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Mr. Kevin Barron (Rother Valley): The nation will be grateful for my right hon. Friend's statement. Given the
years of neglect of the NHS, especially in nurse training, I am glad that we may now look forward to a future with more nurses looking after patients in the national health service. Does my right hon. Friend agree that, over Christmas, the right hon. Member for Maidstone and The Weald (Miss Widdecombe) appeared to be more obsessed with opening up the private sector for NHS patients than with sorting out the problems of the NHS that the Tories neglected for decades?
Mr. Dobson: I certainly accept the points that my hon. Friend makes. We must try to ensure that the additional resources, in the various forms that I have described, are in place in the future. We must also try to make additional provision this winter for those areas that are suffering particular problems. That is what I authorised last week and those areas that can benefit from an immediate cash injection will get it, but many can not.
Mr. Simon Hughes (Southwark, North and Bermondsey): First, the Liberal Democrats join in the tribute to all those who work for the health service in both winter and summer. The Royal College of General Practitioners and the Public Health Laboratory Service have confirmed that there is no flu epidemic and that, although the numbers suffering from flu and flu-like illnesses have risen, they are not exceptional for a winter in Britain. In November, the Secretary of State said that unless we had exceptionally bad weather or a flu epidemic the NHS could face the winter with confidence. Just last week, the Secretary of State said that the NHS is in crisis. What changed in a month?
Secondly, I have to agree with the right hon. Member for Maidstone and The Weald (Miss Widdecombe) and others who have said clearly to the Secretary of State for months now--as the Liberal Democrats have said for years--that the obsession with reducing waiting lists is a folly and should be replaced by concentration on reducing waiting times and improving the quality of treatment. Will the right hon. Gentleman now give up that Government obsession of last year and replace it with better targets for this year? Can he assure us that no one has waited on a trolley for a bed because that bed has been kept for someone from the waiting list initiative instead of for emergency admissions?
Finally, the Secretary of State tried to put much of the blame on to the Conservative administration of the health service, which certainly under-resourced it. With hindsight, does he agree that a Labour Government who came to power in May 1997, but did not commit additional resources to the health service until July 1998--14 months later--should share responsibility for the under-resourcing of the health service this winter? If winter announcements are made in November, four weeks before winter begins, anyone can see that they may be too late to be effective in a winter such as the one we are having. In December, the Minister for Public Health said that there is no rationing in the health service, but that does not appear to be true unless the Secretary of State can guarantee to the House that everybody who needs a bed will get one at the moment they need it.
Mr. Dobson:
First, I do not believe that anyone has any great faith in the scientific accuracy of the Public Health Laboratory Service epidemic figures, including the people who assemble them--[Interruption.] For the
Secondly, we have brought down not only waiting lists but waiting times. During the period in which waiting lists have come down, the average time that people waited for treatment has also fallen, as has the number of people waiting more than 12 months for treatment. Unlike the Tories, we are not content with keeping only our own promises; we have kept some of theirs, too. During all the time the Tories had a target of having no one wait for 18 months, they failed to deliver on it in a single month. We have delivered it, and we are reducing waiting times.
The hon. Member for Southwark, North and Bermondsey (Mr. Hughes) seemed to suggest that the extra money that we provided for the NHS somehow did not come in until July last year. He should cast his mind back a little. We found money for winter pressures for the previous winter. From 1 April, we found £1.7 million extra for the health service, and we have found another £250 million on top of that. In case the hon. Gentleman has forgotten his election promises, let me remind him that that is roughly three times as much as his party promised to spend on the NHS.
Mr. David Hinchliffe (Wakefield):
I join my right hon. Friend's tribute to those who work in the national health service, and I particularly welcome his reference to those who work in social services. What was new both this year and last was that the Government brought about much closer working relationships with social services, which, despite all the difficulties of recent weeks, have substantially improved their ability to care for people in their own homes on discharge from hospital. Have the Government had an opportunity to evaluate fully the impact of the winter pressures initiative either last year or so far during the current winter?
May I tell my right hon. Friend of my concerns about West Yorkshire, where there have been specific difficulties and pressures? I pay particular tribute to those who work in the area, but the difficulties relate to some primary care services that patients have been unable to access. I recognise that general practitioners work extremely hard and have every right to their Christmas holidays. However, people have presented themselves to accident and emergency units in several cases because they have been unable to receive advice from GPs. Given the NHS Bill that will come before the House soon on the abolition of competition between GPs, might we consider future arrangements for GP practices to work together over holiday periods to provide back-up provision that would prevent people from presenting themselves unnecessarily at hospitals?
Mr. Dobson:
My hon. Friend raises some important points. I do not have all the detailed figures for every part of the country, but I can illustrate the extra sums going into providing care for people outside hospitals by mentioning the money that has gone to the West Kent
My hon. Friend referred to primary care services. In some parts of the country it appears that when general practitioners took holidays around Christmas and new year--not unreasonably; they are just like everyone else--there was a build-up of people seeking treatment. To be fair to GPs, many who realised that that was happening re-opened their surgeries. We must consider that problem carefully for next year. People go on about the millennium bug, but the millennium humans are even more important, and we shall have to make special arrangements to make sure that the NHS can cope with the extraordinary holiday period that we can expect next Christmas and new year.
Mrs. Virginia Bottomley (South-West Surrey):
I have heard a bit of window dressing today, and quite a bit of sensible evolution. Even more, I experienced a familiar flavour during the statement. What the Secretary of State did not have to contend with was demonstrating junior doctors. I dare say that the modest improvement to the hours of junior doctors is one of the issues that has led to the other difficulties that the health service is experiencing. Ever was it thus.
I urge the Secretary of State to reflect on two serious comments. I welcome his commitment to reconsider how Project 2000 is working in practice. Saying that nursing should be a graduate profession had much merit, particularly for nurses in the community and specialist nurses. However, it may have discouraged some and resulted in disappointment for others who think that they are pursuing academic training for what is ultimately a practical task. Will he consider carefully nurses' education for the necessary tasks?
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