Health secretary Jeremy Hunt has blamed GPs for rising A&E attendances, saying that ‘poor primary care provision’ is the reason for increased pressure on emergency services.
Mr Hunt said four million additional people were going to A&E because of the ‘disastrous’ GP contract negotiated by the previous Government that removed responsibility from the profession for out-of-hours services.
In comments the GPC said were ‘nonsense’, Mr Hunt told MPs today that ‘poor primary care alternatives’ which were the result of the changes to the GP contract were contributing to the ‘huge pressure’ on the emergency services.
A Department of Health spokesperson later insisted that Mr Hunt was ‘clearly not blaming GPs themselves’ and was instead blaming the GP contract for GPs’ ‘working practices that could be much better suited to modern demands’.
Earlier this month, the Labour Party published figures that showed the NHS had missed the national four-hour A&E wait target every week for six months.
In response to a question in the House of Commons about rising pressure on A&E departments, Mr Hunt said: ‘’The reason that there is so much pressure on A&E is because of the disastrous GP contract that was negotiated by her Government, since when an additional four million people every year are going to our A&Es.’
‘That is what is causing the huge pressure. That is what we are determined to put right.’
Responding to another question, Mr Hunt added: ‘We are looking at the root causes of the fact that admissions to A&E are going up so fast - namely, that there is such poor primary care provision; that, as we discussed earlier, changes to the GP contract led to a big decline in the availability of out-of-hour services; and, that health and social care services are so badly joined up.
‘That is how we are going to tackle this issue with A&E, and that is what we are doing.’
But GPC chair Dr Laurence Buckman said the health secretary’s comments revealed an ‘impressively superficial analysis based on no evidence’.
He said: ‘It is the sort of analysis you expect from people who don’t know much about the health service. GP services are available around the clock. They have been before and since 2004 and it is, as I said, a superficial and unwise analysis to say that one is the corollary of the other, as they are not related in any way.’
‘Most GPs were not providing personal access out of hours anyway, it was provided through a variety of out-of-hours routes and that has been the case for the past 30 years, so it would be nonsense to suggest that because GPs haven’t been personally responsible since 2004, therefore casualty is full of people. That is just such fatuous nonsense I question the wisdom of the people briefing the Secretary of State.’
‘It is always useful to point the finger at someone else when actually you are to blame for what has happened, and he and his Government have imposed a contract which is going to significantly reduce access for patients and maybe he should reflect on that.’
A DH spokesperson later said: ‘Jeremy Hunt was clearly not blaming GPs themselves. He was blaming the GP contract which ties GPs to working practices that could be much better suited to modern demands - especially an aging population with more complex needs.’
The exchange came after Mr Hunt had also been fielding questions from MPs over the troubled rollout of the new urgent care number 111, which was branded by Labour MP Diane Abbott as ‘a trademark Government shambles’ after she highlighted the leaked report that was obtained by Pulse last week showing evidence of delays, dropped calls and an 11-hour wait for a call-back.
Jeremy Hunt on the pressure on A&E
Andy Burnham (Leigh) (Lab):
Accident and emergency departments across England are being closed, even though all are under intense pressure. For 11 weeks running, the NHS has missed the Government’s national A and E target. Last week, in places, one in three patients waited more than four hours in scenes not seen since the bad old days of the mid-1990s. What clearer symbol of the growing crisis in A and E is there than a tent as a makeshift ward in the car park at Norwich? The Secretary of State’s failure to address that cannot continue. Nursing jobs have been lost, ambulances are queuing outside A and E and patients are being treated in car parks. When will he get a grip?
The statistic that the right hon. Gentleman will not give the House is that for the year as a whole, which ended last March, the Government hit our A and E target. Furthermore, he still will not tell the House about the disaster that is happening in Labour-controlled Wales, where the A and E target has not been hit since 2009. He still refuses to condemn what is happening there. There is a lot of pressure on A and E, because 1 million more people are using A and E every year, compared with just two years ago. What are the root causes? They are poor primary care alternatives that date directly to the disastrous GP contract negotiated by his Government, since when more than 4 million additional people have been using A and E every year, social care and hospital sectors that are not joined up — Labour had 13 years to sort that out but did nothing — and problems in recruitment that have been made a great deal worse by his disastrous decision to implement the working time directive. It is time he sorted out his own issues before trying to criticise the Government for sorting them out.
Meg Munn (Sheffield, Heeley) (Lab/Co-op):
Under the previous Government, my constituents could get an appointment with their GP within 48 hours. I recently heard of a wait for a routine appointment taking three weeks. Is not this one of the reasons there is such pressure on A and Es, and will the Secretary of State reintroduce the 48-hour appointment?
The reason there is so much pressure on A and Es is the disastrous GP contract negotiated by the hon. Lady’s party in government, since when — I do not know whether she was listening to what I said earlier — an additional 4 million people every year are going to our A and Es. That is what is causing the huge pressure, and that is what we are determined to put right.
Lucy Powell (Manchester Central) (Lab/Co-op):
As we have heard, A and E waiting times are at their worst level for a decade, yet we hear of proposed A and E reconfigurations based on tackling so-called inappropriate presentations. Does the Secretary of State agree that that approach is the wrong way around and that he would be better off tackling why people are going to A and E first, before he embarks on any reconfigurations?
That is exactly what we are doing. We are looking at the root causes of the fact that admissions to A and E are going up so fast — namely, that there is such poor primary care provision; that, as we discussed earlier, changes to the GP contract led to a big decline in the availability of out-of-hour services; and, that health and social care services are so badly joined up. That is how we are going to tackle this issue with A and E, and that is what we are doing.