Accident and Emergency Waiting Times

Phillip Lee Excerpts

Wednesday 5th June 2013 Commons Chamber

[Dr Phillip Lee (Bracknell) (Con)]

It is a pleasure to follow the hon. Member for Ealing North (Stephen Pound). I agreed with some of the points that he made, but I did not agree with all his conclusions and he may not agree with mine.

It is striking that nobody has mentioned the report that was published today by the NHS Confederation and the Academy of Medical Royal Colleges. That report calls for the closure of hospitals and indicates that the funding model for health care in this country is not sustainable in the medium to long term. It is significant that so many organisations that should be respected by this Chamber have come to such difficult and politically unpalatable conclusions.

I have been encouraged by some of the contributions from the Back Benches in the past hour or so. There has been mention of the drivers of demand in this country and across western society, such as ageing, obesity and increased drug and technology costs. As was mentioned by the hon. Member for Ealing North, there has also been a significant change in attitude, which is difficult politically. Essentially, the population is becoming a bit softer. The generation that survived the war, a more stoic generation, would not think or dream of calling their GP in the middle of the night unless their arms were dropping off, but they are passing away and are being replaced by people who think it appropriate to call their GP at midnight because they have had a sore throat for a couple of hours. Clearly, that is not sustainable.

The challenge of the A and E crisis, which is the reason for this debate, is I suspect a first manifestation of evidence that the system is not fit for purpose. It is not fit for purpose before the baby boomer generation hit their 70s, and we should mull on that. We should also recognise the fact that change is inevitable and that hospital closures and reconfigurations will have to take place. My conclusion on how to deal with that is not party political.

An ideological legacy is in play here. We have a system that was designed for a stoic post-war generation—taxpayer funded and copied only by Cuba. We need to recognise that it is not fit for purpose and we need to have some tough debates with the public about how to fund it going forward. A financial legacy is also relevant. A recent one is the PFI scandal of the last few years, but let us be realistic: this country has significant debts and liabilities five times the size of our economy, so it means we need to be realistic about what we can afford in the future.

In conclusion, I agree with Members who said that we should take the party politics out of this debate. I would like to see a plan of where hospitals should be in the future. We need a hub-and-spoke model for acute hospitals; there has to be a national plan, so that we do not see some hospitals unfairly closed and others retained for various legacy reasons. The plan needs to be cross party; otherwise it will not pass. We need to reflect, too, on GP out-of-hours provision. I think GP surgeries should be open for longer and more appointments should be available for about 12 hours a day. I am not so sure that the current out-of-hours service is sustainable or, indeed, advisable in the longer term. Above all, we need a proper informed and rational debate with the British public about what is affordable, what is do-able and what is in all our best interests.