Health Care (London and South East)

Part of Opposition Day – in the House of Commons at 6:27 pm on 20th February 1995.

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Photo of Jim Dowd Jim Dowd Opposition Whip (Commons) 6:27 pm, 20th February 1995

I shall try not to delay the winding-up speeches too long. As the motion makes clear, more than anything else, there is a crisis of confidence in health care in London, especially in south-east London, and I am delighted to follow my good friend, the hon. Member for Lewisham, East (Mrs. Prentice).

I was a member of the area health authority, as it was then, for Lambeth, Lewisham and Southwark in 1976 and went on to be a member of the successor district health authority—it was disbanded in 1990—until I had to leave for having had the temerity to be an elected member representing Lewisham council. When I first joined the area health authority, there were at least 16 hospitals in Lambeth, Lewisham and Southwark. Today, there are four. At that time, there were six hospitals in Lewisham alone—today there is one.

As a member of the district health authority, I was deeply involved in the planning of what became known as Guy's phase 3—Philip Harris house, which has been mentioned. I took great pleasure in imagining that, one day, it would serve the needs of the people of south London and much further beyond in the ways for which it was designed. That will not happen now.

Trusts in south-east London need to be rebuilt. We suffered the first of the flagship authorities in the formation of Guy's and Lewisham. We were told at the time that Lewisham had to amalgamate with Guy's because it could have no independent existence worthy of the name and the matter was a fait accompli. The result of the consultation that took place was overwhelmingly against the creation of that trust, yet no notice was taken of it and the flagship set sail.

The Tomlinson report, which was merely a cover for the fact that, left to themselves, the market reforms would have severely damaged health care in inner London, then suggested that the Lewisham and Guy's trust could be broken and Lewisham could happily find its own way in the world as an independent trust. It said that Guy's needed to erect a new flag of convenience and amalgamate with St. Thomas's. If Lewisham did not have a secure future on its own in 1990, how could it have one in 1993? Either way, somebody was telling the people of south-east London less than the truth. Although the result of a consultation on the Tomlinson report was overwhelmingly against the setting up of a Guy's and St. Thomas's trust, once again that view was tossed to one side.

The consultation on the latest plan closed last Friday. Most people fear that it will lead to the closure of Guy's hospital in all but name and that all its services as a district general hospital will be extinguished. South-east London needs that district general hospital and the expertise and excellence that Guy's has come to represent. I implore the Secretary of State to make this a genuine consultation exercise, to listen to what people say and to consider the alternatives. Nobody says that nothing at Guy's must change, but that part of south-east London needs four district general hospitals to serve the community.

We need only look at the pressure that already exists at the accident and emergency departments of Guy's, King's, Greenwich and Lewisham, made worse by the closure of both Bart's and the Brook. The Brook hospital estimates a 20 per cent. increase in the pressure on the accident and emergency departments in surrounding hospitals and everyone in the area knows that those departments are not coping even now. Earlier speakers mentioned the fact that people are kept waiting on trolleys. A constituent wrote to me about her father, for whom even a trolley could not be found, who had to sit in a wheelchair for six hours at Lewisham hospital. It is foolish to believe that that position will do anything but deteriorate sharply if we lose the services at Guy's.

To understand that, one need only see the response of clinicians at Guy's about the safety of medical procedures if the A and E and intensive care departments are curtailed. I remember speaking to Peter Griffiths, who was general manager of the district health authority in 1986. He went on to be chief executive of Lewisham and Guy's and was famed for being the man who could drive two cars at once, because that is what he got for the job. He then joined the national health service executive. In 1986, he said that there would be a Government clear-out of hospitals in central London, and his job was to ensure that, whatever else happened, Guy's was not one of them. Sadly, he has failed, but the thrust of what he foresaw was patently clear. We need to save the services at Guy's, not just for the people of south-east London but for its reputation as a research centre, which will be seriously undermined if the watered-down scheme being advanced is proceeded with.

My final point is about the acute trusts and relates to what my hon. Friend the Member for Woolwich (Mr. Austin-Walker) said about accountability. I do not have the same problem with the mental health or primary care trusts, but getting responses to inquiries on behalf of constituents from any of the acute trusts is almost impossible. They respond only after they have been badgered time and again. I have occasionally been forced to table questions asking the Secretary of State to tell them to reply. They do not reply because they know that they are accountable to no one for what they do and think that they can reply, or not, as they see fit.

I shall have to ask the Secretary of State to press the acute service to respond to a letter about a case with which I am dealing. I have had replies, but only once they have been pressed into replying, from the patient liaison manager; the operational and nursing director; the service manager, anaesthetics and intensive care unit service; and the chief executive, all of whom say that they will provide more information at a later date. That shows the insularity that they enjoy in their privileged positions, where they are cut off from the public whom they serve.

Others have said how the London ambulance service is scandalously failing to provide a proper service for the people of London, exacerbating people's problems when they eventually arrive at accident and emergency departments.

Despite Government figures, people know that London's health services are being damaged. That is not because we are spreading bad news to them; on the contrary, they come to us with complaints of what is happening to them and to their families and loved ones. It is patently clear that that is damaging the Government. On Saturday, I received a letter from a woman who said that it took 10 hours for her son to have an emergency operation at Lewisham hospital. She said: I am afraid I never voted for you at the last election, but as my MP I would like you to take up a matter with Lewisham Hospital. She went on to say: I do not blame the doctors or nurses, but I do blame the bloated management and contractors for the poor state of cleanliness in the hospital—I will never again vote Conservative! That is what the experience of the NHS is doing to Government supporters.

The people of London need and deserve better from their health service. Once this Government are out of the way, they will get better.