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Mr. Hayes: I do not want to indulge in gossip, but will my hon. Friend illustrate his point by reference to beta interferon? The number of multiple sclerosis sufferers prescribed beta interferon in France, Germany, Italy, Spain, Finland, Greece, Ireland and Turkey is considerably greater than in Great Britain. Perhaps that is why my constituent Mr. Kevin Keeble, of Roman Bank, Holbeach Bank, cannot get the drug.
Mr. Swayne: I have no need to illustrate the point because my hon. Friend has done it so effectively.
It is all very well saying that in a few years' or, indeed, in many years' time we will achieve European levels of expenditure on health care, because the crisis is happening now. It may be stretching the point to say that, in some respects, this country has a third-world level of health care, but anyone who read the series of articles in The Daily Telegraph just before Christmas about the level of treatment available to many of our elderly people would not think it an exaggeration. We have much lower levels of satisfactory health outcomes for critical diseases such as heart conditions and cancer care than in Germany, France, the Netherlands and Belgium, and that is not acceptable.
Returning to clinical distortion, we know that out-patient waiting lists have risen by 248,000 since the election. Even in-patient waiting lists--a higher priority target for the Government--rose by 36,000 in December alone. However, the greatest potential clinical distortion is the alarming growth in the number of patients waiting to get on to a waiting list, and who are awaiting their first appointment with a hospital consultant. That number has risen by some 500,000. Those people represent a clinical distortion because we do not know what is wrong with them and they have not been assessed by a consultant.
It is all very well the Secretary of State making a gibe at our proposals by saying about the winter crisis, "We wouldn't be guilty of turning people away because of the wrong sort of illness." The fact is that, at the moment, people with critical conditions are being turned away.
A constituency case was brought to my attention of an elderly lady who was seriously ill with bowel cancer. Her operation was cancelled because of the winter crisis.
Last week, Dr. Peter Wilde, consultant cardiologist at the Bristol Royal infirmary, told the Prime Minister clearly that, if he had been able to operate on all the patients with heart conditions under his care, he would have saved the lives of half of them.
The Secretary of State and, indeed, the hon. Member for Wakefield (Mr. Hinchliffe) have made it clear that there is no certainty of any relief from the private health care sector. The Secretary of State said that there was not an army of under-employed surgeons who could suddenly take up the slack. That is, of course, true, because often enough--in fact, usually--the very same people operate in both the private and public sectors.
However, it is monstrous to suggest that the private sector cannot provide some capacity. We all know--I certainly know, and I doubt whether I am the only person who has had this brought to his attention--that NHS operations are being cancelled because of cash shortages. Such operations could take place using resources available in the private sector--and they ought to do so. That was the basis of the comments of my hon. Friend the Member for West Chelmsford (Mr. Burns), and it goes to the heart of our patients guarantee.
Our solution, which has of course been much criticised by the Secretary of State, is to provide a core NHS in which those with, let us say, Cinderella conditions such as hernias and in-growing toenails would be treated elsewhere and would pay for it. I reject any such suggestion. In fact, it strikes me as monstrous that any such health service could be devised. It is ridiculous to suggest that, for example, varicose veins would have to be treated outside the NHS because the condition was not critical or life threatening and therefore did not meet the criteria that might be devised for a core health service. Although a varicose vein might almost be a matter of cosmetic surgery to one person, it might be a life-threatening condition, causing severe ulcers, to another.
The Minister of State, Department of Health (Mr. John Denham):
Will the hon. Gentleman help me and other hon. Members by giving his interpretation of the comments of the hon. Member for Runnymede and Weybridge (Mr. Hammond), a Conservative Front-Bench spokesman, who told "Sky News" that, under the Conservatives, people would look to the NHS
Mr. Swayne:
I do not think that that is so. I am not here to speak for my hon. Friend, but I shall honestly tell the Minister what I think my hon. Friend meant--I shall certainly tell him what I mean.
If we are honest and work within the same resource restraints, reprioritising the NHS so that the sickest patients are given the highest priority and treated first-- I assume that that would be entirely reasonable to all people--will of necessity mean that people with less critical conditions will wait longer.
One problem that results from fixation with the overall size of the waiting list is that some people are not waiting long enough. Simple conditions are treated quickly to massage the overall figures while those with more critical conditions are waiting. If, as a result of a patients
guarantee, the sickest patients are treated first, those with lower clinical priorities might consider other possibilities. That is, after all, the basis of freedom of choice. Such a structure would crystallise and focus the private insurance market, unlike the current position, and might result in the development of products that addressed many of our people's needs.
Mr. Trickett:
Will the hon. Gentleman give way?
Mr. Swayne:
No, I am afraid that I do not have the time to give way.
In addition to prioritisation of existing resources, we must of necessity seek to increase such resources. Labour Members believe that spending in the existing NHS model, almost alone in providing for the health care needs of the United Kingdom, can reach the European average. I suggest that they look elsewhere in the world--they are alone. In no other nation is such a proportion of gross national product spent without a much healthier contribution from the private sector.
There has been much criticism of our ability to continue to fund the health service as in the past owing to our overall tax guarantee.
Mr. Trickett:
Will the hon. Gentleman give way?
Mr. Swayne:
No, I will not give way; I have told the hon. Gentleman so.
Dr. Howard Stoate (Dartford):
I appreciate that I do not have much time to speak, so I shall be brief and not indulge in too much rhetoric.
We have heard a great deal of rhetoric from Opposition Members--despite the fact that there have been only two to four of them in the Chamber throughout--but we have not heard anything approaching a policy. We have also heard much gloom, doom and despondency from them, which saddens me. Frankly, they need to get out more. They need to go to hospitals, to visit general practices, and to speak to nurses, doctors, health workers and, above all, patients. If they did so, they would find that most patients are very satisfied with the health service. Survey after survey has revealed a very high degree not only of satisfaction but of trust in those who provide health care--more than can be said of politicians.
It is obviously the job of the Opposition to rubbish the Government, and they are doing what they consider a good job--others may have other views and I could not possibly comment. However, it upsets me greatly when I hear the health service being run down. The hon. Member for Bromsgrove (Miss Kirkbride), who is no longer present, said several times that we have the worst health service in Europe. The hon. Member for New Forest, West (Mr. Swayne) talked about the third-world status of our health service. Those are disgraceful comments, which I deplore. They drive down public confidence,
morale and the standards that the 1 million people working in the health service strive daily to achieve for their patients. I shall give an example of that.
I recently visited a very elderly patient, of whom I do not see much--I still do some GP work, as hon. Members know. She asked me to look at a lump in her breast. When I examined her at home, I found that she had a fungating breast cancer, which is a very advanced form of cancer, unpleasant to deal with, a nasty thing to have and medically very bad news. I asked her why she had waited so long before calling me, and she said that she had discovered the lump only the week before. I said, "That is not true, is it?" She said that it was not but that she did not want to trouble me. I told her that I had known her for many years and that she knew that she was not troubling me. The truth was that she had read in the paper that elderly people did not matter in the NHS, and concluded that there was no point in calling me because there was nothing much that I could do.
What saddens me is that I know that, within two weeks of seeing that lady, I could guarantee that she would be seen by a cancer specialist in the local hospital's breast unit, where she would receive expert care. She had read in the papers not the good news that this Government have made cancer treatment a priority, so that people can be seen within two weeks of their GP referring them, but that elderly people did not matter. If we talk down the health service and those who work in it, we drive down patient expectation. People expect bad treatment before they even start.
when they had serious life-threatening conditions and would look to their private insurance to help them
with the rest? The hon. Gentleman seems to be arguing a rather different point.
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