Accident and Emergency Waiting Times

Ben Bradshaw Excerpts

Wednesday 5th June 2013 Commons Chamber

[Dr Wollaston]

The reality that we face is that there is a limited amount of public funding. We can spend that pot of public money only once, so we must spend it in the right place, and that often means that we need to spend more of it within social care. That is why I welcome the fact that some of the health budget has been shifted to social care, and that is very important. I also commend Torbay. My constituency covers Brixham and Paignton, and Torbay has been nationally and internationally recognised for its work on integrating health and social care. It is no coincidence that it does so well on A and E waiting times, and we should be looking at what it has achieved.

But how will we keep people out of our A and E centres? In the Health Committee, we heard evidence about the effect that paramedic crews have. If the paramedic crew in an ambulance are highly skilled, the person they treat is less likely to need to go to casualty in the first place because the expertise is there to keep them at home. There needs to be better access to records. We need to consider how we can improve IT so that the patient owns their record and every part of the system can safely access their drug and medical history—with their consent, of course.

[Mr Bradshaw]

Given the hon. Lady’s previous distinguished career as a Devon GP, does she, like me, deplore the comments made today by a Government Minister, who sought to blame the current crisis in the NHS on the growth in the number of women doctors?

--- Later in debate ---

[Mr Ben Bradshaw (Exeter) (Lab)]

I associate myself absolutely with the remarks made by the hon. Member for Totnes (Dr Wollaston) about tariff reform, but given the time constraints, I will restrict my remarks to one particular issue that is putting pressure on the A and E crisis. I am talking about access to GPs.

I want to share testimony that I have recently received from people in Exeter. The first comes from a young teacher:

“Again and again, whenever I want to see a doctor there are no appointments available for as long as a week away, in addition to appointments not being made available at accessible times. Being a teacher, I am unable to easily pop out for a doctor’s appointment.”

Another constituent wrote to me last month about the A and E crisis:

“I believe one of the main reasons for this is that it has become very difficult to see your own GP unless you are prepared to wait three weeks for an appointment. I have personal experience of this, as do many of my friends and colleagues, and this is making people with minor ailments attend A and E in order to be seen.”

You will remember, Madam Deputy Speaker, that when Labour was in government, we introduced a requirement on GPs to grant appointments to their patients within 48 hours. We also introduced incentives in the GP contract for GPs to open at weekends and in the evenings, and we established GP walk-in centres in every primary care trust in England—in some areas, we established more than that. It worked. By the end of our Government, complaints from the public about GP access had declined significantly, as had pressure on A and Es that resulted from people not being able to see a GP.

By May 2010 more than 75% of GP practices in England were opening in the evenings and at weekends. Under this Government, however, 500 of those practices have reduced their opening times again. By May 2010, there were walk-in centres in every area offering quick, easy access to a GP, seven days a week and 12 hours a day. Since 2011, 25% of those centres have closed, and scrapping the requirement for GPs to offer an appointment within 48 hours has led to a return of the bad old days of people waiting days or weeks to see a GP, and therefore going to A and E instead.

[Mr Lammy]

Will my right hon. Friend give way?

[Mr Bradshaw]

I regret I will not do so because I have so little time.

When I wrote to the Health Secretary with the cases from Exeter that I referred to earlier, his colleague, Earl Howe, replied:

“It is our view that 48-hour access did not focus on outcomes, and specifying a particular model to deliver better services for patients misses the point about local needs, local services and local accountability.”

That, I am afraid, is gobbledegook. My hard-working constituents, who pay for the NHS, want to be able to see a GP when they need to and at a time convenient for them. Earl Howe’s letter went on to say that as this was a local issue, I should raise my concerns with the clinical commissioning group, which I promptly did. It replied stating:

“As this relates to GP services, the letter should be sent to NHS England.”

I await its response with interest.

Will the Minister help the House by making clear in her response who is responsible for ensuring that the public can see a GP quickly and conveniently? I was encouraged to hear the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) tell the “World at One” yesterday that he wanted to improved GP access, including opening times, in response to the A and E crisis. Hallelujah! May I suggest, however, that he and he colleagues start by stopping the closure of walk-in centres, and reintroduce Labour’s requirements and incentives for GPs to give appointments within 48 hours and to open their surgeries at weekends and in the evenings? Without such measures, I am afraid that current pressures on A and Es will simply get worse.