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11.36 am
Sir Sydney Chapman (Chipping Barnet): As the House will know, this is my re-entry attempt as I am speaking in a debate on the Floor of the House for the first time in nearly seven years. The reason is that until last July, I had the privilege of being in the Government Whips Office. One condition of belonging to that most prestigious club, of which right hon. Friend the Secretary
of State for Health has had some experience, is that one is supposed to take a vow of silence. It was not a complete vow of silence, because I should say, with all due immodesty, that we made some of the most popular speeches in the House, not only because they were the shortest, but because we asked the person in the Chair to adjourn the House.
I have to say, and I hope I am not breaking the Official Secrets Act in so doing, that I could best describe more than six and a half years in the Whips Office by saying that as time passed I increasingly realised the truth of the ancient Chinese curse, "May you live in interesting times". However, just as every Member agrees on one thing--that it is an honour and privilege to have the opportunity to serve our constituents in this august Chamber--I would like to put on record my appreciation to my right hon. Friend the Prime Minister for the privilege that I felt in serving in his Administration and that of his predecessor. To adapt a well-worn adage, they also serve who only stand and Whip.
I should also add that, as some of my hon. Friends will know, for the past three and a quarter years I had the additional privilege of being Vice-Chamberlain of Her Majesty's Household. That required three specific and extra duties: to carry messages to and from the House and to write to Her Majesty every day that the House was sitting to let her know what was going on. As those letters will not be made public for 30 years, I assure the House that I always wrote with impeccable political impartiality. Thirdly, on three occasions I had the duty to be the hostage at state openings of Parliament and I could not return here until the safe return of Her Majesty to Buckingham palace. The problem was when she safely returned I wanted to stay there rather than come back here.
I am grateful to have the opportunity to follow the hon. Member for Crewe and Nantwich (Mrs. Dunwoody) as I was born in a different part of the county that she represents. I am also pleased to follow also my right hon. Friend the Member for Brent, North (Sir R. Boyson), for whom I have such a tremendous regard that I have just signed his nomination papers for re-election to our 1922 Committee.
It is worth remembering that when we are talking about the national health service, we are talking about people. The difficulty that politicians face is that in addressing the problems and achievements of the NHS, we inevitably have to deal with statistics. Some will come tumbling from my lips. The Government's greatest achievement in the NHS over the past 16 years is to have committed-- thanks to the taxpayer--an additional £30,000 million a year to the service. As my right hon. Friend the Secretary of State said, that represents an increase in real terms, after allowing for inflation, of 70 per cent.
I am trying to deal with the real issues in the NHS. The hon. Member for Crewe and Nantwich, for whom I have a great deal of respect, was rather unfair in her comments on my right hon. Friend's speech. Of course there are problems, the main one being the escalating demand for NHS services. That is due to two factors--first, because of the introduction of so many new and very expensive operations, treatments and drugs, and, secondly, because as the years go by demographic changes in our society result in more elderly people as a percentage of our total population. Not long ago, my right hon. Friend the Secretary of State for Social Security said that 42 per cent.
of his budget is spent on the elderly in our society, who represent about 16 per cent. of the total population. A staggering statistic to bear in mind is that as those demographic changes continue, in 35 years' time there will be 50 per cent. more elderly people and a correspondingly shrinking work force.
The very exciting, almost mind-boggling, advances that there have been and will continue to be in medical know-how and technology have had a profound effect on the way that we deliver health care services to the nation. There is a good example of that in Barnet and I want to pick up one or two of the relevant points mentioned in the eloquent speech by my right hon. Friend the Member for Brent, North.
For more than 60 years we have been fighting for a new general hospital in Barnet. I shall be even-handed in political partisanship and admit that successive Governments have thwarted that wish. In 1970, Barnet received approval to demolish old huts--separate corrugated iron sheds, which are presently wards and where operations have been carried out--and to build a new ward block. That was frustrated by a Labour Government. I can be even more politically even-handed by saying that the then Minister responsible for health was a Dr. David Owen, who I understand has moved to new political pastures and, for all I know, may be moving even further. He wrote to Barnet community health council in 1975:
I shall continue to be even-handed and say that a new Barnet general hospital was put back on the agenda four or five years later. By that time there had been a change of Government. At the beginning of 1980 the health authority put forward proposals to build a surgical block, but a year later that scheme fell victim to the need to rein in public spending. We must treat with caution some of the Opposition's admonitions when they talk about the need for more funding for the NHS.
The good news is that the first phase of the redevelopment of Barnet is going ahead and is due for completion in 1997. That phase centres around a new and enlarged accident and emergency department with a new maternity unit. In recent years my constituents facing a happy event have had to go to Edgware to have their babies. Soon, those who want to do so can have them in Barnet.
The problem in Barnet cannot be put simply, but it must be put medically and fairly. Because the A and E departments were on two separate sites, sufficient cover could not be given to both. There is a popular misconception among all our constituents that an A and E department in a hospital can cater for any accident or emergency. That is not the case and never has been. There is strong evidence, at least in my part of the world, that where A and E facilities have been split over two sites lives have been lost.
I want to quote one or two statistics--not those produced by politicians, but given to us by the experts. A Royal College of Surgeons' report contains the shocking statistic that one in four deaths in A and E departments is avoidable. A British Orthopaedic Association report states that one in five people is inadequately treated after major surgery and one in eight left with a severe avoidable disability. I find those statistics shocking.
Even closer to home, a study undertaken by a Dr. Richard Warren shows that in the old north-west Thames region--it is now amalgamated into a new north Thames region--there were 86 avoidable deaths a year in A and E departments. It seems to me that if we are at all interested in what must be the highest priority of any health service--to save lives--changes must be made to reduce the number of deaths and casualties. That can be achieved by having a new and enlarged A and E department on one site. We should not forsake the other site completely, but use it for other NHS functions, including a minor accident treatment centre.
I have at least partial good news for my right hon. Friend the Member for Brent, North, for my hon. Friends the Members for Hendon, South (Mr. Marshall) and for Finchley (Mr. Booth), who I am delighted to see here today, and for my hon. Friend the Member for Hendon, North (Sir J. Gorst), who is unavoidably absent. The new minor accident treatment centre, which we have been promised before the A and E department at Edgware merges with Barnet, is due to open next week. We can take comfort from that.
Mr. Booth:
Will my hon. Friend allow the comment to be made that the casualty unit in Edgware will cope with the problem raised by my right hon. Friend the Member for Brent, North (Sir R. Boyson)? Is he aware that there is a fear in the Edgware area that people may die before they reach a casualty unit in that there will be, as part of the casualty unit in Edgware, a place where crisis cases will be stabilised, as they are in the community hospital in Finchley, before they are moved on, in time, to the major trauma centre, which will be either Northwick Park hospital or Barnet general?
Sir Sydney Chapman:
As my hon. Friend will understand, I cannot be expected to answer his question definitively.
It is important to understand that the majority of cases now being dealt with at Edgware will continue to be dealt with there. Of about 40,000 cases a year that are dealt with at the accident and emergency department at Edgware, only 1 or 2 per cent. could be described as life threatening. Even if one of my constituents collapsed and suffered a serious injury almost in the next road to Barnet general hospital, he or she would not necessarily be taken to that hospital. According to the seriousness and the nature of the injury, it may be that the person could best be dealt with at another hospital. I am sorry to be so morbid, but a person collapsing just outside Edgware hospital may not, even now, be taken to it. He or she may be taken to Northwick Park, the Royal Free or Barnet general.
It is important that we get these issues over to the public honestly and intelligibly. My hon. Friend the Member for Finchley will know that nowadays about 55 per cent. of surgery cases are day care. That has been a tremendous development in the NHS.
"We are all aware of the pressing need for better hospital facilities in the Barnet area. It is the economic situation we face which prevents us remedying Barnet's particular difficulties."
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