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Knee Replacement Operations
7. Mr. Harry Cohen (Leyton and Wanstead): If he will make a statement on the number of knee replacement operations carried out in the NHS in 1998-99. [110859]
The Secretary of State for Health (Mr. Alan Milburn): According to provisional data for 1998-99, 28,876 primary knee replacement operations were carried out in national health service hospitals in England.
Mr. Cohen: I have had a letter from my constituent, Mr. Bracewell, which describes as "great news" and "a miracle" his successful knee operation. He said:
- as a Godfearing man, you will be rewarded for helping in due course.
Mr. Milburn: It was going so well until then. I am sure that my hon. Friend will receive his due reward.
I can only agree with my hon. Friend. Indeed, I cannot do anything other than agree with the Conservative central office briefing for today's Health questions, which makes very impressive reading.
Dr. Liam Fox (Woodspring):
You must be getting desperate.
Mr. Milburn:
Indeed I must be if I am reading that. The briefing states:
The Conservative central office briefing is right. That treatment should be provided according to clinical need, not ability to pay. Why does Conservative central office say one thing while those on the Conservative Front Bench say another? I know that Conservative central
office spends half its time briefing against those on the Front Bench, but I did not realise that it had taken to doing so in writing.
Mr. Graham Brady (Altrincham and Sale, West):
My constituent, Mr. James Hickson, agrees with the Secretary of State that such treatments should be provided according to clinical need. Yet six months ago, after an interminable wait under this Government to have a seriously diseased hip replaced, he was forced to go the private sector for an operation. He is without private health insurance and I have at least one other constituent who has been forced, under the Labour Government, to resort to private treatment without having insurance to pay for it.
Will the Secretary of State now recognise what is happening under his stewardship of the Department of Health and reimburse my constituents who have to pay but who have not got private health insurance?
Mr. Milburn:
The hon. Gentleman rails against private treatment for hip and knee replacements. People talk about joined-up government, but what about a bit of joined-up opposition between Conservative Back Benchers and Front Benchers? Once again, Front Benchers say one thing and Back Benchers say another, and the Conservatives' health policy is in tatters.
Mr. Barry Gardiner (Brent, North):
Will my right hon. Friend assure the House not only that the Government will eschew any suggestion that we go down the route of postcode health care provision, but that they will eschew what Conservative Members would suggest--bank sort code health care provision?
Mr. Milburn:
My hon. Friend is right. It is about time those on the Conservative Front Bench came clean. They give interviews to newspapers and to television companies, and it is the Conservatives' policy in which people are interested. Overwhelmingly, cataract, hip and knee operations are operations of old age. Older people will therefore literally pay the price of Conservative health policy. They will pay the price in a new tax on old age if the Conservatives have their way.
Conservative Members are now threatening to take a host of procedures out of the public sector, where they are free in the NHS, and instead force people to go private. That policy will not work and the people will not vote for it, either.
8. Sir Geoffrey Johnson Smith (Wealden):
What assessment he has made of the role the independent hospitals can play in easing demands on national health service hospitals. [110860]
The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart):
We have considered at length the role that independent hospitals can play in easing demands on NHS hospitals. Our existing policy on commissioning health care services from the private sector allows the NHS to negotiate with the private sector where no local NHS beds are available, and where it is cost-effective. It has also been a long-standing practice in the NHS to use the independent sector where historically
We do not believe that we need to change our existing policy. Health authorities and NHS trusts are already aware of their powers and of the availability of private provision in their areas. We believe that commissioning from the private sector must be decided at local level, by those who are most familiar with their local circumstances.
Sir Geoffrey Johnson Smith:
That contradicts everything that I have heard takes place not many miles from my home and in a wide area of the south-east. The complaint is--it follows very much the statement attributed to the Secretary of State, who came down like a ton of bricks on anyone who had anything to do with the private sector--that in point of fact--
Mr. Andy King (Rugby and Kenilworth):
Ask a question.
Sir Geoffrey Johnson Smith:
I am coming to the question. Why does the prevailing evidence suggest that the national health service is prevented from sending its patients to charitably and independently financed hospitals that would help to relieve pressure on the national health service? Someone must have got the truth wrong in the information provided to the Minister.
Ms Stuart:
Circumstances on the ground may not be precisely those rumoured to exist. Some hospitals--such as in Bristol, which had a shortage--negotiate with and use the private sector. This winter, local hospitals negotiated with social services and private providers. It is not true that there is a surplus of private beds that the NHS does not use. It is true that we need to build capacity across NHS. Beds in the private sector that are registered but not supported by staff would not be available for use.
Sir Geoffrey Johnson Smith:
Madam Speaker, in view of the conflicting evidence that I have--
Madam Speaker:
Order. I thought that the right hon. Gentleman was seeking to withdraw and to have an Adjournment debate.
Sir Geoffrey Johnson Smith:
Yes, Madam Speaker.
Madam Speaker:
In that case, I cannot proceed. That is reasonable.
9. Mr. David Kidney (Stafford):
What progress is being made in reducing the waiting times for cataract operations. [110861]
The Minister of State, Department of Health (Mr. John Hutton):
The Government have launched action on cataracts--a major programme to ensure that all local NHS eye services can match the best in providing a modern and convenient service. It will enable us to build on the substantial progress that we have already made, which has seen the number of cataract operations rise from 157,000 in 1996-97 to more than 200,000 last year.
Mr. Kidney:
I am delighted that the Government are planning for the best quality NHS cataract surgery nationally. That is also a feature of the strategic review of South Staffordshire health authority, which last year paid for 1,762 NHS cataract operations. Does my hon. Friend agree that it is right to reassure patients of improving free NHS cataract surgery, not threaten them--as the Conservative party would--with having to take out medical insurance to pay for operations privately?
Mr. Hutton:
I strongly agree. It is clearly the Government's ambition to improve the quality of NHS services for people who need cataract operations--unlike the Conservative party's, whose intention is to privatise that aspect of the NHS, and whose policy is not popular with the country. I am sure that ours is popular with my hon. Friend's constituents, who have benefited from free operations on the NHS.
Mr. Nick St. Aubyn (Guildford):
A constituent recently wrote to me about his wife, who went blind in both eyes while waiting for a cataract operation, owing to the much longer waiting lists under the present Government. Does the Minister think it preferable to any other alternative that under the Labour Government, old people who are going blind are forced to go private and spend their savings, never having thought that they would need private health insurance? Does the Minister think that is the best system for this country's health care?
Mr. Hutton:
The hon. Gentleman ought to check his facts. If he will write to me with the details of the particular case he mentioned, I will look into it. This Government reintroduced free eye tests for pensioners--something that the last Conservative Government withdrew. If he is complaining that his constituents have to go private, he might like to take up his concerns with his own Front Benchers. The Conservative party wants to make sure in future that patients who need such operations go private rather than use the NHS.
Dr. Liam Fox (Woodspring):
Does the Minister accept that the problem with all waiting lists--including those for cataract operations--is that the Government's waiting list initiative is distorting clinical priorities? Dr. Peter Wilde, consultant cardiologist at the Bristol Royal infirmary, said this morning that heart patients are dying unnecessarily because they were waiting too long for surgery. Tragically, that is not due to a lack of resources.
Ministers are forcing health authorities to perform minor procedures to shorten waiting lists faster--even if that means sicker patients, such as those of Dr. Wilde, having to wait longer. Is that not an unfair, unethical and immoral way to run a health service? Patient care gets worse so that Minister's press releases can get better.
Mr. Hutton:
I do not accept any of the hon. Gentleman's points. If he studies the December waiting list figures, he will see conclusive proof that the opposite is the case. We have always made it clear that clinical
Dr. George Turner (North-West Norfolk):
I am clear about the need for the initiative to improve the rate at which cataract operations take place, as there are 22,000 pensioners in my constituency and I hear of sad cases of some disabled pensioners having to wait month after month after month. Deteriorating vision must make their lives much more miserable, not least because of the risk of falling. Can the Minister give us any idea of how long a wait he would think reasonable once the Government have achieved their objectives--and how quickly will we reach that day?
Mr. Hutton:
The average waiting time for cataract operations is falling. Currently, it is about seven months. Everyone in the House, including my hon. Friend, would want us to make further progress in reducing the waiting times--that is precisely what the initiatives that I have outlined to the House will do--but he, like me, would agree that the best way to ensure equitable access to health care for older people, particularly those who need cataract operations, is to ensure that a first-class national health service is available to meet their needs. That is what the Government are committed to doing, but sadly it is not the policy of the Opposition.
Knee replacements are important to enable patients to retain mobility and, therefore, independence. They should be available according to clinical need.
That is right; they should be available according to clinical need. However, the hon. Member for Woodspring (Dr. Fox), the shadow Secretary of State, told The Sunday Times, on 16 January, that
conditions...like hip and knee replacements, hernia and cataract operations
should be covered by private medical insurance. Why did he say that? His hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) told Sky News on 31 January that, under Conservative plans, people would look to the NHS
when they had serious, life-threatening conditions and would look to their private insurance to help them with the rest.
Why did the hon. Gentleman say that?
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