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The Minister of State, Department of Health (Mr. John Hutton): On 31 March 1997, there were 247,488 patients waiting 13 weeks or more for a first out-patient appointment. The figures for 31 March 2002 will be published shortly.
Mr. Bellingham: I am grateful to the Minister for that somewhat inadequate reply. Can he give me the figures for my local hospital, the Queen Elizabeth hospital in King's Lynn? Will he join me in congratulating all the staff at that hospital on the superb work that they do in serving the local community? They do an excellent job. However, is he aware that there are serious shortages of radiographers and radiologists, which means that people wait far too long for CAT and MRI scans? Serious nursing shortages are also building up, so what guarantees can he give my constituents that the extra money promised for the health service will solve local problems?
Mr. Hutton: I certainly agree with the hon. Gentleman that it is important to keep the investment coming through to the national health service, but he and his hon. Friends have some explaining to do. They come here and talk about the need for extra investment but, when they are given the opportunity to vote for those resources to go the NHS, they vote against the increase. He should go away and rehearse his lines.
I accept that, overall, patients wait too long for out-patient appointments. That is as true in the hon. Gentleman's hospital as it is in hospitals in my constituency. I am glad to say that after many years of both in-patient and out-patient figures rising, they are now coming down sharply. He will have to wait until later this month for the latest figures, however, and I hope that he will be encouraged by them. It is important that the investment keeps coming through. That is the way to tackle the capacity problems that are a result of 30 years of underinvestment in the NHS. We have a plan for doing that; he is opposed to it.
Mr. Barry Sheerman (Huddersfield): Will my right hon. Friend comment on the fact that there has been a marked improvement in waiting times to see consultants in my region of Yorkshire and Humber? However, as one talks to hospital administrators, it is emerging that one of the side effects of the Coleman recommendations on training and on the continuous training of surgeons is the significant and growing number of surgeons who are suspended. Will my right hon. Friend look into that to see whether it is a national problem, because there is real concern in the Yorkshire region about it?
Mr. Hutton: I am not familiar with the problem that my hon. Friend raises. I will certainly look into it, however, and I am sure that he, like me, welcomes the progress on reducing waiting times in Yorkshire.
Mr. Hutton: I can only assume that the right hon. Gentleman is being ironic. He asks me to commit investment next year, but he and his right hon. and hon. Friends have just voted against such increases. He has no credibility in making that point in that way. I strongly believe that, in addition to the investment, we need to reform the way in which we organise and deliver health care, and that will be part of our approach. I honestly believe that the right hon. Gentleman needs to go away and think about his position more carefully than he has done since the Budget was published.
Helen Jones (Warrington, North): Does my right hon. Friend agree that more progress would be made in cutting waiting times if we ensured that consultants who are trained by the NHS and paid full-time by the NHS actually worked full-time for the service? What progress is being made on reforming consultants' contracts to ensure that that happens?
Mr. Hutton: I agree that it is right to follow the principle that those who make the greatest commitment to the NHS should get the greatest reward. We published our proposals, as my hon. Friend will be aware, to reform key elements of consultants' contracts in February of last year. Those negotiations are under way. We are making good progress in general and I hope that they will be concluded in the near future.
Tim Loughton (East Worthing and Shoreham): Do the figures that the Minister gave include the hidden waiting lists? Will he confirm the figure in the "Not the waiting list" report in The Sunday Times last weekendthat at least 250,000 people who are waiting for tests to determine the type of surgery or other treatment that they need are excluded from the Government's published figures? Does he think it legitimate for senior NHS executives to warn hospitals against "overstatement of waiting lists" and to order chief executives to keep certain people who are waiting for diagnostic tests off those lists? Given the National Audit Office exposé of hospitals fiddling waiting times last year and now this, why should anyone believe any figures produced by the right hon. Gentleman's Department?
Mr. Hutton: The figures are reliable. The hon. Gentleman is doing a disservice to the NHS by claiming anything else. The figures that he relies on to make his point about access to diagnostic testing and so on are collected in the same way as his party collected figures when it left office in 1997. There has been no change whatsoever in the collection of that data.
The hon. Gentleman and I may agree on one thing, however: it is important that we increase access to important diagnostic treatments and, in particular, to therapeutic treatments. That is why the NHS cancer plan includes, for the first time, an important commitment to reduce the waiting time for treatment, and I hope that the hon. Gentleman will be able to support that.
The Parliamentary Under-Secretary of State for Health (Yvette Cooper): In 200001, the last full year for which data are available, there were 77,818 operations cancelled by the hospital for non-clinical reasons when the patient was due to be admitted for treatment.
Mr. Baron: I thank the Minister for that response. Given that there has been a 50 per cent. increase in the number of cancelled operations since 1997, what estimate have the Government made of both the cost to local government and the effect on council tax of their latest policy of fining councils for bed blocking in hospitals?
Yvette Cooper: Clearly, too many people are having their operations cancelled, but the most recent quarterly figures show that the number of cancellations is dropping and progress is being made. It is right that social services departments support the reductions in NHS delayed discharges, and that is exactly why they are getting a substantial increase in their resourcesway above the increases that they got under Conservative Governments.
Mrs. Anne Campbell (Cambridge): Does my hon. Friend make the connection between delayed discharges, cancelled operations and the fact that, in my constituency, Conservative-controlled Cambridgeshire county council is still spending only 85 per cent. of its standard spending assessment on services for elderly people?
Yvette Cooper: Obviously local councils that are not making the right decisions on delayed discharges will have to take responsibility for those decisions. That is why we are effecting reforms, as part of the Budget package. This is about investment and reform: investment that the Conservatives have decided to vote against, and reform that is essential to provide everyone with the incentive to improve NHS care.
Mr. Peter Lilley (Hitchin and Harpenden): Does the Minister expect that when the Government have increased the proportion of national income spent on health in England to the levels already prevailing in France and Scotland, the number of cancelled operations, waiting lists and other indicators of health performance will have reached French levels or Scottish levels?
Yvette Cooper: Waiting times and cancellations are already falling. Substantial improvements are already being made throughout the NHS as a result of the extra investment. The right hon. Gentleman really must join his party in making a decision on this. Do the Conservatives want the extra investment to go into the NHS to bring down waiting times and improve services for NHS
Dr. Phyllis Starkey (Milton Keynes, South-West): May I support the Minister's efforts to reduce delayed discharges as a way of reducing cancellations? I draw her attention to the single most effective measure that is being taken in Milton Keynes to deal with delayed discharges, which is a single social care assessment protocol agreed by social services and the NHS. May I urge her to try to make sure that a national social care assessment protocol is agreed, so that all social services and NHS personnel throughout the country can work more effectively to reduce delayed discharges?
Yvette Cooper: Yes, and I can also say that considerable work is being done throughout the country to improve the co-ordination between social services and the NHS. That is part of a broader modernisation programme, including an £8.5 million programme by the modernisation agency to cut cancelled operations.
Sandra Gidley (Romsey): The Minister will be aware that if an operation is cancelled at the last minute, it should take place within a month, but for 21 per cent. of patients that does not happen. Is the Minister happy with that state of affairs? If not, what is she going to do about it?
Mr. David Kidney (Stafford): Given South Staffordshire's success in reducing the number of cancelled operations and cutting waiting times for cataract operations by using modernisation fund money to establish a cataract surgical unit, will my hon. Friend support places such as South Staffordshire in establishing orthopaedic surgical units to enable similar success in cutting the number of cancelled operations and reducing waiting times for hip and other joint replacements?
Yvette Cooper: My hon. Friend is right; changing the way in which services are provided can make a substantial difference, particularly in the separation of emergency care from elective care, which is exactly why we are supporting a substantial number of new diagnostic and treatment centres that are being developed and invested in across the country.
Dr. Fox: Even by this Government's standards on evasive answers, that was fairly appalling. Let me give the Minister another problem and offer her a second chance. Given that bed blocking is one of the major causes of cancelled operations and that the Government's policy is to fine local authorities that have bed blocking in their areas, will she confirm not only that that will cost about £400 million, which will be passed on to the council tax payer, but that it will offer the ultimate perverse incentive? GPs in areas where there is bed blocking will realise that the best way to get patients into a local nursing home is to admit them to hospital, which will increase pressure on hospitals, worsen bed blocking and increase the number of cancelled operations. Will the Minister admit that that is the craziest of all the Government's insane policies on health, and will she stop doing damage now before it gets even worse?
Yvette Cooper: No; clearly there is an issue about delayed discharges, but the proportion of older people waiting to be discharged has fallen in the past few years. Additional investment is going in, and it is right that it should continue to do so, which is why the Budget included proposals for an extra 6 per cent. in real terms for social services, compared with less than 0.5 per cent. under the Conservative Government. The hon. Gentleman has to explain how he expects councils to tackle the issue of delayed discharges with the level of funding provided by the Tories, who year after year managed less than0.5 per cent., which is pathetic. The hon. Gentleman's party is unable to fund the NHS or social services.