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6.34 pm

Mr. Tony McNulty (Harrow, East): I shall be brief, much to the pleasure of Opposition Front-Bench Members, not least the hon. Member for Orpington (Mr. Horam) who is now on his third party, I believe, in terms of representation in the House. It is a pity that the hon. Member for Rutland and Melton (Mr. Duncan) is not here. As he has done before, he called for a grown-up, serious, mature debate and then promptly descended into a childish, petulant, right-wing rant, which was of no value to anyone. He did the House a disservice by suggesting anything other than fact, which is that Edgware A and E facility stopped as a blue light function on 1 April 1997, not afterwards. I have the records and I can send him clear evidence that the health authority started the wind-down at the behest of the right hon. Member for Charnwood (Mr. Dorrell), or Loughborough as it then was, in February 1997, while his hon. Friends the then Members for Harrow, East, Mr. Dykes, and for Hendon, North, Sir John Gorst, were rallying round threatening to bring down the Government--and then, what a surprise, did not bother. It is a shame that the unique, innovative consultation process that followed, which included over 200 organisations and

6 May 1999 : Column 1179

gave the local community what they wanted in terms of a community hospital, is also pooh-poohed by Opposition Members.

I want to touch briefly on those issues that are not in Turnberg. A specific local one concerns the Royal National Orthopaedic hospital. It is the international orthopaedic facility in the world. It awaits still, some 10 years on in terms of the grinding wheels of health bureaucracy, a decision following the musculo-skeletal review in the area. I fully support the refurbishment and modernisation of this key international facility on the Stanmore site.

The one comment that I would endorse from the sixth form representative of Kingston--and on and on--and Surbiton (Mr. Davey) is that there are significant pockets of deep deprivation, which we miss at our peril, throughout outer London and suburban areas which often get overlooked because of the notion that, somehow, areas such as Harrow and Uxbridge are seas of affluence. We need to pick that up.

I am not one who indulges in luvvie behaviour. I do not subscribe to the school report that says that, no matter what they have done during their time in power since 1948, at heart, deep down the Conservatives really like the NHS. I do not believe that for a moment. I would not associate the hon. Member or right hon. Member for Macclesfield (Mr. Winterton)--I am not sure which--with this remark.

Mr. Nicholas Winterton: The hon. Member.

Mr. McNulty: It should be right hon. Member, not least for the real service he did in the House as a strong, independent Chairman of the Select Committee on Health. He is to be fully applauded for that; he deserves a gong for it if for nothing else. He certainly deserves one for the exceptional way in which he chaired the Greater London Authority Bill. At the risk of being mildly offensive, I would say that at best he is a semi-detached member, certainly of the last Government, if not of the Conservative party.

The luvvie behaviour stops here because the economic spokespersons for the Conservatives cannot say, as they have done, that they will freeze duty on fuel and tobacco. That impacts on London's NHS; the cash register rings £6 billion straight away. That is roughly a year's worth of the total £21 billion that we are putting into the health service. Where is that money going to come from? The Conservatives cannot, as some of them do, say that they now subscribe to the £40 billion, yet, at the same time, make all these other commitments elsewhere. They cannot do that and be credible to the public.

The Conservative Opposition are all over the place when it comes to the health service and, as ever, the Liberal Democrats are irrelevant. Unless hon. Members stand up and say that the hon. Member for Rutland and Melton is wrong to suggest charging people to visit GPs and to go to hospital, and to suggest getting more and more public money to subsidise further private medicine, they will be damned for ever as the enemies, not the friends, of the NHS--with the occasional honourable exception.

6.39 pm

Mr. John Horam (Orpington): For once, I am grateful to the Secretary of State because he has spared the House what Conservative Members call the Dobson rant: that is

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a wholly partial diatribe about the mystical or mythical behaviour of the Conservatives during the past 30 years or so, buttressed by some partial facts and colourful epithets. On this occasion, he actually talked about the subject in hand, unlike his introduction of the Health Bill, when he barely considered the Bill. Today, he was rather more positive, although he gave us a rather partial and highly complacent view of the national health service in London.

It is my job to introduce a little reality to the debate. Although there are always some worthwhile things going on in the health service in London--I have no doubt about that--there is much that is not good from the point of view of our constituents and of patients. There is much that is actually deteriorating--for example, in relation to waiting lists. As we all know, waiting lists are one of the Government's central targets. However, formal waiting lists have gone up since the general election and have only now gone back to what they were at that time. In my area, Bromley has a most efficient national health service trust which does a good job for its patients--in referring to that I am being extremely fair to the Secretary of State--but even there the number of people on the waiting list is still more than 6,000, as it was at the general election.

That change is nothing like the 30 per cent. mentioned by the hon. Member for Ilford, South (Mr. Gapes) for his area; in fact, the change is less than 4 per cent. since the general election. The problem is that the number of people on the waiting list for the waiting list has increased; it has gone up by about 250,000 countrywide and has certainly increased substantially in Bromley. Furthermore, more operations are cancelled than previously; five operations a day have been routinely cancelled during the past few weeks. One day, more than 50 per cent. of operations were cancelled. Bromley used to take great pride in its operations service; it can no longer do so--not, of course, as a result of the actions of the consultants, the nurses and so on, who do the best they can, but because of the situation created by the Government.

The problem is not only the waiting times per se for ordinary surgery, but the fact that the waiting time for admission to a bed via the accident and emergency department is now the longest ever recorded in Bromley. As my hon. Friend the Member for Uxbridge (Mr. Randall) pointed out, in his notably fair-minded and humorous speech, that is one of the tests that we must consider--the number of people on the waiting list and the time it takes for them to be seen.

Last winter, the accident and emergency service was a disaster in Bromley; on 44 per cent. of days in December, January and February restrictions were placed on admissions to the A and E department. There were delays in admitting patients to the department on 80 per cent. of the days. I am sure that Labour Members are well aware that, in their own constituencies, there were figures similar to those for that efficient NHS service in Bromley.

There were some distressing cases; for example, an 87-year-old lady with cardiovascular problems had to wait more than 20 hours. I will not refer to such examples at length, because we are all familiar with such events. However, they should not occur; even the Bromley community health council--our local health watchdog--stated that such cases should not happen. However, last winter they happened in the NHS in London. Why did they happen? Some reasons are not under the control of the Government. I accept that winters vary in their

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severity, and, accordingly, the demand on services is greater or less, and that last winter was not a particularly good one.

However, some things are under the Government's control--one of which is how they handle the money that they allocate to the NHS to deal with winter emergencies. For example, in the case of Bromley, the problem was made much worse because the money to deal with those winter pressures did not arrive until December. I ask hon. Members to imagine that. When does the Secretary of State think that winter starts? As a result, there was no possibility of real planning for the winter emergencies. How could one expect to recruit staff at a moment's notice to deal with acute problems when one did not know until December how much money would be received?

Those are the sort of problems that we had to face. The fact is that the Government were incompetent in the way that they handed out the money--never mind the amount, although that was too small, as the chairman of the health authority pointed out.

The subject of the London ambulance service was raised by my hon. Friend the Member for Rutland and Melton (Mr. Duncan), and I hope that the Minister will mention it when she winds up the debate. The great breakthrough in improving efficiency and performance and achieving targets came when ambulance services throughout the country achieved trust status. As a consequence of that, many ambulance services--Staffordshire, Essex and Kent, to name but a few--became excellent services, performing extremely well and meeting all their eight and 14-minute targets.

The London ambulance service has lagged behind, but, as a consequence of measures that the Conservative Government put in hand, its performance had been steadily improving, year after year. However, it has now collapsed all over again, and we read in the Evening Standard that only two out of five ambulances arrive within eight minutes--the target is being only 40 per cent. achieved. Why is that?

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