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Mr. Deputy Speaker (Mr. Michael Lord): Order. Before I call the next speaker, I must inform the House that many hon. Members are still seeking to catch my eye. Unless speeches are considerably shorter, several of them will be disappointed.
5.58 pm
Mrs. Marion Roe (Broxbourne): I congratulate the Secretary of State on his announcement concerning meningitis, which is very good news. I congratulate all those associated with the initiative.
It is with a sense of enormous sadness that I have watched the decline in the standards of health care provision in Britain since the Labour Government and the Secretary of State took control in 1997. I believe in a national health service and in the magnificent work of our doctors, nurses and other health professionals in the face of huge difficulties that have been generated by this Labour Government's policies.
My principal interest is in primary care. I have watched with pride over 14 years the innovative developments in practices in my constituency which have improved the quality and efficiency of their services.
I fully endorse the points that my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) made about fundholding. I watched with pleasure as clinics were established by fundholders in local surgeries to provide convenient local and cost-effective care for the local population. They developed day-surgery clinics, cutting waiting times for surgical procedures. They employed medical professionals such as counsellors to reduce the demands on the mental health services. Since 1997, I have seen those clinics systematically destroyed as a result of the Government's reforms.
The Government seem to spurn innovation and entrepreneurialism. They seem to be working to the lowest common denominator in medicine. They fail to
realise that all developments in medicine have always depended on the introduction of ideas in individual pioneering units, rolled out to all for the greater good. The current primary care reforms, corralling and coercing doctors into arbitrary groups and forcing them to work to confusing agendas in disparate environments, deride and destroy the progress that Conservative Governments for so long fostered and nurtured. Those groups, often working to impossibly tight budgets, are being forced to close those clinics and services as a niggardly cost-cutting exercise. The result is less good, less convenient services.
The doctors are being forced to act as Government hit-men, rationing services while the Secretary of State denies that rationing even exists. Indeed, he is setting up the National Institute for Clinical Excellence to intervene in the clinical care provided by doctors by imposing dubious guidelines and applying professional and financial pressures to force the withholding of some types of care. The Secretary of State has certainly caused chaos with Viagra, leaving practitioners unsure how to manage the often serious symptoms for which it is available.
The service will deteriorate further as other new drugs, possibly with life-saving actions, are allocated to patients arbitrarily by a Minister who seems more interested in named diseases and financial constraints than in the distress and morbidity resulting from the illnesses from which patients suffer.
I watch with sorrow as the primary care groups take clinicians out of their surgeries to try to manage the unmanageable. Half a million consultations a month are stolen from the system by their absence to attend committees. Half a million patients a month are deprived of their own doctor and are forced either to wait or to obtain medical advice from other practitioners in whom they may not have as much confidence.
I watch with sorrow as primary care is fragmented by this gung-ho Government, who are introducing NHS Direct and walk-in centres without proper evaluation, putting dogmatism before realism. Why can the royal colleges, the British Medical Association and the profession as a whole all see what the Government fail to see--that these new and gimmicky services will fuel demand, diluting care and consuming enormous financial resources? Worse, to use the words of Dr. John Chisholm, the BMA's general practice committee chairman,
Mrs. Roe:
I take the hon. Gentleman's point, but the doctors to whom I have spoken feel that the freedom and flexibility that they had as fundholders gave a much better
I am saddened to see the British Medical Association so concerned by the Labour Government's changes. Last week in Belfast, Dr. Ian Bogle, BMA council chairman, made an unprecedented attack on the Prime Minister. He pointed out that morale in the health service had never been so low. He offered mock congratulations to the Prime Minister on managing to alienate the whole medical profession. He attacked the Prime Minister's personal style of "spin and grin".
In my constituency, I have never had so many complaints. It is surrounded by deterioration in local hospital services. My constituents have access to three hospitals--the Chase Farm hospital in Enfield to the south, the Queen Elizabeth II hospital in Welwyn Garden City to the west and the Princess Alexandra hospital in Harlow to the east. All are faced with downgrading, closures and service reductions born out of financial stringencies and staff shortages. Up to 50 beds will go at the Princess Alexandra; the Queen Elizabeth II faces a merger with the Lister hospital at Stevenage with the loss of some of its key services; and the Chase Farm hospital has already been merged with Barnet general and, I believe, now faces a declining future.
Many of my constituents are infuriated by a Government who claim to be bountiful while cutting and cutting service after service. In the past 24 hours, I have received several tragic letters from constituents. One was about a frail, elderly and sick lady suffering an appallingly long wait in hospital with nursing and medical shortages, defective equipment and not even any refreshments.
I am hugely concerned about the future security of my local breast disease service, threatened with relocation in an inappropriate merger with another hospital.
Another constituent, a frail, elderly gentleman, experienced a five-and-a-half hour wait for an ambulance to take him home, resulting in his not arriving until late at night, long after his carer had left. If it had not been for the good will of the carer, who returned to help him to bed, he might have had to face a night in his wheelchair.
The Government have ridden roughshod over the health professions, imposing change of dubious benefit and doubtful efficacy. The real success, the jewel in the crown, are the health professionals, who have risen to meet this folly with dedication and vigour, challenging the steady deterioration in service with ever more commitment in time and energy.
I do not believe that this can go on. The Government must realise that they cannot expect dedicated health professionals to bail out unworkable and nonsensical policies. They must remove the coercion to join primary care groups. If they are so good, why are they compulsory? They should reconsider the roll-out of NHS Direct and walk-in centres until proper evaluations have been carried out and the results have been submitted to public scrutiny, and they must realise that GPs cannot subsidise in time and money the management of our vital service. Only then will our NHS start to recover from the ill-conceived and chaotic policies of this Labour Government.
6.8 pm
Dr. Howard Stoate (Dartford):
No one seems to have a good word to say for the national health service these days, so it behoves me, as one of the very few medically qualified Members of the House who still does a certain amount of practice, to answer some of the points that have been raised.
Mrs. Virginia Bottomley:
Is the hon. Gentleman the Minister?
Dr. Stoate:
In answer to the right hon. Lady's question from a sedentary position, I do have the right to answer the debate, even though I am not winding up for the Government. I still feel that I have arguments to make in answer to points that Labour Members and Opposition Members have raised in the debate so far.
Dr. Stoate:
I shall give way in a minute.
"the Government could casually destroy or weaken our model of general practice."
Dr. Brand:
We may be getting slightly carried away by dogma. Does the hon. Lady accept that single-practice fundholding was extremely costly on doctors' time, as they had to negotiate with every clinical department of every hospital with which they negotiated? Does she agree that the setting up of consortiums of fundholders was a great improvement? There is no reason why primary care groups cannot carry forward that effectiveness. It is up to the ex-fundholders to get stuck in to the new system and make it work instead of slagging it off.
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