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5.43 pm
Mr. Eric Illsley (Barnsley, Central): I welcome the Secretary of State's statement about meningitis. I, too, would have liked a separate statement about that issue as I wanted to question my right hon. Friend about the age ranges for which the vaccine will be available. When my hon. Friend the Minister of State winds up the debate, perhaps he will confirm whether the vaccine will be made available to students in halls of residence throughout the country where meningitis has been a problem.
I agreed wholeheartedly with the comments of my hon. Friend the Member for Wakefield (Mr. Hinchliffe)--except his remarks about the right hon. Member for Maidstone and The Weald (Miss Widdecombe). I agreed with my hon. Friend's views about policy, so I shall confine my remarks mainly to constituency points.
Before I do so, however, I want to take issue with the right hon. and learned Member for Rushcliffe (Mr. Clarke), who refused to accept that the introduction of fundholding resulted in a two-tier system. A few years ago, under the previous Government, the Central Sheffield University Hospitals NHS trust told all GPs in the South Yorkshire area, "We shall not accept any patients who are not from fundholding practices." When I took that up with the trust, it said that the reason for its decision was that fundholding practices' patients came with the money up front, whereas health authority patients did not, and the trust's perilous state at the time--it was, among other things, 9 per cent. over budget--meant that it could not afford to take anyone who did not come with the money in their hand, as it were.
Before I move on to my constituency points, I want also to deal with rationing, which is mentioned in the Opposition motion. As other hon. Members have pointed out, that motion, which claims that the system is deteriorating, is remarkably poor. Rationing existed under the previous Government to a large degree, but previous Secretaries of State refused to admit that.
Mr. Hammond:
Does the hon. Gentleman believe that rationing exists under the present Government?
Mr. Illsley:
I believe that rationing has existed in the national health service since it was formed. It is obvious that if there is an increasing demand for services and an increasing number of people want access to the system, the strains on the system will lead to some form of rationing. I disagree with the Opposition's accusation that
Consultants in my area had to hope that GPs would prescribe to their patients the drugs that they wanted to prescribe because hospital trusts would not allow consultants to prescribe those drugs from the hospital's budget. I can quote chapter and verse on that matter because for many years my daughter was prescribed an expensive drug simply because we have a good, sympathetic general practitioner.
Some of the comments of Conservative Members about bureaucracy beggar belief. The previous Government introduced bureaucracy into the national health service by increasing management to the point where a previous Secretary of State had to remove 3 per cent. of the management staff who had been introduced because they cost too much.
There have been improvements in the national health service under this Government. For a start, there is the extra funding that is mentioned in the Prime Minister's amendment. That is a clear example of Labour's commitment to the NHS.
On funding, Barnsley health authority in my area has traditionally been the lowest-funded health authority in the country. We have been at the bottom of the list for a long time. Similarly, we were at the bottom of the list for the revenue support grant. When we queried our status with the previous Government, we received the scientific response, "Someone has to be at the bottom of the list, so why can't it be you?" There was no explanation of why the funding formula always discriminated against us when we had, and still have, some of the worst health indicators in the country.
I am pleased to say that under this Government my health authority received a funding increase of 7.85 per cent. this year, which is one of the highest increases for any health authority. That is very welcome. However, we still have considerable problems, one or two of which I shall outline, and we are still one of the lowest-funded health authorities.
Some colleagues and I recently attended a meeting with the Trent area health authorities and were shown a presentation in which almost every slide or indicator from the Trent region placed my health authority in the worst position and revealed problems with, among other things, coronary care and so on.
Mr. Jeff Ennis (Barnsley, East and Mexborough):
Mortality rates.
Mr. Illsley:
I shall deal with those in a moment.
Every indicator that is highlighted by health authorities in the Trent region points to our authority being the worst, yet our funding does not allow us to tackle the problems.
Traditionally, my area has high levels of disability. It is a former coal mining area--sadly, the previous Government decided to close the mines--and we have a legacy of problems from such heavy industry. There is a high incidence of disability, coronary disease, stroke and cancer, most of which relate to poor life style, diet, and so forth as a result of living in a poor and economically disadvantaged area. This Government have recognised that: they have introduced health action zones and I am
pleased to say that South Yorkshire is one such zone. The incidence of heart disease and stroke in particular will be dealt with, I hope, and we will see an improvement.
The standard mortality ratio in the Barnsley health authority area is the worst in the country. Apart from the incidence of heart disease, stroke and so on, I am not sure why, but it is a cause for concern. When the figure is broken down by ward, the difference between the highest and lowest is very small. In other words, no area covered by Barnsley health authority is good or bad; the figure is simply bad throughout. That needs to be tackled. I hope that the regional health authority and my hon. Friend the Minister will consider the matter for the future because in an area that has a history of heavy industry and which wants to regenerate and improve itself economically, such figures are not conducive to people settling.
Another recent indicator that caused concern is that for the prescription of anti-depressants, where again--and I am not sure why--our area is the worst in the country. I do not know whether it is simply a question of GPs prescribing such drugs to get people out of their surgeries, but it should be addressed. I was encouraged recently to hear that the new GP-led primary care group has appointed a GP from within the group to tackle the issue among GPs themselves. That GP can go to the worst offenders and find out why they are prescribing so many anti-depressants and whether their practices--either previous fundholding or single-handed GP practices--are up to scratch. The history of prescribing in my area may not be as good as it should be. Now that we have a PCG, we are able to address that.
For some reason, the highest number of deaths--albeit a low number--from breast cancer occurs in my area. Neither the health authority nor Trent executive region can identify the reason why--nobody knows. Some time ago, I went to the opening of the breast cancer unit in Barnsley district general hospital. It is a superb facility--nicely decorated and situated, and established to make patients feel comfortable and to encourage them to come forward with breast cancer problems and related issues. The unit is excellent, but no one can explain why we have the highest rate of deaths from breast cancer. Nobody has been able to identify whether it is because people are not coming forward early enough or at all.
There is a shortage of GPs in our area. Several are due to retire in the not-too-distant future, but we are not attracting people to replace them, so we may soon have a crisis in such provision. Also, for some reason, we have a large number of single-handed general practices. In fact, the primary care group GP who represents them is responsible for 148,000 patients in the Barnsley area, which appears to be a very high number. Perhaps that too ought to be addressed.
In Barnsley, waiting lists for two types of treatment are far too long. People must wait three years to see a consultant orthodontist. All concerned have acknowledged that, but no one appears to be doing anything about it. I would welcome the comments of my hon. Friend the Minister on whether the matter can be addressed.
Second only to one or two areas in the north-east and Northern Ireland, Barnsley has the highest rate of coronary heart disease in the country, yet patients must wait up to nine months for an angiogram. In one case,
which was referred to me recently and is a cause for concern, a man aged 38 was required to wait nine months. He decided to obtain the angiogram privately, at quite some cost, only to find that he needed quadruple heart bypass surgery. He is fearful that, had he not taken the option of private treatment, he might not still be alive.
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