NHS and Social Care Funding

Henry Smith Excerpts

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

The Secretary of State shakes his head and says, “Nonsense”, but let me remind him of what he said in the House on Monday:

“we need to have an honest discussion with the public about the purpose of A&E departments.”

He began by saying he wanted to provoke a discussion. He has certainly provoked a backlash, not least by blaming the public, it seems, for turning up at A&E departments. He went on to say that the four-hour target

“is a promise to sort out all urgent health problems within four hours”,

but he added a little clarification, continuing:

“but not all health problems, however minor.”—[Official Report, 9 January 2017; Vol. 619, c. 38.]

That is what he said in the House, and now we have seen the letter from NHS Improvement to trusts a few weeks ago, which talks of

“broadening our oversight of A&E”.

On the four-hour standard, it said that it believed

“there is merit in broadening our oversight approach, beyond a single metric”.

So in the interests of that discussion the Secretary of State wants to engage in, perhaps he can answer our questions, although I know he avoided the questions on Sky yesterday. Does he recall that in 2015, when he asked Sir Bruce Keogh to review these matters on waiting times, Sir Bruce said:

“The A&E standard has been an important means of ensuring people who need it get rapid access to urgent and emergency care and we must not lose this focus”?

[Henry Smith (Crawley) (Con)]

rose—

[Jonathan Ashworth]

I will give way in a few moments. Sir Bruce continued:

“I do not consider that there is a case for changing the 4 hour standard at this time.”

Does the Secretary of State still agree with Bruce Keogh? If he does, why did he make his remarks on Monday about needing to have a discussion about the future of the A&E standard?

--- Later in debate ---

[Jonathan Ashworth]

My hon. Friend makes a powerful point. Indeed, I remember, when we were in government, shadow Health Secretaries standing at this Dispatch Box opposing every penny piece of money that Labour was putting into the NHS. I remember a shadow Health Secretary, who now sits in the Cabinet as the Secretary of State for International Trade, standing at this Dispatch Box and saying that the A&E target was “indecent.” That was the Tories’ attitude when we were in government, so it is no wonder that we are sceptical about the Government’s intentions for the A&E target when we look at their history.

[Henry Smith]

The shadow Secretary of State is talking about the Labour record on the NHS. Does he recall Labour closing not only maternity at Crawley hospital, but accident and emergency in 2005?

[Jonathan Ashworth]

I do not have the details of the Sussex STP to hand, but presumably if it contains any suggested closures the hon. Gentleman will be campaigning against them and knocking on the door of the Secretary of State, if those remarks are an indication of his point of view on these matters.

--- Later in debate ---

[Mr Hunt]

I will give way to as many people as I can, but I also want to address the substantive points made by the shadow Health Secretary. He talked about the four-hour target. In his motion and his speech, he made the totally spurious suggestion that we are not committed to that target. I remind him what my right hon. Friend the former Chief Whip quoted me as saying on Monday. I did not just commit the Government to the target; I said that it was one of the best things that the NHS does. However, I also said that we need to find different ways to offer treatment to people who do not need to be in A&E. It is hardly rocket science. When there is pressure in A&E, it is sensible—indeed, I would argue that it is the duty of the Health Secretary—to suggest that people who can relieve pressure on A&E by using other facilities do so.

[Henry Smith]

Just yesterday at Crawley hospital, an acute care unit was opened, which is designed precisely to ensure that people who do not need to attend A&E are properly directed to the most appropriate care, which is good for them as individual patients and good for the whole system.

[Mr Hunt]

That is absolutely right. To back up my hon. Friend’s point, yesterday’s OECD report said that in Australia, Belgium, Canada, France, Italy and Portugal, at least 20% of A&E visits are inappropriate. NHS England’s figure is up to 30%, which is why we need the public’s help to relieve pressure and that is what I meant when I talked about an honest discussion.

--- Later in debate ---

[Henry Smith (Crawley) (Con)]

There is no NHS A&E waiting crisis in my constituency, because there is no A&E unit. It was closed a dozen years ago by the then Labour Government, and people who need to access emergency services must now travel nearly 10 miles on single-carriageway roads to East Surrey hospital. That is the legacy of the Labour Government in my constituency.

I am pleased to say that since 2010 services have been returning to Crawley hospital as a direct consequence of the protection and, indeed, enhancement of the health budget to which the Government have committed themselves, and to which they are still committed. I know that this is often dismissed by the Labour Opposition and by others, but it is quite significant that the NHS asked for an additional £8 billion for the coming period and the Conservative Government are delivering £10 billion of extra investment. That has a very real effect.

I do not deny that there are huge pressures on our health service. As many Members have pointed out today, we have an ageing and a growing population. It is fortunate that people are living longer because new drugs are available to treat conditions that were previously not very treatable, but that puts additional pressure on the health service, although, in a way, those are nice problems to have.

We should not use this issue as some sort of political tit-for-tat. Concern for the health service and our wellbeing is felt by us all, both for ourselves and, of course, for our families and loved ones. I think that, when discussing how to address the increasing health needs of our nation, we should focus on constructive arguments rather than the political point-scoring of which we have heard so much today. I have to say that, as other Members have mentioned, in the 33 minutes of the shadow Health spokesman’s speech we did not hear a single policy suggestion on how under a Labour Administration there would be a different approach to the NHS.

I am delighted to say that Crawley this week celebrates the 70th anniversary of being designated a new town. One of the most disastrous decisions in those 70 years was the loss of the A&E in 2005, although, as I have said, some services are returning. Just yesterday, a new clinical assessment unit was opened that seeks to do precisely what we have been discussing: take pressure off A&E whereby those who should not be treated in an emergency environment are triaged and signposted to better support services. That unit is to be welcomed. In recent years, a new 24-hour, seven-day-a-week urgent care centre opened in Crawley hospital as well as an out-of-hours GP surgery. As we strive to achieve that 24/7 NHS, all these steps are ways we can better serve patients and relieve pressure on emergency care in the whole system, which almost every winter comes under additional strain.

I will support the Government amendment this evening, because we need to recognise the hard work done by our NHS staff and the additional investment. This is not just about funding, however; it is also about the way we deliver healthcare in an acute setting when people present.

Finally, I want to touch on social care, because, of course, health and social care are inextricably interlinked. We have an ageing population, as many Members have mentioned, and it has increasing health needs. One of the areas of increased health need is dementia, and I am pleased to say Crawley was one of the first designated dementia-friendly towns. That is not just a label; it means multi-agency working between health and local authorities, and indeed the voluntary and private sector, to ensure those with dementia are better supported. I am delighted to announce that recently a new ward, the Piper ward, was opened in Crawley hospital. It is a dementia-friendly ward specifically to better treat the health and social care needs of our elderly population.

I could say much more in this debate, which is of importance not just today but throughout this Parliament, but as we have limited time I will let other Members contribute, too.

[Paula Sherriff (Dewsbury) (Lab)]

First, may I pay tribute to my hon. Friend the Member for Chesterfield (Toby Perkins) for his incredibly moving speech?

People are dying—literally. We are no longer saying people will die unnecessarily; we are now in the present tense, and we are hearing horror stories from around the country of people dying on hospital trolleys and at home waiting for ambulances to arrive. These are lives that could have been saved had it not been for this crisis.

People are dying in hospitals undetected by overworked nurses and other members of our amazing medical staff. A constituent of mine went to visit her grandad in hospital and, very sadly, found him dead in his bed on the ward. The overworked nurses had missed the fact that he was at the end of his life and had passed away. He died alone while his relatives were at home, unaware of how seriously ill he was.

I am bemused to hear Member after Member on the Government Benches standing up to defend the Government, when the facts are absolutely clear. They seem to be in severe denial. How can this be normal? How can the Government sit back and say that the solution is to discard the waiting time target? It is not the people who turn up with sore throats who are clogging up the system; it is genuinely sick people who desperately need medical attention.

Another constituent of mine arrived at A&E just last week, only to be told that she would have to wait at least 10 hours to see a doctor. That is not good enough. We are one of the richest nations in the world. It transpired that she had sepsis, a potentially fatal illness, and it is only because an overworked and stressed triage nurse recognised her symptoms and immediately instigated treatment that she is alive today and is able to tell me her horrendous story. Her treatment was started in the hospital corridor, where she sat on a chair while on an intravenous drip, because there were no beds available, not only in that hospital but in any of the neighbouring hospitals in the trust.

The theme is the same from all my constituents who come to me with their horrendous experiences. The doctors, nurses and other healthcare staff are doing absolutely everything they can. They are on their knees. No one wants to blame them, because they can see that what is being asked of them is far beyond what anyone would ever be asked to do in any other profession, but they can all see that the system is at breaking point. Instead of berating the Red Cross for suggesting that our NHS is in the midst of a humanitarian crisis, let us stop for a moment and think about why it had to use that term. Let us talk about what we can do.

We owe our incredible junior doctors so much, and they have been treated appallingly recently. A friend of mine recently attended an outpatient appointment at our local hospital and mentioned to the overworked junior doctor that I was an MP. He pleaded with her to tell me how bad things were, how overworked they were, how the NHS was crumbling around us, and how he and his colleagues could not perform to the best of their abilities due to the horrendous pressure they were under. He talked about working 12 to 14-hour shifts with a 10-minute break. He told her that he loved his job, saying that it was a vocation, never just a job. He said that he was proud of this country and its national health service, and that the only thing that kept him working here instead of fleeing abroad, as many of his friends had done, was that he cared so much for his NHS.

When is the Secretary of State going to stand up and take responsibility for what is going on? People are waiting hours for ambulances and waiting for hours in A&E. They are being treated on trolleys in seminar rooms and in corridors. Where does this end? We are already seeing the creeping privatisation of our NHS, with companies such as the dreadful Virgin Care putting profits before patients. Perhaps the end goal is for us to move to an American-style system where people are literally dying on the streets and where someone turns up at A&E and the first question is, “Have you got insurance, and can you prove it?”

My constituency is served by two hospitals: Dewsbury and district hospital and Huddersfield royal infirmary. Both are due to be downgraded, losing vital services and beds as their respective trusts struggle to meet the financial pressures that have been placed on them. One of the hospitals that is supposed to pick up the resulting demand from the downgrades, Pinderfields hospital in Wakefield, was last week warning people against attending its A&E, and this is before the downgrades have even taken place. I am in absolutely no doubt that if the downgrades go ahead, lives will be lost. I plead with the Ministers and the Secretary of State to stop those downgrades now and to bring forward the much-needed funds that could save the lives of my constituents. It was interesting to hear the Prime Minister refer to those hospitals today at Prime Minister’s questions. She said that there were two hospitals in the trust. Perhaps someone could pass on to her the fact that there are three.

I have quoted Nye Bevan, the founder of our great national health service, before, but I feel that this is more relevant today than ever. He said:

“The NHS will last as long as there are folk left with the faith to fight for it.”

As those on the Conservative Benches appear to have lost faith and stopped fighting, it is our duty on the Labour Benches, now more than ever, to step up that fight. I would not like to speculate about when a Government Member last set foot in an NHS hospital outside of an official visit—[Interruption.]

[Henry Smith]

Between Christmas and new year.

[Paula Sherriff]

I thank the hon. Gentleman for his intervention. Perhaps he should show some more empathy for the patients who are waiting on trolleys for up to 10 hours just to be seen. One thing I know for sure is that many thousands of my constituents rely on such services every day and the message from them is unequivocal: the NHS needs funds, and needs them now.

I was admonished by Mr Speaker today for berating the Prime Minister during PMQs, but let me be absolutely clear: I will continue to do that while this mismanagement of our national health service is ongoing. I will never, ever stop fighting for our NHS.