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6.7 pm
Mr. Kevin Hughes (Doncaster, North): After the rant from the Secretary of State, it is obvious that the Government did not want today's debate on health. We all know that there is no good time for the Government to have a health debate, but after a week when they announced a mere 2 per cent. increase for nurses and when the Prime Minister stood at the Dispatch Box and refused to condemn the massive golden handshake given to Cedric Brown of British Gas, we can certainly see why the Government do not want health issues on the agenda.
The hon. Member for Mid-Staffordshire(Mr. Fabricant), in his closing remarks, mentioned an average nurse receiving £310 per week. I suspect that, at his advice surgery this weekend, there will be a queue of average nurses wanting to know where their share is. I do not believe that an average nurse receives £310. Thehon. Gentleman may be able to ratchet the figure up by lumping together the money of consultants and chief executives, but he will not be able to arrive at that figure on the basis of the figures for nursing staff.
Mr. Fabricant:
The figures come from the earnings-related database and the standard payroll system. The information applies to nurses--it does not include any other bodies.
Mr. Hughes:
I certainly cannot accept that the average nurse receives £310 per week, and I do not think that the average nurse would agree with the hon. Gentleman.
The Royal College of Nursing described the nurses' pay award as
and it will not tackle the increasingly evident shortages and low morale in the service.
I pay tribute to the work of national health service staff in Doncaster and throughout the country who, despite the Government's policies, manage to provide an excellent service and much comfort and advice to patients. I am sure that, in initiating the debate, my Front-Bench colleagues wanted to recognise that service and to take the Government to task for what they have done to the morale of those dedicated staff over the years.
The Government surely cannot fail to perceive that morale in the NHS is low and falling, that increased work loads are causing stress and that low pay awards and the strain of increased bureaucracy are producing outrage. The Government must realise that doctors are leaving the NHS due to poor working conditions and that, worryingly, nursing shortages are increasing.
That is happening against the background of encroaching privatisation of the national health service. Beds are being shut and we hear daily horror stories of patients being shunted around the country in search of a bed. The latest, published in today's Standard, is entitled:
His parents took him to the Frimley Park hospital in Camberley, but were told to take him to Poole in Dorset. That is what the national health service has been reduced to under the present Government. Patients are being shunted from hospital to hospital and from county to county.
Artificial waiting lists are being created. Accident and emergency admissions have increased by 16 per cent. in the past five years. Do the Government not realise that doctors and nurses feel let down by a Government whose policies have made them unable to get on with the work to which NHS staff are dedicated--that of caring for patients?
There is much anecdotal evidence about staff morale in the NHS. People are very anxious about the lack of resources and about short-term thinking. There are reports from the RCN that, in my constituency, the Doncaster Royal infirmary has a shortage of theatre nurses and there are not enough specialist nurses to cover the operating theatre; yet 32 senior nursing posts have been threatened in the Trent region alone as part of the Government's proposals for management cuts. Those are nursing cuts, not management cuts.
Mr. O'Hara:
My hon. Friend will not be surprised to hear about the position in a hospital in my area.
Faced with the task of making a 5 per cent. cutin a £4 million management budget--£200,000--the management found that they had to invest an extra £200,000 to finance the internal market. They had to meet the costs of corresponding with general practitioners in connection with meeting contractual standards and enhancing their record keeping to meet the continued data requirements of the regional office. They had to spend £70,000 on correspondence, £80,000 on medical reports and £50,000 to meet the data requirements of regional office.
Does it therefore surprise my hon. Friend to know that, when it came to the crunch, most of the cuts were in nursing staff and pharmaceutical staff and not in management?
Mr. Hughes:
My hon. Friend is right to draw attention to that position. No, I am not surprised. His words reinforce my arguments.
Today, we hear of six nursing sisters working in accident and emergency at Leicester Royal infirmary facing redundancy while at the same hospital parts of the accident and emergency department have recently had to be closed on occasions due to staff shortages. There are worrying reports that the use of bank and agency staff is increasing, which obviously denies patients all-important continuity of care.
Nurse managers complain that non-clinical duties take up too much time and that they are not on the wards as much as they would like. They are consumed by paperwork. Those issues, in my constituency and others, reflect the position locally and nationally, which gives cause for concern.
Unison officials in the Trent area have reported that nursing shortages are becoming worse and that increasing numbers of staff do double shifts to keep the service running. Between 1989 and 1994, the number of nurses in the Trent region was cut by 9 per cent. while the number of managers escalated by 470 per cent. A survey undertaken by the Institute for Employment Studies for the Royal College of Nursing shows that nearly40 per cent. of nurses in the Trent region said that they would leave nursing if they could.
The national statistics speak for themselves:90 per cent. of nurses felt that
for some nurses, and 87 per cent. felt that local pay would increase uncertainty about future pay. Moreover, an increasing proportion of nurses regarded nursing as an insecure job. As nurses leave the profession, student places have nevertheless decreased dramatically--by two thirds since 1983.
More and more hard evidence is emerging of increasing stress and low morale among doctors. As recently as yesterday, we heard of a survey carried out by Middlesex university among London GPs. It was a small survey, but the results were revealing: 98 per cent. of the doctors questioned complained that their paperwork had increased, and nine out of 10 said that they did not have enough time to keep up with medical developments. Two thirds of the GPs said that they had less time to spend with each patient since the NHS changes.
The British Medical Association recognises that many doctors are leaving the medical profession. The reasons that it cites for that haemorrhage of staff are increasing work load, inflexible training, the internal market and the long hours worked by junior doctors. In a study of229 doctors, it was found that half had thought of leaving the profession. A recruitment survey by the National Association of Health Authorities and Trusts noted a significant fall in the number of trainee doctors wanting to become GPs. It attributes that fall to the low morale and increased work loads in general practice.
We may also consider more specific cases. Christopher Adams resigned as head consultant in February 1995 from the department of neurosurgery at Radcliffe infirmary, Oxford, after being asked to create waiting lists artificially. In an article in the British Medical Journal, Mr. Adams said that his department, which has the lowest average cost per case in England, at one point became
his words, not mine.
"derisory and out of touch",
"Meningitis scare boy faced 100-mile trip for hospital bed".
"local pay will result in unfair deals"
"unsafe . . . hyperefficient . . . with exhausted and demoralised staff"--
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