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Mrs. Anne Campbell (Cambridge): Will the hon. Lady give way?
Dame Jill Knight: Other hon. Members want to speak, so if the hon. Lady will forgive me, I shall hurry along.
I am putting this on record, because it is true.Our health service has never been as good as it is today.For every one of the cases that the hon. Member for Bootle mentioned, I can tell him of 10, 20 or 30 patients who were very satisfied with the care that they received. Many of them have written to me about it. I have a file from people who wished to tell me how satisfied they were with the care that they received. Never in our history have so many doctors treated so many patients for so many ills with so few failures. Indeed, they are carrying out miracles, when I look at some of the cases of tiny babies being operated on today who would have died only a few years ago.
There are such cases not just in Birmingham, but throughout the country. Hip replacements are now carried out as a matter of common practice. Twenty years ago, transplant surgery was unheard of on its present scale,but it is now widespread. Consider how miraculous that is and the benefits that it gives. Nowadays people have not one heart bypass but triple or quadruple heart bypasses in one operation. Our clever doctors have never served the people so well. Our health service has never been as miraculous as it is today.
The second basic truth to which Opposition Members should listen carefully is that no Government of any political colour will ever be able to ensure that every single patient is treated for every single ill, in the hospital of his choice, by the consultant whom he prefers, the instant that the need arises. That may be a good goal for which to strive, but it ain't gonna happen because it is impossible. We can work towards it, but it is unlikely to be achieved, whoever is in power.
In Birmingham, we are grateful for the excellent health care available. However, Opposition Members have taken care to dwell on the few times when things do not go right rather than the thousands of times when they do. The newspapers are the same. I am aware that editors believe that only bad news sells papers, but I wish that they would not lie. A recent story in Birmingham referred to the huge loss of beds in Birmingham hospitals.
Incidentally, I was worried to deduce that the hon. Member for Peckham must have misled the House when she read a portion of a letter this afternoon. I know that my right hon. Friend the Member for Sutton Coldfield (Sir N. Fowler) will have been disappointed that she was not present during his speech, because he also had information from the same official. The information that my right hon. Friend gave me was almost directly opposite to that given by the hon. Lady, so one of them must be wrong and we should be told which one. My right hon. Friend, who has been a Secretary of State, had the information in front of him and he read some of it.
I do not believe that the Birmingham health authorities are lying when they say:
We should at least have the truth, and the authorities that are in charge say that such claims are not true.
It is right to recognise--nobody referred to this when talking about the lack of hospital beds--that many patients today are dealt with in day care facilities. Surely we do not need the same number of beds when thousands of patients are dealt with in the course of a day. I also welcome that advance, which medicine has given us.
The substantial investment in our Birmingham hospitals should be acknowledged. The Queen Elizabeth hospital has had a new neuro-science unit at a cost of £7.2 million, a cancer centre will open shortly at a cost of £8.5 million and there is a £30 million budget for improving theatres and wards. At Selly Oak hospital, £7.5 million has been spent on a new accident and emergency trauma unit and £2 million has been allocated for upgrading the outpatients' department. That was certainly needed, but £2 million is a lot of money. City hospital has had£7.2 million for a high-tech eye unit and £1.4 million for the upgrading of the accident and emergency unit, and it is also to have a new dermatology unit. Such figures are exceedingly encouraging.
Birmingham Heartlands, Good Hope and the Children's hospital have had £34.7 million between them. We also have a miraculous new women's hospital costing£17 million, for which we in Birmingham are grateful. All in all, Birmingham health authorities now have a budget of £600 million. That is one city--an important city, but one city.
Why will the Opposition never tell us whether they will put any more money into the health service, or even whether they will put as much money in? We just do not know. But those are the cold, hard facts and they are true. Of course, difficulties and problems can arise and they do, but there could not be a better sign of Government commitment to the health service than the fact that one city alone has had £600 million for the improvements that are needed.
I am rather tired of the unjustified criticisms made in the debate, which are constantly made, for reasons that can only be political. A favourite grumble is that too much is spent on management. My right hon. Friend the Member for Sutton Coldfield pointed out that inefficient management in the health service leads to bad patient care. However, I want to put on record the fact that Birmingham spends less than 3 per cent. of its resources on management--less than 3 per cent. That is not a waste of money on large cars and all the rest of it. In addition, there is no trace of self-congratulation when Birmingham says:
I am sure that the Government feel the same.
Finally, I want to make two suggestions for the improvement of health care, particularly for the elderly. Too often in hospital, the elderly are robbed of their dignity. That occurs in two particular ways, which have been brought home to me, about which the previous Secretary of State tried to do something.
Many people hate being in a mixed ward. We understand that intensive care is a different matter because people are often unconscious. But men and women do not want to be mixed up in an ordinary hospital ward, and they should not be. It takes away their dignity and it is wrong.
There is also far too much taking away of elderly people's dignity by immediately referring to them as Betty, Jim or Bill. That may seem a small thing, but it is not. That surprises younger people, but I have known many elderly people--hon. Members know that there is validity in what I say--who feel a loss of dignity if they are addressed by their Christian name, often by nurses and doctors young enough to be their grandchildren, if they are not used to it. That is hurtful and there is no need for it. Surely to goodness we could recognise that every scrap of help that we can give our patients to preserve their dignity as well as their health should be made available.
With those two suggestions, I strongly support the amendment and I hope that it is carried.
Mr. Ronnie Campbell (Blyth Valley):
Listening to some Conservative Members, one would think that the health service was safe in their hands, but the complaints that I have received and the troubles about which I have heard during a number of years under this Administration suggest otherwise. As a member of the Select Committee on the Parliamentary Commissioner for Administration,I know that there has been a large increase in the number of complaints about the health service.
I recognise that more operations are carried out now than ever before as a result of improved techniques.A person can go into hospital one day and come out the next, whereas a few years ago, he might have had to stay for a week. That, however, does not account for some of the horror stories that my hon. Friends have told. I have heard such stories myself, particularly in relation to a hospital in my area, the Cheviot and Wansbeck hospital.
Originally, a hospital was built in the constituencyof my hon. Friend the Member for Wansbeck(Mr. Thompson), at considerable cost. Another hospital existed on another site, but, although still operational, it was run down and in a decaying state. The new hospital became a trust shortly after being opened, despite suggestions that it should not take that step too quickly. Lo and behold! In that first year of its existence, it was in debt to the tune of £2.5 million. That is when the problems started.
Two mothers are currently taking legal action against the hospital because they lost their children, which was undoubtedly due to neglect on the part of the hospital and, in particular, the maternity ward. I do not know what progress their cases are making, as legal action is a lengthy process. One of those patients is a constituent of mine; the other is a constituent of my hon. Friend the Member for Wansbeck. My constituent was left in the maternity ward. After her waters broke, she was left again. Although obviously in labour, she was left for hours with no one to tend her. Finally, someone came along and found that she was in labour--as she had been for some time. As it was her first child, she did not realise what was happening. The child was born, and taken from her; when she woke up, the doctors told her that it was very ill and that there was not much hope. The baby subsequently died.
The moral of that story is simple. As I said, the hospital had been advised not to become a trust yet, but it did so under pressure from the Government. It was £2.5 million in debt. It had cut the number of midwives on its staff to save a few bob: it had to save money in some way.
Because of the cut, the midwife who was looking after my constituent was having to do 32 other things at the same time. She was under enormous pressure.
The chief executive, chairman and finance officer of that hospital have all left. I thank God for that, because it was they who made a mess of things. I must admit that those who took over are doing a pretty good job at present: at least they have clawed back £1 million, and patients to whom I have spoken seem fairly satisfied. I have not received many complaints.
I see that the hon. Member for Rugby and Kenilworth (Mr. Pawsey), who chairs the Select Committee on the Parliamentary Commissioner for Administration, is present. The Committee often investigates the health service, and we repeatedly find that trust managers and chief executives are not taking seriously their responsibility to deal with complaints. When serious complaints are made, they ignore them. The health service ombudsman is said to have renewed his attack on national health service managers' handling of complaints, and the way in which they ignore the necessary procedures. I wonder how many complaints are received by the Parliamentary Commissioner, and whether any of the complaints cited by my hon. Friend the Member for Bootle (Mr. Benton) have been investigated.
My local practice in Blyth Valley has 12,000 patients. The practice, which is one of the biggest in the area, refused to adopt fundholding, although other local practices have. I have heard stories and tried to gather evidence, and I questioned the Parliamentary Commissioner some time ago when he was giving evidence to the Committee. I had an inkling that fundholders were beginning to receive preferential treatment, although that has always been denied. I asked the Commissioner whether, if someone told me that a patient in a fundholding practice had been seen before them, that would constitute a legitimate complaint. The Commissioner said that he would investigate the matter.
I am examining the position carefully, and I have written to the executive at the Cheviot and Wansbeck hospital to that effect. Of course, those involved may have smartened themselves up because they know that I have my eye on them. I ask other hon. Members who obtain any relevant evidence to write to the Commissioner, and to inform my hon. Friend the Member for Rugby and Kenilworth and me. As I said, however, the hospital is getting back on its feet, and I hope that phase 3 will proceed successfully.
Only last year, Gallup conducted a survey among NHS workers. I doubt that the Minister has seen the results, but I shall provide him with a copy if he would like one. The survey found that nurses were leaving the NHS in droves, piling pressure on those who remained. I remind hon. Members that Gallup is entirely independent.
When workers were asked whether they would consider leaving the NHS if they could obtain another job, 62 per cent. said that they would--an increase of 48 per cent. since the last survey in 1993; 75 per cent. of ward sisters and charge nurses said that they would leave, and 74 per cent. of staff nurses, 70 per cent. of health visitors and69 per cent. of midwives said the same. When asked for their reasons, they cited falling standards: 62 per cent. mentioned having to compromise in regard to standards
of care, while 63 per cent. referred to acute staff shortages and 75 per cent. said that they felt undervalued. If that is the reaction from health service workers, no wonder my hon. Friend the Member for Bootle and others are receiving complaints. Sixty per cent. said that their reason was the treatment by management. Of course, management is hard on the heels of the poor unfortunate people working in the health service. The service is being cut and those people are under pressure, understaffed and under great stress, and they are doing more work now than before. Of course, they are sick of it, and managers are always on their back--that is what they are for.
Fifty-one per cent. of nurses said that their reason was level of pay. They were concerned about the Government's policy of breaking the national agreement and bringing in local pay. Many of them thought that that was just another way of devaluing their pay in different regions, so a nurse in one region would get less than a nurse in another region doing the same job. If nurses want to work in a rich region, they are "Okay, mate," but if they want to work in a poor one, they are not.
There was a good article on health in one of the national newspapers in the north-east. Newspapers are newspapers, but I have heard this before and it was not far from the mark. In the north, the number of nurses has fallen by 4,000 in five years. It was interesting to read that Scottish and Newcastle Breweries is luring nurses to pull pints. One of its executive members said:
That is obviously because nurses are tolerant and understanding--that is all people want in a pub manager. Breweries are luring nurses and nurses are going to work for them.
This year, the Nursing Times and Nursing Mirror carried 1,000 job advertisements for nurses--there were five pages of them. More than 100 nursing posts are vacant in the north-east of England. There must be something wrong, unless all nurses go to a bank--as an agency is called. Apparently, nurses who use them get more money. A hospital or a trust can sack a nurse tomorrow and she can join a bank, come back to that hospital and cost the hospital more. I cannot fathom that out for my life, but it happens.
There are short-term contracts for nurses now. When a nurse is employed, she is put on only a one or two-month contract, so she has no job security. In the health service, hospital trusts can float people out and float them in at a whim. It is a pity that we cannot do the same with some of the executive members and chairmen of the trusts, although I must admit that I did pretty well in achieving that in the Cheviot and Wansbeck NHS trust, getting rid of three of them in almost one go.
Staff shortages and a growing work load cause great stress. At least 87 per cent. of nurses interviewed in the Gallup poll said that they were overworked and under great stress. That says a lot. I hope that the Minister will take note of the fact that people are under stress. We must ask why that is happening. It might be because they see all these people on trolleys. They might be seeing the things that my hon. Friend the Member for Bootle has made complaints about, and they cannot do anything about it because they are overworked and overstressed.
In the past few years, complaints about the health service have increased by 55,000. There is a serious fault somewhere. If we do not get to grips with it, and if we do not give nurses a decent wage and make the job worth their while, problems will pile up.
How many times have we heard a patient say how wonderful it was being in hospital, seeing nurses at work and seeing their dedication to the people whom they are there to serve? I have heard that many times in hospital, yet nurses' wages have fallen and, as the survey showed, many want to leave the health service. That counteracts all that. If those things are happening, big accidents will occur and complaints will be made.
"Claims in the local press and elsewhere, that there has been a huge loss of beds across Birmingham hospitals are not true."
24 Jan 1996 : Column 409
"We know there is further room for further improvement and we will go for it."
7.18 pm
"In our experience, trained nurses make superb pub managers".
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