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27 Nov 2002 : Column 351—continued

Mr. Jon Owen Jones (Cardiff, Central): Will my right hon. Friend acknowledge that, given the impressive list of inputs in the health service that he has mentioned, it is all the more important that we have a rigorous and independent audit structure so that we measure outputs and ensure that they are commensurate with the input that the management of our economy under a Labour Government has managed to provide for the health service?

Peter Hain: I very much agree, and the proposals provide for an independent inspection audit. I acknowledge my hon. Friend's contribution towards creating the foundations of the success on which the Assembly is now building when he was Minister for health in the then Welsh Office, succeeding another good Welsh health Minister, my hon. Friend the Member for Bridgend (Mr. Griffiths).

The recent opening of the Swansea clinical school, the proposal for clinical schools in north Wales and at the Royal Gwent hospital, together with a graduate entry scheme to medicine also planned for Swansea, are significant stages in the Assembly's plans to increase the number of doctors in Wales. There are 700 specialist registrar training posts in Wales and there will be 60 extra posts by next year, with particular emphasis being placed on areas with shortages. We have also pioneered innovative ideas to improve services for the public. That includes NHS Direct Wales, a 24-hour helpline staffed by nurses which is available throughout Wales. It took nearly 239,000 calls in the 12 months to September 2002, an increase of more than 40 per cent. on the previous 12 months.

The NHS in Wales is treating more patients than ever before, and I salute the dedication of NHS staff in Wales—doctors, nurses and many others—as they cope with the ever-increasing demand for treatment and care. After decades of underinvestment, there can be no quick fixes on waiting times. Significant progress has been made, however. The target to reduce waits for cardiac surgery to a maximum of 12 months has been met in full and the challenging target of reducing waits for orthopaedic surgery to a maximum of 18 months has been broadly met. The latter target is especially important for those of us who represent constituencies in Wales with a long legacy of industrial disease. The waiting lists for people who need hip or knee operations, for instance, are coming down, and they are on target to reduce even further.

Mr. Evans: The Secretary of State pays a glowing tribute to the reduction in waiting lists. In 1997, 378 people waited for more than 12 months for out-patient treatment. The figure for 2002 stands at 36,302. How does he account for that enormous increase?

Peter Hain: I do not gloss over the fact that the waiting list situation in Wales is not as good as it should be. The hon. Gentleman is right to draw attention

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to that. Two factors primarily account for the difference. The first is the increased demand for the use of the NHS in Wales. That is a sign of increasing excellence in our hospitals and health services in Wales. The second factor is best demonstrated by the example of turning an oil tanker around. That tanker was going in wrong direction under his Government, and it takes time to change its direction.

Waiting lists for orthopaedics fell by more than 36 per cent. last month. That is good news for patients because most trusts in Wales now have no one waiting for more than 18 months for orthopaedic operations. Progress has also been made on cataract waiting times, with the number of people waiting for more than four months falling by more than 10 per cent. The waiting time target for cardiac surgery has been sustained with no patients waiting more than 12 months.

The hon. Gentleman made an important point. One of the greatest health challenges facing the Assembly is the length of time that many patients have to wait to receive treatment or to see a consultant. We all recognise that too many people have to wait far too long. There are no quick fixes. The reasons behind that are complex. They relate to the legacy that we inherited from the hon. Gentleman's Government and to increasing demands on the system. There is no doubt, however, that substantial progress has been made, especially in the priority areas targeted by the Assembly. We are on target to improve the quality of health care in respect of waiting times and other matters.

Mr. Bill Wiggin (Leominster): Does the Secretary of State agree that the level of funding for the NHS in Wales is already at a European level, where there are no waiting lists, and that the over-18-month waiting list has increased by more than 1,800 people since the pledge was made when the Assembly was established?

Peter Hain: I have partly answered that point. I do not think that we have yet reached European average levels. Getting there will take time, and the money to achieve that objective is being made available. Turning the NHS around from its state when we inherited it a little over five and a half years ago will be a long job.

The difference between us is that we are willing to put in the investment while the Conservative party would cut that investment. Indeed, its Front-Bench spokesmen have repeatedly said that they oppose our public spending plans, and they have confirmed that this afternoon. We are able to maintain public investment at record levels and, in the health service, to increase it every year until 2008. Those are long-term plans enabling hospital managers, consultants, doctors and nurses to plan ahead. The quality of care, with the NHS treating more people all the time, is steadily going up.

The NHS in Wales is treating more patients than ever before, and I salute the dedication of all its staff. In contrast to the Conservatives, who closed 17 hospitals between 1979 and 1997, we promised in our general election manifesto last year to open 10 new hospitals in Wales over 10 years. The latest steps in the capital programme were announced in the Assembly budget last month and include a replacement for the cottage hospital in Tenby and new community hospitals in Merthyr and in Ebbw Vale, in the constituency of my

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hon. Friend the Member for Blaenau Gwent (Llew Smith). I am sure that he endorses that decision by the Assembly, if few others.

Both the Government at Westminster and the Welsh Assembly Government in Cardiff believe that the future of the health service in Wales depends on a process of investment and reform. That is why the Bill builds on the measures in the National Health Service Reform and Health Care Professions Act 2002 which remove an unnecessary tier of bureaucracy in the health service in Wales and introduce greater local accountability, placing local decision making in the hands of local communities, health professionals and patients. The proposals build on earlier restructuring by the Welsh Office, which reduced the number of NHS trusts—they might be described as quangos—from 26 to 15.

The Assembly has been working hard to increase the responsiveness of the NHS to patients and the public and to strengthen the public's influence over the running of the health service. Proposals in the Bill will involve the people of Wales in their health service more fully than ever before. Already, strong relationships are being built between health and social care, and the Assembly has been at the forefront of bringing the patient's voice into decision making. The strengthening of that voice through the enhanced community health council structure, which is largely co-terminous with the local authority and local health board structures, will give the people of Wales an unparalleled, strong and meaningful local structure that will deliver for them, provided that the investment continues as we intend it should.

Alan Howarth (Newport, East): Does my right hon. Friend agree that the continuing existence of community health councils in Wales will be of great assistance to the new health boards, enabling them to fulfil their remit of developing health, social care and well-being strategies for their communities, thereby enabling Wales to make progress in preventive health care strategies? It will also enable the health service to play the part that it ought to play with the crime and disorder reduction partnerships. In those respects, Wales will be leading the United Kingdom.

Peter Hain: And not for the first time. I agree with my right hon. Friend that the retention of community health councils in Wales provides the bedrock for community involvement. Wales is leading England in that matter just as it is leading England by introducing free bus passes for pensioners and disabled people and by introducing Assembly learning grants, and so on.

Further evidence of the importance of the reform process in Wales and of our commitment to ensure that the extra resources allocated to health in Wales are spent in the most effective way came with the welcome recent announcement by the Assembly Finance Minister, Edwina Hart, that Derek Wanless, who advised the Chancellor on the funding of the NHS at a UK level, has agreed to act as an advisor to a review of health and social care in Wales.

Mr. Simon Thomas: I thank the right hon. Gentleman for his generosity in giving way. He will recall that the Wanless report stated clearly that public investment in health care was the best and most effective and efficient way forward, and I am sure that he, like me, supports

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that. Will he therefore take this opportunity to support all those in the National Assembly who want to rule out the introduction of foundation hospitals in Wales?

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