What clearer symbol of the growing Crisis in A and E is there than a tent as a makeshift ward in the car park at Norwich?

As he approaches his third anniversary as Prime Minister, he needs to explain why an A and E Crisis is happening on his watch.

There is a Crisis in A and E, and it is no surprise: he has cut the number of nurses; his NHS helpline is in crisis; and he is wasting billions of pounds on a top-down reorganisation that he promised would not happen.

We hear that last week he was trying to hatch a panic plan to deal with the A and E Crisis.

Where is the evidence to support his contention that that will solve the A and E Crisis?

The Secretary of State attributes the current Crisis in A and E in part to a contract that doctors signed back in 2004 and the fact that large parts of the NHS turn off the lights at 5 pm or 6 pm, which they have done for 60 years.

The Secretary of State seems to have decided that changing GP out-of-hours services is part of the solution to the A and E Crisis.

The Crisis in A and E has happened on this Government's watch.

I hope that the Minister will take the time to address all the issues, and to outline the Government's plan to deal with the Current A and E Crisis that they have caused.

She makes an almost Kafkaesque defence of the Government's NHS record, but will she accept that the awful implementation of the 111 scheme, the collapse of adult social care, the closure of walk-in centres and the huge pressures on the NHS elsewhere in the system have resulted in the present Crisis in A and E?

He has got to do better than this on the A and E Crisis.

Does not the scale of those problems show that, on his watch, there is a Crisis in A and E?

There are people all round this country waiting for hours and hours in A and E, and all they see is a complacent, out-of-touch Prime Minister reading out a list of statistics not about A and E. People want to know about the Crisis in A and E happening on his watch.

Patients waiting on trolleys; operations cancelled; a Crisis in A and E; history repeating itself.

I do not think it is going to solve the A and E Crisis right here, right now, but I do not disagree with it as an aim.

Simply handing it back to the Treasury when there is an A and E Crisis and social care is collapsing is not good enough.

That is important, because the public will rightly ask this simple question: how can it make sense to close A and Es in the middle of an A and E Crisis?

So they knew the risks they were taking when they reorganised the NHS at a time of financial stress; they were warned about This A and E Crisis, but ploughed on regardless.

So Labour's solution to the A and E Crisis is to cut funding to hospitals - about as logical as wanting to reduce debt by increasing the deficit.

I associate myself absolutely with the remarks made bythe hon. Member for Totnes (Dr Wollaston) about tariff reform, but given the time constraints, I will restrict my remarks to one particular issue that is putting pressure on the A and E Crisis.

I was encouraged to hear the Under-Secretary of State for Health, the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) tell the “World at One” yesterday that he wanted to improved GP access, including opening times, in response to the A and E Crisis.

The challenge of the A and E Crisis, which is the reason for this debate, is I suspect a first manifestation of evidence that the system is not fit for purpose.

I have great respect for the shadow Secretary of State, but I do not think the A and E Crisis is as acute as the Opposition like to suggest.

We have a Crisis in A and E; that is clear from this afternoon's debate.

That is a major cause of the A and E Crisis, as fewer older people get the care that they need at home, and ever more have to be admitted to hospital.

Last week Monitor, the regulator for foundation trust hospitals, said that cancer patients are now waiting longer for treatment and diagnosis because of the A and E Crisis in hospitals.

Last week, the Select Committee on Health took expert evidence on the increased pressures in emergency departments and the causes of the Worst A and E Crisis in a decade.

Perhaps the Minister could explain why - at a time when the NHS is facing its biggest financial challenge, when 4,000 nursing posts have been lost and when there is a Crisis in A and E - they have decided to hand the full £2.

The situation with social care is deteriorating by the week and it is causing issues in the NHS, such as the Recent A and E Crisis.

I am sure the Secretary of State is aware of the pattern of the seasons, so if he wants to avoid Another A and E Crisis this winter, can he explain why Bruce Keogh's review of urgent and emergency care will not even report until next spring?

With the NHS already laid low by cuts and reorganisation, the Secretary of State has opened up a new front on staff: nurses repeatedly blamed for not caring enough; hospitals blamed for coasting, as I have said; GPs blamed for causing the A and E Crisis.

This Government have presided over the Worst A and E Crisis in a decade.

This Government have presided over the worst A and E Crisis in a decade.

Given the Crisis in A and E in London, has he any new ideas as to how A and E services should be provided in Lewisham, and if so, will he share them with the local MPs?

If the 2004 GP contract was to blame for the current Crisis in A and E, could the Secretary of State explain why, in 2009-10, over 98% of patients were seen within four hours?

The A and E Crisis in Wycombe results from the closure of the department under the previous Government.

When will the Secretary of State deal with the staffing cuts and budget issues that are actually causing the A and E Crisis?

In view of the continuing and worsening Crisis in A and E, will the Secretary of State concede that closing four out of nine A and E departments and 500 beds at Charing Cross hospital is now unsustainable?

Does the Prime Minister think that the A and E Crisis has anything to do with the fact that he has cut the number of nurses by more than 5,000 since the general election, according to figures published by the Health and Social Care Information Centre?

With so many NHS trusts in deficit and many missing their A and E targets, when will the Minister stop blaming everybody else and get a grip on the A and E Crisis?

People at home will have listened carefully to what the Secretary of State has just said, and they will have one simple question in their mind: why is this man trying to close so many A and Es when we are in the middle of an A and E Crisis?

Across the medical profession they are saying that there is a Crisis in A and E, but the Prime Minister is saying, “Crisis?

There is only one person responsible for the A and E Crisis, and that is him.

What the whole country will have heard today is a Prime Minister complacent about the A and E Crisis and clueless about what is actually happening in the NHS.

Is the Secretary of State aware that the A and E Crisis is creating a huge backlog in specialist procedures, and will Paul Keogh's review take that into account?

Will the Secretary of State give the House an assurance that there will be no Crisis of A and E on his watch this winter?

The report by the Health Select Committee on the A and E Crisis found that only 16% of hospitals had the right level of consultant cover in A and E. Yesterday, we learned that half the vacancies for senior A and E doctors are unfilled, as doctors move to work overseas.

The question is: why was the Health Secretary the last person in the entire NHS to realise that there was an A and E Crisis?

When will the Minister accept that cuts to elderly care have increased pressure on the NHS, and are a major cause of the A and E Crisis?

Today I want to put to the Secretary of State new evidence that the A and E Crisis is deepening, and having a serious knock-on effect on ambulance services.

8 billion from local authority care budgets - Stoke-on-Trent has lost a third of its overall funding - will have no impact on the A and E Crisis?

In my area, the A and E Crisis, which means that many people have to wait more than four hours, is happening because the hospital is running “hot”.

If the Government's answer to an A and E Crisis is to close A and E departments, we really are in trouble in Halifax.

That is why he has an A and E Crisis - because hospitals are full.

Given the A and E Crisis, we need that prevention.

Those situations are combining to leave a Crisis in A and E - we will have that debate on Wednesday, but that is what has been allowed to develop.

How can it make sense to close so many A and E departments in the middle of an A and E Crisis?

I have heard from two senior sources that the Secretary of State has discussed within government whether Cobra should be convened to discuss the A and E Crisis.

Does he accept that there is a Crisis in A and E?

Will the Secretary of State give a straight answer to this simple question: is there or is there not a Crisis in A and E?

I say that because it was 14 years ago, yet I am hearing that this is the A and E Crisis to end all crises.

The Crisis in A and E is of the Government's making.

The fact is that the A and E Crisis - if there is indeed an A and E crisis - has existed and has been endemic in the NHS before and after 2010.

The components of the A and E Crisis might be complex, but the real cause is very simple: you just cannot trust the Tories with the national health service.

Labour colleagues who are facing the closure or downgrading of their A and Es will know what their own communities are telling them, which is that closing A and E units in the midst of an A and E Crisis is utterly perverse and should not happen until and unless trusted alternatives are in place.

That is so significant that the country's top emergency doctor has said that the Current A and E Crisis could have been averted two years ago had the Government heeded warnings of a looming collapse in casualty ward staffing.

The concerns that we have in my constituency and in west London will obviously be replicated across London with the threat of more closures in the midst of an A and E Crisis.

Several hon. Members have referred repeatedly to an A and E Crisis.

Is it the case that worries about winter pressures are greatest in A and E, and that the Crisis in A and E is entirely of the coalition's own making?

The Opposition try to talk up a Crisis in A and E, but unfortunately, such talk does not withstand the facts.

Before Christmas, the Secretary of State said that the A and E Crisis is behind us.

Will he now concede that breaking the coalition agreement promise of no top-down reorganisation has weakened the NHS and made the A and E Crisis worse - [Interruption.

I will come on to say that the single most important underlying cause of the A and E Crisis is the severe cuts that we have seen to adult social care.

How can it make sense to close and downgrade A and Es in the midst of an A and E Crisis?

Only when that is tackled will we begin to address the underlying causes of the A and E Crisis.

The truth is that the Government have failed to get the A and E Crisis under control and it is threatening to drag down the rest of the NHS.

The A and E Crisis will be permanent, unless the Government accept its root causes and remove the barriers to its solution.

The A and E Crisis can largely be placed at the Government's door, because they have not faced up to some of the problems.

The purpose of this debate is to consider the A and E Crisis.

I am concerned that the current Crisis in A and E will continue, and indeed worsen, as a result of continued cuts to social care budgets.

They are utterly complacent, hopelessly out of touch, and in complete denial not only about the scale of the Crisis in A and E, but about how their changes to competition rules are making things even worse.

It will devastate people's lives further and actually cost more, particularly by putting pressure on accident and emergency services while we are having an A and E Crisis.

How can that make sense when we are in the middle of an A and E Crisis?

The truth is that the Crisis in A and E is a symptom of the crisis in elderly care and in relation to getting to see a GP.

Will he remind us again why it made sense to close two west London A and E units in the middle of an A and E Crisis?

Will the Minister accept that his Government have made it harder to see a GP, and have caused the A and E Crisis in the process?

It is increasingly recognised that the causes of the A and E Crisis include the closure of walk-in centres, such as the one in Little Hulton in my constituency and this Government's savage cuts to council budgets, leading in Salford to 1,000 fewer people getting care packages funded this year.

On exactly that point, the Health Committee looked at the A and E Crisis last week and was told by the president of the College of Emergency Medicine that delayed discharges were due to under-investment in the community, by which he meant social care, GPs and district nurses.

Until there are proper answers to that simple question - and agreement about the true causes of the A and E Crisis - we will not be able to move forward with a proper solution, and that is the point of today's debate.

If the causes of the A and E Crisis are deep and structural, as the Secretary of State has implied, why is it that the number of people in London waiting outside A and E in ambulances rose by 66% in one month - between November and December?

That is clearly a central cause of the Current A and E Crisis, exactly as my right hon. Friend is arguing.

The collapse of social care is a root cause of the Current A and E Crisis because it has led to increased pressure at the entrance door of the hospital, and to the exit door becoming blocked.

All those measures could help in the short term, but the truth is that all parties must recognise that there will not be a long-term solution to the A and E Crisis until we face up to the crisis in social care, and rethink how we care for the most vulnerable older people.

The central proposition is that what I described as the “root cause” of the A and E Crisis was the imposition of devastating cuts in social care, which are leaving people unsupported in their own homes.

We have had two major incidents declared in local hospitals in Salford in one week recently, and I have great concerns that this sort of guidance means that it is harder for clinicians to take the steps necessary to resolve the A and E Crisis.

In the past 12 months, more than 1 million people have waited more than four hours in A and E. The Tory care cuts of more than £3 billion have been the root cause of the A and E Crisis during this Parliament.