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NHS England: A&E

Volume 617: debated on Tuesday 15 November 2016

9. What assessment he has made of the performance of NHS England in meeting A&E waiting time targets in the last 12 months. (907205)

Last year, the NHS in England handled 2.4 million more A&E attendances than when this Government took office. There has been a 4.6% increase in attendances, compared with only a 1.2% increase in Scotland. Despite that significant increase in demand the NHS has coped well, with nine out of 10 patients still seen within four hours.

I thank the Minister for that answer, but the truth is it must do better and needs more support. In September, only 86% of patients were treated within the four hour target time in English A&E departments; by contrast, in Scotland it was 95%, for a record consecutive period. Given that winter is coming, what will the Minister do to ensure the service copes?

The hon. Gentleman should know that, according to figures for the most recent month available, 90.6% of A&E attendances were seen within the four hours. We are aware that the system remains under pressure, and are putting efforts into identifying steps through the A&E improvement plan, with five specific measures to improve front-door streaming, back-door discharge and patient pathways through hospitals to improve that performance.

19. Rural areas have high demand for primary and social care that increases the pressure on A&E if it is not met. Given the relationship between primary, secondary, A&E and social care, does the Minister also measure waiting times in primary and social care in the same way? That would give him a fuller picture of the demands on the system that need addressing. (907217)

The short answer is that at present we do not record waiting times in the same way. Tests are being undertaken in relation to waiting times for GPs, but at this point I do not have access to the data.

22. As we are unlikely to reach my question on the Order Paper, perhaps the Minister could now direct his attention to the east midlands where we have problems with A&E, particularly for people in rural areas. For those of us who rely completely on the NHS, this is obviously a matter of vital concern. I just wonder whether we should not have an honest debate about this and recognise that we have an ageing population. Our A&E times are stressed and we may have to either tax people more or even think the unthinkable and charge people for—[Interruption.] See, it is unthinkable, but we have to concentrate on the essentials. Let us have an honest debate about the finances of the NHS. (907220)

My hon. Friend will be aware that the sustainability and transformation plans discussed earlier today are designed to bring closer integration of health providers and commissioners within a health system area, such as the east midlands. The ambition is to integrate better health and social care provision to avoid some of the challenges he identifies.

The A&E target the Minister mentions is actually a measure of the entire acute system. Important in that is the flow of patients from admission through treatment to discharge. In Scotland, delayed discharges have fallen 9% since health and social care were integrated. In England, they have gone up 30%. Does the Minister accept the need to fund social care properly to relieve the back pressure on A&E?

I listen with great interest to what the hon. Lady says, but I gently remind her of two things. First, as the result of the generosity of the Barnett formula, Scotland receives £1,500 per capita more to spend on health than England. Secondly, the Auditor General for Scotland recently reported that NHS Scotland was failing to meet seven out of eight key targets, including waiting times for A&E.

I wonder how many targets are being missed in England. The Royal College of Emergency Medicine report demonstrates that in the 176 emergency departments in England there are only enough consultants to provide the cover of one for 16 hours a day. On top of that, rota gaps among junior doctors are causing safety concerns. What exactly is the Minister going to do this winter and will he agree to lift his ban on locum agency staff to help to keep A&Es functioning?

We recognise that there have been pressures on emergency departments for some years, which is why we have put particular effort into recruiting more consultants. There are, I believe, 50% more consultants working in emergency departments in England than there were in 2010, and 25% more doctors.