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11.54 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): I am glad to have the opportunity to respond to the Adjournment debate of the hon. Member for Southampton, Itchen (Mr. Denham).
First, I note that the hon. Gentleman acknowledged the excellent work done particularly by the Southampton University Hospitals NHS trust, working in partnership with local purchasers. The Government have honoured their manifesto pledge to increase health spending in real terms every year, and new spending plans announced in the Budget mean that total spending by the NHS in England has increased from £6.5 billion in 1978-79, to £34.7 billion this year. That is equivalent to a real-terms increase of 72 per cent. since 1978-79.
The hon. Gentleman will be aware of some of the implications of that funding for Southampton. For example, a new £10 million hospital development for elderly people was opened on the former Southampton Western hospital site in January. It will provide 104 beds. Secondly, three neurosurgical theatres are being built at Southampton General hospital, at cost of£6 million, and are due to open in the summer. Thirdly, that funding will allow for cardiac expansion, including extra ward and intensive care unit capacity at Southampton University Hospitals NHS trust, which will be ready in the autumn. Those three items of capital expenditure are being funded by the huge increase in the budget for the NHS.
At the end of last year, the vast majority of patients in Southampton--more than 98 per cent.--were seen within nine months, and only five people had been waiting for more than 12 months. The hon. Gentleman may be aware that the Southampton University Hospitals trust was the first university teaching trust in the United Kingdom to achieve the excellent nine month standard. I believe that the hon. Gentleman will agree that that achievement compares rather well with the patients charter standard of 18 months. Southampton is therefore succeeding in setting and achieving a much tighter and more challenging standard for its own population. Overall, general and acute sector episodes of care completed by the trust have increased by more than 20 per cent in the past three years--a quite remarkable achievement.
I acknowledge that that level of activity has caused some financial problems in the trust recently, but I am sure that the trust, the health authority and the NHS executive south and west regional office are currently discussing an agreed strategic approach to address that problem. It would therefore be inappropriate for me to comment in any detail on the issue now, but I understand that emergency and urgent work will be unaffected, although there may some slippage in waiting times as the financial problems are resolved.
The health authority will retain its standard of nine months' waiting time, but it recognises that it may have increasing difficulty in maintaining that standard. The health authority and the trust have a long and strong strategic relationship, and I am confident that they will be able to agree on a way forward.
Secondly, may I deal with the hon. Gentleman's points about two-tierism? As the internal market develops, fundholders are improving services for their patients and
others are following their example. Having a range of purchasers--health authorities and GP fundholders--stimulates innovation and critical consideration of service delivery to the benefit of all patients. Joint guidance issued by the Department of Health and the profession in June 1991 clearly states that hospitals should not offer contracts to one purchaser to the disadvantage of patients of another. All emergencies are seen immediately, and all urgent cases that cannot be seen immediately are placed on a common waiting list.
The amount of hospital activity purchased will always depend to some extent on the skill of the purchaser. All purchasers need to learn from that and ensure that they place equally good elective contracts on behalf of the patients of non-fundholding GPs. Inevitably, when driving up standards, some improve before others. Our aim is to bring the quality of all services up to the standard of the best.
Thirdly, the hon. Gentleman spoke about dentistry in Southampton. We have a good record, which is demonstrated by the figures, which speak for themselves. For example, expenditure on the general dental service between 1978-79 and 1994-95 has grown by nearly60 per cent. in real terms. In 1994-95, courses of adult treatment had increased by 7.6 million from a similar figure for 1979, and there had been a 33.7 million increase in adult examinations in the same period.
I am aware that, in parts of the Southampton area, there are currently no NHS adult services for new patients. I have seen the recent Southampton and South West Hampshire community health council report on dental health services in the area, which the hon. Gentleman mentioned, and I do take it seriously. I understand that the health authority has already responded to that report, and I know that the hon. Gentleman has sent a copy to my right hon. Friend the Secretary of State for Health, who will reply to him in due course.
The hon. Gentleman may wish to know that 59 per cent. of the adult population of Hampshire are registered with an NHS dentist. That compares favourably with the national average, which is less than that--57 per cent. The health authority runs a very efficient dental helpline service to assist patients with access to NHS dentists and to help unregistered patients in an emergency.
As the hon. Gentleman acknowledged, the health authority has already appointed one salaried dentist, in November 1995, in Southampton. I would not pretend that that addresses the whole problem, but I understand that the health authority intends to apply to my Department for a further five salaried posts to cover the areas where there is at present no NHS cover. In addition, there is an emergency dental service based at Southampton general hospital. The service has been increased from two half-day sessions per weekend to full-time sessions at weekends and on bank holidays. I understand that those may be extended to some weekday evening sessions, so the problem is being tackled locally.
It would be incomplete of me to cover the changes that we are introducing in the general dental service without mentioning the reforms that my hon. Friend the Minister for Health announced last year. The hon. Gentleman mentioned him, so I may bring him into the debate as well. That was a comprehensive package of across-the-board reforms, the product of extensive study and wide consultation following on from the 1994 Green
Paper, "Improving NHS Dentistry". We are working on the reforms with representatives of the dental profession, and I believe that they will deliver concrete improvements in general dental services and help the NHS to tackle the oral health challenges ahead as well as providing stability and security for dentists.
All that will provide a strong framework in which the general dental service can continue to develop throughout the country--in Southampton and elsewhere.
Question put and agreed to.
Adjourned accordingly at one minute past Twelve midnight.
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