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The Minister of State, Department of Health (Mr. John Hutton): We do not collect information on the number of people who have operations performed privately in the independent sector, nor on the source of funding for those operations.
Mr. Hoban: Given that independent health care companies calculate that there has been a 30 per cent. increase in the number of people who are paying for their own operations, are the Government proud of the fact that they have created a two-tier health service in which those who can pay do so, and those who cannot pay are left on longer and longer waiting lists for out-patient appointments and operations?
Mr. Hutton: This is all getting slightly ridiculous. The policy that the hon. Gentleman describes is the Conservative policy to encourage greater take-up of the private sector. That is not our policy. It is worth pointing out to the hon. Gentleman and to his hon. Friends, who appear to be unaware of it, that the NHS is treating more people and that waiting lists and waiting times are coming down. That is very much what we want to achieve and that is where the investment is going in order to produce the results that the hon. Gentleman and others want.
Mr. Oliver Heald (North-East Hertfordshire): Does not the Minister agree that the huge rise in the number of people who are paying for their own operations highlights the dilemma of patients in having to decide whether to wait for months in pain and fear for an operation or to use their life savings to pay for it? Is not that choice creating the two-tier health service that we have todaya tier of those who wait and a tier of those who pay, neither really able to afford it?
Mr. Hutton: I thought that when we heard from the hon. Member for Fareham (Mr. Hoban) we had reached rock bottom, but obviously I was wrong. This is preposterous hypocrisy by Conservative Members, who never showed any interest in or concern about such issues when they were responsible for running the affairs of the NHS. [Interruption.] They did not do better; they did substantially worse. The way to deal with the issues is not to indulge in such ludicrous, absurd posturing, but to keep the investment going in, keep the reforms on track, and, as we do so, ensure that we reduce waiting lists and times and treat more patients on the NHS. That is what we are committed to doing and that is what we are delivering.
The Minister of State, Department of Health (Mr. John Hutton): Edgware community hospital currently provides a range of out-patient and day care acute services, which include intermediate care services, an urgent treatment centre, maternity services, diagnostic facilities and acute mental health services. The development of the new Edgware community hospital means that they will continue to be provided in improved surroundings, together with a range of additional services for the local community such as a dedicated children's service. The contract for the new hospital is expected to be signed next month with a view to building work beginning in May.
Mr. Dismore: I thank my right hon. Friend for that reply and congratulate the Department on the progress in restoring services at Edgware since the Tories closed the hospital before the 1997 election. However, the fly in the ointment is last week's decision to close the urgent treatment centre at night. It has caused great anger and resentment in the community and is universally opposed. Given that overnight services in our area are generally not up to scratch, the decision should be reconsidered.
Mr. Hutton: I have listened carefully to my hon. Friend. It is worth putting it on record that the urgent treatment centre at Edgware hospital has been much used by local people during the day. The figures have increased from about 19,000 when it opened to approximately 47,000. Clearly, the service is used. At night, the circumstances are different because the number of people who use it is much reduced. However, I understand that the local community health council will oppose the
Sir Sydney Chapman (Chipping Barnet): Whether the urgent treatment centre at Edgware remains open at night or not, will the Minister assess the number of people who are sent there wrongly, believing that they will receive attention for a serious injury? The phrase "urgent treatment centre" causes confusion and delays in dealing with serious injuries.
Mr. Hutton: The hon. Gentleman is right to raise that matter, which local doctors and nurses have also brought to our attention. I assure him, my hon. Friend the Member for Hendon (Mr. Dismore) and others who are worried that we shall consider carefully the proposals that are likely to come before me. I shall have to make a decision on the matter and the comments of the hon. Member for Chipping Barnet (Sir Sydney Chapman) and others will contribute to it.
The Secretary of State for Health (Mr. Alan Milburn): There are six priorities for reducing health inequalities: early years; children and young people; primary care; heart disease and cancer; disadvantaged communities, and addressing the wider determinants of ill health.
Fiona Mactaggart: I thank my right hon. Friend for that reply. He will not be surprised to hear that of those priorities, I am most concerned about heart disease. Many communities such as the one that I represent have high levels of it. Slough is in the top 10 constituencies for early male deaths from heart disease, yet it is in the healthiest county in the country. I am worried that the new health authorities will take money but not action to deal with the problems.
I am grateful for the action that has been taken so far such as statins prescribing and the new cardiology unit at Wexham Park hospital, but I want my right hon. Friend to reassure me that he will ensure that new health authorities direct resources where they are needed, especially when there are pockets of serious ill health in relatively healthy counties.
Mr. Milburn: My hon. Friend makes an important point. Her constituency is not unusual in being a deprived community in a sea of greater affluence. Two things need to happen. In the short term, the health authorities and the new strategic health authorities that will come into being in the next financial year in a week or so, must ensure a reasonable distribution of resources to tackle the problems in the most deprived communities. Secondly, as my hon. Friend knows, from the next financial year, allocations will go directly to primary care trusts, thus creating a much more localised system of getting the money where it is most needed.
My hon. Friend is right to raise the question of heart disease. It kills more people than cancer and is the disease that kills most people in our country. There is some progress; deaths have fallen by 5 per cent. in the last year for which we have figures. The number of operations is increasing, and waiting times for operations are falling. My hon. Friend has rightly mentioned statins; prescribing of that treatment is up by one third. In addition, the smoking cessation services are beginning to have a real impact in her constituency and elsewhere. That shows that, despite the fact that these are intractable problems, if we adopt the right approachthe right policyand back it with the right level of resources, we can get results. We now have to keep that moving in the right direction.
Mr. David Tredinnick (Bosworth): Is the right hon. Gentleman aware that one of the worst inequalities in the health service is in the provision of complementary and integrated medicine? Will he confirm that I gave him notice of a question on the use of homeopathy in deprived areas, and is he also aware that he gives the impression that he really does not care about complementary and integrated health care? That is rather dangerous, given Labour's slide in the polls and the fact that one fifth of the population uses such health care.
Mr. Milburn: That is obviously the answer. The hon. Member for Bosworth (Mr. Tredinnick) is nothing if not persistent, and consistent, on these problems. I well remember him asking my right hon. Friend the Member for Southampton, Itchen (Mr. Denham), a question, and my right hon. Friend quite rightly referring to him as the hon. Member for Holland and Barrett. The hon. Gentleman makes an important point, however. As he is aware, there is an increasing evidence base for some of the interventions that he is incessantly, persistently and consistently talking about, and it is important that general practitioners should be aware of that information so that they can make their own decisions about what is right for their patients in different parts of the country.
Derek Twigg (Halton): The mortality rate from cancers and heart disease in my constituency is among the highest in the country; there is a shortage of GPs in Widnes; and we have been trying to get a health care resource centre for more than eight years now. Will my right hon. Friend do something about the north-west office of the NHS executive, which is shortly to be abolished, and perhaps use his good offices to get things moving? The executive has still not made a decision about what is to happen in Widnes, and it is crucial to get more GPs in to get the good facilities that we deserve. Will my right hon. Friend do something about that when he has discussions with
Mr. Milburn: I am aware of my hon. Friend's frustration. He has asked us to do something about the north-west regional office, and I can promise that that will happen, because it is being abolished in about a week's time. I do not know whether that is what my hon. Friend was asking for. So far as the issue of GPs in his constituency and other deprived communities is concerned, a specific initiative is under wayof which he is aware, and which I hope will be of benefit to him and his constituentsinvolving GPs being recruited from Spain to work in the north-west of England. In the more medium term, we also have to ensure that the incentives are right for GPs to work in the more deprived communities. We have made a start, and I personally think that we need to do more to ensure that we get the right level of primary care resources in the most disadvantaged communities.