A&E Departments: Staffing

Motion made, and Question proposed, That this House do now adjourn.—(James Morris.)

I should be grateful if Members left quietly, if only because this debate is meant to be about the staffing of accident and emergency departments throughout the whole United Kingdom.

I guess that if general practice is the beating heart of the national health service, A&E departments are the keep-beating heart of the national health service. Everybody in the land has a particular emotional attachment to their local A&E department. Even if they hope that they will never need to go there, many of them will have, from their own family experiences, either a granny, a grampy, an uncle, an aunt or a child who has had to go to A&E and whose life will have been saved. For them, those will be such heightened moments of strong emotion that the local A&E will be vital and essential to them.

Sometimes, in valleys areas in south Wales and in other rural or semi-rural areas of the United Kingdom, A&E departments feel as if they are even more important, because people feel that they need to be close to home and the geography makes it difficult to get to A&E in the critical hour to get the support, help and medical intervention that will save somebody’s life, so the attachment is felt deeply. There has been a big battle in my local area about the Royal Glamorgan Hospital’s A&E department. I am glad that the Cwm Taf Morgannwg health board has decided to put on hold any decision about the future of that A&E during the coronavirus crisis.

There have recently been significant advances in A&E, and we need to praise those who have made those advances. Major trauma centres, which the Government introduced in England—we are soon to have one in Cardiff—have made a dramatic difference in saving literally hundreds of additional lives every year. We should praise all those who have been involved in those decisions.

I congratulate my hon. Friend on securing this Adjournment debate on a very important subject. Does he agree that the staff in A&E departments and across our NHS really should have the protection at work that they deserve? Does he believe that when we look back at the current crisis, one issue that will really come to the fore will be the lack of protective equipment and the lack of testing that has been available up until this point, and I am afraid is still unavailable, for many of our NHS staff?

Two things are vital in this key moment when the NHS is fearing a tsunami coming down the road, if that is not a mixed metaphor. The first is personal protective equipment. My view is that, frankly, every single fashion brand in this country should be devoting every minute it has to trying to deliver enough PPE for all the doctors in our A&Es. Secondly, we should be straining every sinew to ensure that testing is available for every staff member in our health service, because apart from anything else, it will mean that they can get back to the frontline faster.

The hon. Member made a good point about PPE—does he welcome the fact that O’Reillys in Northern Ireland is turning its production to just that? A&E is not a static body or just a building. It is a collection of people who are giving their heart and soul to our community. Will he welcome with me the birth today of Grace Louise Elliott, born at home because her mother could not quite make it to the A&E in time, and yet the staff managed to get the A&E to her home?

That is a brilliant moment, and of course I celebrate it. When I was a vicar, I used to be there for quite a lot of births, giving blessings for babies in the special care baby unit. That is a vital part of the business, as it were, of accident and emergency departments.

I am conscious that the A&E close to me at Ulster Hospital in Dundonald is one where there has been an increase in the number of violent attacks on staff. Does the hon. Gentleman agree that we must protect staff by not only providing them with protective gear but having CCTV and police available?

My heart wants to sink every time I hear of any assaults on emergency workers. That is why I brought forward a private Member’s Bill a few years ago, which I know the hon. Member supported, and I wish the prosecuting authorities used it more frequently. Any attack on our emergency workers is an attack on all of us, because they are there to save our lives and protect us in our most difficult moments.

Does my hon. Friend agree that, as well as our emergency service workers, NHS staff urgently need guaranteed accommodation near their workplace and food supplies, and that the Government need to make those practical things available to them immediately, along with PPE?

One of the things I have been so angry about over the past few days is the panic buying going on, with people virtually elbowing one another out of the way to get the last remaining courgette or tin of tomatoes. When I see that, I think to myself, what will happen when the poor person coming off their long shift at A&E at 8 or 10 o’clock at night finds that there is literally nothing left in the shop to buy? The person who was so greedy, hoarding and selfish will then turn up at A&E in two weeks’ time and be treated by somebody who was unable to get enough food. My fundamental premise is that we can only get through all this together, because in the end we achieve far more by our common endeavour than we do by going it alone.

In the presence of an appropriate Minister, can we urge the point that food supplies ought to be made available at the place of work for key workers? When they come off their unduly long shifts, they should not be in the position of not being able to get any food to take home.

That is an extremely good point. I wonder whether Tesco, Sainsbury’s, Morrisons and all the other supermarkets—once they have managed to recruit more delivery staff—should think about making deliveries specifically to hospitals and other care points, so that there is specific provision for key workers. That could make a significant difference.

What is essential to running a good accident and emergency department is, first, good, strong leadership. That means consultants who are well trained, and not just relying on locums who are on a part-time contract. It requires really strong teamwork. There is just as much value in a calm receptionist or a meticulous cleaner as a well-trained doctor, consultant or nurse. We need resources and training to make an A&E flourish. We need people with an extraordinary set of skills, including the ability to make swift and yet very important, time-critical decisions. We need a wide range of disciplines that feed into the whole of the rest of the hospital. Those people have to be able to deal with strong emotions, from rage and anger to grief, anguish, upset, fear and love, all mingled in a very difficult situation. Unfortunately, they have to be able to deal with the particularly strange combination of adrenaline and alcohol, which sometimes makes an accident and emergency department—especially on a Friday or Saturday night—a very difficult place to be.

The truth of the matter is that we have a great number of shortages in our A&Es across the country. In terms of consultants, we are somewhere between 1,200 and 1,500 consultants short across the whole of the UK. There is a particular shortage at my local hospital, the Royal Glamorgan, which is why it has had to rely substantially on locums for the last year. That is not a sustainable model for the future, which is why I am determined to make sure that the local health board campaigns to recruit more consultants for local hospitals. Other countries have a much higher number of A&E consultants per 1,000 people than we do in the UK. We are aiming to get to one for every 7,000 people, and in most other countries it is one to every 4,000. We still have not reached one to every 7,000, so that is a problem. I would urge any doctor who is thinking of training now, or any young person who is thinking of going into medicine, to please think about being an A&E doctor. You will see over the next few months that we love our A&E doctors almost more than anybody else in the whole of the NHS.

Just for clarification, clapping is not the norm in this Chamber. The reason why it is banned is that if it became the norm and was done many times every day, it would be meaningless once we were in an exceptional situation. This is an exceptional situation, and the hon. Gentleman is right—the whole Chamber and, indeed, our whole Parliament is right—to pay tribute, in a way that will be noticed, to the many people who work in our wonderful health service.

I thank the hon. Member for Rhondda (Chris Bryant) for calling this debate and for leading us in that tribute to the NHS workforce.

As we stand here, our NHS faces daunting challenges, as it will continue to do for weeks and months to come. I, too, want to take a moment this evening to thank each and every one of our health and care staff and their individual families for all they are doing for our country at this most challenging of times. I know they are making incredible sacrifices, selflessly working at the frontline in looking after our families in our hour of need, while their families are at home concerned for their safety and welfare. They are there on the frontline around the clock, tackling this head-on. As a country, we will be eternally grateful to them, and from us all, thank you.

I will also pause, if I may, to mention some of the heart-warming gestures across our communities, such as small businesses and large multinationals offering staff hot drinks and hot food, supermarkets making specific opening times for NHS and social care staff, and hotels and chains making beds available to staff to use. Thank you to each and every one of you. You do our country proud.

I want to assure everyone this evening and, most importantly, all our NHS staff that we are here to support them, and we will not let them down. First, we know the NHS needs more people to fill the gaps when staff have to stay home and to cope with the particular needs of patients with coronavirus. We have made a call to arms to those who have left the healthcare professions in the last three years. The healthcare regulators have been contacting doctors, nurses, pharmacists, paramedics and others to ask them to return to practise to support the coronavirus response, and the response from the workforce has been amazing. At noon today, 1,930 doctors and 5,630 nurses had responded by indicating that they were willing to return to the NHS. They will help the NHS not only to treat coronavirus patients, but to continue other emergency healthcare, including urgent operations and cancer treatments. We are also working with professional leaders across nursing, midwifery and allied healthcare professionals to see how students in their final year of study can provide support at the frontline. Our nursing leaders, staff representatives and university bodies will put out a joint statement on that tomorrow.

There is some indication in the news today that some of the personal protection equipment and material available is not up to standard. Will the Minister confirm that everything the Government are sourcing is of a standard suitable for the needs of staff at the frontline?

I have been absolutely assured that the equipment being supplied to the frontline is appropriate and that it has been tested to make sure that it is fit for purpose.