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6.53 pm
Rev. William McCrea (Mid-Ulster): The debate has been interesting--each hon. Member has naturally referred to his or her part of the United Kingdom. I have been left with the impression that Conservative Members are saying that everything is grand and good, while Opposition Members are saying that everything is bad and wrong. To be honest, I do not think that what either side is saying is strictly true: everything in the health service is not good, but nor is it bad.
I wholeheartedly agree with the comments of the hon. Member for Southwark and Bermondsey (Mr. Hughes), who said that we should speak about a common health service and its common ownership. As has been said, the NHS--and its record over the years--of which we in the House are rightly proud, is not the property of any one political party, but of the nation. We must therefore be careful not to overstate the case on either side of the argument. Right hon. and hon. Members should express their constituents' feelings and concerns about something that is near and dear to their heart.
The public rightly wants value for money. No one can excuse inefficiency in any public service--inefficiency is unacceptable. Cost-effectiveness is appropriate and proper, whether it be in the health service or any other community service. The people of Northern Ireland--a part of the United Kingdom--believe that the NHS is in crisis. Owing to lack of finances for capital and revenue costs, we face difficult times, especially as we approach the winter months.
I am not trying to make a party-political point. Amendment (b) states that the following words should be added to the motion:
There was a direct shift of policy in Northern Ireland designed to put care back into the community. I do not argue with that concept as I believe that people should be kept in the community for as long as possible. But although that policy has been introduced, arrangements and finances for the changeover have not been made available. The change from the use of institutions to placing people in the community--there was a dramatic change in the number of mental health beds in the Province and people were encouraged to go back into the community--cannot be made without appropriate preparation for such a move. Neither appropriate preparation nor sufficient finances were made available for that move.
We are proud of our NHS. I join other right hon. and hon. Members in congratulating those who work in it on their commitment--their service and high-quality care to the community is beyond reproach. But it would be wrong to suggest that there are no problems. My constituents tell me daily about their genuine problems and concerns at
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I am greatly concerned that many doctors are anxious about the fact that, no sooner has a patient been in hospital for a few days, they are handed brochures for nursing homes to help them to choose to which one they should go. Homes are touting for business. I have no objection to nursing homes--they provide a service that the people need--but many of our elderly people are concerned about that. Many people who have worked all their lives and tried to save a few pounds for their old age are now finding that, when they are put into nursing homes, most of their savings are used up. Those concerns are widely felt in my constituency.
Many of the farms in my constituency are small, family farms that have been handed down for generations. The farmers do not consider that they own those farms, but that the farms have been lent to them for the period of time that they are on this earth, to be passed on to the next generation. Now, however, when many elderly people enter nursing homes, their farms have to be sold, which has caused a change in the make-up of the community. The elderly are right to express their concerns to us, as their elected representatives, and, as such, it is right that we express those concerns in the Chamber tonight to the Minister concerned.
The Minister with responsibility for health services in Northern Ireland, the hon. Member for North-East Cambridgeshire (Mr. Moss), sent out a document stating that there had to be a 3 per cent. cut for three consecutive years, starting this year. Half of that--1.5 per cent.--is demanded from cuts and savings in administration; but the other 1.5 per cent. will come directly from the service to the people.
To be fair to the Under-Secretary, I have to say that he is the first Minister who has come out and stated that to be a fact. Every other Minister would cover it up and say, "No, no, no. There are no real cuts--we are looking for those 3 per cent. cuts, but it will not affect the service." At least this Minister had the honesty to state openly that savings were being sought in the service. Although I am prepared to give him full credit for his honesty, it does not alleviate my concern about the effect of the cuts on the community.
Rev. Ian Paisley (North Antrim):
My hon. Friend will be aware that there was an Adjournment debate today, in which was highlighted the case of a hospital that five successive Ministers for health promised would be built in the Causeway to serve the region of north Antrim and east Londonderry. That project is now in doubt and, although £10 million has already been spent on the scheme, it is now questionable whether it will ever be completed. Surely that should set the alarm bells ringing.
Rev. William McCrea:
I thank my hon. Friend for his intervention--that case causes me great concern. I have been a member of several delegations and deputations to the Minister in respect of that hospital. The Minister promised us, with hand on heart, that the hospital would be built and that, therefore, the moneys that had already
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There is an urgent need for a Causeway hospital in Coleraine to serve that wide area. A hospital was taken away from Ballymena, in the constituency of my hon. Friend the Member for North Antrim (Rev. Ian Paisley), and the people were promised that the area around Coleraine and Portrush would be served by a modern, up-to-date hospital. The Minister cannot get away with reneging on a promise that he has made and that successive Ministers have consistently made to the community.
Those year-on-year 3 per cent. cuts will eat into the very heart of health service provision to the community and we must not permit them to happen. Although the Government, perhaps with the forthcoming election in mind, have suggested that more money will be made available on the mainland--perhaps as much as £300 million will be released for the health service here--the truth is that no extra finance is coming to the Province. Therefore, the 1.5 per cent. direct cut in the service will certainly be felt by the community. We face the closure of homes for the elderly and cuts in the home-help service. That is a crying shame and the community is deeply concerned at the lack of resources.
Mr. Simon Hughes:
I support the hon. Gentleman in the two points that he has made. First, as an English Member of Parliament, I say that it would be completely unfair if the additional money for the health service that has been announced by the Chancellor and by the Secretary of State for Health was not shared throughout the United Kingdom on an equal basis. Secondly, we cannot continue to have an arbitrary percentage cut in the budget year on year imposed simply in the name of efficiency, without any explanation or justification. The Government cannot set a target without explaining it. If the health service needs more money, it needs more money even if it also has to strive continually to be efficient.
Rev. William McCrea:
I thank the hon. Gentleman for his intervention. First, it is sadly true that none of the tranche of money that has been announced will go to Northern Ireland. Secondly, as the Minister has openly stated, half of that 3 per cent. cut--1.5 per cent.--will directly hurt the service that is provided. I wholeheartedly accept the points that the hon. Gentleman made, both in that intervention and in his earlier speech.
The current system of trusts in the Province has created a level of administration that is unprecedented in any other part of the United Kingdom. In order to enable competition within the service, we have created many businesses--more than 20, serving 1.6 million people and all with their own chief executives, accountants and other administrative staff. We seem to be filling up the health service with an increasing number of senior administrators, who exert a great draw on the available resources, while at the same time the number of staff who actually deliver service to the patients is decreasing, to the detriment of patients in the Province. We need extra nursing staff and doctors in the health service.
I give the ambulance service in my constituency as an example. Two weeks ago, a newspaper reported that the ambulances going out on emergencies to people suffering
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Many other hon. Members want to speak, so I shall conclude. Although in the Province we appreciate the good things--and there are good things--in the health service, we believe that we are confronted with a crisis. We believe that the waiting times of patients requiring urgent hospital treatment and so on need to be attended to, and they cannot be attended to without adequate resources.
"and regrets that the official Opposition is proposing almost no extra funding for the NHS."
While I agree with much of the motion, which expresses many of the concerns that I hear from my constituents--it is right that those worries should be expressed on the Floor of the House--I do not believe that any credible political party can say that it condemns what another party is doing unless it says that it will make more funds available to the NHS. There have been White Papers, major documents, consultation documents and charter marks--all intended to improve the service--but there have to be follow-up finances.
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