NHS and Social Care Funding — House of Commons, 2017-01-11
Topic: Health
Matthew Toby Perkins (Labour, Centre-left): This is a vital issue, and I congratulate my hon. Friend the Member for Leicester South (Jonathan Ashworth) on bringing it before the House. The pressures on our national health service have a multitude of causes. Many of them are societal: whoever was in power would be dealing with an ageing population, limited financial resources and global competition for skills. However, many aspects of the crisis have a political origin, and the Government cannot continue to avert their eyes from that In my contribution today, I want to talk about my own experience of the pressures that our NHS staff, and particularly those in A&E, are facing and ask Members to walk a mile in the shoes of those who are on the frontline, making life-and-death decisions every single day. My exposure to these pressures is both professional and personal. Professionally, in common with many other MPs, I have recently spent time in the A&E department of my local hospital, the Chesterfield royal, shadowing staff on the watch. I have said that my exposure to these issues was also a personal one. Last year, on Friday 15 July, my father died of an aneurysm. Four days earlier, he had been sent home from the A&E department at Coventry and Warwickshire hospital with what a vascular surgeon described at my father’s inquest as "classical aneurysm symptoms". With a history of vascular problems and a previous near-fatal aneurysm, he presented at the hospital’s A&E department, suffering extreme pain in his right groin, radiating to side and back. He was described as being confused and uncommunicative. Yet, after five hours in A&E, he was sent home in a taxi. Four days later, he died in my arms Although individual mistakes by an experienced and, I believe, respected A&E registrar were clearly made in this case, what was particularly haunting was his response to questions during the inquest about why my father was sent home. He recounted the pressures in the A&E department that day, and said that it was non-stop and particularly busy on that Friday afternoon, so that from one case to another, he was constantly having to decide, as he did most days, which sick patients, all of whom needed to be in a hospital bed, to send home this time. He said: "There simply aren’t enough beds for those who need to be in them, so every day we have to make these choices. I probably sent home 5 people that day who should have been in a hospital bed, but those are the choices we are left with, when there aren’t enough beds" He asked if my father minded going home and when he did not object, he stuck him in a cab These pressures and these life-or-death decisions are not unique to that registrar or that hospital. Dr Stephen Hitchin, an out-of-hours doctor and an A&E doctor at Chesterfield royal said: "Chesterfield Royal Hospital have confirmed to the CCG today that they are experiencing SEVERE pressure (RED STATUS) in A&E, Emergency Management Unit, Clinical Decision Unit and critical care beds…This has come from a toxic combination of underinvestment, social care cuts, staff cuts, poor planning and GP surgery shortages. This is a failure of policy from this Government plain & simple. They are to blame & must take responsibility & action to correct this crisis" Another consultant said: "The only thing keeping the wheels even vaguely on is a grim determination and professionalism. Any good will to the system was eroded months ago. The government have thought that Emergency Departments can just soak up exploitation and abuse ad infinitum but we can’t. We have exceeded ‘acceptable tolerances’ long ago." If that is the experience of people working within the system, how can we be surprised when it leads to personal catastrophes? How can we be surprised when doctors on whom we have spent tens of thousands of pounds to train, take the expensive training and move to other countries where they feel they are better appreciated? The experiences of those consultants and registrars were echoed by those I met when shadowing the A&E department at Chesterfield royal. Other issues emerged. Certainly there were people in the A&E department who were not urgent cases and should have been at their GP. When I asked one of them why he had come to A&E, he said it was because he had been trying to get a doctor’s appointment for three days at his GP surgery and just could not get one. The scale of the GP crisis is adding to our A&E crisis, not just because people present who should be seeing a GP, but because problems that could have been sorted out or identified if they were seen early enough escalate without access to primary care. The Government must take responsibility. The cuts in training budgets in 2010-11 and 2011-12 were catastrophic for the provision of the next generation of staff, and we are now reaping the full cost of that decision. Quite apart from the ethics of having to rely on overseas staff to keep our NHS sustainable and the impact that has on health services in developing countries, it is crazy that, at a time of a global shortage of trained medical staff, the Government deliberately cut off the flow of new home-grown recruits The story is similar in nursing. In 2010-11, 25,525 students enrolled on a nursing degree course, but owing to budget cuts, that number had been reduced by nearly 15% within two years of a Tory Government, and even now it is more than 10% down. The staff shortages have also led to a ballooning of agency costs: in the past two years, an additional £2 billion has been spent on agency staff. More and more money is being spent on extra staff and not, as it should be, on patient care We need to remind ourselves that things were different under a Labour Government. A Labour Government led to record NHS satisfaction levels, achievement of the 98% waiting target, a sustainable GP and A&E system, and, in the words of the King’s Fund, the most efficient health service in the world. The Labour Government led to much higher patient expectations, but under the present Government that progress is being eroded. By 2008, after 11 years of Labour investment, the UK’s health spending had finally caught up with that of leading EU nations, but OECD figures show that, once again, our spending is now "significantly below" theirs I am ashamed to say that I am grateful that my father experienced his first life-threatening aneurysm on holiday in Germany. The quality of the emergency care that he received in Munich saved his life and gave us, his family, three more years with him. I regret that the same could not be said of our NHS last year We have it in our hands to make our NHS once again a service admired around the world. Although the challenges that it faces are substantial, they are also predictable. If the Government had listened to those who questioned their cuts in training, the impact of pension reforms on GP retention, the impact of GP shortages on A&E departments and the impact of care cuts in the poorest areas on our health service, we would not be facing the crisis that we face today. The call for further action on A&E waiting times and investment in our care system cannot be ignored The Government seem to be presiding over the managed decline of our NHS, but the scale of this crisis will engulf them if action is not taken now. It means old people struggling to cope; it means the disabled being left in their homes rather than being able to take advantage of things that we all take for granted; and it means people being sent home from A&E departments to die. We must do better.