A&E Services

Robert Flello Excerpts

Wednesday 24th June 2015 Commons Chamber

[Mr Reed]

I congratulate the right hon. Gentleman on his knighthood—it is remiss of me not to have done that. He will know that real-terms increases and cash increases are not the same. He will also know, because he voted for it, that the budget in Wales has been cut by this Government by more than £2 billion. Let us compare like with like.

The Royal College of Nursing has calculated that almost £1 billion—£980 million—was spent on agency staff in the last year alone. Those and other choices made by this Government have meant that, collectively, trusts in England reported a total deficit of £822 million in 2014-15. That is simply unsustainable. A recent survey by the King’s Fund found that 90% of trust financial directors and 85% of commissioners are concerned about the financial state of their local health economies, and that view will be shared by many Members on both sides of the House. An investigation by Pulse revealed that clinical commissioning groups were being forced to use their 2015-16 winter pressures allocations just to maintain regular services.

Questions must also be asked about this week’s revelations that thousands of foreign nurses working in our NHS could be forced to leave the country as a result of the Government’s immigration rules. The RCN points out that this would cause chaos for the NHS and waste tens of millions of pounds—the Secretary of State laughs as I mention that. It would make matters much worse for patients and for front-line clinicians. Will the Minister tell us how many nurses will be lost from A&E and how many will be lost in total as a result of this move? Where in the country will they be lost? How will the vacancies be filled? What will this cost? Has he or any Minister in his Department made representations to the Prime Minister about the effects of this policy? If so, will he share those with the House? When did Health Ministers know that this policy might cause so much damage?

[Robert Flello (Stoke-on-Trent South) (Lab)]

When the Minister replies it will also be interesting to hear him say exactly how that cut and restriction on nurses will impact on the Royal Stoke university hospital, which had the great misfortune, for patients and the public more generally, of topping the list for the longest waits last winter of more than 12 hours on trolleys.

[Mr Reed]

My hon. Friend is absolutely right. Stoke deserves better, and no one has worked harder than him to ensure that it gets something better. Let us ensure that the Minister answers those points.

The understaffing crisis represents a dire situation that will only get worse unless the Government demonstrate an understanding of these issues and give them the attention that they deserve. We know that, as well as deficits this year, the“Five Year Forward View” is based on assumptions that the NHS can save £22 million by 2020. Will the Minister assure us that this will not result in any fewer medical staff or cuts to hospital or community services? Will he also commit to placing the analysis and the assumptions behind the efficiency plans in the public domain so that we can have an informed and honest debate about NHS funding? We do not want a programme of services being set up to fail and then being cut by stealth.

--- Later in debate ---

[Mr Reed]

I am grateful to the hon. Gentleman for his intervention. I absolutely agree that models such as that and local best practice can exist in pockets all over the country. It is just a shame that so many health economies are getting cut to the bone, because that stops them developing such care models. He is right that it is precisely that kind of integration that points the way to the future. Have the effects of these public health budget cuts on primary care and accident and emergency been modelled by the Department, and will the Minister share that work with the House? If that work has not been done, will he explain why? Has the Department consulted on these latest cuts, and what was the response?

I now wish to turn to the situation in general practice. In the previous Parliament, we saw a marked increase in the number of people waiting longer for a GP appointment. By 2013-14, almost 6 million people could not get a GP appointment. If the trend continues, that figure could be around 10 million by the end of this Parliament. Those people are often left with little option but to turn to accident and emergency. The GP patient survey suggests that almost 1 million patients went to A&E last year because they could not get a convenient GP appointment. It is clear that the GP workforce crisis is a major driver of the issues under discussion today.

[Robert Flello]

My hon. Friend is making an extremely good speech and is being very generous in giving way. On that point, Stoke-on-Trent has traditionally had far more patients per GP than the national average, and the age of that population is rapidly approaching, and often way past, retirement age. What we are seeing is not that people cannot get an appointment when it is convenient, but that they cannot get an appointment for days on end.

[Mr Reed]

My hon. Friend makes the case. What is happening in Stoke, I regret to say, appears to be something of a canary in a coal mine for the NHS around the country, and its issues will increasingly be seen in areas all over the country.

It is clear that the GP workforce crisis is a major driver of the problems. The number of full-time equivalent GPs per head has fallen over the past five years, even as demand has increased.

--- Later in debate ---

[Ben Gummer]

It is a matter of importance, Madam Deputy Speaker, because in this episode of “Health Handbags”, we have been given an insight into the crisis within the Labour party and Labour Members’ inability to understand what the priorities are for the NHS and for the country.

If the NHS and A&E services are of such importance to the Labour party, one would expect the shadow Secretary of State—

[Robert Flello]

On a point of order, Madam Deputy Speaker.

[Ben Gummer]

rose—

[Madam Deputy Speaker (Natascha Engel)]

Order. If the Minister could sit down for a moment, I will take the point of order, which I imagine is very similar to the previous one. It would be nice if we could move the debate on, as there are several maiden speeches waiting to be taken. It is an important subject and I would like to move on, rather than get bogged down in this. I will take the point of order, and then I hope we will move on.

[Robert Flello]

I am grateful, Madam Deputy Speaker. For the benefit of new Members on both sides of the House, I think it would be helpful if you spent a moment clarifying when it is in order to challenge the Chair’s ruling on something and when it is not.

[Madam Deputy Speaker (Natascha Engel)]

Thank you very much. It is the person in the Chair’s decision whether something is within scope or not. I did not take the Minister’s response to my decision as a challenge to the Chair; I merely wanted to point out that it would be nice to get on with the debate and to allow other hon. Members to speak, especially new Members who wish to make their maiden speech. If the Minister could move on, we would all be very grateful.