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House of Commons
Tuesday 5 November 1996
The House met at half-past Two o'clock
PRAYERS
[Madam Speaker in the Chair]
King's College London Bill [Lords]
Motion made, and Question proposed,
That the Promoters of the King's College London Bill [Lords] may, notwithstanding anything in the Standing Orders or practice of this House, proceed with the Bill in the present Session; and the Petition for the Bill shall be deemed to have been deposited and all Standing Orders applicable thereto shall be deemed to have been complied with; That if the Bill is brought from the Lords in the present Session, the Agents for the Bill shall deposit in the Private Bill Office a declaration signed by them stating that the Bill is the same, in every respect, as the Bill which was brought from the Lords in the last Session;
Hon. Members:
Object.
That, as soon as a certificate by one of the Clerks in the Private Bill Office, that such a declaration has been so deposited, has been laid upon the Table of the House, the Bill shall be read the first and second time (and shall be recorded in the Journal of this House as having been so read) and shall be ordered to be read the third time;
That no further Fees shall be charged in respect of any proceedings on the Bill in respect of which Fees have already been incurred during any previous Session.--[The Chairman of Ways and Means.]
City of Edinburgh Council Order Confirmation Bill
Edinburgh Merchant Company Order
Confirmation Bill
Considered; to be read the Third time tomorrow.
Oral Answers to Questions
HEALTH
Census Information
1. Mr. Barry Field: To ask the Secretary of State for Health what conclusions his Department has drawn from the last census. [609]
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): Census information, along with other information, helps us to monitor the nation's health. I am glad to tell my hon. Friend that the underlying trend continues to improve.
Mr. Field: Does my hon. Friend agree that the census shows without any shadow of a doubt that people are living longer, healthier and more fulfilled lives? Is that not the true testament to the reforms that we have introduced in the national health service, as opposed to the myths peddled by the quack doctors of the Opposition?
Mr. Horam: I entirely agree with my hon. Friend and I am delighted to tell him that, standardised for age, the
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health of people in the Isle of Wight is significantly better than that of the rest of us. Is there something special about the Isle of Wight?
Mr. Barron: I wonder whether the Minister and the hon. Member for Isle of Wight (Mr. Field) are reading from some census other than the one that was carried out in this country. We know from that census, for example, that people in poor housing use the national health service 50 per cent. more than the average, adding about £2 billion a year to our NHS bill; that deaths from coronary heart disease among women from the Indian sub-continent are up to 45 per cent. higher than the national average; and that people in lower socio-economic groups can expect to die eight years sooner than the most privileged.
The growing gap between rich and poor is leading to growing inequalities in health; to tackle that problem we must tackle the underlying causes of poverty, which the census clearly shows to be increasing. We and the people want to know what action the Government intend to take cross-departmentally about the increase in poverty and the consequential health inequalities.
Mr. Horam:
I am quite surprised at the hon. Gentleman; he is the one surviving member of the Labour health team from before the summer, so I should have thought that he would have more knowledge than the rest. He ought to know that the census is one of the items included in the capitation formula that decides the amount of money that goes to every health authority in the country. The formula is adjusted year by year to take into account exactly the sort of factors that he is talking about. I am surprised at him, because I thought that he was better briefed.
Mr. David Nicholson:
All Government Members will support the Secretary of State in his efforts to secure resources to treat the growing numbers of people requiring health care, but does the Minister recognise that concern about bureaucracy, form filling and paper pushing in hospitals and NHS trusts is not confined to the Opposition Benches but is felt just as strongly on our side? If hospitals and trusts give priority to patient care rather than to form filling and paper pushing over the coming months, they will have the vigorous support of their Members of Parliament.
Mr. Horam:
That is precisely why my right hon. Friend the Secretary of State put together a package worth £300 million, which is designed to do away with such excessive bureaucracy and form filling. The money will go directly to patient care.
2. Mr. Cousins:
To ask the Secretary of State for Health how many trusts have so far settled nurses' pay in the present financial year. [610]
The Minister for Health (Mr. Gerald Malone):
Sixty-six out of the 412 that have made offers.
Mr. Cousins:
The Minister must know that nine out of every 10 NHS trusts have not settled the current pay round for nurses, and the next pay round is due to begin.
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Mr. Malone:
My message of hope for nurses this winter is the pledge that the Government have given continuously to fund our health service in real terms on an increasing basis year on year. That is a pledge that the Labour party will not make.
There are now 412 detailed offers on the table for nurses and other health care professionals to pick up through negotiation. I hope that they will do that and conclude negotiations as quickly as possible. Whether or not they settle is a matter not entirely within my control.
Mrs. Roe:
Can my hon. Friend confirm that a staff nurse can now earn more than £340 a week with additional payments for unsocial hours and overtime, while a sister with ward responsibilities can now earn more than £410 a week?
Mr. Malone:
Yes, I can generally confirm those figures. If my hon. Friend looks at what was happening in 1979, she will discover that, in today's money, average nursing pay was £191, compared with £326 today under this Government.
Mr. Simon Hughes:
Any decisions that the Government may have made this morning to increase resources for the health service are clearly welcome.
As the Minister well knows, this week marks the 50th anniversary of the setting up by statute of the national health service, promoted by William Beveridge and supported by my party in the post-war Parliament. Besides additional resources, removing unnecessary costs would also make a difference. I refer, for instance, to the costs incurred by local pay negotiations in the health service. If it is indeed a national health service, why do not Ministers heed the proposals of all the professionals and have national pay negotiations, thereby releasing a lot of time and money that could be spent on patient care?
Mr. Malone:
I remind the hon. Gentleman that it was this Government who put in place the review body for nurses' pay which underpinned our commitment to national fairness for the nursing profession and other health care professionals. The pay review body remains in place. The nursing profession and other health professionals agreed to the introduction of local pay under a framework last year. That is what we are working towards; it will bring real benefits to people all across the country once it is finally introduced.
3. Sir Sydney Chapman:
To ask the Secretary of State for Health what was the number of in-patient and out-patient treatments in the national health service in 1978-79; and what were the figures in 1995-96. [611]
The Secretary of State for Health (Mr. Stephen Dorrell):
In-patient acute treatments rose from 5.1 million patients in 1978 to 9.2 million in 1995-96. That represents
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Sir Sydney Chapman:
I warmly welcome that staggering increase in the number of patient treatments. Will my right hon. Friend confirm that it is due to the Government raising expenditure on the NHS from £8 billion in 1979 to about £40 billion this year; and to the Government ensuring that those ever-increasing resources have been used in the most effective way for the benefit of patients? Will my right hon. Friend therefore accept that the figures that he has given prove beyond doubt that the Government's NHS reforms have been on the right lines?
Mr. Dorrell:
My hon. Friend is exactly right on both counts. We give two pledges to the NHS, neither of which is given by the Labour party. The first is a commitment to insist that the health service is efficiently managed. The second is the Prime Minister's guarantee to raise the real resources available for health care in the service year by year by year. That is a pledge which the Labour party refuses to give.
Mr. Cunliffe:
Is the Minister aware that, since the health authority closed down the accident and emergency department of Leigh infirmary--it was eventually replaced by a minor injuries unit that opened 24 hours a day--the authority has reneged on its assurances of a 24-hour service and now, in a disgraceful cost-cutting exercise, proposes to close the unit between 10 pm and 8 am? What does he propose to do to safeguard the welfare of the affected patients?
Mr. Dorrell:
I give the pledge that we shall continue to increase the resources available for the treatment of patients in the health service. I also give the pledge that we shall continue to insist that those resources are used in the way that is most efficient and gives the most effective health care to the patients in the hon. Gentleman's constituency and in every other constituency.
Sir Irvine Patnick:
I have made my right hon. Friend aware of the day case centre at the Royal Hallamshire hospital in Sheffield. Are not the staff to be congratulated on the way in which the unit functions? If that unit were copied throughout the country, would that not reduce waiting lists and waiting times? Will the Secretary of State take an opportunity to visit the unit and see how its wonderful facilities are made available to everyone through the national health service?
Mr. Dorrell:
My hon. Friend is on to an important point. I certainly hope to visit my hon. Friend's constituency, but my problem is that day case units are becoming available throughout the country. Were I to undertake to visit every day care unit, I should have to visit every constituency represented by hon. Members on both sides of the House.
The units to which my hon. Friend referred have, over the past 17 years, seen an increase in the number of patients treated as day cases from 500,000 in 1978-79 to 2.8 million last year--a fivefold increase. My hon. Friend is right to say that that is a more efficient way of treating them, but it is a better treatment from the patient's point
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Ms Jowell:
Can we get behind the Secretary of State's favourite barrage of statistics? Will he confirm that a patient who is treated and discharged too early and who has to be readmitted counts as two finished consultant episodes; whereas a patient who stays in hospital until he or she has recovered and is able to cope at home counts as only one? The first course is bad for the patient, but good for the statistics, while the second is good for the patient, but bad for the statistics. Does that not show the absurdity of using finished consultant episodes as a measurement of performance in the NHS?
Mr. Dorrell:
It is the hon. Lady who is quibbling about statistics. She quibbles because she refuses to give a pledge parallel to the one given by my right hon. Friend the Prime Minister--the pledge to ensure that health service funding rises in real terms year by year by year. That is the question that hon. Members on the Labour Front Bench have to answer, but they resolutely refuse to address the issue.
Mr. John Marshall:
Does my right hon. Friend remember the statement of the right hon. Member for Livingston (Mr. Cook) that the test of the NHS reforms would be whether they resulted in the treatment of more or fewer patients? Have we not passed the Cook test with flying colours?
Mr. Dorrell:
My hon. Friend is precisely right. In 1991, the Cook test was set by the right hon. Member for Livingston (Mr. Cook). It was: would the Government accept the test and judge the success of the reforms on whether the health service treated more patients? The fact is that, since 1990, the health service has grown by one third in terms of the number of acute patients treated.
Mr. Skinner:
The Minister cooked the books.
Mr. Dorrell:
The Cook test that the hon. Gentleman should apply has been passed with flying colours by the NHS under this Government.
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