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Sir Norman Fowler (Sutton Coldfield): Will the hon. Gentleman give way?
Mr. Smith: Perhaps the Government can also tell us why hospital after hospital around the country and contractor after contractor complain about the
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bureaucratic process, the expense, the complexity and the inadequacy of the PFI system for funding hospital building work. I will give way for the final time.
Sir Norman Fowler: Will the hon. Gentleman concede that the biggest cuts in the capital programme for hospital building were made by the last Labour Government in the 1970s? That is indisputable.
Mr. Smith: Perhaps the right hon. Gentleman can tell us why, back in 1990, the Government promised that Norwich would have its new hospital under the private finance initiative, yet it is still not signed, sealed and delivered. The Government relaunch the plan every year and tell us that it is about to happen, but Norwich is still waiting for its new hospital.
There are two more specific points that I want to raise. The first relates to mixed sex wards in hospitals. The Patients Association is right to describe having to be in a mixed sex ward against one's will as an affront to the dignity of the patient. It causes distress and concern to many patients, especially women, to be placed in a mixed ward when they do not want to be in such a ward. This, of course, happens at a time of great trauma: when patients face surgery or treatment.
When my right hon. Friend the Leader of the Opposition pressed the Prime Minister on this point yesterday, he pointed out that that promise was made by the Government two years ago in the patients charter. Yet it remains unfulfilled. In January 1995, the patients charter said that patients could expect single-sex washing and toilet facilities and that their wish to be treated in single-sex wards
In addition, I am very concerned that the Department of Health does not even collect information on hospitals that force patients on to mixed sexed wards against their will. The Prime Minister did not appear to understand the question when asked by my right hon. Friend yesterday, let alone answer it.
In almost every case, both men and women prefer to be treated in single-sex wards in hospital. Labour believes that it should be a matter of good practice, and the improved management of beds to achieve this end should be one of the priorities in the Government's management of the health service.
Mr. Smith:
The Secretary of State says that it is, but the Prime Minister appeared to disagree with that yesterday. He was saying, "There are other things that are more important. We have been concentrating on other things. Then in due course we'll turn to this matter." He does not recognise the urgency of the matter and the need to deal with it in the immediate future.
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The second issue that I wish to raise is the gagging of national health service staff, who are told in their contracts that they cannot speak out about the service in general or in particular. It is all right, of course, for the bigwigs who support the Government. The national health service "good news network" has been established by the Conservative party. Four of the group's regional organisers hold positions on trusts and health authority boards. They include Mrs. Audrey Collins, chair of South Tees Acute Hospitals NHS trust, Charles Bunker, director of East Hertfordshire NHS trust, Mrs. Mary Firth, chair of the Royal Oldham Hospital and Community Services NHS trust, and Mrs. Susan Wrigley, chair of the North Yorkshire health authority.
The good news network in the national health service is supposed to supply information to help the Government. It engages in overtly political activities, such as
Mr. Smith:
Perhaps he would like to say that to the ambulance man from Surrey ambulance service whom I met this morning. He told me that he had written a letter to his local newspaper to complain about the downgrading of the local fire station and the implications that it would have for other emergency services in being able to reach and treat patients. He is now threatened with disciplinary action by the Surrey ambulance service. If the Secretary of State means what he says--that it is perfectly all right for people who work in the health service to speak out about what they see and are worried about and to raise complaints of a general nature about what is happening in the service and in their area--perhaps he will tell not just the Surrey ambulance service but hospital after hospital throughout the country, as they are disciplining members of staff who speak out. Perhaps he will tell them that the Government's policy has changed, because it certainly has not changed on the ground.
We have a health service that is in crisis, that tries to silence its members of staff, that cannot even deliver same sex wards to the people who wish to have them. Year on year, the Government creates a winter crisis. Year on year we see an explosion of bureaucracy. Year on year we see more managers and fewer nurses. Year on year, we see patients on trolleys in accident and emergency departments. Year on year we see cancelled operations. Year on year we see lengthening waiting lists. Year on year we see staff in the health service struggling to cope with the changes that the Government have imposed on them.
The Secretary of State for Health (Mr. Stephen Dorrell):
I beg to move, To leave out from "House" to the end of the Question and to add instead thereof:
We are having this debate because the Opposition Front Bench chose health as the subject for today's debate--
Mr. Chris Smith:
Yes, and we will keep on doing so.
Mr. Dorrell:
I look forward to it--every week if we can have this kind of debate and speech from the hon. Gentleman.
We might have expected, as the Opposition chose this subject for debate, that they would have had something to say. Instead, we have heard a tissue of innuendo and half truth, undermining public confidence in a great public service. Frankly, there is something rather indecent about the spectacle of the hon. Gentleman luxuriating in anecdotes of service weakness while offering absolutely nothing of any substance as to what he thinks should be done to strengthen, build and plan for the future of the national health service.
We heard not even the merest hint of a policy from the hon. Gentleman this afternoon, simply the complacent suggestion that the national calamity of a Labour Government somehow offers a short cut into a garden of Eden for the national health service. Let us take his arguments one by one and analyse what he told the House.
Mr. Spearing:
Will the Secretary of State give way?
Mr. Dorrell:
No, I shall develop my argument and give way later.
Let us begin by examining the so-called arguments--that is a grand word to describe what the hon. Gentleman used. He referred to the statistics that were much beloved of his predecessor, the hon. Member for Peckham (Ms Harman), but mere repetition does not make them true. They like talking about 50,000 fewer nurses. The only problem with that argument is that the nursing work force of the national health service has grown by 55,000 under the Conservative Government, and the nursing work force today is at exactly the same level as it was in 1990. It is simply not true to say that the nursing work force in the health service has decreased.
The hon. Gentleman and his hon. Friends like to talk about the increasing number of managers in the NHS, but they speak with forked tongue on that subject. In June this year, the Leader of the Opposition told the Daily Mirror:
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"will be respected wherever possible".
Those two promises sound very good on paper, but the report from the Patients Association yesterday revealed that segregated washing and toilet facilities are far from being the norm, and that patients throughout the country commonly report that if they express a preference to be treated in a single-sex ward--as the charter encourages them to do--they are suddenly told that their wait for treatment will be far longer as a result. The pledge in the patients charter effectively offers patients only a Hobson's choice, and it is not worth the paper that it is written on.
"feeding back good news stories so that Ministers and Conservative Central Office can use them."
There is one rule for them, but for ordinary staff in the national health service it is completely different. [Interruption.] The Secretary of State says that that is total rubbish.
"believes the National Health Service is one of the success stories of modern Britain and is wholeheartedly committed to developing the NHS on the basis of its founding principles of universality, high quality and availability on the basis of clinical need, without regard for the patient's ability to pay; expresses its support for the Government's initiatives to release £300 million from unnecessary NHS administration; welcomes both the Government's further plans to develop NHS primary care and the recent White Paper A Service With Ambitions, which sets out a medium-term framework for a high-quality patient-focused NHS; and welcomes the Government's pledge to spend more money on the NHS, over and above inflation, for each year of the five years of the next Parliament."
The House has just heard a speech of breathtaking complacency from the hon. Member for Islington, South and Finsbury (Mr. Smith). Not only that, his speech further demonstrates, if it were necessary, the bankruptcy of the Labour party--the dilettante approach that it has taken for 17 years to the development of health policy.
"The Health Service needs to be managed and the management probably needed to be improved."
When they are under pressure, Labour Front Benchers acknowledge that the traditional system of management in the health service was inadequate. The Leader of the Opposition and the hon. Gentleman's predecessor, the hon. Member for Peckham, have said so repeatedly. A few years ago, the Socialist Health Association said that the NHS was "traditionally under-managed" and that Labour "should avoid bureaucrat-bashing". That is rather good advice, and the hon. Gentleman would do well to take it.
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