| Previous Section | Index | Home Page |
8.36 pm
Rev. Martin Smyth (Belfast, South): The hon. Member for Wimbledon (Dr. Goodson-Wickes) gave a balanced speech and, while pointing out the positive aspects, expressed his concerns about what has happened with some of the reforms. I should like to share the positive note that he struck, because too often we minimise the excellent work that has been done in the national health service over the years. I am familiar with the NHS through my personal experience and as a pastor and because my family has used it, and I understand not only the good work that it has done but the changes that it has undergone. Having said that, however, I think that the Government occasionally overstress the positive side of the NHS and fail to realise that there may be problems with it.
Some years back, when he was a Health Minister, the right hon. Member for Peterborough (Dr. Mawhinney) was answering in a very positive manner for the Government during Question Time, and I was called by Madam Speaker to ask my supplementary question. I asked, "Will the Minister accept that we are not in heaven yet?" There was a sedentary intervention from a Conservative Member, who cried out, "That's what we're trying to prevent." I understood what he meant, but the fact is that there are problems in the health service, and we should at least be dealing with them.
Earlier in the debate, it was said that, in the past, hospitals and health authorities were always able to balance their books. I wonder whether the problem today is that we have a different type of accountant, or that medical politics are being played. We are consistently told that we cannot provide services because we are already in the red. If it was possible to balance the books in the past when there were shortages in the health service, why can that not be done now? At no time have any Government been able to provide the finance to cover all the health service's demands.
Another difficulty through the years has been with changing medical practices. Some practices were held on to for too long because people were accustomed to the work, happy in their environment and not prepared to move on. At times, developments were retarded.
Rather interesting comments have been made about cutting administration costs, for which there is a place in some areas. Dr. Sandy Macara of the British Medical Association said not so very long ago that the question was not whether there should be less management; the service was happy with it. What it needed, he said, was more money. When we constantly criticise the amount spent on administration, we should bear in mind such a salutary warning, which was repeated by a recent witness to the Select Committee on Health, who claimed that more and better management was necessary to improve and co-ordinate children's health services.
On the other hand, we must fire a shot across the bows of some managers, for I am not convinced that some of them are managing well. When one bears it in mind that some of them are getting more money for a year's work than the Prime Minister of the nation, it seems that we should demand a better service from them. In previous debates both in the Province and in the House, I have asked whether it is right to give bonuses to managers for cutting down on lower-paid workers, which seems to have been happening for some time. I have very little sympathy
20 Nov 1996 : Column 1056
I have a letter from a person in North Down, a copy of which he sent to the hospital's chief executive. It said:
I share the concerns of the hon. Member for Belfast, West (Dr. Hendron), who referred to the letter that the medical director of the trust wrote to general practitioners in October, which said:
There is an experiment in total fundholding at the moment. Given last year's experiences, it seems that there is a tendency to go ahead with spending the money that is available from GP fundholding, in the knowledge that at the year end the boards will be able to provide extra money because they have saved it. Have the Government rightly been blamed for gross underfunding, when no one--from my party, other Opposition parties, the BMA or anybody else--has said what amount is needed adequately to provide what is demanded of the NHS? Those who constantly criticise the health service will have to address that issue realistically.
At the same time, I am not prepared to accept the explanations of the Department and of others in Northern Ireland who blame the shortage in health care and other areas on what they call the "disturbances" of the summer. As I understand it, all the budgets were set before the summer. Unless the Minister and the Department employed the services of Mystic Meg, I do not know how they foresaw that perceived disturbances in the summer would have an impact on the budget. I refute such an allegation, especially bearing in mind the fact that the Consolidated Fund does not include security matters. Indeed, we are regularly told in appropriation debates that we should not be referring to the security budget. The 3 per cent. cut was changed to 1.5 per cent. when the Minister realised that such a cut could not be made.
Concerns are being raised--I have heard the Minister and others speak of them--that capital investment might be cut to feed current expenditure. That would be deplorable and short-sighted, bearing in mind the fact that it has been pointed out in the debate that, under a former Administration, there was no funding of capital building for years. It takes a long time to catch up on such capital
20 Nov 1996 : Column 1057
Mr. Matthew Banks (Southport):
It is a great pleasure to catch your eye, Mr. Deputy Speaker, in this important health service debate. Hon. Members on both sides of the House know only too well that sometimes, as a result of commitments in this place to Standing Committees, and so on, it is not always possible to be present for all the debate. I sincerely apologise to the Opposition Front-Bench spokesman, and to my right hon. Friend the Secretary of State for Health for--unusually for me--not being able to be here as a result of service in a Committee earlier this afternoon.
The debate has been interesting. As I look across the Chamber and along the Conservative Benches--although to a place perhaps a little detached--it is pleasing to see that we not have not only Members who represent English constituencies but our friends from Northern Ireland. Northern Ireland is very much an integral part of the United Kingdom, and it is entirely right that Northern Ireland Members should contribute to the debate. I regret that, in the unlikely event of there ever being a Labour Government, devolution plans will carve up the country, and who knows what will transpire.
In an interesting and forthright speech, which we have come to expect from him, my hon. Friend the Member for Welwyn Hatfield (Mr. Evans) read out what to me was an appalling record, and an indictment, of the last Labour Government.
My constituency should have had its brand new hospital in the 1970s. The references made by my hon. Friend the Member for Welwyn Hatfield to the Chancellor rushing to the airport and then having to come back to London and the crisis surrounding this country having to go cap in hand to the International Monetary Fund struck a chord with me, because the new hospital in which I have been a patient and which many of my constituents use, should have been built in the 1970s but was not, because the capital building programme was cut by one third by the Labour Government. My constituents had to wait for the election of a Conservative Government before progress could be made.
In the same vein as other hon. Members, I should like to refer to some of my personal experiences of the national health service and make a couple of points on national issues, as well as referring to one particularly important local issue for Southport. I know that one or two other hon. Members wish to speak, so I shall be brief.
I do not propose to repeat most of the points raised by my hon. Friend the Member for Welwyn Hatfield in his early remarks. However, when I receive a critical letter
20 Nov 1996 : Column 1058
I have been fortunate in having been in hospital on only a couple of occasions. Touch wood, I have had good health, apart from when my career in the Gordon Highlanders was cut short and I had to be invalided out; and, more recently, during the Maastricht debates. I do not know whether it was because we seemed to be going through the night rather a lot, but I remember turning up for what I thought would be a routine meeting of about 30 minutes with the chairman of my local NHS trust in 1993, and coming out of intensive care seven days later.
I pay tribute to the professionalism and care of all the staff and administrators at the Southport and Formby Community Services trust. I am sure that the quality of health care provided to my constituents by one of the country's flagship trusts is reflected in other parts of the country. What my hon. Friends have already said proves that.
The difficulties in and around my constituency are, in some ways, the difficulties of success. As a result of the Government's policies and the year-on-year real-terms increases in health service spending, we have a couple of pretty new hospitals five miles apart. Over the past few months, two local health authorities--South Lancashire and Sefton--have conducted a public consultation exercise on their plans to put particular specialist services in one hospital or the other. The advice of the clinicians--not the bureaucrats--has been that, to maintain important services such as cancer services, there must be centres of excellence throughout the region, never mind throughout the country.
With two new hospitals not far apart, tough decisions sometimes have to be made. One difficulty of having two health authorities is that sometimes, for the wrong reasons, bureaucracy can take over. The provision for my constituents and those of the hon. Member for West Lancashire (Mr. Pickthall), who, unfortunately, cannot be here for this debate because of important engagements elsewhere, has been the subject of a review, because the two authorities have not been able to agree on what to do. Because they could not decide which services should be concentrated on one site, they decided to commission Sir Duncan Nichol, the former chief executive of the national health service, to undertake a report. He decided that there should be a hot site and a cold site. He then decided that the hot site should be in Southport, and the cold site in Ormskirk.
Unfortunately, in spite of having commissioned the report, the two health authorities were still not able to agree on implementing its recommendations. I understand perhaps more than most the sensitivities of the issue, but, as others have pointed out, it was as a sop to those in the Ormskirk area that the two authorities decided that, although all the services would go to Southport, a new maternity unit would be based in Ormskirk.
That process has got no further, because a petition was put together with more than 20,000 signatories. It was concocted by several local people with a passionate and genuine interest in the continued provision of local maternity services in Southport. They did not want those services to go five miles down the road to Ormskirk.
20 Nov 1996 : Column 1059
Unfortunately, as so often happens, one or two local politicians jumped on the bandwagon of what had, until then, been a non-political public debate. One in particular, a local councillor by the name of Ronnie Fearn, who is known to hon. Members, decided to take hold of the petition, saying that it would be safe in his hands, and he would present it to the health authority. So safe was it in his hands and so competent was he that he presented it to the wrong people. They had to put it in a brown envelope, put some stamps on it and send it to the health authority that was conducting the review.
The point of that story is that neither of the community health councils, made up of local people, has been prepared to object to the health authority's proposals. We have a problem if local people on the community health council are not prepared to oppose plans that concern so many people in my constituency.
As I have made clear once before, I believe that the way to make progress on this constituency difficulty is to try to bring all the health services in Southport on to one site. The way forward is certainly through the private finance initiative. I am pleased that the Southport and Formby Community Services trust is undertaking pioneering work in that respect on new buildings.
"I visited a friend who is a patient in ward 17 . . . and found that she and others on the ward were on beds that did not have sheets, pillowcases or indeed any proper bed covers. When I enquired why this was so my friend advised that the laundry had not been received, this was at 4.00 pm!!
I had had experience of such a problem earlier when I raised a similar issue with the management.
I find this totally appalling and unacceptable. I realise that it has been necessary to implement cuts in the health service but surely the people who are ill deserve to receive humane treatment, and that includes clean bedding."
"elective activity for patients of non fund holding medical practices"--
within the board area--
"will be ceasing".
I am not convinced that the question is simply one of giving preferential treatment to GP fundholders, for I am reminded constantly that emergency work and other types of serious surgery are still paid for--even that of GP fundholders--by the boards and regional authorities.
| Next Section
| Index | Home Page |