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Mr. Fabricant: I want to probe my hon. Friend. Does he think that Labour candidates deliberately misled and lied to the electorate, or were they just naive?
Ms Ann Coffey (Stockport): Think about it.
Mr. Burns: Given my anger at what has happened to my constituents, I am thinking, first, that I do not want to use unparliamentary language and secondly, that even Labour politicians are basically decent human beings. I think that they were spun out of control by the prince of darkness and spin doctors in Millbank because they were desperate to get into power. They saw an emotive issue and milked it for all its worth.
Over the past few months, my right hon. Friend the Member for Maidstone and The Weald has highlighted the fiddle that has been going on in an attempt to remedy the political damage caused by the Government's appalling waiting lists. The Government cannot fiddle figures in my constituency for a very simple reason: the number of people waiting for 12 months or more for hospital treatment has risen so dramatically. Nobody can dispute that; even the Government have produced figures to show it.
Let us get under the skin of the figures: let us consider the numbers of people who are waiting to see a consultant following a GP visit--even before they are put on a waiting list for hospital treatment. They, too, are appalling. On 31 March 1997, the number of such people waiting between 13 and 25 weeks in the Mid-Essex area was 481. By 30 June this year--the last month for which figures for this category are available--the figure had escalated to 1,348. In March 1997, 74 unfortunate people were waiting 26 weeks or more to see a consultant, but by 30 June this year, the figure was 256. In only 14 months of a Labour Government, even the number of people waiting for more than 13 weeks to see a consultant rose from a maximum of 555 to 1,604. That does not suggest that new Labour is honouring its pledges to the people of the Mid-Essex area.
The total number of people waiting in Mid-Essex for hospital treatment for any period of time was 8,391 on 31 March 1997. The latest figure, 18 months after the Government came to power, having pledged to bring down waiting lists--unlike, apparently, the previous Government, who did reduce waiting lists--was 11,615. I repeat that those are not my figures.
In written answers, the Minister for Public Health happened to say--I welcome this--that North Essex health authority is working with the waiting list task force to see what can be done to meet its target of reducing
waiting lists by 31 March 1999, which is almost two years after the Government came to power. That intrigued me; nowhere in the answer did it say what the target was. I thought, "Wonderful!" I thought that the Government must be so concerned that, according to the Sunday papers last weekend, the area has the highest waiting lists in the country, and so embarrassed about breaking their pledge that they are pouring loads of extra money and expertise into the area so that fewer people will have to wait than did when they came to power. I tabled some more questions. Hon. Members can imagine my disappointment when I discovered that that was not so.
I welcome any target that reduces waiting lists so that fewer people have to wait--and wait for less time--for hospital treatment. However, the Government's target is very modest: to reduce the figure from 11,615 to 9,738--about 1,400 people more than when they came to power. What sort of target is that?
I pray that we do not have a hard winter. As anybody who has worked or been involved at ministerial level in the health service knows, the winter crisis period is the most worrying time for the Government of the day and the NHS. If there is a harsh winter, the number of illnesses and of people needing operations rises dramatically. That is regrettable, and can throw even the best-laid plans for treating more people more quickly. Even if we ignore that consideration, however, the Government's target for waiting lists in Mid-Essex is incredibly modest. It is still the case that significantly more people are on the waiting list than when the Government came to power.
It is ironic that a Government and a Prime Minister who have made such a deal--day after day--about keeping their promises have not kept their promises to my constituents who are ill and need non-emergency operations and other hospital treatment. More and more of them are having to wait longer and longer under new Labour.
Let me say one more thing on this subject. I wonder what the West Chelmsford Labour party thinks. We have not heard a dicky bird from it on this subject over the past 18 months. I understand how ashamed it is, but one would have thought that its candidate at the last election--who happens to be a consultant in psychiatry in the Mid-Essex community and mental health trust working at Broomfield hospital, which is at the heart of the health trust area--might have had something to say. He made a big deal--citing his medical background when talking to my constituents on the doorstep and in his literature--of the fact that his party's Government, like a new Jerusalem, would cure my constituents' problem. The irony is that their problem is infinitely worse under his party's Government than it ever was under my party's Government. Under my party's Government, waiting lists were reduced in the Mid-Essex hospital trust area.
I realise that the Secretary of State who will reply is responsible for social security rather than health, but, because the Secretary of State for Health was not prepared to discuss the issue earlier, I ask him to give me some answers when he winds up the debate. I do not want to hear the usual platitudes about what the Government are doing.
I would be grateful if the Secretary of State would listen for a minute, rather than talking to the Whip about--presumably--an entirely different matter. He might then be able to give a specific answer to my questions.
Why have my hospital waiting lists lengthened? Why is the target for reducing them by March next year 1,400 higher than the target set by the Government when they came to power? Why has this happened under new Labour, which promised to reduce hospital waiting lists?
Let me now pick up an important point made by the hon. Member for Warrington, North. She spoke knowledgeably about mental health, and implied that, like me, she considered that for too long mental health services have been the Cinderella of the NHS. They have been underfunded and pushed aside by Governments of all political parties--
Ms Coffey:
That happened under the last Government.
Mr. Burns:
As I said, it happened under Governments of all political parties. Let me reply to the hon. Member for Stockport (Ms Coffey). Over the past five years, mental illness has been given much more recognition, and much more priority. More and more money was channelled into it as the Government tried to help to change attitudes, both in the medical profession--where, sadly, the wrong attitudes still obtained--and outside it. They wanted to break down the barriers, and to end the prejudices afflicting mentally ill people. I am sorry that the Queen's Speech contained no specific measures to deal with that, but I recognise that the Department and the relevant Minister are examining the whole subject of mental health.
I hope that arrangements regarding patients in the community will be tightened. I am not saying for a moment that caring for such patients in the community is the wrong policy, but I think that the policy should be improved in certain respects. One example that we have seen over the last few days showed, tragically, that something must be done--not, I hope, in a party political way. I look forward to hearing an announcement from the Department of Health. I hope that the Department will come up with a framework allowing people of all political persuasions to work together to improve the medical care and physical well-being of mentally ill people.
It is equally important for much more to be done--by us, using our positions of responsibility, but also by the medical profession and the voluntary sector--to end the horrendous prejudice that affects the mentally ill. Everyone sympathises with someone who has appendicitis or flu, telephoning and sending flowers and good wishes. The awful thing about our society is what happens to those with mental health problems. This tends to be forgotten.
All too often, because of the prejudice that they know to exist, relatives will try to hide the fact that a member of the family is suffering from a mental health problem. Far too few people will telephone, show genuine interest or send flowers. Mental illness is a stigma: it is something that must be brushed under the carpet. People suffering from mental illness are suffering through no fault of their own, like people suffering from flu. The barriers that have built up are unacceptable in a society that is heading towards the millennium.
I look forward to the Government's announcements, and hope that they will tackle many of the problems that desperately need to be tackled in the next few months.
7.57 pm
Dr. Alan Whitehead (Southampton, Test):
I am pleased to see that the hon. Member for Lichfield (Mr. Fabricant) is present, and sad to see that the right hon. Member for Henley (Mr. Heseltine) is not. Both made interesting speeches. The hon. Member for Lichfield spoke of the recent history of the national health service, which is an interesting subject, although I did not agree with all that he said. He assumed that a background of common sense existed; I can only put it like that.
In what could kindly be termed a wide-ranging speech, the right hon. Member for Henley concentrated on best value in local government, and a number of associated issues. He demonstrated comprehensively that he had signally failed to understand the first thing about what the Government are saying about best value, assuming that his prejudices of many years ago still hold true. In discussing GP fundholding and best value in local government, both speakers implied that what they had suggested--suggestions that preceded the two proposals in the Gracious Speech--was common sense, and that the Government's proposals were, in some way, deeply ideological.
Interestingly, the right hon. Member for Maidstone and The Weald (Miss Widdecombe) could hardly contain herself before, after a few minutes, claiming that the GP commissioning bodies that the Government propose were aimed to collectivise the profession. It seems that Opposition Members are saying that they have adopted a commonsense position and that the Government are attempting to introduce ideology into the provision of public services. My view is that the contrary is true. The Government are attempting to undo the damage that was inflicted by the previous, deeply ideological, Government by the Acts that they introduced, which brought about compulsory competitive tendering, general practitioner fundholding and the internal market in the health service.
By way of evidence, I shall read a brief quotation from 1993 from William Waldegrave. I shall be interested to see whether anyone on the Conservative Benches nods when I read it. The right hon. Gentleman said:
The quote suggests, as have some of the contributions to the debate, that Opposition Members are still thinking about public services as if they are cans of pineapple--as if we can buy and sell them. They seem to think that they can be obtained off the shelf and that if they prove to be defective they can be taken back and the shop will replace them. They seem to think that it is all about customers going into stores and buying commodities.
I suggest that public services are not capable of being boiled down to the whims of the market. However, that is the course that the previous Government took in the
public service areas that we are discussing. Those who required good public services in both health and local government had foisted on them GP fundholding and compulsory competitive tendering. Those policies arose from the assumptions that the market is always superior to the public service ethos; that competition would of itself sort out any problems that might arise; and that both would inevitably produce a better service.
Those who have argued that the Government would wish simply to remove the internal market from the health service and from local government should understand that the issue is not that competition is never right for public service provision. If, for example, I wish to organise the purchase of some textbooks or some roughbooks for a school, I can think of no better method than to specify what I require, obtain tenders and opt for the cheapest one, provided that it meets what my specification sought to achieve. That tender would win. However, as competition attempts to deal with issues that become ever more complex, it becomes increasingly apparent that we cannot apply it on the basis of one size fits all to the public service.
That is what happened in local government with compulsory competitive tendering. Whatever the circumstances were, the previous Government slapped on competition. That is what happened in the health service. The previous Government attempted systematically to introduce crude competition in the quasi-market that they sought to establish throughout the health service. Similarly, they introduced GP fundholding to try to make GPs subject to the market in the way in which they dealt with their patients and in organising their own practices.
"The key point is not whether those who run our public services are elected, but whether they are producer-responsive or consumer-responsive. Services are not necessarily made to respond to the public by giving our citizens a democratic voice, and a distant and diffuse one at that, in their make-up. They can be made responsive by giving the public choices, or by instituting mechanisms which build in publicly-approved standards and redress when they are not attained."
If any Opposition Members are thinking to themselves that that sounds perfectly fine and a reasonable argument, that demonstrates why the Conservative party so comprehensively lost the 1997 election and why it is so far out of touch with what the public these days are thinking.
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