| Previous Section | Index | Home Page |
8.58 pm
Mrs. Audrey Wise (Preston): We have heard a pretty remarkable display of complacency from Conservative Members, who have suggested that any criticism of the national health service is a slur on the service, or even shroud waving. Conservative Members seem to think that Labour Members are the only people who are worried about the current situation in the NHS. If that were so, it would not really matter, but it is not. Conservative Members should listen more to their constituents and to the staff who work in the service.
Much praise has been directed towards the staff from both sides of the House and I certainly want to add my voice to that. I admire the devotion of most people who work in the NHS, who are expressing their worries in no
20 Nov 1996 : Column 1060
People who work in the NHS do not complain only, or even mainly, about their pay. I think that all hon. Members will have received the briefing from the Royal College of Nursing, which states:
The management of the Preston Acute Hospitals NHS trust were not casting a slur on the national health service when they recently expressed to me their great worry and unease that the private finance initiative, at least as it is presently constituted, would remove from them the control that they should have over future hospital development. Theirs was a thoughtful appraisal of something that will have a long-term effect; it was not casting slurs or shroud waving. We ignore such expressions of concern at our peril.
Of course, Conservative Members are too busy filling the airwaves with claims that more and more people are being treated. All sorts of somewhat spurious statistics are put before us. In the figures used by the Government Front-Bench team, it is not patients who are measured, but finished consultant episodes. Those are not necessarily the same as people. The Government should spend more time and effort trying to collect meaningful statistics--for example, for the league tables that rate hospitals one against another, which are important, as they can greatly affect which hospitals attract contracts. Often it is not the most vital things that are measured.
Why not do as the RCN suggests, and collect information about the incidence of hospital-acquired infections? That would be a measure of hospital efficiency, and it would be a great deal more meaningful.
Day care is another item that has to be considered. We are all in favour of day surgery units for appropriate use. I recently had the pleasure of opening a day surgery unit at the Royal Preston hospital. As a member of the Select Committee on Health, I have questioned Ministers about how they define day surgery units, and have discovered that they count only those that send people home in the evening; so, if a hospital prefers to have a unit that provides overnight recovery beds, it is not counted as a day surgery unit, yet that unit can use its facilities far more efficiently, because the whole day is available equally for operations and procedures.
In other units, less recovery time is available as the day wears on, so only more minimal procedures can be carried out in the afternoon; yet a hospital that considers that and decides to have overnight beds will not be counted as providing day surgery, and will suffer in the league tables and when purchasers consider awarding contracts.
In the national health service, we have to consider equity according to age and equity according to geography, among other issues. The national health
20 Nov 1996 : Column 1061
It may be that other health authorities do things that are not done in the north-west, but the differences stem not from local accountability to people but from a lack of strategic planning and overall consideration of people's needs. If clinical need were the guide, geography would not normally be, as it often is, the deciding factor in whether or for whom treatment was available.
I reinforce what my hon. Friend the Member for Islington, South and Finsbury (Mr. Smith) said about mixed sex wards. I, too, believe that they are an affront to the dignity of patients, and cause a great deal of distress. I also believe that to cause distress to patients is to be inefficient. Those who consider beds and people as though the people were merely pawns to be moved around are not doing their care any favours. My hon. Friend dealt extremely well with the subject of mixed sex wards, but he did not make particular mention of psychiatric wards. I believe that mixed sex psychiatric wards are especially obnoxious and worrying.
There is much talk about value for money, and I agree entirely that we should obtain it, but that cannot be done if people are treated and cared for by staff who are not appropriately trained; yet that is the case for many of our children.
There is a shortage of paediatricians and other child-trained clinicians in our hospitals. I am shocked that paediatrics is regarded as a Cinderella specialty. Children form a quarter of our population, and what happens to them when they are sick can affect them all their lives. To achieve efficiency, we must ensure good and appropriate treatment for children. Half the children in hospital are in adult wards. That is a disgrace. I do not think that one Conservative Member has mentioned children. That is typical of our neglect of that quarter of the population in health matters.
Many of our sick children, including children with complex disabilities, are now cared for at home. It is especially important to examine the care available for them. They need a community children's nursing service, but in half the country there is no such service. As adults, we expect trained nurses--district and community nurses--to be available. They give us wonderful service. Children have equal need, and should have an equal right to a nursing service trained for their special care, yet half the country has no such service.
Only 10 per cent. of the country has a 24-hour nursing service. Conservative Members who are pointing at their watches should desist. I have sat here for many hours; none of them has been here for as long as I have. It speaks volumes that it is while I am talking about our children and telling the House some uncomfortable facts about how we do not look after them properly, that I am interrupted.
20 Nov 1996 : Column 1062
Only 10 per cent. of the country has a 24-hour children's community nursing service. That means that 90 per cent. of parents with kids who may have complex difficulties or be terminally ill have no district nurse to call on who is trained to look after children. In the whole country, there are only about 400 such nurses. More urgently need to be trained, and then employed to provide that service. Without appropriately trained staff, we do not get value for money.
I also suggest that we would get value for money if we gave better support to voluntary organisations such as Home-Start, which exists to support families with needs, often health needs. It is wrong that, when people are willing to give time and effort to voluntary work, they should be given the overwhelming burden of perpetual fund-raising. If we are trying to get the best value from every pound expended by the state, we should direct more money at organisations such as Home-Start.
A Conservative Member said that a strong economy was the fundamental need. Of course I agree with that, but it is rich coming from a Government who have presided over constant high unemployment and the destruction of our manufacturing industry. It is not only to provide the wherewithal that we need a strong economy. Economic and social problems make people's health worse, so it is important that we have a strong economy with people in work, because, if people are unemployed, they suffer more sickness.
Mr. Michael Fabricant (Mid-Staffordshire):
The hon. Member for Preston (Mrs. Wise) has allowed me only five minutes, because I know that those on the Front Benches wish to start summing up at about 9.20 pm.
The hon. Lady says that statistics are meaningless, yet, like so many other Opposition Members, she presented a tirade of criticisms of the national health service. The NHS, which is the largest employer in the United Kingdom, is certainly not perfect. Of course it is not. There will always be room for improvement. However, my local chairman always said to me, "If you want to know how the health service is doing, ask someone who has been a patient." That is extremely good advice.
I shall talk briefly about the NHS generally, but more particularly in Lichfield, which I have the honour to represent as part of my constituency. The overriding statistic that Opposition Members choose to ignore is that, in 1979, in the last few months of the Labour Administration, 25 per cent. of all patients waiting for treatment had to wait for hospital treatment for over a year. Now, in 1996, there has been a reduction to only 0.4 per cent. Instead of one in four patients, it is now one in 250 waiting for hospital treatment for longer than one year. Surely that is something of which we must be proud.
The right hon. Member for Livingston (Mr. Cook) said that the acid test of how well the health service is doing is the number of patients who are being treated. In that respect, too, even by the right hon. Gentleman's criterion,
20 Nov 1996 : Column 1063
Premier Health trust, which is based in Lichfield, runs the Victoria hospital in Lichfield. Waiting times at that hospital have been reduced to the shortest time ever. The majority of patients with non-urgent problems are seen within four weeks for their first appointment. That enables more patients than ever before to be treated.
A rehabilitation unit has been operating for the past 18 months. It provides more appropriate services in responding to need in Lichfield, where previously patients had to go to Birmingham, Sutton Coldfield, Burton or Stafford.
The Victoria hospital has introduced an abdominal ultrascan unit. Since July 1994, when it was introduced, the number of patients scanned has doubled. Obstetric scanning was introduced at the beginning of 1995, enabling mothers to be scanned locally rather than travelling to the district general hospital. The minor injuries unit is meeting patient charter standards for the first time this year.
I am impressed by the number of consultants who now go to the Victoria hospital to treat patients. In the old days, under the old NHS scheme which Labour would like to preserve in aspic, it was always the patients who had to follow the consultants. We now see the consultants following the patients. In the out-patients department of the Lichfield Victoria hospital, 51 consultants are attending each week. For day cases, there are 20 visiting consultants in five different specialties, whereas previously patients would have to travel to Burton, Stafford, Sutton Coldfield or Birmingham.
"The RCN has conducted two surveys of accident and emergency units in 1994 and 1996. Last winter our survey results showed that nearly half the A and E units monitored still had patients waiting overnight on trolleys."
The RCN is not casting a slur on the NHS. Its members work in the NHS, and I believe that they are proud of it. They are not proud when patients have to spend many hours on trolleys.
| Next Section
| Index | Home Page |