The Tories need to stop the spin and urgently get a grip on the A&E crisis

Andrew Gwynne

The crisis engulfing Accident and Emergency departments across England is a mess of David Cameron and his hapless Health Secretary’s own making.

The number of people waiting in the back of ambulances to be transferred into A&E has doubled over the last three years, while the number waiting more than four hours to be treated inside A&E has more than doubled.

While David Cameron enjoys the Ibiza sun, back in Britain this Bank Holiday weekend, ambulances are queuing outside emergency departments, patients are waiting for hours to be seen or left on trolleys in corridors and people are suffering.

The Health Secretary appears to be in ‘crisis, what crisis?’ mode.

Instead of getting a grip of a crisis caused by this Government’s own cuts and reorganisation, he has grasped the decade old GP contract as his convenient scapegoat for this occasion.  He’d rather have a fight with doctors than confront his own failing policies.

In 2009, five years after the introduction of the GP contract, 98% of patients were seen within 4-hours in A&E. The deterioration in A&E performance has only happened over the last two years – on David Cameron’s watch. Now, major A&Es have missed their targets for 33 of the 36 weeks Jeremy Hunt has been in the Department of Health.

It’s the usual PR spin of this Government – when things are going wrong on their watch, find someone else to blame.

Mike Farrar, the Chief Executive of the NHS Confederation has said that he “sees no correlation” between A&E four-hour performance and the 2004 GP contract.  A recent King’s Fund report also said that there is no link between the GP contract and the current situation in A&Es.

The ‘perfect storm’ is now hitting the health service.

In something as complex as the NHS there are multiple factors that impact on A&E – including the closure of popular NHS walk-in centres, the failing 111 helpline service, and over 4,000 nursing posts cut on Cameron’s watch.

The Health Secretary needs to sort out the failing 111 helpline service quickly.

He should stop the large-scale closure of walk-in centres and personally review all planned A&E closures.

The Care Quality Commission has found that one in ten hospitals do not have adequate staffing levels.  Jeremy Hunt must act to make sure that all hospitals are safely staffed.

And if GP Out-Of-Hours services are not operating well enough he should work with GPs to improve that provision, not blame them for his own policy failings.

The more fundamental cause of this crisis is the Government’s decision to cut social care funding to the bone.

All councils, whatever their political control, are having their budgets slashed and are increasingly not able to provide the care and support, particularly for older people, that would enable them stay in their homes.

Instead, many older people left without that support are failing to cope at home and ending up at A&E.  But that’s not the whole story.  Failures in social care support hit the NHS at both ends.

Even when an older person is ready to leave hospital, they often can’t return home because the necessary home-care is not available to support them.

So beds remain full, people can’t be admitted to the ward, pressure builds on A&E and ambulances are left queuing to transfer their patients.

It is why we have repeatedly said that you can’t slash social care budgets without there being a direct impact on the NHS.

In this, the century of the ageing society, more and more individuals and families are coming into contact with the social care system.   And as they do, they are left shocked at the level of care charges, dismayed by the lack of home support and angry that their mums and dads, grannies and granddads are ending up in hospital for long periods.

We need a bold response to this crisis, not more political point-scoring.  That is why Labour has proposed radical plans to fully integrate health and social care.

The current crisis in A&E won’t be solved by the Health Secretary’s spin, nor by him ignoring the root cause of the problem.

But when faced with this crisis David Cameron and Jeremy Hunt have been found woefully wanting.

They need to stop the spin and urgently get a grip.

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