A&E Departments: Winter Pressure
Debate between Andrew Selous and Sarah Wollaston(7 years, 5 months ago)
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Dr Wollaston
Certainly, the evidence we heard in our inquiry was that there is grave concern about the level of existing pressure. As the right hon. Gentleman says, if we see a very cold winter, and the flu vaccine does not work as well as it did last winter, we are in serious difficulties. But I stress again that the Committee was very clear that we want to see the four-hour waiting time standard continued, because it is a good measure of whole-system pressure, and if people are facing very long waits that leads to a deterioration in patient safety. So it is a quality issue, as well as an issue about patient experience.
Andrew Selous (South West Bedfordshire) (Con)
I note what the Chair of the Health Committee says about social care and delayed transfers of care. Would she commend an initiative taken in hospitals in Fife, where the most senior consultants were put into accident and emergency, which led to a 30% reduction in admissions to the hospital? Does she not agree that more junior staff are sometimes perhaps slightly more risk-averse because they do not have the experience? Does she not think that, where Fife has led, other hospitals around the UK could usefully follow?
Dr Wollaston
I thank my hon. Friend, and I welcome him to the Health Committee. Yes, he is absolutely right that one of the initiatives that has been put forward is to look at streaming at the front door, but what we heard is that this is quite nuanced. If very senior staff are tied up seeing every single person at the front door, that can be a waste of resources. However, if the patients who are most at risk of needing admission—the sickest individuals —are identified early on and seen by the most senior doctors available, then yes, absolutely, that makes a difference.
SELECT COMMITTEE ON HEALTH
Debate between Andrew Selous and Sarah Wollaston(7 years, 5 months ago)
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Dr Wollaston
Certainly, the evidence we heard in our inquiry was that there is grave concern about the level of existing pressure. As the right hon. Gentleman says, if we see a very cold winter, and the flu vaccine does not work as well as it did last winter, we are in serious difficulties. But I stress again that the Committee was very clear that we want to see the four-hour waiting time standard continued, because it is a good measure of whole-system pressure, and if people are facing very long waits that leads to a deterioration in patient safety. So it is a quality issue, as well as an issue about patient experience.
Andrew Selous (South West Bedfordshire) (Con)
I note what the Chair of the Health Committee says about social care and delayed transfers of care. Would she commend an initiative taken in hospitals in Fife, where the most senior consultants were put into accident and emergency, which led to a 30% reduction in admissions to the hospital? Does she not agree that more junior staff are sometimes perhaps slightly more risk-averse because they do not have the experience? Does she not think that, where Fife has led, other hospitals around the UK could usefully follow?
Dr Wollaston
I thank my hon. Friend, and I welcome him to the Health Committee. Yes, he is absolutely right that one of the initiatives that has been put forward is to look at streaming at the front door, but what we heard is that this is quite nuanced. If very senior staff are tied up seeing every single person at the front door, that can be a waste of resources. However, if the patients who are most at risk of needing admission—the sickest individuals —are identified early on and seen by the most senior doctors available, then yes, absolutely, that makes a difference.
Cycling
Debate between Andrew Selous and Sarah Wollaston(10 years, 7 months ago)
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Dr Wollaston
I thank my hon. Friend. Rural speed limits are important. In fact, the introduction of networks of 40 mph speed limits on rural roads had a great benefit in Holland. There is a lot of evidence to support their use, but this is about money. I welcome the £10 a head in the eight cities that will benefit and the spending in, for example, the Dartmoor national park in my part of the world, but that is not what the report called for. Our report called for £10 a head nationally and for us to think of the benefits—a real, lasting legacy—that that could achieve.
However, this is also about speed, as my hon. Friend pointed out. Let us look at the benefits we would see if we had 20 mph speed limits in urban areas. Too often, highways departments look at accident data before making decisions about speed limits. However, we all know that parents will not let their children cycle in the first place if they do not feel they are safe, and the perception of safety is strongly linked to the speed at which the traffic is travelling. We should look at speed limits across the board. I recently visited Falcon Park in Torbay, which is a park home development with many elderly residents who cannot walk down the road, let alone cross it, because of high-speed traffic. In any other residential area, the speed limit would have been reduced to 30 mph.
This is not only about 20 mph limits in towns and cities on a network of roads; it is about reducing speed across the board and assessing our priorities. Whom do we prioritise? Are we prioritising vulnerable road users like pedestrians and cyclists, or are we prioritising the motorist and speed? We need to change our priorities completely to achieve that. It does not take a great deal of money to reduce speed limits—everyone recognises that there is a financial imperative—but the issue is not just reducing the speed limit, but enforcing it. We heard shocking evidence in our inquiry about a level of complacency towards enforcement. What discussions have taken place across Departments to ensure that welcome changes in the issuing of fixed penalty notices for careless driving will be extended to penalising people who breach speed limits directly? It is immediate consequences that will drive change.
Andrew Selous (South West Bedfordshire) (Con)
I am sure that, like me, my hon. Friend is delighted to see the Government Chief Whip in his place. He must be the grandfather of parliamentary cycling. On enforcement, does she agree that although motorists should absolutely do the right thing and obey the rules, it is also incumbent on cyclists to obey rules, and that a small minority of cyclists give most cyclists a bad name on occasion by not obeying the Highway Code?