NHS Corridor Care
Rosena Allin-Khan Excerpts(3 weeks, 3 days ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
I beg to move,
That this House has considered NHS corridor care.
I express my sincere thanks to the Backbench Business Committee for granting time to the important subject of corridor care, and I declare my interest as a proud serving NHS emergency doctor working in A&E at St George’s hospital in my Tooting constituency. In my 21 years as a doctor—I know; I can hear the audible gasp because I do not look old enough—I have never felt more proud to serve with a group of individuals such as those at St George’s hospital. The leadership team, to which we welcome a new CEO in Mat Shaw, and the team of nurses, doctors, reception staff, porters and healthcare assistants in my emergency department, make me proud to go and do every single shift that I do there, and it feels like a pleasure, not a chore.
Paul Waugh (Rochdale) (Lab/Co-op)
I thank my hon. Friend for her fantastic work in the NHS as a doctor; it is much appreciated. Like many NHS workers, she struggles against the odds and sees on a daily basis the impact of corridor care. Does she agree that NHS staff feel frustration with corridor care as much as patients do, and that they want to act and see it end as much as anyone else? Crucially, the key is more staff. Is that not, ultimately, what we all want?
Dr Allin-Khan
My hon. Friend and I are not performing a double act today, but he leads me on perfectly to the next part of my speech, as I go on to say that “corridor care” is something of a misnomer. Treatment in a corridor, far away from oxygen, proper equipment and emergency cords to pull, without privacy or dignity, without access to decent and appropriate toilet facilities, and without the highest standard of infection prevention and control, cannot be classified as care in any realistic sense. It is important to say that the staff go above and beyond with what they have. It is not the case that patients are suffering in pain because the staff do not care or do not provide a first-class service; it is because, quite simply, a corridor or any other space not built to serve and care for patients in is not the right place for a patient to be.
It is not just corridors, because patients across the NHS have been seen in antenatal rooms, store cupboards, waiting rooms and even car parks, filling every conceivable inch of a hospital. Members can imagine that people are coming in feeling particularly vulnerable, and they are happy to get the care wherever they can get it. I have never heard of any of my colleagues across the country say that they have had a patient who refused to be seen in a cupboard; they are just grateful to be seen. Even the official definition of so-called corridor care is problematic. NHS data relies on local clinical judgment about whether an environment is safe and whether patients’ privacy and dignity are being maintained. Trusts are applying these standards differently, and some feel the need, sadly, to game the system to artificially lower their corridor care statistics.
Irene Campbell (North Ayrshire and Arran) (Lab)
I would just like to highlight that the Scottish Government do not record or publish any statistics on the number of patients being treated in corridors. However, we know that it happens. The Crosshouse hospital, which serves my constituency, was recorded in January as having one of Scotland’s most under-pressure emergency departments. It exceeded capacity by 50% in December, revealing corridor care conditions in the hospital. Does my hon. Friend agree that it is important to record accurate data so that we can track improvement?
Dr Allin-Khan
My hon. Friend is absolutely right, and I am so sorry to hear of the situation in her community in Scotland. It is regrettable, and patients and their families deserve better. Absolutely, if we cannot accurately assess the issue in full, it is impossible to deal with, and I hope the Minister will talk today about how she will commit to revising this definition to make it more robust.
Iqbal Mohamed (Dewsbury and Batley) (Ind)
I thank the hon. Member for securing this debate and for allowing me to intervene. The Mid Yorkshire Teaching NHS trust published data about patients in corridors for the first time only in May, and in that month it recorded 121 patients per day being treated outside clinical rooms and areas. A constituent of mine, Catherine, wrote to me to describe seeing at first hand elderly people waiting in corridors for hours with no family members to support them. Does the hon. Member agree that corridor care has moved from being an exceptional problem to an everyday issue in many NHS trusts, and that the Government must act to address the root cause of this issue?
Dr Allin-Khan
The hon. Member is right, but I know that the Government care deeply about this. This is not something on which I am in tension with the Government in any way. I have spoken to the Ministers and the Secretary of State, and I know that they are committed to acting and ensuring that every single patient across our country gets the best possible care. Let us be really clear: the NHS should not be a political football. Safe and dignified healthcare should not be a political football. I hope that we are all in agreement on this issue today. I would have hoped to see more Members on the Opposition Benches today, and I hope that their absence is not a reflection of how much they care about the issue, because, quite frankly, we owe it to all our communities to get this right.
I know from my own experience, as will other hon. Friends in the Chamber, that when someone comes to A&E, it is often the worst day of their life. It could be the worst day of their life because of their experience as a patient, or it could be the worst day of their life because someone they love—their child, their partner, their mother or their father—is dying or has died. When we think about the dignity and care that we give, we have to look at it holistically—not simply as a set of symptoms that we are treating but as a family and the experience that they take away with them of what has happened on that day. People are in tears, people are in pain, and we owe it to them to get this right.
Helen Maguire (Epsom and Ewell) (LD)
Many people in my constituency have written about experiencing corridor care, and that loss of dignity when vulnerable and elderly patients are sitting in corridors. Does the hon. Member agree that we desperately need urgent action to ensure that dignity is prioritised wherever care is given?
Dr Allin-Khan
That is absolutely right—the hon. Member makes a valid point. People can be enduring a heart attack; they can be losing a baby; they can have had a road traffic accident and be lying on a trolley, blocked and collared, or lying on a board and looking up at the ceiling, wondering when they might make it into the scanner. People will definitely be having a time in hospital that will be etched on their memory, and sadly for many patients, and many loved ones, that is the last day they will ever see—the A&E will be the last place they know.
In the NHS we want that experience to be as comfortable and reassuring as possible. We want the best possible care, delivered in the fastest possible time, to patients who are treated fairly, efficiently, and with compassion and dignity. Frankly, that is impossible in a corridor, even with the greatest will in the world. In my A&E at St George’s hospital we have patients in corridors, as we do across the country, but we have nurses who are there and dedicated to check their observations, ask if they need pain relief, and try to deliver—and they do—the best possible gold-standard care. But there is no privacy in a corridor, or in a cupboard, or anywhere where there should be, and that simply is not right. In emergency departments across the country, regardless of data that some trusts try to put forward to show that it is in only a certain number of places, we know from our inboxes that corridor care is everywhere.
Anna Dixon (Shipley) (Lab)
I thank my hon. Friend for securing this debate. She has spoken about some of the impacts of this issue. My 80-odd-year-old mum was recently admitted to Airedale hospital with acute respiratory issues. She had to wait in a chair for over 12 hours, alongside my dad, in a very undignified way. Does my hon. Friend agree that ideally we should be preventing admissions for older and frail patients, and does she believe that the stronger proactive primary and community care services proposed by the Government with neighbourhood health teams could help to prevent some admissions for older and frail elderly people like my mum?
Dr Allin-Khan
I hope my hon. Friend’s mum is making a swift and healthy recovery, and I am sorry to hear that that was her family’s experience. I agree that prioritising care for the frailer, elder population can often be dealt with more effectively before someone comes to hospital. I also know that my hospital of St George’s in Tooting has a special dedicated frailty unit that goes a long way in speeding things up for people. Good pilots are going on across the country, where care can be taken to our elderly community before people come in. Tackling social care is something I am coming to in my speech, because we could not have a speech on corridor care without a huge nod—or an entire body bend—to social care and the need to fix it.
While this situation is extremely hard for patients and their families, the toll it takes on healthcare staff is huge. By healthcare staff I do not just mean doctors such as myself, but nurses, porters, healthcare assistants and cleaners—we are one big family in the NHS, and no one job is more important than any other. We are unable to do any of our roles without all the others, and for that we are truly grateful. Knowing that they might be caring for a patient in their mid-80s, who is trying to hold back tears because they do not want to upset anybody very publicly in a corridor, is absolutely heartbreaking and takes a toll on their mental health. Our nurses, doctors and all the staff I have mentioned are going home absolutely burnt out—this is not what they trained and studied for, and not what they go to work to deliver. They go to work to deliver the best possible gold-standard care for the community that they care about.
Perran Moon (Camborne and Redruth) (Lab)
On my hon. Friend’s point about burnout, we are entering what for many Cornish men and women is the dreaded tourist season, when our population doubles or trebles. My constituents in Camborne, Redruth and Hayle are concerned about the chronic capacity issues and the impact of the tourist season on patient safety at Treliske, our one general hospital that covers the whole of Cornwall. Does my hon. Friend agree that NHS workforce planning and funding for places like Cornwall need to reflect the additional pressures placed on healthcare services during periods of peak tourist activity?
Dr Allin-Khan
I remember meeting my hon. Friend before he became an MP when I visited a hospital in his community, and I know that he has been a powerful advocate from long before he came to this place. I thank him for that and for raising this issue. We often think about winter pressures and forget that different communities experience different pressures—it is not a one-size-fits-all situation. It is important to look at the tourist season in Cornwall, and I am hopeful that the Government take that into account in their planning.
Madam Deputy Speaker, you will be appalled, as we all are, to know that there are places up and down the country where bodies are being wheeled to the mortuary past living patients in corridors. People are spending hours in pain and distress, desperate for privacy, and exhausted staff are working while feeling that they have one arm tied behind their back.
Gordon McKee (Glasgow South) (Lab)
My hon. Friend is being generous in taking interventions. There are few Members of this House, if any, who know about this subject in more detail than her. In Scotland, where my own constituents are facing the problem of corridor care, the Royal College of Nursing said a few weeks ago that we are “trailing behind” even what is happening in England, partly because the NHS in England is publishing statistics on corridor care. Does she agree that the Scottish Government should do the same so that we can track corridor care and therefore help resolve it?
Dr Allin-Khan
My hon. Friend is a powerful advocate for the people of Scotland. Yes, of course those statistics should be published, because in order to have any understanding of the issue, we have to have the data. Quite frankly, without the data, it is “not happening”. We should keep pushing for that and I hope that he puts the clip of him asking this question on social media to spark a little fire under some boffins to make that happen.
The reality is that corridor care is happening in every corner of the country. The drivers of the issue of corridor care are multifaceted, but one key cause that we cannot escape is our failing social care system that forces medically fit patients to sit and wait in hospital beds, seemingly endlessly. Without a hospital back door that works efficiently, we simply cannot get people through the front door to treat them effectively and move them on appropriately. The social care sector must be empowered because that will prevent hospital admissions in the first place and support timely discharges.
All sorts of unappealing names are given to people who have to spend a long time in hospital waiting for appropriate social care. Our vulnerable elderly, our grandmas and grandpas, are called bed blockers because they cannot get the social care that they need to safely be in their own homes. This requires a complete change in thinking and approach, one that understands the inherent link between the NHS and social care. Most significantly, we need leadership that is willing to address the crisis with the urgency it deserves, so that people get the highest quality of care.
Adam Dance (Yeovil) (LD)
One of my relatives went into hospital to get intravenous antibiotics but later died in that hospital due to being stuck there. She was ready to move on to a community hospital, but she gave up because she was scared in the hospital—they did not keep an eye on her, she fell out of bed and cracked her head open, and she later passed away. Does the hon. Lady agree that we need a lot more investment in social care to ensure that does not happen and our relatives do not have to go into hospital in the first place?
Dr Allin-Khan
I am heartbroken to hear about the hon. Member’s relative. This is the point: anyone who works in a hospital understands that, just by being in an emergency department waiting room and accessing people who are unwell, it is possible to catch other illnesses.
One thing we try to do is prevent unnecessary admission, because we know that a vulnerable elderly person who comes to hospital and is admitted to a ward with people who are unwell is more at risk of catching illnesses. As in the case of the relative of the hon. Member for Yeovil (Adam Dance), people can be vulnerable and not in an appropriate bed. There may not be enough staff able to check on them appropriately. Without tackling social care, we will never get on top of that issue. I am truly sorry to hear about the hon. Member’s relative. Simply put, we cannot dither or delay; we need answers to the social care crisis, and we need them quickly.
Another group of people who are very often overlooked are mental health patients. They continue to spend extraordinary amounts of time waiting in A&E. People experiencing a mental health crisis are two-and-a-half times more likely to face long delays in A&E. Just for a moment, let me paint a picture of what that looks like. The patient could be somebody with auditory or visual hallucinations who feels extremely scared and vulnerable. They may need security to ensure that they do not leave their room. They may be wondering what they have done to deserve this. They may not have staff there who know about their usual medication. Very often, they are shouting very loudly, and other patients will be concerned, not understanding that they have a mental health issue.
As doctors and nurses, we are not allowed to talk about somebody else in the hospital, so we can have a very loud A&E department, with someone who is very vulnerable—screaming and shouting and really suffering—being completely in the wrong place for so long and with everyone confused about why they are there. That is not appropriate, safe or dignified for mental health patients.
We are as far away as ever from parity between mental and physical health in the NHS. As I have just outlined, we witness that daily in emergency departments across the country. We need to create more partnerships between our emergency departments and mental health trusts, where mental health patients can be triaged and seen by a mental health team in a more dignified and appropriate manner.
St George’s hospital, where all hon. Members will know by now that I work my A&E shifts, is exploring a partnership with South West London and St George’s Mental Health NHS Trust, which would set up an assessment unit to triage mental health patients outside the emergency department. That would be safer, more appropriate and more dignified, and a calmer and more pleasant environment in which those patients could be assessed by mental health professionals.
Amanda Martin (Portsmouth North) (Lab)
Does my hon. Friend agree that often this is compounded when somebody has been arrested and police officers are sitting for hours? I was recently in A&E, and there were two police officers there for the duration that a member of the public was there. They may also need somewhere else to deal with that situation.
Dr Allin-Khan
I think my hon. Friend has been on most of my last A&E shifts with me. [Laughter.] That is absolutely a common occurrence, and that is not the best, safest or most efficient place for any of our incredible teams of police officers and mental health nurses, who are trying to get on with their job. It is incredibly distressing. In parts of hospitals, colleagues tell me that they are waiting in relatives’ rooms with police officers and mentally unwell patients next to the resus area of an A&E department with bereaved families. None of that should be happening for anyone involved.
I am sure the Minister will agree that the best solution to this crisis will involve a holistic, multi-agency approach involving councils, social care providers and NHS trusts. As I have just outlined, this unacceptable and dangerous situation is shared not just by patients, but by their families and NHS staff, who are trying to do their best in a difficult situation.
Moving on to the professional bodies, corridor care has rightly been condemned by the Royal College of Nursing, the Royal College of Emergency Medicine—my royal college—the British Medical Association, and other professional bodies and trade unions. Some 65% of respondents to the Royal College of Emergency Medicine’s violence and aggression survey, which is due to be published later this year, said that care in inappropriate and non-clinical spaces contributes to the increase in violence and aggression towards staff and other patients. The impact of corridor care is clearly much more wide-reaching than we realise. It results in violence against our own NHS heroes—the very best of humanity—who, in a fractured and dangerous world, exemplify compassion, decency and selfless care for strangers. I can tell the House beyond a shadow of a doubt that staff in emergency settings are upset, traumatised and driven to tears of rage, and we know that NHS staff have to take a disproportionately large number of days off for the sake of their mental health.
Adam Dance
The hon. Member is making a fantastic speech. On the topic of staff, one of the biggest problems in Yeovil hospital is bullying culture, as we saw in the Baroness Amos report in relation to maternity. Does the hon. Member believe that staff should be free to speak up without the worry of losing their job?
Dr Allin-Khan
I thank the hon. Member for his intervention. Although it digresses from the debate about corridor care, I will happily answer his question. I think everybody in the NHS must be able to go to work free of intimidation, bullying and harassment. Wherever that happens, people should feel free to speak out—not to their direct line manager, because very often they are involved, but to a safe third party within the hospital, clinic or public setting where it happens, so that they will not be concerned about finding themselves moved or no longer in the job they love. I thank the hon. Member for raising that point; I have gone off topic, but it is an important point to acknowledge.
Madam Deputy Speaker (Judith Cummins)
I am sure the hon. Lady understands how much support there is in the Chamber for this debate, and will be coming to a conclusion shortly.
Dr Allin-Khan
Thank you very much for raising that, Madam Deputy Speaker—I am nothing if not a talker. I am sorry that I am taking such a long time, and I will move forward quickly with my speech.
The Royal College of Emergency Care and I, as the chair of the all-party parliamentary group on emergency care, have put together a number of recommendations. First, restore patient flow by reducing delayed discharges; secondly, focus equally on four-hour and 12-hour performance; thirdly, reform funding and incentives; fourthly, spread responsibility for patient flow across the hospital; and lastly, address inequalities in access and outcomes. We cannot have a debate like this without recognising the terrible inequalities that scar our healthcare service—we have to work to reduce the disproportionate burden of long waits on deprived communities, older patients and people with mental health needs. Those measures would make a real difference to hospital systems, patient experience, and the overall effectiveness of the NHS.
The founding principles of the NHS are stretched to breaking point every time someone waits for 10 hours, in terrible pain and sometimes in their own urine, under the harsh strip lights of a corridor, unable to feel that they can ask for help. It is completely undignified. The Minister will be very familiar with the stats we have sent to the Department, which show the disproportionate number of deaths in our country that are due to corridor care. The fact that we in the UK have people dying because they have been treated in a corridor is simply unacceptable to me and other Members of this House, so let us commit today to ending it once and for all, and ending corridor care forever.
Several hon. Members rose—
Dr Allin-Khan
As I stand here now to give my closing remarks, I am filled with a sense of pride. There are very few occasions when we all come together across the House in unison on an issue. Today is an example of where Members from every party and those who sit as independents have come together to say: enough is enough, we all stand united against the scourge that is corridor care.
It would not be fair of me to single out individual contributions, because they were all worthy of accolades. Members have shared their own deeply personal experiences or those of their families. They have highlighted how important it is that we understand the geographical implications of how this is a challenge that does not require a one-size-fits-all approach.
I am really pleased to hear the commitments from the Minister, especially as we know that, according to the Royal College of Emergency Medicine, 1,300 excess deaths occur every month due to long A&E waits. That is the equivalent of a plane crash of people dying every single week. We cannot allow that to happen. I appreciate everything the Minister said, but my closing request is this. Can we please do everything we can to heed the remarks of everyone across the House today and speed up whatever we can to ensure there is not a single excess death attributed to something that could be avoided?
For every person who dies when it could have been prevented, we have a family in grief and a life taken too soon. If we know there are things we could be doing—money we could be spending, a social care system we could be fixing to ensure people have extra precious time with their loved ones and that people have dignity on what is, on many occasions, the last day of their lives—we must spend every ounce of energy in the Department of Health and Social Care to fix this problem.
I thank everyone who has taken part in this debate and I thank the Minister. Let us end corridor care for good.
Question put and agreed to.
Resolved,
That this House has considered NHS corridor care.
Hughes Report: Second Anniversary
Rosena Allin-Khan Excerpts(5 months, 3 weeks ago)
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Several hon. Members rose—
Dr Rosena Allin-Khan (in the Chair)
Order. This is an incredibly important topic. I remind Members that they should bob if they wish to be called to speak. Because so many Members want to get in, I would be grateful if you can try to stick to approximately four minutes each, to allow everyone to get a say.
Lizzi Collinge
My hon. Friend is absolutely right. This scandal follows a pattern that we have seen far too many times before: early warnings ignored, information withheld or downplayed, measures to protect people not effectively enacted, and public bodies closing ranks rather than being open and honest when things go wrong. I have done a lot of work on maternity safety, and I have seen those patterns again and again; the parallels are really clear. Had concerns been properly addressed at the outset, so much harm could have been avoided, and so many more children would not have been born with lifelong, preventable conditions.
Their families have been waiting for far too long. There were initial recommendations for redress six years ago in the Cumberlege review, but the previous Government failed to act. Through the Hughes report, we have an even more comprehensive examination of what needs to be done to support those families, but they are no closer to getting even a formal response to that. That constant delay increases the cost, delays support and builds up ill-will with affected families, who have already spent their lives fighting for their kids.
I urge the Government to provide an interim payment for those families. We know that that is possible; Dr Hughes has outlined how to do it in this case, and we have seen it in the infected blood scandal. The main question for the Minister is this: when will we get a full response to the Hughes report? When will we actually see some action?
Like so many of my colleagues, I pay tribute to Emma and Janet from the Independent Fetal Anti-convulsant Trust, who are here today. Their children were affected by sodium valproate, and they have been tireless campaigners for compensation for affected families—I have known them for many years now. They have been invaluable in raising awareness about foetal valproate spectrum disorder. I also thank my hon. Friend the Member for Lancaster and Wyre (Cat Smith), who has worked with In-FACT for many years on this and has been a staunch advocate for their campaign.
Despite all their hard work, progress from the Government’s side seems to have stalled yet again, and families are left waiting. We know that things go wrong in medicine, and that all drugs have side effects, but when a harm that is caused was preventable, and when the state fails to act on warnings, the Government must step up. We should do what we should have done years ago, and give justice and support to the families who have already paid a heavy price for our failings.
Dr Rosena Allin-Khan (in the Chair)
I remind Members that it is discourteous not to attend for the opening speeches and then to make interventions. As a result, those Members who have been here from the start and will be here until the end will now have a shorter time limit imposed on them. Because of the number of Members who have indicated that they wish to speak, with the authority of the Chairman of Ways and Means, I am imposing a time limit on Back-Bench speeches of three and a half minutes.
Several hon. Members rose—
Dr Rosena Allin-Khan (in the Chair)
Order. I know that people are keen to hear from the Minister, so I will bring the speaking time down to three minutes. If there are any interventions, I will have to bring it down even further.
Anna Sabine (Frome and East Somerset) (LD)
It is a pleasure to serve under your chairship, Dr Allin-Khan. I thank my hon. Friend the Member for Chesham and Amersham (Sarah Green) for securing this important debate.
We have had the findings of the Hughes report for over two years now. It called on the Government to provide financial redress to patients and families affected by the use of sodium valproate and pelvic mesh. The previous Government refused to act and increasingly it feels as though the current Government are also burying their head in the sand rather than confronting the scale of this injustice.
My constituent Nick is one of those living with the consequences of that inaction. His son Oliver was born with foetal valproate syndrome after Nick’s wife took valproate during pregnancy to control her epilepsy. Tragically, Nick’s wife has since died, leaving Nick to raise Oliver alone. Nick told me that it is hard for him to adequately explain how difficult Oliver’s life has been and how much he worries about his son’s future.
Valproate has changed Oliver’s life forever, and all Nick wants is answers and meaningful action from the Government. Quite rightly, Nick continually chases me for answers on when the Government will make a decision on the Hughes report. On behalf of Nick and Oliver, I ask very directly: can the Minister say when we will finally get a response to the Hughes report? How much longer do the Government need to “carefully consider” recommendations that have already been scrutinised, evidenced and endorsed? Families such as Nick’s cannot wait indefinitely while the Government deliberate.
I take this opportunity to say that it is also vital that we recognise the devastating impact of Primodos, a hormonal pregnancy test used until the 1980s. Primodos was not considered by the Hughes report, but it was part of the Cumberlege review of hundreds of children born with foetal abnormalities. Many of those affected are now older; tragically, some of them are dying without ever receiving acknowledgment, accountability or compensation.
The pelvic mesh, valproate and Primodos scandals are some of the most significant health scandals of modern times. They have disproportionately affected women, yet time and again we see the same pattern: warnings being ignored; evidence being dismissed; and victims being left to fight for justice on their own. These scandals have gone on for far too long, with little action from successive Governments. Those affected by valproate and Primodos are not asking for the impossible; they simply want those responsible to acknowledge the mistakes made and to take responsibility for the harms caused.
If we are serious about restoring trust in our healthcare system and serious about supporting women, we must start by delivering justice to those who have been failed so profoundly.
Dr Rosena Allin-Khan (in the Chair)
We now come to the Front-Bench spokespeople. I call Caroline Voaden.
Oral Answers to Questions
Rosena Allin-Khan Excerpts(6 months, 2 weeks ago)
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Wes Streeting
A number of critical incidents have been running across the country this week. To be clear, a critical incident does not mean that there is unsafe care or that we are unable to provide care. A critical incident means that there is a challenge, and the system mobilises in response to help meet that challenge so that people do receive safe care. As I have said, we are investing more in our urgent and emergency care services and we are seeing the impact of that through year-on-year improvements to date. We are not out of winter yet; we still have lots of hard yards ahead. I am confident that when we emerge from winter, we will be able to tell a story of year-on-year improvement. However, while the NHS is on the road to recovery, I would not want anyone watching—not least the hon. Member’s constituents—to think that the Government believe that what we have seen this winter is acceptable every day, in every case everywhere. Until that is the case, we will continue to strive for further improvement day by day, week by week, month by month, and year on year.
Dr Rosena Allin-Khan (Tooting) (Lab)
Working my shifts in A&E over Christmas and the new year, like many colleagues up and down the country I experienced what has become the undignified norm of corridor care. I welcome the Secretary of State’s commitment to ending it. The all-party parliamentary group on emergency care, which I chair, working closely with the Royal College of Emergency Medicine, is keen that the Government adopt our recommendations on ending corridor care. The Secretary of State previously agreed to meet us. Will he today reaffirm his commitment to meet us to end this scourge in our A&Es?
Wes Streeting
My hon. Friend can be absolutely assured of that. I thank her for her powerful advocacy in this place, as well as for putting her words into action on the NHS frontline. She does not need to do that—she could do the bare minimum to keep her licence going—but she always goes above and beyond to take care of patients and constituents, literally rolling up her sleeves and putting on her scrubs to do that. She has made a number of thoughtful recommendations in her report, and I look forward to engaging with her and the all-party group on that.
NHS: Winter Preparedness
Rosena Allin-Khan Excerpts(7 months, 2 weeks ago)
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Wes Streeting
I will ignore the political nonsense about banning strikes and clamping down on trade unions. I will, however, take on directly the charge that we have not prepared for this winter.
We have delivered over 17 million flu vaccinations this season—hundreds of thousands more than this time last year—and 60,000 more NHS staff than last year are also getting their jab. We are on track to deliver the 5 percentage points increase in flu vaccine uptake in healthcare workers, as set out in our urgent and emergency care plan. On children and young people, half a million two to three-year-olds have been vaccinated, which is the same as last year, and 3.6 million school-age children have been vaccinated, which is up 100,000 on last year. We will be going back to schools to do repeat visits in areas where uptake in schools has not been as high as we would like. For care home residents, flu vaccination uptake is 71%. We are on track to meet the RSV vaccination uptake target for 2025-26 in the published urgent and emergency care plan, so we are doing a lot on the vaccination front to prepare.
In fact, on winter planning more generally, we started earlier and did more than ever to prepare for this winter. We had stress-tested winter plans trust by trust. Local NHS leaders ran scenario-based exercises, including managing surges in demand and responding to virus outbreaks to test and strengthen their winter readiness plans, which are now being put into action. We have strengthened access by boosting GP access to keep people well and out of hospital. Through advertising campaigns, new online access routes and more GP practices open for longer hours over the Christmas period, we are making sure more people can be seen closer to home. That matters, because when people can get help early from their GP, they are less likely to end up in A&E.
We are also going further to improve our urgent and emergency care performance this winter. That is set out in our urgent and emergency care plan. We are investing almost £450 million into UEC this winter, meaning: 500 new ambulances on the roads; expanding same-day and urgent treatment centres; providing targeted support to the most challenged trusts; creating capacity and keeping flow moving by sharing weekly data with trusts; encouraging the use of alternative community services; and streamlining in-hospital discharge processes to get patients discharged more quickly from hospital when it is safe to do so, including joining up the NHS and social care, where relationships between health and social care have been improving year on year. If I think about where we are this year compared to last year, there has been sustained improvement. A lot done; more to do.
Of course our job is made harder by strike action. That is why the Government are doing everything we possibly can to get the NHS through this winter. I just wish we were doing it with the BMA, rather than against the BMA.
Dr Rosena Allin-Khan (Tooting) (Lab)
I would like to pay tribute to all the incredible staff at St George’s hospital in Tooting. I did my A&E shift with them this week, together in the trenches.
The Labour Government inherited an NHS that was bursting at the seams. With flu cases on the rise, the NHS feels as though it is working with one arm tied behind its back. Over half a million people this year were treated in corridors in A&E. That is unsafe and undignified. The all-party parliamentary group on emergency care, which I have the privilege of chairing, working very closely with the Royal College of Emergency Medicine, published a report outlining our recommendations to end so-called corridor care. I know this is a matter about which the Secretary of State cares deeply, so will he meet us to discuss the report’s recommendations to provide safe and more dignified care for patients and staff?
Wes Streeting
I echo my hon. Friend’s thanks to frontline NHS staff for what they are doing against a very challenging backdrop, which will be made all the more difficult this coming week. I also thank her personally for her ongoing frontline service, which she performs in addition to her duties in this House. I am always delighted to meet her and I would be very happy to discuss her report with her.
HIV Testing Week
Rosena Allin-Khan Excerpts(1 year, 5 months ago)
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Several hon. Members rose—
Dr Rosena Allin-Khan (in the Chair)
I remind Members that they should bob—as they are doing—if they wish to be called in the debate. Given the number of Members who wish to speak, and to ensure that everybody gets to say what they wish to, I suggest an approximate time limit of five minutes. We will move to the Front-Bench spokespeople at about 2.28 pm. I call Jim Dickson.
Siân Berry (Brighton Pavilion) (Green)
It is a pleasure to serve under your chairship for the second time this week, Dr Allin-Khan. I thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) and the co-chairs of the APPG for all the work that they do.
I also echo calls from hon. Members for the funding for global work that is being shamefully cut back by the new US Government to be found from within this country. I ask the Minister to look at the pressure that is also being put on, and the funding that is being withdrawn from, wider rights-based groups, which we spoke to yesterday in a fantastic and interesting roundtable. There are many groups working in the global south to support LGBT rights and reproductive rights, which include healthcare. The impact of the cutback more widely will be on health, and we owe it to those groups to ensure that we are doing what we can to make up for what the American Government are so awfully doing.
I am pleased to join this important debate and to support HIV testing week. I absolutely commend the efforts being made by so many MPs, including the Prime Minister, to promote HIV testing. That is great to see. As an MP for Brighton, I am proud of the work of the Terrence Higgins Trust—which is partly based in my constituency, not far from my office—for making this a bigger event every year, and more and more inclusive. I recently visited THT to see first-hand the incredible work it is doing to end new transmissions of HIV, supporting people to live well with HIV, and challenging the stigma and all the things that go around that. Its work with partners in my city, like the pioneering Lawson unit at the Royal Sussex County hospital and the local HIV charity, the Sussex Beacon, is all so exciting.
Opt-out testing was mentioned. The emergency department at the Royal Sussex has been doing that testing since March 2022. It has since been rolled out nationally in areas of very high HIV prevalence. In Brighton, the team at the Lawson clinic has identified 16 new HIV diagnoses in recent years. That sounds like a small number, but the impact for each individual is absolutely massive. They are all people whose HIV will almost certainly have gone undetected up until then. All the work that is being done to normalise testing as part of a trip to A&E, when blood is drawn, does so much to reduce HIV stigma, help people, and save and improve lives.
Brighton also has some groundbreaking digital pathway work happening. The locally co-designed HIV app EmERGE has been a big success. It is a European project centred in Brighton, and I am told that people absolutely love it. There are about 720 people using it for PrEP access, appointments and support. This innovative approach has helped ease the pressure on local services and freed up about 1,000 local appointments per year. That is fantastic work, making all our money go further and helping people to cut their transmission risk without fuss and bother. That is what we all need to be working towards.
Let us be clear: zero transmission of HIV is possible by the target date of 2030. The work in Brighton that I have just described proves that. I truly believe that Brighton could be the first place in the UK to achieve that target, given the comprehensive work going on. I know that hon. Members in the Chamber are aware of all of that, and I hope the Minister will set out how a roll-out of that model across the UK will be funded.
Dr Rosena Allin-Khan (in the Chair)
In order to get all Members to speak in this important debate, I gently suggest a time limit of three and a half minutes.
Health and Social Care: Winter Update
Rosena Allin-Khan Excerpts(1 year, 6 months ago)
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Wes Streeting
Where to begin, Madam Deputy Speaker? The shadow Health Secretary does a really good line in diagnosing the problem as if these are somehow new facts to him, or to the country. In fact, one does not have to be a Minister of long service in this House, or indeed a Member of long service, to remember that only a short matter of months ago, the shadow Secretary of State was a Minister in the Department. Time and again, he asks questions about the state of the crisis and the challenge in the NHS without showing a shred of responsibility for that crisis, which he played a part in creating.
It is not just the shadow Secretary of State but every one of his predecessors who had a hand in creating the situation that Lord Darzi spelled out: underinvestment and botched reform. It is the situation we see today, with pretty much every part of our health and care services—be it primary care, community care, mental health services, secondary care or social care—under extraordinary and historic pressures. It is all very well criticising from the Opposition Benches, but the shadow Secretary of State demonstrates the same pattern of behaviour as his predecessor: acting like the arsonist criticising the fire brigade for not doing enough, quickly enough, to put out the fire they started. It is truly shameful.
I turn to the questions raised by the shadow Secretary of State. On delayed discharges, in December—the latest data we have—12,000 on average per day were medically fit for discharge but unable to be discharged. Bed numbers are broadly the same as they were this time last year: 102,546, versus 102,226 under the previous Government. That actually says something about what we have experienced in our weekly updates: the work that is taking place between health and social care services to improve the flow of patients is having some effect when we take into account our ability to flex bed numbers up and down against the backdrop of higher occupancy from flu, the added challenge of norovirus, and the other seasonal conditions that we see at this time of year.
The shadow Secretary of State asked about vaccination uptake. As I said in my statement, there have been more flu vaccinations this year than there were last year, but he raised the important issue of vaccination rates among NHS staff. Those rates are lower than we would like or expect, and we have to do some work with staff to understand why that is the case and how we can encourage further uptake. As I said, if staff are suffering with flu having not been vaccinated, not only is that a really unpleasant experience for them, it is an unpleasant experience for their colleagues if staff are off sick, and indeed for patients who are waiting longer.
On critical incidents, the shadow Secretary of State asked about the support that is being provided to NHS organisations. NHS England regional teams are working closely with integrated care boards to ensure appropriate responses are in place to address and mitigate the issues identified within each declared critical incident, all of which will have variations. We have also seen NHS England—rightly, in my view—using the critical incident tool proactively to ensure we can provide wider system support to emergency departments that are under particular pressure.
The shadow Secretary of State asked about additional funding for winter. When I was shadow Health and Social Care Secretary, I was very clear about my cynicism regarding the pattern of behaviour we saw from our predecessors. Year after year, they would arrive in the middle of winter—often after the winter peak—with a gimmicky package of last-minute funding that delivered too little, too late without making any real difference on the frontline, all to give the impression that they were doing something to mitigate the crisis in the NHS, in which they played a serious part. I said that we would not do that, and we are not doing it. As soon as we came into office, looked at the books and saw the black hole, the Chancellor released additional funding for the NHS in-year to ensure that it had the resources it needed not to cut back. Thanks to the decisions taken by the Chancellor, the NHS has received more than £2 billion more in-year than it would have received if the Conservatives had remained in power, so we do not need any lectures on funding. Indeed, they continue to oppose the £26 billion we provided for the NHS.
Finally, the shadow Secretary of State accuses us of capitulation to frontline doctors who were out on strike because of the way they were treated by our Conservative predecessors. I just say to resident doctors who are following these proceedings, and to patients who can see the state of the NHS today and wish it were better, that we are now left in no doubt. Had the country kept the Conservatives in power, doctors would have been on the picket lines instead of the frontlines this winter; taxpayers would have continued to pay a heavy price for failure; and patients would continue to pay the price through delayed, rearranged or cancelled operations, appointments and procedures. It is proof positive that even after it was booted out of office, the Conservative party has not listened, has not learned, and is not fit to govern.
Dr Rosena Allin-Khan (Tooting) (Lab)
For years, like many in this House, I have seen a regular stream of local people in my surgeries and inbox who have been waiting far too long for NHS treatment. What shocks me the most, though, is when I see the same local people turn up in A&E when I am doing my shifts, having deteriorated and in even worse pain than before. Locally, there are 66,000 cases of people who have had to wait over 18 weeks for treatment, so does my colleague the Secretary of State agree that we need an urgent and emergency care plan to deliver much-needed year-on-year improvements?
Wes Streeting
I wholeheartedly agree with my hon. Friend, and thank her for the work she has been doing this winter on the NHS frontline, providing support to her colleagues at her local hospital—literally rolling her sleeves up and looking after people. She is absolutely right that we need an urgent and emergency care plan to make sure we see continued year-on-year improvements. I can reassure my hon. Friend that that plan is already being written; we are learning the lessons from this winter in order to apply them next winter. As I should have said to the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), I took the same approach when I was shadow Secretary of State: the very first meetings I held on winter planning were ahead of the general election in access talks with the Department. The first briefing I received on winter preparation was on my first day in office. Throughout the past six months heading into winter, I continued to talk to staff in the Department, NHS England and social care leaders to ensure that we were as well prepared for this winter as we could be. Right now, we are learning the lessons to prepare for next winter.
Health and Adult Social Care Reform
Rosena Allin-Khan Excerpts(1 year, 6 months ago)
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Wes Streeting
That is a great question. First, I will put on my shin pads and crash helmet if Andrew Dilnot is in front of the hon. Lady’s Select Committee this week. I can well understand his frustration. He is a decent man who did an excellent piece of work. It must be frustrating to see one Government after the next not implementing something that was welcomed. The issue for us as an incoming Government is that the money was not there, and even if it had been, the system had not been set up to deliver for the October 2025 deadline. We chose to act on other immediate pressures in other areas, because we saw those needs as more pressing. That does not mean for a moment that I think Andrew Dilnot’s work is no longer valuable—I think it might well be. However, we have to consider the issues in the round and come up with a clear and sustainable plan that we can stick to.
On why the Casey commission will be different and will work, it is important to have as much political consensus around the House as possible. The national consensus and getting the public on board will be important. Anyone who has ever met Louise Casey will know she is a difficult woman to say no to. I have no doubt that if Louise Casey says something needs to be done, this Government and future Governments—whoever is in government—will make sure that it happens.
Dr Rosena Allin-Khan (Tooting) (Lab)
Happy new year, Mr Speaker. Yesterday and over the Christmas recess I was working shifts in my local A&E at St George’s in Tooting. Up and down the country, doctors like me were seeing older and disabled patients who could not be discharged from hospital due to a lack of good, affordable social care in the community, so I welcome the steps that have been outlined. What steps will the Secretary of State outline to ameliorate the imminent pressures sooner?
Oral Answers to Questions
Rosena Allin-Khan Excerpts(2 years, 3 months ago)
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Helen Whately
The hon. Gentleman makes the point that the performance of A&E depends on the flow of patients through hospital and our ability to discharge them. That is why, as part of our work on urgent and emergency care, we have invested in supporting hospitals to discharge patients, and have been supporting social care. We have seen an increased number of discharges across the country over the last year, which has enabled hospitals to treat more people and supported the improved performance in A&E that I mentioned. We continue to work on that, and of course we are supporting social care with up to £8.6 extra billion funding over two years.
Dr Rosena Allin-Khan (Tooting) (Lab)
The Minister for Health and Secondary Care (Andrew Stephenson)
Every day, NHS staff do an extraordinary job for their patients, and it is vital that the NHS supports them in maintaining their mental health. The long-term workforce plan commits the NHS to supporting staff health and wellbeing and asks integrated care systems to develop plans to support them. I am pleased that NHS England is reviewing mental health services for all staff, to ensure that all staff in the NHS have the support that they need.
Dr Allin-Khan
Fighting to save a dying child’s life, telling families that their loved one will not make it through the night, and working desperately in substandard conditions—it will come as little shock to hear that all that takes a toll. Last year, 6.4 million mental health sick days were taken across the NHS. Instead of receiving support, our NHS heroes have a Tory Government who treat them with disdain and kick them to the kerb. Will the Minister commit to funding the NHS practitioner health service beyond the next 12 months, or will the Government just try to shut it down again?
Andrew Stephenson
As an NHS community first responder who served on the frontline during the pandemic, who had to see people say goodbye to their loved ones for the last time before being admitted to hospital, and who has dealt with cardiac arrests, I know the mental toll that working for or volunteering with the NHS can take on our workforce, and therefore we do give a very high priority to the subject. The NHS people plan sets out a range of actions to build a more modern, compassionate and inclusive culture, and includes a much stronger focus on the availability of quality health and wellbeing support. It is right that we keep services under review, so I will not make a commitment today to continuing to fund something that we have agreed to fund for another year while those services are reviewed.
Building an NHS Fit for the Future
Rosena Allin-Khan Excerpts(2 years, 8 months ago)
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Dr Rosena Allin-Khan (Tooting) (Lab)
“A profound betrayal”, “An insult”, “Incomprehensible”, “A major breach of trust”, “A huge blow”, demonstrating “what little regard the current UK government has for mental health”, having “broken its promise to thousands of people”—not my words but those of mental health experts in response to the Government’s scrapping of the reform of the Mental Health Act.
Back in 2017, there was hope of real change when the Government pledged to reform the Act. Six years later, and after much posturing from Government Ministers, that promise has sadly been broken. I sat for many months with colleagues from across the House on the Joint Committee of the draft Mental Health Bill. We took evidence from experts and those with lived experiences. Many had to unpick painful, traumatic experiences, and did so willingly so that no other person would have to endure the same. That would all be for nothing. Trauma relived for nothing. Recommendations made for nothing. The Government never even bothered to respond to the Committee’s report.
Black people are five times more likely to be sectioned. More than 2,000 people with learning disabilities are held in mental health hospitals, of whom 200 are children. That is the reality of the Mental Health Act in modern Britain. All that is set amid years of Tory failure on mental health. Waiting lists are through the roof, standards of care are falling and staff are burnt out. Poor standards of social housing, the cost living crisis, the decimated benefits system and growing job precarity are the social ills driving the mental health crisis we now face. Those ills have been intensified by a Conservative Government who have underfunded our NHS and public services. That is the hallmark of a Government who simply do not care.
This Government do not care if children languish on waiting lists. They do not care if parents have to give up their jobs to sit at home on suicide watch because their children cannot get the help they need. They do not care about people in all our communities. Health is something that bridges the economic divide and the class divide. It is a factor that matters to every single one of our constituents in some way or form.
But the failures are not just in health. Across Tooting, whether they live in a council house, rent privately or are a homeowner, the Government have failed everyone. Not content with selling off over 20,000 council homes in Wandsworth, leaving thousands of children homeless each winter, the Conservatives then made it impossible for people to get on the housing ladder. Average rent in Tooting for a two-bedroom flat is £2,300 a month, with bills. In what world is that feasible or even acceptable? Homeowners are no better off either. After the previous Prime Minister crashed the economy, which Conservative Members all supported, homeowners across Tooting are having to pay hundreds of pounds more on their mortgages. Everyone deserves the security and safety of their own home.
Speaking of safety, talk to people across Tooting and they will tell you of their worries about antisocial behaviour and crime, with multiple incidents of children—children—being mugged after school and of drug dealing not being addressed. Why? Because the police are under-resourced and overstretched. My local police teams are absolutely incredible. Local police teams do their best and I pay tribute to their efforts, but we all know that most low-level crimes go unsolved, and they are often a feeder for the most serious stuff, such as drug dealing. This the direct result of real-terms budget cuts and a cut to safer neighbourhood teams.
The Government are record breakers, but it is not something to be proud of. Waiting lists for NHS treatment have reached a record high of 7.7 million people. That includes many people from across Tooting. They are waiting in pain for a hip replacement, worried their cancer might spread, or stuck in a bay for many, many hours in A&E, where I do shifts. Back in 2010, patients waiting more than 12 hours in A&E were pretty much non-existent, but that was the sad reality for 44,000 people last month alone. In 2010, when Labour left office, doctors like me were not having to perform intimate exams in cupboards and patients were not having to line the halls waiting to be seen, lying on the floor. With yet another Health Secretary coming into post, nothing will change and Tooting people will continue to be let down by the Government.
This was a King’s Speech lacking in ambition and failing to address the problems faced by people across the country on a daily basis; a King’s Speech that is truly a testament to broken Britain and the Government who caused it. We now need a Government willing to give Britain its future back. We need a Labour Government.
Oral Answers to Questions
Rosena Allin-Khan Excerpts(2 years, 9 months ago)
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Maria Caulfield
I have met with 3 Dads Walking; I have not met the mums group but am very happy to do so. Because of their intervention and campaigning, we were able to successfully put their campaign about improving mental health awareness in the school curriculum into our suicide prevention strategy. It is a cross-Government strategy, and the Department for Education has very much taken their points on board.
Dr Rosena Allin-Khan (Tooting) (Lab)
Over 1.8 million people languishing on mental health waiting lists, black people five times more likely to be detained under the Mental Health Act 1983, and over 2,000 people with learning disabilities detained in hospital, all while the Government are dragging their feet on mental health and suicide prevention. You will be interested to know, Mr Speaker, that we had cross-party support to tackle these burning injustices through the draft Mental Health Bill, yet since the Joint Committee on the Draft Mental Health Bill published our report in January we have heard nothing from the Government, so will the Minister today commit to including reform of the Mental Health Act in the King’s Speech?
Maria Caulfield
I was going to pay tribute to the hon. Lady for her work on mental health campaigning, and she will know we have done a huge amount. The suicide prevention strategy is a cross-Government piece of work, which makes sure suicide is everyone’s business, not just that of health and social care. Whether by supporting families bereaved by suicide or rolling out mental health support schemes in schools, it is this Government who are delivering on mental health services.