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North Middlesex Hospital debate

July 13, 2016

 

Yesterday, I spoke in a debate on the failures of North Middlesex hospital alongside colleagues who are very concerned about the situation at the hospital.

 

Referencing the recent damning CQC report, I condemned the complete lack of intervention and transparency from the Health Secretary. Members of Parliament and the public have been left in the dark on these hospital failures for months.

 

I have been raising my concerns about the situation at the hospital since March, yet the Secretary of State totally ignored my calls for a meeting and has so far refused to step in to address the situation at North Middlesex. This negligence on the part our Government is shocking and it absolutely unacceptable that my constituents will pay for these failures with their health and, in some dire cases, their lives.


Responding for the Government, Parliamentary Under-Secretary of State for Health Ben Gummer MP admitted that "I am afraid that I am not able to give a complete answer at this stage, but Members are entirely right to ask why this happened... I offer an apology to Members on behalf of NHS organisations.

 

We have reached a breaking point, and now the situation is too dire to ignore. The Government must be held accountable for covering up hospital failures which have for too long risked the safety of the thousands of people that North Middlesex Hospital serves.

 

You can read my speech and the debate in full here. I have also copied my speech below:

 

“I am grateful to have the opportunity to speak in this debate. The hospital serves almost the entirety of the constituency of Tottenham and has done ever since the closure of the Prince of Wales hospital in my constituency in the 1980s. It is important to emphasise that North Middlesex hospital is located in a strategically essential area. It serves not only the boroughs of Enfield and Haringey, but some of Barnet and Waltham Forest. Many years ago, when I was a Minister for Health, a neighbouring hospital, Whipps Cross, was a general hospital that on occasion struggled considerably with its emergency department, so I cannot emphasise enough that it is critical for the broader health economy of north-east London that the North Middlesex survives, flourishes and does well.​

 

The concern that has been raised in this Chamber is really about how the situation has got to this stage over such a length of time, with so many Members of Parliament ringing alarm bells in a context where all of us have privately said, “We must tread carefully. We don’t want to talk down the hospital.” We say, “The chief exec seems to be…” as we whisper among ourselves. We do not want to talk down the hospital, but it has now got to the point at which we have to be absolutely frank about what has been happening at that trust, as we have heard, and we must ask some very hard questions about what has been going on.

 

I hope that the Minister will assist me on this point. There have been successive risk summits, meetings have been held, and the chief exec has asked for support, but I am not clear why support was not provided. In the old days, Members of Parliament would have been able to contact the strategic health authority and there would have been a clear line of leadership. We literally had two bodies to deal with: the strategic health authority and the chief executive of the trust. Frankly, chief executives went if they were not up to the job, and emergency teams were brought in to run the hospital. I did that as a Minister responsible for emergency care. I saw it happen in a range of trusts across the country as, under the Tony Blair Government, we pushed for the first targets of four-hour waits. I am struggling to understand how things have got to this level.

 

Life expectancy in a constituency such as mine is among the lowest in the country: men reach 74, six years behind the average life expectancy. We have homelessness and we have had two riots in a generation. The issues are clear, but what is not clear is who was in strategic charge? Why were meetings held in successive years? What is the role of NHS Improvement? Is it ever the case that anyone there would contact a Member of Parliament to say what they are doing to improve a trust? What is the role of NHS England’s London office? The individuals there are paid a hell of a lot of money—hundreds of thousands of pounds. Have they got a responsibility to contact a Member of Parliament to ask for a meeting or a conference call to speak to us about what is happening in the trust?

 

What is the role of Health Education England, which has been concerned about training and qualifications? We know the role of the General Medical Council, but has it been nobbled not to withdraw doctors by NHS England or any other body? What we have are numerous quangos. I have not even mentioned the clinical commissioning group. We have CCGs, HEE, NHS Improvement, NHS England London and the chief executive. The Government came into office determined to reduce the number of bureaucrats, but—my God!—each of us has at least 10 or 12. Then there are all the staff that work under them. Meetings have been held, but what has been done?

 

I have done the Minister’s job, so I feel for him. When I did his job, we did a lot of the running of the NHS from Whitehall. The Minister’s party came in and I understand why they said they could not run it from Whitehall, but we now have all these bodies and I am not clear what they have done. As a former Minister, I want to hear more of what they have been up to. I hope that the Minister will answer the question asked by my right hon. Friend the Member for Enfield North (Joan Ryan). Given that there have been CQC reports—the ​one that we had on the 6th is not the first—and risk summits, what is the obligation to inform Members of Parliament and therefore our constituents? At what point does that kick in? Or is it expected that that should be done solely by the trust? If it is, that is problematic if it is a failing trust in which the chief executive has been put on emergency leave. I have the CQC report before me and it says that safety at the hospital is inadequate, and so is responsiveness. As to whether it is well led—leadership is also inadequate, which is presumably why the chief executive has been put on emergency leave. Overall the hospital is inadequate. Under the headings of caring and effectiveness, it requires improvement. That is pretty damning. It does not get much worse than that.

 

Many hon. Members are concerned—and my right hon. Friend the Member for Enfield North, the hon. Member for Enfield, Southgate (Mr Burrowes) and I certainly are, having been around for a few years. We campaigned to get the PFI that put millions—I think it was £150 million—into building a brand new hospital. It is therefore deeply frustrating that we now have such an uphill struggle. Chase Farm has been mentioned and I will not discuss it again, but the Minister will recognise that we all rang alarm bells about the implications of closing emergency there. Money was put into the trust; yet it has got to its present situation.

 

I heard yesterday about the case of Mrs Alice Morfett, a 92-year-old lady who still went shopping in Morrisons. She had a heart operation in Barts and she was recuperating on the T3 ward. In the morning she told her daughter about her concern about a male nurse’s behaviour; she could not understand why he kept wanting to touch her chest. Her daughter said she did not believe Mrs Morfett and thought the anaesthetic had not worn off, but her mother complained about the nurse rubbing against her chest. After that Mrs Morfett was scared to ask for help. No one was summoned to help her. The next day, after an hour of asking for someone to take her to the toilet, Mrs Morfett tried to get out of bed herself and she fell. She ended up with huge open wounds; my constituent sent me a photo of the terrible wounds her mother suffered. Mrs Morfett died a couple of weeks later, and her daughter believes that she died as a result of her injuries. Mrs Morfett said to her daughter, “Please don’t let them get away with it; they have to pay for what they’ve done to me.” I do not lightly raise constituency case work in this way. I have used this letter because it is the latest one I have in a stream of letters from constituents about what is happening in the trust.

 

The CQC report confirms what we all long feared—that the closure of the emergency department at Chase Farm hospital in December 2013 had a significant impact on demand at North Middlesex hospital. Concerns were also raised about doctors training in anaesthetics, and they were removed from training in the hospital in April 2015, and have never returned to it because the GMC was so concerned. I wrote to the Secretary of State for Health on 22 March—four months ago. I did not get a reply. I am grateful to have seen the Minister eventually, a couple of weeks ago; but he can see why I am concerned when, after failures of the kind we have heard about in the debate, the Secretary of State did not reply to me in March. I will gently say that a hospital where alarm bells are ringing about such issues would have commanded the attention of the Secretary of State in the past, under successive Governments. Certainly MPs and local authority leaders would have been called together and the issue would have been addressed. I raise the matter in the gentlest of ways, because I am concerned about it.

 

Many issues have been raised and other hon. Members want to contribute; and we want to hear from the shadow Minister, too. The bottom line is that we are very concerned that the hospital has reached the state it has, given the investment that has gone into it. Week after week there are complaints from constituents. Yes, the leadership has now changed. It is important that local governance and the hospital’s relationship with Enfield and the London Borough of Haringey should be retained; but we want to hear from the Minister that such things cannot happen again. It is a question of who is accountable, and when, and of how Members of Parliament could have been heard much more constructively. Given all that happened at Mid Staffordshire, it is a matter of deep concern that although things are clearly ​not quite at that stage, they could have reached it had leaks not been published in The Guardian and had MPs such as my hon. Friend the Member for Edmonton (Kate Osamor) and my right hon. Friend the Member for Enfield North not rung alarm bells as they have in the past few weeks.

 

 

 

 

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David Lammy

From Tottenham. For Tottenham.