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Mr. Deputy Speaker: Order. The hon. Gentleman's speech is time limited.
5.15 pm
Ann Keen (Brentford and Isleworth): I shall begin by using my nursing skills, as a clinical diagnosis of the occupants of the Opposition Benches reveals that some Conservative Members are suffering from an outbreak of what I recognise as amnesia.
Like the hon. Member for Woodspring (Dr. Fox), I too worked in the national health service. I was a nurse for 20 years, and I was working the afternoon shift in a medical ward on the day that Mrs. Thatcher was elected. Her Government promised that they would not privatise the health service in the same way as they privatised the electricity, gas and other services--they knew that the British people would not let them get away with it. Instead, they set up a clever framework that allowed them to dismantle the system gradually by chipping away at it bit by bit.
The hon. Member for Woodspring is not in his place, but he is very worried about the cleanliness of our hospitals. I am too, as was the ward domestic with whom I worked for some years. I was a ward sister, and she worked permanently on my ward. She worked there every day and looked after the ward as if it were her own home. The evening cleaning shift were not just cleaners: they were domestic staff and part of the ward team. They cleaned the wards, looked out for patients' needs and ran errands for them--until the contracting-out process began.
The guidelines set by the previous Conservative Government required that contracts were awarded to the lowest tender. That meant that many low-paid health service workers had to accept short-term contracts at even lower rates of pay. Those rates did not equal today's minimum wage--which the Conservative party voted
against, just as it voted against the inception of the health service. The Conservative Government were prepared to have a hospital cleaning force who were low in skills and poorly paid. That is not acceptable: hospitals must be clean if infection is to be kept down.Contrary to popular belief, I did not work with Florence Nightingale, but she said that hospitals should do the sick no harm. The truth, however, is that they can do the sick an awful lot of harm. I urge my hon. Friends on the Front Bench to take note of the problem and to put measures to correct it into immediate effect. Permanent domestic staff must be restored to wards and hospital clinics and given responsibility for cleanliness there on a daily basis. That would contrast with what happens with people working on a contractual basis, who move on once they have done their stint with the cleaning fluid in any particular area.
I was working in the health service when the right hon. and learned Member for Rushcliffe (Mr. Clarke) introduced his new version of the NHS. He travelled to the privatised Limehouse studios by boat along the Thames to make a video for NHS workers. The video's presenter was Nick Ross, who also presents a programme called "Crimewatch UK". I am sure that it is merely a coincidence, but I am convinced that the right hon. and learned Gentleman's innovations amounted to the biggest crime ever inflicted on the British people.
The internal market that was established set hospital against hospital. I worked in the London area, where research centres and famous hospitals competed with each other instead of doing what they do best--advancing knowledge by sharing results, which is the central ethos of research.
At my interview for the West Middlesex hospital in 1985, I was shown the plans for the new hospital in which I would be working in 1987. I am pleased to say that, under a Labour Government, we will at last have that new hospital. The project is on schedule, the contractors are in place, and work will commence at the end of this year or the beginning of next.
The sale of the South Middlesex hospital took place in 1985 and £12 million was raised to go towards the new building at the West Middlesex hospital. Alas, the then Government had got their figures wrong for the Chelsea and Westminster and seemed to be £12 million out--so the money was moved to that project. How interesting; markets have always produced winners and losers.
This time, I want the national plan to make sure that we are all winners. Much has been said about choice, but one does not choose to have appendicitis, to have cancer, to have an accident, to become frail or to have a chronic condition. People want a high standard of treatment in the hospital that is closest to them--unless it has a specialist element for which one may have to travel. We want the hospital to be of a high standard in terms of staff and resources.
Mr. Lilley: Does the hon. Lady accept that some people might want to go to a hospital that is some distance away, but is near their relatives; that some might want to go to a hospital that has single-sex rather than mixed-sex wards; that some might want to go to a hospital with a better success record than the local one; and that some
might want to go to a hospital with a shorter waiting time than the local one? Should they be prevented, for ideological reasons, from exercising that choice?
Ann Keen: The right hon. Gentleman makes the point that, sometimes, we must look at particular aspects of individual patients. We always have done that and we will continue to do so. If specialist treatment is needed, there are specialist facilities.
Choice was not available under the internal market. The only time people had any choice was if they collapsed outside the hospital of their choice. However, one certainly did not enter the contractual system out of choice; that only ever worked for a small group of people. That fact is stated by professionals of no political persuasion.
For the future, we want everyone to have a national standard. Standards should be the same and there should be clinical governance throughout all professions. The hon. Member for West Chelmsford (Mr. Burns) is rightly interested in his constituency waiting list, but he should discuss with managers why that list exists. In my local hospital we have looked at modernising the systems.
A patient with a suspected hernia goes to the GP, and GPs are very capable of diagnosing a hernia. There is no need, in most instances, to refer that patient to a consultant to have the diagnosis confirmed, and then for the patient to wait again for the hernia to be repaired. The GP should be able to use information technology, and set up an appointment for the day of surgery. That is happening in parts of Isleworth and west London, so the hon. Gentleman needs to ask why it is not happening in his area. That is where the money is going and what modernisation means.
Mr. Burns: I have meetings on a quarterly basis, and have done so now for two and a half years. As the situation is so bad, I have also had meetings with Ministers who, unfortunately, cannot tell me why my trust is worse than so many others. Part of the reason is lack of funding, despite the increases announced by the Chancellor.
Ann Keen: I cannot accept that funding is the reason. We must always look at the way in which we work.
I want to mention two aspects of care with regard to the national plan. The winter pressure, as it is described, can be felt at all times. So why are many older people admitted into hospital from accident and emergency departments when a skilled primary care team, along with people from social services, could care intensively for them at home? A 24-hour, community-led service is essential for many of our older people. They can have treatment at home as long as such a service is available. In that way, patients are not disorientated because they are not moved from their homes. They do not have to stay in hospital beds for weeks and then encounter difficulties in rehabilitating themselves when they are back home.
My final point about the plan is cancer care. We need to look at the prescribing of chemotherapy drugs. A professor at Hammersmith hospital has told me that the country's prescribing bill is higher for laxatives than it is for chemotherapy. We need to look into the causes of
some of that prescribing, given that our position in the European league tables is very low for prescribing chemotherapy drugs, but our mortality rates are high. I want there to be a national cancer centre. There should be consensus on many of the cancer drugs, such as Taxol, about which the National Institute for Clinical Excellence has recently made an announcement.I thank you for giving me the opportunity to speak in the debate, Mr. Deputy Speaker. I feel very positive about the health service. It will continue to be very demanding, and the skills of all the staff need to be taken into account. We should see a little more humility from Conservative Members because, without question, their short-term, market-led health service failed the people of this country. It will take all of us to ensure that we have a health service that we can be proud of in the future.
5.27 pm
Mr. Peter Viggers (Gosport): One abiding memory of the previous election was of meeting some nurses at a charity fair in the town hall in my constituency. It was a couple of days before the election, and I was talking to half a dozen nurses, many of whom I had known for many years and many of whom I knew to be Conservative supporters. Their eyes were shining--they were so thrilled that, at last, the national health service was going to be saved.
The Labour party was incredibly successful in persuading people that it could save the national health service. It said in its manifesto:
- if the Conservatives are elected again there may well not be an NHS in five years' time--either national nor comprehensive.
- Our fundamental purpose is simple but hugely important: to restore the NHS as a public service working co-operatively for patients, not a commercial business driven by competition.
This Government, meanwhile, have imposed extra burdens on the health service. The pensions cost in the health service, for instance, is about £495 million more than it was when the Government came to power. The working time directive and the provisions of the Disability Discrimination Act 1995 will add extra burdens to the national health service too.
We all remember when, in July 1998, the Chancellor of the Exchequer announced the amount provided for health in the comprehensive spending review for 1998-99. He announced an extra £18 billion, by double and triple counting the amounts in question. He added the £3 billion increase to the £2 billion increase to the £2 billion increase, and instead of arriving at a figure of £8.7 billion, he arrived at a figure of £18 billion. There has been a lot of double counting in the NHS finances.
What has actually happened? Notably, Lord Winston said that the national health service was
- gradually deteriorating because we blame everything on the previous government.
-
Another doctor working in the national health service--Margaret Cook, the former wife of the Foreign Secretary--said:
The NHS is still grossly underfunded and Labour have done not a thing.
- national waiting list diverts attention away from the issues that matter most to patients. By focusing simply on the number of people waiting for treatment after seeing a hospital consultant, the list ignores the time people are waiting and the severity of their need.
In my constituency, the waiting time for cardiac surgery has gone from nine to 18 months within a year. I see that the Minister of State, the hon. Member for Southampton, Itchen (Mr. Denham), has rejoined us in the Chamber. In a written answer recently, he told me that the waiting time for cardiac surgery in my area was 15 months, but that the Government's ambition was to get it down to 12. That answer was not correct, as the waiting time is 18 months. Therefore this Government in action have not been successful nationally.
What about the local situation in the area that I represent, the Portsmouth-Gosport area? The News, the local newspaper, reported in January 1999:
- Relatives and friends of patients in Portsmouth hospital are being asked to help wash and feed their loved ones because of a drastic shortage of nurses.
Notices are being handed out at Queen Alexandra Hospital, Cosham, and St. Mary's Hospital, Milton, asking for help to wash, shave and feed patients.
It is the first time Portsmouth Hospitals NHS Trust, which runs QA and St. Mary's, has approached relatives, friends and carers for help in this way.
- This is the worst winter I remember in terms of pressure.
- Everybody's thoroughly fed up. Staff are leaving in droves because they have had enough.
Patients and their relatives keep moaning at us all the time when we're struggling to make the best of a bad job.
- Earlier this week, there were only three beds free at QA and St. Mary's hospitals. Lin Kennett, operational director for medicine at the Portsmouth hospitals' trust, which runs both hospitals, said: "This is the worst I have known in the 25 years since I have been here."
- Staff are absolutely exhausted. I don't know how they can carry on at the pace they are. Some nurses are going off-duty in tears because they can't give the care they want to give.
- The news comes as new Patient's Charter figures for Portsmouth hospitals show the worst recorded performance in two-and-a-half years--
- There were 251 operations cancelled at Portsmouth hospitals from last December to March. Earlier this year The News reported Portsmouth hospitals were suffering their worst beds shortage for 25 years . . . spokeswoman . . . Mrs Forsyth, said both hospitals were still on red alert--an emergency status to show a lack of beds. They have been on red alert since mid-December which is a record.
What are the Government doing about that? Colleagues will perhaps not believe this, but the Government propose to close my local hospital. The Royal Hospital Haslar serves as the district general for my area of Gosport. It is a defence medical hospital. In 1994, the Conservative Government chose Haslar as the only tri-service hospital and concentrated all the resources of Army, Navy and Air Force medicine there, together with small Ministry of Defence hospital units at three other locations in the south of England. Yet the Labour Government, to the disbelief of many people involved, in December 1998 announced the closure of Haslar and the intention to create a new centre of excellence elsewhere, at that time undefined.
Many people within defence medical services hoped that the new centre of medical excellence would be either at St. Thomas's and Guy's in London or possibly at the John Radcliffe hospital in Oxford. There was even some suggestion that it should be in Newcastle. It is going to be in Birmingham, which is probably the largest city with no particularly strong services connection. It has no strong connection with the Navy, the Army or the Air Force. The people in my area are incredulous that the Government are pressing ahead with this plan.
When the announcement was first made in December 1998, I announced a rally and march, thinking we might have a few hundred or, possibly, a few thousand people. I was staggered to find that we had 22,000 people marching to Haslar hospital, everyone dedicated and committed to maintaining its existence. That is just the civilian side of Haslar hospital--the demand by local civilians.
Within the armed forces there is a similar determination that the hospital must not close. Already defence medical services are losing many doctors and nurses who, in 1994-95, were told that they should move to the Gosport area to the only tri-service hospital and are now told that in the medium to long term they will have to move to Birmingham. They do not want to go; they are voting with their feet and leaving.
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