Accident and Emergency

David Wright Excerpts

Wednesday 18th December 2013 Commons Chamber

[Andy Burnham (Leigh) (Lab)]

I beg to move,

That this House is concerned about recent Government statements on Accident and Emergency (A&E) and Government claims that it is not in crisis; notes that last week, 79 A&Es and the NHS overall missed the Government’s A&E target; further notes that attendances at hospital A&Es have increased three times faster since 2009-10 than in the period from 2004-05 to 2009-10, and that in the last 12 months more than one million people have waited more than four hours; believes there are a range of reasons for the current pressure on Accident and Emergency but that difficulty in accessing GP services is one of the primary causes; regrets the Government’s decision to cut funding for evening and weekend GP opening and scrap the guarantee of a GP appointment within 48 hours; and, to ease the pressure in Accident and Emergency, calls on the Government to reverse for winter 2013 its scrapping of the 48-hour appointment guarantee.

As we approach the end of 2013, it is becoming clear that this has been the worst year in accident and emergency for at least a decade. All year, the pressure has been relentless. It is not just a winter crisis, but a spring, summer and autumn crisis. Across the 12 months, more than 1 million people have waited more than four hours to be seen, which is a threefold increase since 2010. For the past 22 weeks, hospital accident and emergency departments have missed this Government’s target. Last week, the target was missed by the NHS as a whole, which is a warning sign that winter has now arrived and things are getting even worse.

Accident and emergency is the barometer of the whole health and care system. All year, that barometer has been warning us of severe storms ahead, and yet, three weeks ago, the Secretary of State stood at that Dispatch Box and claimed that this was

“a crisis that is not happening”.—[Official Report, 26 November 2013; Vol. 571, c. 155.]

He should try telling that to the families of people left waiting for hours on trolleys in corridors; to the people who have been ferried to hospital in police cars and taxis because ambulances are trapped in queues at accident and emergency; and to the A and E sister who attended our A and E summit here in Parliament last week and said:

“It feels like we’re fire fighting. It’s crisis management.”

[David Wright (Telford) (Lab)]

Is this problem not compounded by the fact that in many places such as Telford and Wrekin and the wider Shropshire area, the future of full A and E services at many hospitals is in doubt? That situation is bad for morale, and it compounds the other problems such as waiting times. People want some reassurance about the future of their A and E services.

[Andy Burnham]

That is a question for the Secretary of State. How can it make sense to close so many A and E departments in the middle of an A and E crisis? This year, the facts on the ground have changed. As I have said, it has been the worst year for a decade. Any proposal to change A and E in areas such as that of my hon. Friend needs to be considered in the light of that new evidence. We need to consider whether it is safe to proceed. As the A and E sister said, it is crisis management. That is the view from the real world. In here, it is a different story. It is, “Crisis, what crisis?”

My purpose in holding this debate is to cut through the spin. I want to bring into our debate today the voices of those A and E nurses, occupational therapists, paramedics, community nurses, and NHS 111 staff and mental health professionals who came to our summit. For instance, there is the paramedic who told us of his worries about ambulance response times getting longer because ambulances are trapped at A and E; and of the time when a patient who was held a long time at the door of a busy A and E suffered a heart attack and had to be rushed back to the ambulance. Another paramedic told us about being at the scene of a serious incident in a city centre. After calling for back-up, he was joined by a private ambulance which did not appear to have adequately trained staff to take patients to hospital. A community nurse spoke of her frustration at spending an hour and a half on the phone trying to get a GP appointment for a frail patient. An A and E-based occupational therapist said that she was now regularly diagnosing dementia for the first time in older patients who had ended up in A and E. Surely we can do better than that.

--- Later in debate ---

[Mr Hunt]

I will tell the hon. Gentleman why. It was done on clinical advice, for the good reason that there are some patients whom it is better to see, even if it takes longer than four hours, so that they can be discharged and sent home, rather than admitting them to the hospital, which is what was happening under the 98% target. Labour agrees with that, because it is following the same procedure in Wales.

[David Wright]

Will the Secretary of State give way?

[Mr Hunt]

I am going to make some progress.

I want to talk about what is happening in England, because the right hon. Gentleman wanted to know the truth. These are the statistics he did not want to tell the House about the comparison with his time in power, which he said was so good: 1.2 million more people are going through A and E every year, and more than 2,000 are being seen within four hours every single day, compared with when he was Health Secretary. The average wait to be seen is now 33 minutes compared with 77 minutes when he was Health Secretary—that is 44 more minutes longer, on average, to be seen under Labour than under this Government. For treatment, the average wait is now 75 minutes compared with 102 minutes when he was in office.

--- Later in debate ---

[Mr Hunt]

I recognise the hon. Lady’s concern for her constituents. I have looked into the issues in the Manchester and Trafford areas very carefully, and I am assured by people on the ground that the problems and challenges they face do not relate to the changes that have been announced in Trafford.

[David Wright]

rose—

[Mike Gapes (Ilford South) (Lab/Co-op)]

rose—