Kramer, Davey and Cable on Kingston Hospital (Twickenham & Richmond Liberal Democrats)

Kramer, Davey and Cable on Kingston Hospital

February 9, 2010 1:45 PM

• Feb 08 Susan Kramer: I APPRECIATE having this opportunity to raise . . the future of Kingston hospital . . we have a vigorous campaign to save the accident and emergency and the maternity units at the hospital, but we have also now discovered that, in addition, in-patient paediatric and elective surgery are under review, again with closure under consideration.

Kingston hospital serves primarily the residents of my constituency and that of my hon. Friend Mr. Davey. It has always been my intention to share the time available to me with him, as his comments will serve to provide the full view, which should be expressed, and, fortunately, I have more available time than expected, as the previous debate finished early. I should also say that we have been supported in all of this by my hon. Friend Dr. Cable, whose constituents also make extensive use of Kingston hospital. Other users come from Surrey and Wimbledon, although, sadly, Conservative and Labour representatives, including Conservative candidates in the area, have joined forces to dismiss our campaign. We are standing up for Kingston hospital, along with thousands of our local residents, and my hon. Friend the Member for Kingston and Surbiton will give a more detailed account of their views.

Michael Penning (Shadow Minister, Health; Hemel Hempstead, Conservative): On what date was the news of the closures the hon. Lady is predicting given to her?

Susan Kramer: I am grateful for that intervention, as it leads me nicely on to some other points I want to make. I will address it briefly, but I shall then want to return to talking about the importance of Kingston hospital. My hon. Friend the Member for Kingston and Surbiton and I had separate meetings with senior members of the NHS in late November or the very beginning of December. On 18 December, we first heard that these services were under review and that a paper would be produced listing a series of options, including, significantly, the possible closure of the maternity and the accident and emergency units at Kingston hospital. Both of us, quite independently, thought that somebody was having us on because, as I will go on to explain, the quality of Kingston hospital and the services it provides cannot be disputed.

We followed this up with a series of meetings with other senior members of the NHS-chief executives and clinicians. The information we received was generally concerning, but we were asked whether we would hold back from making any public comment because of the report that was due on 18 December. As we approached that date, we were asked whether we would delay again because Christmas was coming and the report would be issued on 25 January. As we approached that date, we found, again, that the report was not going to be issued; we were told that the whole matter would not be put into any arena where we could request the papers until after the general election.

I find that utterly outrageous, but I am going to return to my original comments about Kingston hospital because it is important to understand the framework in which this all takes place. The hospital is part of the south-west London region of the NHS, which comprises four hospitals: Kingston; St. George's in Tooting; Mayday in Croydon; and St. Helier in Carshalton. I wish to illustrate the importance of Kingston hospital to hon. Members. This past year it had 5,800 births, which is by far the largest number for those four hospitals, and it is set to increase its capacity to 7,000 births per year. The unit has an outstanding record, it is a centre of excellence and it is the only maternity unit out of the four to have consultant cover 98 per cent. of the time. The demographics of the area are of growing young families-we see that in our schools and in the number of live births. People's opportunity to use the maternity unit at Kingston hospital is constantly under pressure from the increasing demand and the changing shape of the demographics in my area. The hospital's accident and emergency unit is similarly very heavily used; last year's throughput was 103,000 people which, again, is the highest of those four hospitals in the south-west group. The in-patient paediatric service and the elective surgery unit, which is new and state of the art, are also very well used.

As I said in my reply to the question I was just asked, somewhere around the end of November and the beginning of December we first received the initial information that these services were being considered for cuts. As we continued our various discussions, we were told that about 18 options would be put on the table. We were not given the details of any of those options. Ironically, we actually asked for the information to be shared with other politicians because we thought that this was going to be a much broader discussion-it should be-than the one we were having. However, we initially agreed that we would stay silent until the report became available to be publicly requested. After we were told, just before 25 January, that this would not happen until after the election we made a decision, because we were outraged, that we would not join in this pact of silence. It is true that we had no substantial piece of paper to back up the conversations that we had had, but they were with people of integrity and honour and we had no reason to question the information that was passed to us.

Michael Penning): I am fascinated by the dateline that the hon. Lady is giving. She said that she promised that the Liberal Democrats would keep quiet beyond 18 December and that it was only around 25 January that they made the decision to go public with this, yet on 11 December one Susan Kramer-that is the name on the piece of paper that I am holding-bought the domain name www.savekingstonhospital.org.uk. This is a public document and it is available to anybody who wants to look at it, so it was obvious then to anybody that the Liberal Democrats would run their campaign to save the hospital despite their promises that they would not reveal the information that they had been given.

Susan Kramer: I do not think that the hon. Gentleman has been listening to what I have said and I suggest that he listens more closely. We agreed that we would not go public before 18 December, but we prepared to do so. We bought the domain name and we prepared for what we knew would be a very important and significant campaign.

Michael Penning): To frighten people.

Susan Kramer: I hear very clearly what the hon. Gentleman is saying and it absolutely clarifies what the Conservatives would have done had they shared the same information that we shared. I am very glad that that is now on the record, in Hansard, for anyone in this House or outside to read-

Michael Penning): rose-

Susan Kramer: The hon. Gentleman keeps intervening-let me finish- Interruption. I am very pleased to know all that- Interruption.

Sylvia Heal (Deputy Speaker)

Order. If the hon. Lady is not allowing an intervention at this moment, that is entirely up to her.

Susan Kramer: I want the Minister to be able to respond substantially to the debate.

We prepared for a campaign and we were completely open with those to whom we spoke that we would campaign strongly on this issue, but we agreed to hold back until the 18th. We were then told that it would be the 25th and then, just before the 25th, we were told "No, it's being held over until after the election." At that point, we felt that it was an outrage-I believe that most of our residents consider it to be an outrage, too-for the decision-making process to proceed and continue without an opportunity for the public to be brought in, to be informed or to be able to shape that process as it developed. The public would be left unaware of the situation until the options had been narrowed down to three, possibly four, with much of the thinking closed off and much of the direction predetermined. We believe that our local residents need to be involved and that their voices need to be heard at a stage when the decisions are, potentially, a little fluid and when there is some flexibility in the system. We believe that local decision making and local input on health issues is absolutely and centrally crucial.

We have applied to the various branches of the NHS with freedom of information requests for the papers that we wish to have and that we wish to put in the public domain. I urge the Minister to ensure that the responses to those FOI requests are given, and that they are given in full. Something strange always happens, however, when one goes public with an issue and with a campaign and when one raises concerns-

Michael Penning): It scares people.

Susan Kramer: I note that from his seat, Mike Penning has used the word scaremongering, which has been used by the various Conservative candidates in the area. That has done a lot to undermine our campaign. However, the effect of the campaign has been that those who were privy to the information that we disclosed, and disclosed accurately, have decided that it is time for them to act. Over the weekend, I received a copy-I believe that my hon. Friend the Member for Kingston and Surbiton did, too-of four pages from the report on the south-west London strategic plan, which we had hoped for on 18 December. I am lucky enough to have a copy of that in my hands now.

We received those pages this weekend, and now we find it extraordinary how accurate the information that was shared with us was. The recommended scenario in the paper is that there should be only three hot sites, as it describes them, among the four hospitals. It is clear from the paper that St. George's is safe as the major acute hospital in the area, leaving Mayday, St. Helier and Kingston as the hospitals where services are at risk. Indeed, we were right to say that there were 18 options- 18 options are laid out in the paper. In only two of those options does Kingston retain its current services in full. In six, it loses accident and emergency, maternity and in-patient paediatrics. In 12 options, it loses in-patient paediatrics. In eight options, it loses its elective surgery. I am sure that the Minister has seen the paper and is able to confirm what I have just said. If he has not, we will be pleased to try to provide him with a copy of the part that we have and we would be grateful if he provided us with the missing pages.

I use Kingston hospital-in a sense, I suppose, I could have declared an interest-as does every resident in my area. I have rushed a sick grandchild there in the middle of the night. It took about 20 minutes-had I tried to get to St. George's, I doubt that I would have made it in 40. It would probably have taken closer to an hour-and that is if I could have found the hospital, which is extraordinarily difficult unless one knows the area well. My godmother suffered from severe dehydration just a few weeks ago and was taken to Kingston hospital in the middle of the day. To get to St. George's at that time of the day would take one and half hours, if the traffic was relatively light. In rush hour, it would take far longer. So, the alternative hospitals to Kingston hospital are very difficult to access from my area. The importance of the maternity, accident and emergency, and in-patient paediatric services, and the importance of having a place to go to for elective surgery cannot be overstated.

Everywhere I go in my constituency, residents tell me about their experiences, and they are horrified that they might have to go to St. George's in Tooting for the services that they can currently use at Kingston hospital. They have come to love and respect Kingston hospital and to value its services. They also see it as being vital to their ability to access acute services within their area.

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Martin Horwood (Cheltenham, Liberal Democrat): I warmly congratulate my hon. Friend on her campaign, which has eerie echoes of the campaign that we fought in Cheltenham in 2006 to preserve maternity and other services. Is she aware that although we saved the maternity ward in Cheltenham, lasting damage was done to the public's trust in NHS decision-making processes because of what happened with that process? The situation in this case sounds all too familiar from what she says.

Susan Kramer: I thank my hon. Friend for those comments. The fact that relevant information has not been put into the public arena so that ordinary residents can be involved and can have their say when matters touch their lives so closely is a vital part of the reason why I am on my feet today. He mentioned his success in keeping open a maternity ward in a particular hospital. The hospital that those in the Richmond end of my constituency used to use was Queen Mary's in Roehampton. The accident and emergency department there closed, and shortly afterwards the rest of the hospital was gradually shut down. Without accident and emergency, it became unsustainable as a district general hospital. It has now been rebuilt and is a lovely facility, but it has only a handful of specialist services. It does not function as a general hospital any more, but deals just with minor injuries and orthopaedics and has a couple of mental health wards. It is very pleasant, but is not in any way a hospital. It is a shock to the system to know that my residents will no longer be able to go to Kingston, which they can at least get to-there is a decent, or possible, train service and one can get there reasonably well by car-and that they will instead have to go to Tooting. That is completely unacceptable.

We have seen all the reports today about the closures in north-east London-I think that my hon. Friend the Member for Kingston and Surbiton will take us through the reports in more detail-but at least the NHS in north-east London has made the effort to put that information into the public domain. We now ask for the same in relation to south-west London. We ask for information, we ask to be told about these matters, and we ask to be included in the process. We are here to say that the key services at Kingston hospital-the accident and emergency, maternity, in-patient paediatric and elective surgery services-are done well and that we need a hospital in the area that is within decent reach for members of our community. We ask the Minister to step back and rethink this issue in great detail. If he wishes to join us in our campaign, we would more than welcome having him on board, because it is crucial that we save the services at Kingston hospital.

• Edward Davey (Kingston & Surbiton, Liberal Democrat): May I pay tribute to my hon. Friend Susan Kramer for securing the debate and for the way in which she has presented the case for Kingston hospital? It is a fantastic hospital that has served the people of my constituency, Richmond Park and many others in south-west London for many years. In recent times, it has, if anything, improved significantly; indeed, with the campaigns that my colleagues and I have run in the past 10 to 12 years, there has been more investment. We now have a relatively new accident and emergency department, which was rebuilt between 1999 and 2001, and the maternity service has expanded and is extremely popular. The only complaint that I ever receive about it is that people are not able to get in to give birth to their children at Kingston hospital. That is why I campaigned for it to be expanded.

The House does not have to take my word for the excellent and improving services. Hon. Members can look at reports by various regulators. I refer them particularly to the independent report from outside the NHS by Dr. Foster. His 2009 hospital guide lists Kingston hospital as London's top district general hospital. Of 149 hospital trusts in England, it came 15th, topping band 4 and only fractionally missing out of being in the top band, which was made up of mainly large teaching hospitals, not district general hospitals such as Kingston. On all the reports that Dr. Foster gives, Kingston scores extremely high. That is independent non-NHS recent verification of our confidence in the hospital.

That confidence is shared not only by us and by our constituents, but by the Prime Minister. A few days into his term in office, he chose with the then Secretary of State for Health, now the Home Secretary, to visit Kingston hospital. It was his first visit to an NHS facility as Prime Minister. Why did he do that? Because of the progress at Kingston hospital in reducing MRSA, and because of the innovation and success in the hospital in many other aspects of its service. So we had the Prime Minister giving a vote of confidence to Kingston hospital.

I can give Kingston hospital a vote of confidence from my own family. On two or three occasions I had to take my late grandmother to A and E, where she received fantastic care when she needed it when she was extremely ill. Just over two years ago, we had the happy experience of our first child being born in Kingston maternity unit. We were there for a while, and I was enormously impressed by the care of the midwives, consultants, and all the medical and other staff in the hospital, who looked after us fantastically. From my own personal experience, I can say what a wonderful hospital it is. As important is the experience of my constituents who, one after the other, over the years have come to me to praise Kingston hospital. That is not to say that there has not been the odd problem. Of course there has. I have dealt with complaints too, but the vast majority of my constituents support the hospital.

So when I was told by a local NHS chief executive that Kingston hospital's accident and emergency and maternity units were under threat, I thought it was a joke. I said, and I still say, that that was inconceivable, but I am afraid that, having been told by not just one NHS chief executive in the area but by four, and by a senior clinician at four meetings, and having met some staff who have to crunch the data and are distressed at the idea that the maternity department at Kingston could be closed, I had to take their word for it.

We expected the report on 18 December. We had prepared a website, ready to launch our campaign on 18 December because that is when we had been told the NHS would go public. We were then told that the document would not be published until 25 January, as my hon. Friend the Member for Richmond Park said. Interestingly, over the weekend, I received a document, the south-west London strategic plan, marked "Private and confidential" and "Final draft" and dated 18 December 2009. We had been told that it was not ready for that date, but now it clearly was ready. We have a few pages of it-the most relevant ones, which we will put on our campaign website tonight, so that everyone can see what the NHS, the Government and others have been trying to hide before the election.

Given that we are putting into the public domain the pages that we have been sent, I hope the Minister will put the whole report into the public domain. The thrust of the report is clear. Of the 18 options proposed in the report, one in three would see Kingston hospital's maternity, accident and emergency, and paediatric in-patient departments closed. That is the threat that we have been talking about. In 16 of the 18 options, Kingston would lose a significant service from its hospital. That is a serious threat to local health care. The report mentions other potential closures at nearby hospitals, and let me make it absolutely clear that we support those hospitals and note the concerns about the threat to them, not least because the health system is a system: if one place is cut, the effects can be felt elsewhere.

Motion lapsed (Standing Order No. 9(3)).

Motion made, and Question proposed, That this House do now adjourn. -(Mrs. Hodgson.)

10:00 pm

Edward Davey: If other units at nearby hospitals are closed, that will impact on Kingston hospital. Anyone who has gone to the hospital's A and E department or, indeed, its maternity department will know how busy they are. Those departments do not have lots of spare capacity, with staff sitting around doing nothing; the units and the staff are at full stretch and do a fantastic job. If units at St. Helier hospital were to close, for example, that would have a big impact on Kingston hospital, too.

These are serious proposals; they are under active consideration; and they would seriously undermine the health care of our constituents. We therefore make no apology for launching our campaign, and, given that we are publishing the evidence today, I hope that our political opponents in the Labour and Conservative parties who accuse us of scaremongering will withdraw that accusation and join our campaign. On our website we have almost 7,000 signatures; we have more in hard copy; and no doubt we will present those petitions to the House in due course. On our Facebook site almost 14,000 have joined us, and from their testimonies we hear story after story about the excellent care that they and their families have enjoyed. It is a tribute to Kingston hospital staff and the wider NHS that the hospital is held in such high esteem, and I find it outrageous that some people have tried to undermine the campaign and make people question whether the stories were true, when we have put forward the evidence to back up what we say.

Back in November, before we went public, the British Medical Association published a document entitled, "London's NHS: on the brink". It mentioned a review not just in south-west London, but throughout the capital, and it cited all the work that had taken place and all the contracts that had been let to consultants, such as McKinsey, to do the number-crunching in order to close down services throughout the capital. Interestingly, on page 31 of the document, which is on our website and the BMA's, the document concludes that

"few of their plans to scale back spending are going to attract much-if any-public support: and in many areas they have been discussing plans at PCT and sector level in secret. NHS London has refused to publish the full McKinsey report on which they have based their guidance to PCTs."

I shall quote a little more from the report, because it is directly relevant to our debate. It states:

"A key focus for those campaigning to defend London's services must therefore centre on full disclosure and public debate on all of these policies and on the assumptions and projections on which they are based. This is vital to give Londoners a real chance to campaign not only against cuts they oppose at local level but to take a wider view of the framework which is dictating cutbacks across the NHS."

The BMA therefore said to politicians in November, "Let's get this in the public domain and expose what's going on so the public can be involved."

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• Vincent Cable (Twickenham, Liberal Democrat): My hon. Friend is helpfully putting that information in the public domain, but the disquiet is even wider than he suggests. In that private and confidential document, which I obtained because it affects my constituency, too, the West Middlesex University hospital is also noted as being considered for hot or cold siting. That new hospital was opened by the current Prime Minister and the then Minister for Health only a few years ago, and it, too, now appears to be in the mix. If it is brought into question, the impact on west and south-west London will be utterly devastating and compound the effects that my hon. Friend has described.

Edward Davey: My hon. Friend is absolutely right.

In case Members, who are listening and who may have spoken to NHS staff but clearly have not seen the report that we now have, are in any doubt that this is a concerted campaign to try to cut local NHS services, I have put on our campaign website a document from 29 June 2009, "South-west London sector presentation", which has also come our way. Slides 13 and 14 of that make very clear our assertion that A and E units, maternity units and in-patient paediatric services have been under fire and targeted by some people in the NHS for many months now. We have the evidence-it is absolutely unambiguous. I hope that the Minister is now going to do what Ministers, and the NHS, should have been doing before, and put all this evidence in the public domain.

In the north-east of London, as my hon. Friend the Member for Richmond Park told the House, we are seeing the cuts that will be entailed. In north-east London, which is the first of five NHS sectors in the capital to spell out the cost-cutting plans, a total of 800 hospital beds are to go and more than £500 million is to be slashed from hospital budgets by 2017. No wonder NHS bosses, and presumably Ministers, did not want all the other sector reports in the public domain before the election, although, bizarrely, they told us that that was what they were going to do-then they shut up shop. Astonishingly, the Conservatives-certainly some people in south-west London who want to represent the Conservative party-have been accusing us of scaremongering, so presumably if they had received this information, they would have colluded in the secrecy and not have put it into the public domain. That is the implication of their criticisms of us. We believe that this information should be in the public domain. We call on the Government and the NHS to give full disclosure-then the public can have a real debate and we will not continue to have all the slurs that we have had from some people about our campaign.

I have spoken to the leader of my party, to our health spokesman, and to my hon. Friend Dr. Cable, from the Treasury team. We are clear that we will protect front-line NHS services. We will campaign for these services to be retained, because they are critical if we are to maintain and improve the quality of health care. Now that this debate is in the public domain, all political parties, all candidates, and those outside political parties can make their position plain. The Conservatives have said-I am reading from a leaflet of theirs:

"We will impose an immediate moratorium on proposed closures of A and E and maternity units across the country."

Well, in my dictionary a moratorium says a delay or a suspension-it does not say, "We will not close these services." That is the concern that people will have when they look at what the Conservatives are saying. They may then realise that the Conservatives did not want this information in the public domain and wanted to undermine the campaign because they are not committed to maintaining these services as fully as we are. I hope that they will change their minds as a result of what we are doing tonight and what we are putting into the public domain. It is not good enough for them to sit on the fence and talk about moratoriums when the people of Kingston and Surbiton, Richmond Park and Twickenham want to ensure that these services are not lost.

Who is to blame? We know about the Government's spending plans. They are talking about a real-terms freeze on health spending for the next four or five years; no doubt the Minister will be able to give us more detail. That sounds okay-they are going to maintain spending in real terms-but then we look at the fine print, which says that in each year while there is a real-terms freeze there will have to be a 3.5 per cent. efficiency saving. Over five years-do the maths-that is getting on for a 20 per cent. reduction in resources across the capital. I hope that the Minister will give us his figures on this. If he denies our figures, he needs to tell his NHS managers, because the figures came from them. They have said that over the next five years we are looking at cuts of possibly up to £5 billion across London's NHS and £600 million in south-west London. That is a lot from a relatively small part of London.

We are told that half the savings will be made in cuts to mental health services, primary care and community health services and the other £300 million in cuts to the acute sector. It will be interesting to see whether the Minister confirms that or denies it, because those are the figures to which NHS staff are working and what they say the Government tell them to work to. Considering the financial difficulties faced by this country in the years ahead, no one will deny that we must find ways to make savings, but those are not the savings that the Government should be making. Cuts to front-line services are unacceptable.

Some people are saying that the savings are due to the introduction of polyclinics. If that is the case, let us have that debate, but it is interesting that although Surbiton hospital in my constituency is scheduled to be modernised by becoming one of the new polyclinics, the services that the Kingston NHS trust is discussing are not services that will be closed at Kingston hospital. No one is suggesting that accident and emergency, maternity or paediatric inpatient services should move to Surbiton; the trust is saying that out-patient services will move. That is not controversial in our area. I have spoken to NHS Kingston and the hospital, which say that the services could move from Kingston to Surbiton hospital with their blessing as long as they are involved. There is absolutely nothing wrong with that, but it prompts the question why the Government are pursuing those plans.

Michael Penning): If the case that the hon. Gentleman and Susan Kramer are making is true, why did the Liberal Democrats have to use an activist to spin the story to the London Evening Standard, as reported by Guido Fawkes? The hon. Gentleman likes online information; well, here is some:

"Guido reported on Friday the tale of the Lib Dem activist boasting about his spin that got the Standard to report"

the proposed closure of Kingston hospital. Is that person still a member of the Liberal Democrats, or has he been thrown out?

Edward Davey: It is interesting that that is the best that the hon. Gentleman can do, having visited Kingston hospital last week. We are talking about unpublished documents from the NHS that have come into our hands confirming our charge that the Government had secret plans that they would not allow to be published. We are debating not Guido Fawkes, but NHS documents that are now in the public domain. If the hon. Gentleman relies for his health policies on Guido Fawkes, he has problems. He ought to be reading the NHS documents that show that what we are saying is correct and what he and his colleagues say is wrong.

Michael Penning): Interestingly, the hon. Gentleman says that he has the final draft. The full copy was leaked to me; it dates from 15 January, not 18 December. I will give him a copy after the debate. A reputable journalist-actually, he is a journalist from the Daily Mail who supports the Labour party-was sitting opposite that Liberal Democrat activist, who was boasting on the phone that he had spun a story that was not true to the London Evening Standard. Is that person still a member of the Liberal Democrats, and why did they have to spin a story to a local paper if all the facts were there to be publicised?

Edward Davey: I am sure that the hon. Gentleman listens to all Conservative activists, as they often give some very rum quotes. We are talking about two Members of Parliament who met four chief executives and one medical director, and who had NHS documents that we are putting in the public domain. That is serious politics, unlike the politics that he seems to go in for.

I am grateful to the Kingston Informer, the Kingston Guardian and the Surrey Comet, which have attended our press conferences, listened to what we have had to say, read the documents that we have put in the public domain and reported our campaign fairly. I am grateful to my right hon. Friend Mr. Clegg, whose wife Miriam gave birth to their third son at Kingston hospital. My right hon. Friend can vouch personally for its excellent service. He has come down to join and support our campaign to save these services.

Will the Minister ensure that all the documents will be put into the public domain in full? We want a debate based not on myths and half-truths but on the full facts. We have now got the facts, and we want all the back-dated documents and all the working papers. We want to see the assumptions that the NHS, the McKinsey consultants and others are using to come up with these ludicrous proposals.

More than that, we want the Minister to give the people of Kingston and Surbiton, the people of Richmond Park, the people of Twickenham and the people of south-west London a guarantee that Kingston hospital's A and E and maternity units, its paediatric in-patients department and its elective surgery facilities-all of which have had important investment from the Labour Government in recent years-are not going to be closed. We need a guarantee that the investments and the campaigns that have been run to build up our hospital are not going to be given up on. The people of my constituency want the hospital's services to be saved, and it would be outrageous if secret, undisclosed plans that are being looked at by unelected bureaucrats were to produce a fait accompli for the next Secretary of State for Health. It is time that we had this debate, and I hope that the Minister will ensure that it can be a fully informed, public debate.

10:16 pm

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Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour): Thank you for allowing me to respond to the debate, Mr. Deputy Speaker. I agree with one word that Mr. Davey used; he said that this was outrageous. Susan Kramer also used the word. It is outrageous: here we have a cynical winding-up of the electorate, and it is very sad to see.

Let me go through what is happening, but before that, I should like to begin by recognising the hard work and dedication of the clinicians and staff at Kingston hospital and throughout south-west London.

Michael Penning): I thank the Minister for giving way. I am conscious that I am taking up time, which was not allowed to me by the Liberal Democrats, to talk about my visit to Kingston hospital last week. The staff there are dedicated and professional, and it was a fantastic hospital to visit. It was obvious, however, that morale had been affected by this cynical campaign, and that the staff were worried about what is going to happen. The campaign, which has been conducted for cynical purposes on behalf of the Liberal Democrats, has affected the staff at the hospital.

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Mike O'Brien (Minister of State (Health Services), Department of Health; North Warwickshire, Labour): It is little wonder that some members of the public have become cynical about politicians, when we hear what we have just heard in the debate.

The local community is rightly proud of Kingston hospital, and it sits within an area that has worked hard to improve the health of its population. NHS services in south-west London and across the capital have seen great improvements in recent years. The hon. Gentleman suggested that that was all down to himself and the hon. Member for Richmond Park; I suggest that it has something to do with the investment that this Government have put in. No credit was given for that in their speeches, however; there was just a bit of party political knockabout from both hon. Members during the debate. Again, that is just a sad reflection on them.

The NHS in London has improved access to GP services and community health services, reduced waiting times in accident and emergency, and transformed cardiac services. This is certainly a success story, but it is only the beginning. Access to primary care needs to be further improved, to reduce the reliance on accident and emergency departments. The NHS faces increased demand for maternity and children's services, and it must, as the hon. Lady suggested, respond to that challenge, ensuring that those services are adequately staffed by properly trained professionals.

Today, advances in medicine and technology mean that more and more patients can be treated and cared for in their own homes and communities. We can do better for the people of south-west London, and the central question here is how that should be done. That is why five clinical groups have been working, as both hon. Members well know, to review the clinical evidence-I emphasise that it is clinical evidence-from doctors and other NHS professionals for changing health care services, so that we can better meet local needs. Clinicians have identified a case for improvement. Ministers and officials in the Department of Health have not seen that work by those five clinical groups. It is being done locally in order to try to evaluate the best service for the NHS in that area. It is not-I emphasise this point, because it was one of the hon. Members' outrageous claims-some secret Labour plan or plot to reduce services. Far from it, over the coming months clinicians will refine their ideas and start to think about how the challenges that I have identified can be addressed.

Clinicians have identified other areas for further work, such as the provision of diagnostics in community and children's palliative care. It is anticipated that the clinical working groups will identify a range of options in the summer of 2010 to provide a clinically and financially viable health care service for south-west London. That will form the basis of further discussion between clinicians, patients and stakeholders with a view to making some proposals. I have not been party to that, nor has the Department of Health, so the claim made by both hon. Members that we have a political agenda is a complete cynical invention. The only agenda is the open Darzi agenda of trying to improve health care in London, based on the clinical need to improve the quality of care.

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Stewart Jackson (- Shadow Minister, Communities and Local Government; Peterborough, Conservative): Does the Minister agree that the Liberal Democrats have form in this area? Does he recollect that Mr. Leech campaigned against the "imminent" closure of the Christie hospital in Manchester five years ago? Funnily enough, that hospital is still open.

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Mike O'Brien: It is indeed still there, and the Liberal Democrats have a record of running scare stories and asking people to join the campaign by sending in their addresses, petitions and email addresses. They can then canvas those people-it is all about elections.

The hon. Members mentioned a document, but I have never seen this document. I also asked my officials this morning, and apparently no one in the Department of Health has seen it either. I do not doubt that there is a document, but it is being dealt with locally by the five groups of clinicians that I have mentioned. I gather that it is also being dealt with by the NHS in south-west London. I am told that it is very tentative, unformed and informal. It is certainly no Government plan or a final document in any sense. It is part of a discussion that may lead to some conclusions at some point, perhaps at the end of the year or next year, when some further discussions and engagement with stakeholders might arise. The hon. Members know about that process because they have been briefed on it repeatedly by officials, so there is nothing secretive about it.

The clinicians are trying to have a discussion without politicians coming in and stirring up unjustified allegations that all the services are now somehow under threat. The discussions are about how the services can be improved. As for cuts, the NHS PCTs will get a 5.5 per cent. overall increase in funding next year and the same this year. I simply do not accept the argument that large cuts are needed, as suggested by the hon. Members. Yes, NHS managers have been asked to find savings. Yes, they have been asked to identify where money can be found-not to make cuts, but to redirect the funding into better services for the people who elect those two hon. Members.

Michael Penning): Does the Minister agree that it would have been very easy for other political parties, not least my own, to jump on the Liberal Democrats' bandwagon of scaremongering? As he knows, I have campaigned against Labour cuts on many occasions, but when there has been proper information and documentation. Has scaring the electorate at this stage damaged the consultation or enhanced it?

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Mike O'Brien: At the moment, some clinicians and managers are meeting and asking, "What are the options here? How can we improve services? How can we ensure that we deal with some of the very serious issues in relation to health care that need to be addressed in south-west London?" We can have a big argument in the media, with every clinician being frightened to speak because the moment they say anything, they will be attacked by the hon. Members for Richmond Park and for Kingston and Surbiton for cynical political advantage, but then where will we get to with the NHS? It will be frozen in aspic, improvements will not be able to take place and there will not be proper discussion of health care.

We need to give clinicians and others room to talk through the options, and when there is some view about what those options might possibly be, they can then come forward and engage seriously with stakeholders. In due course, when there are proposals, they can be properly discussed, but we are a considerable distance from that.

I spoke this morning to Kevin Maguire, the respected Daily Mirror political journalist. He told me to check what was going on, and I had a look on his Twitter page. I know that we all need to be careful about Twitter, but apparently he was sitting on a train and updating it. I shall read through what his page said, as he suggested I should. First, he wrote:

"On train a bloke's boasting on mobile he got Evening Standard to claim Lab has secret plans to shut Kingston Hospital".

The next post was:

"Train bloke now boasting the hospital scare story cooked up at his kitchen table. Very proud of Facebook following".

"He's 'a manifesto to write'. Tory? Wearing Hibs scarf. Clocking his details. May sneak photo to track down. Or could always ask!"

The next post begins, "Name's Dan", and then gives part of his telephone number and continues:

"Wondering if he's a Lib Dem."

The next post reads:

"Got Hospital Closure Man's pic. Going into meeting then will discover who Dan is".

Then the next one:

"This is the Kingston hospital scare bloke. Anyone know him? He's a loud mouth in public places".

And then:

"Ta all Tweeters. Hospital phone man ID'd as Lib Dem activist Dan Falchikov. He should stop SHOUTING on train".

I bet the hon. Members for Richmond Park and for Kingston and Surbiton wish he would stop shouting on trains, because it appears to have disclosed the nature of what is going on here.

Edward Davey: Will the Minister give way?

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Mike O'Brien: Only if the hon. Gentleman plans to accept that that gentleman is indeed a Liberal Democrat, and indeed that he and the hon. Member for Richmond Park have been winding this up. They were approached by NHS officials who explained what was going on. It was explained to them properly, honestly and openly that there were going to be discussions. Papers will be circulated, and the one that they have may be one of them-I do not know, I have not seen it. It certainly is not Labour or the Department of Health that is putting it forward.

Edward Davey: rose-

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Mike O'Brien: The hon. Gentleman can wait, because I spent a lot of time listening to him make a lot of allegations, and I have been left with a very short time to respond to him. He deserves a response, because a lot of people in his area have been frightened by what he says. They are now worried that there is some sort of plan to close these NHS facilities, which there is not, and that there is more going on than just some discussion between clinicians. I accept that that is happening, and it is part of the Darzi process of involving clinicians in discussing how to improve the quality of services, but he and the hon. Member for Richmond Park are playing politics with the matter. I care about the NHS, and I actually think that behind it all they do too. What they are doing, however, is trying to frighten people into believing that services are definitely closing, when all that is going on is some discussions between clinicians. What the eventual proposals will be I do not know, and nor does he. We should not at this stage use scare stories like this for election purposes, in a cynical way-

House adjourned without Question put (Standing Order No. 9(7)).

Richmond upon Thames Liberal Democrats: