The ongoing social care crisis poses major difficulties. We all know that private care homes are struggling and that there is an issue of quality. It seems to me that one advantage of the King George Hospital site is that it is co-located next door to the facilities of the North East London NHS Foundation Trust’s Goodmayes Hospital and various other facilities that provide support for people with learning difficulties and people with acute, severe and less severe mental health problems. It would seem logical, if we are to have joined-up NHS treatment, to have alongside a hospital facilities for those who need short-term, temporary or longer-term care in transition to or from the NHS facilities next door. The site is big enough to do that and, with imagination, could be a model to be followed.

We also have a third cloud on the horizon, which is the north-east London draft sustainability and transformation plan. The Minister will recall that he and I had a very useful meeting in February, along with his then colleague, Mr David Mowat. We had a useful discussion about the implications of the huge deficit in north-east London—£586 million—the potential huge cuts in the budget over the next four years, and the implications they might have. I raised the issue in detail in a debate on 16 December 2016 and that was why I had the meeting with Ministers.

I am very concerned that the funding gap, even if we have predicted regular savings of about £220 million or £240 million in the NHS, would still be £336 million by 2021. One of the most worrying points about the plan—I understand it is still a draft and has not been signed off—is that I went to a meeting last week when the people involved in the organisation considering the plan were discussing it and senior figures in the London NHS referred to it, saying, “You have to work within the basis of the plan.” It has not been signed off or approved, but the people in the NHS health economy in London are thinking ahead as though it will be.

The plan points out that the population of the north-east London boroughs will increase by 18% over the next 15 years, equivalent to a new city. Normally that level of population increase would require a new hospital, but there is no provision, no funding and no expectation of a new hospital. Instead, the proposal is to downgrade King George Hospital in my Constituency and take away its accident and emergency department. That is still in the plan, and it is not a new proposal. In fact, I have been campaigning to save the A&E in my constituency for more than 10 years. But the formal decision was taken by the former Health Secretary, Andrew Lansley, only in 2011. That decision, which was linked at the time to a suggestion of closing maternity services at King George Hospital, provided that those two things would happen in around two years. That was in October 2011.

The reality is that maternity services went to Queen’s Hospital in early 2013—I do not question that there have been improvements—but the A&E could not close as there was no capacity at other hospitals in the region. In addition, it was quite clear that it required huge capital investment, which was not forthcoming. The decision was made in 2011, but in 2013 there was no action and the issue was deferred. The trust then went into special measures three years ago because of a variety of issues, which I have already mentioned.

As the trust comes out of special measures, the question becomes whether it will go ahead with the plans to close the A&E. Practically, it is impossible for that closure to happen soon, but the sustainability and transformation plan still states that the intention is to close the A&E in 2019. The original suggestion was that it would stop the 24-hour service, getting rid of the overnight A&E from September this year. That plan was dropped in January, and I welcome that, but the reality is that it is still in the plan and is still proposed. That cloud still hangs over the trust and all its excellent staff, who have done so much to bring our hospital out of special measures.