HL Deb 13 November 1989 vol 512 cc1083-5

2.57 p.m.

Lord Auckland asked Her Majesty's Government:

What measures they are currently taking to upgrade casualty departments in National Health Service hospitals, and whether they are satisfied with staffing ratios.

Lord Henley

My Lords, in general our accident and emergency departments provide excellent care. A recent Royal College of Surgeons' report identified a need for improvements in the care of the most seriously injured. Following consultations, the Department of Health is giving urgent consideration to these aspects of care.

Lord Auckland

My Lords, I thank my noble friend and kinsman for that Answer, which is partly satisfactory. Will he accept that there is general agreement that there has been improvement in the upgrading of casualty departments? Further, is he aware that at weekends there are real problems both of accommodation for the staff and for patients waiting for treatment, particularly in regard to road accidents, altercations and other such serious problems? Can he also say, where additional staff, particularly doctors, have to be brought in on a short-term or long-term basis, that regional health authorities will not be penalised and that extra funds will be available? Does not the Minister accept that, by doing that, a more efficient service will be given?

Lord Henley

My Lords, we are not aware of any specific problems with regard to weekend facilities in accident and emergency departments. If my noble kinsman knows of any specific instances, I shall be most grateful if he will bring them to my attention. It is for the health authority management locally to decide what level of staffing is necessary and to ensure that that is provided.

Regarding additional staff in an accident and emergency department, again it is a matter for the local health authority to make its own decisions as to what additional staff to take on and to fund that from its existing budget. However, from time to time central funding is provided for specific initiatives. An example of that would be the 100 extra consultant posts made available under Achieving a Balance. It will, however, be a matter for the health authority to make a bid if it considers that central funding is appropriate for its needs.

Lord Mellish

My Lords, the Question refers to upgrading casualty departments. What yardstick is used for that, bearing in mind that some casualty departments are terribly busy? I think of Guy's Hospital in my own locality where the casualty department is out of this world. How do you grade them?

Lord Henley

My Lords, some casualty departments are better than others. We recognised the fact that some needed improvement and that is what both the department and the Royal College of Surgeons have been looking at.

Lord Dean of Beswick

My Lords, is the Minister aware that there has been severe criticism of the Government's policy as regards more centralisation of casualty departments? Centralisation has resulted in the closure of some of the outlying hospitals which historically had casualty departments that worked very well. Is the Minister aware that this situation is causing great concern among people who have to go longer distances for emergency treatment?

Lord Henley

My Lords, I recognise the concern. However, it is very difficult to get the balance exactly right between having a great number of accident and emergency departments that it might not be possible to fund adequately or having fewer and better departments with more time to provide care. I believe that is another problem which the Royal College of Surgeons addressed. As I said originally, we are considering its report.

Lord John-Mackie

My Lords, is there any connection between ambulances and hospitals so as to prevent people being taken to a hospital which is too busy to cope and taken to another hospital which can cope? I particularly have in mind London where there are plenty of hospitals available.

Lord Henley

My Lords, we have always stated that we recognise the importance of the ambulance service in terms of getting patients to hospitals.

Lord Ennals

My Lords, since the Minister has raised the question of the ambulance service, has he a statement to make concerning any action that may be taken by the Secretary of State in the light of the initiative taken by the ambulancemen over the weekend? It would be very encouraging for all those who are extremely concerned at the present basis of cover.

Lord Henley

My Lords, the noble Lord will understand that we are not going to be drawn on to the subject of the ambulance dispute.

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