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The Minister of State, Department of Health (Mr. John Denham): That is stupid.
Mr. Webb: The Minister says that that is stupid, but we must be clear whether the Government's declared new priorities are to be funded at the expense of other parts of the NHS, or whether new money, over and above the amount that had already been announced when the new Secretary of State took his post, has been found. If it has not, the less headline-grabbing, glamorous priorities will be left aside.
What do my constituents have in common? What about my 81-year-old constituent about whom the GP from Yate wrote, or Mrs. Aze, who is nearly 70 years old? Are elderly people who need routine operations such as hip operations to be forced to wait for years and, in the words of Mrs. Aze, left to become a cripple?
This debate is about out-patient waiting times in Avon, not just orthopaedic services; there are many more horror stories. I plead with the Minister to spare us from bombardment by a raft of statistics on all the money that is being invested in the NHS. We have heard it all before. My constituents hear it on the television time and again, and write to me asking, "What do these people know?" We are told that waiting times are falling, but I receive letters about 70 or 100-week waits, and about how my constituents must either take a year and a half off work or wait two years at the age of 70 or 80 for treatment. Such matters need urgent attention.
My plea is for the Minister to accept that the buck stops with him. The trust has been investigated several times by the Government and various departments, but its consultants are working their socks off. There is no suggestion that they are not pulling their weight. Indeed, the trust chief executive suggests that some may be working too hard.
The Minister of State, Department of Health (Mr. John Denham):
I congratulate the hon. Member for Northavon (Mr. Webb) on securing a debate on a subject of great importance to his constituents. I shall cover the Government's overall waiting list policy, and the measures that we are taking nationally to improve patient access to NHS services, and then look at the level of Government investment in both the national health service nationally and the Avon health authority, and the measures that are being taken in Avon to reduce the number of patients who are waiting longer than 13 weeks to see a consultant.
It is important to say at the outset that I recognise, as everybody does, that waiting a long time to see a consultant is distressing and worrying for patients and their families, particularly if people are in pain. That is why we as a Government are committed to tackling out-patient waiting times. As the constituency cases that the hon. Gentleman brought to the attention of the House make clear, Avon health authority has major problems with long out-patient waits in certain specialties. Considerable effort will have to be made to address that
problem. In fairness, it is important to emphasise that the extremely long waiting times that he raised are the exception. The average first out-patient appointment waiting time is the same as that in Avon health authority: seven weeks.
Waiting times and lists are a key concern of NHS patients, which we recognise. In modernising the NHS, we are determined to make access to services faster and more convenient. We are committed to reducing both the number of people waiting and the time that they wait. We are working to improve access for all NHS users.
We are also introducing important, special measures for patients for whom rapid access to the NHS is vital, such as those who are suspected of suffering from one of the big killers of modern times--cancer. The new focus on diseases such as cancer and coronary heart disease that my right hon. Friend the Secretary of State announced is within the context of achieving our targets for waiting lists and waiting times. It is not an alternative.
Yes, of course all that we do in the NHS is funded by the resources that we make available to it, including the additional £21 billion investment. However, it is right for us to set our overall aims--as we have very clearly on waiting lists--and, within that, to make clear our targets.
It was disappointing that the hon. Gentleman had nothing to say about the hard work of staff in Avon. As he will know, we have already instituted a two-week wait for patients who are referred urgently with suspected breast cancer. The Avon health community has responded marvellously to the challenge of meeting the breast cancer waiting targets. The whole health community can be proud of the out-patient waiting list. In the first quarter of this year, 100 per cent of patients were seen by a consultant within two weeks when the urgent referral was received from the GP within 24 hours.
The hon. Gentleman would have painted a fairer picture of the work of staff in Avon health community had he referred to that considerable success. The staff are excellent, and I am sure that, when the two-week wait for urgent referrals is extended to cover all cancers next year, Avon will once again be among the leaders in achieving that standard.
We have tackled in-patient waiting lists: the list has fallen by 200,000 over the past year, and is now 69,000 below the level of March 1997. We are on track to achieve our manifesto commitment to reduce waiting lists by 100,000 from the level that we inherited.
This year, we are applying the same determination and good practice to reducing waiting times for out-patients. Last year, NHS trusts saw 175,000 new out-patients. This year, we expect the NHS to see more than a third of a million more new out-patients. That will mean that, in 1990-2000, more than 11 million new out-patients will be seen--for the first time in the history of the NHS.
In September, following a top-level meeting with NHS staff and Health Ministers, the Prime Minister announced a package of measures to tackle out-patient waiting times, including a £30 million boost to out-patient services, tough new monitoring of performance and the extension of the booked admissions programme.
Money from the £30 million waiting lists and times performance fund will go directly to the NHS to help tackle out-patient waiting times. It will allow the NHS to focus on tackling problems locally, providing additional
out-patient clinics, employing additional staff and investing in new medical equipment. It will also help to fund sustainable solutions, modernising out-patient services and access to the NHS.
The national patients access team, which this Government established, is in the lead in taking forward such initiatives. It is providing intensive programme management for the booked admissions programme, and runs a visit programme to advise trusts and health authorities on how to reduce waiting lists and times and ensure widespread adoption of best practice. I understand that NPAT visited North Bristol NHS trust and made several suggestions, which the trust is beginning to implement. It is also assisting in the review of orthopaedic services across Avon.
The booked admissions programme is part of the Government's on-going commitment to modernise the health service, to make it more dependable, and to enable the NHS of the future to provide immediate access to dependable health advice, same-day testing and diagnosis, and prompt and convenient access to care and treatment.
We announced the first wave of 24 booked admissions pilot schemes in September 1998, with an investment of £5 million. A further £20 million is being invested this year in a significant expansion of the programme. The Royal United hospital in Bath was one of the hospitals in that first wave, and has received an NHS beacon award for the excellence of its pilot scheme.
In September, the Prime Minister announced a further 60 new pilot sites, taking the total number of people benefiting from the programme to 2 million. Three of those schemes are in Avon--at the Weston Area NHS trust, the North Bristol NHS trust and the Royal United Hospital Bath NHS trust. Since that announcement by the Prime Minister, the programme has been extended to cancer services in order to streamline services and minimise delays for patients with suspected or diagnosed cancer.
Cancer services in Avon, together with those in Somerset and Wiltshire, will benefit from an additional £500,000 to develop a scheme for booked admissions. That will enable patients whom their GP suspects of having cancer to receive the earliest possible appointment with a specialist. It will avoid delays between different treatments and enable care to be carefully co-ordinated.
As I mentioned, to underpin the Government's programme for the modernisation of the NHS, we are spending more than ever before on the health service. The comprehensive spending review provides £17 billion for the NHS in England over the next three years. That is the biggest cash injection in the history of the NHS.
The money is now reaching local health authorities. Avon health authority will this year receive £582.5 million--a cash increase of £36.5 million or 6.69 per cent. That gives Avon the highest level of growth in the south-west region, and includes almost £5 million from the modernisation fund specifically to target waiting lists. In addition, the health authority has received £5.6 million in targeted funding in areas such as staff recruitment and retention, mental health, cancer waiting times and nurse prescribing.
We are not neglecting the fabric of the NHS. As part of the largest capital programme in the history of the NHS, it is forecast that the total capital spend in Avon will be more than £83 million. That includes £2.64 million from
the modernisation fund to improve the accident and emergency departments at all the major acute trusts in Avon.
Unlike the hon. Gentleman, I pay tribute to the staff of the NHS in Avon, who last year treated 11,331 more elective cases than in the previous year, an increase of 11.9 per cent. They also dealt with a growth in the number of emergency admissions of 3,800 or 4.5 per cent.
However, there is no doubt that Avon's performance in certain specialties is worse than that of the NHS as a whole. I am happy to acknowledge that Health Ministers must take responsibility for what happens in the health service, but, in the delivery of services, there is a huge responsibility on everyone working in the NHS in Avon to work together to tackle the problems and bring the standards in Avon up to the levels achieved in other parts of the country. We will support Avon through the national patients access team, the finance and additional measures that I have set out and the booked admissions programme, but it is the local NHS that must deliver.
As I stated at the start of my speech, the health authority and the trusts recognise that the current position is unsatisfactory. This year, the health authority and trusts have planned to reduce substantially the number of patients waiting more than 13 weeks for an appointment. Although the problem of long waiters is common to all the major hospitals in Avon, it is most marked in the United Bristol Healthcare NHS trust and the North Bristol NHS trust.
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