National Health Service — House of Commons, 2015-01-21
Topic: Health
Jeremy John Elton Lefroy (Conservative, Centre-right): I entirely agree, which is why I welcome the introduction of an overnight doctor-led service at the County hospital in Stafford, even though I would like such services to go further. A parent whose child is sick with a temperature may not want to be a burden on the ambulance service by calling one out but will still want to be seen at that time, rather than having to wait until morning, so being able to go to such a service gives them reassurance. If the child is particularly unwell, they can then be referred to a specialist centre, but otherwise the parent can be reassured that they can wait until the morning. Such matters are vital for our constituents It is, indeed, a problem to get GP appointments, and it is vital that the issue is sorted out. There are wide discrepancies. In the practice I attend, I can get an appointment the next day not just because they want the local MP to be seen, but because they are very well organised and their patient load is not huge. That is simply not the case in other practices, and some people in my constituency have to wait two or three weeks for an appointment. The problem must be sorted out, and there must be evenness across the country GP surgeries put an additional pressure on A and Es. The statistics show that the patients of some GP surgeries attend A and E far less often than those of other surgeries, because such GPs take the time to have longer appointments and take the trouble to go through problems and deal with them on the spot, whereas others are more inclined to say, "I haven’t got the time, so you had better go to A and E." The statistics show that for some GP surgeries the ratio of patients attending A and E is almost twice that of others in the same area and with the same demographic Delayed discharges have often been referred to in this debate. The figure was relatively stable until the start of 2014-15, but since then the total number of delays has risen by 19%. The King’s Fund analysis suggests that delays attributable to NHS services have risen from 60% to 68%, whereas those attributable to social care have fallen from 35% to 26%. It states: "This suggests that capacity and workforce issues, particularly in nursing homes and non-acute services" —within the NHS— "are becoming more important than social care funding" I find that very interesting. I do not know on what evidence it is based, but the King’s Fund is a respected institution and we must look at what it says. It implies that there is an issue with integration not just between the NHS and social care, but between acute NHS services and non-acute NHS services So what should we do? First, we have to recognise that there will be increasing demand for complex acute care and, hence, for accident and emergency services. A and E departments therefore need to remain open and to expand. I welcome the fact that the A and E in Stafford will double under the investment plans. Secondly, we need clear pathways for out-of-hours care, rather than complicated pathways that are difficult to understand. Thirdly, we need clear information relating to those pathways. Fourthly, we need to do much more work on access to GPs and must look much more closely at the results of GPs in avoiding A and E admissions among their patients. Finally, we need to make integration a reality, not just between health and social care, but within all NHS services and social care.