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7.42 pm

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): I congratulate the hon. Member for Guildford (Mr. St. Aubyn) on securing tonight's debate on NHS provision in west Surrey.

Conservative Members are doing the national health service and those working in it a great disservice by continually criticising those who tirelessly and on a daily basis work hard for their communities. Just to put the record straight, let me take the opportunity to thank everyone in the NHS, including those in west Surrey, on behalf of the House for their tremendous work over the winter period. They coped with extra pressure due to flu and the extended holiday over Christmas and the millennium. That needed to be put on record.

The Government are committed to a high-quality NHS wherever our citizens live. Our principle is that the very best should be available to everyone. The previous Government did their very best to dismantle and erode that principle.

Tonight's debate is about west Surrey, but I cannot reply without at least in part drawing on the national picture. In 1997, we inherited a disgraceful state of affairs. There were record waiting lists, which were rising, and debts were being built up year after year. Nationally, they amounted to £450 million and a £20 million deficit had built up in west Surrey. The number of nurses training had been cut and investment in building was the lowest in 10 years. The system set doctor against doctor and hospital against hospital and the pay system was archaic and inflexible.

Mrs. Virginia Bottomley: If the hon. Lady is right, having praised NHS staff, why is she now challenging their credibility? I have here letters from doctors throughout the area saying that waiting times have increased dramatically since her party came to power. It has shut 111 beds and there are more than 300 nurse vacancies. If the situation was so bad and is now so good, why should all those doctors be writing with such strong feelings and why have we had unprecedented numbers of complaints from patients and their families who are in despair?

Ms Stuart: If the right hon. Lady would care to listen to the rest of my speech, I will answer some of her questions. She has on previous occasions raised individual cases in the House and I have invited her formally to follow up those cases, but she has not written to me. Similarly, accusations were made earlier about waiting times in casualty departments of four to five days. If that has happened, perhaps she would do me the courtesy of writing to me about such cases.

Mrs. Bottomley: On a point of order, Mr. Deputy Speaker. I gave the Secretary of State for Health the details of those cases when I met him before Christmas--

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. The right hon. Lady knows that that is a point of debate. This is a half-hour Adjournment debate raised by the hon. Member for Guildford (Mr. St. Aubyn) about a specific matter relating to his constituency and everyone would do better to direct their thoughts and words to that subject.

Ms Stuart: Thank you, Mr. Deputy Speaker. Things are starting to change after the disgraceful situation that

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we inherited. Investment in accident and emergency has increased, waiting lists are lower than they were in 1997 and falling. Waiting times will improve. We have seen the highest level of nurse recruitment and an expansion in the role played by nurses. More money has been made available for suspected cancer patients and cardiac patients. We have a 10-year programme.

Great concern has been expressed forcefully tonight by hon. Members about the situation in west Surrey. West Surrey health authority has spent more than its allocation. It had to be bailed out two years ago when it ran up a huge deficit to the tune of £18 million, and that has to be repaid because this Government are interested in a sustainable and long-term investment.

The current funding allocation for West Surrey health authority for 1999-2000--the hon. Member for Guildford said that he wanted a fair system--is £371 million, which is a cash increase of £19.3 million, or 5.48 per cent. That is £8.5 million, or 2.35 per cent., more than the fair share target. The allocation per weighted head of population in west Surrey is £643, but the national average in England is £629. For 2000-01, the south-east region will receive £5.4 billion and west Surrey will receive £394 million, which is a cash increase of £23.2 million or 6.2 per cent.

Mr. St. Aubyn: Does the Minister understand that all those weighted figures go back to the same flawed formula that said that Surrey was overspending when it was simply meeting core health needs? Does she further understand that by demanding back that £18 million she has not put any new money into the system?

Ms Stuart: Conservative Members continually call for more money for their constituents, but do not vote for more money for the NHS and they call our proposals to increase cash for the NHS reckless. We want long-term, decent investment in the health service. I fully agree that future allocations should be fairer, but they must be fair for everyone.

We are reviewing the weighted capitation formula because we want it to be fairer, but it must provide for the NHS of the future. At the moment, the review is at an early stage and further changes are frozen until 2002 because we want some stability and certainty in the system. Even with the generous funding for west Surrey, change is still needed. Conservative Members portray the situation as driven simply by financial needs, but that is not the case. We expect the health authority to fulfil its statutory duty to live within its means, but other changes need to be made in west Surrey to bring the service up to date, and to take into account changes in medical practice, technology and the training needs of doctors

The health authority needs to live within its means and changes are needed to achieve that quickly. That means some hard choices, because west Surrey deserves a service that is modern, sustainable and affordable and that meets the needs of the people of west Surrey. A number of proposed changes are in hand.

Mr. St. Aubyn: Will the Minister say on which of the nine cases that I described there has been overspending?

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Ms Stuart: Changes in the service structure have to be made to deal with such matters. West Surrey does not have a sustainable health economy. Consultation on some of the long-term changes is already complete. I have taken careful note of the objections made by the community health council to the changes at the Ashford hospital and at St. Peter's hospital, and an announcement will be made soon.

I see that the right hon. Member for South-West Surrey (Mrs. Bottomley) has a copy of the document "Ensuring a Sustainable NHS--Phase II". That document asks for comments, and I hope that all hon. Members affected by the consultation process will respond. We are also in the process of setting up an independent advisory panel, which will help to ensure local consensus on the changes.

Somehow, the good news seems to escape the consciousness radar of Conservative Members. I shall describe some of the investment that has been made in west Surrey. Between June 1997 and October 1999, the number of day cases and the in-patient waiting list fell by 13 per cent. Between 1996 and 1999, there was a 21 per cent. increase in the number of out-patients attended to. An extra £3 million was devoted to reducing in-patient and day cases. A further £351,000 has already been spent to reduce out-patient waiting times, and £1.2 million has been invested in local accident and emergency departments. The Royal Surrey hospital received £276,000 for a new admissions unit.

Those changes in the provision were necessary to achieve a sustainable health service. Frimley Park hospital received more than £500,000 for new X-ray and IT equipment. The Ashford, St. Peter's and Frimley Park hospitals, in conjunction with local GPs, took part in one of the pilot projects for on-the-spot booking. Under that system, when patients visit out-patient clinics, doctors are able to book dates for operations. In addition, GPs are able to make out-patient appointments, with the result that dates are arranged to suit the convenience of patients.

A new primary care centre serving Weybridge and Woking is now operational. Investment of about £4 million has been made in health centre facilities and community hospital services. A pilot for a primary care walk-in centre is being developed in Weybridge, and NHS Direct is already available in south-west Surrey. Conservative Members smile at NHS Direct, but it has had a huge impact in the area.

Mr. St. Aubyn: The core of the NHS are the acute and nursing services. Will the Minister address the question of how they are being decimated in the area?

Ms Stuart: Fundamental changes have to be made to the health economy. We are putting in extra money to accomplish those changes. Claims that west Surrey never gets the extra money that it applies for are not substantiated, as the list that I have given proves. Hospitals have made tremendous progress in recruiting nurses. The previous Administration slashed the numbers of nurses in training. We are providing extra training places and recruiting extra nurses.

Eighteen months ago, the vacancy factor at the Royal Surrey hospital was 17 per cent., which meant that the hospital was lacking 310 qualified nurses. By next month, the factor will have fallen to 10 per cent. That huge

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improvement must be recognised. At its recent open day, the hospital recruited another 11 nurses who wanted to return to work.

Social services spending in Surrey has increased by 4.9 per cent., compared with a national average of 4.4 per cent. The claim that west Surrey does not get its fair share of money simply does not stand up when we look at the figures.

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I should like to take up the hon. Gentleman's invitation to come to west Surrey. I know that accusations have been made in the House that Ministers never visit west Surrey, but I am very happy to do so. More to the point, I thought that it was very fitting to choose St. Valentine's day, 14 February, to visit the hon. Gentleman's constituency.

Question put and agreed to.

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