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5.52 pm

Rev. Ian Paisley (North Antrim): I wish to offer my condolences and those of my colleagues to the Under-Secretary of State for Northern Ireland, the hon. Member for North-East Cambridgeshire (Mr. Moss), who is responsible for health in Northern Ireland. At talks yesterday at which all parties were represented, there was a public and unanimous expression of sympathy for him. I trust that the Ministers here today will convey that to him as soon as they can.

I must pay a brief tribute to the Under-Secretary. The Minister for Health said that some people were on another planet. I assure him that North Antrim is not on another planet; indeed, it is not far from Scotland--just 20 miles across the water.

When I entered the House in 1970, there were eight hospitals with acute units in my area. Today there are no such acute hospitals within the bounds of my constituency. Ballycastle, Ballymena and Ballymoney are three local government areas which make up my constituency. Ballycastle hospital is closed, Ballymoney hospital is being closed, and Ballymena hospital, which was to be the main hospital, is also closing.

As Ballymena is the geographical centre of the locality, we were promised that it would be the site for a new acute hospital. That was put on the long finger, and then rejected. A new hospital--or a third of a new hospital--has been erected in Antrim. No one knows when the rest of it will be completed, but I am sure that it will not be in the lifetime of anyone here.

The northern part of the district lost out, and we were then promised a new hospital outside the area, nearer to Coleraine. That was put on the long finger for 30 years. The recent cuts in the finance to Northern Ireland meant that there was a question mark over that, too. In fact, building was stopped, and it was decided not to proceed. It was thanks to the Under-Secretary that the project was retained.

The Secretary of State for Northern Ireland told me himself that the Under-Secretary was lacerated for the bold stand he took to ensure that the promise of 30 years ago was implemented. I pay tribute to the Under-Secretary--but for him, we would not be getting that hospital, although it is outside the bounds of my constituency. I am glad to have put that fact on record.

There is no increase in NHS expenditure in Northern Ireland. As the hon. Member for Belfast, South (Rev. Martin Smyth) said, there has been a year-by-year 3 per cent. cut. We are told that the reductions can be made in so-called efficiency savings, but that is impossible, and the health service is being decimated. The flesh is disappearing, and the bones are beginning to show--anyone can see that by going to the Province. The facts cannot be covered up or argued away. All sections of the community agree on that.

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I pay a warm and whole-hearted tribute to all who work in the health service. This is a difficult time not only for the health service but for our Province. The people who work in the service have even more pressure on them; they need even greater patience, and have to make sacrifices. They are providing care and making sacrifices, but if they do not have the finances to do the job, services are seriously curtailed.

Wards have been closed, waiting lists for elective surgery are increasing, and people waiting for major operations are being telephoned on the very day they are due to enter hospital and told that, because of a lack of funds, the operations are cancelled. Indeed, even patients prepared and ready for theatre are being sent back to the ward and then home. That has happened time and again. Of course, the Minister receives representations from all Members of Parliament about such incidents.

Assessments are taking ever longer to complete. There are numerous examples of bed blocking because the community trusts have no money to put care packages in place or provide residential or nursing home care finance. Surely it must be more cost-effective to keep a person in their own home or in residential or nursing care than in a hospital. That has to be faced up to. If we do so, money could be made available. We need to take a decision on that.

The Government's decision not to proceed with adjustment capitation funding will have devastating consequences on the Eastern health and social services board, which covers Belfast, where the major regional hospitals are. A report was submitted last year, but so far the Government have put it on the long finger.

The main hospital in Belfast is the Royal Victoria hospital, but the House must recognise that it is in the heart of IRA Provoland. People do not want to go there, and more and more are objecting. Mr. Nigel Dodds, who is my assistant in the European Parliament and was the youngest Lord Mayor of Belfast, had his young child in the sick children's hospital in the Royal complex. Before Christmas, the IRA attempted to kill him and his wife on the ward when they were going to visit their boy. A bullet from an IRA gun went through an incubator. We cannot ask parents to go to a hospital under those circumstances. It is a very serious situation.

I do not visit the Royal Victoria hospital any more, even though I have pastoral duties that I should attend to, because a massive security operation is needed to get me in and out. I cannot put 40 members of the security forces at risk just because I want to visit one patient. I once went to see one of my church officers, who was seriously ill. When I left the ward, two IRA men came in and demanded to know "the bed that Paisley visited". That is what is happening in the Royal Victoria hospital. We must decide whether to continue pouring money into that complex, where people are afraid to go and where life is being jeopardised. The Government must consider that.

The current review considering the possibility of introducing charging into health provision in the community is rightly causing alarm in my area, where we have the most vulnerable and needy sections of all communities. It would be scandalous for the Government to introduce charges for services such as home help, occupational therapy and a range of other vital work. The people in my area need those services on a no-charge basis. They cannot meet the commitment otherwise.

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It is also reprehensible that trusts should be proposing to introduce charges for nurses and other hospital staff to park their cars in the hospital grounds. Just think about that. That is what is happening at the Royal Victoria hospital. Surely there is no better place for them to park their cars than an area where the police have to keep them under surveillance. They have to pay for parking. Even though they have already paid up, nurses from the Royal group of hospitals are not even guaranteed parking space if people get there before them. How can we expect the best from our nurses and doctors if we do not look after them? They need to be looked after. The hospital trusts in my country must think again.

The Government introduced the patients charter, which was widely welcomed by my party, but we warned at the time that a charter is meaningless if the funding and resources are not in place to allow its targets to be met. How can targets be met without the financial wherewithal? That is particularly true on the reduction of waiting lists, which, as I have already said, are on the increase. Many hospitals in my country have made it clear that there will be no more surgery for non-emergency patients until the new financial year in April. They are all stopped.

There is also great concern--mentioned by the hon. Member for Dulwich (Ms Jowell)--about the two-tier health service, which we now have, in effect, in Northern Ireland. GP fundholders have no difficulty getting treatment for their patients, while the patients of non-fundholders have to take their place in the queue. They pay the same taxes and rates as anyone else. Why should they be discriminated against? When everyone has to pay the same taxes to provide health care, can the Government allow discrimination in patient care because of a patient's choice to stay with a non-fundholding doctor?

The hon. Member for Belfast, South mentioned nurses' pay. A serious situation has arisen on that, and I shall not go over the points he made. I remind the House that 80 per cent. of the female work force in Northern Ireland are employed by the NHS. Pay and conditions for those female workers are being driven down, destroying quality standards and equality. I have raised in the House before the on-going dispute between workers, the NHS trusts and Compass. We are in great difficulty. We have had strikes, and there is a lot of opposition.

The Government and the trusts have not lived up to their responsibilities. The Government cannot wash their hands of the issue and claim that it is a matter for the trusts, which has nothing to do with them. The Government have tried to shunt the matter off, saying that it pertains to the private sector. Remember that 80 per cent. of our female work force are employed in the NHS. The pay they are offered is atrocious--it is an insult to them. The Government must take that into account. They cannot wash their hands of it.

Those are some of the serious difficulties that the health service in Northern Ireland is up against. We have rightly emphasised those issues today. We are not trying to do down the health service. The Government have taken credit for building the health service. I ask them not to destroy what they have built. Being a preacher, I am reminded of the apostle Paul's words that, if I pull down that which I once built, I am a transgressor. My final homily to the Government is, "Please do not be a transgressor."

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6.7 pm

Mr. Robert Maclennan (Caithness and Sutherland): I am glad to follow the hon. Member for North Antrim (Rev. Ian Paisley). In particular, I share the concerns he expressed about nurses, who are waiting with great interest and hope for the announcement from the pay review body and the Government's reaction to it.

My party's view is that the presumption should be that the Government accept the findings of an independent pay review body that they established. That must be the starting point. If we are to believe what prior indications and leaks suggest, the proposals are likely to be modest. It certainly ought to be within the Government's capability to meet in full the award, which should have been taken into account in the Chancellor's forward budgetary predictions.

I emphasise the importance of nurses and those who deliver the health service, because they frequently work under enormous pressure.

We often hear about the predicament of young doctors who spend very long hours in hospitals when they are training and in the early years of their specialisations. I am the son of a gynaecologist and a specialist in public health, and have always been conscious of the long hours that doctors work. However, there is considerable evidence that recently the pressure on people upon whom we rely so heavily has become too acute.

Another sector of health providers to whom I pay tribute is the general practitioners. Although the Secretary of State for Health has not attended the debate, the presence of the Minister of State, Scottish Office is most welcome. I believe that, when the House is debating a central issue of policy such as the health service, there is no more important ministerial duty than to be present and hear hon. Members, representing all parts of the United Kingdom, relating widely differing experiences.

Rural doctors can also be under great pressure, not from hour upon hour of accident and emergency treatment, although that may form part of their care and concern, but because they are on constant duty without necessarily having any back up. The case of the inducement practitioners in the highlands of Scotland has to be kept under constant scrutiny and regard lest the pressure upon them becomes insupportable.

I find it unsatisfactory that, in my constituency, there should be arguments about whether 0.5 per cent. of a doctor should be included in the medical resources available to a practitioner whose practice may cover hundreds of square miles, where he is the only person providing medical cover.


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