The Secretary of State for Health (Mr Jeremy
Hunt):...However, looking to the future, it is clear we
need to have an honest discussion with the public about the purpose
of A&E departments. Nowhere outside the UK commits to all
patients to sort out any urgent health need within four hours. Only
four other countries—New Zealand, Sweden, Australia
and Canada—have similar national
standards, which are generally less stringent than ours. This
Government are committed to maintaining and delivering that vital
four-hour commitment to patients, but since it was announced in
2000, there are nearly 9 million more visits to our A&Es, up to
30% of which NHS England estimates do not need to be made, and the
tide is continuing to rise. If we are going to protect our
four-hour standard, 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. As Professor Keith Willett, NHS
England’s medical director for acute care, has said, no country in
the world has a standard for all health problems, however small,
and if we are to protect services for the most vulnerable, nor can
we...
Sir (Mid Sussex)
(Con): As a frequent user and admirer of the Red Cross,
I regard its claims as being grossly over the top. I join the
Secretary of State in his tribute to the wonderful work of the
frontline staff of the NHS at a very difficult time. Does he
agree that the pressures are not going to go away, and that there
must be a continuing drive for reform and to do these things
better? What exactly are the impediments in the NHS to the
sharing of best practice, and what steps is he taking to create a
more experienced and better trained leadership who are more
prepared for the exceptional medical and management challenges
that the NHS now faces?
Mr Hunt: My right hon. Friend speaks extremely
wisely. I, too, think that we have to be very careful about the
language we use in these situations because many vulnerable
people can be frightened if we get the tone wrong. The vast
majority of NHS services are performing extremely well under a
great deal of pressure. His point about leadership is extremely
important and one to which I have given a lot of thought. At the
heart of the problem is that we do not have enough hospitals
being run by doctors and nurses. Around 56% of our managers have
a clinical background, compared with 76% in Canada and 96% in
Sweden. To put it bluntly, doctors like to be given instructions
by other doctors. Exceptional people from a non-clinical
background can do it, but it is hard because doctors have many
years of training and are highly experienced people. I have put
in place measures to try to make it easier for more clinicians to
become our managers of the future.
