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Mr. Smith: The advice I certainly do not take is that of the Secretary of State, who obviously did not hear what

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I said. I said that I did not agree with the application of that remark to the figures that Labour has produced. The figures were accurate and painstakingly collected--

Mr. Dorrell: They tell us nothing.

Mr. Smith: They actually tell us an awful lot. They tell us that children referred to paediatric intensive care units near where they live and where they can get immediate treatment are being told, by hospital after hospital, that they cannot be seen there. Quite possibly they get a bed somewhere else eventually--100 or 200 miles away--but that is not an adequate response to the needs of very sick children.

Mr. Dorrell: Will the hon. Gentleman confirm that no child who needed intensive care and was referred to the emergency bed service was denied intensive care? Will he also tell the House, if that is not the right standard, what standard he would apply to the service?

Mr. Smith: The Secretary of State has quoted one paediatric intensive care consultant to me. I will quote another to him. Dr. Mark Darowski, paediatric intensive care consultant at Leeds general infirmary, says:

"Mr. Dorrell has not learnt the lessons of last winter".

He told the Yorkshire Evening Post on 4 January:

"It is just luck that we have not had another Nicholas Geldard. On New Year's eve there was one paediatric intensive care bed available in the whole of the North of England. We've been operating at 100 per cent. and only luck has prevented the system crashing."

It is all very well the Secretary of State claiming that there have been only 40 referrals to the intensive bed central monitoring unit over this period--nothing like the figures that the Labour party has produced. He ignores the fact that many referrals are made outside the centralised system--

Mr. Dorrell: Successfully.

Mr. Smith: I do not call it success when children have to be carted from one end of the country to the other to find intensive care beds.

Mr. Hugh Bayley (York): I remind the House that Dr. Mark Darowski was the doctor who admitted Nicholas Geldard to Leeds general infirmary and who had the unpleasant task of telling the child's parents that he had died on his way over the Pennines through a snowstorm. A year ago Dr. Darowski wrote to me drawing my attention to the fact that the regional health authority, just before it was abolished, recommended that the Northern and Yorkshire region needed seven additional paediatric intensive care beds to meet patient demand. Since then, just one has been provided. Surely the Secretary of State must explain how the promise that he gave the House in the spring of last year is to be kept.

Mr. Smith: I have the Secretary of State's words of 6 March 1996 in front of me. He said:

"There is no doubt about the need now to deliver a proper level of paediatric intensive bed space. It will be done".--[Official Report, 6 March 1996; Vol. 273, c. 360.]

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Certainly, the Secretary of State organised a report which was published and put in the Library of the House a couple of months after his statement. About 20 more beds were provided around the country--

Mr. Dorrell: Thirty, actually.

Mr. Smith: The latest Library figure was 20. In any event, it is welcome news that more beds have been provided, but it is clear from what happened this winter that we still do not have a proper service. It would behove the Government rather more, instead of trying to bluster their way out of the problem, to admit that the service is not yet adequate and tell us how they intend to make it so.

One of the problems is that the Government do not know what is happening in relation to many aspects of health care. It is interesting that they can now give us precise figures for paediatric intensive care beds. When my hon. Friend the Member for Dulwich asked, in a parliamentary question on 12 December last year, how many paediatric intensive care beds there were in this country, the Secretary of State replied that the information was not held centrally. He can tell us how many extra beds the Government have created since his statement of 6 March last year, so perhaps he can now say that the information is held centrally. It is important that it should be held centrally for the proper planning of serious emergency services. I shall return to that point in a moment because it is not the only area in which the Government do not know what is happening.

It may be because the Government do not know what is happening within the health service that they blithely claim that everything is going wonderfully well. I was struck at Prime Minister's Question Time when, in response to an Opposition question about the Government's handling of the national health service, the Prime Minister's final remark was that this was a success story. How can it be a success story when patients have to wait on hospital trolleys or ambulance trolleys, operations are cancelled, beds are closed, accident and emergency services are in crisis and children are being sent halfway across the country for paediatric intensive care? I do not call that a success story.

The Secretary of State told the "Today" programme this morning that the NHS is improving year by year. I do not call it improvement. In the real world, people who work in the health service are struggling in the face of ferocious odds to preserve a decent service, provision for ordinary people is collapsing, operations are being cancelled in hospital after hospital and in many parts of the country it is now impossible to get elective general surgery before the next financial year.

Mrs. Alice Mahon (Halifax): This morning I contacted hospitals in Leeds to find out why a constituent of mine who has been waiting 14 months for heart bypass surgery had been sent a letter saying that he could not have the surgery in the foreseeable future, but that if he went to Leicester he could have it in two or three months' time. I understand that all Calderdale patients waiting for heart bypass surgery are in exactly the same position. That is the reality of Conservative health care.

Mr. Smith: That is, indeed, the reality of what is now happening. It is even worse because not only are

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distinctions made between people in different areas, depending on their hospital or health authority, but distinctions are also made between availability of and access to treatment, depending on the general practitioner. GP fundholders' patients who happen to come under the aegis of Lincoln county hospital can have their out-patient appointments within the following month, but patients of a non-fundholding GP cannot have an out-patient appointment until the next financial year. Not only are people told that they must wait months for operations or out-patient appointments, but they are treated differently even though they have the same medical condition. The health service was supposed to treat people according to need, not according to where they happen to live or the type of GP that they happen to have.

Mr. Stuart Randall (Kingston upon Hull, West): Is my hon. Friend aware that at Hull royal infirmary the unit which deals with coronary cases is no longer making forward appointments? I am advised that that is because the beds are being used for orthopaedic and medical cases.

Mr. Smith: My hon. Friend gives me information of which I was not aware, but it adds to the overall picture of the condition of the NHS.

Perhaps the Secretary of State does not realise what is going on, as he has had other things on his mind. One day during the Christmas and new year recess, he popped up on our television screens as the Conservative spokesman on the family. A couple of days later, he popped up on the radio as the Conservative spokesman on the constitution. A few days after that, he decided to give us his considered views on Europe, which do not appear to have done him much good with either wing of his party. While all that frenetic activity was going on, it is small wonder that the NHS was falling to pieces without the Secretary of State noticing.

Mr. Simon Hughes (Southwark and Bermondsey): The hon. Gentleman knows that I share his view that much in the health service is not going right. It is difficult to take an objective view of the aspects that have or have not improved; many aspects have improved. Does he object to the idea that I proposed to him--that we should try to separate the argument from the facts, and that we take out of the political arena an assessment of what the NHS has by way of beds and hospital capacity and what it needs? We should get independent people to examine that, so that we can argue on the basis of objective, agreed facts, and not on the basis of the hon. Gentleman's political views, mine or those of the Secretary of State.

Mr. Smith: I hesitate to point out to the hon. Gentleman that the last time that a supposedly objective examination was conducted, it was carried out by a character called Professor Tomlinson in relation to London's hospital provision. I am not sure that a repetition of that exercise would be helpful. However, I sympathise with the hon. Gentleman's suggestion. A proper assessment of provision across the country, conducted as far outside the political football arena as possible, would be a sensible approach. I am not sure that I would go along with him in saying that everything

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should freeze while that was under way, but I welcome his approach and look forward to further discussions with him.

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