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Renal Services (Greater Manchester and Cheshire)
6. Mr. Nicholas Winterton: To ask the Secretary of State for Health if he will make a statement on the provision of renal services in Greater Manchester and Cheshire. [10361]
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Mr. Horam: Health authorities serving Greater Manchester and south Cheshire have recently consulted the public on proposals to reorganise renal services in the area. The health authority that is co-ordinating the review is presenting its evaluation to all seven participating authorities this month. Afterwards, health authority members and others will have the opportunity to consider the proposals further.
Mr. Winterton: Does my hon. Friend accept that renal failure is a complex illness that often needs the support of other specialties? Does he accept that Macclesfield community health council, which has conducted an in-depth inquiry into the matter and sought public views on the provision of renal services in Cheshire and Greater Manchester, has advanced the unanimous opinion that Wythenshawe hospital, under Dr. Mike Venning and his colleagues, would provide a wonderful hub for the provision of renal services? It found that it would be an advantage to retain three hubs--the Manchester royal infirmary, Hope hospital and Wythenshawe hospital--rather than reducing the hubs to two, with all the associated problems that that would create for those with renal diseases.
Mr. Horam: I hear what my hon. Friend says. He raises an important point. I put it to him that this is a clinician-led review that involves a lot of capital investment. It will obviously be predicated on the desire to secure better health care for renal patients. I am delighted to tell my hon. Friend--the House will understand my relief in saying this, knowing my hon. Friend's formidable lobbying attributes--that it will include improved satellite facilities in Macclesfield which, as he knows, are not nurse or clinician-led at the moment. They will receive full medical support under the proposals.
My hon. Friend will also understand that, if there is opposition to the proposals, or if the health authorities cannot agree on them, they will come to Ministers. In light of that, I must retain the independent view of Ministers to judge the proposals properly when they come before us. However, I shall certainly take into account the points raised by my hon. Friend.
Mrs. Dunwoody:
Would the Minister like to astonish us all by putting the patients' interests first? This is not a matter that can be decided by the ill-mannered fighting of individual consultants: it is a matter of providing high-quality satellite facilities to serve not just Macclesfield but any patient in south Cheshire who requires renal assistance. Will the Minister confirm that, as far as he is concerned, the quality of renal services will always take precedence over the particular interests of individual Members of Parliament?
Mr. Horam:
Of course that is the case. As I pointed out to my hon. Friend the Member for Macclesfield (Mr. Winterton), this is a clinician-led review with the object of putting more capital investment into a necessary area in order to provide a better service. I am sure that the proposals will achieve that aim, but we take into account all points of view--both those opposed and those in favour--when we consider them.
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GP Fundholding
7. Mr. Butler: To ask the Secretary of State for Health how many residents of (a) Buckinghamshire and (b) Milton Keynes are served by fundholding general practitioners (i) as a percentage of the population and (ii) in total. [10362]
Mr. Malone: The total registered population in Buckinghamshire covered by a fundholding general practitioner is appropriately 486,000. In Milton Keynes, fundholders serve around 156,000 people. Those figures represent 71 per cent. of the registered population of Buckinghamshire and 80 per cent. of the registered population of Milton Keynes.
Mr. Butler: As a registered patient with one of the best fundholding GP practices, not just in Newport Pagnell and my constituency but in the country, may I invite my hon. Friend to join me in congratulating the doctors who have demonstrated that this policy works in providing an ever-improving and outstanding service to their patients? What advice would he give to my constituents and others who are anxious to continue to enjoy the benefits of GP fundholding after the next election?
Mr. Malone: I am grateful to my hon. Friend for pointing out the excellent work that is being done not only by his GP fundholder but by others in his constituency. I extend that to across the country as well, where the majority of the population of England are now served by GP fundholders. There is a very simple answer to the question that he posed, because in the election one party will be pledged to abolish GP fundholding--the Labour party. The Conservative Government will sustain GP fundholding when re-elected, so my advice is pretty clear: vote Conservative.
Health Service Savings
8. Mr. Richards: To ask the Secretary of State for Health what assessment has been made of the likely savings to be made for the health services as a result of the measures contained in the Health Authorities Act 1995. [10363]
Mr. Dorrell: Total annual savings as a result of the Health Authorities Act 1995 are estimated at £150 million: £100 million from the abolition of regional health authorities, and £50 million from the introduction of single, unified health authorities. Those savings will be used for direct patient care.
Mr. Richards: Does my right hon. Friend recall that the savings from administration that he just announced were bitterly opposed by the Labour party? Will he confirm that an additional £300 million a year will be diverted to patient care from cuts in hospital bureaucracy? Therefore, is it realistic for the Labour party to claim that a further £100 million a year can be saved? Where would the money come from?
Mr. Dorrell: My hon. Friend is absolutely right. There will be an extra £300 million a year for patient care as a result of the Government's squeeze on unnecessary administrative processes.
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The hon. Member for Islington, South and Finsbury (Mr. Smith) loves talking about savings from reduced administration, but he is not serious about it. Indeed, so unserious is he that the Health Service Journal, which circulates among health service managers, says:
Mr. McNamara:
The Minister will be aware that, a fortnight ago, a patient from Leeds was sent to the intensive care unit in Hull, a journey of 60 miles, because there was no room in the Leeds intensive care unit. Last Tuesday, because of no room in the Hull royal infirmary intensive care unit, a constituent of mine, Mr. Dennis Drax, was sent to Leeds, another journey of 60 miles. Sadly, both patients died. How much of the new surplus will be given to our intensive care unit?
Mr. Dorrell:
The hon. Gentleman raises an important point; it is not directly relevant to this question, but I shall answer it none the less.
Any individual case where the service may be seen to have failed will of course be investigated, but I hope that the hon. Gentleman will tell the House the whole story of intensive care referrals this winter. I hope that he will remind the House that, this winter, for the first time, every intensive care unit in the health service is connected to an emergency bed referral system, and that an intensive care clinician who needs to refer a patient to another intensive care unit has immediate access to availability in the health service for the first time. The hon. Gentleman might have spared time to welcome that development of service.
9. Mr. Jacques Arnold:
To ask the Secretary of State for Health if he will make a statement on the development of the private finance initiative for the construction of new hospitals. [10364]
Mr. Horam:
Contracts have been signed for 43 private finance initiative schemes, with a total capital value of £317 million.
Mr. Arnold:
Does my hon. Friend remember that, three years ago, when the PFI policy was in its infancy and we were considering the prospects for a brand new district general hospital in Darenth park for the people of north-west Kent, the then spokesman on health for the Labour party, the hon. Member for Peckham (Ms Harman), derided the project as being on a B list and highly unlikely to take place? Will he tell the House what progress is being made with that project, and emphasise the excellent quality of the team in our local NHS trust and the very strong support for the project from the people of north-west Kent?
Mr. Horam:
If, indeed, it was on a B list when the Opposition said it was, it has done pretty well since. The Darenth park scheme is progressing extremely well and making good progress. As the House knows, my right hon. Friend the Secretary of State, not least among many others, has put a great deal of effort into introducing a successful product. I am glad to be able to say that he is
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Mr. Barron:
Is the hon. Member for Gravesham (Mr. Arnold) aware that he has some support from the Opposition? He said in his last election manifesto that he had taken a leading role in securing the recently announced district general hospital. In fact, it has still not been agreed. We await the hon. Gentleman's next election manifesto.
The Minister referred to 43 projects under the private finance initiative. Not one of them is a new hospital. The Tories have promised PFI hospitals since 1990 but not one has been delivered. The Secretary of State has promised the Prime Minister £500 million of new PFI hospital contracts by April, yet has not delivered £1.
The Government have tried to sweeten PFI deals with tailor-made Acts, but have failed to do so. I understand that, last week, new guidelines were offered to prop up the PFI scheme by making available national health service budget building cuts.
Is not the scenario that I have outlined jeopardising the future of our NHS? When will the Government clean up the mess and start to build new hospitals instead of talking about so doing?
Mr. Horam:
That was a long question. In turn, I will ask the hon. Gentleman a short question. Are the Opposition in favour of PFI or are they not? It is--
Madam Speaker:
Order. The Government are here to answer questions, not to ask them.
Mr. Horam:
We would like some answers, Madam Speaker.
The hon. Gentleman seems not to understand that the proposal for a Norfolk and Norwich general hospital is indeed for a hospital. It will amaze hon. Members on both sides of the House in that area to learn from him that the proposal is not for a new general hospital. In fact, we all know that it is for a new general hospital. What is the hon. Gentleman talking about?
Mr. Dunn:
I remember a time when the International Monetary Fund, not the then Government, determined our health expenditure. Will my hon. Friend accept my thanks on behalf of the people of Dartford for all the help that he has given to the PFI, leading to the construction of a new district hospital with 400 beds--a state-of-the-art hospital--in my constituency, which was opposed by the Labour party throughout, by its Front-Bench spokesmen?
Mr. Horam:
That is a fact. The reality is that hospital projects are going forward throughout the country and not only in west Kent. We are seeing projects going forward in Norfolk and Norwich, Durham, Worcester and Carlisle. Such projects are progressing throughout the country as a result of the PFI, with no thanks to the Opposition, who have constantly sniped and accused us of privatisation, all to no effect.
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"Managers will not lose their jobs, says Smith".
So he will reduce costs on administration but he will not reduce the number of people in administration.
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