National Health Service

David Lammy Excerpts

Wednesday 21st January 2015 Commons Chamber

[Mr David Lammy (Tottenham) (Lab)]

Two years ago, a friend of mine collapsed on a football playing field and an ambulance was called. The ambulance should have reached this major emergency within eight minutes, but it took 17 minutes and my friend died of a heart attack on that field. The seriousness of this debate for many families beyond this Chamber—I am thinking of the wife and three children that he left behind—cannot be conveyed. It is right to begin by saying that the £700 million that has been found and the £150 million for the challenge fund are absolutely desirable and necessary at this time. I remember, as a former Minister in the Department dealing with the winter crisis, that those funds are very important.

I want to take the House back to a dark time for the NHS, when it was routine to wait in A and E for six, eight or 12 hours, and to what it took to change that system. It was a great privilege for me to begin my ministerial career in the Department of Health. The then Member for Darlington was busy, controversially, dealing with foundation hospitals. The then Member for Barrow and Furness was busy at that time, controversially dealing with nurses’ pay and increases we wanted, and with the GP contract. I found myself leading on emergency care, and I was the Minister who took through the changes for that A and E target.

We brought in Professor Sir George Alberti. For a number of reasons, it was hugely important that we had a clinician leading the charge across the NHS. We needed to persuade the GPs about access if this was to work. We brought in the target—48 hours, since abolished —and a lot of practice at the front door of A and E. The phrase we used all the time at that point was “See and treat and triage”, but it worked only if we looked at the system as a whole system. Important targets in the rest of the hospital—in cancer, in cardiac care—were necessary. Frankly, it is a crying shame that seven of the 15 major targets were missed under this Government.

We also needed to deal with social care, of course. If £3.53 billion is taken out of social care, there must be consequences. We should remember that much of this debate has been in the past tense. There are further cuts to come, with day centres to be closed. We see phrases pop up in local authorities such as “New pathways for the elderly”. New pathways to what? New pathways to isolation; new pathways to falling over at home alone; new pathways to going without food; and new pathways to ending up at the door of A and E.

We also introduced NHS Direct to ensure that nurses could deal with calls promptly and move on. I never conceived that we would get rid of the nurses in NHS Direct, and that we would move solely to a system of algorithm. Is it surprising that NHS Direct staff are directing people to the door of A and E? Our system worked because before people went to A and E they could go to a walk-in centre. We can call them urgent care centres if we want, but they are essential—they are part of the triage, a part of the see and treat method that we need. Again, however, one in four of them has been lost, resulting in the crisis we see before us.

Here in London it is worse, because we are losing A and Es—gone at Chase Farm, gone at Hammersmith, gone at Central Middlesex, going perhaps at Epsom and St Helier, gone at Charing Cross—and with a population rising to 10 million. This is a serious debate because it is about to get worse. No wonder the chief executive of the London ambulance service resigned yesterday. She is leaving a sinking ship under this Government’s watch, and this House and the people will remember that, because it is specious of the Secretary of State to come to this Chamber and say the debate is solely about more nurses and more doctors. It is not. It is about the system—the NHS.

Who is accountable under this new structure? Is it NHS England? Is it the CCGs? Is it the CQC? Is it another jargon organisation? No one is responsible—certainly the Secretary of State is not, because he gave up those responsibilities in 2012. That is the mess this Government have got into without even putting it in the manifesto. It is a disgrace.