House of Commons Hansard Debates for 21 Jan 1997 (pt 28)

Sir Raymond Whitney: The hon. Lady has just said, "It was not like that before". She is right, because during the time of the Labour Government, 7 million people were treated each year. Now we treat 10 million patients a year. There are 55,000 more nurses and 20,000 more doctors than when Labour was in government, and they are all paid more. There are no NHS strikes to prevent people getting into hospital. The hon. Lady is right; it was not like that before.

Ms Jowell: That intervention shows precisely the problem with Conservative Members. They paint a picture of the national health service that is unrecognisable to those who work in hospitals and to patients throughout the country who are waiting for treatment. As usual, Ministers have failed to notice, even less to accept,

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the recent advice to London hospitals by inner-London chief executives whose study of the balance between planned and emergency admissions led them to recommend a bed occupancy rate of 85 per cent. instead of the 98 per cent. or more than 100 per cent. at which most hospitals are now required to operate under the strictures of competition.

As today's King's Fund report makes clear, psychiatric hospitals are barely coping because in some cases bed occupancies are running at 125 per cent. It is called hot bedding. In paediatric intensive care, 70 per cent. bed occupancy is recommended to guarantee consistent levels of care. Apparently, there is a difference between the inevitable and the entirely predictable. Ministers believe in the inevitability of patients on trolleys, cancelled operations and the consequent despair, but apparently none of it is predictable.

My hon. Friend the Member for Morley and Leeds, South (Mr. Gunnell) spoke about the growth of the NHS as a safety net service. There is an intolerable and rising level of violence in accident and emergency units. For staff seeking to offer treatment, it is appalling and unforgivable that people in need of emergency treatment should attack those who are there to help them. However, that is what happens when the accident and emergency department becomes the safety net and the court of last resort.

There is an alternative to the crisis. Even at this late stage in their life, let the Government admit that the internal market, or what Dr. Sandy Macara of the British Medical Association prefers to call the infernal market, has failed. Let them free hospitals to co-operate in delivering a public service rather than forcing them to compete as private businesses. That would create flexibility and allow hospitals to match beds and treatment to need. That is especially important at this time for the elderly who make up the majority of those who are queuing for beds.

We shall shortly publish proposals for a recovery service that will bridge the gap between hospital and home for elderly people. I have no hope that the Government will accept our proposals, but I urge them to study them carefully during their leisure days. They will have plenty of them in opposition. We must stop the haemorrhaging of staff, particularly nurses, from the national health service.

The Secretary of State said on the radio this morning that the national health service can never be perfect. Perhaps that is the standard that Conservative Members are prepared to settle for. The achievements are great, but they are great despite the Government rather than because of them.

For the sake of staff and patients, we have attempted in this debate to puncture the Government's complacency and provide a glimpse of the difficult reality being faced by our hospitals throughout the country, but we have no hope that the Government will listen, and act on what they have heard. Rebuilding the national health service will come with a Labour Government after the next election.

9.40 pm

The Minister for Health (Mr. Gerald Malone): General elections are won on substance and there has been no substance from the Labour party on what will be one of the key battlegrounds of the general election whenever

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it comes. Early in her speech, the hon. Member for Dulwich (Ms Jowell) mentioned co-operation, not competition. That is the only policy that the Labour party has to offer for health. It is a cliche, a mere slogan, which is as meaningless as the social contract of the 1970s. Anybody involved in the health service will understand that that is so.

Many hon. Members have participated in the debate and I should like to deal with the detailed points they raised. The hon. Member for Birmingham, Northfield (Mr. Burden) was concerned about the Longbridge primary care centre in his constituency. Approval for funding of £2.5 million for that centre has now been forthcoming and we are awaiting planning permission, which is being sought. I hope that there will be rapid progress.

Mr. Burden rose--

Mr. Malone: If the hon. Gentleman does not mind, I will not give way, because I want to respond to all the points raised rather than enter into a debate on each of them.

My hon. Friend the Member for Broxbourne (Mrs. Roe) spoke wisely and with care about the real world of the health service as she has experienced it in her constituency. Not for her the single unsubstantiated allegation: she had gone to considerable effort to find out what was going on in the hospitals in her constituency this winter of difficult pressure.

What my hon. Friend told the House was probably typical of what is happening in many hospitals. She said that there was an excellent spirit among the staff and that many of them returned to work during periods of leave when other staff were ill. She talked about positive management of the problems in hospitals, with team work helping to solve the problems that many of them face when there is increased pressure, which we concede has occurred during this winter.

The hon. Member for Southwark and Bermondsey (Mr. Hughes) introduced what I thought was an interesting approach, and the House may agree. He wanted to take politics out of the NHS. Whenever we hear that from a Liberal Democrat spokesman, we look to our constituencies to see whether the party is taking politics out of the NHS there. I thoroughly agree that the NHS should not be the political football that the Labour party tries to make it, but admonitions from the hon. Gentleman suggesting that we need a system of independent statistics, to be set up in a way that he did not entirely explain, are bizarre.

My hon. Friends will be aware of the tactics of Liberal Democrats in their constituencies when it comes to presenting statistics. We have nearly all been subject to spoof surveys issued by the Liberal Democrats' campaigning department, announcing what the results of the survey should be before it has been carried out. At least I accept that the hon. Member for Dulwich probably made some telephone calls before she reached her conclusions. The party of the hon. Member for Southwark and Bermondsey does not even bother to do that.

I can also tell the hon. Gentleman that, if we are to hear any lessons about playing fair with the health service, perhaps he or those responsible for his party's operations will stop parliamentary candidates across the country

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setting up false stories so that they can simply knock them down. I had an example of that in my constituency this week. The prospective Liberal parliamentary candidate set up a story about a closure, which was a complete myth and was not even being suggested. He then said that he would be the saviour to step in and solve the problem. It was all bogus. We need no lessons from the hon. Member for Southwark and Bermondsey about independent statistics of that kind.

My hon. Friend the Member for Wycombe (Sir R. Whitney) was right to remind us of the history of the national health service and how far its roots go back beyond 1947-48. In an excellent speech, he made it perfectly clear that, as a Government, we had custody over these matters before the inception of the NHS, which has developed in our hands for far longer than it has been in the hands of the Labour party.

The hon. Member for Morley and Leeds, South (Mr. Gunnell) seemed to support the spending plans of the British Medical Association. I hope that he has got that message through to his Front-Bench team. Many Opposition Members were keen to support every suggestion that extra spending should take place in the NHS--that was a common theme of the debate. I suggest that all those Opposition Members look to their Front-Bench spokesmen to find out whether the commitments that they expect to be honoured if Labour were ever elected would be honoured. On the basis of the stated policy of the Labour Front-Bench team, that would not happen.

The hon. Member for Morley and Leeds, South also referred to private finance initiative schemes. I can confirm that 32 schemes have been completed, at a value of £78.6 million. In spite of what the hon. Member for City of Durham (Mr. Steinberg) may have asked for in the Library, if the Library does not have the information, I will undertake to put it there.

I hope that Opposition Members understand that the shilly-shallying of Opposition Front Benchers about their proposals for the PFI damages the prospects of building hospitals and facilities in each and every one of their constituencies.

My hon. Friend the Member for Birmingham, Edgbaston (Dame J. Knight) said something important about the changed structure of the NHS, which the Opposition are criticising. She said that our reforms have given us some facts about costs, so we have been able to save money. Labour has consistently voted against that. My hon. Friend is right to remind us of that fact; when the Labour party says, "Co-operation, not competition," and says that it believes in the purchaser-provider split, but not in the internal market, it is saying that it wants to avoid all the difficult decisions that have to be taken in health care if one is going to drive better-quality health care out of the system for every pound of the taxpayer's money. The two go hand in hand. Ask anyone in the national health service if that can be done entirely comfortably and one will be told that Labour's policies are an Alice-in-Wonderland world.