A & E fears fall on coalition governments deaf esrs

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."

11 Replies

  • I hate doing politics on here because it is just not supportive to health in so mAny ways. I wonder if it has even occurred to the intelligences why this situation has arisen, could it be that the increased pressures on existing A&E, is the result of the previously actioned closures. As for the reason there are not enough doctors, well that's not rocket science either. The entire problem imo is certain persons have failed to consider the consequences of their actions long term. Like many businesses the focus has been on making a quick buck but generally this is idiot long term planning.

  • Good long term planning is the problem you need a 10 year plan but we do not have a 10 year government most of the time and that is a good thing all sides need to look at what is best for the people not the polls.

  • This is all a prelude to selling off the NHS to the private sector. God help us all. The insane have taken over the asylum.

  • its the insane what are governing us ,shows they don't take there medications ,but I read somewere the commons is covered with crack,xxx

  • The blog post above comes from Mike Sivier whose blog is generally very well worth following and reading for anyone interested.


  • I read somewere that the tories want the ,n,h,s shut and everything private,and whoever wins the nxt election you can bet the tories will install a last policy that cant be overturned by the new elect we are still waiting on being allowed a vote on the e, u,,as I,m not sure but I,ll stand corrected ,any new medication as to go first to the e,u,then hear to this government which takes to long for people who need it,,xxxtime is crucial to people who don't have the time and energy or strength to play ring a ring roses,they still expect our votes no matter how ill we are ,wont get mine ,

  • Hmmm...

    There is SO MUCH that I could say about this.

    Several years ago, I qualified as a Social Worker. I worked very happily for a while in a secure Mental Health Facility. Then (due to a family crisis that demanded my time) I made the foolish decision to move to a new job. Put simply, the job was closer to home, and thus required less commuting time. I envisaged that this would leave me with more of my evening available to deal with the family problems (death of father in law, and my mother's serious illness). So... I left a job I LOVED, and moved to...

    The new post was as a Social Worker in a Hospital Discherge Team. During the interview, I had been made to feel that the team was cohesive, progressive, interested in the improvement of patient care, innovative... genuinely GOOD for patients...

    OH MY GOD! Pretty much the first week I started work, there, I KNEW something was NOT right!

    The team was supposed to be an integrated team of Social Workers, Nurses and Care Assistants. The Nurses were facing job cuts, and pay re-evaluations. THEY made it painfully clear that they resented a new Social Worker joining the team. Furthermore, my colleagues seemed in general disinterested and unhelpful. My induction was near non-existent. I worked unsupervised most of the time (despite rules saying Social Workers should have regular case supervision). I was not provided with even basic - and very vital training - such as health and safety lectures, or fire safety. Worst of all, I did not even have the BASIC REQUIREMENTS to do my own job! NO DESK AND NO COMPUTER!!

    Other problems started to dawn on me the longer I remained there... my Boss was hardly ever visible - he remained cut off in his office. Two Nurses on the team appeared to "run the show", doing whatever they liked, with apparent impunity. Making personal phone calls in work time. Browsing the internet in work time. Taking numerous, and very lengthy, cigarette breaks. Worst of all - making offensive comments about PATIENTS! I recall that, on one occasion, one of them had been hoping to move house. She had a SCREAMING ARGUMENT on the telephone to her estate agent, right in the middle of a busy office! Another time, one of these two women made a comment about a patient I had visited on a Ward. The patient had been anxious about accepting home care, having had bad experiences in the past. My colleague had asked me why I was arranging care for the patient, further implying that because the patient had cancelled care in the past, they "did not deserve it now"! I CANNOT DESCRIBE MY DISGUST. People in CARING jobs are supposed to be CARING!

    I noted further issues... colleagues looking through patients' notes without their permission. Colleagues who, when asked to assess a patient, took so long to get round to doing it that the patient was discharged back home without ever being seen. Colleagues who endlessly used the words "that's not my remit" to get away with providing scant, or no, care for patients. Colleagues who bent rules, ignored policy and procedure - and, frankly, wanted to get paid for doing as LITTLE WORK as they possibly could.


    The simple truth is that there are those who know the problems that exist in the NHS and Social Care. WE ARE NOT TO BE LISTENED TO... SHOOT THE MESSENGER! THAT'S THE CLEAR MESSAGE!

  • I went to a job interview once. They told me you are overqualified for this job! Meaning,we don't want to let you in because we only appoint yes men!

    In times of trouble people pull the blanket (with the food in it) to themselves!

  • This is very sad and my local A&E are at risk of closing for many years we travelled around 20 miles on a country lane to get to the nearest A&E. I think the A&E department's up and down are being abused this in its self is a huge cost to the public purse and don't forget the people who will abuse the NHS regardless, the NHS was set up to treat ill people and if it is sold off I hope both parties never get in again

  • You can't help getting old!

    I go to A and E when my doctor sends me or when she suggests that is the best place for me to go. I put patience in my pocket because I know I shall wait hours. Despite this, I've very often been well treated. But i did notice when I got pneumonia in October last year, they only kept me 5 days and told me to recover at home! I'm glad that I know about my case as I had sent just before going to hospital a sputum sample that the microbiologist revealed to contain TB.

    when I had mentioned that I was perspiring at night in hospital, they just shrugged their shoulders. I looked it up on Patients;co;uk and found out that the cause of night perspiration is either cancer or TB. I started again teh medication that I had had for this particular case.

    I then saw my consultant who confirmed that I had had the presence of the germs of TB. He was pleased I had started the drug - which did indeed stopped my perspiration at night and stopped the bug. One has to be alert for oneself and as much as possible take charge.

  • Excellent posting Daz - thank you - and sorry Blakey disagree that politics is not supportive of health - politics affects and effects every aspect of our lives and whatever our political views we ignore it at our peril.

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