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The Minister of State, Department of Health (Mr. John Denham): The average waiting time for heart bypass surgery in the NHS in England in 1997-98, the latest year for which figures are available, was 188 days. We have made it clear that tackling coronary heart diseases is one of the Government's top priorities.
Mr. Robertson: I am grateful to the Minister for that reply. Will he perhaps explain, or look into, why one of my constituents was told nine months ago that he would have to wait between seven and nine months for such an operation, only to be told a couple of weeks ago that he would have to wait a further 12 months? Is that typical, or is it an unusual case?
Mr. Denham: We all regret it when any patient waiting for a serious operation has that procedure cancelled. I understand that the hon. Gentleman's constituents--I do not know about the individual case that he mentioned--are often treated in Bristol and particular issues there are being addressed by an additional £100,000 of funding for the health authority and the United Bristol Healthcare NHS trust.
More generally, we recognise that the provision of cardiac surgery is simply not good enough at the moment. That is why, just a couple of months ago, my right hon. Friend the Secretary of State announced the injection of a further £50 million into the NHS to improve coronary heart services and, in particular, to increase the rate of revascularisation by 10 per cent., with more than 3,000 extra operations over the next two years.
Mr. Denham: What is clear is that we inherited wide variations in access to treatment and care in different parts of the country. Indeed, in some parts of the country, there is an inverse relationship between the likelihood of serious coronary heart disease in the community and the likelihood of someone getting a bypass operation. One of the central purposes of the national service framework for coronary heart disease that we intend to publish next year is to set standards of care, from prevention right through to the most serious surgery. We shall expect the national health service to meet those standards, wherever in the country a patient may be. That will need to be backed up with the investment in equipment and in staff announced by my right hon. Friend a couple of months ago.
Mr. Peter Lilley (Hitchin and Harpenden): Will the Minister confirm that, as a result of the reforms introduced in April, any patient who needs a coronary bypass, or any other operation, and who chooses to attend a hospital with a shorter waiting time than the one contracted to his local primary care group, can no longer exercise that choice? Does the Minister agree with the director of the College of Health that, as a result of the Government's reforms, NHS patients now have less choice of hospitals within the NHS than at any time since the health service existed?
Mr. Denham: No. No such choice ever existed for individual patients under the previous Administration. We have swept aside the incredibly bureaucratic system of extra-contractual referrals that required approval before someone could be sent to a particular consultant. We expect that the vast majority of treatments for the vast majority of patients will be provided according to agreements reached locally between the primary care group and the main trust serving that area.
However, in changing the system, we have not removed the right of doctors to refer patients to the consultants that they want. The use of out-of-area treatments is an integral part of the current system. However, it is much better to plan for the vast majority of patients to receive high-quality services in their most local hospital, rather than to use the ridiculous model advocated by the right hon. Member for Hitchin and Harpenden (Mr. Lilley). Under that model, one can receive the best treatment only in a few parts of the country; patients have to chase all over the place to try to find out where the best treatment is available. People want good-quality services in their own local hospital--that is what we want to deliver.
The Parliamentary Under-Secretary of State for Health (Yvette Cooper): The Government are funding the Royal College of Obstetricians and Gynaecologists to undertake an audit of NHS and independent sector abortion services, including information on waiting times.
Fiona Mactaggart: I thank my hon. Friend for that reply. Is she aware that a recent survey conducted by the Abortion Law Reform Association revealed that the most common reason for women to seek private terminations was unacceptable delays in the NHS? The survey showed that about half the health authorities set or monitor targets for waiting times for terminations. Will she consider the establishment, within the evidence-based framework produced by the Royal College of Obstetricians and Gynaecologists, of a target waiting time of 14 to 21 days? Will she ensure that that target is monitored so that women can have access to abortion on the NHS?
Yvette Cooper: I am aware of the survey to which my hon. Friend refers. I assure her that the Government take the matter extremely seriously. I further assure her that the sexual health strategy will consider those issues; it will consider access to all services and how to ensure equity. The report will be produced during the next year.
Mrs. Maria Fyfe (Glasgow, Maryhill): Has my hon. Friend noticed the existence of an organisation called Precious Life? Thus far, the organisation has confined its activities to Northern Ireland and Scotland. It has attempted to intimidate workers in clinics and now threatens to picket the homes of Ministers of the Scottish Parliament. Does my hon. Friend agree with the Minister for Health and Community Care in the Scottish Parliament that any activities that attempt to prevent people from carrying out lawful functions will be met with the full force of the law?
The Minister of State, Department of Health (Mr. John Hutton): Decisions about the provision of erythropoetin should be based on the clinical needs of individual patients. There are, however, no national guidelines or protocols issued by the Department of Health specifically on prescribing erythropoetin.
Mr. Brady: I thank the Minister for his reply. If my constituents reside in the Salford and Trafford health authority area and are told by the Manchester royal infirmary that they have a clinical need for erythropoetin, they are denied it as a matter of course. However, if they live across the border in the Manchester health authority area, they will receive it. The Secretary of State says that he wants to end the lottery of care, so will the Minister now undertake to do that?
Mr. Hutton: I am aware of the particular concerns that the hon. Gentleman has raised and to which the Minister of State, my hon. Friend the Member for Southampton, Itchen (Mr. Denham), replied in February. My understanding is that the local health authority and the trust are working to establish a proper mechanism for prescribing erythropoetin, and I very much hope that an understanding will be reached soon. I think that there was a meeting yesterday to discuss the matter.
The hon. Gentleman raised a wider point that several other Conservative Members have mentioned today. Again, I point out that such problems of availability did not start on 1 May 1997. The difference between the Government whom he supported and this Government is that we have put in place a fairer system of resolving the issues and it will address the concerns of his constituents. I hope that he will recognise that additional resources have been made available to his health authority to date. However, sadly, he conspicuously failed to mention that.