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Health Care in London

I am pleased to follow the hon. Member for Islington, South and Finsbury (Emily Thornberry). We are part of the north central London sector, facing similar challenges from the 80 or so wise men and women who are determining the health care of the people in our areas. We often say that our constituencies are unique and require special attention, and no more so than my constituency and Enfield more widely. Perhaps, however, that should not the case in this instance, as we are all concerned about secrecy and plans that are being meted out without proper public consultation or clinical input. In Enfield, we can peer into and go beyond the world of Darzi and see what the real world could be like. We are, in a sense, the leaders of the pack when it comes to health care for London. Plans were put in place three years ago, which in many ways have been mirrored across London, so let us peer in and see what has happened in Enfield. A consultation took place. We hear a lot in documents about wide consultation, but it did not reach the doors of many of my constituents or, indeed, those of my hon. Friends the Members for Chipping Barnet (Mrs. Villiers) and for Broxbourne (Mr. Walker). The consultation was woeful and incomplete, leading to widespread concern and a lack of confidence. It gave a clue as to what the world would look like if the Darzi model were followed through, and people should be concerned. It is apparent that the call for a local-led solution was nowhere near the mark when it came to Enfield. This was a top-down model, prescribed from on high and greatly restricted in the options presented. It asked the questions to produce the answers that were wanted in order to justify the Secretary of State's decision in September 2008 to downgrade consultant-led A and E and maternity services. Interestingly, if one had gone across the country at the time of the consultation, one would have seen a replica model of health care being followed through. The model had nothing to do with any particular input or variation in local need. There were similar campaigns on the Sussex coast—across Chichester and Worthing, for example. All the models were based on the same one that came from on high in Enfield. The same has been said elsewhere. Sir George Alberti came in as the troubleshooter to fix the problem. He also recognised the lack of public engagement and expressed concerns about the need for clinical engagement. Crucially, he said there was a need for pump-priming and bridge funding for the PCTs to ensure that their primary care services were in place before any of the secondary care changes were made. Was there a bright new dawn in Enfield, which others could welcome and then follow down the same road? In the cold light of day in 2010, we see a primary care trust that is still strapped for cash and facing a historic debt of some £25 million. It is still struggling to get within a double-digit figure for its current debt, while the area still struggles to get any decent primary care. The poly-systems are hardly in place across the borough and we are left with the Secretary of State's decision to downgrade consultant-led A and E and maternity services. We have had some clarity about the situation, so we know that we are left with a 12-hour urgent care centre and at best a 24-hour doctor-led primary care service at Chase Farm hospital. As in Islington and elsewhere, we had a march, with thousands of people participating, and I was joined by my hon. Friends the Member for Broxbourne and for Chipping Barnet and by the hon. Member for Edmonton (Mr. Love) and the right hon. Member for Enfield, North (Joan Ryan). We were all together, campaigning to ensure that we retained our consultant-led A and E and maternity services. Thousands of people signed petitions; the Conservative parliamentary candidate for Enfield, North, Nick de Bois, led the campaign, presented the petition and worked extremely hard. What has happened to the campaign now? We have lost it. There has been a division. Conservative Members are full square behind the need to recognise that there should be consultant-led care, but the champagne has been popped, regrettably, by the right hon. Lady at the door of the A and E unit. What was the celebration? A downgrade of our services. It is not possible to sit on both sides of the barricades in this argument; it is necessary to stand full square behind the people of Enfield, who do not want a downgrade of our services. What is the situation 18 months after the consultation? There is increasing demand, with more than 3,300 births at Chase Farm hospital and more than 100,000 attendances in A and E. My constituents—all our constituents—are asking why, given all the money that is going into the health service and given the rising demand, we are reducing access to accident and emergency services while increasing management of contracts and increasing waste. They want a new financial model and a new clinical model that would ensure that we look at the position again.