Toby Perkins: Thank you Mr Deputy Speaker. The Secretary of State is absolutely right about the abject failure in care that his government has overseen over the last 12 years but his statement didn’t refer so much to the pressures in A&E and it just seems entirely wrong to me that, if you walk in to an A&E department you are the responsibility of the A&E but if you turn up in an ambulance they expect you to sit in the ambulance for hours on end until they’re willing to take responsibility for that. Will the Secretary of State say more about dealing with this so that A&E departments realise however someone arrives, whether they walk through the door or whether they arrive in an ambulance they should be the responsibility of the A&E and the ambulance should be out fetching other people from around their area?

Secretary of State: It’s a very fair point he makes, because actually what’s within the question he raises is the unmet need if an ambulance doesn’t reach a patient in the community as opposed to the known risk in terms of the patient once they are within the hospital trust’s purview. In terms of capacity at A&E, that’s why, I touched on in my opening statement, we put £450 million in spending review 2022, upgrade A&E facilities at 120 trusts. To the specific point he raises, he may be aware of the letter that Stephen Powis, Prof Stephen Powis, the NHS Medical Director and Ruth May, the Chief Nurse, sent at the time of the heatwave, in terms of where risk sits within hospitals and of course there’s further work that the task force has been doing on free cohort and post cohort and observation bays in order that we can better free up that ambulance capacity and get in back on the road.