A&E Services

Baroness Stuart of Edgbaston Excerpts

Wednesday 24th June 2015 Commons Chamber

[Ms Gisela Stuart (Birmingham, Edgbaston) (Lab)]

Thank you, Madam Deputy Speaker; it is an exceptional pleasure to speak while you are in the Chair. I hope that I will be forgiven for returning to the motion, which seems to have slipped Members’ minds over the past hour or so. It specifically states:

“That this House notes that hospital A&E departments have now missed the four-hour A&E target for 100 weeks in a row; further notes that trusts are predicting record deficits this year”.

The Government were asked to respond to that. As the Minister singularly failed to do so at the start of the debate, I hope that he will return to it in closing.

I have in my patch the University Hospitals Birmingham NHS Foundation Trust, where I first met a heart surgeon call Sir Bruce Keogh—I am not entirely sure what happened to him. I therefore have either the highest or the second highest proportion of constituents who are either doctors or who work in the health service, so the NHS and everything associated with it is something that I cannot escape. I thought that it would be useful to have an NHS tracker survey, which records over a period of time how the health service is seen not just by those who use it, but by those who work in it. I want briefly to share the results of the surveys with the House, because they show that the people who use the NHS and who work in it are becoming increasingly concerned about the conditions in which they are treated or in which they work.

I received about 400 responses to the last survey. Some 74% of respondents said that they were very concerned about the future of the NHS. One respondent commented:

“I work in a large university hospital Emergency Department”.

We have a number of large trusts in the west midlands conurbation, so people might be living in my constituency but working in a different trust.

“The hospital bed occupancy consistently exceeds 99%, with hundreds of well patients in beds unable to be discharged due to inadequate social care. Consequently, the A&E is overwhelmed with patients lying on trolleys while I scrabble around trying to get something done.”

Another respondent said:

“My work load leaves me worrying about my own health in the future.”

Another referred to

“staff shortage on wards leading to the use of more agency staff, wasting money on unnecessary management… staff are stressed due to doing more shifts to make ends meet.”

Another said:

“All parties want better 24-hour access but there are not enough trained doctors—especially GPs—coming through the system, and too much money is spent on bank staff and locums.

That is not political scaremongering; that is what people who work in the health service have said.

We have face up to that. It is no good sitting here and pretending that we have no control over it. Decisions on the NHS are political decisions, because we decide annually how much money to spend on it. That means that there has to be some element of control. University Hospitals Birmingham has said:

“Emergency Department activity has continued to rise with the Trust passing the 102,000 ED attendances a year… equating to a 4.9% increase”.

Those are enormous numbers—102,000 emergency admissions in one hospital—and they are going up year on year.

That brings me to the targets. I know that they are difficult, but I remember that when we introduced them they were about the only way we could get good consultants to change their way of doing things. They kept saying, “This is the only way of doing it,” so we said, “Let’s try with targets.” If we look at the most recent statistics on waiting times of four hours or less in the west midlands, we see that Walsall Healthcare NHS Trust has achieved 95%; University Hospitals Birmingham has achieved 95%; but University Hospitals Coventry and Warwickshire NHS Trust achieved 79%; Worcestershire Acute Hospitals NHS Trust achieved 81%; and the University Hospital of North Staffordshire NHS Trust achieved 87%. That tells us that something is going on that is not quite right. I think that we ought to start debates such as this one by saying, “Both sides agree that something is going on that is not quite right.” These figures are not just inventions. They tell us the trend, so how do we address it?

The Government got rid of NHS Direct, and 111 did not replace it—[Interruption.] It is no good the Minister shaking his head. I set up NHS Direct, and the big thing was that there were trained nurses, not call handlers. They managed to deal with demand because the person on the other end of the phone could make a clinical decision, not just pass it on. We have had those knock-on effects. I hope that at least at some stage over the next two hours the motion on the Order Paper will be addressed. The trend is in the wrong direction and we need to think about what to do about it. People are waiting longer and the hospital deficits will be horrendous. This will be a problem for us all.