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Ms Glenda Jackson (Hampstead and Highgate): The local flexibility to which the Secretary of State referred operates at the Royal Free hospital trust in my constituency. One of my constituents, a cancer patient, was given a day for admittance to the hospital but his admittance was cancelled at 5 o'clock on the day that he was due to go in. He went in one day later and went through the entire pre-operation medical procedures, only to be told that the operation had been cancelled. At that time, the hospital could not give him an alternative date. Instead, it has allowed him to go home every day but he must return to the hospital at 6 o'clock in the evening. He believes, and I have had that belief confirmed by others, that during his absence his bed is used. That is not redesignation of beds but hot bedding.
Mr. Dorrell: It is well known that, if an hon. Member wants a Minister to examine a specific case, he or she will
do so. I shall not seek to respond off the cuff to a specific case. I remind the House that, over the past two months, the national health service has done what it is there to do: treat priority cases first. In the overwhelming majority of cases, it has delivered the emergency service that we want to see.
Sir John Gorst (Hendon, North): How does my right hon. Friend reconcile all that he has said and the principles that he correctly outlined at the beginning of his speech with the intention to close the accident and emergency unit in my constituency and replace it with a miserable alternative that is of no consequence when compared to the original?
Mr. Dorrell: My hon. Friend knows that we are currently engaged in consultation on the shape of services to be delivered at Edgware hospital in the future, and part of a state-of-the-art accident and emergency service for his constituents will be delivered through Edgware hospital. The precise nature of the total service to be delivered at Edgware is the subject of current consultation.
Mr. Hugh Dykes (Harrow, East): Will my right hon. Friend give way?
Mr. John Marshall (Hendon, South): Will my right hon. Friend give way?
Mr. Dorrell: I shall give way to one of my hon. Friends--my hon. Friend the Member for Harrow, East (Mr. Dykes).
Mr. Dykes: I am grateful to my right hon. Friend. Does he agree that a perfect example of his point about the increase in treatment figures and in the accident and emergency figures is Northwick Park hospital--a big district general hospital shared by my constituency and that of my hon. Friend the Member for Harrow, West (Mr. Hughes)--where the figures have risen enormously recently, but where treatment has improved, as all of its patients say, without any reasoned exception?
Mr. Dorrell: My hon. Friend is exactly right, and that has been the overwhelming experience of patients of the emergency services of the NHS. I must move on, because the hon. Member for Peckham said in response to my arguments--
Mr. Simon Hughes (Southwark and Bermondsey): Will the Secretary of State give way?
Mr. Dorrell: Later. The hon. Lady said that the shift to meet the emergency work load has led to a reduced service for those on elective waiting lists, with the result--she claims--that there has been an increase in the proportion of elective surgery done by the private sector. I have heard her make that claim several times since I took up my present responsibilities, so I have had it examined. I have looked at the evidence to see whether it is true that there has been a dramatic increase in the share of elective surgery conducted in the private sector.
The fact is that, in the past 14 years, the share of elective surgery done in this country on people resident in this country by the private sector has risen from 14 per
cent. of the total to 15.3 per cent. of the total--an increase of 1.3 percentage points. The House will not recognise from that statistic the rhetoric of the hon. Lady.
That brings me to another element of the choice and diversity for which the hon. Lady has made herself famous this week--the application of that principle within the NHS. Many of my hon. Friends have raised the issue of GP fundholding, and they are right to do so. The Government have made it clear that we are determined to develop the primary health care service of the NHS because--[Interruption.] Opposition Members appear to have lost interest in the NHS. So much for their passionate interest in the development of primary care in the health service. They seem to be more interested in their private internal bickering. No doubt they are all discussing the performance of the hon. Member for Peckham. We know from the lunchtime news what Labour Members think of her performance, and we can see them all plotting their next move in the battles that are going on within the Labour party.
When Opposition Members have concluded their private discussions, perhaps they would like to turn their attention for a moment to the future of the NHS and the delivery of high-quality primary health care. The fundholding system has been described by the chairman of the Socialist Health Association, Julian LeGrand, as the biggest success story of the health service reforms. Perhaps more tellingly, the hon. Member for Peckham's predecessor as Opposition health spokesman, the right hon. Member for Derby, South (Mrs. Beckett), went to the National Association of Fund Holding Practices--
Mr. Henry McLeish (Fife, Central):
This is old hat.
Mr. Dorrell:
Old hat? This happened last October. How long does a policy last in the Labour party? Last October, the right hon. Member for Derby, South went to the National Association of Fund Holding Practices conference, and thought that she had better curry favour from the audience. She said that Labour understood and welcomed the advances fundholding has brought to many patients. The hon. Member for Peckham has shown us this week that she thinks services should be determined by--in her case--the interests of the son. I would argue that the same principle should apply to the patient.
There is, in the words of the right hon. Member for Derby, South, clear evidence that fundholding brings benefits to patients. I look forward to hearing from the hon. Member for Peckham how she justifies her policy of replacing fundholding. How can a party which espouses the true interests of patients be committed to sweeping away a system that its own previous health spokesman has recognised serves the interests of patients?
Mr. Jerry Hayes (Harlow):
Does my right hon. Friend recall that the right hon. Member for Derby, South(Mrs. Beckett) went on to say that she hoped that fundholding would be abolished in the first year of a Labour Government? Does that still stand?
Mr. Dorrell:
The right hon. Member for Derby, South's line on fundholding was reminiscent of the line taken by Anthony Crosland on selective schools. Her line was, "We shall get rid of fundholding." The hon. Member for Peckham's words, however, are slightly more
Mr. Nicholas Winterton (Macclesfield):
Fundholding has brought immense benefits to the patients in the large village of Poynton in the north of my constituency. I had the privilege to open a new medical centre there that provides, on the doorstep of patients, facilities that hitherto would not have been available and for which local people would have to have gone to the district general hospital. The fundholding practice is working closely with the district general hospital and is providing additional, technologically advanced services right on the doorstep of patients.
Mr. Dorrell:
My hon. Friend is precisely right. He quotes a good example where service has been enhanced, and that has happened not just in the practicein the constituency of my hon. Friend, but acrossthe NHS. When one fundholding practice makessuch a breakthrough, others--fundholders and non-fundholders--want to apply the same principles.
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