A&E fears fall on deaf ears

Andy Burnham, Shadow Health Secretary: He'd rather listen to real doctors than spin doctors.

Andy Burnham, Shadow Health Secretary: He’d rather listen to real doctors than spin doctors.

The title of this article should seem brutally ironic, considering that the Coalition government famously ‘paused’ the passage of the hugely controversial Health and Social Care Act through Parliament in order to perform a ‘listening exercise’ and get the views of the public.

… Then again, maybe not – as the Tories (with the Liberal Democrats trailing behind like puppies) went on to do exactly what they originally wanted, anyway.

Have a look at the motion that went before the House of Commons today:

“That this House is concerned about recent pressure in Accident and Emergency departments and the increase in the number of people attending hospital A&Es since 2009-10; notes a recent report by the Care Quality Commission which found that more than half a million people aged 65 and over were admitted as an emergency to hospital with potentially avoidable conditions in the last year; believes that better integration to improve care in the home or community can relieve pressure on A&E; notes comments made by the Chief Executive of NHS England in oral evidence to the Health Select Committee on 5 November 2013, that the NHS is getting bogged down in a morass of competition law, that this is causing significant cost and that to make integration happen there may need to be legislative change; is further concerned that the competition aspects of the Health and Social Care Act 2012 are causing increased costs in the NHS at a time when there is a shortage of A&E doctors; and calls on the Government to reverse its changes to NHS competition policy that are holding back the integration needed to help solve the A&E crisis and diverting resources which should be better spent on improving patient care.”

Now have a look at the amendment that was passed:

“That this House notes the strong performance of NHS accident and emergency departments this winter; further notes that the average waiting time to be seen in A&E has more than halved since 2010; commends the hard work of NHS staff who are seeing more people and carrying out more operations every year since May 2010; notes that this has been supported by the Government’s decision to protect the NHS budget and to shift resources to frontline patient care, delivering 12,000 more clinical staff and 23,000 fewer administrators; welcomes changes to the GP contract which restore the personal link between doctors and their most vulnerable patients; welcomes the announcement of the Better Care Fund which designates £3.8 billion to join up health and care provision and the Integration Pioneers to provide better care closer to home; believes that clinicians are in the best position to make judgements about the most appropriate care for their patients; notes that rules on tendering are no different to the rules that applied to primary care trusts; and, a year on from the publication of the Francis Report, notes that the NHS is placing an increased emphasis on compassionate care, integration, transparency, safe staffing and patient safety.”

Big difference, isn’t it?

From the wording that won the vote, you would think there was nothing wrong with the health service at all – and you would be totally mistaken.

But this indicates the sort of cuckooland where the Coalition government wants you to live; Jeremy Hunt knows what the problems are – he just won’t acknowledge them. And he doesn’t have to – the media are run by right-wing Tory adherents.

So here, for the benefit of those of you who had work to do and missed the debate, are a few of the salient points.

Principal among them is the fact that ward beds are being ‘blocked’ – in other words, their current occupants are unable to move out, so new patients cannot move in. This is because the current occupants are frail elderly people with no support in place for them to live outside hospital. With no space on wards, accident and emergency departments have nowhere to put their new admissions, meaning they cannot free up their own beds.

Health Secretary Jeremy Hunt had nothing to say about this.

Andy Burnham, who opened proceedings, pointed out the huge increase in admissions to hospital accident and emergency departments – from a rise of 16,000 between 2007 and 2010 to “a staggering” 633,000 in the first three years of the Conservative-Liberal Democrat Coalition government.

Why the rapid rise? “There has been a rise in people arriving at A and E who have a range of problems linked to their living circumstances, from people who have severe dental pain because they cannot afford to see the dentist, to people who are suffering a breakdown or who are in crisis, to people who cannot afford to keep warm and are suffering a range of cold-related conditions.”

He said almost a million people have waited more than four hours for treatment in the last year, compared with 350,000 in his year as Health Secretary; the statement in the government amendment that waiting times have halved only relates to the time until an initial assessment – not total waiting time. Hospital A and Es have missed the government’s targets in 44 of the last 52 weeks.

Illnesses including hypothermia are on the rise, and the old Victorian ailments of rickets and scurvy are back, due to increased malnutrition.

Hospitals are filling up with the frail elderly, who should never have ended up there or who cannot get the support needed to go home because of a £1.8 billion cut in adult social services and support. This, Mr Burnham said, was “the single most important underlying cause of the A and E crisis”; ward admissions cannot be made because the beds are full. The number of emergency admissions of pensioners has topped 500,000 for the first time.

Ambulances have been held in queues outside A and E, unable to hand over patients to staff because it is full. That has left large swathes of the country — particularly in rural areas — without adequate ambulance cover.

The government is downgrading A and E units across the country into GP-run clinics, while pretending that they are still to be used for accidents and emergencies – in the middle of the A and E crisis.

People in England are reducing the number of drugs they are taking because they cannot afford to buy them. Families are choosing between eating, heating or other essentials, like prescriptions.

Competition rules have been stifling care, Mr Burnham said: “The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive.”

He added: “Two CCGs in Blackpool have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.”

And the health trust in Bournemouth wanted to merge with neighbouring Poole trust, but competition rules stopped the merger taking place.

Mr Burnham demanded to know: “Since when have we allowed competition lawyers to call the shots instead of clinicians? The Government said that they were going to put GPs in charge. Instead, they have put the market in charge of these decisions and that is completely unjustifiable. The chief executive of Poole hospital said that it cost it more than £6 million in lawyers and paperwork and that without the merger the trust will now have an £8 million deficit.

“The chief executive of NHS England told the Health Committee about the market madness that we now have in the NHS: ‘I think we’ve got a problem, we may need legislative change… What is happening at the moment… we are getting bogged down in a morass of competition law… causing significant cost and frustration for people in the service in making change happen. If that is the case, to make integration happen we will need to change it’ – that is, the law. That is from the chief executive of NHS England.”

The response from current Health Secretary Jeremy Hunt needs to be examined carefully.

He said more than 96 per cent of patients were seen within four hours – but this conforms with Mr Burnham’s remark; they were seen, but not treated.

He tried to rubbish Mr Burnham’s remarks about scurvy by saying there had been only 26 admissions relating to scurvy since 2011 – but this misses the point. How many were there before 2011? This was an illness that had been eradicated in the UK – but is now returning due to Coalition policies that have forced people into malnutrition.

He dodged the issue of competition rules strangling the NHS, by saying that these rules were in place before the Health and Social Care Act was passed. In that case, asked Mr Burnham, “Why did the government legislate?” No answer.

As stated at the top of this article. he did not answer the question of the frail elderly blocking hospital beds at all.

The vote was won by the government because it has the majority of MPs and can therefore have its own way in any division, unless the vote is free (unwhipped) or a major rebellion takes place among its own members.

But anyone considering the difference between the Labour Party’s motion and the government’s amendment can see that there is a serious problem of perception going on here.

Or, as Andy Burnham put it: “This Secretary of State … seems to spend more time paying attention to spin doctors than he does to real doctors.”

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15 thoughts on “A&E fears fall on deaf ears

  1. Barry Davies

    Andy Burnham has been ostracised by the tories but he is the only one coming near to talking sense on the NHS at the present time, certain;y Hunt does not have any sort of clue.

  2. Jean Casale

    7.00pm. Called 111, Mum was not well. Was told a clinician would get back to me soon.
    2 hours later the ‘clinician’ called. When I mentioned Mum has dementia, he asked ‘Has she had it before?”. Was told a doctor would come within 2-3 hours.
    Phoned back a few times, asking when doctor would be here. Was told, “We are very busy”. By 5.00am next morning, I phoned them again and told them not to bother, I would contact her own doctor, who came to see Mum later about 12 noon.
    This is why many people will call for an ambulance, especially for an elderly person with a chest complaint.

  3. hellsbells46

    The only person who has the vision for the future of the NHS is ANDY BURNHAM. I would trust him to deliver a forward looking service. He is genuinely passionate AND informed, his vision of how the service should be developing in the future is one of the best ways of preventing bed blocking. Hunt is just a waste of space and air.

  4. Joseph Smith

    Hunt is way out of his depth, he is one of the countries least capable MPs, however he’s very capable when it comes to trying to grab favourable press and TV headlines, at these times he can move at the speed of light. Our sedgefield MP was instrumental and worked very hard to facilitate Hitachis move to County Durham. Hunt tried to grab the glory and was informed by locals to go f*** himself. Like all the dimwits and miscreants in the coalition he’s self seeking and self promoting first second and third. He’s also clueless untrustworthy disliked and needs to be out of government. Before he destroys the remnants of OUR NHS.

  5. Joseph Smith

    I was fitted with a CRT-D, some weeks after fitting the alarm went off, “controlled panic” ensued phoned the hospital clinic, get here soon as but don’t drive. Friend away wife away, rang for Ambulance, this is not a taxi service I was informed by the helpful operator, called again, patient transport has to be pre-booked. Hospital 35-40 miles away. Called doctors surgery explained what happened. It’s the cutbacks leave it to us. GP rang the hospital then organised an ambulance, got to hospital 5 hours later. They re-set the device. Ambulance volunteer car brought me home. The cutbacks make it impossible to obtain help for non specific events. My point is after a 45 year working life having unwillingly paid huge amounts of tax and NI, when I want an Ambulance for an event concerning my Heart condition get it there. Cameron Hunt and the rest of the useless coalition idiots go screw yourselves. When I ask for the help which by law I’ve been forced to pay for you better ensure its available. Or you get done for culpable manslaughter. You miserable bunch of B……ds.

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  8. jaypot2012

    Well done Andy Burnham – I especially liked the “spin doctors instead of real doctors” – that did make me giggle.
    Nevertheless the rest of the article made me feel sick – this tory led government are a national disgrace where the NHS is concerned, where the health of the nation is concerned and where utter greed leads them.
    I wonder what Labour would do about the state of the NHS (and the fact that competition lawyers are calling the shots!), should they win at the next election?

    1. marje

      totally agrree. Andy Burnham did a great job and made some of the tories look like utter idiots. i found it very interesting to hear some of the denials and comments from the tories. however we know that the ultimate aim is to privatise the NHS.

  9. Colin M. Taylor

    the bTories’ plan is blindingly obvious now: put public services under so much strain that eventually something breaks down. when that happens, there will be a mass outpouring of Outrage from the Tabloids that ‘The NHS is not fit for purpose – the people of Britain deserve better’ and , like a knight on his steed, in will come Unum, BUPA et al …

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