NHS and Social Care Funding — House of Commons, 2017-01-11
Topic: Health
Rosalie Winterton (Labour, Centre-left): It is always important to look at the feedback from clinicians, and I did that as a Health Minister. It started during my time as a Minister, and I remember that we had constantly to consider whether there was a clinical reason for reducing the 95% target. It became clear that some patients needed longer to be assessed owing to their particular condition. In such cases, I could see why the target might need to be reduced, but that was based on clinical need. By contrast, the impression given last week was, "My goodness! We’re going to have to cope with some winter pressures. Let’s reduce the target in order to meet it," rather than there being an assessment of clinical need. That sent completely the wrong message to the NHS. I think it was the wrong thing to do I want briefly to set out some areas in which we can bring the community input together with what is happening in emergency departments to reduce some of the pressures. The first point was that made by my hon. Friend the Member for Leicester South (Jonathan Ashworth), who spoke from the Front Bench. Good social care is vital to ensuring that people do not end up in A&E. I have previously raised problems with the Government’s current proposition to, in a sense, move responsibility for raising money to local councils. That is particularly unfair in areas such as mine, which simply cannot raise the same amount of money through a council precept as better-off areas can. It simply does not work. We need it probably more than any other area, but we will be less able to raise the money On shortages, I have been talking to senior NHS staff in Doncaster, and there are real problems with emergency care staffing. They tell me that although more doctors are being trained—I accept that—it will take years for them to come through. The single most effective step we can take to ease pressure on A&E departments is immediately to increase funding for social care, because it would keep people out of A&E departments, and it could be done straightaway. The personnel are out there; the Government just need to increase the funding, as my hon. Friend said from the Front Bench We also have to look seriously at the problem of GP shortages. As others have said, if patients are waiting three weeks to get an appointment with a GP, they are bound to end up in A&E. This needs to be addressed very quickly, with proper forward looks at exactly where the gaps are in GP services. I have said before that PCTs—now clinical commissioning groups—or NHS England should be able to take over practices and employ salaried GPs. That would make a huge difference Furthermore, on community pharmacies, if people are confident that going to a pharmacy will save them a visit to A&E, again that will relieve pressure on the system. I hope, therefore, that the Minister will assure us that he is looking seriously at the community pharmacy forward view, which sets out how pharmacies can be integrated into the NHS and social care Briefly on mental health, the Prime Minister answered a question today about mental health and the crises that people can get into, which mean that they end up in A&E. She talked, in particular, about young people. I urge the Minister to consider the role that educational psychologists can play in children’s mental health and in keeping them out of A&E It was my experience as a Health Minister that we needed people on the ground locally to help organisations across the spectrum—local government through to social care, pharmacies, GPs and ambulances—to work with A&E departments, yet the £2 billion reorganisation that removed PCTs and strategic health authorities has made it much more difficult to drive through the necessary changes. I hope, therefore, that the Minister will look very seriously at what has happened, because local knowledge can be vital On the basis of the Secretary of State’s contributions, it seemed that he was trying to use every excuse not to face up to the reality of what is happening. I think that sends a terrible message to NHS staff. I hope that, as a result of today’s debate, the concerns raised will be taken on board by Ministers and the Secretary of State and that they will come back to us with a proper plan that recognises the problems and offers real solutions.