A&E is just a barometer of the whole hospital system which is in crisis, says Dr Louise Irvine

BBC London ‘phone in with Dr Louise Irvine this morning on the subject of A&E waiting times being at their highest level for a decade .

BBC LONDON INTRODUCTION: Let’s return to our top story. An unprecedented surge of patients turning up to A&E departments has led to more hospitals declaring major incidents. Amongst them St Peter’s in Chertsey & Ashford Hospital near Heathrow where the majority of outpatient appointments have been cancelled and non-emergency patients have been warned to expect an extremely long wait. Figures are due out this morning which are expected to show that waiting times in A&E are at their highest level for a decade. Some of London’s hospitals are coping with new arrangements after several A&E units were merged.

This is the section of the interview with Dr Louise Irvine.

BBC LONDON: Dr Louise Irvine is standing against the Health Secretary, Jeremy Hunt, in the next election. She is standing for the National Health Action Party. She is a GP in Lewisham. Good morning to you.

DR LOUISE IRVINE: Good morning.

BBC LONDON: So, how are you looking at this situation?

Louise-IrvineDR LOUISE IRVINE: Well, I looked at the figures actually that were published in the 2nd week in December (2014). They showed in fact that the number of attendances is not any higher than in the summer. This is a really interesting fact. The main thing is that the admissions are much higher. The trolley waits and people having to wait for between 4 and 12 hours were at their highest ever. I think the latest stats will show that this is even worse. So, this is an issue of a crisis of hospital beds and hospital facilities. This is something the government is not facing up to. Your report talked about the A&E closures in North West London. There have been A&Es closed around the country. There are not enough beds for the patients to be admitted to in the hospitals and the worst thing is the delayed transfers, people stuck in hospital beds because of cuts to social services budgets, meaning the elderly patients are not able to get the package of care they need to get out of hospital back into the community. These are the big issues. A&E is just a barometer of the whole hospital system which is in crisis.

BBC LONDON: Earlier we spoke to Professor John Ashton, a public health professor. He actually said one of the problems is the country is regarded as a one-size-fits-all NHS. In fact in London he said we had too many beds but not enough GPs and GP surgeries. So, he is contradicting directly what you are saying.

DR LOUISE IRVINE: Well, he is a very clever guy and I hate to challenge him but there is no evidence that London has too many beds relative to the rest of the country. I can certainly send you the statistics about that. Also, London actually meets a lot of demand from beyond London. Some of the beds in London are specialist beds which people go in from outside London so that bumps up the figures. In terms of the hospital beds that you would be admitted to if you were sick London does not have an excess of those.

BBC LONDON: What about his more general point that we are trying to tackle this as if it is one country with the same needs? London is very different to anywhere else. Rural areas have their own problems. Even smaller cities, Birmingham and Manchester, are very different to London.

DR LOUISE IRVINE: Yes. I mean every area is different and that is why we need to have proper planning. What this crisis shows is there has been a complete failure of government planning. We have known for years that hospital admissions have been rising. They have been rising steadily over the years. The theory is that as people are becoming older, they may have more long term conditions, more complex, more likely to get very ill when they do get ill. That is known and we should be planning for that. Jeremy Hunt says there are over 350,000 more people over the age of 75 than 4 years ago. Again, that is a known factor that should be properly planned for. There is supposed to have been investment in out of hospital services. That has actually not materialised. We’ve seen 12% cuts in social services spending. We’ve seen a reduction of about half of a number of district nurses. So, it’s a complete lack of proper investment in out of hospital services. There have been cuts to GP budgets as well. GPs have been working flat out. It is a myth that GP surgeries closed for the entire Christmas time. That is just not true.

BBC LONDON: Lots of surgeries were closed for days on end.

DR LOUISE IRVINE: No. They weren’t. GPs are obliged over Christmas Day, Boxing Day and New Year’s Day (the three public holidays) to provide out of hours cover. They must provide cover. There is out of hours cover of GP services across the whole country. I was working until 6.30pm on Christmas Eve and New Year’s Eve and on the Saturday morning between Christmas and the New Year. I am not unusual. We are very busy as well. That is a fact. So you’ve got A&Es that are busy, ambulances are very busy, social services are under pressure, GPs are extremely busy. This is a whole system in crisis because of underfunding and because of cuts and closures which we have seen. It is not true that NHS funding has been maintained. It was only maintained according to a slight rise above inflation. The real needs have been rising over the years because of a rising population. This in effect means a cut. All the hospitals have experienced 7% year-on-year budget cuts. It is a complete myth to say that NHS spending has been maintained. It has not been maintained to match the growing need.

BBC LONDON: What the government is effectively saying is that it has been maintained. What you are saying is they should have increased it.

DR LOUISE IRVINE: They should have increased it to match need and that is what protecting the NHS budget means to most normal people. You protect the budget so it can continue to meet the needs of the people. It has not been protected to meet our needs.

BBC LONDON: We will have to leave it there. Thank you very much. That is Dr Louise Irvine standing against the Health Secretary Jeremy Hunt in the next election for the National Health Action Party.

Please also read a formal statement from Dr Louise Irvine on the National Health Action Party website: Abysmal government failure to avert A&E crisis.

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