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Treatments
8. Dr. Fox: To ask the Secretary of State for Health what numbers of patients he expects the national health service to treat in each of the next three years. [7949]
The Parliamentary Under-Secretary of State for Health (Mr. Paul Boateng): The range of services provided by the NHS, whether in hospitals, in the community or in GP practices, and the variety of means of
measurement, are such that it has not historically proved possible to arrive at a single figure for the number of patients to be treated.
Dr. Fox: Notwithstanding that somewhat disappointing answer, it is obvious that the number treated will depend on the budgets available to the NHS. In response to the hon. Member for Crewe and Nantwich (Mrs. Dunwoody), the Minister of State indicated that he would like wages in the NHS to rise. If a settlement similar to the £4 minimum wage now given to local authority workers in Scotland is reached in the NHS, what additional costs does the Minister estimate the NHS will have to bear?
Mr. Boateng: The disappointment, such as it is, arises from the appalling legacy left by the Conservative Government's stewardship of the Department of Health over some 18 years. This year's Budget settlement was very good; it will seek real growth of some 2.35 per cent. as opposed to the growth anticipated by the previous Government of some 1.2 per cent. That is progress under Labour, delivered in a way that is about patient care, not about bureaucracy.
Mr. Stevenson: Does my hon. Friend agree that the ability of the NHS to treat and discharge patients depends on multi-agency assessments and the provision of care in the community? In that regard, the additional resources for the NHS are most welcome, but does he share my concern that, if they are not matched by additional resources for social services, we shall be in danger of riding a tandem with the risk of one wheel dropping off?
Mr. Boateng: We need to make sure and we will make sure--my hon. Friend is right to say that we must make sure--that local authorities and the NHS work well together. That means making sure that resources are used as effectively as possible. We have already begun a dialogue with the Local Government Association and the NHS executive to make sure that that happens.
Mr. Jack: The Minister will be aware that, last week, there was an announcement about waiting lists. That will have a crucial effect on the number of patients who can be treated in the NHS. Can the Minister clear up some confusion caused by the announcement in respect of hospital trusts? What will happen in the case of a hospital trust that has negotiated contracts with more than one health authority? In the case of a trust that has a contract with, say, four authorities, three of which have specified a higher level of service than the fourth, can he confirm that the new arrangements will require--without the Secretary of State's prompting--that all those patients face a levelling down of service as a result of the creation of a common waiting list?
Mr. Boateng: The right hon. Gentleman really ought not to believe that a Labour Government work on the same basis as the previous, discredited, Tory Government. We are concerned to level up patient care, but he thinks in terms of levelling down. The assumption he makes is totally without foundation: we will aim for the best practice and we will encourage trusts and authorities to work together to make sure that that happens.
Health Service Funding
9. Mr. David Taylor: To ask the Secretary of State for Health how much extra money was allocated to health for 1998-99 as a result of the 1997 Budget. [7951]
Mr. Dobson: In the recent Budget, my right hon. Friend the Chancellor of the Exchequer announced an extra £1 billion for the national health service in England in 1998-99. That, combined with the planned increase of £775 million, amounts to an increase of 2.35 per cent. in real terms--the largest increase for the past four years.
Mr. Taylor: Will the Secretary of State confirm that the Tory plans that he inherited would have meant a real-terms cut in NHS expenditure next year, thus bringing closer the Tories' long-term objective of running down the NHS into a basic safety net service for those unable to afford private care?
Mr. Dobson: I can confirm my hon. Friend's point. Had we not given the extra £1 billion to the national health service next year, there would indeed have been a reduction in the amount of money spent in real terms, resulting from the budget that we inherited from the profligate Tories.
Mrs. Roe: Does the Secretary of State believe that the NHS is underfunded?
Mr. Dobson: Of course it is underfunded; everyone knows that. It has been underfunded since 1948.
Mr. Sheerman: Would my right hon. Friend care to comment on what he could have achieved with the health service if the £5 billion that has been squandered on the bovine spongiform encephalopathy crisis by the previous Government had been available to him to spend?
Mr. Dobson: Indeed. I am going around the country explaining how useful £10 million will be when spent on breast cancer services--we shall announce the details on Thursday. Given the immediate benefits that will flow from just £10 million, it is almost impossible to imagine the improvements that could be made to people's health if we had access to the £5 billion that is squandered on BSE-related compensation as a result of the previous Government's stupidity.
Mr. Simon Hughes: The Secretary of State is fortunate in that this question was altered between the time of tabling and today, to ask about not this year's, but next year's, Budget. However, given that the Minister of State said a minute ago that the trouble with Tory figures was that they were wrong, will the Secretary of State come clean about the figures that follow on from the percentage figure that he gave? The increase to the health service this year is nothing and the increase next year, after taking inflation into account, is significantly less than £1 billion--right or wrong?
Mr. Dobson: For a start, the Budget that my right hon. Friend the Chancellor of the Exchequer announced was basically the Budget for spending, not for this financial year, but for the next financial year--a fact that does not seem to have sunk into some people's minds. The increase
that we have announced, together with the increase that was already in the Budget, means that there will be a 2.35 per cent. increase in real terms--more than twice what the Liberal Democrats promised in their election manifesto.
Mr. Martlew: Does my right hon. Friend agree that, although budgets are tight, trusts are not collecting money that is owed to them? I am talking about the money that is owed to them by insurance companies as a result of road traffic accidents. What effort is my right hon. Friend making to encourage trusts to collect the many millions of pounds that insurance companies owe the NHS?
Mr. Dobson: As recently as 1988, the previous Government confirmed the law under which insurance companies are supposed to pay up for the cost of treating people who suffer from road accidents. The system that was then introduced brings in practically no money, and we will change the law so that we get the money to which the public purse is entitled from the insurance companies. The amounts vary between £50 million a year, estimated by the Department of Health, and £440 million a year, estimated by the Automobile Association. I look forward to receiving the money, and I am at the moment pondering arrears.
Waiting Times
11. Mr. Blunt: To ask the Secretary of State for Health how many NHS in-patients were waiting over one year for treatment (a) in March 1979 and (b) in the latest month for which figures are available. [7953]
Mr. Milburn: At the end of March 1979, there were 185,195 patients waiting more than a year for treatment at national health service hospitals--an increase of 24 per cent. over the previous year. The final figure for the end of March 1997 is 31,208. This represents an increase of 580 per cent. over the previous year.
Mr. Blunt: Given the startling contrast between 180,000 in 1979 and 30,000 today, when does the Minister expect the Government to deliver on their manifesto promise of reducing waiting lists by 100,000? Or is it impossible to give a date, because the Minister knows that the Government's policies are a mirage and will not work or deliver reduced waiting lists? Perhaps the Minister would be better off speculating about the date when the Prime Minister will invite the Secretary of State to pay the price of the hospital pass that he gave when he appointed him.
Mr. Milburn: The Government are already delivering on their manifesto promises. We said that we would cut bureaucracy: we are cutting it. We said that we would get rid of the two-tier national health service: we are. We said that we would replace the internal market: we are. No one in the Labour party underestimates the problems that we were left by the previous Government. Certainly, the Conservative party set some NHS records--record numbers of patients waiting for treatment, record numbers of health authorities in trouble and a record fall in staff morale.
Mr. Pike: My hon. Friend will recognise that the real waiting time for the average member of the public waiting
for hospital surgery starts from the date of first referral by the general practitioner, not from the first consultation with a specialist. When will Labour's commitment to abolishing the bureaucracy that has been created be put into effect to eliminate that problem, to ensure that people get surgery as speedily as possible?
Mr. Milburn: My hon. Friend is absolutely right. Patients judge how long it takes to get NHS treatment from the point of referral by the GP, so waiting times are high. In the short term, they are set to get higher, precisely because of the legacy that we face. We shall do all we can as soon as we can to bring waiting times down.
Mr. Keetch: When will these 100,000 additional placements be dealt with by the Government? How will the Government calculate the number? Did not the Under-Secretary accept earlier that there is no way of calculating the figure? Is it not true that the Government gave a manifesto commitment that they do not know how to achieve?
Mr. Milburn: I repeat, for the benefit of the hon. Gentleman, who was clearly not listening earlier, that the Government are committed to delivering, and are delivering, their manifesto commitments. The fact that we have cut £100 million from NHS bureaucracy to put it into patient care is the first sign of things to come. The second sign of things to come is the Budget announcement by my right hon. Friend the Chancellor of increased NHS spending of £1 billion in England. I remind the hon. Gentleman that the Liberal Democrats went into the general election promising to increase the NHS budget by £500 million: we have doubled that.
Mr. Maples: I assume that the hon. Gentleman took his earlier figures from the Department of Health statistical bulletin for 1997; it was good to hear him quoting the Department's statistics without rubbishing them. Will he confirm, however, that they also show that, in March 1979, 25 per cent. of people on the waiting list had been waiting for more than a year, whereas at the end of March this year, when this Government took over, the figure was down to 6 per cent.?
Mr. Milburn: I can confirm that, by March 1997, there had been an increase of 580 per cent. in the number of NHS patients waiting for hospital treatment. In the year to March 1979, there had been an increase of rather less than that. We have certainly set some records concerning the NHS waiting list. [Interruption.] If the hon. Gentleman would stop chuntering and start listening, perhaps he would learn something.
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