NHS Winter Pressures

Roger Gale Excerpts

Monday 9th January 2023 Commons Chamber

[Rob Butler (Aylesbury) (Con)]

In addition to the substantial increase in the number of cases of flu that my right hon. Friend mentioned, the intense cold snap shortly before Christmas put further unforeseeable pressure on hospitals. Stoke Mandeville Hospital in my own constituency saw four times as many broken hips as it normally would in that period, so I pay tribute to all the staff at Buckinghamshire Healthcare NHS Trust for treating those additional patients. I warmly welcome the Health and Social Care Secretary’s announcement on freeing up thousands of beds. Does he agree that putting a real, great focus on intermediate care and intermediate step-down beds is key, so it will be very important for integrated care boards, including the one covering Buckinghamshire, to put an intense concentration on that and on working constructively and effectively with the local authority and the local NHS trust?

[Mr Deputy Speaker (Sir Roger Gale)]

I call Clive Efford—

[Steve Barclay]

My hon. Friend raises an extremely important point, which is the role of step-down care in freeing up capacity in hospital. I was keen to emphasise, in my opening remarks, the right wrap-around support and care for patients when they are discharged from hospital. Over the next few weeks, it will not simply be a question of discharging those patients; there needs to be the wrap-around care as well. He is also right to point to the fact that there have been significant increases in demand—the fourfold increase that he highlights—which, combined with flu, covid and the pandemic legacy, resulted in very significant pressures. That demand pressure combined with an impact on supply—for example, from flu—also exacerbated staff absences during the Christmas period.

[Mr Deputy Speaker]

My apologies to the Secretary of State. I now call Clive Efford.

[Clive Efford (Eltham) (Lab)]

Thank you, Mr Deputy Speaker; I was as enthusiastic to make a contribution as you were for me to make it. What contingency did the Secretary of State put in place for a spike in flu cases? He speaks as if it took the Department by surprise, but it was widely predicted that there would be a spike in flu cases following on from the lockdowns during covid. He has announced 4,500 places to ease pressure, but in his statement he said that in 2020 there were just 6,000 cases of delayed discharge per day—“just” 6,000, as if that is not significant—whereas last year it was between 12,000 and 13,000 cases per day. What he has announced is roughly one third of what he said was the average per day for the last year. Is this not just too little, too late?

--- Later in debate ---

[Steve Barclay]

Yes, I can; that is the whole purpose of the announcement. Although my hon. Friend campaigns assiduously for the new hospital, he will concede that, regardless of the decision, that would take time. To his point about the hospital being full, there is an immediate challenge about how we get additional capacity into the emergency department so that it can operate more effectively, because if there are too many people, that impedes an emergency department’s ability to operate effectively. There is also a challenge about how we address the wider occupancy in the hospital as a whole, because that is at the core of getting flow into the system. That is the essence of the feedback that we have listened to and taken on board from the clinical community —as he did on Friday—particularly within emergency departments. Today’s announcement speaks to the exact issue that he raises.

[Mr Deputy Speaker (Sir Roger Gale)]

Finally, with the prize for patience, I call Shaun Bailey.

[Shaun Bailey (West Bromwich West) (Con)]

Thank you, Mr Deputy Speaker—I am last but I hope I am certainly not least. Some 700 beds are due to come online thanks to the Midland Metropolitan University Hospital and there is a new primary care centre in Wednesbury, so when my right hon. Friend’s Department delivers, we see the benefit. Clearly, however, that means nothing if we cannot get the processes right. The most pressing issue for my constituents during the winter has still been access to their GPs, as I am sure hon. Members on both sides of the House will agree. I welcome what he has said about the use of technology to ensure that people are seen, but fundamentally, people still want face-to-face appointments, because if they are digitally disconnected, they cannot access that technology. It is as simple as that. I ask him to commit—just after he commits to come to Wednesbury to see our new primary care centre—to work through his good offices with GP practices where there is best practice, particularly in the Black Country ICB, to ensure that we enable people who are digitally disconnected to access GPs.

[Steve Barclay]

We are working actively with the primary care community. Indeed, that was a key focus of the Prime Minister’s summit in No. 10 on Saturday and it is part of the work that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Harborough (Neil O’Brien) is leading through the primary care recovery plan. Last year’s GP patient survey suggested that continuity of care and face-to-face appointments were extremely important for two fifths of patients, but that suggests that for three fifths—often younger patients—speed of access is more pertinent. Continuity of care is important for those with multiple conditions, particularly elderly patients.

Alongside that, my hon. Friend is right to raise the Midland Metropolitan University Hospital. Four years ago, when I visited as a Minister of State in the Department, it was near completion. As he knows, it has taken a significant amount of time since then to get to its opening, which is why we need to look at doing things differently when it comes to value for money. Looking at the hospital estate programme, nine of the last 10 hospitals were built over time and over spec, so we need to look at modular design, modern methods of construction, and standardisation, which deliver a 35% unit-on-unit reduction in cost and much quicker operational performance, and would enable us to get hospitals up and running earlier.

It is important to do things differently and the new hospital building programme is part of that. We have listened to the concerns of those on the frontline and today’s statement addresses the immediate issue of bed occupancy in hospitals and the pressure on emergency departments.

[Mr Deputy Speaker (Sir Roger Gale)]

My thanks to all hon. Members—Front Benchers and others—who have taken part in an important discussion.