NHS

Luciana Berger Excerpts

Wednesday 5th February 2014 Commons Chamber

[Mr Hunt]

I am about to answer, if the right hon. Gentleman will be a little bit patient. The Act does not change the procurement requirements under which PCTs operated. It does not change the locus of the Competition Commission or the OFT under the Enterprise Act.

While we are correcting some facts, the right hon. Gentleman may be interested to know—as would my hon. Friend the Member for Taunton Deane (Mr Browne), but he is no longer in the Chamber—that we have the figures for the number of people admitted to the NHS with scurvy in 2011-12 and in 2012-13. In 2011-12, the number of admissions not just to A and E departments but in total—[Interruption.] Yes, including A and E departments. In 2011-12, eight people were admitted—[Interruption.] This was the right hon. Gentleman’s big argument about why A and E departments are under so much pressure. In 2012-13, 18 people were admitted. With the greatest respect, I think that the right hon. Gentleman is building his house on sand.

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

We have figures for 2010-11, because they were included in the answer to a parliamentary question that I asked just before Christmas. The Minister of State, who is present, replied that they were not the total figures, because the Department had the hospital admission figures but did not have the figures for primary care admissions.

[Mr Hunt]

With the greatest respect, what we heard earlier from the right hon. Member for Leigh was a big argument about a massive growth of pressure on A and E departments that had been caused by, among other things, scurvy, and we found that the total number of admissions was 18. I think that that says a great deal.

--- Later in debate ---

[Luciana Berger (Liverpool, Wavertree) (Lab/Co-op)]

This debate has laid bare the stark reality of the Government’s blinkered approach to the NHS. They are utterly complacent, hopelessly out of touch, and in complete denial not only about the scale of the crisis in A and E, but about how their changes to competition rules are making things even worse. They have nothing to offer patients and our hard-working doctors and nurses who tirelessly serve the NHS every single day, except smoke and mirrors to try to disguise the real causes.

The Government have come to the House today celebrating “the strong performance”—it is in their amendment—of A and E. We have previously heard the Secretary of State insisting that the NHS is getting better. Almost 1 million patients have waited longer than four hours in the last year and Ministers are asking for a pat on the back. In the last 12 months, trolley waits are up; delayed discharges are up; 18-week waits are up; median and mean waiting times are up; emergency admissions are up; cancelled elective operations are up; cancelled urgent operations are up; and we have even seen patients being ferried to A and E in the back of police cars because no ambulances are available. It is not getting better, it is getting worse.

If Ministers will not listen to us, perhaps they will listen to the experts and those on the front line. Today, the Foundation Trust Network has said that

“pressure on the emergency care system is growing”.

Ministers like to forget about the confusion and disorder that they have inflicted upon the NHS through their £3 billion top-down reorganisation, but they should acknowledge it. My hon. Friend the Member for Walsall South (Valerie Vaz) referred to it in detail, and it is the same top-down reorganisation that the Prime Minister promised would never happen on his watch.

Let me remind the House of the warnings the Government were given at the time. In December, Dr Clifford Mann, president of the College of Emergency Medicine, revealed that he advised Ministers more than two years ago of a growing crisis in A and E. But his words were unheeded, leaving him and his colleagues feeling like

“John the Baptist crying in the wilderness.”

Dr Mann warned that the Health and Social Care Act 2012 would take up

“a lot of time and resources from the medical royal colleges and other organisations.”

He added that it

“tied us all up in knots”—

and created—

“a lot of decision-making paralysis and stasis in the system”.

While Dr Mann was warning of dangerously low staffing levels, spending on expensive locum doctors in A and E has rocketed by 60% in the past three years.

The issue here is that too few doctors are picking emergency medicine in the final stages of their training, and who could blame them? It might take six years to train a doctor, but it only takes a second for the Government’s A and E crisis to deter a junior doctor from going into emergency medicine.

The disruption the College of Emergency Medicine talks about is the disruption that the care Minister and his fellow Liberal Democrats allowed to happen when they nodded through the Health and Social Care Act, but we hear reports that his party is preparing to disown the NHS reorganisation and pretend it had nothing to do with them.

The right hon. Member for Sutton and Cheam (Paul Burstow) has admitted today that he got it wrong on competition. Why does the care Minister not own up and admit that he got this wrong, and that he should have listened to his own supporters and hundreds of thousands of people across the country who pleaded with him not to go through with it?

The human cost of that mistake is clear for all to see. We can see it in the sheer number of people coming through the doors of A and E. As my right hon. Friend the shadow Health Secretary pointed out at the beginning of this debate, attendances at A and E rose by 16,000 in the last three years of the Labour Government. In the first three years of this Government, they have rocketed by 633,000. Ministers may be pleased that the NHS is still standing after being subjected to this level of pressure, but the question they should ask is, why are so many more people coming to A and E in the first place?

[Mr Jeremy Browne]

The hon. Lady mentioned the figure of 633,000 extra people presenting to A and E. In his opening speech, the shadow Health Secretary attributed a proportion of that number to people who had scurvy or rickets, as he tried to paint a Dickensian picture of national squalor. Now that she has had a few hours to check, can she tell me how many of those 633,000 people were diagnosed in A and E with either scurvy or rickets?

[Luciana Berger]

The hon. Gentleman may not have been here when we had the response from the Health Secretary. I will come on to the very points the hon. Gentleman raises in my speech, and I look forward to going through all the big issues we have with malnutrition in this country.

I echo the comments made by my right hon. Friend the shadow Secretary of State about the sneering we have heard from Government Members this afternoon regarding some very serious issues. Any case of scurvy in 21st-century Britain is shameful.

My hon. Friend the Member for Stretford and Urmston (Kate Green) talked about the catalogue of coincidences that have led to so many more people going to A and E in the first place. I refer back to the increase of 16,000 in the last three years of the Labour Government, and of 633,000 in the first three years of this Government. Why is that? A quarter of walk-in centres have closed. NHS Direct was abolished. The guarantee of a GP appointment in 48 hours was scrapped, and extended GP opening hours were cut. As my hon. Friends the Members for Easington (Grahame M. Morris) and for Worsley and Eccles South (Barbara Keeley) said, £1.8 billion has been hacked from social care budgets, with thousands of people losing their care packages.

[Angie Bray (Ealing Central and Acton) (Con)]

Is the hon. Lady prepared to admit, just a teensy bit, that some of the added numbers going to A and E, which I agree are putting a lot of pressure on the departments, are partly to do with the change in GP contracts introduced by the Labour Government? That is driving people to A and E, because no GPs are working the hours that would allow people to be seen.

[Luciana Berger]

I just do not know what to say to that because it is so ridiculous. There was an increase of 16,000 in the last three years of the Labour Government, which has rocketed to 633,000 in the first three years of this Government. The gap in those figures is tremendous. The GP contract happened in 2004. When have we seen crises in A and E? Not under the Labour Government, but under this Government—the Tory-Liberal Democrat Government.

What else has happened under this Government? We have seen the Health Secretary handing back £2.2 billion of underspend to the Treasury, 2,300 managers receiving six-figure pay outs and £1.4 billion siphoned off to pay for redundancies. My right hon. Friend the Member for Leigh also raise the issue of the amount of money NHS trusts are now having to spend on expensive legal fees as a result of competition, introduced through the Health and Social Care Act. That goes to show that when it comes to our NHS, this Government know the cost of everything but the value of nothing.

As the hon. Member for Stafford (Jeremy Lefroy) said, our elderly population is growing, but half a million fewer older people are receiving support compared to 10 years ago. That means more older people going to A and E because they cannot receive the care they need at home, and more older people stuck in hospital beds because there is no safe place to discharge them to.

[Margot James]

Will the hon. Lady give way?

[Luciana Berger]

I am not giving way because I have only three minutes left.

As my right hon. Friend the Member for Leigh said earlier, the CQC recently reported that in the last year, more than half a million pensioners were admitted as an emergency to hospital with potentially avoidable conditions. There is another reason for that: it is now harder, not easier, to get a GP appointment under this Government. The Royal College of General Practitioners says that it will soon become the norm for people to wait a week or longer to see their GP. Just this week, I was contacted by a constituent whose partner was suffering from chest pains. They contacted the GP but could not get an appointment for eight days.

This is what patients are having to endure right across the country, and it is being made even harder by the cost of living crisis hitting families all over Britain. People are having to eat less, and less healthily, and more than half a million people are being forced to turn to food banks. As my hon. Friend the Member for Worsley and Eccles South described so poignantly, carers are having to make the choice between heating and eating. GPs are now asking patients when they last had a meal. It is no coincidence that, as food bank use has exploded, so have cases of malnutrition. There has been a 42% increase in malnutrition cases, and in 2012-13 more than 5,000 people were thus diagnosed in English hospitals. I share the view of my hon. Friend the Member for Stretford and Urmston that that is a disgrace in 21st-century Britain.

Doctors are now treating diseases we thought had all but disappeared. It is not just scurvy; rickets and vitamin deficiency are also on the rise. The Government have already given us the longest fall in living standards since the 1870s; we now have the Victorian diseases to match. They should be ashamed of every single case of these 19th-century diseases returning to 21st-century Britain.

That is not all. With energy bills up by £300 and more children living in fuel poverty, is it any wonder that episodes of hypothermia have jumped by 40% in the past three years? We have seen a 29% increase in the number of excess winter deaths—31,000 deaths that by definition were entirely preventable—while new figures this week show a dramatic increase in the number of older people being admitted to A and E for cold-related illnesses. Furthermore, there have been 145,000 more cases of over-75s being treated in hospital for respiratory or circulatory diseases, compared with 2009-10.

Ministers cannot resolve the crisis in our NHS. They know what is happening and that their policies are stoking the crisis, but they will not admit it. Only Labour can preserve, protect and progress our NHS. Our approach focuses on the patient, and it champions integration and collaboration, not competition, fragmentation and profit. We want a public, integrated NHS free at the point of use, and a whole-person approach that combines physical, mental and social care and helps to take the pressure off A and E. That is the principle behind our motion today, and I urge Members on both sides of the House to support it.