National Health Service

Alex Cunningham Excerpts

Wednesday 21st January 2015 Commons Chamber

[Andy Burnham]

I want to make some more progress; I will give way later.

We need to know the reasons for the increase in A and E attendance. Safely meeting that demand would require an extra eight accident and emergency departments in England, but the Government have been closing, not opening, A and E’s. That is why there is so much pressure in the system.

There has been an even more dramatic increase in the last year. NHS England figures show that there were an extra 446 extra visits to A and E in the 2014 calendar year. That is a dramatic change on the Secretary of State’s watch and the time has come for some honesty from him about the real reasons for it. Until he faces up to those reasons, however uncomfortable they may be for him, he will not be able to develop a proper solution and the situation will get worse. We cannot let that happen.

Let me list what I believe are the decisions of this Government that led to the increase. I will identify four and take each in turn. The first, as Opposition colleagues mentioned, is the decision to scrap NHS Direct and replace it with the flawed NHS 111 service. NHS 111 was originally intended to be a call-handling service, and indeed was conceived by the previous Government. It was intended to simplify access; it was intended to patch people through to the relevant agency, be it the GP out-of-hours service or NHS Direct.

However, when the present Government came into office, they made a major change: they decided that NHS 111 would not signpost NHS Direct but replace it. That was a major mistake. The established and trusted NHS Direct model, a single national contract in the public sector, was replaced with 46 patchwork contracts in the public and private sectors across the country. They replaced the model of nurses on the end of the phone, to provide reassurance for families, with call handlers and computer screens. As a result, where 60% of calls to NHS Direct were handled by nurses, with NHS 111 it is only 20%.

But the present system of call handlers and computer screens is not a case of “computer says no”. The problem is that too often it is a case of “computer says, ‘Go to A and E.’” NHS England figures show that there has been a dramatic increase, in the last year, in the number of people calling NHS 111 who are referred to A and E, or to whom an ambulance was dispatched. In November 2014, there were 67,000 referrals to A and E—a 26% increase on the same month in 2013—and 108,000 ambulances dispatched—a 20% increase on November 2013.

[Alex Cunningham (Stockton North) (Lab)]

All these problems have led to an increase in the number of days that people are taking off as a result of stress—nurses especially. Thousands of days are being lost to the system, adding to the crisis. Should we not be appreciating the staff in our NHS hospitals, and maybe starting by awarding them the 1% pay rise that the pay review body recommended for all of them?

[Andy Burnham]

The Secretary of State’s decision to reject the independent advice of the pay review body about what was fair and affordable, and to single out NHS staff for exclusion from the promise that the Chancellor had made that the public sector, as part of his restraint policy, would get 1%—to say that NHS staff would get less than that—was a kick in the teeth, and was to risk staff morale just at the moment that the NHS needed to be recognising and rewarding those staff, who are working so hard to keep things going. To make inflammatory comments such as those that the Secretary of State has made in the newspapers today is the wrong response. He should be getting back round the negotiating table with those staff. He should be working with them to find solutions. They are keeping the NHS going right now, and they deserve a bit better than they have had off this Secretary of State.