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Dr. Tony Wright (Cannock Chase): I commend my right hon. Friend on his report, and I commend too all the
people whose work he has described. However, is it not the sad truth that much of the work described in the report is undermined whenever the people to whom the young look up, such as pop or sports stars, are found to be users--often conspicuous users--of the hardest of hard drugs? What can he and the Government do to proclaim the message that those who have and exercise responsibility should behave responsibly too?
Dr. Cunningham: I very much agree with my hon. Friend. As I was just saying, public figures who glamorise drug taking, or who falsely present it as a good or fashionable thing that everyone does, perform a very damaging disservice to the young people of this country. There can be no compromise on the very hard line that we have to take with such examples, which of course undermine everything that the Government and the various local agencies are trying to achieve in raising young people's awareness of the dangers that they face by getting involved in the misuse of drugs.
Recently, there has been a series of high profile cases such as my hon. Friend described. I can only say that they are very damaging to the well-being of this country's young people.
Mr. Peter L. Pike (Burnley):
I accept that my right hon. Friend rightly wants to reduce the waiting time at treatment centres, which will benefit drug users and the wider public. However, does the report identify where waiting lists are unacceptably long? In which parts of the country are the lists longer than the average to which he referred? Is priority action being taken in those areas to ensure that the health authorities and other relevant local organisations take the action needed to deal with the problem?
Dr. Cunningham:
The report does not specify those areas, but we are aware of where the problems occur, and are learning more all the time. We are therefore identifying those areas in which we must concentrate resources and activity. That is the work of the local drugs action teams, among others. As I have said, we are assessing their effectiveness. In due course, we shall produce a report on that work. My hon. Friend is right to draw attention to the fact that in some parts of the country the availability of treatment centres is inadequate. We need to work hard to improve that.
Mr. Michael Connarty (Falkirk, East):
I thank my right hon. Friend for the vigorous and determined tone of his statement, in relation to both class B and class A drugs. I know that he is a great advocate of joined-up government, and I note that with him on the Front Bench today is my hon. Friend the Member for Knowsley, North and Sefton, East (Mr. Howarth). My hon. Friend, who is Under-Secretary of State for the Home Department, will shortly be going to Colombia, where I was recently. In that country, a multinational industry has grown up in the production of cocaine and, now, of heroin, even though poppies do not grow naturally there.
Will my right hon. Friend assure the House and the country that this domestic report is linked to a determination to help the international fight against drugs? That fight is being conducted by bodies such as the anti-narcotics police in Colombia and Europol in Europe, through which new supply routes set up by the Russian
mafia bring more and more heroin and cocaine into this country, for use in the domestic market and for onward export to America.
Dr. Cunningham:
I am grateful for my hon. Friend's support. I can confirm that we are addressing those matters internationally through the United Nations and by bilateral co-operation with, for example, the United States of America in the Caribbean. My hon. Friend is right to point out that we are confronted by huge, powerful, multinational cartels determined, for their own illegal gain, to supply class A drugs to our country and to others. They show no concern for the appalling damage and consequences that will result from their action. Through the Foreign Office, the Home Office and any other body, we shall seek more effective international co-operation.
Mr. Jim Murphy (Eastwood):
On a point of order, Madam Speaker, of which I have given the hon. Member for Woodspring (Dr. Fox) notice. Scotland has a tradition of tolerance, but during Scottish questions today, the hon. Gentleman linked Scottish devolution with the balkanisation of Britain. It was a shameful soundbite, and I wonder whether you are able to invite the hon. Gentleman to withdraw it.
Madam Speaker:
Order. That is a matter of argument, not a point of order. There is nothing in it for me to resolve.
4.21 pm
Mr. David Amess (Southend, West): I beg to move,
- That leave be given to bring in a Bill to require the publication of average patient waiting times for first outpatient appointments by specialty and average patient waiting times for treatment by specialty; and for connected purposes.
Only today, an article has appeared telling us that a rising number of patients must wait more than six months to see a hospital doctor. The patients charter says that no one should face a delay of more than 26 weeks after being referred to a specialist. Yet by the end of March, 153,000 people had waited 26 weeks or more for a first consultation, and the number was up from 144,000 in the previous quarter.
My Bill is supported by my hon. Friends, who know that it is right. If any Liberal Democrats were interested in the NHS, they might have supported it too. The best that can be said of them, however, is that they like to be popular. Labour Members should also support the Bill as it meets their No. 1 priority--transparency. The Labour party is anxious to be seen to be transparent. If the Bill becomes law it will be transparent to all that the Labour Government have made an awful mess of our NHS since 1 May 1997.
The size of the waiting list is irrelevant to the patient. What matters is how long patients must wait for an operation. Patients have good reason for worrying about that. They may be in pain, or their condition may be deteriorating. A long list does not necessarily mean a long wait. Many patients could be quickly put through hospital in the days of the excellent Conservative Government, but that--sadly--happens no more.
Waiting lists are easily distorted, massaged and controlled, and we know of the Government's expertise in those areas. Waiting times to see consultants have increased, so that it takes far longer to get on a list at all. There are waiting lists for waiting lists for waiting lists. Waiting lists are also gatekeeper-controlled now. It is relatively easy to remove or recategorise patients who are on a waiting list for sound clinical reasons, but it is also easy to do so for more dubious motives.
Waiting list figures are not now comparable to those of five years ago because more stringent criteria are being applied before anyone is placed on a waiting list.
Management and direction of NHS resources based on waiting lists is a distortion of clinical need. Doctors prioritise patients according to clinical need and the urgency involved. Attempts simply to cut waiting lists for operation X, as this Government do all the time, mean that routine cases--for instance a non-life-threatening hernia operation--might be re-prioritised and performed sooner than an operation for a more serious condition.
That is why it is essential to know how long a patient waits to be seen in an out-patients department and how long it takes to be placed on a waiting list by medical or surgical specialty. It is important to know not merely the
average time, but the mode and range of waiting times. Obviously, a mathematical average can hide a variety of unpleasant surprises. If two patients are on a waiting list, one could wait 20 months and the other two. The average would be 11 months, but we have to consider the circumstances of the person who has to wait 20 months.
When in opposition, the Labour party used to wine and dine with the British Medical Association all the time. It appears that the BMA will support my Bill. It does not want people to wait for an unacceptably long time in pain and distress. It believes that waiting lists are rationing by the back door--in that, it is entirely right. Under the present system, a patient may be waiting in pain for a hip replacement in a queue behind someone with a benign and non-urgent skin condition. To meet performance targets, the patient with the non-urgent skin condition must be treated first if he or she has reached the 18-month list.
Then, of course, we have Her Majesty's Government's six fiddles on the waiting list. First, they have a subsidiary waiting list; secondly, a waiting list for the waiting list; thirdly, the withdrawal of routine operations; fourthly, prioritisation; fifthly, an administrative clean-up; and sixthly, reduced referral rates from general practitioners. That is an absolute disgrace.
I happen to have in my hand a letter. The person who wrote it will remain anonymous, but the letter mentions the specialties of general surgery, urology, orthopaedics and gynaecology. This very important person on a national health service trust writes:
I have been inundated with letters from the general public complaining about the length of time that they have to wait for operations. Mrs. X needs a heart bypass and she has an indefinite wait. Mrs. Y needs a hearing test and she has an indefinite wait. Mrs. Z needs an X-ray and she has an indefinite wait. Mr. X has a pain in the leg and he has an indefinite wait.
Mr. Sizer had an X-ray on 11 November 1997. He wrote to tell me that it was found that he had osteoarthritis. He says:
A doctor has written to me to say:
There are even two people working in the House who have told me today about their cases. One has skin cancer, the other arthritis in both knees; neither can get anything done. I hope that the whole House will support the Bill because if it becomes law, it will be clearly seen that the national health service is in crisis, and that the only people to blame are the Government. Perhaps we might get the opportunity to elect a Government, a Conservative Government, who will sort the NHS out.
"I am informed that the patient's current position on the waiting list is irrelevant. The aim of the Trust is simply to reduce the waiting list to the numbers previously agreed with the Purchasing Authority."
That just about says it all.
"I might get my operation in August 99."
That is an absolute disgrace.
"patients are waiting up to fifteen months before they are seen for the first time by a specialist and they are then put on a waiting list, where they will wait eighteen months before admission."
A Mr. Bartlam has written to me saying that in January 1998 he tore a ligament in his right shoulder. It will be more than two years from the time he suffered the injury before he is dealt with by the hospital. He writes:
"Can you imagine having excruciating pain in your shoulder together with only limited use of your left arm for 2 years?"
Finally, another doctor has written to me saying that he is attempting to treat a patient at a local hospital. The patient has been waiting about three months to date. On recent inquiries the doctor was told that the neurophysiology wait is at least 18 months and the orthopaedic wait 12 to 18 months.
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