division_name: Nhs and Social Care Funding
motion: <p class="indent" pid="c335.2/2" pwmotiontext="yes">That this House supports NHS England&#8217;s four-hour standard, which sets out that a minimum of 95 per cent of all patients to A&amp;E will be treated within four hours; notes the widespread public and medical professional support for this standard; further notes that &#163;4.6 billion has been cut from the social care budget since 2010 and that NHS funding will fall per head of population in 2018-19 and 2019-20; and calls on the Government to bring forward extra funding now for social care to help hospitals cope this winter, and to pledge a new improved funding settlement for the NHS and social care in the March 2017 Budget.</p>
  
  <p class="indent" pid="c335.2/5" pwmotiontext="yes">&#8220;There was a point when A&amp;E was completely full and we had no space for a major trauma call that was coming in. The trauma case was going to have to be put into a corridor because the resuscitation area was full.&#8221;</p>
  
  <p class="indent" pid="c335.2/7" pwmotiontext="yes">&#8220;In my A&amp;E &#8216;Corridor Care&#8217; isn&#8217;t unusual, it&#8217;s now the norm. Patient buzzers have actually been installed on the walls in said corridor.&#8221;</p>
  
  <p class="indent" pid="c335.2/9" pwmotiontext="yes">&#8220;We&#8217;re&#8230;trying our best to keep patients safe but there aren&#8217;t enough of us and we&#8217;re on our knees. Doctor and nurses in tears&#8221;?</p>
  
  <p class="indent" pid="c335.2/11" pwmotiontext="yes">&#8220;Over the weekend my bosses repeatedly asked for ambulances to be diverted away from our hospital because we had no beds, but we had multiple requests denied.&#8221;</p>
  
  <p class="indent" pid="c335.2/13" pwmotiontext="yes">&#8220;The A&amp;E is perpetually rammed with the corridor full of ambulance trolleys and paramedics.&#8221;</p>
  
  <p class="indent" pid="c339.1/2" pwmotiontext="yes">&#8220;mismatch between funding and activity&#8221;</p>
  
  <p class="indent" pid="c339.1/4" pwmotiontext="yes">&#8220;falling over in a couple of places&#8221;.</p>
  
  <p class="indent" pid="c339.1/6" pwmotiontext="yes">&#8220;additional funding to support emergency care any time before the next election.&#8221;</p>
  
  <p class="indent" pid="c339.3/2" pwmotiontext="yes">&#8220;we need to have an honest discussion with the public about the purpose of A&amp;E departments.&#8221;</p>
  
  <p class="indent" pid="c339.3/5" pwmotiontext="yes">&#8220;is a promise to sort out all urgent health problems within four hours&#8221;,</p>
  
  <p class="indent" pid="c339.3/7" pwmotiontext="yes">&#8220;but not all health problems, however minor.&#8221;&#8212;[Official Report, <phrase class="date" code="2017-01-09">9 January</phrase> 2017; Vol. 619, c. 38.]</p>
  
  <p class="indent" pid="c339.3/9" pwmotiontext="yes">&#8220;broadening our oversight of A&amp;E&#8221;.</p>
  
  <p class="indent" pid="c339.3/11" pwmotiontext="yes">&#8220;there is merit in broadening our oversight approach, beyond a single metric&#8221;.</p>
  
  <p class="indent" pid="c339.3/13" pwmotiontext="yes">&#8220;The A&amp;E standard has been an important means of ensuring people who need it get rapid access to urgent and emergency care and we must not lose this focus&#8221;?</p>
  
  <p class="indent" pid="c340.1/2" pwmotiontext="yes">&#8220;I do not consider that there is a case for changing the 4 hour standard at this time.&#8221;</p>
  
  <p class="indent" pid="c341.7/2" pwmotiontext="yes">&#8220;we need to be clear that it is a promise to sort out all urgent health problems within four hours, but not all health problems, however minor.&#8221;&#8212;[Official Report, <phrase class="date" code="2017-01-09">9 January</phrase> 2017; Vol. 619, c. 38.]</p>
  
  <p class="indent" pid="c344.4/2" pwmotiontext="yes">&#8220;I refuse to go back to the days when people had to wait for hours on end to be seen in A&amp;E, or months and months to have surgery done. So let me be absolutely clear: we won&#8217;t.&#8221;</p>
  
  <p class="indent" pid="c346.0/2" pwmotiontext="yes">&#8220;commends NHS staff for their hard work in ensuring record numbers of patients are being seen in A&amp;E; supports and endorses the target for 95 per cent of patients using A&amp;E to be seen and discharged or admitted within four hours; welcomes the Government's support for the Five Year Forward View, the NHS's own plan to reduce pressure on hospitals by expanding community provision; notes that improvements to 111 and ensuring evening and weekend access to GPs, already covering 17 million people, will further help to relieve that pressure; and believes that funding for the NHS and social care is underpinned by the maintenance of a strong economy, which under this administration is now the fastest growing in the G7.&#8221;</p>
  
  <p class="indent" pid="c347.7/4" pwmotiontext="yes">&#8220;in part the consequence of allowing a focus on reaching national access targets.&#8221;</p>
  
  <p class="indent" pid="c349.5/2" pwmotiontext="yes">&#8220;We have to persuade those people not in medical emergencies to use other parts of the system to get the help they need&#8221;.</p>
  
  <p class="indent" pid="c350.1/3" pwmotiontext="yes">&#8220;Emergency care in Wales is in a state of crisis&#8230;Performance is as bad, if not worse, as England, in some areas.&#8221;</p>
  
  <p class="indent" pid="c351.0/2" pwmotiontext="yes">&#8220;I truly despair that there will not be an NHS this time next year&#8221;&#8212;[Interruption.]</p>
  
  <p class="indent" pid="c351.2/3" pwmotiontext="yes">&#8220;The NHS is in crisis, the government knows this, CCGs have failed, foundation trusts are failing. GPs are on their knees. So they&#8217;re&#8221;&#8212;</p>
  
  <p class="indent" pid="c351.2/5" pwmotiontext="yes">&#8220;handing it back to local areas and saying, &#8216;you fix it, and by the way there&#8217;s no money.&#8217; It&#8217;s a whole system reorganisation&#8221;,</p>
  
  <p class="indent" pid="c372.0/5" pwmotiontext="yes">&#8220;one of the best things about the NHS&#8221;,&#8212;[Official Report, <phrase class="date" code="2017-01-09">9 January</phrase> 2017; Vol. 619, c. 46.]</p>
  
  <p class="indent" pid="c372.0/8" pwmotiontext="yes">&#8220;no country in the world has a&#8221;&#8212;</p>
  
  <p class="indent" pid="c372.0/10" pwmotiontext="yes">&#8220;standard for all health problems&#8221;.&#8212;[Official Report, <phrase class="date" code="2017-01-09">9 January</phrase> 2017; Vol. 619, c. 38.]</p>
  
  <p class="indent" pid="c374.2/3" pwmotiontext="yes">&#8220;I and my colleagues are frequently overwhelmed, frustrated and in disbelief about the amount of work we need to manage, the difficulties in working across services because of cuts and   changes to policy. Everyone is perpetually exhausted and burnt out. When we&#8217;re not at work because of training, illness or leave we feel simultaneously guilty and relieved.&#8221;</p>
  
  <p class="indent" pid="c384.0/3" pwmotiontext="yes">&#8220;That is why I believe that&#8230;the central challenge of our times is to overcome division and bring our country together.&#8221;</p>
  
  <p class="indent" pid="c384.0/5" pwmotiontext="yes">&#8220;a society that respects the bonds that we share as a union of people and nations.&#8221;</p>
  
  <p class="indent" pid="c385.0/3" pwmotiontext="yes">&#8220;We live in a country where if you&#8217;re born poor, you will die on average 9 years earlier than others.&#8221;</p>
  
  <p class="indent" pid="c387.0/5" pwmotiontext="yes">&#8220;There simply aren&#8217;t enough beds for those who need to be in them, so every day we have to make these choices. I probably sent home 5 people that day who should have been in a hospital bed, but those are the choices we are left with, when there aren&#8217;t enough beds&#8221;.</p>
  
  <p class="indent" pid="c387.0/8" pwmotiontext="yes">&#8220;Chesterfield Royal Hospital have confirmed to the CCG today that they are experiencing SEVERE pressure (RED STATUS) in A&amp;E, Emergency Management Unit, Clinical Decision Unit and critical care beds&#8230;This has come from a toxic combination of underinvestment, social care cuts, staff cuts, poor planning and GP surgery shortages. This is a failure of policy from this Government plain &amp; simple. They are to blame &amp; must take responsibility &amp; action to correct this crisis&#8221;.</p>
  
  <p class="indent" pid="c387.0/10" pwmotiontext="yes">&#8220;The only thing keeping the wheels even vaguely on is a grim determination and professionalism. Any good will to the system was eroded months ago. The government have thought that Emergency Departments can just soak up exploitation and abuse ad infinitum but we can&#8217;t. We have exceeded &#8216;acceptable tolerances&#8217; long ago.&#8221;</p>
  
  <p class="indent" pid="c391.0/11" pwmotiontext="yes">&#8220;The NHS will last as long as there are folk left with the faith to fight for it.&#8221;</p>
  
  <p class="indent" pid="c398.0/2" pwmotiontext="yes">&#8220;centre of excellence for integrated health and social care provision in rural, remote and dispersed communities.&#8221;</p>
  
  <p class="indent" pid="c398.0/6" pwmotiontext="yes">&#8220;bring more care closer to home&#8221;,</p>
  
  <p class="indent" pid="c398.0/8" pwmotiontext="yes">&#8220;ensure provision of safe, high quality care and provide a first class experience&#8221;.</p>
  
  <p class="indent" pid="c401.0/8" pwmotiontext="yes">&#8220;Arthur&#8217;s son was worried that his health was deteriorating because of the many hours he was spending alone in his flat in sheltered accommodation. He was unwilling to participate in group activities because of difficulties hearing. He had had a busy social life, but most of his friends had died...Age UK introduced him to Paul, who had had to retire early after an accident and was feeling increasingly isolated...They play dominoes and cribbage. They dissect the latest football match and reminisce about their time in the building trade&#8212;swapping funny stories of mishaps and adventures. Paul has provided Arthur with good company and a &#8216;link&#8217; back to the job he loved. Arthur has helped restore Paul&#8217;s sense of purpose and self-worth.&#8221;</p>
  
  <p class="indent" pid="c401.0/12" pwmotiontext="yes">&#8220;Find out&#8230;about loneliness among older people in your constituency&#8230;raise awareness&#8230;Become an Age Champion&#8221;,</p>
  
  <p class="indent" pid="c401.0/14" pwmotiontext="yes">&#8220;Take steps to put loneliness in later life on the Government&#8217;s agenda&#8221;&#8212;</p>
  
  <p class="indent" pid="c401.0/16" pwmotiontext="yes">&#8220;and hold them to account for progress&#8221;,</p>
  
  <p class="indent" pid="c401.0/18" pwmotiontext="yes">&#8220;Make the case for investment in local community resources to support sustainable, long term action to help lonely older people, wherever they may be.&#8221;</p>
  
  <p class="indent" pid="c401.0/20" pwmotiontext="yes">&#8220;Support the work of the Jo Cox Commission on Loneliness&#8221;,</p>
  
  <p class="indent" pid="c405.0/2" pwmotiontext="yes">&#8220;We need to have an honest discussion with the public about the purpose of A&amp;E departments&#8221;.</p>
  
  <p class="indent" pid="c413.0/4" pwmotiontext="yes">&#8220;The STPs and national policy are currently pushing for a redesign of services&#8212;primary care at scale and a move to make system-wide organisations. The real punch line is there is no   funding to make these changes. Locally there is talk about an Accountable Care Organisation for Wirral&#8212;meetings of senior managers across health and social care are being held on almost a weekly basis to create a roadmap for this to happen. With no money with which to do it. Having fragmented services and finally recognised the failure and destruction caused by the faux &#8216;internal market&#8217; in the NHS, they are now making services use what pitiful resources they have to try and put it all back together. I truly despair that there will not be an NHS this time next year.&#8221;</p>
  
  <p class="indent" pid="c416.0/5" pwmotiontext="yes">&#8220;Crisis is the new normal&#8221;.</p>
  
  <p class="indent" pid="c416.0/12" pwmotiontext="yes">&#8220;no government that attempts to destroy the Health Service can hope to command the support of the British people.&#8221;</p>
  
  <p class="indent" pid="c417.0/5" pwmotiontext="yes">&#8220;we got less than we asked for&#8221;</p>
  
  <p class="indent" pid="c417.0/7" pwmotiontext="yes">&#8220;stretching it to say the NHS&#8230;got more&#8221;.</p>
  
  <p class="indent" pid="c417.0/9" pwmotiontext="yes">&#8220;No, we don&#8217;t believe the NHS has got all the money it needs&#8221;</p>
  
  <p class="indent" pid="c417.0/14" pwmotiontext="yes">&#8220;Even having sorted that out, if we have a widening gap between the availability of social care and the rising number of frail old people, that is going to show up as extra pressure on them, their families, carers and of course the NHS.&#8221;</p>
  
  <p class="indent" pid="c417.0/17" pwmotiontext="yes">&#8220;The Care Quality Commission is not the only organisation with worries about inadequate adult social care funding and the impact on already clogged-up hospitals.&#8221;</p>
  
  <p class="indent" pid="c417.0/19" pwmotiontext="yes">&#8220;a welcome move, it falls many millions of pounds short of what is needed now&#8212;let alone in two decades.&#8221;</p>
  
  <p class="indent" pid="c417.0/21" pwmotiontext="yes">&#8220;on its knees&#8230;mainly due to a lack of investment in both social and acute health care beds&#8221;.</p>
  
  <p class="indent" pid="c419.1/4" pwmotiontext="yes">&#8220;We have got patients with severe illnesses on chairs receiving drips, antibiotics, medications, and patients with cardiac problems on chairs because there are no trolleys for them to go on to.&#8221;</p>
  
  <p class="indent" pid="c419.1/6" pwmotiontext="yes">&#8220;Patients have absolutely no dignity left.&#8221;</p>
  
  <p class="italic" pid="c423.0/5" pwmotiontext="yes">The House divided:</p>
  
  <p pid="c423.0/6" pwmotiontext="yes">Ayes 209, Noes 295.</p>