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

27th May, 2013 3:13 pm

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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  • Alexwilliamz

    With the health and welfare bill, the gvt is effectively abandoning strategic health care provision. Devolving that which is left to local authorities, who i imagine still have no idea what the boards should be/do/work at this stage. And the prime scape goat in cheif will be the gp’s who afterall are going to be given all the ‘freedom’ to mould their own service. If it were not so tragic it would be laughable. Expect more pilatesque hand washing over the coming years, not only in health care but in all the other ‘localised’ and privatised services.

  • A couple of points:

    1) “a crisis caused by this Government’s own cuts” sure, but these cuts are due to the so-called QIPP “efficiency savings” which mean that although demand for healthcare is growing at 4% a year, the year-on-year increase in funding for the NHS is zero, real terms. I agree that these are cuts, but what will Labour pledge to do in 2015? Will you actually give a figure of the real terms increase you’ll allow the NHS to have?

    2) Contributory principle. Liam Byrne is touting this for the other significant part of the welfare state – benefits – will Labour suggest this for the NHS too? If not, then can you drop the entire “contributory principle” thing? If you don’t, then you’ll look muddled and inconsistent.

    3) One of the most important issues with this crisis is that the emergency tariffs are inadequate. That is, the money that hospitals are paid to treat an emergency case is less than they need (and if there are more emergency cases than 2009, hospitals only get 30% of that inadequate tariff). Labour needs to reform this to ensure that hospitals do not make a loss treating emergency cases, and…

    4) “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” sure, but since emergency tariffs are inadequate hospitals need to do elective treatment to subsidise emergency care (elective tariffs are more generous, and oddly, the private sector only does electives, perhaps there is a connection…). When hospitals are full of emergency cases they do not have the beds for electives and hence do not have the subsidy… the result is that hospitals will also suffer a financial crisis.

  • Pingback: LABOURLIST: Tories need to cut spin and get grip of A&E crisis | Andrew Gwynne MP()


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