Thomas Moore: Well let’s look at the workforce then, 36% of hospitals trusts have got vacancies for consultants, training posts aren’t being filled. Where are you going to find the doctors to help out this winter?

Jeremy Hunt: Well, we need more doctors, we need more nurses and you know, we are, we’ve put in place plans to recruit them but it doesn’t happen overnight, you’re absolutely right. And so, some of the things you can find with temporary support and help, but that’s only a short term solution and we will need, going forward more A&E consultants for sure. We’re also going to need more GPs, because we need to have all the alternatives to A&E in the community so that people find it easier to get in front of their GP. I mean, if you look at one of the underlying reasons for the pressure it’s the fact that over the last decade we’ve made it easier and easier to get to see a doctor in A&E but it’s become harder and harder to see GPs who are incredibly busy but the demand feels limitless when you talk to GP surgeries and so we have to address that imbalance too.   The fundamental thing that has to change, is, the role of GPs in primary care for the most vulnerable older people, needs to become a proactive role, where you are checking up on people, finding out how they are, heading off problems before they happen. Rather than a reactive role and I, I have to say that GPs are incredibly busy so in order to make that change we have to find a way of getting more capacity into the system and that is a big challenge but we have to address that because in the end if the NHS is going to be sustainable, it has to be about prevention as much as cure.  

TM: But if you look at this winter, GPs already feel under pressure, they say they can do no more. Who is going to look after all these patients that A&E doctors say should be dealt with elsewhere?  

JH: Well, I think it is a bigger role for GPs, we’ve said we want to recruit 2,000 more GPs and the long term solution is to have better alternatives in the community. But for this winter there are some short term things we can do, which is, you know, giving, making sure that the hospitals that are struggling the most are doing the things that will make the biggest difference. For some of them it’ll actually be recruiting GPs to work in A&E departments, to give that primary care in an A&E department. For some of them it’ll mean having better links with the social services department of the local authority, so that they can discharge people more easily. For some of them it’ll mean having more consultant cover at weekends. So it’s different solutions in different places. But you’re right, those are the short term solutions and we need to make sure we’re addressing the long term problems as well.  

TM: So how confident are you that we won’t see a repeat this winter, of what we had last winter?  

JH: Well it’s going to be very, very tough and, you know, people are working extremely hard, no question about it.  And I, I feel humbled, frankly, every time I go to a hospital A&E department and just see the pressure that people are under and the, you know, the good humour that they work with, under really, really tough circumstances.  But we can get through this winter and it is entirely possible to meet those A&E targets and I’m absolutely determined that we should.  

TM: But the patients’ safety surely has to come first and if there is a shortage of consultants and you know there is this link between the number of consultants and the number of patient deaths and mistakes that are made, surely that must give you a great deal of concern about the winter ahead?  

JH:  Well, we’re very concerned and that’s why we’ve introduced these measures, that’s why the Prime Minster announced half a billion pounds of additional support for A&E departments over the winter period. So, there’s a lot of things happening to give support to those people on the frontline but I wouldn’t want to say that, you know, that we’re not worried about it because, you know, it’s going to be very tough and we understand that.  

TM: You know that if you go to an A&E on a Saturday night the majority people there are because of alcohol, what about charging those who do find themselves demanding care from the NHS simply because they’ve drunk too much?  

JH: Well I understand why people would want that but I think in practise it’s very, very difficult to differentiate between the people who have a health problem because of a direct decision that they’ve taken themselves and people who are, are unlucky. I think establishing that responsibility is a really difficult area and I think it’s also one of the fundamental things that, that we all love about the NHS. That in an emergency you can turn up at a hospital and get treated and I think the day that we started differentiating and saying, well we’re only going to treat some people and other people are going to have to pay, I think, would be a step in the wrong direction.  

ENDS