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Mr. Sackville : Yes, indeed, and in hospitals that have become trusts, the number of patients treated rose faster than in other hospitals. Throughout our hospital system, a rapid increase both in the quality of care and in the number of patients treated is taking place.
Mr. Blunkett : On Sunday evening, the hon. Gentleman described the comments of the Bishop of Birmingham, saying that he lived "in a fairy-tale world" where no attempt at competitiveness existed. Is not such competitiveness best exemplified by today's revelation about the business plan at Charing Cross hospital, which involves headhunting a specialist from the Royal Marsden hospital, in order
"to assist in destabilising a competitor".
Is not that entirely to do with business and commercial ethics, and nothing to do with serving the people ?
Mr. Sackville : Health service management personnel are central and vital to the NHS. Unless we attract top-level management to run our hospitals it will be patients who suffer, because hospitals will be less well used, there will be a lower quality of care and fewer patients will be treated.
Mr. Rowe : Is my hon. Friend aware how pleased we all are that the Front-Bench team is unmarked by the Santer claws ? Does my hon. Friend agree that the opportunities for using volunteers--for example, in freeing beds by escorting patients home at weekends--are under-used, and will he ensure that more health authorities and trusts are aware of the opportunities for making full use of volunteers ?
Mr. Sackville : One of the greatest features of our national health service is the commitment of local people to their local hospitals. Anything that we can do to encourage that further is good for patients.
NHS Service --
10. Mr. Bill Michie : To ask the Secretary of State for Health what assessment she has made of the extent to which the NHS provides a comprehensive service.
Dr. Mawhinney : My assessment is that the national health service is excellently comprehensive.
Mr. Michie : Is that the best that the Minister can do ? May I remind the Secretary of State that the availability of the legal abortion of pregnancies, long-term care for the elderly, infertility treatment for women and physiotherapy
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for old people are not universally available on the national health service ? Added to that are the possible closure of the accident unit in Sheffield and threats to the children's services in Sheffield. Is not it true that the Secretary of State has failed to provide a comprehensive national health service in that city, too ? Is not it about time that she either got on with the job or got out--or preferably both ?Dr. Mawhinney : My right hon. Friend the Secretary of State has responsibility for an excellently comprehensive national health service, for which she deserves great credit. As for the various things that the hon. Gentleman has mentioned, all of them are available on the national health service to those whose medical practitioners believe that they have a clinical need. Of course, the hon. Gentleman did not tell the House that the resources in Sheffield have gone up in real terms year on year, that the number of patients treated in Sheffield has gone up year on year--both in-patients and day-case patients--and that there has been a reduction in the waiting lists in Sheffield. All that is also part of the excellently comprehensive national health service.
Mr. John Greenway : Does my right hon. Friend agree that the health service is comprehensive from the moment a child is born in one of our maternity units ? I am sure that the House and the country will wish for the safe return of Abbie Humphries, but, rather than rejecting the possibility of introducing electronic tagging in maternity wards, will he and his right hon. and hon. Friends visit York district hospital maternity unit, where an electronic tagging system introduced last year has been extremely effective in improving security ?
Dr. Mawhinney : I associate myself with what my hon. Friend said about Abbie, and our prayers and thoughts go out to her parents and to her at this time. I agree with my hon. Friend that the national health service provides a comprehensive service from the day that babies are born, but I would add that it continues until people die. I take pride in the fact that 40 per cent. of the national health service resources are devoted to that 16 per cent. of the population who are of retirement age.
Mr. Burden : But is not the market mechanism that the Government have imposed causing chaos in terms of the ability of the NHS to provide a comprehensive service ? That is known by patients, who have to wait longer to see a consultant. Rather than attacking the Bishop of Birmingham for telling the truth, should not the Government reject a system that treats patients as mere commodities ?
Dr. Mawhinney : The hon. Gentleman is precisely wrong. I always wish to be positive about the national health service. I want to welcome the extra number of patients who have been treated since the reforms came in, and I hope that the bishop agrees with me. I want to welcome the improvement in the quality of service of the national health service since the reforms came in, and I hope that the bishop agrees with me. I want to welcome the £100 million package of extra resources for Birmingham which was announced on Friday, and I hope that the bishop agrees with me. When I go to Birmingham again tomorrow, I shall be making it clear that, if the bishop would like to have a full briefing on what is actually happening in the national health service, I shall personally be happy to provide it for him.
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Suicides --
11. Mr. Brandreth : To ask the Secretary of State for Health what representations she has received concerning the "Health of the Nation" targets for the reduction in the number of suicides ; and if she will make a statement.
Mrs. Virginia Bottomley : I have received a number of representations from professional bodies, representatives of high-risk groups, voluntary organisations and members of the public. Recent representations have been constructive and broadly supportive of the targets.
Mr. Brandreth : Will my right hon. Friend confirm that the White Paper "The Health of the Nation" represents the first time that suicide has been treated and tackled as a public health issue ? In anticipation of the exhibition by the Samaritans that is coming to Westminster in two weeks' time, will my right hon. Friend give us an update on the progress that has been made in tackling the targets, under the "Health of the Nation" strategy.
Mrs. Bottomley : I look forward to the event organised by the Samaritans. On behalf of many, I should like to express my appreciation for their work and for the work of the great number of volunteers across the country who man the telephone lines. More people die by taking their own lives than are killed in accidents on the roads. One of the areas in the "Health of the Nation" strategy where we set out to achieve marked improvement was that of mental health--for the first time it has been identified. A great number of measures have been taken to help us to meet the targets, which we are determined to do.
Mr. Simon Hughes : Will the Secretary of State accept that when people are so distressed that they try to take their own lives--as a young man in my constituency did yesterday--one of the best ways of reducing the number of suicides is to ensure that they are as close as possible to the best possible medical treatment, to prevent their attempts turning into deaths and that the preservation of nearby acute services is of the essence ? Will the right hon. Lady ensure that we have the hospitals and accident and emergency units to keep people alive ?
Mrs. Bottomley : I appreciate the hon. Gentleman's point--but frankly it is a misuse of the question. Suicide is a serious matter, and good general practice and primary care services are the key. Six out of 10 people who take their own lives have consulted a family doctor in the fortnight beforehand, and the changes that we are seeking to achieve in London are designed precisely to ensure that London has the same quality primary care services as are available elsewhere. That is the single most important factor.
PRIME MINISTER --
Engagements --
Q1. Mr. Bayley : To ask the Prime Minister if he will list his official engagements for Tuesday 5 July.
The Lord President of the Council and Leader of the House of Commons (Mr. Tony Newton) rose
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Mr. Newton : Hang on, and I will tell the House. I have been asked to reply.
My right hon. Friend the Prime Minister is in Edinburgh to greet the King and Queen of Norway at the start of their state visit. Here in Westminster we await the visit of the hon. Member for Sedgefield (Mr. Blair) to discuss the Police and Magistrates' Courts Bill.
Mr. Bayley : What help will the Government give to the victims of a £30 million theft--that is to say, Asil Nadir's creditors, who yesterday announced that they were suing the Conservative party for the return of £400,000 given by Mr. Nadir to the Conservative party before the general election ?
Mr. Newton : I think that the hon. Gentleman knows the position. My right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) has made it quite clear that the Conservative party will of course return the money received from Polly Peck and Unipac--if it proves to have been stolen.
Mr. Forman : In the interests of enhancing the aesthetic and architectural attractions of central London, particularly some of our finer buildings and their surroundings, will my right hon. Friend have another look, within Whitehall and with his colleagues, at the apparent determination of Ministers to endorse the decision, suggested to them by senior civil servants, that Horse Guards parade should continue to be used, unusually, for the parking of motor cars by senior civil servants ? Surely, its architectural and other beauties should be enhanced by leaving it as a public open space.
Mr. Newton : My hon. Friend will be well aware of the discussions that have taken place on these matters. I shall certainly bring his observations to the attention of my right hon. Friend.
Mrs. Beckett : Why does the Lord President think that the British Medical Association's conference is saying that the Government's health service changes have failed the nation ?
Mr. Newton : The British Medical Association's conference is making those remarks, but it appears to be overlooking the fact that the number of patients treated in hospital has grown by record amounts, that the quality of care has improved and that the number of patients waiting more than a year has fallen by 100,000 to not much more than 60,000.
Mrs. Beckett : But does not the Lord President understand that the remarks that he makes are recognised only by the Cabinet as a depiction of the picture of the health service and that those people at the sharp end of the national health service, including--but not only--the doctors, are talking about alienation, despair and a two-tier health service ? They said yesterday :
"treatment except in emergencies has now become a national and local lottery."
How can he defend that ?
Mr. Newton : I do not accept for a moment--and I do not think many of the people to whom I talk in hospitals and general practitioner practices up and down the country accept for a moment--what the right hon. Lady is saying. As for two-tierism, the Government stand four square on their 1991 agreement that common waiting lists apply to
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all urgent cases ; that all emergencies will be treated immediately ; and that no hospital is to offer contracts to one purchaser which will disadvantage patients of another.Mrs. Beckett : But the BMA is telling the Government that this is happening. Does the Lord President dispute the fact that there are three times as many managers and 12,000 fewer nurses than when all this started ? I remind him again of what the BMA said yesterday : "business plans override clinical priority. Money does not follow the patient--The patient has no choice but to follow the money until it runs out."
The Government are destroying the principle on which the health service is based. What will it take to make them realise, acknowledge and stop that ?
Mr. Newton : The right hon. Lady's criticisms and those she attributes to others simply do not stand up alongside the fact that, for every 100 patients treated in hospital in 1990-91--the last year before the reforms--the NHS expects to treat 121 this year. That is a 20 per cent. increase.
Mr. Alexander : Is my right hon. Friend aware of the concern about the granting of legal aid on occasions to people of apparently significant means and sometimes to foreign nationals of very great means ? Is not it time that the legal aid authorities looked far more closely at the applicants who come before them and said that under no circumstances should legal aid be granted to nationals of foreign countries unless there is a reciprocal arrangement in force ?
Mr. Newton : I am sure that my hon. Friend will understand that it would wrong for me to be drawn into commenting from the Dispatch Box on an individual case. I want to recognise the concern that he and others have expressed. He will know that my right hon. and noble Friend the Lord Chancellor does consider carefully, and has made a number of adjustments of, the legal aid arrangements and will certainly want to look at what my hon. Friend has said.
Q2. Mr. Betts : To ask the Prime Minister if he will list his official engagements for Tuesday 5 July.
Mr. Newton : I have been asked to reply.
I refer the hon. Member to the answer I gave some moments ago.
Mr. Betts : Is the Leader of the House aware that, among its many inefficiencies, the Child Support Agency is regularly taking up to two weeks and sometimes longer to pass the maintenance that it receives on to parents with care ? Is he further aware that that not only creates problems for those people, but means that the agency accrues large sums in interest on the money that it holds ? Does he believe that the money should be paid back to those people making maintenance payments or those receiving them, or does he believe that the agency should continue to make a profit out of its own inefficiencies, and that the Government should make a profit out of the misery that they have inflicted on those people because of this appalling legislation ?
Mr. Newton : This subject was rightly debated extensively in the House yesterday and the hon. Gentleman, who no doubt was here, will have heard my right hon. Friend the Secretary of State for Social Security acknowledge that there is a need for improvement in the
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administration of the Child Support Agency and indicate that steps are being taken to bring that about. Indeed, that commitment is backed by some 700 extra staff and an increased budget to tackle just the sort of problems to which the hon. Gentleman has referred. Q3. Mr. Sims : To ask the Prime Minister if he will list his official engagements for Tuesday 5 July.Mr. Newton : I have been asked to reply.
I refer my hon. Friend to the answer I gave some moments ago.
Mr. Sims : Does my right hon. Friend agree that neither side in the signalmen's dispute merits much credit for the way in which the dispute has been handled ? Does he further agree that not only are his constituents and mine becoming increasingly frustrated by the weekly disruption of their business and social life but the economy is being damaged ? Is not it time for all parties in the House to condemn this foolish and unnecessary strike ?
Mr. Newton : I very much agree with my hon. Friend. Once again, I must regret the extent to which the right hon. Member for Derby, South (Mrs. Beckett) felt unable to make her position clear. I am sure that my constituents and those of my hon. Friends regard a strike in support of an 11 per cent. pay rise with no productivity or restructuring as one that should be reconsidered and called off with a view to returning to sensible negotiation.
Mr. Chisholm : Did the Leader of the House see the research from North Thames health authority last week, which showed that more money is spent on average on the patients of GP fundholders than on those of non-GP fundholders ? Has he seen the report in this morning's papers to the effect that a trust hospital in Kent has admitted operating a two-tier system with the tacit approval of the local health authority ? Will he act against this blatant inequity and instruct Scottish Office Ministers to withdraw their edict that 30 per cent. of patients in Scotland should be looked after by GP fundholders by next April ?
Mr. Newton : I have already commented on the allegations of a two- tier service that were made by the right hon. Member for Derby, South. Let me make one thing absolutely clear : GP fundholders are not preferentially funded. They make contracts with trusts on the same terms as health authorities.
Q4. Mr. Matthew Banks : To ask the Prime Minister if he will list his official engagements for Tuesday 5 July.
Mr. Newton : I have been asked to reply.
I refer my hon. Friend to the answer I gave some moments ago.
Mr. Banks : My right hon. Friend will be aware of the strong support on both sides of the House, particularly given recent tragedies, for the introduction of seat belts in minibuses and coaches. Britain has been at the forefront in Europe in introducing measures to reduce road casualties, but will he assure the House that Britain will continue to be at the forefront on this issue ?
Mr. Newton : My right hon. Friend the Secretary of State for Transport has already indicated his support for some of the moves that are being proposed in Europe, but, more comprehensively, we are reviewing the fitting of seat
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belts in minibuses and coaches, including the technical and cost implications. My right hon. Friend hopes to publish the report, and our conclusions, before the summer recess.Q5. Rev. Martin Smyth : To ask the Prime Minister if he will list his official engagements for Tuesday 5 July.
Mr. Newton : I have been asked to reply.
I refer the hon. Member to the answer I gave some moments ago.
Rev. Martin Smyth : Is the Lord President prepared to commend to all our people for study and action the Alzheimer's Disease Society's publication "Home Alone" ? Does he agree that more doctors should be aware of the disease and more ready not simply to diagnose people as suffering from old age when they are suffering from Alzheimer's disease ?
Mr. Newton : I very much agree with the hon. Gentleman. He will know that, like him, I have had many contacts with the excellent Alzheimer's Disease Society over the years. It is important with that disease, as with others, that general practitioners are alert in identifying it and do not see it simply as a phenomenon of age. They should be able to steer people in the right direction, and part of the aim of our care in the community policy, not least the emphasis on carers as well as sufferers, is to improve our capacity to deal with such difficulties when they arise.
Dr. Goodson-Wickes : Is my right hon. Friend aware that last week a pioneering project was opened in my constituency sponsored by Shaftesbury housing, which combines housing with long-term care ? Does he agree that that represents the very best of community care in action ?
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Not only does it debunk Labour's accusations of decentralisation but, more important, it gives residents a secure environment in which they do not have to sacrifice their independence.Mr. Newton : At the outset, I had better acknowledge that I was not aware of the scheme in my hon. Friend's constituency, which certainly sounds excellent. It is representative of a number of community care schemes throughout the country that are assisted by the Housing Corporation, a mixture of public and private finance and voluntary organisations. Such schemes greatly improve our capacity to care for Alzheimer's disease sufferers and for the others whom my hon. Friend has in mind.
Q6. Mr. Gerrard : To ask the Prime Minister if he will list his official engagements for Tuesday 5 July.
Mr. Newton : I have been asked to reply.
I refer the hon. Gentleman to the answer I gave some moments ago.
Mr. Gerrard : Does the Leader of the House agree that it is completely unacceptable for the privatised electricity companies to apply a surcharge for consumers using pre-payment meters, such as key charge ? Such consumers are nearly always those who are least able to afford to pay a surcharge. What action will the Government take to stop the practice ?
Mr. Newton : In general, charging policies for electricity companies or any other private operations are for the owners and managers of the individual operations to determine. Additional costs will often be incurred in providing a facility of the sort that the hon. Gentleman has described. That factor is one which, rightly, should be taken into account.
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