Accident and Emergency Waiting Times

Siobhain McDonagh Excerpts

Wednesday 5th June 2013 Commons Chamber

[Andy Burnham]

I agree entirely. That decision was catastrophic for the NHS. Not only did it siphon £3 billion out of the front line to pay for back-office restructuring; it took people’s eyes of the ball. When they should have been focusing on the front line and patient care, they were worrying about their jobs and which organisations they would work in. The Government were warned about this reorganisation and I will come on to that. I have new evidence, which I will put before the House today, that says that this Government were explicitly warned about the risks to A and E of proceeding with their reorganisation at a time of financial stress. It is pretty damning and I will come on to it later.

What I want to do today is achieve something for NHS staff watching this debate. Let us try to reach some agreement about the causes and the practical steps that now should be taken. First, on social care, which my hon. Friend the Member for Warrington North (Helen Jones) has mentioned, the survey of NHS financial directors says that this is the single biggest cause of the pressure. More than £1 billion has already been taken out of budgets already by this Government, and the Association of Directors of Adult Social Services says that councils are planning further spending and services cuts this year. This is simply not sustainable. It is a false economy. Social care is the preventative part of the care system. If the Government continue to hammer councils, the problem will simply end up on the doorstep of the NHS and it will get bigger and bigger. The human cost will be huge.

We heard at last week’s summit that more and more people with dementia are presenting at A and E. That is intensely sad and it is the wrong place for them to be.

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Does my right hon. Friend agree that the most upsetting comment made at the summit was by the nurse at Kingston who told us of a lady with dementia who, when she is hungry or lonely, phones 999 for an ambulance and says that she has heart pain?

--- Later in debate ---

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

I will be very brief, as I want all Members who wish to contribute to the debate to be able to do so.

It feels as though we are telling the public that somehow they are being irrational by attending A and E. They are being entirely rational, however, if they live in urban London. They are being rational because they cannot get access to their GP services. Their GPs have contracted-in times and their walk-in clinics have been closed, so their only alternative is A and E. The 111 service is also, in effect, A and E, because it is so risk-averse. Our current system is not based on what is best for the patient; it is based on what is going to cause the least legal damage to the NHS if things go wrong.

My local hospital, St Helier, is up for closure despite the fact that its A and E is the only one in south-west London that meets the targets. Its maternity unit is also to close, even though it is the most clinically safe unit in the country. It is very difficult to explain that that is a rational decision to any member of the public, including me.

On issues to do with the NHS and how consultations are carried out, we are told and implored to see things differently. How can we see things differently when consultations do not include the public and when consultations are held over the school summer holidays rather than at a time when people and halls are available, and those of us who rely on voluntary assistance in making our arguments can get people to provide it? Better Services Better Value in my constituency intends to start its consultation at the end of the month and run it over July and August, dismissive of the arguments of the public that they cannot meet that timetable. Better Services Better Value has meetings without announcing where they are or what time they are at, and it does not even use microphones. I have been a publicly elected politician for more than 30 years and some of these NHS meetings I have attended have been the worst I have ever encountered during that time. If we wish to bring the public with us in difficult decisions, we have to be reasonable, fair and straightforward in our proposals. Nobody in my constituency understands why the solution to longer A and E waits is the closure of A and Es that are effective and actually work.