NHS

Debate between Andy Burnham and Margot James

Wednesday 5th February 2014 Commons Chamber

[Andy Burnham]

That is an indictment of the Government. They have made it harder for people to afford a good basic diet. We have seen a rise in hypothermia, rickets and scurvy. Sadly, we have also seen the rise of food banks under this Government. That is why I am beginning my speech by saying that there is a range of reasons for the sustained pressure on A and E.

[Margot James (Stourbridge) (Con)]

rose—

[Yasmin Qureshi (Bolton South East) (Lab)]

rose—

[Andy Burnham]

I will make a little progress and then I will give way.

There have been record levels of hypothermia this year and thousands of over-75s have been treated in hospital for respiratory or circulatory diseases. That brings me to the second underlying cause of the increase in attendances at A and E. The ageing society is not a distant prospect on the horizon. Demographic change is happening now and it is applying increasing pressure on the front line of the NHS.

We all need to face up to the uncomfortable fact that our hospitals are increasingly full of extremely frail elderly people. Too many older people are in hospital who ought not to have ended up there or who are trapped there because they cannot get the right support to go home. That situation is unacceptable and it has to be addressed.

[Margot James]

Does the right hon. Gentleman not accept that the emergence of older people visiting A and E in far greater numbers has been coming on for a long time? I know that he does not like to be reminded of the 2004 GP contract, but surely he agrees that it is a factor, because older people have not been able to get the necessary support over a long period. The Government are putting that right by integrating health and social care far better.

[Andy Burnham]

The hon. Lady wants me to answer that question, but I direct her to her right hon. Friend, the Chairman of the Health Committee, who has dismissed the self-serving spin from the Government that says that these problem are all to do with a contract that was signed 10 years ago. I began my speech by citing figures that show an exponential rise in the number of people attending A and E since 2010. Many of those people are very frail older people. That is the issue before the House, so it does not help the debate for the hon. Lady to stand up and make a spurious political point.

--- Later in debate ---

[Andy Burnham]

First, I would be grateful if the hon. Gentleman did not continue to misrepresent what I said on the NHS. I have never said, “Cut the NHS”. I stood at the last election on a commitment to protect the NHS budget in real terms. He stood on a manifesto promising real-terms increases for the NHS. I said that if there were to be increases for the NHS, they should be given to social care instead, and that would have relieved some of the pressures on A and E. Let us have the facts straight.

Secondly, the hon. Gentleman boasts about having enough A and E doctors. Perhaps he should speak to people from the College of Emergency Medicine and hear what they have to say on that subject. They talk of warning the Government of a recruitment crisis in A and E about two or three years ago. They said that they could not get through to Ministers who were obsessed with structural reorganisation. They were left feeling like John the Baptist crying in the wilderness—their words. Perhaps before the hon. Gentleman shouts the odds in the House, he should speak to the people who know about these things and who warned his Government —who failed to act.

One of the major problems with the pressure on A and E is the number of older people trapped in hospital. This is a product of demographic pressure and the ageing society. Nursing staff talk of how, when they first qualified, it was rare to see someone in their 90s on the ward. Now they are there in great numbers and that makes the task of meeting their needs much more complex. When people reach an advanced age it is simply not possible to separate out their physical, social and mental needs. Need becomes a blur of all three. Our hospitals are not geared up to provide the additional mental and social support that very frail elderly people often need.

[Margot James]

Will the right hon. Gentleman give way?

[Andy Burnham]

I have given way to the hon. Lady once: I want to make some progress.

Some, but not all, of the needs of older people are met in an acute hospital environment, which explains why their condition often drops like a stone. It is a phenomenon that was accurately identified by Robert Francis QC in his report, published a year ago this week. He called for an overhaul of the way in which older people are cared for in acute hospitals. He was right to do so, and while I applaud some of the steps the Secretary of State has taken in that regard, such as the move towards a named consultant, I do not believe it will tackle the root cause of the problem, which is the arrival of far too many older people in hospital in the first place. Only when that is tackled will we begin to address the underlying causes of the A and E crisis.

--- Later in debate ---

[Andy Burnham]

My hon. Friend is absolutely right. She knows the pressure people are under in our area. What we have heard from the Government is denial that this is the reality in many parts of the country. [Interruption.] We can hear them shouting now, claiming that it is a myth that people are using food banks and not eating properly, and that they cannot afford to heat their homes because of the rise in fuel bills under this Government. All of that is placing extra pressure on A and E, and people are waiting longer and longer to be seen.

[Margot James]

rose—

[Andy Burnham]

I give way to the hon. Lady, but this will be the last time.

[Margot James]

I thank the right hon. Gentleman for giving way; he is being very generous. As he is widening the debate out to the wider economy, does he not accept that, although there are many reasons for increased A and E consultations and some of the issues relating to nutrition are valid, the point made by the hon. Member for Bolton West (Julie Hilling) about people not being able to afford prescriptions must be fallacious? They will receive free prescriptions if they have a very low income and are attending food banks. There are many more reasons than the right hon. Gentleman is giving credit for.

[Andy Burnham]

Not for the first time, Government Members are showing how out of touch they are with what is happening. The hon. Lady says that she is not aware that any family is unable to afford a prescription item. Let me put her straight: that is what many families are facing at the moment, particularly those who are in work, who do not get free prescriptions. They are facing difficult choices about whether they can afford to buy their prescriptions. If she is saying she does not recognise that problem, then I am afraid she really needs to get out of this place a bit more.

Accident and Emergency Waiting Times

Debate between Andy Burnham and Margot James

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

That is part of my point. NHS England wrote to clinical commissioning groups on 9 May. What is going on here? They were all in the chaos of reorganisation until then—no one could have received a letter, because CCGs were not in place. In the crucial period between January and March, when the NHS was under intense pressure, primary care trusts were on the way out and CCGs were not in place. As a result, the NHS was in limbo; at the precise moment that it needed grip and leadership, it was drifting. That is absolutely shocking.

As I have said repeatedly, the Government must act to shore up social care in England, which is collapsing. Our solution is for the Secretary of State to use about half of last year’s underspend in the NHS, £1.2 billion, to provide emergency support to councils over the next two years to maintain integrated, home-based support. As he knows, the Budget revealed a £2.2 billion underspend in last year’s Department of Health budget. No use was made of the budget exchange scheme. In other words, he handed that money back to the Treasury. I call on him to reconsider his decision, reopen negotiations with the Treasury and act to prevent a social care emergency.

[Margot James (Stourbridge) (Con)]

Between 2005 and 2010, the population of over-65s grew by 730,000 and the population of over-80s—the very elderly—grew by 27%. Why did the previous Government increase the budget for adult social care by less than 1% a year to cope with that additional demand?

[Andy Burnham]

Oh dear, Mr Deputy Speaker. It is hard for this Government, who have decimated social care, to lecture us about it. Between 2005 and 2010, A and E waits fell. That was after the GP contract was signed. Let us have some facts. We did much to support social care and to deliver an NHS with the lowest ever waiting lists and the highest ever patient satisfaction.

The second point in our A and E rescue plan concerns safe staffing levels—another aspect that we have raised repeatedly with the Secretary of State.

Education Maintenance Allowance

Debate between Andy Burnham and Margot James

Wednesday 19th January 2011 Commons Chamber

[Margot James (Stourbridge) (Con)]

rose—

[Andy Burnham]

I will make further progress before giving way.

EMA is one of the few practical policies that has directly supported social mobility and equality of opportunity, so today I will set out a comprehensive case for its retention—the educational case, the social case, the economic case and the democratic case. The Government wanted to close down EMA quietly. They have closed the scheme to new applicants. They have not begun to replace it, as their amendment claims. We have called this debate because EMA has worked and is worth fighting for.

[Margot James]

Does the right hon. Gentleman appreciate that the enhanced learner support fund, which is the Government’s proposed replacement for EMA, will help many of the hard cases with which he illustrated the earlier part of his speech? Some 90% of students are telling us that they do not need EMA and will continue with their studies without it. If he does not accept that figure, what would he accept as the dead-weight figure?

[Andy Burnham]

The hon. Lady has just shown how hopelessly out of touch Government Members are. Is she telling me that nine out of 10 young people in her constituency who get EMA are saying they do not need it? If so, she has been speaking to some very different young people—although I am glad that she has at least been speaking to them, unlike those on her Front Bench. She needs to answer this question. The Government are proposing a scheme that is a tenth—