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Health Care in London

I beg to move,"That this House recognises that London has some of the leading hospitals and healthcare services and expertise in the world; notes with concern that some areas of London have the worst outcomes for stroke, heart disease and cancer in the country; is alarmed that health inequalities in the capital rank among the worst in the country; believes in improving services to meet the needs of London's 7.5 million inhabitants; calls for the delivery of a public health strategy geared towards the reduction of health inequalities; calls on NHS London to halt the implementation of current sector-wide reconfiguration proposals across London, including accident and emergency services, until a more effective public consultation is in place; further calls for service configurations that are soundly evidence-based and which meet the choice of patients and the referral intentions of local GPs; further believes that consultant-led obstetric departments and maternity units should not be closed, whilst they are safe, accessible and responsive to a continuing need; and calls on NHS London and the Department of Health to publish the details of the commitments made at the time of the Olympics bid to fund healthcare services in the capital, and to disclose what the current estimate is of the cost of providing services for the Olympics and how it is proposed that this should be funded." Members of the House, particularly the many with London constituencies, will be aware that for the past two years there has been a process called Healthcare for London, which has increasingly sought to prescribe to the health economies across London how they should design their services, which services should be provided and by whom, and, by implication therefore, where patients should go for their treatment. The purpose of the debate is to give the House, for what I think is the first time, the opportunity to express a view on how we want health care services in London to be provided in future. We want literally to fire a shot across the bows of those in the upper hierarchies of the NHS who want to determine these things without reference to the public whom they serve, to the general practitioners who refer patients, or to the patients themselves, who have a right to exercise choice. We also want to give the House an opportunity to set out how it wishes Healthcare for London to be improved in the years ahead. My first point is at the heart of improving health outcomes. We need to focus on improving public health in London, which has some of the greatest health inequalities in the country. At ward level, between Tottenham and Kensington and Chelsea, for example, there is a disparity in life expectancy of 17 years. I know that such disparities exist in other parts of the country, but those are very pronounced. We feel the issue even more keenly when we see such relative wealth and poverty side by side in London, where nearly one in four children live in poverty. There are many specific health problems that are greater in London than anywhere else in the country. The level of sexually transmitted infections is higher in London than anywhere else, and the level of alcohol abuse and dependency is higher than in any other region in the country, as is the level of drug use and abuse. We know—not least because London is where many refugees, asylum seekers and, indeed, rough sleepers are found—that London has 40 per cent. of the total number of tuberculosis cases in the country and more than 50 per cent. of HIV cases. The importance of having an effective public health strategy must be at the heart of this issue. I commend the Mayor of London for the health inequalities strategy that he published last October. I shall not dwell on that at length, although there is plenty of reason to do so, because time will not permit it. The document that I published with my right hon. Friend the Member for Witney (Mr. Cameron) in February was about focusing on public health, having a dedicated public health budget and having a health premium that is intended to support successful local strategies. In the London context, I want to make it clear that if we were given the opportunity to do so by the electorate of London, we would equip the local NHS with individual London boroughs to pursue locally owned strategies to improve public health. We also intend that the NHS should co-operate, on a London basis, directly with the Mayor of London to pursue the health inequalities strategy. Given the particular characteristic of London as a city with city-wide government, we want that city-wide government to bear down on the particular public health challenges that I have mentioned and to exploit opportunities for promoting better health in London, and I know from my conversations with the Mayor that he is immensely keen to do that.