Accident and Emergency

Clive Efford Excerpts

Wednesday 18th December 2013 Commons Chamber

[Mike Gapes]

rose—

[Clive Efford (Eltham) (Lab)]

rose—

[Mr Hunt]

I am going to make some progress.

Our plans go much further than simply reversing the 2004 contract. GPs will offer the most vulnerable guaranteed same-day telephone consultations, which never happened under Labour. There will be a dedicated telephone line so that A and E doctors, ambulance paramedics and others can get advice from GPs about treatment in urgent situations. GPs will co-ordinate care for elderly patients discharged from A and E to try to ensure they get proper wrap-around care to minimise the chance of needing to go back.

We have done something else that the right hon. Member for Leigh never did to tackle long-term pressure on A and E. One of the biggest problems has been not being able to discharge people from hospital because of poor links between the health and social care systems. Through our £3.8 billion better care fund, this Government are doing something that Labour talked about a lot but never actually delivered: we are merging the health and social care systems. Gone will be people being pushed from pillar to post, because in order to access this fund, clinical commissioning groups and local authorities will have to commit to joint commissioning and joint provision.

Finally, we have looked at the long-term structure of A and E. The previous Government were battered by a succession of failed reconfigurations. We, too, have had challenges over decisions, such as those with regard to Lewisham. Sir Bruce Keogh’s recent review of urgent and emergency care has changed the terms of this debate by setting out a 21st-centruy vision of emergency care. Sir Bruce rightly said there should be more extensive services outside hospital, and this, too, will help to reduce A and E queues. He rightly said that while the number of A and Es is not expected to change, the services offered by all of them should not be identical if we are to maximise the number of lives saved. Our duty to patients is to make that a reality and we will not hesitate to drive that vision forward.

A and E and the ambulance services are performing well under unprecedented pressure. I cannot speak highly enough of the hard-working staff who are working around the clock to deliver vital services. They share our overriding commitment to putting patients first this winter. Unlike Labour Members, we do not seek to turn a tough winter into a political football. If they want to make the comparison between our record and theirs, we are happy to do so: more people being seen within four hours, shorter waiting times, and long-term problems being tackled—not posturing from the Opposition, but action from the Government, and a commitment to do what it takes to support hard-working front-line staff over Christmas. We should get behind them and not undermine their efforts.

--- Later in debate ---

[Clive Efford (Eltham) (Lab)]

The hon. Member for Bracknell (Dr Lee) has just said that there is a perfect storm coming and has appealed for a cross-party approach to deal with the issues in the national health service. I absolutely agree with him about that.

Before the last general election, that is exactly what we had in south-east London. We had a consultation over a couple of years on the “A picture of health” programme, which involved the closure of an A and E. The point is that that was a clinically led consultation. Doctors came to us politicians and said that, if we reconfigured services in a certain way, they could treat patients better and save more lives. I took the view before the general election that the sensible approach was to support those clinicians. It would have been easy for me to man the barricades, defend my local services, say that the reconfiguration was horrible and be a populist local MP. However, I took the view that we needed leadership and cross-party agreement to make the changes that were needed to improve services.

Sadly, when this Government came in, they threw out the whole APOH reconfiguration. After saying in their manifesto that there would be no “forced closure” of A and E and maternity services, the Conservatives came in and said to Lewisham hospital, “Close your A and E and maternity services.”

The Conservatives had said that they would stop the closure of Queen Mary’s hospital, Sidcup. People could have been knocked over in the rush of Tories who wanted to join the campaign to save Queen Mary’s. What happened when they got into power? They closed Queen Mary’s. On that site, there is now a health industrial estate. It will be an incubator for private health care. There will be elective surgery there under Gravesham health care for a short period, but it will go out to tender. We all know where it will go. It will go out to the private sector. There is a site for hire at Queen Mary’s, Sidcup. All sorts of services will come in and compete with NHS services.

[Mr Andy Slaughter (Hammersmith) (Lab)]

That is a familiar story to all of us. There are four A and Es closing in west London and two major hospitals are changing. Charing Cross hospital will no longer be a major teaching hospital and half the site is being sold off. In its place, there will be a local hospital that provides primary care services. The Tories said that those hospitals were closing under Labour when they were not. They are now going back on their promises. In many cases, direct promises were given on site before the last election.

[Clive Efford]

There is example after example of broken promises. The Conservatives accused people of planning to close hospitals when there was no plan to do so, and then came in and did it themselves.

We have a curious situation. The Secretary of State has been saying, “Crisis? What crisis?” Today, he read out a quote saying that the crisis is behind us. That is a little confusing. Of course, the crisis that he was talking about was a summer crisis. He did not mention that. He presided over a summer crisis. That is pretty unique. I do not think that even Virginia Bottomley achieved a summer crisis, but I could be wrong.

The crisis is of the Government’s own making. The Secretary of State talked about the need for services away from the hospital to protect A and E from being overwhelmed. However, one of the first things that they did was to do away with the 24-hour promise of a visit to the GP. They then introduced 111, which had algorithms and questions that all ended with the advice, “Go to your A and E.” There are now 850 fewer surgeries opening at evenings and weekends, and a quarter of walk-in centres have closed. Talk about reinventing the wheel—the Government are now saying that those are the sorts of things that we need to do. The crisis in A and E is of the Government’s making. It is their decisions that have created the situation.

To return to south-east London, the Secretary of State appointed the trust special administrator to oversee the merger of Lewisham and Queen Elizabeth hospitals. The local authority took on that decision because the powers that the Government took were not within their remit. The Government were challenged in the court and defeated. The Government are now moving the goalposts. Having said before the last general election that there would be no top-down reconfiguration and that they would not enforce closures if the local community did not agree with them, they are taking powers to impose closures on local communities.

In the minute that I have left, I want to say to the Minister that there has been a series of broken promises. It is fitting that a Liberal Democrat is summing up a debate on broken promises on the NHS.

[Norman Lamb]

indicated dissent.

[Clive Efford]

It is true. Where were any of the things that are happening to our NHS in the Liberal Democrats’ manifesto? None of them was in their manifesto. They never put them before the electorate.

We want no return to the closure of Lewisham A and E. The closure of Queen Mary’s, Sidcup has had the knock-on effect of overwhelming the other A and Es in south-east London. That is clear for all to see. Those A and Es are under serious pressure. It is clear that there is no slack in the system to pick up the additional burden from that closure. We must have a guarantee from the Government that they will not impose the closure of another A and E on the people of south-east London. I would like to hear that from the Minister when he sums up.