A and E Waiting Times

Jim Shannon Excerpts

Tuesday 23rd April 2013 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the right hon. Member for Cynon Valley (Ann Clwyd) on securing this important debate and on giving us all an opportunity to speak on accident and emergency provision. The last time we had such a debate in Westminster Hall, the Minister gave a positive response to our concerns, so we look forward to her doing the same again today.

Health is a devolved matter in Northern Ireland, and the Northern Ireland Assembly has full responsibility for it. None the less, I want to contribute to the debate and outline some of the important issues that we face. I preface my remarks by commending the ambulance staff and the accident and emergency staff on the long, tedious and hard work they do under intense pressure. For many of them, their job is a vocation. That is true of many of the accident and emergency staff in my constituency, especially those in Ulster hospital in Dundonald and in Ards community hospital. They should all be commended on their excellent work and commitment.

Across the UK, waiting times in A and E departments are on the increase, and Northern Ireland is no different. A report in The Daily Telegraph said:

“Data obtained from 60 NHS finance directors as part of the study revealed that 40 per cent of trusts did not meet their productivity targets in 2011-12.”

It went on to say:

“This will be a significant concern as last year was the first in a four-year spending squeeze, during which the NHS needs to find £20 billion in productivity improvements.”

Just four of the finance chiefs questioned said that their organisation was forecasting a deficit this year, backing up national figures that estimate a surplus of £1.5 billion across the NHS. That is worrying, not just for the patients coming in to A and E, but for the doctors and nurses on the front line who are bearing the brunt of the pressure along with the brunt of people’s frustration at being held waiting.

In her speech, the right hon. Member for Cynon Valley gave some examples of where A and E units have found it difficult to respond to people’s needs, and we can all reiterate such examples over and over again. However, an important point is that whenever someone is ill and in need of help, sometimes their frustration spills over towards those people who are trying to help them. We must have a system whereby those who are in need can be helped at the time they are in need.

Due to the cuts in the block grant and the need for massive savings, our Health Minister in Northern Ireland has been forced into making very hard decisions such as closing the A and E unit at Belfast city hospital, which then impacted on my constituency. Yet there was no option, because those were hard decisions that had to be made. We had to take the impact upon the surrounding A and E units into full consideration and the extra staff and resources needed to deal with that. By and large, that consideration seems to have taken place, but I want to give a few examples of issues.

The savings had to be made to meet Government cuts in the block grant. That is the position that many of our trusts are in, and the Government must decide which is more important at this time—achieving productivity targets or achieving their efficiency savings. It is abundantly clear that it is becoming harder and harder to do both, and it is grossly unfair for the trusts to have to balance what cannot be balanced. Our Health Minister in Northern Ireland is doing a good job in difficult circumstances. However, my fear is that more and more will be asked, and that it will be impossible to deliver on those extra demands as time goes on and as the savings required become more and more difficult to achieve.

I have had occasion to visit the A and E unit in my constituency, because of complaints that my constituents have made about an inability to be seen, waiting times, unavailability of staff and the cramped conditions. I have passed on those complaints to the trust and I have met the chief executive, Hugh McCaughey. I have explained to him the complaints that were made, and, in fairness, he and his staff responded by putting in place a number of measures: better allocation of staff when it comes to A and E units; access to services centrally, which is sometimes required rather than people having to go across town to another hospital to get the service they need; and a more accountable and fluent monitoring response at A and E units. The hon. Member for Stretford and Urmston (Kate Green) mentioned triage; it is so important to get that right at A and E units. As I say, those significant changes have been made at the A and E unit at the Ulster hospital in Dundonald, as a result of complaints by my constituents and the meetings that we have had with staff.

Such improvements are good news. However, as the restriction on moneys continues, we have extra pressures on the A and E units, which are now under pressure because of the changes that have taken place. I am particularly concerned about that issue. It is closely monitored in the devolved Northern Ireland Assembly, with the Health Minister receiving monthly reports and the Committee for Health, Social Services and Public Safety receiving quarterly reports. The Minister and I came into political life at the same time. We live in different parts of the country, but we are good friends and we communicate regularly on these issues. However, there is too much pressure on the A and E departments for them to be able to handle their case load, and I know that the Royal College of Nursing, among other professional bodies, has expressed concern that there is not enough cover, but once again this comes back to the age-old issue of money and how the resources can be better spent.

It is my opinion—and I believe that of many people—that the trusts are doing as well as possible, but it is clear that the efficiencies that have been required of them are too much to balance with the targets that have been set, and above all to ensure that patients receive a good standard of care, which is the standard they should expect from one of the best health care systems in the world—indeed, the NHS is the envy of many in the world. Our doctors and nurses do a fine job, indeed a great job. I know that they do the best that they can, and we must assume some responsibility in this place for the care that people receive; that care is down to decisions that are made here. For that reason, I again implore the Government to reconsider the efficiency targets that have been set. Instead, they should allow trusts to have the ability to have a good staff, on duty and on call, to handle what is required and to protect the most important thing that we possess, which is our health.

I apologise in advance, Mr Hollobone, for leaving early because there is a Public Bill Committee that I should attend.