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9.15 pm

Dr. Howard Stoate (Dartford): I have listened to the debate with great attention and interest as this subject is dear to my heart. I am one of only two general practitioners who are Members of the House; the other, who is sitting opposite me, is listening closely as well.

The Opposition have played their usual tricks, which has rather disappointed me. I was hoping for an intelligent and adult debate, as billed by the Opposition spokesman, but unfortunately his words did not match his intentions and what we heard from them was not intelligent or enlightening discussion but a series of tricks to run down the NHS, demoralise staff and frighten patients into believing that the NHS is falling apart around their ears.

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The truth is exactly the opposite. I am becoming well versed in parliamentary ways, and I was afraid that that might happen, so I took the precaution of phoning around my health authority, my trust and my local primary care group yesterday and today to find out exactly what is happening in my patch, which is in the West Kent health authority area. It is not noted for its left-wing leanings or views and, in the main, is represented by Conservative Members, so the allegation that the Government are rigging the NHS in favour of Labour-controlled areas is nonsense. I shall give examples to back that up.

My local hospital told me that its waiting list stood at 4,395 on 31 March 1998. By 30 September 1999, the figure was 3,429, which is a 22 per cent. decrease, with no patients waiting more than 18 months and all Department of Health targets being met.

I asked about recruitment, which is often mentioned.

Mr. Brady: Will the hon. Gentleman give way?

Dr. Stoate: I am afraid that I do not have time. I have a lot to get through and, unfortunately, only 10 minutes in which to do it.

I was told that there was no problem in recruiting junior doctors and that consultant posts are generally well filled, apart from one in radiology. There is a national shortage of radiologists and the problem is being addressed by the trust as that post is currently covered by a locum. The trust is short of 70 nurses and has planned a recruitment drive for the new year, but it told me that that figure is considerably better than it was.

Today, West Kent health authority has published its annual report, which is entitled "West Kent's Health" and headlined "A Healthier West Kent". The area contains places such as Sevenoaks, Tunbridge Wells and Maidstone, which are not represented by Labour Members. Nevertheless, it is doing extremely well in terms of health care. I shall give an example from the document, which was sent to me this morning, concerning winter pressures. Time and again, we have heard that the health service is about to fall apart and that it disintegrates when winter comes on, but last year


That is all well and good, but did it work?

The document says:


That was during a so-called winter crisis. Obviously, the health authority coped very well indeed.

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I contacted Dr. Alasdair Thomson--

Dr. Brand: Will the hon. Gentleman give way?

Dr. Stoate: Unfortunately, I do not have time.

Dr. Brand: On that point.

Dr. Stoate: Very well; I give way.

Dr. Brand: I believe that interventions are treated as injury time in these debates. Was the winter pressures money not a one-off arrangement, and does the hon. Gentleman agree that it is sad that there can be no consistent planning in the NHS? These schemes ought to be learned from and incorporated in the proper delivery of service.

Dr. Stoate: In answer to the hon. Gentleman, I shall continue to quote the article. It says that this winter


That is not my document, but a West Kent health authority document.

As I was saying, I contacted the chairman of my local primary health care group, Dr Alasdair Thomson, a GP in my constituency, about what the group was doing to progress to primary care trust status. A ballot has just been held and 116 ballot papers were sent to GPs in the area; 72.4 per cent. responded and 69 per cent. of those who voted, voted yes. That was an overwhelming majority in favour of proceeding to primary care trust status as soon as possible. Public consultation will begin next week and continue until January.

The group has also started partnership working in many areas, including mental health, and a new psychiatric unit will open in January in my constituency. It has also joined the partnership in action scheme, involving health, social services and user groups of mental health services, radically to improve mental health services in my patch. It is developing clinical pathways with consultants, the idea being that GPs will be able to carry out more investigations more quickly, thereby reducing the number of people passed on to consultants, which in turn will reduce waiting lists and waiting times to see specialists. That is all good, innovative stuff coming out of a primary care group that wants to become a primary care trust as soon as possible.

However, not everything in the health service is perfect. Many hon. Members have made some valuable points about the difficulties. I wish to raise a number of issues about what we can do to improve the health service yet further. Of course, the health service needs more money, and I am sure that the ministerial team will work hard with the Chancellor to free up resources for it as money becomes available in the economy.

Naturally, we must continue to increase efficiency in the health service. Will the Minister say how the Government are getting on with their task of cutting red tape and the money spent on bureaucracy? We must make best use of resources, ensuring that every penny is spent to best effect. That means cost-effectiveness as well as clinical effectiveness. It means looking at clinical outcomes to ensure that best practice is available everywhere, every time. We must also ensure that we get

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best value from goods and services. I am alarmed by the rise in the cost of generic drugs due to shortages and difficulties in obtaining them, and I am pleased that my colleagues on the Health Committee have agreed with my suggestion to meet to discuss that issue next week to see what we can do to improve the supply of generic drugs so that primary care groups do not overspend their budgets because of the unavailability of drugs.

We must also make best use of expertise in the health service. I am particularly concerned that community pharmacists are an under-used resource. They are highly trained and qualified and have much to offer. If there are extra winter pressures--for example, because of respiratory infections or flu--who better than community pharmacists to give good, sensible general advice and symptomatic treatment to people suffering from unpleasant, but generally not life-threatening conditions? That would free up clinicians, doctors and nurses to treat people who really need medical and nursing help and the few who may need hospital treatment. I am working with the hon. Member for Richmond Park (Dr. Tonge) to try to set up an all-party pharmacists group in this House. It will look at exactly that issue and try to raise awareness of how community pharmacists could be used to best effect within the health service.

Factors outside the health service can also affect health. We have already heard tonight that public health is a huge issue. It is not just about the NHS but includes many other aspects of society as we seek to improve the nation's health. We have heard about the smoking epidemic and the fact that every five minutes someone in this country dies from a smoking-related illness. We are beginning to find out that children are becoming fatter and less active because their diets do not necessarily suit them, and they are storing up the possibility of ill health in later life. That must be tackled. We must ensure that exercise programmes are geared to young people in schools so that they achieve maximum fitness.

We have heard that poor health is closely related to poverty, social circumstances, life chances and poor education. I know that the new Minister responsible for public health is working hard on that. All the different strands of government should be brought together to ensure that health is a matter not just for the health service but for the whole Government.

I believe that the NHS is under healthy pressure. Pressure is often a dynamic force for change. If properly harnessed, that pressure can be the driving engine of meaningful change, because we must respond to changing needs in society, changing expectations and the fact that people rightly expect more from the health service. They are entitled to more from the health service and, under this Government, they will get more from the health service.


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