorganisations of the past 40 years have not dealt with the real health care issues and needs in our area. What is happening will be another exercise involving abortive costs, which will frustrate the provision of real health care to whose who need it.

Southern Cross Care Homes

John McDonnell Excerpts

Tuesday 12th July 2011 Commons Chamber

[Paul Burstow]

I am grateful to the hon. Gentleman for his question, which allows me to deal with an earlier question on the same subject. The answer is absolutely yes. The continuity of care will be not just for the benefit of older residents of care homes, but for the benefit of any individual who relies on the services provided by the company.

[John McDonnell (Hayes and Harlington) (Lab)]

I have been raising concerns about the management of Southern Cross in the House since 2007, in early-day motions and Adjournment debates. Despite assurances from the Care Quality Commission and from the company itself, the system resulted in neglect and abuse in my borough, which, at one point, suspended all placements in Southern Cross homes. I therefore view with some scepticism the assurances given today by the commission and participants in the company. Will the Minister be able to empower local authorities to take control of homes if they are threatened with closure and residents may be forcibly moved?

[Paul Burstow]

The hon. Gentleman has been raising those concerns in the way that he has, and I will certainly look at the points he has raised in the past. Local authorities have certain statutory powers in respect of their ability to respond to the closure of a care home by managing and resourcing that. We have been, and continue to be, in discussion with local authorities on that, so that they are able to respond in the event of a closure. I return to my key point, however, and the key reassurance we have not only from the company, but from the landlords: this is a solvent restructuring of the business, so that the care homes continue to operate and to provide homes for their residents.