A&E Crisis

MQT on 2015-01-21
Session date: 
January 21, 2015
Question By: 
Onkar Sahota
Labour Group
Asked Of: 
The Mayor



This month we have seen the worst A&E waiting times ever recorded. In one London Trust we saw the number of patients waiting longer than four hours drop to 56%. Only four trusts achieved the target. Ambulance response times have fallen to critical levels. In some boroughs Ambulances are reaching the most serious incidence in 8 minutes less than half the time. Last month over 2,000 of Ambulances waited outside A&Es over 30 minutes. Croydon University Hospital trust has declared a major internal incident, the London Ambulance Service has appealed for help from neighbouring services while individuals are left hours for help to arrive.

Whatever the causes does the Mayor consider it time to call the situation in London's NHS, Ambulance Service and A&E departments a crisis?


Answer for A&E Crisis

Answer for A&E Crisis

Answered By: 
The Mayor

Boris Johnson (Mayor of London):  Thanks.  Onkar, yes.  This is something that we discussed at the [Assembly] Health Committee a little bit the other day.


I accept that the system is under huge pressure.  Everybody can see that.  There was a massive spike before Christmas.  Attendances at A&Es were very much increased.  We have talked to Anne Rainsberry [Regional Director – London, NHS England] and she is coming in regularly now to City Hall to brief us about what is going on, in spite of - as everybody knows - the limited statutory functions that the Greater London Authority (GLA) has in respect of health.  It is important that we should show a lead.  We are trying to get some reassurances about these response times and the failure of too many London ambulances to get there within the right delay and indeed the excessive waiting times at the A&E itself.


You know my views.  Probably they are shared around the place.  The rise in A&E use is caused by many, many things, but the solution has to include a reform of primary care in London and progress on that whole agenda.


One thing that might console you or interest you is that the London Ambulance Service reported that calls on New Year’s Eve were considerably lower than they normally expect them to be.  That, they think, was possibly because of the new ticketing arrangements that we had or the campaign that we ran to raise awareness of not abusing alcohol and not calling out an ambulance unnecessarily.


Dr Onkar Sahota AM:  Mr Mayor, you did not use the word ‘crisis’.  There is a crisis in London.  We have had 33,000 people wait more than four hours in A&Es in London.  Last month on 2,000 occasions, ambulances had to wait more than 30 minutes to drop off their patients.  We have 400 vacancies for paramedics who live in London.  Yesterday, I was sorry to see Ann Radmore leave as the Chief Executive of the London Ambulance Service.  She had an impossible task: an underfunded service, overstretched by this Government and by the cuts imposed.  She had a very difficult job.


Given all of these things - and I know that you talked about leadership in terms of London Bridge and no one taking responsibility - who is taking responsibility for what is happening in London at the moment?


Boris Johnson (Mayor of London):  Let us be clear.  I have every confidence that things are getting better.  I talked yesterday to Ann [Radmore, Chief Executive, London Ambulance Service] and indeed to her successor, Fionna [Moore] , and things are moving forward.


The recruitment of the paramedics that London is looking for is proceeding apace.  They are arriving ‑‑


Dr Onkar Sahota AM:  From Australia and New Zealand?


Boris Johnson (Mayor of London):  ‑‑ I am afraid from Australia and New Zealand and you know that is because of the chronic failure to train enough in our country.  You will also know about the changes to the statute surrounding paramedic qualifications.  It basically meant that it was much more lucrative if you were a paramedic to get a job at a sports ground or something rather than to work in the Ambulance Service.  That is why we have seen a drain of so many paramedics.  However, they are now arriving in numbers.  We are seeing improvements, as I was assured yesterday, in the response times.


This is a problem that needs to be addressed in the round.  In my view, it will not be properly addressed until people somehow are discouraged from seeking what is effectively primary care at an A&E.  It is very important that we phrase this sensitively because we do not want to discourage people from urgent needs from going to A&E.  However, on the other hand, we do not want people unnecessarily using that vital resource.


Dr Onkar Sahota AM:  Mr Mayor, I agree that we need to do something with primary care.  We have a shortage of doctors there and we have a shortage of premises.  What can we do better next year?  There will be another Mayor in 2016.  What can you do now to prevent a crisis next winter?


Boris Johnson (Mayor of London):  The most important thing is to recruit enough paramedics - and that is happening - and to get the message across to the public about when and how to use the A&E service.  I am encouraged by developments in the last few days.  I went around an A&E recently.  Just in the last few days, I went around an A&E and I was very struck by the ‑‑


Dr Onkar Sahota AM:  Mr Mayor, the problem with A&E is not due to the patients, by the way.  It is due to the service cuts that they are experiencing.  Do not blame it on the patients.


Boris Johnson (Mayor of London):  Can I just finish the point?  I was very struck by the account of the doctors and nurses I met who said that in the last few days - this was last week - or in the last week or so, they had seen a 40% drop in the number of people presenting at A&E and they speculated as to the reasons why that might be.


Dr Onkar Sahota AM:  Thank you, Mr Mayor.


Boris Johnson (Mayor of London):  Perhaps it is because people were starting to go with non-emergency conditions; people were starting to find other ways of seeking treatment.  However, we do not want to encourage people who genuinely have emergency conditions from going to A&E.


Dr Onkar Sahota AM:  Thank you.