Accident and Emergency

Andrew Gwynne Excerpts

Wednesday 18th December 2013 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

We have had a good debate, with many powerful contributions from my hon. Friends the Members for Mitcham and Morden (Siobhain McDonagh),for Wigan (Lisa Nandy), for Eltham (Clive Efford), for Stretford and Urmston (Kate Green), for Chesterfield (Toby Perkins), for Worsley and Eccles South (Barbara Keeley) and for Middlesbrough South and East Cleveland (Tom Blenkinsop).

I have to say, however, that people outside listening to some Government Members’ contributions will think that they simply do not get it. They simply do not understand how hard it is to get a GP appointment; they do not understand the real issues facing their own local A and E departments; and they do not understand the pressures hitting the NHS in England. I politely suggest that they do what the shadow Health team has done—go and spend an evening at their local A and E to see for themselves the real pressures that departments serving their constituents are under.

It would be remiss of me not to place on record my own tribute to the doctors, nurses, health care assistants and other dedicated NHS staff who—as I found out myself when I visited Tameside hospital’s A and E department last Friday night—provide such extraordinary and professional care. We have a work force who are completely dedicated and caring, but the House should be in absolutely no doubt that they are under increasing pressure, and that this is a crisis of the Secretary of State’s making. The Secretary of State may wish that Labour Members had short memories, but we remember the summer news reports of ambulances queuing outside hospitals with unacceptably long waits, and some people even having to be treated in tents erected in car parks, while the Secretary of State and his Ministers buried their heads in the sand and the Secretary of State’s “Crisis, what crisis?” strategy unravelled. Labour Members highlighted those problems, as would have been expected of us.

What we are seeing in A and E is also the culmination of three and a half years of mismanagement of our NHS, with a needless top-down reorganisation and the waste of billions of pounds that could and should have been spent on front-line care. It is little wonder that, as we discovered last week, 79 A and E departments missed the Government’s own targets.

As we have heard in the debate, the reasons for the crisis are many and complicated, but it is on the lack of access to GPs’ services that we have focused today. Surely no amount of spin can hide the fact that this Government have made it harder to obtain an appointment to see a GP. All Members will know of constituents who have had to phone their doctors only to be told that no appointments are available and that they should ring back the next day, which they do, only to experience the same problem again.

Is it not obvious to all—except, seemingly, the Secretary of State and his Ministers—that many patients who phone the surgery at 9 am and find it impossible to obtain an appointment will turn to A and E for help? That is not just my conclusion. According to an analysis carried out for the Department of Health, 42% of A and E attenders had attempted to contact their GPs beforehand, and researchers at Imperial College London found that patients who were able to see their GPs within 48 hours made fewer visits to A and E departments.

Here are some inconvenient truths that the Minister and other Government Members need to consider. First, by the time Labour left office, 98% of patients were being seen within four hours at A and E departments. Secondly, by May 2010 more than three quarters of the general practices in England offered extended opening hours at weekends and in the evenings. It is also clear that Labour’s achievement in widening access to primary care is being undone on this Government’s watch: data released by the Health and Social Care Information Centre have revealed that 854 fewer general practices now offer extended opening hours than was the case in 2009.

The truth is that now, during evenings and at weekends, many people are left with no alternative but to go to A and E because of this Government’s actions. It was this Government who cut funding for extended opening hours for GPs’ surgeries, it was this Government who scrapped Labour’s guarantee that patients would be able to obtain an appointment with a GP within 48 hours, and it is this Secretary of State who shows not one degree of regret for those actions: actions that have piled more unnecessary pressure on A and E departments and more misery on patients, at the very time when they need the NHS to help them.

No wonder things are going so wrong so quickly. To put it simply, under this Secretary of State and under this Prime Minister, it has become harder, not easier, to see a doctor, and as a result more people are heading towards A and E. What more evidence do Ministers need that A and E departments in England are under real pressure and that action is needed now to prevent them from struggling further over the winter months? Their confusion has been laid bare today for all to see. In three weeks, they have gone from “Crisis, what crisis?” to “The crisis is behind us.” It does not sound as though the Secretary of State is in control; people will struggle to take reassurance from his mixed messages. The problems in A and E have the fingerprints of the Secretary of State and the Prime Minister all over them. The components of the A and E crisis might be complex, but the real cause is very simple: you just cannot trust the Tories with the national health service.

[The Minister of State, Department of Health (Norman Lamb)]

We have heard a lot of scaremongering about the NHS today, including endless claims about a crisis. If the Opposition are thinking about new year’s resolutions, I have one for them: stop misleading and misinforming the public. Let us look at the evidence.

[Andrew Gwynne]

rose—

[Norman Lamb]

I will not give way; I do not have time.

Up until this week, A and E targets were met in the past 32 weeks in a row. Is that evidence of a crisis? The average wait for people in A and E during Labour’s last year was 77 minutes; it is now 30 minutes. Is that evidence of a crisis? Even though more people are coming through the doors, 2,000 more patients are being seen in less than four hours every day under this Government than under Labour. Evidence of a crisis? I don’t think so. The Opposition are scaremongering, plain and simple. In fact, the College of Emergency Medicine’s president, Cliff Mann, has today said that any crisis in accident and emergency is “behind us”.

[Norman Lamb]

I applaud the cross-party effort of those Members campaigning for their community, and I am very happy to engage with them further on that matter.

[Andrew Gwynne]

rose—

[Norman Lamb]

I will not give way again; I do not have time.

Last year, of the 21.7 million people who visited accident and emergency departments, almost 96% were admitted, transferred or discharged within four hours. Target achieved. So far, it is the same this year: target achieved. The right hon. Member for Leigh (Andy Burnham) missed his A and E target in two of the three quarters when he was in charge. Did he go around telling everyone that there was a crisis at that time? No, of course he did not—