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Emergency Care

I will not, because I have only 15 minutes. I am sorry that I cannot give way, but time is pressing. I want to go back a little to the remark made by the hon. Member for South Cambridgeshire (Mr. Lansley) that we should stick in this century. I would like to point out that we are only nine years into this century, which is not a lot. The idea that history has no impact on the present or future is clearly nonsense. In 1997, when I was elected MP for Enfield, North, through the doors of my advice surgery came many people, often elderly people, who had waited almost two years for a hip replacement. They had waited in pain. That pain not only made the quality of their lives appalling but, even after the operation, undermined their health. Lots of people came to my surgery who had waited considerable amounts of time for cataract removal. The wait significantly affected their ability to engage in life and to be independent. I no longer have anybody coming through my surgery doors with those problems. That is not to say that nobody comes through the door with issues about the NHS, but they do not come to see me with those problems. The 18-week wait is a significant gain for the people of this country who depend on the NHS. All those factors affect urgent and emergency care. If people are dealt with early in the onset of any illness or disease, they are much more likely to make a good recovery and much less likely to present at an emergency department at some point in the future. The same is true if there is good, accessible, available primary care, as people are then much less likely to need to present at an accident and emergency department or to need urgent care. In Enfield, we very much need the primary care strategy that our primary care trust is planning. I worry that the Conservative policy of deriding and undermining confidence in the notion of a polyclinic will damage the ability to put in place a good primary care strategy. Let me give an example of what that strategy means to us in Enfield. We know now that we are getting a health centre in the Enfield Lock area. Professor Sir George Alberti came to Enfield, and he said, ““You need an improvement in access to primary care in the north-east of your constituency.”” That is now happening. The plan is that we are to have a big health centre with an independent living facility attached to a community school. It will provide a first-class service to the people of Enfield Lock, Enfield Highway and north-east Enfield. That will reduce the number of people who have to leave the area and go to accident and emergency centres with problems that local GPs or walk-in centres can deal with. The health centre will mean that people have much more access to local primary care. The primary care strategy will have another impact in Enfield, North. Although it will not be built in the next two or three years, a polyclinic is planned for the town centre. Many GPs practise in that area, so it is nonsense to say that people will have to travel vast distances to get to their doctor if a polyclinic is set up. It is a densely populated, town-centre area, so there is no need to fear that. The polyclinic will have longer opening hours, and people will have much greater access to a greater range of specialist GPs. Moreover, the centre's technological diagnostic resources will mean that people will not have to wait for a hospital appointment to get the same service. The primary care strategy for Enfield, North means that there will be a polyclinic in the town centre and a health centre in north-east Enfield. Add to that the fact that people will have access to the Forest road health centre just over the border in Edmonton and to the walk-in centre at the North Middlesex hospital, and it is clear that the strategy will be a huge improvement. The result will be that people will have access to their local health centre and then, if they need it, they will be able to go to the much larger health centre set-up that is sometimes known as a polyclinic. Beyond that, they will have the walk-in centres, local accident and emergency facilities, and the trauma centre provided by the North Middlesex hospital. At local level, the primary care strategy will really serve the needs of people living in Enfield. I worry that some of the propaganda pumped out by the Opposition encourages people to fear any kind of change at all. It undermines their confidence in the excellent service provided by the NHS, and in what is very necessary change to primary care provision. I want to say a few words about Chase Farm hospital. I am pleased to have the opportunity to do so as I have spoken about it many times, both in this Chamber and in Westminster Hall. Indeed, the hon. Member for Enfield, Southgate (Mr. Burrowes) had an Adjournment debate on the issue only last week. I attended and intervened, and my hon. Friend the Minister is well aware of my views. I do not oppose change, but it is important that local people are listened to and, without exception, the people and elected representatives in my constituency do not support the proposed changes at Chase Farm hospital. However, that needs to be put in context, and to that end the past is important once again. For the first time in 20 years, the people in my area can be confident that a hospital will be maintained on the Chase Farm site. We have managed to achieve some real gains, including ensuring a secure future for the hospital, and I advise anyone who doubts that—including Opposition Members—to compare local Conservative literature with the hospital trust's original proposals. One of those proposals was to close the hospital altogether, so it is clear that our success in saving it is a real achievement. The second gain is that there will be an expansion in planned surgery at Chase Farm hospital. That protects the heart of the hospital—its wards and operating theatres—and so is very important to people in Enfield, especially those elderly people who are much more likely to need orthopaedic and other operations. It is very important that they be able to go into hospital locally. We have also gained some local accident and emergency services. The original proposals put forward what might be called a ““hot-cold”” model, under which Chase Farm would provide only elective—that is, planned—surgery and nothing else. We have managed to get rid of that proposal, which is a gain in itself. In addition, and with the support of the Minister, we have also managed to achieve agreement about having a midwife-led birthing unit, so that Enfield babies can continue to be born at Chase Farm. I am not in favour of any reduction of service at Chase Farm hospital, but it is important to understand the context. I shall continue to campaign and do everything that I can to maintain the present level of service. The motion refers to a report from the College of Emergency Medicine, but the interpretation offered by the hon. Member for South Cambridgeshire was inaccurate. In an intervention, he spoke about distances, but in that respect the report does not help the argument about Chase Farm hospital. I have asked the Minister to look at the matter again, given the significant increases in birth rate and the elderly population. The report notes:"““There is no single solution to the reorganisation of emergency care. In urban areas where””" emergency departments"““are close together (less than 10 km apart) there may be advantages to amalgamating services””." That would not help our argument, as Chase Farm hospital is 9.43 km from North Middlesex hospital, and 10.48 km from Barnet hospital. Therefore, the report does not make the across-the-board point that the hon. Gentleman imagines. It might be more applicable in rural areas, but I do not know, as I do not represent a rural area. It certainly has very little application in my area. The report says that each case must be taken on its merits. I agree: I have presented the case for Chase Farm hospital and will continue to do so, but I will not accept that the NHS is almost no better than it was in 1997, as it has improved significantly. There has been a huge step change, and it is time that people gave that more credit, rather than always talking the service down and looking for the negative.