Accident and Emergency

Lisa Nandy Excerpts

Wednesday 18th December 2013 Commons Chamber

[Lisa Nandy (Wigan) (Lab)]

My A and E in Wigan is, like so many others across the country, under significant pressure at present. Earlier this year we saw an unprecedented rise in A and E attendances. That is a result of a series of problems, including the difficulty in getting GP appointments, as outlined eloquently by my right hon. Friend the Member for Leigh (Andy Burnham), but I think the single most significant cause is the cuts that have been made over the past three and a half years to social care. Does the Minister have any idea what those cuts and the unfair distribution of them—my constituency of Wigan has been cut three times more than Windsor— have meant to people in their lives?

I want to say something about the situation of older people. I have been shocked over the past couple of years by what is happening to older people because of the deep and front-loaded cuts to social care, which have left councils with no option but to cut services. Over the last two years we have seen an unprecedented rise in the number of over-90-year-olds coming into my local A and E and others across the country by ambulance.

[The Minister of State, Department of Health (Norman Lamb)]

The hon. Lady talks about the situation in social care and of course I understand that there is real pressure, but will she welcome the fact that in 2012-13 there were 37,473 fewer days lost in delayed discharge due to social care, so in other words social services are doing better now than they were in previous years?

[Lisa Nandy]

In the very short amount of time that I have got I will simply echo the words of my hon. Friend the Member for Stretford and Urmston (Kate Green) who said to the Secretary of State that she thought people would be staggered by the complacency of Members on the Government Benches and would not recognise the picture they paint, which stands in stark contrast to the lived experiences of my constituents, some of whom are old and vulnerable and deserve so much better than this. Behind the increase in the number of admittances to hospital lies a picture of older people who are living alone at home, worried, lonely and ill.

The Minister’s Government have not caused all of this, but, like my right hon. Friend the Member for Leigh, I have talked about my concern about what has happened in social care and the rise of zero-hours contracts and choosing the lowest bidder over recent years, so, by God, I must also say this: his Government have made the situation so much worse. By the end of next year the budget of my council in Wigan will have been cut by £66 million, and we were told this summer that another 10% is still to come. We have done everything. We have pared that organisation to the bone. The truth is there are no more efficiencies to be had; there are only cuts.

I say this to the Minister as well: this is not just about councils, because what this Government have done, and the Darwinian approach they have taken to the voluntary sector, has severely undermined the capacity of charities to respond to this crisis at the very time when they are needed most. This is the true meaning of the big society.

We are seriously disrupted in Wigan—

[Norman Lamb]

rose—

--- Later in debate ---

[Lisa Nandy]

I will not give way to the Minister because I presume he will be winding up the debate and I hope he will spend the rest of his time listening to Members rather than trying to explain away such an appalling record.

I cannot understand why, despite all the pressures already being put on my A and E by this Government and despite its still being consistently one of the highest performing A and Es across the north-west, we are being disrupted by the Healthier Together programme, which has caused so much anxiety in Wigan.

[Grahame M. Morris]

Will my hon. Friend give way?

[Lisa Nandy]

I will give way very briefly to my hon. Friend.

[Grahame M. Morris]

I want to reinforce that point in relation to Durham county council. I have just been advised that Library figures show that it is facing cuts of £222 million between 2011 and 2017. That must have a huge impact on social care and a consequential impact of increased demand in A and E.

[Lisa Nandy]

My hon. Friend is absolutely right, as always.

The Healthier Together programme has, at this time, caused huge anxiety across Wigan. In June, documents leaked to my local paper the Wigan Evening Post revealed plans to reclassify hospitals as red and green, with several hospitals downgraded, as my hon. Friend the Member for Stretford and Urmston knows only too well. That prompted real fears across Wigan that it would lose its well-regarded 24-hour A and E. The decision appeared to be based on population, not on the performance of hospitals. In September when I visited the Healthier Together offices in Manchester to explain my concerns with my hon. Friend the Member for Bolton West (Julie Hilling), I was surprised to see, at a time of funding pressures that are causing real pain, how expensive those offices were, situated in the middle of Manchester. Imagine my surprise, Madam Deputy Speaker, when Healthwatch Wigan found through a series of Freedom of Information Act requests that the total cost of the Healthier Together programme in Greater Manchester to date has been £3 million, with £1.3 million of that spent on third-party organisations. The NHS would not reveal who or what that money was spent on. To date, the programme could, in total, have paid for 90 new nurses, 20 A and E doctors or 9,000 bed days at Wigan infirmary. Instead, this hugely expensive programme has caused huge anxiety across my local area, and communication has been dire. I am not alone in thinking that that is a shocking waste of money.

Despite the chaos caused by this Government, our A and E works well: it is a consistently high performer. We are a big borough, with huge transport constraints. To ask people to travel to the nearest alternative hospital in Bolton just is not feasible. It is 15 miles away, which is at least half an hour by car. What the Minister may not know or understand is that many of my constituents do not have cars or the money to take several buses or use public transport. Our borough typically has large, tightly knit families. When someone’s granddad goes into A and E, not just them and their mum and dad but the entire family visit him, which will be impossible if this shambolic programme goes ahead.

The Secretary of State has caused real anxiety by acting unlawfully in respect of Lewisham A and E, announcing the single biggest closure programme the NHS has seen at a time of unprecedented pressure on A and E, and making changes in the Care Bill that will enable the closure of high-performing hospital services such as those in Wigan. Will the Minister give me a cast-iron guarantee that decisions will be made on clinical, not cost grounds, and will he reassure us that financial constraints do not come into this? Will he tell my constituents that the real-life situation of local people—transport, family networks, income and all the things that have a huge impact on people’s well-being—will be considered by this Government before any decision is taken that affects my constituents’ lives?