North-east London STP — House of Commons, 2016-12-16
Topic: Health
Michael John Gapes (Labour, Centre-left): My hon. Friend has given the figure I was about to cite. The STP executive summary states: "Our total financial challenge in a ‘do nothing’ scenario would be £578m by 2021. Achieving ambitious ‘business as usual’ cost improvements as we have done in the past would still leave us with a funding gap of £336m by 2021." Those are eye-watering figures. The claim is made that "we have identified a range of opportunities and interventions to help reduce the gap significantly" However, the £240 million gap between the "business as usual" case model and the actual predicted figure requires a series of other measures, including significant funding from the sustainability and transformation fund, reductions and changes in specialised commissioning, and what is called "potential support for excess Public Finance Initiative (PFI) costs." That covers Whipps Cross hospital, Queen’s hospital, Romford, and, to some extent, King George hospital. "Potential", what a lovely word. So this is not real and it is not even planned—it is just "potential" These plans are based on unrealistic, heroic, Soviet-style assumptions. This is a truly Stakhanovite model of over-estimation of potential, yet the STP still proposes it can transform a deficit of £578 million in 2021 into a potential surplus of £37 million—and improve the services. That will not happen. The plans are also predicated on totally unrealistic assumptions about savings from closing the A&E services at King George hospital, and there is a lack of clarity as to when this will happen and how much we are talking about. I have been told that tens of millions would be invested in the sites at Queen’s and Whipps Cross, but I have been told that at least £75 million is needed to do that, and there is no sign of where this capital is coming from in the Department of Health. So wards are being closed in one hospital and then millions are being invested in rebuilding wards or constructing wards at other hospitals, for no real net gain There is also a problem about what process will be involved in this closure at King George hospital. I am conscious that I do not have limitless time, but let me say that my local Redbridge Council is very concerned about this, because King George is supposed to be transformed from an acute hospital into an urgent care centre and so the local community needs to be involved. Redbridge is requesting that it should be involved, and I note that it has recently been agreed that it will be involved on the transformation board. However, Redbridge wants an independent chair of that board, because it is important to involve a person of public trust so that there is no controversy. There needs to be a transparent, open process as we discuss the options for the future of King George hospital, so that we can challenge the business case and take account of the fact that the assumptions on which this model is based are 10 years old. They go back to the misnamed "Fit for the Future" plans of 2006. The population growth that we have had and the growth that is yet to come, the young population that we have in the area and the movement in population means we have to look at these issues with great doubt and concern We need to assess the implications of all those issues. As Redbridge says, it wants to know how the reconfiguration to an urgent care centre assists primary care, community health services, adult social care, public health, and public health prevention and education. An opportunity exists in the changes, but we need public engagement in those changes, and we do not have that at the moment There will be enormous pressure on my local council because of budget problems, and I am worried about the situation. I am glad that the STP highlights the social care challenge, but it needs to be taken seriously by the Government if we are truly to have an effective health and social care system. The statement in this House yesterday did not offer a solution to my borough. It did not answer the challenge that boroughs such as Redbridge are facing. These boroughs are already ahead of the game in the integration of health and adult social services and are working with neighbours to take up the challenge by being a pilot for the development of an accountable care system Yet with all that transformation, Redbridge still faces a huge social care challenge. That is made worse by a triple whammy of public sector funding reductions to local government—my borough has lost 40% of its income since 2010—chronic underfunding of adult social care by the Government and the fact that Redbridge does not get a fair funding level in the first place. There is, potentially, a major problem. We face a shortfall of about £4 million in social care and the 1% extra on council tax raises less than £1 million. The responses that we have heard from the Government in recent days have been inadequate—indeed they have been worse even than the silence from the Chancellor in the autumn statement. They offer no real solutions to the growing crisis that will impact on some of the most vulnerable in our society. I conclude with this plea: please will the Government look at the situation in north-east London and will the Minister meet me to discuss the fact that this plan is unrealistic, incredible, unachievable and will lead to disaster?