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5.20 pm
Mr. Simon Burns (West Chelmsford): It is a pleasure to follow the Chairman of the Select Committee on Health, the hon. Member for Wakefield (Mr. Hinchliffe). Like the Minister, I listened with great care--the Minister was probably a little aghast--to the hon. Gentleman's comments on what should happen to consultants. I hope that the Minister will fully answer the important points that the Chairman of the Select Committee made. Conservative Members will be fascinated to hear how much the Minister agrees with the hon. Gentleman.
It was also a pleasure in some ways to listen to the characteristically robust, but somewhat worn speech of the Secretary of State. In places, his speech was extremely interesting and non-partisan, and there were even points in it with which no fair-minded person could disagree. The trouble was that he, like many other Ministers in this Government, got hooked on the Millbank syndrome and had to repeat the same catch-phrases, buzz words and on-line messages that the Government try to get across to the country, regardless of whether they are based on fact. Sadly, the hon. Member for Wakefield could not resist clutching at the Secretary of State's coat tails. I refer in particular to the bogus argument about privatisation.
As the hon. Gentleman well knows, we were in government for 18 years. We did not, in any shape or form, in those 18 years seek to privatise the health service. In every year that we were in office, we increased the real-terms funding to the health service. Just to try to convince the hon. Gentleman, may I point out that I certainly believe passionately in the national health service? Under no circumstances would I tolerate its privatisation, in any shape or form.
Mr. Hinchliffe:
I accept that the hon. Gentleman personally believes in the NHS. However, he supported and was a member of a Government who had a key fiscal policy of encouraging people to use the private health sector. His Government gave people tax breaks to do that. That does not suggest to me that they believed in the NHS. They wanted to get people out of the NHS and into the private sector, with a consequential drain on staff in the NHS.
Mr. Burns:
The hon. Gentleman says that we encouraged people to use private health care. That may well be true in certain areas, such as tax relief on insurance premiums for the elderly, but it is not privatisation.
If one makes it attractive, through tax breaks for individuals, totally voluntarily to spend the money that they earn as they wish on private health care, that relieves the pressures on the national health service and must be beneficial to the people on waiting lists. I see no conflict
between the principle of a free national health service and some members of the public wishing to spend their own money to make their own provision. There is nothing wrong with that and it is not privatisation.
I do not want to speak at great length on this subject, but shall make one final point about it. The Government are not averse to using the private health care sector to treat patients, albeit, rightly, free at the point of delivery to those patients. One of the Government's cherished promises--which was that no one would wait more than 18 months for hospital treatment--was broken in my constituency at the end of November and the beginning of December last year. Fourteen people had waited more than 18 months for treatment and the trust picked up on that problem. It was so terrified that it had embarrassed the Secretary of State and that the Government's cherished promise had been broken that it wrote to all those people to say that they could have their operations as quickly as possible whenever they liked, and the private sector carried out the operations. I am delighted for my constituents, because they quickly received their treatment, having waited longer than the Government said they would have to wait. That shows that the Government are not averse to using the private sector when there are problems.
Mr. Hinchliffe:
I do not want to pursue this point, but I want to try to get one thing on the record. The hon. Gentleman is probably a good deal brighter than the average Conservative Front Bencher, so perhaps he can answer a fundamental question that none of his Front-Bench colleagues appear able to answer. When one pushes people into the private sector and expands it, where do the staff come from to service the private sector? They come directly from the NHS; that is the central point.
Mr. Burns:
The hon. Gentleman's question suggested that people are forced into the private sector. No one forces people to take out private health insurance or to use private health care. As he has alluded to, there were in the past encouragements through the tax system for the elderly, but no one forced them to use the private sector.
There are two ways in which staff can be trained for health care in this country. The first--it trains the largest proportion--is through the health service and the second is through the private system, which trains a much smaller proportion.
Dr. Stoate:
Will the hon. Gentleman give way?
Mr. Burns:
No, I will not give way, because I want to finish my point.
The hon. Member for Wakefield raised the issue of consultants and seems to be obsessed by it. I think that I can anticipate the Minister's answer to his suggestion. He will say no, but the hon. Gentleman probably thought it was worth a try to raise the issue. It will reassure the profession and bring relief to the Government when the Minister says that he does not agree with him. Significantly, he did not mention general practitioners, who are all self-employed. It was interesting that he
mentioned consultants, but did not, for some reason, refer to GPs. I assume that that was an omission and that he would like to include them in his system.
Mr. Burns:
The hon. Gentleman says no. That suggests that he has a contradictory view. However, I want to move on, or we shall get bogged down in what is a minor part of my speech.
I read the Government's motion with interest and I listened to the glowing picture that the Secretary of State painted of NHS funding. He suggested that everything was absolutely magnificent in the health service. I agree that some things are magnificent. The staff--the doctors, nurses, consultants and ancillary staff who deliver health care to all our constituents--are excellent. I also concede that the additional money that the Government, like the previous Government, have given to the NHS is welcome. As the country's financial position dictates, and when the economy is healthy and more money pours into the Treasury from tax receipts and other sources, I would like more investment in the health service. I hope that the Chancellor of the Exchequer's war chest for the general election is not squandered buying up different target groups of the electorate for polling day some time, presumably, next year. I hope that more money is given to the health service.
My hon. Friend the Member for Woodspring (Dr. Fox) said that the £21 billion over three years for the whole of the United Kingdom is not as spectacular as the headline figure suggests. He said that, once it is broken down and analysed, and if one takes into account the partial funding of pay awards and medical insurance, in effect, it works out at £5 billion. When the country can afford it--we are perhaps at a unique point in my lifetime because the country can afford it--I hope that substantially more money will be put into the health service. I say that because of what has happened in my constituency, which is causing grave concern to my constituents. Sadly, they have not enjoyed health care that is as good and glowing as the Secretary of State suggested was the case throughout the land.
I shall be fair and say from the outset that, under the Labour Government of the 1970s and my Government from 1979 until the early 1990s, health service spending was allocated under the resource allocation working party system down to the health authority, and what is now the health trust. RAWP was a crude and painful exercise for my constituents because we were part of the North-East Thames regional health authority, which lumped together places such as mid-Essex with Hackney, Tower Hamlets and other east London boroughs, which, to be frank, have worse social problems than mid-Essex. As a result, a disproportionate amount of health care funding, which, on a pound per head of the population basis would have gone to mid-Essex where the population was expanding, went to the east end of London. At the end of RAWP in 1990-91, it was calculated that mid-Essex alone had lost out to the tune of £15 million a year.
My right hon. Friend the Member for South-West Surrey (Mrs. Bottomley) abolished RAWP and, in crude terms, introduced a pound per head system. From 1990-91 until 1997-98, mid-Essex did much better on a pro rata basis and started to recoup some of the
£15 million lost as a result of RAWP. Unfortunately, one of the first things that the Secretary of State did as Minister of State when the Labour Government took office in 1997 was to tweak the funding formula. To be fair, it was only a small tweak, but it meant that more money went back into the east end of London and mid-Essex is losing about £1 million a year that it would have had under the system that existed in 1997-98. I regret that.
As I said in an intervention on the Secretary of State, at the end of this month the Mid Essex Hospital Services NHS trust will have the worst deficit that it has ever had--£4.2 million. Last summer, when the trust believed that the deficit would be £1.8 million by the end of this year, it closed three wards. Owing to the community health council's representations that autumn, it agreed to keep one ward open and, subsequently, due to the winter pressures, it was forced to use part of a second ward, but that was guaranteed only until March. Since then, the deficit has exploded from £1.8 million to £4.2 million. Even the closure of all three wards will not meet the trust's deficit, because that was expected to save only £900,000. One wonders how on earth that deficit would be removed in a recovery plan without even more adverse effects on health care, unless the Government were to provide more money.
The Government's amendment says that my constituents and those of my hon. Friends should welcome the Government's
As my hon. Friend the Member for Woodspring said, the waiting list to get on to the waiting list has increased during the past two and a half years from 250,000 to just over 500,000. The Government have pledged to reduce in-patient waiting lists by 100,000 in the lifetime of this Parliament. We may have only 12 or 14 months to go, so they have an uphill battle. In the Government's first year, waiting lists escalated almost out of control. They then started to come down--to be fair, they came down to 50,000--then they rose again. The Government will say, with some credibility and accuracy, that that was due to winter pressures, but it remains to be seen in the coming months how much of that rise was due to winter pressures and how much to financial pressures and demand on patient care.
Sadly, we in mid-Essex have not shared in that so-called improvement. If only we had, my constituents would not write to me so often about their problems. In mid-Essex in March 1997, 8,361 people were waiting for hospital treatment. In December 1999, the latest available figure, it was 9,851. In March 1997, 104 people, and falling, were waiting 12 months or more for treatment. In December 1999, the figure was 1,060, and rising. We have the added indignity that, at the end of November, early December, the Government's most cherished promise that no one would wait more than 18 months for treatment was also breached, yet we had no apology.
On out-patient lists, the Government thought that they had come up with a wonderful little wheeze. Some bright spark, realising the problems faced by the previous
Secretary of State, the right hon. Member for Holborn and St. Pancras (Mr. Dobson), because the figures were not falling and he had rashly said on the "Today" programme one morning that if they did not come down he would resign, decided to save the right hon. Gentleman's bacon--that was before the Prime Minister decided to save it for him by making him the Labour candidate for the mayor of London--by stringing out the length of time before anyone ever sees a consultant after having seen the GP, so creating a significant waiting list to get on to the waiting list for treatment. Nationally, that has been a disaster. The figure has risen from 250,000 to more than 500,000.
In my constituency, matters are even worse. In March 1997, a total of 555 people were waiting 13 weeks or more to see a consultant. Now, the figure is 3,699, which is unacceptable. That is why we need more money.
I come now to the distortion of clinical needs. The Secretary of State said that that does not exist and the hon. Member for Wakefield confirmed that. But, as Mandy Rice-Davies once said, they would say that wouldn't they? It is in their interests to try to spin that line. Unfortunately, to use a stockbroker term, what we are seeing is churning. If an operation is relatively minor, cheap and quick to do, it will be done more quickly than a non-emergency operation that is more complicated, expensive and time consuming, because of the pressures being placed on hospitals and trusts to deliver the Government's deadlines and targets.
As a general election approaches, the pressures will build even more, because the Government will have to show, by hook or by crook, that they have honoured their pledge on waiting lists. They may do it with mirrors or spin, but, whatever the real situation, they will claim to have achieved it because it would be too politically embarrassing for them to admit otherwise. People in the real world, waiting for treatment, will know what the Government are up to.
There is the further problem of trolley waits. Unison did a survey of my local hospital, Broomfield hospital, from 31 October to 5 December 1999. That end date is slightly before the problems of the winter pressures kicked in, so that cannot be used as an excuse. In that period, the number of people having to wait on a trolley from four to 12 hours for a hospital bed was 120. Even worse, the number waiting from 12 to 24 hours was 47. It is unacceptable to have people waiting around in A and E departments or elsewhere to get onto a ward.
Chelmsford has a problem that is shared throughout the country: the cancellation for non-clinical reasons of non-emergency treatment. A survey conducted at Broomfield between October and 22 December 1999--again, just before the winter pressures began to have a significant impact--showed that the number of people whose operations had been cancelled a month before admission was 118, but the number whose operations had been cancelled on the day of admission was 201.
reduction in waiting lists and times that are being achieved through the dedication and hard work of NHS staff.
I wholeheartedly concur with the second half of that sentence, but the first half causes me problems. Once again, it is Government spin, which bears little relation to reality.
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