Accident and Emergency Departments

Tony Baldry Excerpts

Thursday 7th February 2013 Commons Chamber

[Sir Tony Baldry (Banbury) (Con)]

Our lives are measured out in minutes, Mr Speaker.

In paragraph 1.25 of his report, which was published yesterday, Robert Francis said:

“MPs are accountable to their electorate, but they are not necessarily experts in healthcare and are certainly not regulators. They might wish to consider how to increase their sensitivity with regard to the detection of local problems in healthcare.”

I am not sure how many Members of Parliament Robert Francis QC spoke to before writing that particular paragraph, but I suspect that every MP seeks to be a champion for their local hospital and for the NHS in their own area.

I have left instructions for my body to be given to Oxford university’s anatomy department, for various reasons: there is quite a lot of it and I certainly think that the liver of anyone who has been an MP for more than 30 years is worthy of anatomical examination. Most important, however, I want to ensure that when they open me up they will find inscribed on my heart the words, “Keep the Horton General”. Throughout my 30 years as an MP for north Oxfordshire, the one thing that has been of greatest importance to me, practically above all else, is ensuring that the Horton hospital in Banbury remains a general hospital—that is, one with consultant-led maternity and children’s services, 24/7 A and E services, and a facility for people to see doctors on a 24/7 basis.

I also readily recognise, however, that certain specialist trauma services cannot be provided at hospitals such as the Horton, and that they are best provided at hospitals such as the John Radcliffe in Oxford. That was best demonstrated to me by a constituent, a friend of mine, whom I met the other day. He had suffered a ruptured aorta. My paternal grandmother died of a ruptured aorta, but this constituent survived. I said to him, “You were jolly unlucky to have a ruptured aorta, but you were fantastically lucky to live.” He told me that the only reason he had survived was that the ambulance had taken him from Banbury directly to the John Radcliffe in Oxford, where he received the specialist treatment that he needed.

I echo the point that has been made by several hon. Members that we need total clarity about what people can expect from major trauma units, and what is meant by the terms “accident and emergency department”, “urgent care centre” and “major injuries unit”. We need national standards so that we can all be confident that we are comparing like with like. We could then be confident about the protocols that the ambulance services use—when they are dealing with major road accidents on the M40, for example—and patients, GPs and people generally in my constituency would know what to expect from the accident and emergency services in Banbury, and when it would be more appropriate for them to be directed to the major trauma unit at the JR in Oxford. People would also be clearer about when they ought not to be bothering the accident and emergency department at the Horton at all but should really be going to see their GP. All too often people tend to treat the accident and emergency department as an out-of-hours GP service, but it was not intended for that purpose.

We must also recognise that medicine is constantly changing. The general hospital in Buckinghamshire at which my mother was a sister tutor, and whose accident and emergency department I visited as a child, has long since closed. The general hospital at which my father was a consultant has now merged with St Peter’s hospital in Chertsey. There has been evolution in health care for a long time. The Horton hospital is changing in that medical technology is improving the pace at which patients can be treated. In the past, women who had hysterectomies might have had to stay in hospital for 10 days, but that procedure can now be done as day surgery with an overnight stay.

Changes are also resulting from the fact that we have a much larger older population, many of whom have age-related dementia issues, who need to stay in hospital much longer. We have to reconcile those two growing areas of change within one general hospital. We have to recognise that medicine and service provision will not remain static. We cannot apply a single model throughout the system. We need integrity and honesty about what services are being provided and where, and an acknowledgement that it is not always in the best interest of patients to have a single stand-alone hospital providing every service to every patient. That is not necessarily in the best interests of patient safety.

As this debate has demonstrated, we will all fight tenaciously to ensure that the national health service continues to provide the very best service for patients. The Mid Staffordshire report yesterday was a wake-up call to us all. We all love our NHS and see it as a representative of our national integrity and of the cohesion of citizens and society, but we must also acknowledge that it faces real challenges and that we must all contribute to tackling them.