The graph that shows Labour is to blame for the pressures on A&E Andy Burnham has been touring the TV studios this morning. His central claim is that the huge rise in A&E attendance has "nothing to do" with Labour's introduction of a new GP contract in 2004. But what does the data show us? The public record is remarkably clear. The pressure on A&E started to explode from 2004. The reasons are complex, reflecting demographic changes as well as system changes. But some of the facts are stark. Labour's 2004 contract prompted nine out of ten GPs to ditch out-of-hours care. This made it much harder for people to see a GP, except during working hours on a weekday. For most families, this scenario is all-too familiar and the result is increased attendances at A&E. Labour's 2004 deal with GPs was complicated, but the devil is in the detail. For example, buried in the small print, it helped GPs to secure a 50 per cent pay rise, thanks to a new bonus system - and, at the same time, took away any obligation to see patients in the evenings or at weekends. For only a small financial penalty, GPs were allowed to go home early, with almost no incentive to provide out-of-hours care. As the graph above shows, A&E has been under pressure ever since. The debate now is about how we fix that. We need NHS policy based on facts, not populism. Labour are attacking the Government today, but offer no credible answers to how they would deal with the explosion in A&E attendance. For example, the underspend they propose to channel to A&E is money that otherwise goes back to hospitals, and other parts of the NHS. Not only would they be unable to make up for this shortfall, it is financially irresponsible to make commitments based on one year's underspend, as you can't be sure of its levels in future years. To be fair, not everyone on the Left is brashly opportunistic. There are substantive figures in the Labour Party, who understand the long-term problems and will have a contribution to make to this debate. But Labour's panacea of managerialism and debt is not the answer. People will want politicians to solve the underlying causes of this problem; not trade political cheap-shots. And so we will continue to introduce a system that delivers more joined up community-based care for patients with long-term conditions and disabilities, and one which sees greater emphasis on preventative primary care.