Under pressure: the Queen Elizabeth Hospital in Birmingham has seen a surge in patients at A&E. Photo: Getty
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Jacqui Smith: “The NHS model isn’t broken but it needs urgent attention and support”

The former home secretary on trouble in A&E – plus the triumph of all-women shortlists and the joys of summer caravanning.

You may remember the Queen Elizabeth Hospital in Birmingham as the splendid venue for the launch of Labour’s 2010 election campaign. It was also the place where Tony Blair was challenged by Sharron Storer over her partner’s cancer treatment in 2001 – but don’t let either of those events colour your judgement. I’m very proud to chair the NHS trust that runs it. However, like the rest of the health service, we’re facing unprecedented pressures.

A decade ago, the old emergency department at Selly Oak was seeing 60,000 people each year. The A&E at the Queen Elizabeth Hospital was built to accommodate 81,000. Last year, we saw 95,000 and the figure is rising. Our chief executive, Dame Julie Moore, describes A&E as the “canary in the mine” for the health service. This canary will soon need to be nailed to its perch.

We have found that when it’s harder to see a GP, people visit casualty, where the lights never go off; as social care is cut and social care workers are forced to make shorter visits, more people turn up at the door of a hospital. Mental health faces the biggest cuts in the NHS and we find that those in crisis come to our A&E or go into a police cell. When many are struggling to make ends meet, it’s not surprising that there are more people with malnutrition, scurvy and rickets needing our care.

Recent Commonwealth Fund research identified the NHS as the best system among 11 major developed countries for quality of care, access and efficiency. The NHS model isn’t broken but it needs urgent attention and support.




Spending a lot of time on trains, I enjoy the eccentric pastimes of my fellow travellers. One woman got on to the early-morning train to London, pulled out a hairdryer, plugged it in and dried her hair. Last week, I sat next to someone rolling a cigarette and reflected on the transformation made by the smoking ban. Feel free to roll but thank goodness you can’t smoke it next to me.

The same Commonwealth Fund research that found the NHS to be the most effective health service also reported that we are one of the least healthy societies (the UK came tenth out of the 11 countries). We should learn from the success of the smoking ban. Governments of all persuasions have expected NHS providers to take tough decisions but avoided them themselves. At the Queen Elizabeth Hospital, we transplant livers for alcoholics but the government avoids minimum pricing for alcohol. More than one in ten of our patients have diabetes but action on healthier food is left to the willingness of food manufacturers and retailers to put different colours on their labels.




As the dust settles on the reshuffle, it’s clear that there should be no let-up in the work to gain more equal gender representation in parliament and government. The appointment of two new women cabinet ministers, though welcome, still takes the total in the cabinet to only less than a quarter. In the Labour Women’s Network, we continue to train women to stand for parliament, but self-congratulation from any party on female representation is premature while we languish at 58th in the international league table – with Rwanda, Kazakhstan and Tunisia among those doing better than us. One answer is clear. Why do women MPs make up a third of Labour, while the Tories have less than 16 per cent and the Lib Dems only one in eight? It’s because Labour uses all-women shortlists. In recent weeks, both Nick Clegg and Ken Clarke have supported their use for their own parties. Why not just get on with it?




Don’t hold your breath for the publication of this government’s review of the impact of immigration from the EU. A version recently leaked to the BBC gives a nuanced but largely positive view about immigration’s effect on jobs, pay and community cohesion. A previous version was ready for publication last December but the Home Office stopped publication because it considered it too positive. A much more sceptical, rewritten version was called propagandist by the Lib Dems. It’s clear now that this is a political stitch-up. Wouldn’t it have been better to ask an independent group comprising local government, industry, union and community representatives to consider the evidence? That’s what we set up when I was in the Home Office – the Migration Impacts Forum. This government has got rid of it. Apparently one of the effects of Ukip is the victory of anecdote over evidence.




This summer, I will holiday in my caravan in north-west Wales. With little mobile-phone signal, this was a sanctuary in my ministerial years – though I did manage to speak to two prime ministers standing on a rock at the top of the site where you can just about get a connection. I was not the only caravanning minister: Margaret Beckett loved hers, too. Appropriately, as foreign secretary, she had a touring caravan that she took round Europe, while as home secretary I had a static caravan and stayed at home.

Wherever you are holidaying this year, I hope you have a happy and relaxing time. 

This article first appeared in the 23 July 2014 issue of the New Statesman, Summer Double 2014

Photo: Getty
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The government needs more on airports than just Chris Grayling's hunch

This disastrous plan to expand Heathrow will fail, vows Tom Brake. 

I ought to stop being surprised by Theresa May’s decision making. After all, in her short time as Prime Minister she has made a series of terrible decisions. First, we had Chief Buffoon, Boris Johnson appointed as Foreign Secretary to represent the United Kingdom around the world. Then May, announced full steam ahead with the most extreme version of Brexit, causing mass economic uncertainty before we’ve even begun negotiations with the EU. And now we have the announcement that expansion of Heathrow Airport, in the form of a third runway, will go ahead: a colossally expensive, environmentally disastrous, and ill-advised decision.

In the House of Commons on Tuesday, I asked Transport Secretary Chris Grayling why the government is “disregarding widespread hostility and bulldozing through a third runway, which will inflict crippling noise, significant climate change effects, health-damaging air pollution and catastrophic congestion on a million Londoners.” His response was nothing more than “because we don’t believe it’s going to do those things.”

I find this astonishing. It appears that the government is proceeding with a multi-billion pound project with Grayling’s beliefs as evidence. Why does the government believe that a country of our size should focus on one major airport in an already overcrowded South East? Germany has multiple major airports, Spain three, the French, Italians, and Japanese have at least two. And I find it astonishing that the government is paying such little heed to our legal and moral environmental obligations.

One of my first acts as an MP nineteen years ago was to set out the Liberal Democrat opposition to the expansion of Heathrow or any airport in southeast England. The United Kingdom has a huge imbalance between the London and the South East, and the rest of the country. This imbalance is a serious issue which our government must get to work remedying. Unfortunately, the expansion of Heathrow does just the opposite - it further concentrates government spending and private investment on this overcrowded corner of the country.

Transport for London estimates that to make the necessary upgrades to transport links around Heathrow will be £10-£20 billion pounds. Heathrow airport is reportedly willing to pay only £1billion of those costs. Without upgrades to the Tube and rail links, the impact on London’s already clogged roads will be substantial. Any diversion of investment from improving TfL’s wider network to lines serving Heathrow would be catastrophic for the capital. And it will not be welcomed by Londoners who already face a daily ordeal of crowded tubes and traffic-delayed buses. In the unlikely event that the government agrees to fund this shortfall, this would be salt in the wound for the South-West, the North, and other parts of the country already deprived of funding for improved rail and road links.

Increased congestion in the capital will not only raise the collective blood pressure of Londoners, but will have severe detrimental effects on our already dire levels of air pollution. During each of the last ten years, air pollution levels have been breached at multiple sites around Heathrow. While a large proportion of this air pollution is caused by surface transport serving Heathrow, a third more planes arriving and departing adds yet more particulates to the air. Even without expansion, it is imperative that we work out how to clean this toxic air. Barrelling ahead without doing so is irresponsible, doing nothing but harm our planet and shorten the lives of those living in west London.

We need an innovative, forward-looking strategy. We need to make transferring to a train to Cardiff after a flight from Dubai as straightforward and simple as transferring to another flight is now. We need to invest in better rail links so travelling by train to the centre of Glasgow or Edinburgh is quicker than flying. Expanding Heathrow means missing our climate change targets is a certainty; it makes life a misery for those who live around the airport and it diverts precious Government spending from other more worthy projects.

The Prime Minister would be wise to heed her own advice to the 2008 government and “recognise widespread hostility to Heathrow expansion.” The decision to build a third runway at Heathrow is the wrong one and if she refuses to U-turn she will soon discover the true extent of the opposition to these plans.

Tom Brake is the Liberal Democrat MP for Carshalton & Wallington.