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Mr. John Heppell (Nottingham, East): Can the Secretary of State tell me what a GP-type doctor is? Is it similar to a GP doctor? Perhaps he can explain.
Mr. Dorrell: A GP-type doctor is a doctor who has qualifications similar to those of a GP. I should have thought that was a fairly straightforward definition.
Once again, the hon. Member for Islington, South and Finsbury resorted to his familiar technique to avoid addressing the issues that confront the future of the hospital service. When will we hear from Labour Front Benchers any recognition of the achievements of the hospital service over the past quarter of a century? When will we hear any constructive ideas from Labour Front Benchers for the development of the hospital service under an alternative Government, if we were ever misguided enough to elect one?
Let me set out the achievements of the hospital service in recent years. The treatment of emergencies is up by 20 per cent. over the past four years, and the hon. Member for Islington, South and Finsbury might have done well
to refer to that. He might also have recognised that the trend for increasing the provision of emergency services in our hospitals--a trend that has delivered a 20 per cent. growth rate over four years--continues into the current year with a growth rate of a further 4 per cent. in the first half of this year.
It is true that the hospital service is a system under stress. The hon. Gentleman repeatedly says that I seek to suggest that the health service has no problems. Of course I never suggest that. The winter pressures that the NHS emergency services face each and every year place stress on the health service, and this year is no exception. This year, as every other year, as emergency service pressures reach their peak, some non-urgent operations were delayed in order to treat the most urgent cases first in our hospitals. Does the hon. Gentleman disagree with that principle? If he does, let him come to the Dispatch Box and say so.
Mr. James Couchman (Gillingham):
Is it not also the case that a number of trusts undertook the bulk of their non-elective surgery in the summer and autumn months last year to prepare for the winter emergencies? Inevitably, therefore, waiting lists will now rise from a low point last summer.
Mr. Dorrell:
My hon. Friend is right to say that every well-run hospital seeks to get ahead of its work load in the summer months to make room for the emergency surge that comes every winter. It is also true to say that hospitals have been planning for and expecting the surge in emergency demand that comes in the winter months. That is why, the last time we had a health debate--not five weeks ago--I referred to the fact that we had been opening extra short-term beds during the winter to accommodate the extra demands on the health service at that time of year.
As I said five weeks ago, to accommodate the short-term peaks in emergency demand that come every year at that time of year, Dartford opened an extra 33 beds; Ashford, an extra 40 beds; St. Helier, an extra 35 beds; Poole, an extra 18 beds; Derriford, an extra 11 beds; Plymouth, an extra 35 beds; Rotherham, an extra 33 beds; Doncaster, an extra 38 beds; Mansfield, an extra 28 beds; Burton, an extra 16 beds; and the North West region as a whole opened an extra 200 beds.
The overwhelming picture of the NHS this winter has been, first, of professional staff--we did not hear much from the hon. Member for Islington, South and Finsbury recognising the contribution and commitment of professional staff in the NHS--delivering high-quality care under pressure in the hospital service. We have also seen the results of the much-maligned NHS management system preparing for winter pressures to ensure that those demands are met. It suits the hon. Gentleman never to acknowledge that this year we have seen the results of the Government's political commitment to ensure that the resources and support are there to back the delivery of needs-led health care throughout the NHS.
Mrs. Jane Kennedy (Liverpool, Broadgreen):
The Secretary of State is right to applaud the efforts of the professional, medical, nursing and all the other support staff in the health service--not forgetting the managers. However, will he deal with the question of the waiting list figures that were published last week? His claims about
Mr. Dorrell:
The North West region has made it clear, as, indeed, has the hospital, that the published figures are intended to be a full and complete statement of the number of people on the waiting list for out-patient, in-patient and day-case care. The figures were collected as a straightforward public service by people who have no political commitment to the Government, by people working as public servants. Those are the people whom the hon. Members for Islington, South and Finsbury and for Liverpool, Broad Green (Mrs. Kennedy) are attacking--public servants working within the national health service, setting out information about the people who are waiting for non-urgent care in the national health service.
Mr. Dorrell:
I give way to the hon. Gentleman. The hon. Member for Islington, South and Finsbury seemed to be so terrified of the Liberal Democrat spokesman that he refused to give way to him, but I am more than happy to do so.
Mr. Hughes:
If the Secretary of State sets store by the statistics as accurate, will he confirm that they show three things? First, for the first time since they were produced in this form nearly 10 years ago, more than 1 million people are now on the waiting list; secondly, the same statistics, produced by a method which he attests is accurate, show that in the North West region, which includes the Wirral, more than 4,000 people--the highest number ever--are on the waiting list; and, thirdly, in my district, south London, which is part of South Thames region, 10,000 extra people went on to the waiting list between the last quarter and December last year. It is a record nationally. If those figures are correct, what will the Secretary of State do to bring them down, not in the future but in the next quarter, so that people waiting today have some prospect of being treated--even within the patients charter limits?
Mr. Dorrell:
I shall deal with waiting lists now. The hon. Gentleman is right to say that the total number of people on the waiting list, in the figures published last week, is higher than it has been. What is also true is that the number of patients treated in the health service is higher than it has ever been. What matters to a patient on the waiting list is not how many other people are on the waiting list but the time he or she will have to spend on the waiting list.
The key point of which the hon. Gentleman and the House should take account is that the average time spent on a waiting list has fallen from nine months five years ago to an average of four months now. The position on waiting lists and waiting times is that the performance of the health service has improved. We have dramatically reduced the number of long waits, about which I shall talk later, and more than halved the average time that a patient spends on the waiting list.
Let us now talk about the non-emergency service, the elective work load of the hospital service. The emergency services that I have been talking of thus far account for less than half the total load on the hospital service in terms of finished consultant episodes. The other half is the elective work load, which has increased by 30 per cent. over the past four years. In that period, the emergency service work load has increased by 20 per cent.
The hon. Member for Islington, South and Finsbury spoke at length about waiting lists. He appears to believe that a simple repetition of the statistics and the fact that waiting list totals are rising are substitutes for thought about what to do about them. In fact, every time he opens his mouth about waiting lists, he reveals how little he understands the real issues that confront hospital managers.
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