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7.18 pm
Mr. Michael Fabricant (Mid-Staffordshire): The debate so far has revealed confusion and empty platitudes from the hon. Member for Peckham (Ms Harman) on the Labour Front Bench. I shall identify three areas in which Government policy has been shown to work by setting a safety net below which nobody can fall. That is Conservative party policy and what we would want from the NHS.
The first issue is the private finance initiative. There is a clear chasm between Labour Front Benchers, because the Leader of the Opposition supports the PFI but the hon. Member for Peckham has said again today that she thinks that the PFI is a recipe for the privatisation of the NHS. I shall refer also to trusts and, if I have time, to GP fundholding. I commend to the hon. Member for Peckham and to all Opposition Front-Bench Members the excellent book published by the Treasury entitled "Private Opportunity, Public Benefit", which explains the private finance initiative. It shows how the PFI acts to support the national health service--which is why the Leader of the Opposition has a different view from the shadow health spokesperson.
According to page 9, more than 50 small schemes--that is, schemes under £10 million--are under development or are already in operation. They include waste incineration schemes for south Kent hospitals, a magnetic resonance imaging scanner for the Mid-Sussex NHS trust, a combined heat and power scheme for St. James's University Hospital NHS trust, dialysis services for South Tees Acute Hospitals NHS trust, the completion of negotiations for a concourse development for the Queen's medical centre in Nottingham, and a number of other projects that are under way in Scotland. They are examples of the PFI working for, and not against, the NHS. The PFI is providing additional resources for the NHS. I cannot understand why the hon. Lady disagrees with her leader and insists that the PFI be opposed.
As to trusts, I find it incredible that Opposition Members continue to use what I call Mandelson alliterations. The latest one is "market madness". Far from
creating the market to which the hon. Lady referred, I believe that the trusts have created efficiency. That efficiency has not saved money for the Treasury, but provided better services for patients. That is good news. As my hon. Friend the Member for Wimbledon (Dr. Goodson-Wickes) said earlier, every Government Department has limited resources and we must determine how best to use those resources.
It is interesting to note that the Government have increased spending on the national health service by four times since 1979 and by £9.5 billion in the past few years. It is fascinating that the Labour party is not prepared to make a commitment this evening to similar increases in expenditure. We have heard only empty rhetoric from Labour Members.
I recently visited the Staffordshire ambulance trust, which the National Audit Office has identified as having the best response rates of any ambulance trust in England and Wales. I congratulate the service--particularly the chief executive, Roger Thayne--on that achievement. The Staffordshire ambulance trust has introduced an interesting new concept that it developed partly from a computer package from San Diego. It is the first ambulance trust to apply the concept. Every nine seconds, the trust has updates on where its ambulances are located in Staffordshire. Instead of being in depots as in other ambulance trusts, Staffordshire ambulances are placed strategically around the county and thus are able to respond quickly to calls.
That is the sort of innovative idea that can be introduced under local management. However, the Labour party derides local management. If Labour were to come to power, it would abolish local management, even though that provides the innovation which leads to better health care provision in Staffordshire.
Mr. Purchase:
Will the hon. Gentleman give way?
Mr. Fabricant:
No, I shall not give way, as I may speak for only 10 minutes.
I pay tribute also to the Premier Health trust in Staffordshire--which is ably chaired by Mrs. Margaret Whalley--and to the chief executive, Dr. Diana Rawle, who recently replaced Mike Marchment. The trust is responsible for the Victoria hospital in Lichfield, which has expanded its facilities. At one time, it was thought that a major district general hospital should be built some distance away from Lichfield to serve the people of Lichfield. However, the Premier Health trust--under local management and working hand in glove with local doctors and nurses--has ensured that the Victoria hospital provides the services in Lichfield for the people of Lichfield.
The hospital has a larger minor injuries unit, a new antenatal and maternity ward--which I opened recently--and increased facilities in the renal ward. There has been a rebuild of the in-patient facility, the rehabilitation department has been expanded and there are increased day surgery and out-patient services. Those facilities are available through the Premier Health trust, which owes its existence to so-called "market madness".
As to GP fundholding, it was incredible to watch the hon. Member for Peckham wriggle on the end of her hook. She said that she would not abolish GP fundholding, but then she said that she would abolish it
and introduce in its place "contracting"--or some other Mandelson expression. At the end of the day, we need the managers, the market and, most importantly, the resources. [Interruption.] However, I am sure that the hon. Member for Carlisle (Mr. Martlew)--who tries to intervene from a sedentary position--will not make any financial commitments.
Today I received a fax from Dr. Simon Elsdon, who is based in Staffordshire. I spoke with him last night and he said that he is not obsessed with dogma regarding who owns hospitals or who employs doctors and consultants, so long as good, efficient health care is free at the point of delivery. That is what GP fundholding is all about.
Labour Members are fond of using soundbites, but they have demonstrated today that they lack the ability to manage the economy or the health service. As with its education policy, Labour seeks not to push up health standards but to aggregate at the mediocre. Labour, through the abolition of the critical purchaser-provider divide, would destroy the expansion of hospitals such as the Victoria in Lichfield, or the expansion of the efficient Staffordshire ambulance service. Labour, through its abolition of fundholding, would emasculate general practitioners and thus weaken service provision to patients. Labour, through its opposition to the private finance initiative, would halt hospital building in its tracks.
Ms Rachel Squire (Dunfermline, West):
We have just heard 10 minutes of empty rhetoric and classic soundbites from the hon. Member for Mid-Staffordshire (Mr. Fabricant). I hope that he will listen while I tell him a little about life in the real world for those who depend on the national health service.
I begin by paying tribute to the vast majority of NHS staff for their dedication, commitment and expertise. That is what has kept the national health service going, as it struggled against the impact of 17 years of Conservative Government policy. As a reward, the staff have been paid peanuts for providing vital health care. They have seen the privatisation of health care and they have watched while millions of pounds of public money was spent lining the pockets of the Tories' friends and creating more and more tiers of management.
I wish to use the brief time available to me tonight to highlight what is occurring in the real world. I shall focus particularly on what is happening at my local district general hospital, the Queen Margaret Hospital NHS trust in west Fife. For months, patients, their relatives and the staff have told me how the trust's bureaucracy and its managerial approach have led to the early discharge of patients--particularly the frail elderly--a lack of information and to ever-longer waiting lists.
I have raised my concerns with the chief executive and the health board. I have spent months listening to them saying, first, that I have not heard the full story; secondly,
that prompt action has been taken; and, thirdly, that the complaint that has been raised with me is not a common one. I have been willing to accept that, as a Member of Parliament, I tend to hear rather more complaints than praise, but I have reached the conclusion that I have used the procedures for too long, and it is time for me to make public my concerns about what NHS bureaucracy and the Government's policies, encouraged and promoted by Fife health board and the Queen Margaret Hospital NHS trust, have meant to my constituents.
Let me outline a few of the examples that I had hoped to quote in more detail tonight. Until recently, the Queen Margaret hospital had four consultant radiologists, covering the whole of Fife. Even that is not enough to deal with the demand and provide a fully comprehensive service. But from August there will be only one full-time consultant radiologist, because the other three resigned in disgust at the managerial approach to radiology services, which they believe has resulted in a reduction in quality patient care. When I met the chief executive at the beginning of this month, he put the resignations down largely to personality conflicts. Yet, surprise, surprise, the consultants who are leaving have been snapped up by nearby hospitals.
I quote what one of the consultants said in his letter of resignation:
The second example of NHS bureaucracy and the Government's policies concerns a consultant ophthalmologist. As I said earlier, I have detected growing concerns for a considerable time, but it was difficult to get substantial evidence because patients and relatives were afraid to go public with their complaints in case they came back on them, and staff were afraid that if they spoke out they would be dismissed. A consultant ophthalmologist did speak out and he was dismissed, even though the vice-chairman of the trust said:
As well as the treatment of consultants, that approach has affected the whole staffing of the hospital. The House will not be surprised to learn that the ancillary staff,
who do such essential work, as my hon. Friend the Member for Preston (Mrs. Wise) said earlier in an excellent point, have not only been subject to private contractors, who offer lower pay and worse conditions, but they were recently told that when their contracts come up for renewal in the autumn, the trust will not even bother to make an in-house bid. Yet this is the trust that spent time drawing up a reward package for itself and the people who supported it.
Let me make it clear that the people of west Fife, indeed, Fife as a whole, never wanted trusts. They felt that the time and money involved could be better spent on providing patient care, but they have been landed with three of them. When they complain to me, they make it quite clear that they are not complaining about the vast majority of staff at the hospital. They blame the senior management and the Government for what is happening to patient care.
I was going to quote a number of complaints, but I have time to quote from only one--a letter that I received from a lady last month. I shall quote extracts from it, as it is about the real world of NHS bureaucracy and the Government's policies. She said:
"When I first came to the Queen Margaret Hospital three years ago, like the rest of the staff at the hospital, I was excited by the new challenges, new equipment and the future potential of developing appropriate and top quality services to Fife patients. However, in the last three years I have seen this deteriorate to a point I find professionally and personally unworkable due to a style of management that has no concept of prevalent future roles in modern Radiology which puts balance sheets and outward appearance before patient care and staff requirements for working conditions."
The problems in providing a radiology service became apparent to me during the past two years in complaints from constituents. I have raised the matter on more than one occasion with the hospital trust management, but as a direct result of its behaviour, the Government's policies and the behaviour of Fife health board, which is supposed to ensure that such services are provided, the people of Dunfermline and Fife as a whole will be without an essential quality service that affects many areas of diagnosis and treatment, including surgery. There is a national shortage of consultant radiologists, so what hope is there that patient services will be provided or restored?
"I should stress that Dr. Hunter's clinical competence has not at any time been at issue."
Dr. Hunter was sacked because he dared to complain about the senior trust management. Is it any wonder that the people of west Fife have no faith in the hospital trust management?
"Dear Ms Squire,
four hours later.
I am returning to work after three months' leave following major surgery . . . I was in Ward 19 . . . and was astonished to find on my arrival that I was sharing a room with two geriatrics and two patients awaiting eye surgery. I was told that Ward 10--the original Gynae ward--had been closed last year to make way for another Day Hospital ward. In the course of that week . . . as the continual battle for beds went on . . . lack of funds meant that the ward lacked a permanent charge nurse . . . On my sixth day, my consultant informed me that I would probably be allowed home three days later but that unfortunately I would have to be moved to another ward otherwise he would be unable to perform the next day's operations . . . On my return from the bathroom about 9.30 am, my bed had been stripped . . . and so I sat in a chair until I was finally moved downstairs to a short stay ward at 1.30 pm"--
"One of the other ladies moved was 78 years old and had been moved five times in a week! . . . In my opinion, there are too many 'people in suits' with no medical knowledge who put money before patients' welfare.
Those words speak more powerfully than mine. I challenge the Government to conduct a full investigation--
My conclusion is that the Conservative Government is guilty of serious underfunding in health and, if it was not for the unstinting dedication of all professional and ancillary staff, the National Health Service would be moving ever more quickly into line with the substandard healthcare".
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