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House of Commons
Tuesday 18 June 1991
The House met at half-past Two o'clock
PRAYERS
[Mr. Speaker-- in the Chair ]
PRIVATE BUSINESS
London Underground (Victoria) Bill
Heathrow Express Railway
(No. 2) Bill--
Lords amendments agreed to.
Oral Answers to Questions
HEALTH
NHS and Community Care Act 1990
1. Ms. Quin : To ask the Secretary of State for Health if he will make a statement on the provision of training for local authority staff in preparation for their responsibilities under the National Health Service and Community Care Act 1990.
The Minister for Health (Mrs. Virginia Bottomley) : Training for local authority staff is the responsibility of the employing authority. Our specific grant provision to local authorities for the training support programme this year was increased by 25 per cent. to £25 million. In addition, local authorities should be spending at least £10 million of their own resources on training.
Ms. Quin : Is the Minister aware that many local authorities, including my own in Gateshead, are expressing considerable concern that not nearly enough funds will be available to provide the training that will have to be introduced if community care is to be implemented properly? Will she have urgent discussions with the local authorities on this matter and assure us that the necessary steps will be taken to ensure that recruitment is at its proper level so that community care can become a reality instead of the pretence that it seems to be at the moment?
Mrs. Bottomley : I assure the hon. Lady that we have had close discussions on the implementation of community care. Only last week my right hon. Friend the Secretary of State introduced a check list to ensure that all local authorities and health authorities are properly prepared for full implementation. Central Government have been playing their part. In the hon. Lady's constituency, there has been a 50 per cent. increase in the amount of money that is available for training social workers and I am pleased that that is being used to train three times as many social and other community care workers this year.
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Mr. Thurnham : Will my hon. Friend make sure that local authority workers are trained to make the best use of voluntary and independent groups? Local authorities should not have a monopoly on community care.
Mrs. Bottomley : This is always a difficult issue for the Labour party, given that one third of its Members are sponsored by the health unions. The Conservative party has traditionally had a high regard for the role of the voluntary sector. We envisage the local authorities being enablers and facilitators in a close partnership with the voluntary sector. That is often an extremely productive way of providing high-quality services.
Mr. Rooker : Leaving the party politics to one side for a moment, may I ask whether the Minister agrees that local authorities welcome the addition to the training programme? There is no question about that. However, exactly when did the hon. Lady warn the local authorities about the full consequences of the reforms for elderly and disabled people? Does she now appreciate that duties that were once the sole province of the district nurse are now being carried out by home carers? I refer to bathing, caring for the terminally ill at home and the application of medication. That work is now being placed on local authority social service departments and on the home care service. Will the Minister explain why those tasks have been transferred from the district health authorities to the social services departments, if not for budgetary reasons?
What will be the full consequences-- [Hon. Members :-- "Come on!"] Oh yes. These are not party political points ; I apologise for that. Where was it was ever specified in guidance from the Department or in regulations that the local authorities had been warned about all the consequences of national health service reforms?
Mrs. Bottomley : The hon. Gentleman should address the content of the original Griffiths report on community care. The distinction between health care and social care is one of long standing in the provision of services. To undertake the tasks for which they are responsible, local authorities have this year been given the largest increase for 15 years in the amount that we think that they should spend. They have been given a 23.5 per cent. increase in the amount available for spending. Certainly, the implementation of community care depends on close, effective working relationships between family health service authorities, district health authorities and local authority social services departments. I urge the hon. Gentleman to look at the important check list launched by my right hon. Friend the Secretary of State last week. It addresses precisely the need to ensure that the frail and vulnerable receive a seamless service and do not fall down the gaps between different types of provision.
Mr. Rowe : My hon. Friend will be aware of how welcome the extra money has been. Can she give us an assurance that the training that is provided is consistent with national vocational qualifications? Can she also confirm that her Department is looking forward to the time when it will be easy to interchange social workers between Britain and other European Community countries?
Mrs. Bottomley : Once again, my hon. Friend identifies a matter of great importance. The establishment of national vocational qualifications within social services and health services offers additional flexibility in the
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provision of care. There has been a substantial--25 per cent.--increase in the amount of money available to the training support programme. Certainly, some of that is being used to resolve the question of vocational qualifications. The subject of interchangeability of qualifications with others in the European Community is one on which I have frequent discussions with members of the British Association of Social Workers and others who represent social workers' interests.Baby Units
2. Mr. Madden : To ask the Secretary of State for Health how much has been spent on special care baby units in the NHS in each of the last two years.
Mrs. Virginia Bottomley : Specific information on expenditure on special care baby units is not collected centrally. In 1988-89 and 1989-90- -the latest years for which information is available--total estimated expenditure on maternity and paediatric services was £1,192 million and £1,251 million.
Mr. Madden : Will the Minister persuade the Bradford hospital trust to stop the planned closure of the special care baby unit at St. Luke's hospital in Bradford? If the unit closes, more sick babies will have to be transported across Bradford city centre, or even treated in Leeds or as far away as Manchester. Will she also press the trust to review the centralisation of maternity services which would result in 6,000 babies being born each year under one roof? Lastly, will she persuade the Secretary of State for Health to stop being a wally and accusing me of scaremongering about redundancies as we now know that in Bradford there will be 250 redundancies by next April, rather than 300 over the next three years?
Mrs. Bottomley : The hon. Gentleman is showing the thinking of neanderthal man. He takes an unreconstructed approach to how we can improve the perinatal mortality figures in Bradford. We all agree that the figures need to be improved, but we shall not do so through the reactionary holding on to jobs that is so typical of union-sponsored Labour Members of Parliament. As ever, the Transport and General Workers Union is holding on to its own. The hon. Gentleman should think of his constituents, not of his trade union. He should think of the health of the nation and the strategy for health. In his area the general practitioner list size has fallen by 500 over the past 10 years. The hon. Gentleman should look to health visitors, midwives and community services, not merely to hospital provision. The role of the district and its purchasing function is to make sure that the figures, about which we all share concern, are brought down.
Mrs. Peacock : How many low birthweight babies now survive the most crucial first four weeks of their life?
Mrs. Bottomley : Ninety per cent. of low birthweight babies now survive their first four weeks of life. We have had the most dramatic improvement in perinatal mortality figures. Indeed, we beat the World Health Organisation targets for Europe and, of course, the general targets, too. We now wish to make sure that some of the regional variations are dealt with better because although in some parts of the country the figures are excellent, others lag behind. That is the result of a complex series of matters.
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NHS Trusts
3. Mr. Buckley : To ask the Secretary of State for Health if he will make a statement on his projections for the future activity levels of NHS trusts.
The Secretary of State for Health (Mr. William Waldegrave) : I expect further significant growth in the activity of national health service trusts roughly in line with increased activity across the NHS as a whole.
Mr. Buckley : Does the Secretary of State realise that those who run, work in and use the national health service see no benefit from the introduction of hospital trusts? Does he further realise that those who work in the NHS consider that the job losses that are occurring as a result of the introduction of hospital trusts will have a direct bearing on patient care to the detriment of the service? Does the right hon. Gentleman consider all that to have been a satisfactory outcome of the implementation of the Government's hospital trust policy? Does he further consider-- [Interruption.]
Mr. Speaker : Order. The hon. Member is about to ask a third question. I think that is enough.
Mr. Waldegrave : The hon. Gentleman is completely wrong. More than 100 new applicants for trusts are coming along, supported by many thousands of senior clinicians and managers in the health service. My constituents are served well by a trust and I know the workings of the trust well. The scares that have been handed to the hon. Gentleman to get him to join in our questions on the subject today are quite off the beam.
Mr. Nicholas Winterton : I thank my right hon. Friend for deciding that NHS trusts should make public their business plans. That decision will be widely welcomed. Will he give an assurance that the specialist department in the Department of Health will scrutinise more adequately the financial plans of potential trusts and ensure that their projections of income and expenditure are accurate and are based on fact, not on assumption?
Mr. Waldegrave : Detailed projections for a year ahead are always likely to be false, in some cases because of the allocations that are made later in the year. So there is no way in which those making proposals in July and August can exactly describe the financial situation the following year. However, I agree with my hon. Friend that we must examine all applications with great care, as we did last year.
Mr. Kennedy : As there was no reference in the Conservative manifesto to setting up trust hospitals and as the results of every local referendum on the issue have been overwhelmingly in one direction--against them--although they have been ignored by the right hon. Gentleman, does he agree that when it comes to phase 2 of the trusts, it would be sensible to learn the lessons of the first wave and allow the matter to be put to the test at the next general election, before any more trust hospitals are established?
Mr. Waldegrave : The hon. Gentleman's difficulty is that throughout the country local Liberal parties have taken a completely different line. That is not surprising, as many Liberals have supported trusts. The hon. Gentleman
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tries to maintain a uniformly negative position from here, even though that position is not supported by many of his party's members.Mr. Wolfson : Will my right hon. Friend confirm that when taking a view of trust applications, he will not always be looking merely at trusts that are currently in a good financial state but will encourage others to take NHS trust status to improve their financial position in the future?
Mr. Waldegrave : My hon. Friend puts his finger on an important point. The improved management that we obtain from NHS trusts is necessary in places where there may be problems. That is why I am delighted with the improved management at, for example, Guy's and Lewisham, because everybody knew that for many years there were problems there.
Mr. Robin Cook : Further to the point of the hon. Member for Macclesfield (Mr. Winterton), does the right hon. Gentleman recall that a surplus was forecast when he approved the application from Bradford? By last month Bradford was forecasting a deficit and by last week it had announced the closure of 13 wards, including the special care unit to which my hon. Friend the Member for Bradford, West (Mr. Madden) referred. Why were none of those service closures included in the consultation document published less than a year ago--or was that also one of the biggest lies since the ancient Greeks? If the Minister did not know when he approved that application that approving Bradford as a trust would lead to those closures, will he now halt the second wave of opt-outs until he can tell us what went wrong with the first wave?
Mr. Waldegrave : I liked the word "also". If the hon. Gentleman will think about the implication of his words, he will realise that he has just acknowledged that what he stated in his leaflets is untrue--as I think he very well knows. I am sure that the hon. Gentleman has studied the report of the Select Committee, which discussed these matters more seriously than the hon. Gentleman has done today. It is obvious that ahead of the allocations produced last December, it was impossible to produce a detailed cash flow for a hospital for the next year. What I had to adjudge--as I shall have to do again in respect of the second wave--was whether the management were capable of dealing with the problems in the hospital. Labour is getting wholly left behind on this, as on other things.
There will be a major second and third wave of trusts and that will be the pattern of hospital management for the future.
Project 2000
4. Mrs. Maureen Hicks : To ask the Secretary of State for Health if he plans to announce the inclusion of further nursing colleges for participation in Project 2000.
Mrs. Virginia Bottomley : We made £71 million available for Project 2000 in 1991-92 and have already agreed to implementation in a further 14 colleges of nursing this year. The Project 2000 implementation group will be meeting early next month to advise me on the allocation of the balance of funding available and I shall make an announcement as soon as possible thereafter.
Mrs. Hicks : Although Wolverhampton will not, unfortunately, be getting a child support agency, because
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it does not have an appropriate building ready, my hon. Friend will know--because she had the honour of opening it-- that it has a first-class nursing college, the United Midlands college of nursing and midwifery. My hon. Friend will be aware of Wolverhampton's disappointment that it has not yet been included in Project 2000. Now that there is more money in the kitty, can my hon. Friend guarantee that the United Midlands college will be carefully considered on its merits so that, if it is successful, it can give more representation to Project 2000 in the black country?Mrs. Bottomley : My hon. Friend is a great champion of that college and I much appreciated the opportunity to open it. This year, nearly £3.5 million is being spent on implementing Project 2000 in my hon. Friend's region. We are looking carefully at all the available projects and I give my hon. Friend a clear assurance that the United Midlands college will be given urgent consideration.
Mrs. Margaret Ewing : Is the Minister undertaking any analysis to ensure that an adequate number of bridging courses are available to those who wish to enhance their qualifications ? Will she ensure that such courses are evenly spread throughout the country ?
Mrs. Bottomley : One requirement of Project 2000 is that arrangements are made for enrolled nurses to improve their qualifications. We need to ensure that nurses at every level of qualification have a chance to improve and to continue their training. We spend in the region of £770 million on nurse training and we want it to develop across the board.
GP Fundholders
5. Mr. Squire : To ask the Secretary of State Health if he will make a statement on the progress of GP fundholding.
Mr. Waldegrave : As the House will know, more than 1,700 general practitioners are voluntarily taking part in the fundholding scheme, which in its first year already covers 7.5 per cent. of the population of England. I am sure that my hon. Friend will join me in welcoming the agreement reached with the representatives of the medical profession on joint guidance for hospital consultants on GP fundholding which I announced last Tuesday.
Mr. Squire : Is my right hon. Friend aware that my constituency includes one of the GP fundholders to which he refers ? That practice recently began hiring a consultant--paid for out of NHS funds--to ensure that patients are seen within one month, rather than have to wait for up to a year, as they previously did after being referred to Oldchurch hospital in Romford. Will my hon. Friend congratulate that practice on its initiative and acknowledge that it makes a better use of funds, gives a faster and better deal to the patient and reduces hospital waiting lists ?
Mr. Waldegrave : I am delighted to congratulate the practice to which my hon. Friend refers. It is just one example of how GP fundholders throughout the country are showing how to make better use of the money for patients. They are showing also how the NHS, which
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already does extremely well for its patients, can do even better if we can improve on devolving money to where decisions should be taken.Mr. Robin Cook : Will the Secretary of State take this opportunity to explain the claim that he made on the record that patients of fundholders bring new money with them? Will he confirm that every penny in GPs' budgets has been deducted from health authorities' budgets? Is not it a confidence trick to pretend that the same money becomes new money when laundered via GPs? He told us that 40 per cent. of GPs are expected to become fundholders. How will any number of pilot projects help health managers to plan for local needs with 40 per cent. less money in their budgets?
Mr. Waldegrave : I am glad that the hon. Gentleman, who has been rather left behind in these matters, is catching up. It is perfectly clear that all NHS money comes from taxpayers. If the hon. Gentleman has just discovered that, it is wonderful. We have allocated some of that money to GP fundholders through the regional mechanisms available to us. Every year, we win new money for the health service and I hope that we shall do so again. We have a much better record than the Labour party on that.
On the hon. Gentleman's second point, it is perfectly clear that the close working relationship between GPs and districts can be developed further. I am looking at new ways of making that co-operation even more practical and efficient.
Ancillary Services
6. Mr. David Evans : To ask the Secretary of State for Health what are the total savings from privatisation of ancillary services for the last 10 years.
The Parliamentary Under-Secretary of State for Health (Mr. Stephen Dorrell) : Total savings from competitive tendering in England since1984-85 now amount to £126 million a year.
Mr. Evans : I thank my hon. Friend for that reply. Does he agree that £126 million would buy one new hospital a year, 45,000 hip operations or 145,000 cataract operations? Would not the Labour party hand that money back to COHSE and NUPE? Should not people tell their grandchildren what it was like under Labour in 1978, when cancer patients who were dying were not allowed admission for treatment? Would not it be a good idea if they took note of the fact that the health service would be a hell service if it were coupled with the name of the hon. Member for Livingston (Mr. Cook)?
Mr. Dorrell : My hon. Friend is on to a good point. The Labour party is bound by two commitments : first, to abolish competitive tendering, which will cost £126 million ; and, secondly, that no more money should be available to the health service. Labour Members must explain to the patients whose treatment would not be possible, despite the fact that that money is being provided to the health service, why they should wait so that the Labour party can discharge its pledges to the trade union movement.
Mr. Hinchliffe : Will the Minister give us the full picture on competitive tendering? What is it costing the
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Government in terms of social security payments to low-paid national health service workers because private contractors have driven wages down to poverty levels? How many NHS workers are now forced to take on two jobs to make ends meet? Will the Minister also explain the appalling standards of cleanliness in hospital wards because of private contracting?Mr. Dorrell : What I will do is tell the House about the attitude of the general secretary of COHSE, Mr. Hector MacKenzie. He says : "Success depends on the willingness of members to push for a health service that acts in the interests of its staff."
The hon. Member for Livingston (Mr. Cook) was at the COHSE conference at the weekend. I hope that he took the opportunity to dissociate the Labour party from those sentiments.
Sir George Gardiner : Will my hon. Friend confirm whether competitive tendering is practised by the NHS in Merseyside?
Mr. Dorrell : My hon. Friend is on to an important point. Competitive tendering is practised by the NHS in Merseyside, which is clocking up savings of £6 million a year as a result. That is freeing resources which allows Merseyside to have a waiting list record that is second to none. If every other local service in Merseyside were run as efficiently as the health service, many problems would be solved.
Health Spending
7. Mr. Salmond : To ask the Secretary of State for Health what percentage of gross domestic product is spent on health in (a) the United Kingdom and (b) other European countries.
Mr. Waldegrave : It is estimated that total United Kingdom spending on health as a proportion of GDP will be 6.5 per cent. this year, compared with 5.8 per cent. in 1980. We do not yet have comparable figures for other European countries.
Mr. Salmond : That is hardly surprising, as such figures would show that the percentage of GDP spent on health in the United Kingdom is significantly less than that spent in other European countries--and the GDP figure is lower as well. According to the findings of various surveys, the United Kingdom spends between 50 and 70 per cent. of the amount per patient spent by France and Germany. Given those figures, how can the Secretary of State possibly deny that the national health service is suffering from chronic and debilitating underfunding?
Mr. Waldegrave : The hon. Gentleman should beware of such naive comparisons. The Netherlands, for example, includes nursing homes in its health figures. [Interruption.] I refer to the 1988 figures. If we did the same, our spending figures would be increased by 0.25 per cent.
In many respects, the figures are not comparable. The figures relating to output are far more important. Our perinatal mortality record is now better than that of the United States, although that country spends nearly twice as much of its GDP on health. What matters is the efficiency of the health service, not the result of crude comparisons.
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Dame Jill Knight : As we are comparing Britain's health service with its counterparts on the continent, may I ask whether my right hon. Friend has read an article that appeared this week in the British Medical Journal and which highlighted the enormous number of complaints from Italian patients, who are required to take their own bed linen and food into hospital and have to tip lavishly to attract any attention? Is my right hon. Friend aware that doctors, nurses, medical auxiliaries and pharmacists all over France were on strike last week, protesting about the French health service and, in particular, the cuts imposed by the French Government? Does my right hon. Friend therefore agree that in health matters the grass is not greener on the other side of the channel?Mr. Waldegrave : My hon. Friend's observations confirm that we have a health service to be proud of--recent polls show that up to 80 per cent. of people are satisfied with it, including waiting times--and we are seeking to make the service more efficient. The real questions should be addressed to the Labour party. The hon. Member for Livingston (Mr. Cook) recently tipped the wink to the British Medical Association that under Labour about £6 billion extra would be available per year. That was reported in the British Medical Journal, although the hon. Gentleman provided no press handouts, any more than he provided press handouts in relation to COHSE. If he wishes to deny that statement, let him do so.
HIV Screening
8. Mr. Strang : To ask the Secretary of State for Health whether the anonymised screening programme for HIV is being extended ; and if he will make a statement.
Mrs. Virginia Bottomley : The first results of the anonymised HIV surveys have provided valuable information about the prevalence of HIV infection in England. The number of participating clinics will increase throughout England and Wales as the surveys continue.
Mr. Strang : Will the Minister confirm that "anonymised" screening is truly anonymous, and that there is no way in which a positive result can be traced back to any individual ? Does she agree that the programme will provide valuable information only if it covers a wide enough spread of the population and if that spread is maintained for a number of years ?
Mrs. Bottomley : The screening survey has already proved its usefulness in allowing us to plan services and the development of preventive measures. I can confirm that the testing is entirely anonymous. It is essential that we have fact, not fantasy, on which to work in dealing with the spread of HIV and AIDS which are, after all, the most serious threat to public health this century. That is why we have made it clear from the outset that special resources should be directed deliberately towards research, prevention and services.
Baby Life-saving Units
9. Mr. Janner : To ask the Secretary of State for Health if he will undertake an assessment of the need for, and availability of, extra- corporeal membrane oxygenator baby life-saving units.
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Mr. Janner : Will the Minister assure us that the ECMO baby life- saving unit in the Groby road hospital in my constituency will have enough funding to continue in existence ? Is he aware that unless public funding comes through, that unique unit will almost certainly have to close, resulting in a serious, unnecessary and scandalous loss of babies' lives ?
Mr. Dorrell : I am pleased to be able to give the hon. and learned Gentleman, who is my parliamentary neighbour, the assurance that that will not happen. I spoke to Mr. Field, the clinician in charge, on the telephone this morning, and he will meet Professor Peckham, the director of research and development of the NHS, on 4 July.
Mr. Butterfill : Is not it true that nearly twice as many babies died when the Labour party was last in power, whereas we have succeeded in cutting the death rate from 8.2 per thousand to 4.6 per thousand ?
Mr. Dorrell : My hon. Friend is absolutely right. That is one of the health indicators that have improved dramatically in the past 12 years.
Capital Finance
10. Mr. David Shaw : To ask the Secretary of State for Health if he will make a statement on capital expenditure in the health service between 1971-72 and 1991-92.
16. Mr. Charles Wardle : To ask the Secretary of State for Health what is the level of capital investment in the national health service in 1991-92 ; and what was the figure in 1978-79.
Mr. Waldegrave : Capital expenditure in the national health service in 1991-92 is planned to be 60 per cent. higher in real terms than in 1971- 72 and 68 per cent. higher than in 1978-79.
Mr. Shaw : Will my right hon. Friend confirm that capital expenditure today is almost double what it fell to when Labour cut expenditure in 1977-78? Does he agree that there is much more machinery, equipment and electronics in the health service than there was before, and that we now have lithotripters and magnetic resonance imaging equipment, none of which existed under Labour in 1979?
Mr. Waldegrave : One of the most disgraceful aspects of the previous Labour Government's record was their catastrophic cut in spending on the health service after the International Monetary Fund arrived in this country. The hon. Member for Livingston (Mr. Cook) usually says he voted against that, but in fact, as we discovered, he abstained. For example, we now have MRI scanners, lithotripters and mammography equipment, and defibrillators are present in every front-line ambulance. We have a better- equipped health service.
Mr. Charles Wardle : Does my right hon. Friend have on file a Trades Union Congress report criticising the Government for hospital closures and cuts in the NHS capital investment programme? Will he contrast that report, which was published in 1978 under the last Labour Government, with more recent news of more than 500 major hospital building projects being undertaken, millions more patients being treated and almost £33,000 million to spend on patient care this year?
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Mr. Waldegrave : I confirm that that is so. On the 30th anniversary of the health service, the TUC made a tremendous but justifiable attack on the then Labour Government. Now, however, the hon. Member for Livingston, by nods and winks--by going to the BMA, by saying yes to every pressure group and by promising expenditure that he knows, if he took on my job, he would not be able to honour--is building up the same explosion of resentment and failed expectations as that which occurred under the last Labour Government, causing the winter of discontent and bringing catastrophe to the health service.
Mr. Campbell-Savours : Returning to the comments of Mr. Hector MacKenzie, in the context of this question does the Secretary of State think that the national health service should act against the interests of its own staff?
Mr. Waldegrave : Of course not. I know that the hon. Gentleman, who is sponsored by COHSE, would not believe that to be so, but it is an extraordinary statement not to put first that the national health service should act, above all, in the interests of patients.
Mr. Skinner : If everything has been so good with the national health service during the course of this Tory Government's 12 years, why are wards and hospitals closing, beds being shut down and more than a million people on waiting lists, and why are GP fundholders at a practice in north Derbyshire able to get their patients into hospital six weeks before others who are not GP fund holders?
Mr. Waldegrave : The hon. Gentleman may have missed the agreement that was made with the profession last week, which laid to rest such scare stories. I make no apology for the policy of closing hospitals that are no longer needed ; in saying that, I am quoting the Secretary of State for Health under the last--and I mean last--Labour Government.
NHS Trusts
Mr. David Nicholson : To ask the Secretary of State for Health if he will make a statement on the preparation for improving health care in their areas made by the NHS trusts since their establishment in April.
Mr. Dorrell : The NHS trust programme is already delivering widespread improvements in patient care.
Mr. Nicholson : Is my hon. Friend aware that the myths and allegations put forward by the Opposition parties about NHS trusts are being met by the reality of success, expansion and the recruitment of consultants and other staff, not only by the Taunton and West Somerset trust in my constituency but in east Somerset, Weston, Bristol, and Devon and Cornwall? Has my hon. Friend noticed that the Devon branch of the National Union of Public Employees has welcomed the application and the plans being made by the Devon ambulance service to become an NHS trust?
Mr. Dorrell : I have noticed the attitude of the Devon branch of NUPE. I hope that the more inspired approach of that branch will be applied in competitive tendering, which we discussed earlier. On the improvement in patient care which is attributable to the trust programme, my hon. Friend may like to observe what is happening on Merseyside. There is
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investment of £1.3 million in the kidney service at the Royal Liverpool university hospital and a new lithotripter has been installed so that more patients can be treated on a day-care basis. There are 84 beds for heart patients in the new building at the cardio-thoracic centre in Liverpool. There is also investment of £4.5 million at Broadgreen hospital in Liverpool to build a new 96-bed psychiatric unit. Those are examples of improvements in patient care being brought to Merseyside as a result of the trust programme.Mr. Alton : In that case, how can the Minister justify the closure of St. Paul's eye hospital in Liverpool and the decision--announced yesterday, when I went to see the chairman of Liverpool health authority-- to close a second general hospital, leading to a reduction in the number of beds available for psychiatric patients?
Mr. Dorrell : If local disagreements come to the attention of Ministers, we shall consider the cases then. I had hoped that the hon. Gentleman would take the opportunity to welcome the fact that on Merseyside we have far and away the best record on waiting lists in the NHS--they are down by one quarter compared with 1979. Since 1979, the number of in- patients treated has increased by 29 per cent. and the number of day cases treated has increased by 86 per cent. The health service on Merseyside is a success. If only other local services were so successful.
Mr. Soames : Does my hon. Friend agree that one of the most important benefits of the trust programme has been the tremendous increase in staff motivation? Does he agree that if the NHS is to be seen to be improved, staff motivation will be one of the cardinal characteristics of that improvement?
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