Examination of Witnesses (Questions 100
- 119)
WEDNESDAY 29 MARCH 2000
SIR ALAN
LANGLANDS
100. Were there people over the millennium holiday
who had appointments for elective surgery for some time and expected
to have it then and then found that the arrangements for the holiday
came up? Were there many people who were cancelled in that period?
(Sir Alan Langlands) No.
101. Was that always blocked out as out of bounds
for elective surgery?
(Sir Alan Langlands) The planning in the Health Service,
and indeed across the boundary of the Health Service and Social
Services, was excellent, absolutely splendid, over the millennium
period.
102. I am sure it was but I am asking whether
anyone was cancelled over that period?
(Sir Alan Langlands) Routine operations were cancelled.
103. They were?
(Sir Alan Langlands) Not cancelled. Let me say this
again. Routine elective surgery was essentially closed down during
that period.
104. How long in advance?
(Sir Alan Langlands) If I remember the weeks right
people started running down probably the week commencing 12 December
or something of that nature.
105. My point is if someone had been waiting
for a year, and most people are waiting for a year for elective
surgery, therefore some of those people who started waiting, as
it were, for a target date around this last New Year a year earlier,
would they have known at that stage what the holiday arrangements
for the millennium were going to be?
(Sir Alan Langlands) Yes, they would. Most people
going in for a routine operation do not want to come during the
Christmas holidays or, indeed, the millennium celebrations.
106. So the ones who came in immediately after
that who had waited that extra period for the reasons you have
given, and I agree with you, would have then been even more bitterly
disappointed if they found that their appointments had been cancelled,
as happened at the Conquest Hospital in St Leonards-on-Sea?
(Sir Alan Langlands) There was a period from 4 January
until the middle of January when a large number of people were
being cancelled.
107. These are the figures that you will not
give us but you say the Government is going to announce them?
(Sir Alan Langlands) They announce them every quarter.
108. So when are we going to get this announcement
that you cannot give us today?
(Sir Alan Langlands) At the end of the quarter in
the routine way, three weeks after the end of the quarter. This
is public information. I am not trying to be evasive.
109. I am just teasing you a little. If you
will keep coming back like old blue eyes then you deserve a little
bit of teasing.
(Sir Alan Langlands) Okay.
110. Let me go to page 75, appendix three. It
says that people are also waiting longer for outpatient consultation.
It may seem a daft question but let me try it on you: can the
principles of bed management as outlined in this report be applied
in any sense to the management of outpatient consultations do
you think?
(Sir Alan Langlands) At a broad level they can be,
yes.
111. Is anything being done in that area?
(Sir Alan Langlands) Yes.
112. Let us just move on to the awful thing
when all this work is done, the planning is done, and patients
do not turn up. What analysis is there of consultants who do not
turn up so that the outpatient who turns up to see the consultant
finds that the consultant cannot see him that morning or that
afternoon? What analysis is there to show that it is the vagaries
of the consultants rather than the patients being difficult that
is the problem?
(Sir Alan Langlands) There is no national data on
that issue. 26,000 consultants, millions of transactions, there
is no national data. There is local data. Consultants work to
a work plan which requires—
113. Are they disciplined if they distort that
plan?
(Sir Alan Langlands) Yes.
114. If they do it habitually or if it just
happens occasionally?
(Sir Alan Langlands) First of all, it is very important
to recognise that sometimes there are justifiable reasons for
a problem.
115. Of course.
(Sir Alan Langlands) Someone dealing with an emergency
in theatre who is late for their outpatient clinic who did not
expect to have that emergency.
116. A bit like wretched MPs who turn up 15
minutes late to the Committee of Public Accounts, for which I
apologise.
(Sir Alan Langlands) That sort of thing. There are
other cases where people are tackled. The medical directors of
each trust take that responsibility very seriously indeed.
117. Let me just play devil's advocate, so many
good questions have been asked by colleagues. Anecdotal evidence
suggests that people who are waiting a long time for elective
surgery hear from the consultant they trot along and see every
so many months that they could after all go privately if they
want and, surprise, surprise, they could be treated by precisely
the same consultant at precisely the same hospital only privately.
What analysis has been done to find out whether there is a pattern
of people who have been given a date for elective surgery and
then do not turn up because, in fact, three months earlier the
same consultant dealt with them privately, they paid the money
over and nobody bothered to take their name off the list? Do you
think that is an outrageous thought or does it happen?
(Sir Alan Langlands) Of course it happens.
118. You mean a consultant, having pocketed
the money, could not tell his colleagues in administration "take
that one out, you have got another slot for elective surgery for
somebody else"?
(Sir Alan Langlands) I am sorry, I misunderstood the
question. I thought the question was is it the case that some
people who are waiting a long time decide to go private.
119. I know they do.
(Sir Alan Langlands) There is no national data but,
again, the private activities of consultants are written into
their job plans.
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