NHS and Social Care Funding

Derek Twigg Excerpts

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

I am going to move on a little.

If the Secretary of State is not abandoning the four-hour standard, as he insists he is not, we look forward to hearing him make that absolutely clear. He also said and has implied that we need to educate the public better, so that they do not turn up at A&E departments. That was the implication of his remarks on Monday. Will he tell us how he is going to do that? What will be the cost implications of explaining to the public that they must not turn up at A&E departments? Are we expecting to see a large advertising campaign? Will the cost fall on local authorities’ public health budgets, which have already been cut? Will local authorities be given more resources for this new public education campaign?

[Derek Twigg (Halton) (Lab)]

My hon. Friend is making an important point. The key similarity is that back in 1997, when Labour took over, the health service was in crisis, and it is again today. Is not part of the problem that people are having to go to A&E because they cannot get in to see their GP?

[Jonathan Ashworth]

Absolutely. It is so difficult to get to a GP, which is why there are all these pressures on our A&Es. Of course, it is only going to get worse, because this year we are going to see cuts to community pharmacies—3,000 will be lost from our towns and streets because of the cuts that are being pursued. Let us not forget that the figure of 3,000 community pharmacies being lost was what the previous Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), told MPs.

--- Later in debate ---

[The Secretary of State for Health (Mr Jeremy Hunt)]

I beg to move an amendment, to leave out from “House” in line 1 to the end and add:

“commends NHS staff for their hard work in ensuring record numbers of patients are being seen in A&E; supports and endorses the target for 95 per cent of patients using A&E to be seen and discharged or admitted within four hours; welcomes the Government's support for the Five Year Forward View, the NHS's own plan to reduce pressure on hospitals by expanding community provision; notes that improvements to 111 and ensuring evening and weekend access to GPs, already covering 17 million people, will further help to relieve that pressure; and believes that funding for the NHS and social care is underpinned by the maintenance of a strong economy, which under this administration is now the fastest growing in the G7.”

I thank the shadow Health Secretary for bringing this afternoon’s debate to the House. He is right to draw attention to the pressures in the NHS, but, regrettably, I will have to spend much of my time correcting some totally inaccurate assertions that he has made, and that is a shame. This is an important debate for our constituents—for his and for mine—and for the NHS. The country deserves a proper debate, but that is difficult when we are given misinformation at a time when the NHS is under sustained pressure.

I am also very pleased to see the Leader of the Opposition in his place. I think that he has become rather a fan of my parliamentary appearances—[Interruption.] It is a Jeremy thing, he says—if only. I wish to address one part of my speech to him, because it is an area of policy for which he is perhaps more personally responsible.

Winter is always challenging period, and I want to repeat the thanks of the shadow Health Secretary and the thanks that I gave on Monday to NHS staff. According to NHS Improvement, on the Tuesday after Christmas the NHS had its busiest day ever. Earlier in December, it treated a record number of patients within four hours. Overall, as the Prime Minister said this morning, we are seeing 2,500 more patients within the four-hour standard every single day compared with what happened in 2010. As we discussed on Monday, the NHS made record numbers of preparations for this winter, because it is always a difficult time, including having 3,000 more nurses and 1,600 more doctors in full-time employment.

Let me address what the shadow Health Secretary said with regard to Worcestershire. I met colleagues from Worcestershire on Monday. A huge number of actions are now being taken, but we must say right up front that it is totally unacceptable for anyone to wait 35 hours on a trolley and that we expect the hospital to ensure that that does not happen again. There are plans in place to open additional bed capacity this week. We have already had capacity made available by Worcester Community Trust to support the flow. The trust has deployed its chief operating officer on the task of facilitating discharges. The trust is in special measures, so we have a big management change, and a new chief executive will be starting later on in the spring.

What is wrong with what the shadow Health Secretary has just said is the suggestion that winter problems are entirely unusual. As my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) said, the NHS had difficult winters in 1999, 2008, and 2009. He remembers difficult winters from his time as Health Secretary, but there are things that are different today. One of them is that, compared with six years ago, we have 340,000 more over-80s, many of whom are highly vulnerable or have dementia. We know that when people of that age go to an A&E at this time of year, there is an 80% chance that they will be admitted to hospital.

[Derek Twigg]

The Secretary of State talks about correcting the points that have been made so that the House has the right information. May I repeat the question that I asked him on Monday? What are the latest figures—he should have them up to this week—for the number of people who could be discharged but have to remain in hospital because there is no community support available for them? Can he give us that figure now? He said that he would write to me, but he must know that figure now.

[Mr Hunt]

Last year, on average, it involved around 7,000 beds, which is far too many. That is why the Secretary of State for Communities and Local Government announced in December a new package of support worth around £400 million—

[Derek Twigg]

rose—

[Mr Hunt]

Let me answer the hon. Gentleman’s question. I said that I would write to him, and I will do so. He may have noticed that there are other issues that we are dealing with, which is why I may not have had time to sign the letter. The £400 million extra for local authorities over the next two years will make a significant difference and he should recognise that.

--- Later in debate ---

[Mr Hunt]

I will give way, but first I want to make some progress.

I want to talk about something else that is different in our A&E departments today compared with six years ago. Although we are sticking to the four-hour target, we also insist on much higher standards of safety and quality.

On Monday, I congratulated Labour on the introduction of the four-hour target—I support it—but we should also remember that four years after that standard was introduced, we started to see some horrific problems at Mid Staffs, many of which were in the A&E department. Some were caused because people thought they would be fired if they missed the target. Robert Francis said that the failures at Mid Staffs were

“in part the consequence of allowing a focus on reaching national access targets.”

Therefore, although we retain targets, we will not allow them to be followed slavishly in a way that damages patient care.

[Derek Twigg]

Will the Secretary of State give way?

[Mr Hunt]

I have already given way to the hon. Gentleman. There are many other Members who want to intervene.

That is why we have a new inspection regime that makes it harder to cut corners in the way that used to happen when beds were not being washed, there was poor infection control and ambulances were being used as waiting rooms.