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Mr. David Heath (Somerton and Frome): I agree with much of the hon. Lady's speech. Does she not agree that it is a shame that primary care groups will essentially be general practitioner groups and will not sufficiently include other health care professionals, such as dentists, optometrists and pharmacists? They should be involved; they could provide business skills and would contribute to the holistic approach that she is advocating.
Helen Jones: I do not agree with the hon. Gentleman's view that primary care groups will consist of only doctors. They will include doctors and nurses, who will have the right to work with other health care professionals. We have heard much about bureaucracy. The hon. Gentleman's suggestion would add further layers of bureaucracy to the NHS. For my constituents, the programme is not an optional extra; it is vital to their well-being and, in some cases, to their lives.
I welcome that change in direction, but I say to my right hon. Friend the Minister of State that we must also change direction in other areas of the NHS. Mental health
has been neglected for far too long, and care in the community has been introduced without the necessary back-up services. I know that there are differences of opinion on that matter in the House. Care in the community can work well, but it is not a cheap or easy option. It needs to operate alongside a range of services such as help lines, counselling and 24-crisis intervention teams, which work well in many areas and which help to meet the spectrum of people's needs.
We also need to consider innovative projects such as the Gatehouse assessment centre in Warrington, where there is a dedicated and enthusiastic team of staff who have created a multi-disciplinary way of working. They offer a range of physical treatments but also relaxation classes, health education counselling and even aromatherapy. More important, they have developed a system of clinical nurse assessment which has been validated and which has been proved to work well. It is that kind of forward thinking and multi-disciplinary approach that we need to encourage across the health service, not only in respect of mental health.
We want staff to be able to use and develop their skills; in return, they have to be accountable for what they do. We recognise that the vast majority of people are happy with the treatment that they receive, but when things go wrong--which, tragically, they sometimes do--it is important that mistakes are acknowledged and put right straight away. The commission for health improvement and the plans for clinical audit will have a major part to play in raising standards and in making sure that we learn from mistakes and that people get the most effective treatment. However, that by itself will not be enough.
The Select Committee on Public Administration, of which I am a member, has already heard too much about a reluctance by some doctors and trusts to admit mistakes, to acknowledge patients' need, or even to give simple information. They are a minority, but they have to realise that such attitudes have no place in a modern health service. Sir Lancelot Spratt died a long time ago. Consultants can no longer play God, and administrators and chairmen of trusts have to be accountable.
Mr. Iain Duncan Smith (Chingford and Woodford Green):
Matron is still with us.
Helen Jones:
I take that for granted.
While we require accountability on the part of staff, we must make sure that they are registered and regulated properly. The hon. Member for Southwark, North and Bermondsey (Mr. Hughes) mentioned this in passing. I hope that the review of the Nurses, Midwives and Health Visitors Act 1997, which the Minister is carrying out, will not only ensure stricter checks on the registration of nurses but will examine how we can protect the title of nurse. It is a mystery to me why people cannot call themselves midwives unless they are registered midwives, but can call themselves nurses so long as they do not claim to be registered.
I hope that we shall also make sure that if people are removed from the nursing register, they are not able to get jobs elsewhere in the health service or in social services, perhaps as a health care assistant or in some other capacity where they are still working with vulnerable people.
The NHS has moved on and developed new techniques and skills, but our systems of registration have not necessarily caught up with them. Let us consider the
example of operating theatre practitioners. They do not have to be registered--there is only a voluntary code. However, their jobs are often interchangeable with those of theatre nurses. In fact, trusts often advertise for a nurse or an OTP. Certainly, nurses and OTPs have the same access to sensitive equipment and controlled drugs yet, if an OTP abuses his position, he cannot be removed from a register, unlike the nurse working alongside him, and is quite free to get a job elsewhere.
The public deserve better from us, just as they need us to examine the way in which we register people practising as psychotherapists and physiotherapists and the restrictions that we place on them as to whether they can call themselves psychotherapists and physiotherapists. The good and conscientious staff working in the NHS deserve that protection. Their standing should not be damaged by charlatans who should not be practising.
Mr. Simon Burns (West Chelmsford):
Like the hon. Member for Warrington, North (Helen Jones), I, too, am a child of the national health service, but I also had the privilege of being a Health Minister. This is the first time since 2 May last year that I have contributed to a debate on the health service. That was a deliberate decision, and I want to take part in this important debate because of my concern about what I believe to be a glaring omission in the Queen's Speech. That glaring omission is the absence of anything positive and concrete to deal with the problem of hospital waiting lists.
I am delighted that my right hon. Friend the Member for Maidstone and The Weald (Miss Widdecombe) is present. She has done a great deal of work in the past few months to highlight the problems suffered by our constituents as a result of rising waiting lists. I share a district health trust area with my hon. Friend the Member for Maldon and East Chelmsford (Mr. Whittingdale), who is as concerned as I am about what is happening in the Mid-Essex hospital trust area. Sadly, the Minister for Public Health has had to leave the Chamber, but I am delighted that the Secretary of State for Social Security is present. I shall put to him several questions to which I hope he will have the courtesy to respond when he winds up the debate. My constituents desperately want answers to them.
When the Secretary of State for Health opened the debate, he was very dismissive of my intervention in respect of hospital waiting lists. My constituents will be extremely disappointed that he sought to brush aside my valid point by saying that he did not know where the figures came from and so was not prepared to say anything about them.
The figures came from written answers sent to me by the Minister for Public Health on 22 October and on 9 and 17 November. Therefore, the figures that I shall cite, which illustrate my concern about the lack of action proposed in the Queen's Speech, have not been dreamed up by the Conservative research department to embarrass the Government. They are figures put into the public domain by the Department of Health and the Minister for Public Health, so I assume that even the Government will accept that they are accurate and honest.
As I said, I am concerned about hospital waiting lists in the Mid-Essex hospital trust area and about the lack of any measure to tackle that problem in the Queen's Speech. Let me share with the House the scale of the problem facing my constituents.
During the general election, a little plastic credit card was circulated. It had on it a photograph, taken by Lord Snowdon, of the right hon. Gentleman who is now the Prime Minister. On the back of the card were several irrevocable pledges on which I think the Prime Minister wants his Government to be judged. One of them was that they would reduce waiting lists.
It goes without saying that, since early 1991, my right hon. Friend the Member for Huntingdon (Mr. Major), the former Prime Minister, targeted money each year specifically to bring down waiting lists. We started by eliminating lists of those waiting for more than 24 months. Waiting times were then brought down to under 24 months, then 18 months, and then, for non-emergency treatment, to between 12 and a maximum of 18 months.
During the election campaign, all hon. Members and their opponents had six weeks to canvass. I vividly remember my Labour opponent and the Labour party at large throughout the country saying, "Elect new Labour. We pledge to bring down waiting lists"--not increase them. The campaign was so frenetic that Labour created the perception and raised the expectation that, under new Labour, people would be able to walk into their local hospital on the day that a problem was identified and surgeons would queue up to treat them. The country believed that, if there were a Labour Government, waiting lists would fall and non-emergency hospital treatment would be available infinitely more quickly.
What happened? From day one of this new Labour Government, hospital waiting lists for non-emergency treatments have risen inexorably. My constituents cannot turn up at Broomfield hospital and immediately have the operation that they need. Funnily enough, they are put on a waiting list. Let us consider what has happened to those waiting lists. So that nobody thinks that the Conservative research department is painting a terrible picture, I add the caveat that the following figures are from the Government.
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