We have an emergency on the front line of medicine, and it will only get worse

It’s tough in A&E, and not enough doctors will take it on

(Getty Images)

I’ve spent much of the past week getting to grips with draft proposals for the local NHS, and I confess that a lot mystifies me.

When my grandmother was a GP in Glasgow, she would regularly stitch people up, take out their tonsils and even do minor surgery. But despite technological advance, do you know a GP who does that today? And what is it about accident and emergency departments that sets people’s hearts racing? It’s not just the voters, who understandably worry about headlines like “A&E in crisis”. I’m told that the most important drug in many hospitals is adrenalin, as many of the dwindling number of those who choose to work in emergency medicine actively prefer the drama of trauma to the slower-paced work of a physician.

It’s tough in A&E, and not enough doctors will take it on. What puts them off? Much of the work is neither accident nor emergency but involves dealing with elderly patients with a range of interconnected conditions and who would be better dealt with by a specialist. Many teams have several vacancies, so the consultants don’t have enough time to train junior doctors and each doctor will have to do an all-nighter at least once a week.

In Wales we haven’t had to put up with a vast, costly, unnecessary, ideologically driven, top-down privatisation/reorganisation of the NHS as Messrs Cameron, Lansley and Hunt have inflicted on England. But last year, the five South Wales boards advertised for 14 A&E consultants and managed to appoint only one. We have to change that urgently.

The spirit of Nicodemus lives

I also had a couple of days in Hay-on-Wye, which, when it wasn’t dripping in torrential rain, basked in the softly spoken intelligence of both the literary and the How the Light Gets In festivals. The highlight for me was the Oxford professor, Diarmaid MacCulloch, speaking about his book Silence. He reminded us about John Calvin, that theological hater-in-chief, who reserved his especial venom for those he termed Nicodemites, after the Pharisee Nicodemus who came to visit Jesus to receive instruction, but only secretly, at night. The timid, secret Protestants in Catholic France were Nicodemites, as was the Protestant Elizabeth I, attending Mass during her Catholic sister Mary’s reign.

Modern politics is stuffed full of Nicodemites. Collective responsibility, the steering wheel that keeps government on the road, may be sound in theory. A house divided cannot stand, and a party divided stands a pretty good chance of being routed by the electorate. You can’t have a government within a government. So, one for all and all for one is a decent party motto. If a minister, however junior, wants to hawk his conscience around the chamber of the Commons and votes against government policy, he should resign.

But the voters can smell a Nicodemite through the TV screen every time we politicos trot out the party line, and collective responsibility that is too tightly constrained turns parliamentary politics into a parade of clowns. Somehow we have to find a way of doing serious politics that is not so cauterised by collective responsibility, so that even ministers can speak their mind.

Deafening silence from the top

In the 10 days Parliament has been away, we have seen the Woolwich terrorist attack, the European Commission’s initiation of legal proceedings against the Government over the right-to-reside test, the announcement that the courts may be put out to commercial tender and a very worrying change in UK and EU policy on arming Syrian rebels. Every one of these deserves at least a statement and an hour’s questioning in the Commons. But even more bizarre is the fact that although Tories have been endlessly wittering about the EU and the forthcoming Private Member’s EU Referendum Bill, I would lay money that David Cameron will not be making a statement on the EU council meeting that he attended on 22 May, as it is becoming a habit that there is neither a debate before nor a statement after these meetings. Motes, planks, eyes.

How not to do an email campaign

Over the past two or three weeks, MPs have had a steady trickle of emails entitled “get women on board”, urging us to support the European Commission’s proposal for a binding quota of 40 per cent of board members. I’m not intrinsically opposed to the idea. Indeed, I’d count myself in the ranks of the honorary feminists as the advance of women is painfully slow. But this is the most inept round-robin ever. So, some tips on how to email an MP: 1. Include your name; 2. Include your address; 3. Include the name of the MP; 4. Don’t include all 650 MPs in the To section; 5. Sign the email.

You can’t disguise star quality

I see that John Mills has been in the news, as he has given £1.65m in shares in his TV home shopping company JML to the Labour Party, though why anyone should be surprised mystifies me. After all, John was a successful Labour councillor in Camden for the best part of 35 years. In 1992, he and his wife Barbara, who was later the first female Director of Public Prosecutions and who died in 2011, organised the most sophisticated of telephone canvas operations for Glenda Jackson, left, who was standing in next-door Hampstead and Highgate. Based in the Millses’ basement, an array of Labour worthies would ring the doubters and waverers. Any young voter would get Patrick Stewart, who was then in Star Trek: the Next Generation. Years later, when I was finishing a biography of Glenda, I asked Patrick why he had helped out. He replied that for every minute that he was on stage with her in a touring production of Hedda Gabler, he was aroused. ’Nuff said.

Twitter: @Chris BryantMP