Accident and Emergency Departments

Debate between David Morris and Patrick Mercer

Thursday 7th February 2013 Commons Chamber

[David Morris]

Does my hon. Friend agree that this issue is above party politics?

[Patrick Mercer]

I totally agree. I would never dream of being critical of my hon. Friend, but I do think that this is such an emotive subject that we can be distracted from the realities by the fears these proposals raise.

I hope that I will speak for everybody who lives in semi-rural and remote areas—as I do, living north of Newark—and who depends on hospitals such as Newark. Newark no longer has an A and E. We, like many other parts of the country, are now at least 20 miles away from our nearest A and Es. Our nearest ones are at Lincoln County, Grantham or—extraordinarily and disgracefully—King’s Mill, which is part of the same private finance initiative with which Newark finds itself lumbered.

Newark sits on the A1 and is adjacent to the M1, and it also sits on the crucial and very busy east coast main line railway. The sorts of incidents the hon. Member for Barrow and Furness described in the nuclear industry could also arise on the road and rail networks in and around Newark, yet Newark has no A and E, in common with many towns of the same size in similar areas.

I do not understand why there has been such confusion over my A and E, and I ask the Minister to explain. If this has happened in Newark, I have no doubt that it happens elsewhere, and that it will continue to do so. Let me explain. When I returned to my home town of Newark in 1999, we had a department called “A and E.” Only subsequently did I find out that it was not an A and E at all; it was a sort of minor injuries unit with a big notice above the door saying “A and E.” Nobody had had the political courage to say, “Take that notice down.” That was nothing to do with the Labour Government or the coalition that subsequently came to power; it was to do with the staff in charge of the local NHS, who eventually grasped the nettle and said, “No, this is no longer an A and E.” The fuss caused was disproportionate.

For 10 years, nobody had had the courage to say, “This is not right; we are lying to the people of Newark.” Why was this allowed to happen? The Minister is a fellow Nottinghamshire Member of Parliament, so she knows about what happened at Newark, but I do not understand how A and Es can continue to function like this, and how the protocols of the ambulance crews that service A and Es can cope.

[Patrick Mercer]

My hon. Friend has clearly been reading my notes, as that is exactly the point I am going to make. If we look at the composition of the anti-tank platoon of the 1st Battalion, The Royal Anglian Regiment and the composition of the anti-tank platoon of the 3rd Battalion, The Parachute Regiment—I know that you, too, think a lot about these matters, Mr Deputy Speaker —we will see that they are identical; they have the same weapons, the same troops, the same kit and so forth. There is no difference between them. Why, therefore, do we have this byzantine set of organisations in our NHS, so that an A and E can be a sort of an A and E, perhaps, or not an A and E at all, or an MIU-plus—or have a notice outside its door that is wholly misleading?

Why do ambulance services not have a standard set of operating procedures? Why do they call them protocols? Why do protocols vary? Why are not the staff correctly, and centrally, trained to understand what an A and E delivers, so they can know when they arrive at a hospital that the casualty they are carrying will receive the sort of treatment an A and E should deliver? More to the point, why are those ambulance crews not in a position to understand that, perhaps, town X’s A and E—or MIU, or whatever—cannot cope with a certain sort of injury? As a result of all this confusion, we waste time, resources and lives. This is not the province of party politics. Party politics is not worth a damn when it comes to the lives of our constituents.

I recognise, and most people recognise—even the nay-sayers, the negatives, the people who still want a policeman in every village and the return of the home guard, and even those in Newark who do not understand that we are not going to have a general hospital there—that we are never going to have A and Es, in all their glory, returned to towns the size of Newark. However, despite asking for commonality, I ask the Minister to recognise that there has to be flexibility, although I appreciate that that sits uncomfortably with my last point. The Minister understands the country and its dreadful road systems. May we please take a flexible view of these things? Could clinical cases be assisted in places such as Newark, so that minor injury units can indeed provide other critical services than those they currently provide? We do not need to be hidebound by these things, but we do need to be regulated. We do not need to be narrow-minded, but we do need to understand that different communities have different needs, and that roads in particular impose different travelling times and different strains on ambulance services across the country.

A great deal of noise and fuss is made all the time about the A and E, the critical services and the minor injuries unit in Newark, but that is only a fraction of what our hospitals do. It was widely bruited about in Newark until recently that the hospital was going to close, and yet on Monday I helped to open a new ward there. It is not a critical ward, and it has nothing to do with the minor injuries unit or the A and E; none the less, it is an exceedingly important part of the hospital, nine-tenths of which does not deal with critical matters.

[David Morris]

Does my hon. Friend agree with me that the NHS is actually getting better under this Government?

[Patrick Mercer]

Yes, I do. In my own town, things have improved but, by golly, there is a long way to go before we get to where we need to be. There is one thing that I do not agree with my hon. Friend about. The East Midlands Ambulance Service NHS Trust has had the courage to say that it is not performing properly. I appreciate that it is not part of the NHS trust which forms part of Newark hospital. But patently, A and Es, minor injury units—whatever we are going to call them— cannot work effectively unless the communications between each are properly formulated, properly regulated and properly led.