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Miss Ann Widdecombe (Maidstone and The Weald): Although I join the Secretary of State in his tribute to the many workers in the health service for the way in which they have coped with the emergency, I feel that my first question must be: what is new in the statement? What in the statement is going to make the slightest bit of difference to those who are now lying on trolleys, in fear and pain, waiting for treatment? The second question is: does he really think, with his complacent statement, that he is on the same planet as those people waiting for treatment?
Does the Secretary of State now agree, with the benefit of hindsight, with what I told him as early as last September--that money for winter pressures in our health service is far too little and too late when it is issued in November? Would it not be simple common sense to allow our hospitals to know how much they will receive much earlier in the year, so that they can plan exactly how the money will be spent?
Is it not the case, as the British Medical Association has been saying along with us, that the obsession of the Labour Government with their so-called early pledge on health service waiting lists has made the current crisis in our health service far worse than it need have been and distorted clinical priorities away from patient priorities? Will the Secretary of State tell the House how many hospitals were continuing to admit routine waiting-list cases while patients were lying in pain on trolleys in corridors, with many forced to seek the help of relatives and friends to provide basic nursing care?
The Secretary of State has, understandably, been telling patients not to use accident and emergency services unless it really is an emergency, but at the same time doctors have been telling worried parents not to take any chances if they suspect that their children may have even the earliest symptoms of meningitis. Is not there a breakdown of communication in the Department of Health?
Does the Secretary of State recall that in January 1996 the right hon. Member for Camberwell and Peckham (Ms Harman) and, indeed, the now Prime Minister, promised the public that a Labour Government would immediately set up a trolley task force? What has happened to that task force? Is it stuck on a waiting list along with some of the Government's other early pledges? It is no good the right hon. Gentleman telling us that he has set up an inquiry into beds, when what he promised was an inquiry into the excessive use of trolleys.
Will the Secretary of State confirm that he has cut nurse training by 3 per cent. from the levels that the Conservative Government had planned for 1997-98? He made much in his statement of what he suggested were our reductions. Will he own up to having cut 3 per cent. from our planned levels in his first year in post? His belated attempts last week to wriggle out of the blame for the crisis in our health service will impress nobody in the light of that cut.
How is the Secretary of State's wish list of nursing recruitment intended to be met? Will he acknowledge the use that is even now being made of the private sector, and
deduce from that that it is time to break down the ideological barriers that he continually sets up between the public and private sectors?
The Secretary of State mentioned 35 intensive beds. Where are they? Are intensive beds available in every region, or is there a concentration in particular regions? Why, in the national priorities guidance that he issued last year, is nurse recruitment not listed as a priority? Will he now, at last, abandon his ludicrous concentration on raw numbers on waiting lists in favour of waiting times, which are a far more accurate measure of whether people are getting a satisfactory service from the NHS?
I welcome the Secretary of State's good will on pay for nurses, but can he assure hard-pressed health authorities that he will make the additional money available and not expect it to come from patient care? Will he admit that it is time for a slightly more mature debate on the health service? [Interruption.] I am pleased that Labour Members are agreeing with that at last.
Does the Secretary of State agree that the problems in the health service have been there since its inception and that the extreme, and welcome, expansion of the health service, and the excess of demand over supply, have bothered every Government from Bevan's time onwards? Will he admit that the magic wands that he promised--or, to be fair, because he was not then a health spokesman, that the then Opposition promised--before the general election were not to be found?
Has not the time come for the Secretary of State to be more humble in his approach, when the nation knows that, although he went to the country with the slogan, "14 days to save the NHS", for the past 14 days he and his policies have flayed the NHS?
Mr. Dobson:
I welcome the right hon. Lady's characteristic humility and lack of assertiveness. She asked what was new. I have presented the up-to-date facts, including the ones that she cited. I have given the House and, to the extent that our debate is covered, the people, the true and up-to-date position. That is something new, because, with Parliament not sitting, we did not have the opportunity to do that before.
The right hon. Lady seems to think that, because of the massive effort that people in the national health service put in to reduce waiting lists by 150,000 between April and November, they are somehow rendered incapable of dealing with emergencies and urgent cases in December. If the Opposition think that, they are barking up the wrong tree.
The right hon. Member for Maidstone and The Weald (Miss Widdecombe) has asked me effectively to ban all treatment of waiting list cases. However, as she is constantly ranting on, there are large numbers of people on the waiting list who have serious and life-threatening conditions. We have made it clear, as we always do, that it is up to clinicians to judge who should have priority, including, in some circumstances, who should have priority for intensive care beds.
The right hon. Lady asked about meningitis. Those who are offering advice on meningitis to the public have a dilemma. As I explained, the chief medical officer has advised general practitioners to rush children to hospital if they have any concerns or suspicions that those children may have meningitis. Conversely, the chairman of the BMA--on behalf of the profession generally, not on my
behalf--has said that healthy adults, who generally are not as susceptible as children to meningitis, should think twice before seeking treatment. I do not think that there is any difficulty with that advice. It is certainly not a matter of the Department of Health speaking with two voices. Moreover, it is a silly, stupid, petty and party political point to suggest that the Department is speaking with two voices.
The right hon. Lady suggested that there was something wrong with being concerned about trolleys. When we were elected to office, we discovered that the previous Government had, quite rightly, established an emergency services action team, the function of which is to examine emergency services, to try to sort out emergency services and to plan for the future--which is what we have done.
I have never ruled out the possibility of relying on the private sector to provide additional help if units within the national health service cannot provide it. About a month ago, the right hon. Lady was denouncing me for not allowing such private sector involvement; now, she is denouncing me for allowing it. It would be better if she tried to introduce a little consistency into her argument.
In a factual question, the right hon. Lady asked whether intensive care beds are available in every region. The answer is yes--or the answer was yes when the service provided me with the information. It is quite possible that, in one or another region, there will be a sudden burst of people coming into accident and emergency and the available beds will be occupied. However, I was informed that every region has some intensive care beds. I might add that, once we started examining the matter of intensive care beds, we discovered that the previous Tory Government had never known how many intensive care beds there were in the United Kingdom. We shall therefore take no criticism on the matter from Conservative Members.
The right hon. Lady produced a document entitled "Ten Measures to Help the National Health Service". However, none of the measures dealt with paying nurses, who never got a mention in the document. When she suggests that paying health service staff can be done only at the expense of patient care, she causes great offence to those who work in the national health service, as those who are paid in the national health service are those who are providing patient care.
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