Accident and Emergency Departments

Charles Walker Excerpts

Thursday 7th February 2013 Commons Chamber

[Gavin Barwell]

The honest answer to the hon. Lady’s question is that I do not know. I am simply relying on the report, which is suggesting that that analysis points to 500 as the number of deaths that are purely due to the timing of the week. We could argue about the figure, but I hope that she would agree on the point of principle that having fewer consultants on at the weekend must impose some level of risk.

The report also says:

“The Royal College of Surgeons state that a critical population mass is required in order to provide an efficient and effective emergency service. This is supported by literature that suggests that surgeons who perform a high volume of procedures tend to have better outcomes. The preferred catchment population size for an acute general hospital providing the full range of facilities, specialist staff and expertise for both elective and emergency surgical cases would be 450,000-500,000.”

We have a problem. We have a large number of hospitals in London with accident and emergency departments and they do not have the recommended level of full-time equivalent consultant cover to provide the best medical outcomes. Every single Member of this House will defend their local hospital, as that is where their constituents go for treatment. If I was in the same position as the hon. Member for Mitcham and Morden, I would be doing exactly the same.

[Mr Charles Walker (Broxbourne) (Con)]

rose—

[Siobhain McDonagh]

rose—

[Gavin Barwell]

I shall give way to my hon. Friend, because I promised that I would.

[Mr Charles Walker]

The problem in north London—and in Broxbourne on the edge of north London—is that Chase Farm is serving a growing population. I do not want to keep Chase Farm A and E open because of any emotional attachment to it, but because we have a population that is due to grow by another 40,000 over the next few years.

[Gavin Barwell]

My hon. Friend has put the case for his local hospital firmly on the record. I do not know the detail and would not want to comment. I shall try to make time to allow the hon. Member for Mitcham and Morden to intervene once I have advanced my argument a little. I referred to her, so it is only fair to give her that opportunity.

The point I am trying to make is that there is a need for balance. Constituents want to be able to access facilities at a local hospital, both from their own point of view and because if they have an extended stay they want friends and relatives to be able to come and visit them easily. There is a balance to be struck between convenience and quality of treatment. For example, my hon. Friend the Member for Banbury (Sir Tony Baldry) referred to someone with a serious aortic problem who was able to go to a hospital with specialist expertise.

Let me make a couple of points about improving the quality of care, which was also touched on in the “Better Services, Better Value” review. One concerns the European working time directive’s impact on the NHS. The review states:

“The implementation of the EWTD has resulted in shorter sessions of work with complex rotas as well as more frequent handovers. Resulting difficulties in maintaining continuity of care can have implications for patient safety.”

The review also contained some powerful findings about the four-hour target, introduced by the previous Government for laudable reasons, which included wanting to monitor the level of care people received. The data for south-west London show that A and E admissions spike between 245 and 260 minutes in all south-west London acute trusts, suggesting that internal standards are aligned solely to the four hours rather than other quality issues.

There are a range of issues relating to A and E in south-west London. I want to say a brief word about Lewisham, but first I shall give the hon. Member for Mitcham and Morden a chance to intervene.