Defibrillators: Public Access

Richard Foord Excerpts

Tuesday 4th July 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

I pay tribute to the hon. Member for Erith and Thamesmead (Abena Oppong-Asare), who set out some moving thoughts about the importance of altruism and caring for other people in their moment of need, and about how the Government can perhaps help communities to enable individuals to help other people.

I want to pay particular attention to two aspects of best practice in my constituency and in broader east Devon, and I will close with one ask of the Government. The two examples of great ideas relate to Devon Air Ambulance Trust and Axe Valley Runners club. I met Devon Air Ambulance Trust here in Parliament last winter. The trust let me know that it is running CPR training and training on how to use a defibrillator. It invited me along to Sidmouth rugby club to get some training on CPR and how to use a defibrillator. It was great, because I had not done much of that sort of training since being a Scout as a young lad. It was brilliant to see how much progress has been made in resuscitation and how much more can be achieved these days with technology that we did not have in the 1980s and 1990s.

The Devon Air Ambulance Trust has a “Help with all your Heart” campaign, which seeks the best possible outcomes for patients who suffer a cardiac arrest. Part of the objective is to provide more of the equipment, as well as trying to train people such as myself in how to use it. The trust has put AEDs outside its charity shops on high streets, and it is working with town councils in east Devon to enable better access to AEDs.

The second organisation that is doing great stuff in my part of Devon is Axe Valley Runners club. Earlier this week, as covered by the Midweek Herald newspaper, the club did a “defib dash”. A defib dash is a bit like orienteering, for those who know what that is. The idea is that the runners go off in groups with a map to find a number of defibrillators. They go on various routes, competing against one another, to see who can get back to the beginning having found the most defibrillators. They ran around Seaton, Axmouth, Beer, Colyton and Colyford, covering a big chunk of the Tiverton and Honiton constituency. I pay particular tribute to Heather Simmons, Claire Warner and Sarah and Ronnie Whelan, who deserve credit for that novel and creative idea.

My third and final point is the ask. It would not be necessary for community groups to come up with these fantastic initiatives if there was better understanding of where defibrillators are and how to use them. The hon. Member for Erith and Thamesmead has mentioned the Complete The Circuit campaign being run by the Express. The absence of a complete register of AEDs is a particular issue for rural areas such as my part of Devon. We think that there are 70,000 AEDs on the national register, but our understanding is that there are between 100,000 and 200,000 AEDs in existence. We are, therefore, nowhere near having a good idea of where defibrillators are located. This is an important issue. If someone comes across somebody who has had a cardiac arrest, one of the first things that the ambulance service will do when they call 999 is direct them to the nearest AED. In a rural area such as mine, however, the service might think that the nearest AED is miles away, without knowing that there is one just a few hundred metres away from the incident. As the Express has said, we need to Complete The Circuit. We need a full and proper record of where AEDs are located.

I am a Liberal Democrat and we do not really believe in intervening in matters in which the state need not get involved. In this instance, however, I have been racking my brains for reasons why the Government might not want to legislate or intervene to require community groups to register AEDs on a national database. I have asked the chairman of Sidmouth Town Council and other community groups about the arguments against having a comprehensive register of AEDs, but I have not yet heard a sound argument why we should not require everyone who, through the kindness of their heart, buys an AED to register it so that the ambulance service can direct people to all available AEDs.

In summary, fantastic work is being done outside the House by community groups, but we need a central register and it has to be as comprehensive as possible.

--- Later in debate ---

[Will Quince]

I have not been the Schools Minister for many months, but I will gladly ensure that the relevant Minister—or I, having accessed that information—gets it to the hon. Lady.

I remember that a key point in the design of the scheme—this touches on a point made by many hon. Members—was that providing an AED, in and of itself, is not enough. Accompanying the roll-out, we wanted to ensure that there were awareness videos about how easy it is to use an AED. We want teachers, as part of their training and in the staffroom, and pupils in assemblies to see how easy an AED is to use. In a rolling way, we hoped to create a new generation of young people who are confident in their use. As AEDs become more prevalent across communities, that can only be a good thing.

I think it was the hon. Member for Plymouth, Sutton and Devonport (Luke Pollard) who asked about CPR and first aid training. As a Back Bencher, I campaigned to have first aid included on the curriculum. The Schools Minister at the time was not very happy about that—not because he was against having it on the curriculum, but because the curriculum was already very full—but we did manage to get it included. It is important that we upskill young people so they have the confidence to act in the unlikely but possible event that they encounter someone in cardiac arrest.

The question about vandalism of defibrillators is a fair one. I had not given it any thought, but I will certainly have a conversation with my counterparts in the Home Office and the Ministry of Justice and see if there is any scope to take further action in that area.

Turning to The Circuit, I would certainly like to recognise the incredibly important work that charities do in ensuring that the public have access to defibrillators. The British Heart Foundation, in partnership with Resuscitation Council UK, the Association of Ambulance Chief Executives and of course the national health service, set up The Circuit, which is the national defibrillator network database that provides information on where defibrillators are located.

I heard the point that the hon. Member for Tiverton and Honiton (Richard Foord) made about legislation, which I have some concerns about. At the moment, registration is entirely voluntary, so nobody is forced to register their defibrillator with The Circuit. However, registration enables the emergency services and community first responders to locate the nearest publicly accessible external defibrillator when they are treating someone suffering from an out-of-hospital sudden cardiac arrest. In those crucial moments after a cardiac arrest, we know that locating an AED quickly will help save lives.

[Richard Foord]

What are the arguments against making registration compulsory?

[Will Quince]

That is a question that I had not previously been asked. The danger of legislating in an area like this is that often there are consequences of legislation. One consequence would be that all existing defibrillators were registered as part of The Circuit, and that comes with a tick—that is a merit. However, having created legislation and having worked in Government Departments where legislation has been drafted on numerous occasions, I know that there are invariably and inevitably also negative unintended consequences that need to be considered and thought through.

For example, would registration discourage communities from taking a defibrillator? Would it discourage businesses like the one to which the hon. Member for Plymouth, Sutton and Devonport referred from putting one in their shop? We have to think through that kind of thing. What kind of pressure does it put on those organisations? Would it discourage people? If we are going to create legislation, what are the implications of not registering? Will there be a criminal sanction or a civil one? These are all things we would have to work through, and that is why legislating on something like this is complex. We have to remember that most defibrillators are bought by community groups, although in this particular case the Government support them. We would be placing a legal requirement on them for something that they are purchasing through goodwill, for philanthropic or altruistic reasons.

We have just got to be careful. I am not saying that we should not consider it, but it is not quite as simple as saying, “Let’s legislate,” and thinking that that will address the problem. What we need to do, and are doing, is to encourage as many people as possible to register because of the benefits of registration.

Lung Cancer Screening

Richard Foord Excerpts

Monday 26th June 2023 Commons Chamber

[Steve Barclay]

As part of expanding our capacity, we are doing both: we are expanding the diagnostic capacity—my hon. Friend is right to highlight that investment in Barnsley, as elsewhere—and boosting the surgical capacity through the expansion of our surgical hubs. In addition, we are looking at the patient pathway and identifying bottlenecks and how we design them out, given the additional capacity that is going into the system. So she is right to highlight the investment that is going in, alongside which we need to look at the patient journey and how we expedite that. The bottom line is that we are treating far more patients, the vast majority of whom—more than nine in 10—are getting treatment within a month.

[Richard Foord (Tiverton and Honiton) (LD)]

We know that 28% of victims of lung cancer have not smoked and do not smoke. My mum was one such victim. She died having contracted lung cancer and having not smoked before. But we were lucky in my family that she was diagnosed early. So, on behalf of the Liberal Democrats, I really welcome today’s announcement. However, on behalf of people in Devon whom I represent, I ask why only 40% of the people who are diagnosed will be subject to screening by 2025? Why do we have to wait until 2030 for the screening to be widespread and available to all?

[Steve Barclay]

First, may I express regret about the hon. Gentleman’s own family experience of this condition? On the roll-out programme, we need to build that capacity and to do so in a sustainable way—that point has been raised by Members across the House. We are following the science in targeting those communities that are most deprived; they have the highest prevalence of smoking. Of course we will look at evidence of other risk factors, which colleagues across the House have highlighted, but it is important that we roll this programme out in a sustainable way. What is clear, however, is that it is making progress and it is welcome that so many communities want the programme to be rolled out to their area as soon as possible.

NHS Dentists: South-West England

Richard Foord Excerpts

Wednesday 24th May 2023 Westminster Hall

[Richard Foord (Tiverton and Honiton) (LD)]

I am grateful to serve under your chairmanship, Ms Elliott, and to follow the hon. Member for South Dorset (Richard Drax), who made some excellent points that get to the heart of why the Government are failing us on NHS dentistry. I will follow him by using some examples and giving a voice to some of the constituents in my part of Devon who have written to me to appeal for help.

Chrissy Evans from Seaton wrote:

“I don’t understand why there has been no effort to address the problem of thousands of British children without free access to a dentist…We have tried all the dentists in our area and none are taking on new patients unless they are private.”

John Mason from Branscombe received an email advising him that his check-up was booked, only to be telephoned by the practice in Sidmouth a few weeks later. He wrote:

“I had been an NHS patient in Sidmouth for many years. I was telephoned by the practice”,

which told him that his options were to become a private patient, to try to find another dentist, or to call NHS Devon if he needed emergency treatment.

A woman from Honiton, who I do not have permission to name, has had dental issues since 2011. She wrote to me:

“I have been trying to sort this since 2011, I believe now I am considered too old to matter. I cannot eat, I don’t wish to be seen trying. I hide my face when possible. I don’t smile, I avoid friends and family, my speech is affected, this has ruined my life for the past 12 years and consumes my every thought.”

Finally, Edward Roberts from Tiverton puts it very plainly:

“The situation which prevails is unacceptable but no one in Government seems to be concerned about it.”

People are living in pain. The examples I have just given are a small snapshot of the heart-rending emails that I have received about people’s dental misery. As we have heard already, many in the west country do not have access to an NHS dentist. A survey by the British Dental Association in March laid bare the challenges we face. It found that across the south-west, nearly three in five dentists reported having reduced their NHS commitment by an average of 30%, but a staggering 75% also reported their intention to further reduce the amount of NHS work they undertake this year.

Why is this happening? Because the NHS work that dentists take on simply does not pay enough to be viable. Many NHS dentists are simply overwhelmed by the soaring costs of their work and, on this trajectory, the problem is only going to get worse. The BDA reports that 49% of south-west dentists say that they are likely to go fully private, with 41% likely to change career or seek early retirement. Fifteen per cent say that they will move abroad. Unless the Government take swift action now to start to address the situation, we could see NHS dentistry effectively disappear within a decade.

It is pretty infuriating to see the Government’s lack of recognition of the issue. Ministers at the Dispatch Box should not hide behind the outrageous claim, which I and others will have heard, that the Government have reformed the NHS contract. They have not. In July 2022, they simply paid dentists for a few more units of dental activity—for example, a dentist who is treating a mouth full of teeth that need repair will get paid the same as somebody who is treating a mouth that needs three teeth worked on. Instead, the Government should engage constructively with dentists and overhaul the NHS contract to compensate sufficiently for dental work carried out on the people who need it. Unless those steps are taken, people will continue to suffer in pain. Dentistry should not be only for those fortunate enough to win the postcode lottery.

I hope to hear from the Minister some unequivocal plans to reform the NHS dental contract, and I am curious to know what steps the Government will take to address the crumbling state of NHS dental services—I hope that they will include some measures that my Liberal Democrat colleagues and I have been calling for over many years. Above all else, I want some honesty from this Conservative Government: either reform the NHS dental contract properly, or simply admit that an NHS dental service for our constituents in the west country is a thing of the past that this Government are not willing to prioritise.

NHS Strikes

Richard Foord Excerpts

Monday 6th February 2023 Commons Chamber

[Will Quince]

I completely agree with my hon. Friend. Ensuring that we support the mental health and wellbeing of NHS staff and that working conditions and working environments are the best they can possibly be is how we can attract and retain the best. Measures such as wellbeing champions, training for line managers, occupational health services and flexible working are very important, but the key to this is having conversations with the unions, because they are the representatives, ambassadors and advocates. That is why I very much hope they will engage in the pay review body process and continue to have those conversations with me, not just about pay, but about how we can improve working conditions and working environments and reduce the bureaucracy that makes the job so difficult.

[Richard Foord (Tiverton and Honiton) (LD)]

It is now clearly established that the workforce crisis in the NHS is mirrored by vacancies in adult social care. There are more than 165,000 vacancies in social care, up by 52% in a year. The Liberal Democrats are calling for a carers’ minimum wage of £12.42 per hour from April; will the Minister support a £2 per hour uplift in that minimum wage for care workers by doubling the tax on the profits of online gambling companies?

[Will Quince]

The hon. Gentleman got a plug in for his policy there, but I am not entirely sure how relevant it is to this statement. On NHS staffing, we have 10,500 more nurses and 4,800 more doctors than last year. But I know adult social care represents one of the biggest challenges for our NHS, and it puts pressure on the rest of the system. That is why in the autumn statement the Chancellor put in place £7.5 billion, the largest ever investment in adult social care.

NHS Industrial Action: Government Preparations

Richard Foord Excerpts

Monday 12th December 2022 Commons Chamber

[Will Quince]

I am not one to cast aspersions on the shadow Secretary of State, other than to say that I and the Secretary of State refuse to play politics with this issue. This is all about patient safety and ensuring that if industrial action goes ahead—[Interruption.] The shadow Secretary of State again shouts “Negotiate” from a sedentary position, but he knows that we have an independent pay review body, process and mechanism. It is important that we respect that.

[Richard Foord (Tiverton and Honiton) (LD)]

We simply cannot afford to lose any more nurses and valued NHS staff. We already have huge workforce shortages—40,000 nurses resigned last year and there are more than 130,000 vacancies across the NHS—so cancelling Christmas for members of the armed forces will not fix these problems. Will the Minister explain how paying nurses insufficiently and drafting in military personnel over Christmas serves to attract new recruits to the NHS and the armed forces?

[Will Quince]

That is a bizarre question, because the only reason we have to put in a MACA—military aid to civil authorities—request is that the unions have called strike action over Christmas. As the hon. Member asks about recruitment and retention, let me cover off that issue. As I have set out, we are committed to publishing a comprehensive workforce strategy, which will be independently verified; we have set out new pension flexibilities; we have already recruited about 29,000 more nurses and are on track to meet our 50,000 target; and we plan to boost international recruitment. However, I hope that the hon. Member agrees—in the interests not only of our armed forces, many of whom will have to cancel their Christmas leave, but of patient safety—that we do not want industrial action to take place. I urge the unions to meet us to discuss a way forward.

Cancer Services

Richard Foord Excerpts

Thursday 8th December 2022 Commons Chamber

[Steve Brine]

I think that is right. The public are clear on this. I get that there are different views across this House and that there are those who disagree with much of the work that my hon. Friend and I did in government to push some of those measures on preventing obesity. I could agree with them, but then we would both be wrong. At the end of the day, obesity is a driver of diabetes, and obesity is a driver of certain cancers. We must take that seriously. Next year, the Select Committee will be doing a huge piece of work on prevention, and we will be returning to that. I hope that Ministers are aware of that.

The recognition of the importance of health in the levelling-up White Paper is welcome, but without specific actions to address health disparities, this agenda will be at risk, so it is vital that the Government take up the prevention agenda again to stop people developing cancer in the first place. I hope the Minister will have some good news for us on that front, and I recommend that she returns to the prevention Green Paper that we published back in 2019, which contains lots of helpful ideas in that respect.

[Richard Foord (Tiverton and Honiton) (LD)]

On that point about health disparities and levelling up, I want to draw attention to the Royal Devon University Healthcare NHS Foundation Trust, which serves my constituency. The staff who work there do a fantastic job of cancer diagnosis but, given that the target for the number of people seeing a cancer specialist within two weeks is 93%, it is tragic that only fewer than 60% of people who are served by that trust see a cancer specialist within two weeks of a referral. Does the hon. Member agree that we need to level across, as well as level up, and think about health disparities across the country?

[Steve Brine]

Yes, of course. I hate the term, but this should not be a postcode lottery. We do have integrated care systems and cancer networks, and good, strong, experienced MPs should be driving those local health economies to ensure that they level themselves up and make use of what is there in the system to deliver as well for their population as other parts of the country do. There could be a lot more sharing among us of how we use that ability as Members of Parliament to drive our systems. I do it in my area, and I am sure the hon. Member does it in his. I thank him for his intervention.

There are issues of variation affecting cancer specifically, such as proper screening uptake among certain groups, lower referral rates for some cancers and in certain areas, and higher rates of less survivable cancers among more deprived groups. We called for NHS England and the Office for Health Improvement and Disparities to produce an action plan for addressing disparities in cancer and for the much talked about 10-year cancer plan to include a specific action schedule for rarer and less survivable cancers. That remains, for us, a vital aspect of improving cancer services, and we hope that the long-term cancer plan—should one arrive—makes that part of its work.

Last month, NHS England made it clear to us that it was focusing on delivering the NHS long-term plan for cancer. In many ways, that emphasis on delivery is welcome. The programmes being implemented as part of that work are positive, and I have covered some of them today, but recent research from the International Cancer Benchmarking Partnership has shown that national cancer plans are worth far more than the paper they are written on. The ICBP found that the countries that have made the biggest improvements in cancer since 1995 are those that have ambitious, detailed and costed plans for improving cancer services that are open to scrutiny by those whose job it is to do that—namely, us. Denmark and England used to be at the bottom of the league table for cancer, but thanks to consistent national cancer plans with associated long-term investment, the Danes have made rapid improvements, and they now leave us lagging behind.

In conclusion, the Health and Social Care Committee’s report on cancer services found that there are many areas where the Government and the NHS are doing really good work and using the unique benefits of our national health service, but there are too many other areas where we can go further and faster to improve cancer services and outcomes. I hope the Minister will confirm that the Government intend to do so through the promised 10-year cancer plan.

NHS Workforce

Richard Foord Excerpts

Tuesday 6th December 2022 Commons Chamber

[Chris Stephens]

The hon. Gentleman is right; everybody should have excellent care.

As we debate the NHS workforce, we need to recognise what the challenges of the workforce are: whether they are paid adequately and whether there is a real retention strategy. We need to ensure that we have as many staff as we can and that we pay them properly. I did not hear much from the Secretary of State about the state of play of the pay negotiations and what the Government are doing to try to resolve disputes. I see him sighing; he is more than welcome to intervene. [Interruption.] Oh, he was yawning. I am sorry. [Interruption.] Oh, he was not yawning either. He was making a facial expression. I do apologise. We really need a serious debate about pay for public sector workers, and NHS workers in particular.

[Richard Foord (Tiverton and Honiton) (LD)]

When we think about pay for NHS staff, we also need to consider pay for those who work in NHS dentistry. The Government claim to have reformed the NHS dentistry contract earlier this year, but they brought no new money to bear. Does the hon. Gentleman accept that the Government should be measuring not only the number of dentists who are employed to carry out NHS dentistry, but the number of hours that are committed to NHS dentistry? We need to see whether there is a correlation between that and the poor pay that they are receiving for NHS dentistry.

[Chris Stephens]

The hon. Gentleman makes an excellent point; it is all about pay. What he says about hours is pertinent as well. We know that NHS staff go the extra mile. We know that they work long hours, and we should recognise that. His point about the dentistry service is also important.

As I outlined earlier, the Scottish Government are listening to feedback from the trade unions on pay, and there is a new offer on the table. That means that, in Scotland, porters who are at the top of band 2 will be making £2,502 more a year, nurses or midwives at the top of band 5 will be making £2,431 more, and a paramedic at the top of band 6 will be making £2,698 more. Currently, that is the best deal across the UK, and it is significantly more than the uplift on offer in England—the average value in England is around 4.5%, whereas in Scotland it will be 7.5%.

The Secretary of State also had his usual kick at Wales, but it should be noted that the Welsh Health Minister and the Scottish Health Secretary have written to the UK Government, calling for additional funding this year to support pay deals for NHS staff. I wonder whether, in his response, the Minister will give us an update on the answer to that letter.

I will conclude, because I know that this is a heavily subscribed debate. It is important that we deal with the mental wellbeing of our NHS staff. The Scottish Government have published a wellbeing strategy. We need to show more compassionate and collaborative leadership across the health, social care and social work sectors on these islands. I shall leave it there, Mr Deputy Speaker. The SNP will be supporting the motion submitted by the Labour party today.

Oral Answers to Questions

Richard Foord Excerpts

Tuesday 1st November 2022 Commons Chamber

[The Minister of State, Department of Health and Social Care (Will Quince)]

We are fully committed to delivering a new hospital in Sutton, one of the 40 new hospitals to be built by 2030. Officials from the Department and the NHS are working closely with the trust at every step in the process, and I look forward to working with my hon. Friend to deliver this much-needed hospital improvement.

[Richard Foord (Tiverton and Honiton) (LD)]

T8. In rural areas such as the west country, NHS dentistry is more of a distant memory than a vital service. Does the Minister agree that more must be done to boost NHS dental services in rural areas, and will he commit himself to reforming the NHS dental services contract to ensure that it meets patient need and properly incentivises dentists to take on NHS patients?

[The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)]

In the hon. Gentleman’s local NHS this year there were 758 active NHS dentists, up from 736 in the previous year. I have already mentioned some of the steps we are taking to tackle the problem of dental deserts and ensure that everyone in the country can see the dentists—and the GPs—whom they need to see.

East Kent Maternity Services: Independent Investigation

Richard Foord Excerpts

Thursday 20th October 2022 Commons Chamber

[Dr Johnson]

I understand my hon. Friend’s passion in this area. I am happy to meet him to discuss it further.

[Richard Foord (Tiverton and Honiton) (LD)]

We have seen several tragedies in health and social care services across the country. Both the Ockenden review earlier this year and this recent upsetting report by Dr Kirkup highlight serious multiple failings. It should go without saying that health outcomes should never be determined by location. We must tackle the inequalities that exist between rural and urban maternity services to ensure that people living in rural and coastal areas can access the same range of birthing methods and support. Will the Minister support the Maternity Services (Rural Areas) Bill introduced by my hon. Friend the Member for St Albans (Daisy Cooper) to end maternity service inequalities for people living in rural and coastal areas?

[Dr Johnson]

As a rural Member of Parliament, I understand the need for rural services to be just as good as those in more urban areas and to ensure that they are improved where they are not adequate. A medical education reform programme that is co-sponsored by NHS England and Health Education England is expected to direct investment for specialty training more towards area population need—to smaller and rural hospitals. The programme entered its implementation phase in August. Morecambe Bay, East Kent, James Paget and Shrewsbury and Telford are included in our current smaller hospitals list. I am not certain about the hospital in the hon. Member’s constituency, but I can find that information and write to him about it.

Ambulance and Emergency Department Waiting Times

Richard Foord Excerpts

Wednesday 6th July 2022 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

I beg to move,

That this House has considered waiting times for ambulances and emergency department care.

It is a pleasure to serve with you in the Chair, Mr Stringer, and I am pleased to see so many Members here to discuss the highly concerning issue of the unacceptably long waiting times patients in our constituencies endure to access emergency care.

Our urgent and emergency care system provides a vital service supporting a significant number of patients with a huge variety of medical conditions, ranging from acute emergencies and trauma to mental health crises, the care of our homeless population and care of elderly patients. Emergency care should be there for all of us when we need it. Few of us plan to attend emergency departments, but we are all potential patients.

Covid-19 has had a detrimental effect on our ambulance services. More and more people are calling ambulance services or attending A&E because they are having difficulties accessing other, more appropriate parts of our health system. National NHS performance figures illustrate that our healthcare service does not have the capacity to meet demand, and during May 2022, only 60% of patients were seen, admitted or discharged within four hours of their time of arrival. We should all be worried by those figures, which demonstrate that the health service is unable to meet the needs of patients with current levels of resource and capacity.

I want to share the example of the Royal United Hospital in my Bath constituency. It demonstrates the severity of the problem and the way in which hospitals have to step in because the Government are not willing to accept that there is a real crisis. There have been several cases in Bath in which residents waited many hours for an ambulance. Recently, an elderly man was forced to sleep on the floor of a local church as it took 12 hours for an ambulance to arrive—12 hours. A GP surgery ran out of oxygen for a patient due to the time it took for the ambulance to arrive. Ambulance handover delays are a significant patient-safety risk at the RUH, and up to 90% of the causes of delay are linked to the availability of beds in the hospital.

The RUH has consistently been running with a bed occupancy of over 90% for the past year, which is significantly impacting the hospital’s ability to move patients out of the emergency department. The hospital is one of the most challenged in the south-west for “non-criteria to reside”—in other words, medically fit for discharge—patients, and NHS England is reporting that the RUH has 24.3% of its beds occupied by patients who are medically fit, which is the third highest figure in the south-west. That is driven by gaps in the domiciliary care and social care markets.

My local authority, Bath and North East Somerset Council, has been short of 1,600 hours per week, community teams are struggling to recruit and our local care group has a vacancy rate of more than 30%. The RUH is working with the council to develop its own in-house domiciliary care to try to plug the gaps, but the recruitment crisis remains acute. NHS England is assessing the trust and is trying to help to reduce the bed gap at the RUH. The hospital recently launched a “home is best” transformation programme that aims to increase the number of patients who go home instead of into a community hospital bed. Our hospitals are trying all this, yet there is a crisis. It is important that we recognise that, and that the Government recognise it and step in on behalf of the hospitals.

Our hospital in Bath is also working out ways to reduce the number of patients who need to go into the emergency departments in the first place, and has launched a same-day emergency care offer for frail patients. However, nationally, the lack of staffed beds has resulted in staggering numbers of patients waiting beyond 12 hours after the decision is made by the A&E doctor. There have been more patients waiting 12 hours or more from the decision to admit this year than there were in the entire reporting period leading up to 2022. In May, there were more than 19,000 patients waiting 12 hours or more from the decision to admit, yet research from the Royal College of Emergency Medicine shows that that number is only the tip of the iceberg. We know that far greater numbers of patients endure waits of 12 hours or more if the clock is started as soon as they set foot in A&E. Many more patients endure extremely long waits but are not captured by the current metric. We need to understand the true scale of the problem. If we do not know about the extreme delays that our patients are enduring, we cannot take action. Transparency is key, and reporting metrics from the moment of arrival at the A&E department must be the starting point.

Such delays mean that emergency services are not able to respond to 999 calls from critically ill patients. Instead, they are being held in stacks of hundreds each day, and staff are forced to prioritise among even the most serious cases. Staff have to wait with the patients in corridors, and sometimes even outside the hospital, unable to have them treated and unable to respond to new emergency calls. We must think very carefully about what that means. Behind every statistic is a patient. Those patients are stuck and have no choice but to wait for a bed to be freed up so that they can be admitted and can receive the care they need. Unfortunately, some patients end up on trolleys in crowded corridors with many other patients. We should be treating patients with dignity. We know that crowding is dangerous and is linked to avoidable harm and, in some cases, death.

The pressure that the NHS faces, which has been building over recent decades, has real detrimental consequences on the emergency medicine workforce and patients. Staff are considering reducing hours, changing careers or retiring early. Additionally, emergency staff face constant abuse from those left waiting, which is hugely distressing. The more people leave, the more pressure is created.

The Royal College of Emergency Medicine’s “Retain, Recruit, Recover” report detailed findings from its survey of emergency medicine clinicians. It found that 59% of respondents experienced burnout during the second wave of the pandemic, and described their levels of stress and exhaustion from having worked the second wave as higher than normal. The report found that operational pressures, patient safety and staff wellbeing are intrinsically linked. In 2021, the Royal College of Emergency Medicine highlighted a UK-wide shortfall of 2,000 to 2,500 whole-time equivalent emergency medicine consultants. The needs of our population’s health and wellbeing are greater now than they have ever been. We cannot afford to lose even more of the workforce at this critical time of need.

It is clear that this very serious issue is a matter of life and death for many patients. Among those who are suffering from serious but not necessarily prioritised issues, it is elderly and frail patients who are being hit the hardest. Although it is easy for the Government to point the finger at hospitals and management, it is clear that this issue needs to be addressed centrally at Government level. It is not exclusive to Bath or north Shropshire; it is a national problem, as the range of MPs in the debate demonstrates.

What is more, the consequences of a failed social care system, which does not allow for the timely discharge of patients who are medically fit to leave hospital, has resulted in further crowding and corridor care in our hospitals. The chief executive of NHS England recently acknowledged the important role that social care plays in supporting patient flow through hospitals. The Government must outline the steps they will take to ensure the social care system is adequately equipped ahead of next winter.

Last autumn, the NHS published a 10-point plan for the recovery of the urgent and emergency care system. It has no targets or timelines, and it lacks any indication of how progress will be reported. It details only how the whole system will work together to recover urgent and emergency services, focusing on immediate and medium-term activities. The plan aimed to

“mitigate against the current pressures felt across systems and improve performance in all settings”—

great words, but where are the outcomes? All that is happening is that the situation is getting worse.

The NHS standard contract 2022-23 was recently amended to change the way in which 12-hour waits in A&E are calculated. As a result, A&E is now collecting 12-hour data from the patient’s time of arrival, not from the decision to admit. Despite that, the Government and NHS England have not indicated when the data will be publicly available. Publishing the figures nationwide will allow for transparency across the system, so perhaps the Minister will tell us when that will be publicly available. That should lead to improvements.

The Liberal Democrats have been sounding the alarm bells for months, calling for an urgent investigation into England’s ambulance services and a review of ambulance station closures, but the Government keep turning a blind eye to the crisis. We are calling for more investment in local ambulance services, an urgent campaign to recruit more paramedics, and enabling trusts to restore community ambulance stations in rural areas in Devon, where waiting times are unacceptably long.

[Richard Foord (Tiverton and Honiton) (LD)]

I found on the doorsteps in my part of Devon over the last month that pretty much every door I knocked on had somebody behind it with an anecdote about how ambulance waiting times had affected them personally. In south-west England we have the longest waiting times in the country. One paramedic told me that despite his very best efforts to treat patients, there were times when he came across very undignified scenes. He talked about one example of how he came across a lady who had fallen down and had to wait 14 hours for an ambulance to arrive.

[Graham Stringer (in the Chair)]

Order. I realise that the hon. Gentleman is new, but interventions should be short and to the point. I did not want to interrupt him, but I ask him to remember that interventions should be as brief and to the point as possible.