MPs debate ambulance and emergency department waiting times

Amid the political maelstrom of last Wednesday, MPs found time to debate the continuing ambulance crisis (video). The debate was led by Wera Hobhouse, Lib Dem MP for Bath. There were important contributions made by Lib Dem, Labour and Conservative members.

The government response was given by the Minister for Health, Edward Argar. His view seemed to be that the problems are not as bad Lib Dem, Labour and some Conservative members were suggesting and where there are problems, they are being solved. Watching the debate, I had the distinct impression if MPs were allowed to a appear in fancy dress (Jacob Rees Mogg excepted), Argar would appear dressed as Dumbledore and magic away the problems with a flick of his wand.

Wera Hobhouse:

More and more people are calling ambulance services or attending A&E because they are having difficulties accessing other, more appropriate parts of our health system. National NHS performance figures illustrate that our healthcare service does not have the capacity to meet demand…

Recently, an elderly man was forced to sleep on the floor of a local church [in Bath] as it took 12 hours for an ambulance to arrive—12 hours. A GP surgery ran out of oxygen for a patient due to the time it took for the ambulance to arrive. Ambulance handover delays are a significant patient-safety risk… and up to 90% of the causes of delay are linked to the availability of beds in the hospital.

The RUH has consistently been running with a bed occupancy of over 90% for the past year, which is significantly impacting the hospital’s ability to move patients out of the emergency department [with] 24.3% of its beds occupied by patients who are medically fit…

That is driven by gaps in the domiciliary care and social care markets…The [care] recruitment crisis remains acute…

Many more patients endure extremely long waits but are not captured by the current metric… If we do not know about the extreme delays that our patients are enduring, we cannot take action.

Such delays mean that emergency services are not able to respond to 999 calls from critically ill patients. Instead, they are being held in stacks of hundreds each day, and staff are forced to prioritise among even the most serious cases.

The Liberal Democrats have been sounding the alarm bells for months, calling for an urgent investigation into England’s ambulance services and a review of ambulance station closures, but the Government keep turning a blind eye to the crisis. We are calling for more investment in local ambulance services, an urgent campaign to recruit more paramedics, and enabling trusts to restore community ambulance stations in rural areas in Devon, where waiting times are unacceptably long.

Richard Foord, Lib Dem MP for Tiverton and Honiton intervened:

In south-west England we have the longest waiting times in the country. One paramedic told me that despite his very best efforts to treat patients, there were times when he came across very undignified scenes. He talked about one example of how he came across a lady who had fallen down and had to wait 14 hours for an ambulance to arrive.

Wera Hobhouse:

We are calling for a formal inquiry. The Government need to fund thousands of extra beds to stop handover delays in A&E so that ambulances can get back on the road as soon as possible.

Helen Morgan, Lib Dem MP for North Shropshire:

On 25 May this year, the nursing director of the West Midlands Ambulance Service, Mark Docherty, said that the ambulance trust would face a “Titanic moment” and collapse entirely this summer. He gave the specific date of 17 August. Mark went on to say that patients were “dying every day” from avoidable causes created by ambulance delays. That was 42 days ago. He predicts that we now have another 42 days before the ambulance service in my community collapses…

Ambulance service delays are a symptom of wider issues plaguing the NHS and health services across the country… The Government have failed to address that. They have thrown our hard-working doctors and nurses pretty much under the bus…

West Midlands Ambulance Service reports some of the better response times in the country, but a decent outcome in Birmingham and the black country conurbation is masking a deep crisis in the countryside…

We know there is no quick fix, but one thing the Government could do now… is [to] commission the Care Quality Commission to investigate delays in the ambulance service and their underlying causes…

The Government could also adopt the recommendations of my hon. Friend the Member for St Albans [Daisy Cooper] by commissioning ambulance waiting times by postcode, so that we can direct the resource where it is needed and not just over large regions.

Responding for the government, the Minister for Health Edward Argar defended the government, said statistics could be used for political ends and tried to load the blame for the crisis on Labour. Wera Hobhouse rejoined:

It is not very helpful that we are entering into a party political ding-dong. There is a crisis, and we owe it to our constituents to face it. We are asking the Government, who are in charge, to do something about it.

Edward Argar continued:

It is fair to say that although the ambulance queues and delays are often the most visible manifestation of challenge, they are in many ways a symptom of that broader patient flow and the systemic challenge we face…

The root cause of these issues is hospital bed occupancy. That has consistently remained nationally at around 93%—a level usually seen only during winter pressures… [Wera Hobhouse] called for greater resources to be put in. That has been done. She called for an increase to be made in paramedics and ambulance staff. That has been and continues to be done. None of these are completed works, but they continue to be done. She called for action to stop ambulance station closures or community ambulance station closures. I have to say that those decisions are made clinically by local trusts; the power was not there for the Secretary of State to intervene…

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  • Helen Dudden 9th Jul '22 - 10:03am

    I’ve just been reading about Portugal and its health cover. Someone planning to stay permanently, without residency at present, paid €160 for three visits to a Private Hospital. They had to pay in cash before leaving and comment the treatment was excellent.
    For too many years, the NHS has been poorly backed by Tory cut backs.
    Jeremy Hunt is running for Johnsons post. That’s worrying.

  • David Garlick 10th Jul '22 - 9:37am

    The Conservative mantra is that the costs can always be driven down whilst improvements in Knowledge, training, technology and management will offset the steady and relentless withering away of the cash provided by Govt. Where this doesn’t happen the gap will be filled by those with the finacial resources available to them being looked after by a growing private health care system.
    The NHS is not and never will be safe intheir hands. Those without the resiuces will suffer an ever diminishing level of care.
    We are suffering from us going into coalition (I was always strongly opposed) and the opposition vote being split allowing the Tory minoroty to rule for too long without a reset period of left of center Gov’t.
    Until the money goes in to health care in general there will be little or no improvement rather a continuing decline.

  • It’s not just extra ‘wards/beds’ being needed; it’s the personnel needed to staff them..

    If my 79yo memory serves extra space and beds were created for the Covid emergency. Again, if memory serves, the 8 ‘Nightingale’ hospitals could each hold up to 4,000 beds; but where were the 16,000 staff for those 4k beds to be found? As a report at the time stated, “for an NHS already short of 100,000 staff at the start of the pandemic this would haves have been an’ eyebrow-raising ask’..

    Those hospitals are no more but the understaffing problem remains; A line from the report is even more true now than then (despite inflated government claims)…” But the Nightingales experience also unfortunately highlights the folly of having a chronically under-staffed health service. A properly staffed NHS, which didn’t enter the pandemic in a staffing crisis and with fewer hospital beds than comparable countries, might have been able to make more use of the Nightingales.”

  • Ruth Bright 10th Jul '22 - 1:11pm

    @expats speaking as a clapped out 55 year old if your memory is 79 years old it is a thing of wonder (not being facetious)

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