Accident and Emergency Waiting Times

Andrew Percy Excerpts

Wednesday 5th June 2013 Commons Chamber

[Mr Hunt]

I agree that A and E departments are under huge pressure, and that is why we are taking a lot of measures to deal with them, which is what I am talking about. But I am saying that we have to deal with the root causes, which were things that the shadow Secretary of State’s Government failed to deal with. [Interruption.] Labour Members need to listen. We listened to the shadow Secretary of State’s solutions, which were not really solutions; now I am telling them what we think needs to happen.

We welcome the fact that the Labour party has now seen the light and recognises the need for integration, but Labour Members need to show some humility, because it was the Labour Government who put in place many of the barriers—in particular payment by results mechanisms—that make that so hard to achieve. We are now trying to make integration a reality through the 10 pilots on removing barriers to integration announced by the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), as part of the vulnerable older people’s plan announced to the House last month. Without integration, we will not solve the problem of bed blocking, which is at the heart of the pressures on A and E.

[Andrew Percy (Brigg and Goole) (Con)]

The Secretary of State is right to say that many of the present failures started in the Labour years, particularly the problems with integration. Does he share the concern that I and many of my constituents feel about the 50,000 beds that were lost under Labour Government? We lost the beds, but the intermediate care services and step up, step down facilities were never created to deal with the consequences. That is what is behind a lot of the A and E referrals today.

[Mr Hunt]

That is part of the problem with Labour’s approach to the NHS—a top-down approach of closing or downgrading A and E units and making the NHS sort out the problems. We are not doing that.

It is time that Labour took responsibility for the disastrous changes to the GP contract, which contributed to making it so much harder to get a GP appointment and piled further pressure on A and E departments—[Interruption.] No, they need to listen; this is important. The changes in 2004 handed responsibility for providing out-of-hours services to administrators in primary care trusts, at a stroke removing the 24/7 responsibility for patients that until then had always been a core part of being a family doctor. As we heard earlier today, even a former Labour Health Minister regretted those changes, saying before the last election:

“In many ways, GPs got the best deal they ever had from that 2004 contract and since then we have, in a sense, been recovering.”

It is important that Labour Members hear the list of independent voices all saying that we need fundamental change in primary care if we are to deal with pressures on A and E: the College of Emergency Medicine, the Royal College of Physicians, the NHS Alliance, the Family Doctor Association, the head of the Royal College of General Practitioners, who—surprisingly—said something in support of the Government in The Guardian this morning, the Foundation Trust Network and so on. All those voices were ignored by Labour as it put its head in the sand about that disastrous change to the GP contract.

--- Later in debate ---

[Andrew Percy (Brigg and Goole) (Con)]

This debate has improved as the Back-Bench contributions have gone on. It started off fairly gracelessly, with an attempt to lay all the blame for the pressures in A and E on this Government. That was pretty shameful. I like and respect the shadow Secretary of State, the right hon. Member for Leigh (Andy Burnham), but it was graceless of him to suggest that this is entirely of this Government’s making.

As a number of hon. Members have said, there is a broad range of issues behind the pressures on A and E services. Long before I was elected, I campaigned against some of the changes that made a difference in my own constituency and increased pressure on the NHS. We have heard about bed reductions and the lack of joined-up social and health services. I think there is an issue with GPs and I respect the view of the Health Committee Chairman on that. A lot of residents were confused—this was touched on by the right hon. Member for Exeter (Mr Bradshaw)—about where GPs’ services were and how they could access them after the change in 2004 in particular. I think that that has contributed to people choosing to access other services. I confess that I have absolutely no idea how the out-of-hours service in my area works. I am lucky that I have never had to use it, but a lot of people were incredibly confused by their out-of-hours service after 2004. The right hon. Gentleman also mentioned walk-in centres, but my area did not get one. If we are expected to use the one in Scunthorpe, that is not a sufficient local alternative.

We have also heard about a demographic shift, which is clearly a huge issue, as is population growth. After the failure of health services and all Governments to deal properly with palliative care and end-of-life plans, one of my hospitals in Goole experienced massive reductions in services, largely on the previous Government’s watch. Our mental health ward went and all the town’s mental health beds disappeared, as did medical beds in general. Service after service disappeared. When those mental health services were lost and replaced by apparently intensive home support, we ended up with people in crisis and, as my hon. Friend the Member for Totnes (Dr Wollaston) has said, presenting to A and E and other services.

The failure of social care is a problem, but I remember one of my local authorities—East Riding of Yorkshire—changing the criteria for access to its services many years ago as a result of funding pressures from the previous Government. I wish that Labour councillors at my other council, North Lincolnshire council, had listened to the Secretary of State before they tabled their budget for this year, which proposed removing social care from thousands of my constituents and changing the required criterion from “moderate” to “substantial”. If it had not been for Conservative councillors voting down the Labour budget and instead voting to protect social care, there would have been massive social care cuts in my area. I hope that the right hon. Member for Leigh will relay that to his colleagues in my area.

The failure to have proper intermediate care services has also been mentioned. My local authority is trying to address this through a £3.2 million scheme in my constituency to create a 30-bed unit. Bed blocking has been a massive problem in recent years and we all know about it. Plenty of people come in, but not enough go out the other side. The Labour party has to take some responsibility for that problem, because it has not appeared overnight. The issue has been affected by population growth and a demographic shift.

In the brief time remaining, I concur with the Health Committee Chairman that it would be much better to take the politics out of this debate.