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Mr. Dobson: Let me finish the list.
There will be 450 extra beds in London; 60 in Birmingham; 75 in Leeds; 73 in Berkshire;67 in Liverpool; 36 in east Norfolk; 89 in Suffolk; 60 in Bradford; 115 in Derbyshire--because we are as interested in rural areas as in big cities--and 48 in Durham. Extra staff will be taken on. Moreover, £65 million will go into primary mental health care and community services--all of which can make a contribution by looking after people at home, so that they do not place a demand on hospital beds.
The Government's action has been welcomed across the country--except by the Tories. The right hon. Member for Maidstone and The Weald said that people are moaning about the Government's action. However, I should tell her that, in May, Ruth Carnall, chief executive of the West Kent health authority, told the Gravesend Reporter:
Miss Widdecombe:
The right hon. Gentleman has quite consistently talked about extra beds. I therefore ask him again the question that I asked him earlier: will those extra beds be over and above complete restoration of all the beds that are now being cut and all the hospitals that are now being closed? Will the extra beds in Kent, for example, mean that we will not lose 400 beds at Kent and Canterbury? If we lose 400 beds at Kent and Canterbury, 63 extra beds somewhere else in Kent will be of minimal use.
Mr. Dobson:
The 63 extra beds in Kent will be provided this year. Consultation is under way in Kent about proposals made by the East Kent health authority that involve changes and--if the authority has its way--bed reductions at the Kent and Canterbury hospital. That, if it is approved, may take place in future years. I am talking about this year. There is not going to be any reduction in beds in Canterbury this year.
In addition, the proposition for the changes in Kent to which the right hon. Member for Maidstone and The Weald objects comes from the members of the East Kent health authority, every single one of whom was appointed by a Tory Secretary of State, not by me. As I do not like to mislead the House, I must point out that I reappointed the woman who chairs that health authority because it seemed wrong to change horses in mid-stream. I believe that I have the support of the Tory Member for Thanet--the hon. Member for North Thanet (Mr. Gale)--in so doing.
Mr. Dobson:
I give way to the former Secretary of State for Health.
Mr. Stephen Dorrell (Charnwood):
The Secretary of State can clear up very simply the question whether there is to be a net increase in bed space. Will he give the House a clear undertaking that the published figures for this year will show that 3,000 more acute beds were available in the national health service than were available in the health service last year? Are the acute beds in the health service going to increase by 3,000? Is that the commitment that he is giving the House?
Mr. Dobson:
As the right hon. Gentleman knows, under the present statistical arrangements in the Department of Health, over which he presided, we shall not get those figures until 1999. We are talking about practicalities, not crackpot statistics as provided by the Tories. The practicalities are that the hard-working staff in the NHS will this year have access to 3,000 more beds in which to treat patients. That is clearly a step forward.
The Tory motion also criticises our proposals for improving primary care and giving greater power and influence to general practitioners, community nurses and midwives. We are doing that because everyone recognises
that the Tory reorganisation of the NHS was wrong. The Tories introduced a competitive internal market which produced a two-tier system. It set doctor against doctor and hospital against hospital, and it cost a fortune in bureaucracy. If anyone doubts the huge amount of waste in the bureaucracy, I shall give one simple example.
When we took office, we were faced with having to agree, or otherwise, what was called the eighth wave of fundholding. We decided not to go ahead with it. The previous Government had earmarked £20 million for last year just to pay for the bureaucracy involved in the eighth wave of fundholding. I stopped it. That released £20 million, £10 million of which was spent on improved breast cancer services across the country, including £194,000 in the health authority which serves the shadow Secretary of State and £183,000 in that which serves the shadow Minister of State.
We know from what she has said in the past that the shadow Secretary of State believes that the Tory reforms are now really delivering results, but the main result they delivered was untold harm. Talking to people in the NHS, I find it very difficult to find anyone who will admit to supporting the old system. Admittedly, the majority of people in the health service never did support it, but even some of its former advocates have publicly recanted. Even more disturbing is the fact that the odd one, well known for advocating the internal market years ago, has sidled up to me to whisper that he was a secret member of the resistance all along. Such people are not very convincing, but I give them the benefit of the doubt.
Our proposals will put doctors, nurses and midwives back in the driving seat, not only in primary care but right across the national health service. That is bad news for management consultants, but good news for the rest of us. Management consultants have done untold damage to the NHS.
GPs are rightly concerned about the future of general practice. It is natural that they should be, as it is their careers, their premises, their staff and their patients who are involved. They have raised practical concerns, and there have been talks between the British Medical Association and officials in my Department, and, more recently, between representatives of the BMA and the Minister of State, my hon. Friend the Member for Darlington (Mr. Milburn), whom I should like to thank for the amazing amount of hard work that he has put into those talks. I hope and expect that the talks will achieve a successful outcome.
We share the desire of the professions--not just the medical profession but the nursing profession--that they should have a bigger say, and the desire to raise standards. We want to carry the professions with us.
Mr. Hilton Dawson (Lancaster and Wyre):
Does my right hon. Friend agree that, although GPs raised with him issues such as recruitment to the service on his extremely successful visit to Over Wyre medical centre in my constituency yesterday, there was a real sense of optimism and a determination to provide services close to the
Mr. Dobson:
I confirm that that was the reception I received. We want the health service to provide treatment much closer to home. Many of the procedures, treatments and operations which once had to be carried out in district general hospitals will, with new technology, be able to be delivered on GP premises, much closer to people's homes. That is one of the things that we are trying to develop.
I greatly welcome the strong support of the medical, nursing and midwifery professions for what we are trying to do to improve quality. I do not think that there has ever been a time in the history of medicine in this country when the medical profession has been so committed to trying to improve quality and standards.
Until now, there has been no national health service machinery setting clinical standards, spreading good medical practice or checking on standards of performance. We are putting that machinery in place, with the overt support of the professions. Like them, we are determined that there will be no more Bristols, no more Kent and Canterbury cervical screening scandals, and no more Devon and Exeter breast screening scandals. We are going to put in place machinery to set standards, and then ensure that they are met. [Interruption.] If we are to hear booing from the Opposition about standards, I have to say that machinery should have been in place to pick up what was going wrong in Kent and Canterbury and in Devon and Exeter, but there was not.
When I asked the Tory-appointed chair of the South Thames health region to conduct an inquiry into the scandal in Kent and Canterbury, which had not been cleared up by the previous Government, who had allowed the people who had got it wrong to produce a report and then keep it private, he said--the previous Government were responsible for some of this--that the reasons for failure were poor and confused management; there had been repeated warnings of understaffing, poor training and low morale which had gone unheeded for many years. He said that there was a lack of a clear line of accountability on both management and quality assurance for the national programme. He went on:
"We welcome this money, particularly since we understand"--
she is quite right--
"that it is not just a one-off but part of an intention nationally to enable health authorities to maintain lower lists."
16 Jun 1998 : Column 152
The Government have had such welcomes from the people who actually have to do the work across the country.
The Tory motion, out of date as it is--as the Tories usually are--mentions bed reductions. However, as I said, there will be 3,000 extra beds.
"I have been forcibly struck by the different ways in which the introduction of the internal market . . . exacerbated an already inherently weak situation . . . Many of the decisions which had an adverse effect on the cytology department were made . . . because of the perceived need to be free standing and competitive in the newly created market."
That is why we are opposed to the internal market in the NHS.
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