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Health Deprivation
2. Mr. Llew Smith: To ask the Secretary of State for Health if he will make a statement on the degree of health deprivation in the United Kingdom. [405]
The Minister of State, Department of Health (Ms Tessa Jowell): Social class inequalities in enjoyment of good health exist from cradle to grave and are compounded by inequalities relating to ethnic background, gender and region. A child born to parents in social class V can expect to live seven years less, on average, than a child born to parents in social class I.
The Government are not prepared to tolerate that degree of inequality, which is why, as promised in our manifesto, we have put improving the nation's health at the heart of our agenda in government.
Mr. Smith: Would my hon. Friend care to comment on recent Government statistics showing that, in my constituency, we have some of the lowest income levels in the United Kingdom and some of the worst health problems--41 per cent. of families having a member who is long-term sick or disabled? What is the Government's strategy and policy to respond positively to that problem of health deprivation in communities such as Blaenau Gwent?
Ms Jowell: I thank my hon. Friend for his question. We aim to tackle poverty and inequality through our commitment to helping people move from welfare to work, to ending poverty pay by introducing a national minimum wage, and to improving housing conditions by the phased release of local authority capital receipts. Improving the health of our nation and tackling the legacy of inequality are not just matters for the Department of Health but a job to be confronted across government--and it will be.
Mrs. Marion Roe: As a former Chairman of the Health Committee, I should like to congratulate the Minister and her team on their appointments and to wish them well.
Has the Minister yet had time to study the Department of Health's statistics on the quality of health outcomes in the United Kingdom, such as the dramatic fall in perinatal mortality? Is it not true that, after 18 years of Conservative government, Britain is a much healthier country than it was in 1979?
Ms Jowell:
All the figures tell a story of endemic inequality. Babies in poorer families are more likely to die in the first month of life than babies from better-off families. That is why our policy for attacking inequality and its root causes involves a strategy for improving the nation's health to be pursued across all aspects of government.
3. Dr. Tony Wright:
To ask the Secretary of State for Health if he will make a statement on the financial position of Mid-Staffordshire General Hospitals NHS trust. [406]
The Minister of State, Department of Health (Mr. Alan Milburn):
Latest reports from the trust indicate that it met all its financial duties in 1996-97. The initial plans for 1997-98 show a small deficit; however, the trust is confident that it will regain financial balance in the medium term.
Dr. Wright:
I am grateful for that answer, and I congratulate my hon. Friend on his appointment. Will he take a particular interest in the affairs of the Mid-Staffordshire General Hospitals NHS trust? In the past few weeks, the chief executive has resigned and the contract for operating theatres at Cannock Chase hospital--largely paid for by the League of Friends--has collapsed. Furthermore, there has been an attempt to deal
Mr. Milburn:
I can assure my hon. Friend that I will be keeping a close eye on the performance of the trust. I understand that the matter of the operating theatre is now in the hands of the trust's solicitors, but that the trust has re-tendered the contract and is fully committed to building the operating theatre.
I think that my hon. Friend will shortly see that our priorities are markedly different from those of the former Government, not least because we want NHS resources to go to front-line patient services.
4. Mr. Cox:
To ask the Secretary of State for Health what plans he has to visit St. George's hospital, Tooting to discuss future funding; and if he will make a statement. [407]
Mr. Dobson:
My ministerial colleagues and I will be visiting a large number of hospitals over the coming months. This may well include St. George's. We want to learn at first hand how all the hospitals have been badly affected by the policies of the previous Government, and to make sure that their experience informs the changes that we intend to make.
Mr. Cox:
I congratulate my right hon. Friend and his team on their appointments, and I note his reply to my question. When he comes to St. George's, he will learn a great deal. Some of our wards are closed, and earlier this month more than 30 members of staff were made redundant because there is no money to pay them or to keep the wards open. That is what my right hon. Friend inherits in one of London's major hospitals.
I am sure that the general public realise that we intend to rebuild the health service. Now we must show the loyal people who have worked in it through difficult years that we in turn are wholly committed to them--the members of staff at the hospital will welcome that.
Mr. Dobson:
I agree entirely with my hon. Friend. In the brief period that I have been Secretary of State I have found much enthusiasm among the hard-working people in the health service, who have kept it going during the past 18 years, for the election of the Labour Government and a willingness to recognise that the problems are so enormous that they cannot be put right overnight. The inheritance that my hon. Friend has described at St. George's applies to virtually every hospital and every health authority.
5. Mr. Ian Bruce:
To ask the Secretary of State for Health what estimate he has made of the number of administrative and management staff who will need to be made redundant in Dorset health authority to reduce management costs to the Government target level. [408]
Mr. Milburn:
We are in the process of developing our strategy to maximise the proportion of NHS resources devoted to patient care.
Mr. Bruce:
I congratulate the hon. Gentleman on his thoughtful answer, but will he address the question that I
Mr. Milburn:
If I were the hon. Gentleman, I would exercise a bit of caution about lecturing Labour Members on bureaucracy, because his party left the NHS with 20,000 more managers and 50,000 fewer nurses. Our priority is to ensure that NHS staff are in the business of treating patients, not chasing contracts. That is our priority and it is the public's priority.
Mr. Barry Jones:
Does my hon. Friend intend to increase the number of nurses in hospital wards?
Madam Speaker:
Order. The hon. Gentleman knows better. The substantive question deals with Dorset health authority.
6. Mr. Colvin:
To ask the Secretary of State for Health what percentage of general practitioners are now fundholders. [409]
Mr. Dobson:
As of 1 April 1997, 56 per cent. of general practitioners were members of fundholding schemes.
Mr. Colvin:
I congratulate the Secretary of State on his appointment. His answer shows that more than half of all NHS patients are treated by GPs who are fundholders. If, for ideological reasons, the Government intend to scrap those arrangements, which enable doctors to back their professional judgment with hard cash, which I am sure the late Nye Bevan would have approved of, what alternative arrangement does the Secretary of State intend to propose?
Mr. Dobson:
What I can say is that we have taken immediate action to start to reduce the unfairness and bureaucracy of the existing two-tier system. We are determined that non-fundholding practices, and patients from them, should no longer be at a disadvantage. Looking further ahead, I am inviting the representative bodies and others in the NHS to join us in developing and testing alternative primary care-led models of commissioning, based on the principles of fairness and meeting local needs. To create breathing space for that process of genuine exploration and debate, I can announce today that I propose to defer all further entries to the eighth wave of GP fundholding.
Mr. Sheerman:
May I congratulate my right hon. Friend and his new team on their appointment, and congratulate him also on what he has just said? My constituents are more worried about the quality of GP care than whether they are a fundholder. As a matter of priority, will my right hon. Friend do something about single-person practitioners, who are so often linked to inefficiency and bad service to constituents?
Mr. Dobson:
There is a general feeling that single-handed practitioners are not the best arrangement
Mr. Dorrell:
I join those who have offered the right hon. Gentleman their good wishes in his new responsibilities. In answer to an earlier question, he said that the new Government do not intend to launch into a major further reorganisation of the health service. Will he apply that principle to GP fundholding? Can he confirm that the majority of Britain's GPs, who have chosen fundholding, have chosen it because they think that that is the best way of delivering NHS care to their patients? Can he give the House and Britain's GPs the assurance that if those GPs continue to believe that that is the best way of delivering NHS care to their patients, he will leave that option open to them, or is it his policy to compel those GPs to surrender fundholding against their will, despite the fact that in their view their fundholding status is the best means of delivering NHS care to their patients?
Mr. Dobson:
We are determined to ensure that all patients are treated on the basis of their clinical need, not the status of their general practitioner. That is not the case at present, and we are discussing with the medical profession and the other professions a commissioning approach in which all GPs and other health professionals in each locality can commission a service. The former Secretary of State for Health should get himself up to date. My hon. Friend the Minister of State, the Member for Darlington (Mr. Milburn), like me, has met a number of doctors over the past few days. Today he met representatives of the National Association of Fund Holding Practices and of the general medical services committee of the British Medical Association. They seem to be satisfied with what we are proposing.
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