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Urgent and Emergency Care
05 September 2022
Lead MP
Steve Barclay
Debate Type
Ministerial Statement
Tags
NHSEmploymentParliamentary Procedure
Other Contributors: 27
At a Glance
Steve Barclay raised concerns about urgent and emergency care in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
With permission, Mr Deputy Speaker, I would like to make a statement on our support for urgent and emergency care. Recent statistics indicate that bed occupancy rates have remained high with one in 25 testing positive for covid-19 compared to about one in 60 currently. The Government has implemented several measures including an extra £150 million funding for ambulance trusts, a £30 million contract with St John Ambulance for surge capacity of at least 5,000 hours per month, and an increase in the number of call handlers to nearly 2,300 by December. Additionally, Health Education England has been mandated to train 3,000 paramedic graduates annually, double the previous figure. The Government is also focusing on delayed discharge issues, launching a national discharge taskforce and an international recruitment taskforce for social care workers. Plans include adding 7,000 additional beds this winter and rolling out autumn booster programmes for covid-19 and flu to protect vulnerable individuals.
Wes Streeting
Lab
Ilford North
Question
Can the Secretary of State confirm that the capacity provided by St John Ambulance is being used today? And will he discuss recruitment issues with his colleague, the Secretary of State for Education?
Wes Streeting
Lab
Ilford North
Question
What are the Government's plans to prevent care home closures due to soaring energy prices and to address staffing shortages without relying on immigration alone?
Wes Streeting
Lab
Ilford North
Question
I thank the Secretary of State for advance sight of his statement, and wish him and the ministerial team well as the new Prime Minister appoints her first Government. I also welcome what he said towards the end of his statement about the importance of vaccination and funding for motor neurone disease. Emergency care is in crisis... What a shameful indictment on 12 years of Conservative mismanagement of the NHS.
Minister reply
Let me start with the areas where the hon. Gentleman and I agree. The David Wakeley case was shocking, and we accept that there have been severe pressures, particularly linked to certain trusts; just 10% of trusts account for 45% of ambulance handover delays... In addition to the taskforce, we have enacted a whole range of other measures.
Question
My right hon. Friend knows that Worcestershire is at the sharp end of ambulance pressures; I understand that Worcestershire Acute Hospitals NHS trust is one of six trusts that he has met in recent days to discuss those pressures. Can he assure me that he will do everything he can to reduce delayed discharge and address capacity at our A&E, so that I no longer have to witness situations such as the one I saw earlier this summer, with more than 10 ambulances waiting at the door of the emergency department?
Minister reply
I know my hon. Friend is a strong champion for this issue; when I was Chief Secretary to the Treasury, I remember him lobbying me about how a bridge from one bit of the hospital estate to another could provide additional capacity to meet the pressures his trust has faced... It is important to recognise that the problem does not always manifest where it is caused. Quite often, challenges on the social care side, or further upstream in the conveyancing rate, put pressure on an emergency department and on the trust.
Toby Perkins
Lab
Chesterfield
Question
The Secretary of State is absolutely right about the abject failure in care that his Government have overseen over the past 12 years, but his statement did not refer so much to the pressures in A&E. It seems entirely wrong that if someone walks into an A&E department they are its responsibility, but if they turn up in an ambulance they are expected to sit in it for hours on end until the A&E is willing to take responsibility.
Minister reply
The hon. Member makes a very fair point. Within the question he raises is the unmet need where an ambulance does not reach a patient in the community, as opposed to the known risk once the patient is within the hospital trust’s purview. On capacity in A&E, we put in £450 million at the 2020 spending review to upgrade A&E facilities at 120 trusts.
Ben Spencer
Con
Runnymede and Weybridge
Question
I very much welcome my right hon. Friend’s statement, particularly the focus on retention, training and recruitment. Earlier this year, I met people from the excellent Chertsey Make Ready Centre. They told me about the challenges that they face with staff wellbeing and staff retention, which are compounded by the horrendous abuse that they receive almost daily.
Minister reply
I am very happy to join my hon. Friend in thanking the staff for their work and in condemning the completely unacceptable violence, intimidation and abuse to which people are subjected.
Rushanara Ali
Lab
Bethnal Green and Stepney
Question
We know that 117,000 people have died waiting for treatment on the NHS waiting list, and what we are hearing now is that 500 people a week are dying waiting for ambulances. Can the Secretary of State give us a date by which he can guarantee that people will not lose their lives waiting for an ambulance to come and get them and care for them?
Minister reply
What I can guarantee is that, through the taskforce, we are prioritising how we get ambulances back on the road and how we speed things up to reduce handover delays. We are looking in particular at the 10 trusts in which the issue is most acute.
Question
National headlines do not often reflect the hard work of those in our local hospitals. Although there will be—indeed, there have been—cases of unforgivable waits, will my right hon. Friend join me in thanking all the hard-working paramedics, first responders and emergency department teams who serve Medway, Maidstone and Tunbridge Wells hospitals, supporting my constituents in their time of need? Will he update the House on any conversations he may have had with the Department for Levelling Up, Housing and Communities about major planning applications that have progressed without the appropriate healthcare facilities being provided?
Minister reply
I am happy to join my hon. Friend in thanking the paramedics in Medway, in Maidstone and beyond for all their fantastic work, especially given the pressures the system has been under during the summer.
Rachael Maskell
Lab Co-op
York Central
Question
The Secretary of State is right to talk about the back door rather than focusing on the front door when it comes to the crisis in social care. About a quarter of the patients in our hospital in York are experiencing delayed discharges. However, if we do not pay care staff, we will never resolve the issue. What consideration has the Secretary of State given to putting those staff on a national pay scale, using “Agenda for Change” as a model?
Minister reply
This obviously involves debates with Treasury colleagues about pay—not just on the social care side, but in respect of the NHS and the interplay with pensions—but it is not just about that; it is also about ensuring that we have the right data.
Julian Lewis
Con
New Forest East
Question
On checking my website, I saw that it was in late 2005—not a period of Conservative government—that my right hon. Friend the Member for New Forest West (Sir Desmond Swayne), the then Liberal Democrat Member of Parliament for Romsey and I were complaining about the closure of in-patient beds in small community hospitals. Does the Secretary of State accept that there is a role for such beds in enabling appropriate discharge from the larger hospitals, thus dealing with one of the main causes of people being stuck in ambulances without being able to be given a bed?
Minister reply
That relates to the point about the need for flow in the system and an appropriate step-down capacity.
Helen Hayes
Lab
Dulwich and West Norwood
Question
In July, the average wait time in London for an ambulance needed by someone describing the symptoms of a stroke was more than an hour—more than three times longer than the target time. Many of my constituents have told me that they are living with genuine anxiety and fear that if they or a loved one were stricken by illness or involved in a serious accident, the emergency help that they needed would not arrive in time.
Minister reply
One of my reasons for going out with the London Ambulance Service over the summer was to answer the charge about what Ministers were doing. As the hon. Lady will know, performance has improved since the summer.
Martin Vickers
Con
Brigg and Immingham
Question
In recent weeks I have been supporting a constituent who has complained to the East Midlands Ambulance Service. The complaint centred on the fact that it took nine hours and 26 minutes following a 999 call for an ambulance to arrive at the home of my constituent’s mother.
Minister reply
I am very happy to ensure that that specific case, which is obviously concerning, is looked at. As my hon. Friend will know from my earlier remarks, we are boosting the number of 999 call handlers—those numbers are up and there are around 350 more call handlers than in September 2021.
Barnsley South
Question
A nurse in Barnsley East wrote about her mother's death due to a brain haemorrhage where the emergency services were unable to provide timely assistance, leading to tragedy. What measures is the Government taking to prevent such incidents?
Minister reply
The government has allocated significant funding including £1.5 billion for GP capacity in 2020, £450 million for upgrading A&E facilities across 120 trusts, an additional £150 million specifically for the ambulance service, £30 million to St John Ambulance and a further £50 million for call handling services.
Philip Hollobone
Con
Kettering
Question
Following his visit to Kettering General Hospital where he confirmed the receipt of £38 million, what is the current assessment and future prospects for A&E capacity at this hospital?
Minister reply
Acknowledging ongoing pressure on A&E departments including that at Kettering, additional funding has been allocated to boost call centre capacity, address conveyancing issues among ambulance trusts and improve patient flow into hospitals.
Mark Hendrick
Lab Co-op
Preston
Question
Will the Secretary of State investigate the proposed closure of Preston’s Blackpool Road and Broughton ambulance stations without consultation, potentially adding 26 minutes to travel times for emergency services?
Minister reply
I will draw this case to the attention of relevant parties and ensure the hon. Member receives a written explanation.
Anna Firth
Con
Southend
Question
What progress has been made on funding for Southend University Hospital's A&E capacity, which has seen 15 ambulances waiting at once due to long-standing capital funding delays?
Minister reply
Additional £450 million was allocated in the 2020 spending review across 120 trusts. NHS England taskforce is focusing on areas under acute pressure.
Helen Morgan
Lib Dem
North Shropshire
Question
Will the Secretary of State consider the Ambulance Waiting Times (Local Reporting) Bill to address disparities between urban and rural response times, following reported deaths from delays?
Minister reply
The federated data platform will provide better local ICS data on operational performance. The government has focused on variation in trust performance contributing to handover delays.
Scott Benton
Con
Blackpool
Question
Will the Secretary of State join me in visiting Blackpool Victoria Hospital to see the impact of new emergency village investment, easing pressures and improving ambulance response times?
Minister reply
As my hon. Friend knows, I would be happy to visit given the opportunity.
Emma Hardy
Lab
Kingston upon Hull West and Haltemprice
Question
What is being done about delayed discharge issues at Hull University Teaching Hospitals NHS Trust leading to excessive bed occupancy due to lack of adult social care support?
Minister reply
Integrated care centre innovations in Hull demonstrate effective use of the Better Care Fund for step-down provision and addressing delayed discharges.
Andy Carter
Lab
Warrington South
Question
Will the Secretary of State urge Bridgewater Community Healthcare NHS Trust and Warrington Borough Council to address a 90-bed shortage in step-down care capacity, impacting A&E wait times?
Minister reply
The ICS will focus on better integrating around step-down provision using the Better Care Fund and ensuring best practices are followed.
Tahir Ali
Lab
Birmingham Hall Green and Moseley
Question
The MP asked about long wait times for ambulances in the west midlands, reporting delays of up to 17 hours and at least 68 deaths since April. He criticised the NHS as being at breaking point due to a decade of Tory cuts and urged for immediate measures to deal with the crisis.
Minister reply
The Secretary of State responded that significant funding has gone into various aspects of the health service, including GP capacity, A&E services, ambulances, call handling, and auxiliary ambulance capacity. He also highlighted that overall NHS funding is a major part of day-to-day Government expenditure and noted the fiscal response during the pandemic.
Debbie Abrahams
Lab
Oldham East and Saddleworth
Question
The MP asked for estimates on how much worse the situation might get over winter months, citing nearly 1,000 excess deaths in August.
Minister reply
In response to this question, the Secretary of State mentioned a range of actions being taken such as setting up taskforces focused on delayed discharge and intensive work with trusts that account for major delays. He highlighted efforts towards improved capacity within call handling and data analysis.
Question
The MP questioned the Secretary of State about the current crisis in his constituency's ambulance service, urging for a return to hospital settings when necessary rather than leaving people in ambulances. He also requested an answer regarding A&E services in Rochdale.
Minister reply
The Secretary of State assured that the letter would be highlighted and acknowledged the point made about moving into hospitals if there are no beds available.
Question
This MP discussed issues with planning in response to the ambulance crisis, referencing poor conditions at Brighton's Royal Sussex A&E. He also highlighted low pay for care workers and called for national terms and conditions.
Minister reply
The Secretary of State stated that there has been extensive planning with integration between social care and the NHS through ICSs (Integrated Care Systems). He mentioned initiatives like the federated data platform to address these issues.
Justin Madders
Lab
Ellesmere Port and Bromborough
Question
The MP inquired about estimates of unnecessary deaths due to delays or non-arrival of ambulances, citing a constituent's harrowing experience.
Minister reply
In response, the Secretary of State highlighted increased funding for doctors, nurses, paramedics and training efforts. He also pointed out that part of reducing demand on ambulance systems is related to GP capacity.
Jim Shannon
DUP
Strangford
Question
The MP congratulated the new Conservative leader, Elizabeth Truss, and requested additional funds for air ambulances in Northern Ireland due to increasing use.
Minister reply
The Secretary of State agreed on the importance of air ambulance services and offered to look into any specific issues mentioned by the MP.
Shadow Comment
Wes Streeting
Shadow Comment
I thank the Secretary of State for advance sight of his statement. The NHS is in crisis with high numbers of patients waiting long hours in A&E and for ambulances, estimated to be costing up to 500 lives a week. Criticising the Government's mismanagement over twelve years, the shadow minister points out that the lack of grip on this crisis shows in recent reports predicting an early winter crisis in emergency care. The Labour Party urges the Secretary of State and his party to take responsibility for the inadequate state of the NHS before the pandemic and admit their failures.
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