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Clinical Services
5. Ms Eagle: To ask the Secretary of State for Health what plans he has for use of the private sector in clinical services in the NHS. [19165]
12. Mr. Cunliffe: To ask the Secretary of State for Health if he will make a statement on the use of the private finance initiative in respect of clinical services in the NHS. [19173]
Mr. Dorrell: The private finance initiative in the national health service is concerned with the provision of modern and efficient facilities for the delivery of NHS health care. It is not concerned with the transfer of NHS clinical services to the private sector.
Ms Eagle: How can the people of Britain believe the Secretary of State when they look at the PFI contract for the Royal Hallamshire extension in Sheffield, which includes the privatisation of radiology and pathology services? Do not they, like Opposition Members, know that the Tories cannot be trusted on the NHS? All Tories want is to get as much of it into the private sector as possible.
Mr. Dorrell: The hon. Lady will no doubt keep repeating the mantra, but she will cut no ice. People know that, over the past 18 years, we have delivered a broader range of high-quality care to all patients who need it. That is the commitment that the Conservative party has delivered, about which the Labour party is content only to talk.
Mr. Cunliffe: Does not the Minister understand that, despite the secrecy about clinical services, the creeping privatisation is well known to people in the country? Once again, no reassurance has been given today that a future Conservative Government--heaven forbid--would not take the opportunity to privatise. Does he not understand that people know that, over the past 18 years, the Government have looted the wealth of those who created it and intend, through the internal market, to loot the health of public services by introducing private services? Will he try at least to give a positive answer instead of the same old corny comments on clinical services that he has given up to now?
Mr. Dorrell: The hon. Gentleman's slightly convoluted question might be clearer if he sought to explain the Labour party's policy on the hospital building programme to his constituents and people throughout the country. What the Government have set out is crystal clear. We have launched the PFI, which holds the prospect of long-needed hospital building programmes in Norwich, Dartford, Bishop Auckland, north Durham, Worcester, Calderdale, Bromley, Hereford and Carlisle. Labour's Front Benchers must explain to the people why they would put all those projects on hold.
Sir Geoffrey Johnson Smith: Is my right hon. Friend aware that even the more socialist countries in the
European Union allow and encourage independent health care organisations to supplement the statutory authorities' expenditure on health? Statistics on the proportion of gross domestic product spent on health show that we spend the same as other countries in the public sector; the extra that enables them to boast that they spend more than us is made up by independent care organisations, which are rejected by the Opposition.
Mr. Dorrell: My hon. Friend is right about the arithmetic. It is also worth reflecting on the point that British citizens have exactly the same opportunity to obtain private health care insurance as citizens of other countries, but a smaller proportion of the British find it necessary to do so because the national health service commands a confidence that comparable organisations elsewhere do not. The reality is that the British national health service is the world's most efficient health care system. An endorsement of that principle from the Opposition occasionally would make a welcome change.
Mrs. Roe: Is my right hon. Friend aware that the trade union Unison is wholly opposed to the private finance initiative in the NHS? Given the pecuniary relationship between that union and the offices of Labour Front Benchers, what credence does he give to the claim by the hon. Member for Islington, South and Finsbury (Mr. Smith) that he wants to speed up the PFI in health care?
Mr. Dorrell: The Opposition cannot work out their attitude to the PFI in health care. They say they want to speed it up; they also describe it as the privatisation initiative. We have heard this afternoon the Opposition's visceral suspicion of any suggestion that private capital and management can reinforce the delivery of NHS objectives. They oppose it before they hear the arguments. That is why the Government and the Conservative party, re-elected in the next Parliament, will deliver improvements in the national health service that the Labour party could never dream of.
Mr. Chris Smith: Why does the Secretary of State not have the honesty to admit that the Tory agenda is a piece-by-piece privatisation of the national health service? Will he now confirm what he failed to say a few minutes ago--that, at the Royal Hallamshire hospital in Sheffield, radiology and pathology will be put out to the private sector? He and his colleagues have consistently refused to give a guarantee that they will not privatise clinical services. Will he give such a guarantee now? If he will not, and if the Tories are elected again, we will not have a national health service in five years' time.
Mr. Dorrell: That beggars belief. I gave the hon. Gentleman due warning, and he still comes to the Dispatch Box and calls the PFI privatisation. The last time he mentioned the subject, he said that Labour promised to speed up PFI deals. Now he calls it privatisation. The hon. Gentleman must sort out his ideas--and he does not have long in which to do so.
Mr. Booth: Does my right hon. Friend agree that it is staggering that two of the first three questions tabled by Opposition Members relate to complaints about the private sector? Does he agree that that says something
about their priorities? The right priorities for the national health service are patient care, standards, and more money, which we will deliver.
Mr. Dorrell: My hon. Friend is right on every count. We have the commitment to deliver a growing health service, which the Labour party will not match. We have the commitment to deliver a properly managed health service, which the Labour party will not match. We also have the commitment to deliver quality of care to patients, which the Labour party regards as a boring detail.
Mental Health Patients
6. Rev. Martin Smyth: To ask the Secretary of State for Health if he will make a statement on provision for mental health patients. [19166]
Mr. Burns: A range of policy initiatives have been taken that should enable health authorities, in conjunction with other agencies, to provide a comprehensive service for patients with mental health problems.
Rev. Martin Smyth: I thank the Minister for that response, but does he not accept that there is still work to be done centrally, to gain a better understanding of the needs of the nation and to plan strategy accordingly, and that part of that strategy must include a recognition of the need for more improvement in mental health care for children and adolescents?
Mr. Burns: I am grateful to the hon. Gentleman for that question. Yes, of course the Government and all in the national health service are determined to enhance and further to improve mental health provision for adults and children. As he will be aware, several initiatives designed further to enhance that care have been taken over the past few years. We are not complacent; we shall continue with that work. As for the treatment of adults with severe mental health problems, last month my right hon. Friend the Secretary of State published a Green Paper, to explore the options for moving forward to further improvement in the service.
Mr. Nigel Evans: About a month ago I went to a mental health seminar in Preston, where I was impressed by an initiative that has been taken up by one of the trusts to the west of my constituency, which I hope will be taken up in my constituency, too--a mental health helpline. As my hon. Friend will know, people who need help with mental health problems often need it at unsocial hours, not just between nine and five. Will he congratulate the people who volunteer to give guidance via the helpline, and encourage other trusts to take up such initiatives?
Mr. Burns: I am grateful to my hon. Friend for drawing to the attention of the House what sounds like an excellent idea--providing support and making available through the helpline counselling, advice and help for those in crisis and their families. I strongly recommend other health authorities and trusts to consider that example, and to see what lessons can be learned so as further to enhance support for the families of those suffering from mental illness.
Hospital Waiting Lists (Manchester)
7. Mr. Eastham: To ask the Secretary of State for Health how many patients in the Manchester area have been waiting longer than 12 months for hospital admission. [19167]
The Parliamentary Under-Secretary of State for Health (Mr. John Horam): Provisional figures show that, on 31 December 1996, 384 people resident in the Manchester health authority area had been waiting more than 12 months for admission to hospital.
Mr. Eastham: I thank the Minister for that reply, but I was asking about current figures rather than those for last December. May I tell him that, for the North Manchester hospital alone, 180 people have been waiting longer than 12 months for admission? Further compounding the problem, the equivalent of almost two wards in that hospital are bed-blocked because social services cannot accommodate the patients outside the hospital. As a result, 913 consultant episodes concerning patients who need attention have not taken place.
Mr. Horam: If the hon. Gentleman is concerned about bed-blocking, he should take his complaint to the Manchester local authority, which is in the firing line when it comes to doing something effective about it. Over the past few months, my right hon. Friend the Secretary of State has helped with measures specifically designed to reduce bed blocking, so I am surprised that Manchester has not done a better job.
Equally, I am surprised that the hon. Gentleman is not singing the praises of his native Manchester, which has a good record on waiting times. Over the past few years, there have been periods in which, in Manchester as a whole, nobody waited more than 12 months. As the House should be aware, the national picture shows that we have maintained the progress with waiting times, despite the attention now being turned to emergency care and mental illness. The hon. Gentleman really has nothing to complain about.
Mr. Atkins:
Will not waiting lists in Manchester, at hospitals such as the Christie, be considerably helped by the building of the £5.8 million cancer unit at the Royal Preston, which will do a great deal to provide facilities for people in Preston? That will avoid their having to go to the Christie in Manchester, thereby improving the situation of patients both in Manchester and in Preston.
Mr. Horam:
I am delighted that my right hon. Friend made that point. We are hearing a great deal about Lancashire today, and with good reason. Not only is a Calman cancer unit being developed at Preston and Chorley; there are others at Blackburn and Burnley, Blackpool, Lancaster, and Kendal and Barrow. All represent new initiatives and are part of a clear programme to deal with cancer problems. I am delighted that Lancashire is taking the lead.
Mr. Barron:
Will the Minister confirm that the Manchester figures are not unique, and that more than 1 million people are on hospital waiting lists nationally? That figure is increasing and it is the highest we have ever had. The health authority in Manchester has a current
Mr. Horam:
On the contrary, it is an extremely good reason why we should remain in power. Waiting times have improved: the average wait is down from nine months to four months. When Labour was last in power in 1979, one in four people had to wait more than 12 months. That figure is now down to one in 50 people. In 1979, 25 per cent. waited for more than 12 months, whereas, under the Government, the figure is now only 2 per cent.
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