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Mr. McLeish: What about nursing?
Mr. Malone: I shall be pleased to refer to nursing in a minute. Proper management is right for the health service, and cutting away bureaucracy and cutting management--the policy of my right hon. Friend the Secretary of State--are also right. The two are quite compatible. The hon. Member for Southwark and Bermondsey (Mr. Hughes) talked about the structure of the health service, and about defining the boundaries of clinical effectiveness. I agreed with him on that, but he went on to say we that we should have local government participation.
I read with some interest a famous Liberal Democrat document, "Towards 1996", which said:
I am not sure whether every one of my hon. Friends now has a copy of this document, but probably most do. The document referred to the work done by somebody called the Liberal Democrat party's political warfare officer--whoever that might be. The document dealt with health in some detail, and listed the Liberal Democrats' strengths and weaknesses on the issue. It managed to find one strength and four weaknesses, one of which was the policy enunciated by the hon. Gentleman, who talked of having councillors in control of health authorities. The document said:
The hon. Gentleman would do well to listen to his advisers on that point.
My hon. Friend the Member for Broxbourne (Mrs. Roe), the Chairman of the Health Select Committee, made a powerful and thoughtful speech in which she set out an important future agenda for the Committee, with which we will work with great interest. The Government are keen to respond to the work of the Select Committee--as my hon. Friend pointed out--and we have just submitted an important memorandum on the subject of long-term care. I know that the Committee will consider that with great interest.
The hon. Member for Bootle (Mr. Benton) came out with the real tactic of the Opposition, which was to have a saga of cases to which Ministers might have been able to respond had they been given some notice. I say that because I made an offer to another hon. Member--he is not in his place--at our previous debate on the matter to investigate every single case that he raised. I must say that he was deficient in the facts when we looked at the cases. I make the same offer to the hon. Member for Bootle--I shall look at each of the cases that he raised and respond to him in detail.
The Government suggest that people go to the point of first resort, which is the trust. But if there is dissatisfaction, Ministers are happy to look at the case and take up matters on behalf of hon. Members. The hon. Member for Bootle mentioned specifically a reduction in beds, and the loss of a 59-bed unit at Walton hospital. There is to be a new bed block in an associated hospital, but the hon. Gentleman may be disappointed to hear--as it rather destroys his point--that it will contain not 59 but 72 beds.
The imbalance in the debate was that, although we heard tales such as that told by the hon. Member for Bootle, Opposition Members positively refused to talk about what was happening. The hon. Gentleman referred to Fazakerley hospital, but I was surprised that the hon. Gentleman--as an hon. Member who represents his constituents' interests--failed to mention the investment of £1 million in accident and emergency services in 1994-95. Although he illustrated his point with three cases, he failed to point out that 95 per cent. of patients are now admitted within one hour of the decision to admit. It would be helpful if he looked at the facts.
My hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) paid tribute to what the NHS is achieving, but she raised concerns about mixed wards. We share those concerns, and we need to make progress towards eliminating such wards. She also suggested that NHS staff ought to have care when referring to patients by their Christian name, as that might be insulting. All I can say is that any staff member who referred to my hon. Friend as "Jill" should she ever be in hospital will probably get a thick ear. It is certainly not something that I would try.
I was pleased that the hon. Member for Blyth Valley (Mr. Campbell) acknowledged that there had been improvements in the service. He dealt specifically with nursing, to which I promised the hon. Member for Fife, Central I would return. I find fault with the Labour party because it always refuses to tell the full case. If one looks at the figures and notes that learners and Project 2000 students are now treated in a different way, and includes general medical services practice nurses, whom the
Labour party always seems on purpose to exclude, one sees that there has been a 1.6 per cent. increase in qualified and unqualified nursing and midwifery staff between 1989 and 1994. The full picture shows a different story.
Mr. McLeish:
There are not enough.
Mr. Malone:
The hon. Gentleman says from a sedentary position that that is not enough, but that is not the point. His hon. Friends have said that nursing numbers have decreased, but that is simply not true.
Mr. McLeish:
Will the Minister confirm that if one takes Project 2000 nurses and adds them to the learners who are still within the NHS, there are, based on the Minister's figures, 19,000 fewer nurses in training now than in the past?
Mr. Malone:
The numbers of nurses in training at any given time, as of doctors and any other medical staff, are those sufficient to man the service. The hon. Gentleman forgets that when his party handed the health service to the Government, people were leaving it in droves. The NHS was not retaining its staff. More nurses are now being retained than in the past, and that explains why the figure is different.
My hon. Friend the Member for Wycombe (Mr. Whitney) challenged the Labour party to say what management levels are right. We did not hear anything about that from the Labour party. Judging from what the Opposition have said, however, one would expect them to say that no management was appropriate. That, of course, is absolute nonsense.
The hon. Member for Rossendale and Darwen (Ms Anderson) spoke about the plans for her hospital. The plans to which she referred were based on the recommendations of a working party composed of health care professionals and consultants. They have been discussed with the community health council and the staff. I am sad to say that the chief executive of the hospital has been trying, I understand unsuccessfully, to discuss the plans with the hon. Lady. Perhaps I will write to him tomorrow to tell him of the concerns that the hon. Lady has expressed in the House, and perhaps a meeting can now take place to illustrate what is going on.
Various other speakers contributed to the debate, and I would like to refer specifically to the hon. Member for Ilford, South (Mr. Gapes), who said that he was fed up with statistics. Too many statistics mask a story. What tell a false story are partial statistics, which the Labour party cites. It is all very well for the Opposition to say that they do not like statistics, but the truth of the matter is that the facts do not suit them. That is the problem with the health service--more people are being treated more effectively and there are more satisfied customers than ever before. The hon. Gentleman asked for more resources. I ask him to put that question to his hon. Friends on the Front Bench. The Government have been committed to putting more resources into the health service year on year, but it is his party that is silent on that.
My hon. and learned Friend the Member for Burton (Sir I. Lawrence) paid tribute to what has happened to the health service in his constituency. He is quite right to
point out that it is a great achievement that day surgery is at record levels at his local trust hospital. That improvement is one reason why we have been able to make such progress.
I apologise to other hon. Members to whom I have not been able to respond directly, but my time is limited.
This has been an interesting debate in which the Labour party has not dealt with the current issues in the health service. We heard nothing from the Opposition about the primary care-led NHS and where it is going. They said nothing about how that service will shape the health service for the 21st century. Not a word did we hear.
We heard a mealy-mouthed answer to the question of fundholding. The hon. Member for Peckham (Ms Harman) will have to answer to a number of fundholding practices in her constituency, including Dr. Virji and partners, who offer clinical psychology, minor surgery and other services; Dr. Brownsdon and partners, one mile north of Herne Hill, who offer excellent services; and Doctor Hossain and partners, who provide outreach teaching clinics for dermatology and in-surgery clinics for antenatal treatment, asthma and hypertension. Those are the benefits that her party is, at bottom, committed to sweeping away. She is fudging the issue and refuses to tell the story.
Yesterday, we heard from the Leader of the Opposition that he was not buckling under pressure. The whole country could see that he was twisting. His party has been twisting on the health service today. Policy by staccato soundbite will not do. From what we have heard today, the hon. Member for Peckham is more credible when she acts on education than when she speaks on health.
Question put, That the original words stand part of the Question:--
"Obviously this document will have a very limited circulation."
"Lib-Dem policy of putting councillors in control of LHAs is a barmy idea."
24 Jan 1996 : Column 446
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