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Mr. Michael Mates (East Hampshire): I am grateful to the hon. Gentleman for giving way. He is making a serious speech from his long-time professional expertise and raising a number of serious health issues. Is he
disappointed that there is not a single Minister from the Department of Health on the Front Bench for such a debate?
Dr. Stoate: The Opposition Benches are not particularly well stocked today, either. A shadow Minister is present, but it is a great disappointment to me that Opposition Members in general have not seen fit to take part to a greater extent in the debate on the Queen's Speech.
I was making an important point about pharmacy. I believe that under patient group directions, pharmacists could do a lot more than they are doing. The pilot schemes, especially in Manchester, have been extremely useful. Patients have come forward in large numbers, have received the emergency hormonal contraception that they needed, and have been well satisfied with the service.
I would support a great extension of that. A good example might be the prescribing of Relenza. As hon. Members may know, the National Institute for Clinical Excellence has given the go-ahead for the use of Relenza for the treatment of acute influenza, in certain circumstances. The problem is, first, that flu is extremely difficult to diagnose, and secondly, that the drug must be given within the first 48 hours if it is to be of any use. Clearly, it will be difficult for GPs to see all the patients who may think that they have flu and get them through their surgeries in the required time.
I should like to see a system, perhaps in conjunction with NHS Direct, whereby pharmacists, nurses or a combination of both could prescribe Relenza under patient group directions and clearly defined protocols. That is an example in which the professionalism of a wide range of staff in the NHS could be maximised, and their expertise, enthusiasm and will could be used so that patients would receive a greatly enhanced service, without overburdening GP practices, which in any winter suffer a certain amount of strain.
There should be more focus on such an approach, and I hope that these issues will be dealt with in the health Bill outlined in the Queen's Speech. I am sure that primary legislation would be required, but I would be pleased to see the Government addressing the issues, and considering the circumstances in which it would be appropriate for pharmacists and others to prescribe, how that might work and what the benefits might be, and examining the financial aspects.
I hope that close attention will be paid to that proposal. From my meetings with pharmacists, I know that they are keen to go ahead. Of course I understand the implications, and recognise that the Government would need to consider them closely.
In conclusion, I believe that the NHS is generally in robust shape. The Government are committed to it. It is improving year on year, and my personal experience in the NHS is that my partners and I can give enhanced services year on year. People who may be suffering from cancer can be seen much more quickly, and we are getting people through the system much more quickly than ever before. Nurses have better training than ever before and can deliver more care in the surgeries. Overall, it is a good story, and I am pleased that the Government are showing a renewed long-term commitment to the NHS. I look forward to the debate on the Bill when it comes before the House.
2.28 pm
Mr. Simon Burns (West Chelmsford): Although I fully appreciate the reasons, I am disappointed that the Secretary of State for Health is not in his place. What I shall say at the beginning of my remarks about certain aspects of his speech I would have preferred to say to his face rather than behind his back, through Hansard.
In the Queen's Speech, the section on health begins:
- My Government remains committed to the founding principles of the National Health Service.
Lovable rogue as the Secretary of State may be to some of his friends, I resent bitterly those sections of his speech that were based not on fact but simply on trying to obtain cheap political gain by suggesting that Conservative Members are not committed to the health service and would seek to privatise it. There is no truth in that whatever, as the record of the previous Government shows. Whatever criticisms Members may have of health care in their constituencies in those 18 years, policy on the NHS under my noble Friend Baroness Thatcher and my right hon. Friend the Member for Huntingdon (Mr. Major) was based on the principle underpinning the founding of the NHS--that it should be free at the point of delivery to those who are entitled to free health care. That remains our policy, and it is cheap, erroneous and wrong for a Secretary of State to try to cast doubt on that without a scintilla of evidence.
The Queen's Speech states that the Government will introduce legislation to fulfil the commitments in their national plan, particularly
- to improve the performance of the NHS.
The national plan will introduce a rolling programme over several years to reduce the time that people must wait for hospital treatment. That is a laudable aim that any sensible Government would seek to achieve. We sought it and achieved an 18-month waiting period. Time has moved on, and the present Government are rightly seeking to tighten the service and reduce further the maximum waiting period, as well as waiting periods for certain types of care. It will be interesting to see the small print of the legislation that will bring those proposals into force, as it would be nice if the Government could achieve the targets that they have set themselves before moving on to the next stage.
I apologise for mentioning hospital waiting lists again, but I am gravely concerned about them. On 1 May 1997, we were promised that things could only get better, but those things seem to have passed my constituents by. As I told the Prime Minister 10 days ago at Prime Minister's Question Time, we have had three and a half years of a Labour Government, but hospital waiting lists in my area are longer, with 1,100 more people than when the Government came to office. In fact, since 1 May 1997, there has not been a single day when the numbers on hospital waiting lists in mid-Essex have gone below their level on 31 March 1997.
As my hon. Friend the Member for Woodspring (Dr. Fox) said, the Government have compounded the problem by creating a second waiting list to get on to a waiting list for hospital treatment. Out-patient waiting lists in my area have gone up from 555 people waiting 13 weeks or more to see a consultant in May 1997 to more than 2,800. Before we put in place grandiose schemes that were undoubtedly meant to attract voters' attention at the next election--which, I suspect, will be in spring or summer--we need more concrete evidence that existing targets are being met and that we are not creating waiting lists to help the Government try to cover their political embarrassment if the little pledge card that the Prime Minister produced at the last election is not honoured. The Secretary of State must behave more responsibly when speaking in the House, and should not seek to lash out for partisan gain.
I should like to concentrate on long-term care, although not at great length. It is a crucial area of NHS responsibilities, as older people make up the largest single group of patients using the NHS. As I remember, people over 65 account for two thirds of hospital admissions and 40 per cent. of all emergency admissions. From those figures, it is self-evident that our elderly population is possibly the most vulnerable section of our society and is entitled to proper care, dignity and privacy in the NHS. Sadly, many problems in our NHS are associated with care for the elderly. For example, there are severe strains on personal social services budgets, and indignity and financial waste are associated with delayed discharges from hospitals throughout the country. There are problems with the assessment of the kind of care package that should be provided. There is anecdotal evidence that financial considerations sometimes dictate whether an individual receives residential or nursing care, rather than that being determined on clinical grounds.
We now have the additional problem of a falling number of care home beds and a distortion of provision across the country. Some areas may well have a surplus of care home beds, but other areas in the south-east--including my own area of Essex, which has been mentioned--have a shortage of beds and a terrible problem trying to find places that are acceptable for people to go to. Despite the best intentions of Conservative and Labour Governments, we are still trying to end the undignified and financially wasteful problems of bed blocking.
In the past two weeks or so, as well as in today's debate, different figures have been bandied about in the House concerning the number of beds lost over the past year or so. Ten days ago, the Prime Minister told my right hon. Friend the Leader of the Opposition that the overall net reduction was 5,000. I was slightly surprised at that because five weeks ago the Minister of State, Department of Health, the hon. Member for Barrow and Furness (Mr. Hutton), told the Select Committee on Health that, in the same time scale that the Prime Minister talked about, 7,000 to 8,000 beds had been lost overall, which is about 4 per cent. of total capacity.
My hon. Friend the Member for Woodspring came up with figures based on more up-to-date evidence about what is happening at the moment. However, the problem has got to be addressed. The Government say that they will have discussions with care home owners, but they should do something more positive and urgent, as the problem is on-going. Two care homes in my constituency,
Southborough lodge and Upleathams house, are closing, causing a terrible problem for people who have come to regard them as their homes and are now having to try to find accommodation, preferably in the town of Chelmsford. However, as a result of shortages in Essex and the eastern region, they may well have to be dispersed further afield, away from their families who visit them and help to care for them. That pressing problem needs to be addressed quickly.However, I accept that, overall, the Government are seeking to move forward on long-term care. It will be interesting to see how the details of the Bill that they promised in the Queen's Speech are fleshed out. Following the royal commission's recommendations, the Government will provide the full costs of nursing care from October 2001. In all honesty, I welcome that decision, which I expected the previous Government to make, had the Conservatives been re-elected in 1997--[Interruption.] The hon. Member for Exeter (Mr. Bradshaw) laughs, but he was not in the House at that time. I was a Health Minister then, so I am a little better qualified to form a view about the accuracy of that statement.
I am pleased that the Government will take that course of action.
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