PARLIAMENTARY DEBATE
NHS Winter Crisis - 5 February 2018 (Commons/Commons Chamber)

(Urgent Question): To ask the Secretary of State for Health if he will make a statement on the Government’s response to the resolution of the House of 10 January on the NHS winter crisis.

I welcome the new Minister to his place. However, the Secretary of State should have been here giving an oral statement, because those were the terms of the motion endorsed by the whole House.

The reason that motion was endorsed is that this winter, in recent weeks, over 95% of hospital beds have been full, we have seen the highest-ever number of A&E diverts, 50,000 elective operations have been cancelled, and urgent operations have been cancelled too. The crisis that our NHS is now in is so deep, and the underfunding so severe, that on Friday NHS England was forced to announce that the target of seeing 95% of A&E patients within four hours is now effectively abandoned until March 2019. If the Secretary of State had come to the House last Thursday, he could have been questioned on the NHS guidance.

Last year, more than 2.5 million patients waited longer than they should have done in A&E. Does the Minister expect that number to rise or fall this year? The 18-week target has already been abandoned. Is it not unprecedented that patients will have to accept, even before the financial year starts, that the NHS will not deliver on key constitutional standards of care? The waiting time standards are legal duties contained in the NHS constitution. What legal advice have Ministers received, or will they be seeking to amend the NHS constitution?

On Saturday, thousands of us took to the streets to demand a fully-funded, universal public national health service—and by the way, we will take no lessons from Donald Trump, who wants to deny healthcare to millions with a system that checks your purse before it checks your pulse. The NHS model is not broke but it does need funding. If this Government will not give it the funding it needs, then the next Labour Government will.

So everything in our NHS is fine, is it?

The Minister will know that pressures in the NHS cannot be viewed in isolation from pressures in the community. It is great to see that he is now part of a Department of Health and Social Care. Will he say what is being done about making beds available in the community, to free up pressures in the NHS?

Scottish National party Members want, first and foremost, to put on record our thanks to NHS staff. A number of members of my family work for the NHS. I spent time with them at the weekend, and we got that time because they were working over the Christmas period. We know that Christmas and the winter period has been profoundly challenging due to flu, but it is important that resources follow that. That is why we have record funding support for the NHS in Scotland and NHS Scotland A&E departments are the best performing in the UK.

Last week, the Scottish Parliament voted to abolish the public sector pay cap and to look at bringing in a 3% pay increase for our public sector workers. That is action, rather than warm words. Far too often we hear warm words from this Government, but in the national health service we need to see action, particularly on the public sector pay cap. What steps is the Minister taking to tackle wage stagnation within the national health service?

All over the world, every winter sees a spike in illness and pressures on healthcare. Does the Minister agree that this Government have been proactive? In fact, for the first time ever, care home staff can receive vaccinations for free.

In the light of the funding problems exposed by the winter crisis, what is the Government’s response to the recommendation of the last chief executive of the NHS, the heads of the Royal College of Nursing and the Royal College of General Practitioners and the retiring head of the Treasury that there has to be a form of earmarked taxation to provide stable, sustainable funding?

If we restore the beds to Milford-on-Sea lost under Labour, it will reduce the pressure on Southampton General, will it not?

Will the Minister tell the House why, on Friday, NHS England suspended the requirement for A&E patients to be seen within four hours until 2019, contrary to the NHS constitution, and will he amend the NHS constitution to reflect this advice?

May I ask my hon. Friend what scope there is as we go forward for conversations between his Department, NHS England and NHS trusts about maximising staff numbers in acute settings in our hospitals during the winter months?

It has been reported to me that out of the 17 cubicles at Lewisham A&E one morning last November, five people were awaiting section with severe mental health problems. One person was there for over 72 hours, another for over 26 hours and another for over 21 hours, and all were there for over four hours. When will the Minister acknowledge that the reason why A&Es cannot cope is that the entire system—from social care and GPs through to mental health—is buckling under the enormous pressure of increasing demand, and when is the NHS going to get the funding it needs?

Despite the challenges this winter, does my hon. Friend not agree that we can be extremely proud in this country that we have an NHS free at the point of delivery to all of our citizens? Will he confirm that that will continue to be the policy of this Government, and does he agree with me that we should not listen to the voices from across the Atlantic saying we should adopt a different system?

In my constituency surgery, two sisters came to speak to me about their father, who went to hospital last month. Because the staff were so overstretched, he was placed in the wrong ward, so he did not get seen by a doctor for four days. Will the Minister reassure the sisters, and will he will pause the downgrade of Huddersfield Royal Infirmary and rethink this so that the winter crisis does not become a daily crisis in the NHS?

Not only are this Government increasing the funding available to the NHS; crucially, they are also training more doctors, with 1,500 more medical school places. Does my hon. Friend agree that that is not only a crucial factor that will address areas such as Lincolnshire, which are under-doctored, but another reason to put a medical school in Lincolnshire?

Given that, according to Age UK, one in three older people admitted to hospital is suffering from malnutrition, will the Minister now accept that cuts to adult social care are putting an avoidable and increasing strain on the NHS?

Will the Minister join me in praising the foresight, dedication and hard work of the staff and management of Luton and Dunstable, which was the first hospital to bring in A&E streaming and now regularly and comfortably achieves the 95% target? Does he agree that we need to be better at moving best practice in the NHS around the whole system more quickly?

North Tees Hospital staff are doing a great job of dealing with the winter crisis, but even they have been struggling this year. The trust says it is going to record its first ever deficit, because it cannot make the £18 million cuts demanded by the Government. Is the answer really to deprive it of more money or to have it set up a wholly owned subsidiary company to cut the terms and conditions of future staff?

May I thank my hon. Friend the hospitals Minister for the extra £2.6 million given to Kettering General Hospital to help it to cope with winter pressures this year; and, through him, my I congratulate the NHS on this year undertaking the most comprehensive flu vaccination programme in Europe and the largest in this country’s history?

Does the Minister not realise that 14,000 beds have been taken out of the national health service on this Government’s watch? People are now being treated in ambulances, which is a disgrace. Is he not taking us back to the Major Government of the 1990s, when people were sleeping on trolleys?

I strongly welcome the extra investment in Essex and Harlow in terms of the winter crisis in the national health service, and I very much hope we get a 10-year plan, as suggested by the Secretary of State. Is my hon. Friend aware of the difficulties that Harlow Hospital faces, in that we have among the highest A&E figures per head in England and a hospital that is literally falling down and not fit for purpose, as recognised by the Department? Will he visit the hospital to see what can be done to help us in our campaign for a brand-new hospital for Harlow?

Before the Minister seeks to deflect my question by telling me how much extra my trust has got—his Parliamentary Private Secretary is diligently looking that up at this moment—let me tell him that I am aware of how much we received: £1.1 million. However, I can also tell him that winter cost us £11 million, so there is still a £10 million cost to our trust budget.

However, there is a double hit, because my hospital will be hit by fines as a result of missing A&E targets and handling targets for ambulances, with £120 per missed four-hour target, £1,000 per missed 12-hour target and £200 for each ambulance affected. Will the Minister make sure that those fines are not levied by clinical commissioning groups, and that that money stays where it is needed, which is in frontline care?

While my constituents will welcome the £1.1 million of extra winter funding, they do not want to believe that this issue is decided purely by knockabout in the House of Commons, which is what some others wish to focus on. Will the Minister reassure me that he will look for independent clinical advice on how to deal with pressures in the NHS and then base his response on that advice?

We all knew this was going to be a difficult winter for the NHS, but I just wondered whether the Minister felt that his Department had helped the situation by delaying the announcement of additional funds until the November Budget, with most trusts not receiving that money until December. That meant that my trust, for example, had to make plans without knowing whether it would get additional funding and that it was taking a risk.

Could I reflect on the rather rosy picture that my colleague from the Scottish National party, the hon. Member for Glasgow East (David Linden), painted of the NHS in Scotland? We have poor waiting times at A&Es, we are closing a paediatric ward in Paisley, and the chemotherapy unit at Station 15 in Ayr is under threat. Does the Minister think that having the highest tax base in the United Kingdom is a threat to recruitment in NHS Scotland, and that higher taxes in Scotland might play to the advantage of NHS England?

It is not just integration that will solve the problems in the social care sector. In Trafford, social care providers are being promised £14.61 an hour from this April—well short of what we need to sustain the home care market. What will the Minister do to ensure that there is adequate funding for home care providers?

I am sure that the Minister did not mean to mislead the House regarding the impact of the flu epidemic on our A&Es, so will he confirm that the delays to people being treated in A&E, and the fact that people have been waiting on trollies in corridors and that ambulances have been queueing at the doors of A&E, predated the flu epidemic?

Can the Minister confirm that accountable care organisations, accountable care services and place-based care are being rebranded as integrated care services? Will he explain whether there is actually any difference between those terms, and will he do all he can to ensure that Members in this House are given the opportunity to scrutinise them, as I believe that they are here to act as a Trojan horse to bring in the break-up and privatisation of the national health service?

The programme to reduce acute hospital services and close blue-light A&Es, like that at Charing Cross Hospital, is about to undergo its fourth change of name in five years—“Shaping a healthier future,” “sustainability and transformation,” “accountable care,” and “integrated care”. Would it not be better to reconsider that policy, which is being driven not by local clinicians, but by his Department?