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House of Commons
Tuesday 18 July 1995
The House met at half-past Two o'clock
PRAYERS
[ Madam Speaker -- in the Chair ]
MESSAGE FROM THE QUEEN
Double Taxation Relief
The Vice-Chamberlain of the Household-- reported Her Majesty's Answer to the Address, as followsI have received your Addresses praying that the Double Taxation Relief (Taxes on Income) (Belarus) Order 1995 and the Double Taxation Relief (Taxes on Income) (Bolivia) Order 1995 be made in the form of drafts laid before your House.
I will comply with your request.
PRIVATE BUSINESS
Birmingham Assay Office Bill
Lords amendment agreed to.
London Local Authorities (No. 2) Bill
[Lords] ( By Order ) Order for consideration, as amended, read.
To be considered on Tuesday 17 October.
Barings Report
Ordered,
That there be laid before this House a Return of the Report of the Inquiry into the circumstances of the collapse of Barings, conducted by the Board of Banking Supervision.--[ Mr. McLoughlin. ]
Oral Answers to Questions
HEALTH
Cycling and Walking
1. Mr. Robathan: To ask the Secretary of State for Health what estimate he has made of the potential contribution of (a) cycling and (b) walking to the health of the nation. [33208]
The Parliamentary Under-Secretary of State for Health (Mr. John Bowis): Responsible cycling and walking can improve physical and mental fitness and reduce the risk of coronary heart disease and stroke.
Mr. Robathan: May I, as a fellow Leicestershire Member of Parliament, welcome the new Secretary of State to his first Question Time?
I thank the Minister for that answer. Does he agree that activities such as cycling and walking can also improve blood
pressure--particularly on a day like today when
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people's blood pressure is unnecessarily raised by a fatuous and ridiculous rail strike? To that end, will my hon. Friend co-operate with his colleagues at the Departments of National Heritage and Transport, and others, including Education and Employment, to ensure that cycling and walking are encouraged by all Government Departments?Mr. Bowis: On behalf of my right hon. Friend, I am grateful for my hon. Friend's opening remarks; and I can confirm that he and I walked here for questions. I know of my hon. Friend's prowess as a cyclist. From time to time I am taken for a walk by my border terrier. We can certainly agree that cycling and walking are better for us than captaining losing tug-of- war teams, which he and I have both done. My hon. Friend's point is a serious one: deaths from coronary heart disease could be reduced if we all undertook more regular, moderate exercise. It is also undoubtedly true that the physical and mental health of the nation would be improved if we took more exercise and if there were fewer strikes by the trade unions affiliated to the Labour party.
Mr. Tony Banks: If walking and cycling are so healthy, perhaps we should all be grateful to ASLEF for its strike, which means that people can walk and cycle to work. That is another way of looking at the dispute.
It is all very well recommending walking and cycling in London, but the air outside is poisonous. When is the Minister, in collaboration with his colleagues, going to do something to improve the quality of our air so that it will be a pleasure to walk and cycle in London?
Mr. Bowis: Of course, if public transport was not on strike, fewer people would be in cars, more would be on the railways, and there would be less air pollution. The hon. Gentleman is right, however, to say that the issue needs looking at. Together with our right hon. Friends in other Departments and in our committees, air pollution is being examined at present; but I hope that the hon. Gentleman will indulge in a little exercise whether or not the trains are on strike, so as to improve his mental as well as his physical health.
Sir Jim Spicer: Does my hon. Friend agree that all exercise is important, not just cycling and walking? In that context, does my hon. Friend agree that one of the most successful campaigns in Britain was the one run by the Sports Council, in conjunction with the Health Education Authority, "50 Plus and all to Play For"? Will my hon. Friend give encouragement to a similar campaign on a continuing basis to encourage those of us who are getting on a bit?
Mr. Bowis: First, I congratulate my hon. Friend on swimming the Thames for charity and raising, I think, some £16,000. That is a tremendous achievement. Next time, we look forward to him walking it.
My hon. Friend is right to draw attention to that excellent campaign by the Sports Council and the HEA for sport for the over-50s. The message today goes not just to the over-50s--this links with the launch of my right hon. Friend the Prime Minister's sporting initiative, which is also good for the health of the nation--but to people of whatever age, including those over 65, to take up not only sport but moderate and regular exercise.
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Accident and Emergency Departments
2. Ms Church: To ask the Secretary of State for Health how many accident and emergency departments have been temporarily closed in the last month. [33209]
The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville): That information is not routinely collected, but I can tell the hon. Lady that the London ambulance service has no record of any temporary closures in the area of her constituency during the past month.
Ms Church: I thank the Minister for his reply, but I am extremely shocked that such figures are not available nationally. The figures from the London ambulance service supplied to me show that in June alone eight units were temporarily or partially closed and a further seven were put on "avoid admittance". The Minister must respond to the fact that there is a serious and excess demand for accident and emergency places, particularly in London, and I ask him to review his policy, particularly on Oldchurch hospital, because at the moment the demand there is excessive.
Mr. Sackville: Our hospitals are now seeing 13 million attendances a day which is a remarkable achievement for which the hon. Lady should give credit. This month, reasons for temporary closures included burst water mains in two cases, a power failure, an orthopaedic registrar taken ill and a shortage of junior medical staff. The hon. Lady should not seek to trivialise the difficulties that staff face.
Sir Sydney Chapman: Having read the report of the Royal College of Surgeons containing the shocking statistic that one in four deaths in our accident and emergency departments is avoidable, does my hon. Friend agree that a significant reason for that is the fact that too many accident and emergency departments are fragmented and cannot deal with every type of accident? If the paramount priority of our NHS is to save lives, at least in our more densely populated areas there should be fewer but more comprehensively equipped accident and emergency departments which, apart from anything else, would ensure greater cover by consultants.
Mr. Sackville: I welcome what my hon. Friend says because accident and emergency care has developed and changed more than almost any other part of the health service in recent years. Two things are needed: a network of paramedics--highly trained ambulance staff--who can treat patients on the ground and take them promptly to hospitals, and a network of high-tech accident and emergency units with access to all the major specialties. This is not about politics but about the medical facts of survival in accident and emergency units.
Mrs. Beckett: I join the hon. Member for Blaby (Mr. Robathan) in welcoming the Secretary of State to his new responsibility. The Minister's answer about accident and emergency departments and temporary closures is extraordinary. He says that this is an area of medicine that has changed more than any other. One of the changes, as he should be aware, is that we have seen a pattern of temporary closures of accident and emergency units across the country--in Peterborough, Hull, Wales and Scotland. Clearly, there is a serious problem.
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Does the hon. Gentleman recognise that, first, that is the kind of information that the public want and need, not the stuff in the league tables which the British Medical Association recently called pointless and misleading, and that it is his duty and that of his Department to collect information about what are serious gaps in the service?Mr. Sackville: The right hon. Lady is being ridiculous. The amount of time for which accident and emergency units are closed is a tiny fraction of the number of hours during which they are in operation. It is absurd to suggest that units do not inform each other of problems as they arise, or that they do not have systems enabling them to inform ambulance services.
Closures will happen from time to time. Accident and emergency work is unpredictable: there may be large surges of demand, staff may not be able to come to work, and numerous other problems may arise.
Mrs. Roe: First, may I add my congratulations to those that my right hon. Friend the Secretary of State has already received on his appointment?
Will my hon. Friend confirm that consultant expansion in accident and emergency services has taken place more rapidly than in any other specialty, with more than 100 extra consultants appointed within the past 10 years?
Mr. Sackville: That is true. The new faculty of accident and emergency came into being only a couple of years ago. There has been a rapid increase in the number of specialists, and a growing realisation that the latest techniques in accident and emergency treatment and resuscitation save many lives that would otherwise not have been saved.
Consultants
3. Dr. Wright: To ask the Secretary of State for Health what plans he has to review the working arrangements and contracts of consultants. [33210]
The Secretary of State for Health (Mr. Stephen Dorrell): None. The working arrangements and contracts of consultants are a matter for individual national health service employers.
Dr. Wright: Has the Secretary of State seen a recent report on consultants' working patterns by John Yates, who has advised the Government on waiting lists? In the light of that report, can the right hon. Gentleman explain why some consultant surgeons are operating five times as much as others? In particular, can he explain why some consultant surgeons who are working on maximum NHS contracts are finding it possible to work in the private sector for two or three half-days a week? John Yates has asked for a full and urgent inquiry; will the Minister give us one?
Mr. Dorrell: Let me begin by thanking various hon. Members for their good wishes on my appointment. I hope that they will not evaporate too quickly.
I am aware of the work that John Yates has done, but I do not agree with his conclusion, which appears to be that the planning of consultants' time is best handled at a national planning level. I think that it is best handled at the level of local management of the individual unit.
The hon. Gentleman asked why individual consultants' working patterns vary in different parts of the national health service. The answer is that individual consultants'
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agreements with local NHS employers vary in different parts of the NHS. I should have thought that not only Conservatives but Opposition Members would welcome that. Let me refer the hon. Gentleman to page 26 of the Labour party's NHS policy document, in which, under the heading "Staff: the most vital resource", Labour commits itself to the following proposition:"We favour local flexibility to meet local need."
I agree at least with members of the Labour party who sign up to that policy.
Mr. Rowe: I agree with my right hon. Friend about local arrangements. Does he agree with me that there is national anxiety about the work of consultants who are suspended from their own trusts? It strikes me as extraordinary that a consultant who has been suspended should be able to continue to work in the private sector without let or hindrance. There have also been far too many cases of consultants who have been suspended finding work in other trusts.
Mr. Dorrell: I entirely agree that the maintenance of professional standards of medical conduct, both in the NHS and in private practice, is an important issue for the medical authorities and, ultimately, the General Medical Council to consider. I welcome the fact that the Medical (Professional Performance) Bill, which was passed earlier in the Session, will allow a more rigorous view to be taken by the medical authorities. I shall follow up my hon. Friend's point in that context.
Ms Jowell: Why does the Department propose to stop collecting information about the availability and use of operating theatres? Is it not because the Government want to fiddle the figures for the number of operations that are carried out and cancelled, just as they have fiddled the unemployment figures over the past 10 years?
Mr. Dorrell: No, it is much more straightforward than that. We should collect information that we are going to use; we should not waste taxpayers' resources by collecting information for which there is no effective use, so the test to be applied to all administrative routines in the national health service is: will this improve patient care? If it does not pass that test, the administrative routine will be abolished.
West Sussex NHS
4. Mr. Stephen: To ask the Secretary of State for Health what steps he is taking to strengthen the NHS in West Sussex. [33211]
The Minister for Health (Mr. Gerald Malone): I am pleased to be able to tell my hon. Friend that more than £284 million, including £6 million in growth money, has been allocated to West Sussex this year for investment in health services. They will have nearly £12 million more growth money next year. There is also a five-year capital programme of more than £100 million. That represents a significant demonstration of commitment to the health of my hon. Friend's constituents.
Mr. Stephen: On behalf of all my constituents, I thank my hon. Friend for the massive injection of cash that the Government have put into the local NHS. Will he join me in thanking not only the doctors and nurses, but the administrators, without whose skill and dedication the
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local NHS would not have been able to treat more patients, and to a higher standard today than at any time in its history?Mr. Malone: My hon. Friend is right. It is team work of clinicians, administrators and everyone involved in the NHS that delivers high standards of excellent health care, but I must give him a warning. I mentioned growth money in his constituency and in that part of West Sussex. That comes from savings in bureaucracy from getting rid of regions, which the Labour party has pledged to restore. I ask him therefore to point that out to his constituents, and to tell them that, if they want that growth money to flow, they had better have a careful look at Labour party policy.
Junior Doctors
5. Mrs. Helen Jackson: To ask the Secretary of State for Health how many junior doctors are (a) contracted for and (b) working more than 72 hours per week. [33213]
Mr. Malone: Our task forces reported that, as at 8 February this year, 768 hard-pressed on-call posts still required action to comply with our aim to bring all such posts within 72 contracted hours. That was a reduction of 88 per cent. from the position in March 1994. A further 1,776 posts in the less onerous, non-acute specialties are due to be brought down to 72 contracted hours by December 1996.
Mrs. Jackson: I thank the Minister for his reply, but has he seen the big notices on motorways which say that tiredness can kill, and that applies to lorry drivers whose maximum working week is a mere 45 hours? Is he aware that the 72 contracted hours level that has been agreed is an average, not a maximum, and that as many as six out of 10 junior doctors may regularly be working more than 72 hours? Does he agree that an exhausted young doctor in a hospital ward where the nursing staff is overstretched must be a danger to patients' safety?
Mr. Malone: I suggest that the hon. Lady considers the signs in her constituency, never mind signs on motorways. Northern general hospital has one of the best records in cutting hard-pressed posts--there are none at all over 72 hours. Only 14 per cent. of juniors are working more than 56 hours, which is less than half the national average, so perhaps, when she looks for success in this policy area, she might best look at home.
Of course, we do not want junior doctors who are exhausted. That is why, since 1991, 1,150 extra doctors have been brought into the health service to help reduce hours and why we are determined not just to reach our targets on the 72-hour commitment, but to work with junior doctors to ensure that the real time worked comes down to 56 hours as well.
Mr. Harry Greenway: Why do some junior doctors work much longer hours than the average and than those who work a normal week? Is better management required? Is work going on to achieve that?
Mr. Malone: My hon. Friend is right to point out the variations that take place across specialties. The reason for that is straightforward. Different specialties require different work patterns. For example, in some specialties, a large proportion of the time is spent on call; in others,
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the work is especially active. That is the reason for the variation across specialties, but of course we are trying to ensure that we come within the overall targets set.Mr. Nicholas Brown: I congratulate the Minister of State on surviving the ministerial reshuffle. Given the increasing commercial pressures being placed by the internal market on hospital trusts, and given that the Government recently announced that the contracts of junior doctors are to be held by the trusts, not by the region or the Department, will he confirm that the hours worked by junior doctors now stand to be negotiated locally and that the wages and conditions of junior doctors also stand to be negotiated locally by the hospital trusts?
Mr. Malone: May I congratulate the hon. Gentleman on not being whisked off to Australia with the Leader of the Opposition to deliver a lecture, but remaining here to ensure that the health policy set by his leader is observed by the right hon. Member for Derby, South (Mrs. Beckett). The question of junior hospital doctors' contracts and the custody of them is perfectly straightforward. They are best held at trust level. If they were held at regional level, we should have the curious experience of doctors becoming civil servants, which is not what anyone wants. The details are still being discussed with junior doctors but we are alive to their concerns. Deans will be responsible for the educational aspect of their contracts. I hope that we shall be able to resolve the matter in the not too distant future.
Mr. Waterson: Does my hon. Friend agree that the best measure of the Government's success in this area is not only that 96 per cent. or so of junior doctors are meeting the new deal targets on hours but that we are beginning to hear comments from the profession itself suggesting that junior doctors are missing out on vital experience because they are required to clock on and off, as it were, to meet some of those targets?
Mr. Malone: My hon. Friend is quite right to point out that such comments are increasingly being made by junior hospital doctors, but, despite that, I must stress the Government's commitment to ensuring that those targets are met. We are determined that they should be met, but it depends, of course, how each trust configures the service. It must be done with two things in mind: reducing the burdens on junior doctors and ensuring that they get proper and flexible training.
Parents (Travel Costs Allowance)
6. Ms Lynne: To ask the Secretary of State for Health what plans his Department has to review the travel cost allowance and facilities provided for overnight accommodation for low-income parents of children undergoing major surgery outside their locality. [33214]
Mr. Bowis: The 1993 Audit Commission report "Children First" showed that most hospitals provide facilities for parents to stay overnight at no charge. The hospital travel costs scheme for taking a child to hospital is kept under review. Community care grants for hospital visiting of children are a matter for my right hon. Friend the Secretary of State for Social Security.
Ms Lynne: I am grateful to the Minister for that reply, but does he not think it unacceptable that parents whose children have to have major surgery in an area outside
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their own have to search for funding either from the social fund or from charities to enable all their costs to be met? A constituent of mine eventually managed to obtain funding from the social fund, but it did not meet all the costs. She went to see her daughter who was having surgery in Birmingham but found it very difficult to manage. Will the Minister review the situation and introduce a rule whereby all NHS hospitals provide not only accommodation but transport costs?Mr. Bowis: The hon. Lady says that families should not have to hunt for funds. I have here a guide that contains information for parents of children going to hospital. We have a very good system of support for families on low incomes--if they are taking a child to hospital, they are covered by the hospital travel costs scheme and if they are visiting, they can have access to social fund community care grants. There is discretion for those above income support level if their journeys are regular and frequent.
The hon. Lady should think carefully about what she said about travel beyond local boundaries. If a child is ill, one of course wishes that child to go wherever the best treatment is, and there are now many hospitals in major centres around the country where careful consideration is given to the needs of families. Increasingly, there are beds for parents and even beds next to the children's beds. I hope that the hon. Lady will consider what a success story that is.
Dame Jill Knight: Will my hon. Friend not follow that line of questioning and give help only to children who have had major surgery? Does he accept that although leukaemia sufferers, for example, may not need major surgery, their parents need to be with them? Is he aware that voluntary bodies have set up hostels for just such cases, as happened in Birmingham? Will he listen with a sympathetic ear to any of them who ask for help?
Mr. Bowis: I will always listen with a sympathetic ear to my hon. Friend. I know well of the success story of the voluntary hostels in Birmingham to which she has referred and I shall certainly look at it. As I promised, we shall keep the whole scheme under review. She knows too of the remarkably good facilities in the Birmingham children's hospital, with some 29 parents' beds and five flatlets available for families. There has been progress in that area and we want it to continue.
Cigarette Smoking
7. Mr. MacShane: To ask the Secretary of State for Health what action his Department is taking to reduce the prevalence of cigarette smoking among young people; and if he will make a statement. [33215]
Mr. Sackville: Action is being taken across government to reduce smoking among young people.
Mr. MacShane: Is the Minister aware that for many people the quintessential image of life in Conservative Britain is a young school girl or school leaver with a fag drooping out of his or her mouth? Is he further aware that the incidence of smoking among school girls is on the increase and that the money allocated to campaign against it has been cut by half in the past 12 months? Is not the fundamental problem that the Conservative Government
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take any money in any form from tobacco companies rather than legislate in advertising or any other sphere to put the health of our young people first?Mr. Sackville: A Government who increase by a huge figure the taxation on tobacco in every Budget are hardly trying to encourage tobacco producers or the use of their product. The hon. Gentleman thinks that he is a good European. He may like to ask his friends in Brussels why they continue to pay £1 billion a year for the production of tobacco in southern Europe, and why at least one European country taxes tobacco so low that cigarettes are sold at a fifth of the level in this country. He might like to consider whether behind his question and his new-found interest is a certain whiff of Euro-hypocrisy.
Mrs. Lait: Is my hon. Friend aware that one of the reasons why there has been an increase in smoking among young people is the prevalence of cheap, smuggled tobacco? What is he doing in the Council of Health Ministers to raise public awareness of that issue in the other European countries?
Mr. Sackville: We are doing everything possible to persuade our European partners, in the spirit of harmonisation, to increase their taxation on tobacco. Of the major countries, we are by far the largest taxer of tobacco. I agree with my hon. Friend that just as it is very difficult to persuade young people not to do things on the ground that it is bad for their health, it is also very difficult to persuade them not to buy cigarettes cheaply across the channel and bring them into this country.
Mr. Kirkwood: Is the Minister aware of the new moves being taken by the public health authorities in the United States to consider making tobacco and nicotine controlled substances under the dangerous drugs regime? Will he assure the House that the Department of Health will watch carefully what is happening in that regard? Would not the most effective way of dealing with smoking in young people be for the new ministerial team simply to ban the advertising of cigarettes available to young people?
Mr. Sackville: Having brought the accursed habit of smoking from the American colonies originally, perhaps we can learn some lessons from them on how to reduce consumption here.
GP Fundholders
8. Mr. Duncan Smith: To ask the Secretary of State for Health how many fundholding general practitioners there are in Redbridge and Waltham Forest district. [33216]
Mr. Dorrell: There are currently 86 general practitioners who are fundholders in the Redbridge and Waltham Forest family health services authority area serving an estimated 44 per cent. of the population.
Mr. Duncan Smith: I thank my right hon. Friend for that information. Does he agree that one of the great success stories of fundholders has been the fact that they have helped improve standards across the board for all general practitioners by the use of innovation and best practice, not only by driving down the cost of the drug budget, but by bringing areas of medicine into their practice? Will my right hon. Friend undertake to do two things as a result: first to make it even easier for other
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practitioners to become fundholders as fast as possible, and secondly to expose the nonsense of the Opposition, who seek to level downwards to get rid of best practice and innovation and to crush the whole idea of improvement among general practitioners?Mr. Dorrell: I entirely agree with both my hon. Friend's propositions. He will know that we are developing fundholding by extending the concept to include the total purchase of health care for a particular resident population and by extending it down the patient list size. There is now a fundholding scheme for relatively small general practices. Both of those are welcome developments which follow through the Government's policy of giving real budgets to doctors to allow them to make real choices. That is in preference to Labour's policy, which is to give notional budgets to doctors to allow them to make notional choices.
It is an extraordinary commentary on the Labour party that, when it is given the choice between regional health authorities and fundholding practices, it chooses to keep regional health authorities and to abolish fundholding practices. That, of course, is before we have heard the word from Hayman Island about where the policy should go next.
Mrs. Beckett: Surely the Secretary of State must be aware that, although there is no evidence to justify the statements just made by the hon. Member for Chingford (Mr. Duncan Smith)--there is no proper evidence and no evaluation behind those statements--there is growing evidence that GP commissioning is both more effective and less expensive than fundholding. As the Secretary of State seems to have overlooked them, I draw to his attention the recent remarks by Duncan Nichol, the former head of the health service executive. He said that he preferred GP commissioning and then said:
"You don't necessarily need the budget in your hand but you need to influence it."
As the evidence is on the side of GP commissioning rather than fundholding, why are the Secretary of State and his colleagues trying to discourage commissioning? Why are they wasting money and risking fragmenting the health service by forcing people to become fundholders?
Mr. Dorrell: The right hon. Lady says that there is no evidence; that is not true. The efficiency with which fundholders use their resources has been assessed at between a 3.5 and 4 per cent. improvement year by year. The total cost of the administrative element of the fundholding budget is between 2 and 3 per cent. Even if one assumes that the total cost is extra cost, it is actually paid for by the efficiency achieved by fundholding doctors. In terms of the choice between notional commissioning and hard budgeting, I should like to hear the right hon. Lady explain why she thinks that a doctor is better able to deliver value for his patients if he is given a notional budget than he is if he is given the opportunity to commit real money to buy real care from real health service providers.
Waiting Lists (Dorset)
9. Mr. Ian Bruce: To ask the Secretary of State for Health what assessment he has made of the trend in waiting lists in Dorset compared to the rest of the country. [33217]
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Mr. Malone: The numbers of patients on waiting lists fell last year both in Dorset, by 1.3 per cent., and nationally, by 2 per cent. More importantly, Dorset hospitals have made considerable progress in reducing waiting times.
Mr. Bruce: Does my hon. Friend agree that much of the success of the hospitals in Dorset can be explained by exactly what the right hon. Member for Derby, South (Mrs. Beckett) asked for--the evidence? The evidence is that going ahead quickly with fundholding and trusts has been extremely successful. Will my hon. Friend congratulate the people in the NHS in my constituency and throughout Dorset on their work? There is, perhaps, one cautionary tale. I would be grateful if my hon. Friend would look at dentists in Dorset to see whether he can get them as well sorted out as the rest of the health service in Dorset has been.
Mr. Malone: On the last point, I am of course happy to look at the position of dentists. I am also happy to congratulate all those who work in hospitals in Dorset. There have been fantastic achievements. There were 97 six-month waiters in the West Dorset General Hospitals trust in September 1994. That figure is now down by 100 per cent. There was one six-month waiter at the Poole Hospital NHS trust in 1994; that figure is down by 100 per cent. The Dorset Healthcare trust had only three six-month waiters in 1994; that figure has been reduced by 100 per cent. At the Royal Bournemouth and Christchurch Hospitals NHS trust, there were 333 patients who had waited for more than six months at 30 September 1994; that figure is down by 100 per cent. That is a 100 per cent. success rate for west Dorset. My hon. Friend is right to congratulate all those who are responsible for delivering it.
Mrs. Golding: The Minister may be interested to know that I worked in the Dorchester hospital many years ago. For that reason, I have taken a keen interest in what is happening in the area. The Minister quotes figures. He should be aware that 811 operations were cancelled in Dorset in the past financial year and that 20 per cent. of the patients involved were not readmitted within one month as agreed in the charter. The Minister will also know that nationally in the three months to March 1995, there was a 22 per cent. increase in operation cancellations. The number of patients who were not readmitted within one month increased massively to 49 per cent. on the previous three months.
There is great concern that so many operations are being cancelled, often at the very last moment when patients have received their pre-medication and have been fully prepared for the theatre. Surely the Minister cannot continue to be complacent. The situation is causing extreme distress and inconvenience to many people, especially to children. What does he intend to do about it?
Mr. Malone: I welcome the hon. Lady to the Dispatch Box and to her responsibilities. Cancellation of operations across the country as a whole is a matter for concern, and one that individual hospitals are addressing. Only last week I visited Basingstoke hospital, where a pre-admissions ward has reduced cancellations almost to zero. We must make such initiatives widely known throughout the country, so that the problem can be dealt with.
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