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Health Care in London

I am delighted that we are having this debate and to have the opportunity to put my views on the NHS in London on the record. I represent Islington, North, and most hon. Members who have contributed so far have mentioned the Whittington hospital in my constituency, as I will in a moment. However, the core of the debate is the question of the accountability of the NHS and how it operates. In London, the background is the Darzi report. Behind that, there are a series of associations—in my case, five north London boroughs have decided, as my right hon. Friend the Member for Holborn and St. Pancras (Frank Dobson) has pointed out, that they must cut £500 million from their budget in the next five years. I keep asking where that figure comes from, but nobody can tell me. They say, "Well, it's a possibility," to which I ask, "A possibility of what, from where, by whom?" to which they reply, "We have to think to the future." We all have to think to the future, but I do so in terms of improving health care throughout my constituency, north London and the rest of our capital city. I pay tribute to my right hon. Friend. When he was Health Secretary, he not only ensured large-scale investment in major hospital facilities, GP practices and all the rest of it, but put into operation the Black report, which was hidden by an earlier Conservative Government, and tackled health inequalities through health action zones and public health campaigns. There has been an improvement: life expectancy is greater; infant mortality and child obesity are lower; and a number of other things have improved. We have a long way to go, as everyone should be well aware. The population is increasing, and desperate inequalities still exist, as does very bad housing, so we need investment in health care across the piece. We do not need senior officials who lead shadowy existences to decide that in the long run, there must be a cut in health expenditure through our part of north London. My plea is on behalf of an awful lot of people who rely desperately on local health services and facilities, who do not have the alternative of private medicine—for them, it is the NHS or nothing, so we need the NHS to be the very best. Most speakers today, including my right hon. Friend, mentioned the future configuration of local A and E facilities across north London. As has been said, a proposal is lurking somewhere in the background of this debate. Eighty people—I do not know who they are—are being regularly consulted on the future configuration of health care across north London, and they appear to have decided that the most important hospitals are University College hospital and the North Middlesex, and that they will therefore downgrade or reduce everything else. I find that repugnant and wrong. When news of those proposals leaked out to us, I called two public meetings in my constituency. Three hundred people attended the first, and 350 the second, which does not include those who could not get in because the room was so full. We held a march and demonstration through Islington, and 5,000 people attended. They were not subject to scaremongering: they were there to show their support for their national health service, their local hospital and its A and E department. My hon. Friend the Member for Islington, South and Finsbury, my right hon. Friends the Members for Holborn and St. Pancras (Frank Dobson) and for Tottenham (Mr. Lammy) and the hon. Member for Hornsey and Wood Green (Lynne Featherstone) and I were all there, as was every political party from the Revolutionary Communist party to the Conservative party. Opinion was unanimous in support for that casualty unit. I know that the Minister has heard us and understands what we are saying about this. As a result of the march, I received a letter from the chief executive of NHS London, essentially telling me that I should not be so concerned. I read her letter with great care and was left even more concerned, because she talked about opening a hub at the Whittington hospital for north Islington, called a polysystem. I am not against GP-led health centres or improving primary care facilities. On the contrary, I am in favour of effective, efficient local GPs, but we should not close A and E departments. Casualty unit attendance figures in the north London area were 695,000 last year, of which 86,000 were at the Whittington. Do not close casualty units and do not cut our hospitals, and instead recognise that we conquer ill health and inequality by investment, not by cuts and closure. We conquer them by access, not by making services more complicated and less accessible.