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Mr. Spearing: Will the Secretary of State give way?
In their White Paper, the Government have set out a clear route to the future of the national health service, converting into substance and reality the one thing said by the hon. Member for Islington, South and Finsbury with which I absolutely agree. I refer to the founding principle of the national health service. In this country, we believe that health care should be available on the basis of the patient's clinical need, without regard to ability to pay. That is the key principle on which the national health service was built, and I believe that those who are committed to it have a clear obligation--a clear duty--to show how that high aspiration will be converted into reality. That is the duty that Opposition Front Benchers have failed to discharge.
Mr. Llew Smith (Blaenau Gwent):
I represent an area that is generally regarded as being the birthplace of the national health service. Indeed, my predecessors include not only Michael Foot but Nye Bevan.
My area also has some of the worst health problems in the United Kingdom. The number of deaths from cancer, respiratory diseases and heart disease are well above the national average. The 1991 census for Blaenau Gwent showed that 41 per cent. of households included someone who suffered from either a long-term illness or a disability, and in 1993 the social services department had 4,000 people registered as disabled. On top of all that, we have the worst mental illness problems in Gwent. Ours is also one of the poorest areas in Wales--a fact that even the Welsh Office recognises.
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A Gwent health survey carried out between 1985 and 1989 confirmed that the most deprived parts of the county experienced the worst health. That conclusion is not peculiar to Gwent: it has been reached time and again elsewhere. If we are to tackle bad health, we need not only a first-class health service but to be successful in combating poverty.
I want to concentrate on Gwent health authority, Gwent Community Health NHS trust and the South and East Wales Ambulance NHS trust, which do not seem to care about, or act in response to, the problems that I have described. I will deal first with Gwent health authority. Let me say at once what the authority is good at: it is good at producing one glossy magazine after another, filled with promises that it has no intention of keeping. For example, Jeremy Hallett, who until recently was chief executive of the authority--before, to put it politely, securing a job for one of his colleagues and then doing a runner to a nice little earner in another authority--stated in one of those glossy magazines:
Although everyone accepts that we have major health problems in Blaenau Gwent, Gwent health authority's response has been to cut the number of doctors. Most people would assume that the response to such problems should be an increase in the number. For example, in Cwm, near Ebbw Vale, the authority advertised for a replacement for a doctor who had resigned; instead of appointing another doctor, however, it merely handed over the patient list to another doctor already practising in the village. After a public outcry, the authority retreated, announcing that another doctor was to be appointed, but many local people thought that it would not happen--that it was just a publicity stunt to placate them. I did not believe that at the time, but I do now. I accept that the health authority was deliberately deceiving our people. But those people have no intention of sitting back and accepting the deception: they will continue to fight until they get the justice that they deserve. I hope that the Minister will investigate the health authority's deception, and the way in which it deliberately misled those with the greatest health problems.
I am not surprised at the incompetence of Gwent health authority and its failure to respond to health needs. One has only to look at some of the appointments to its board. An executive from the Midland bank was appointed recently. I look forward to the time when nurses, ancillary workers and doctors are appointed to the board of that bank, although I suspect that it will not happen in the foreseeable future.
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Then we have the South and East Wales Ambulance NHS trust which under the previous chief executive and board decided to organise shopping trips to France in an attempt to generate income. I do not expect the trust's members to know everything, but in the circumstances I would have expected them to find out first whether there was a bank holiday in France and whether the shops would be closed. However, that was obviously too much for the chief executive and senior staff, because when the trippers arrived the shops were closed. The trust was then forced to repay the cost to the trippers, together with compensation.
Never short of ideas, the trust then decided to invest £125,000 in another computer control system, which has still not been made to work. I suspect--I may be wrong--that it may have used that system to organise the trip to France. That seems logical.
Not satisfied with those disasters, the trust decided to invest £3.6 million in new headquarters, which it now accepts was an overspend of 50 per cent. It told the Welsh Office that the cost would be £2.4 million, although the directors knew at the time that it would be £3.1 million, and the actual cost was even higher.
After all that--and much more--the non-executive directors are still in place. Will the Minister investigate and find out why that is? In the mean time, ambulance cover is being cut and morale is at a low ebb. I could give one example after another of the trust's inefficiency, but I will give just one more. The trust spent £350,000 employing consultants to cut transport costs. The cuts still have not reached more than one third of that figure, so that was not good value for money for taxpayers.
Bob Hudson, chief executive of Gwent Community Health NHS trust, decided to reorganise mental health provision for people in a part of my community without consulting patients, their families, friends, nurses, doctors or anyone on the local authorities. When we protested about that in meeting after meeting, Mr. Hudson's response to the most vulnerable people in our community was:
I mention those examples--I could mention many more--to highlight the incompetence of Gwent health authority, Gwent Community Health NHS trust and the South and East Wales Ambulance NHS trust, and the uncaring attitude of their senior people. They do not understand, care or have a commitment to the NHS. To them, it is just another way of making a quick buck. Their promises in those glossy magazines were just words--a publicity stunt.
Sir Norman Fowler (Sutton Coldfield):
At the beginning of the debate, the hon. Member for Islington, South and Finsbury (Mr. Smith) referred with approbation to many quotations about the so-called "crisis in the health service." He gave a further quote, that it was "close to collapse", and said that it was in the "worst position for many years".
Other press cuttings assert:
"Sharing responsibility is more than a quick fix consultation exercise. It must be about developing a long term relationship".
He went on to say:
"To no small extent community involvement has become conventional wisdom because we have been seen to make them work in Gwent to the great benefit of local people."
Lindy Price, chairperson of Gwent health authority, stated, again in one of those many glossy magazines:
"I would like to develop a culture of working together in the trust and county boroughs, with all general practitioners and community health councils"
and
"the general public when they are patients and when they are well".
All those statements are rubbish and no more than a public relations stunt: the authority has continually treated my constituents with total disdain.
"Well folks, you've lost out".
He then told us that he could not make the next meeting as he had decided to go on holiday in Ireland, and that in any event there was no chance of altering the plans. Consultants attended the next meeting, where the plans were totally changed and it was obvious that the reason was based on medical advice as opposed to advice from managers and senior administrators.
"Crisis has become an uncomfortable way of life for the health service".
They even assert that the "NHS faces collapse". The Times asserts:
"Patients are suffering and the wait for an appointment is lengthening into months, and even years".
Those are serious charges. Those phrases are almost identical to the phrases used by the hon. Member for Islington, South and Finsbury. The difference is that those press comments were made in 1975, not in 1995 and 1996. The same sort of comments as the hon. Gentleman made and the same sort of quotations as he used were made in 1975, 1976, 1977 and 1978 under the last Labour Government. In 1975, the Labour Government had to bring in an outsider, Lord Goodman, to sort out the mess in the NHS.
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