House of Commons
Tuesday 23 March 2004
The House met at half-past Eleven o'clock
PRAYERS
[Mr. Speaker in the Chair]
PRIVATE BUSINESS
London Local Authorities Bill [Lords]
Read the Third time, and passed, with amendments.
Oral Answers to Questions
DEPARTMENT OF HEALTH
The Secretary of State was asked—
Patients Choice
1. Lynne Jones (Birmingham, Selly Oak) (Lab): If he will make a statement on the involvement of private sector providers in his proposals for patients choice. [162775]
The Secretary of State for Health (Dr. John Reid): The national health service is expanding as never before and in addition, as we promised in our manifesto, independent sector providers are supplementing this expansion and helping to deliver increased capacity and choice.
Lynne Jones : Do the Government have any plans to make it mandatory for treatment with a private sector provider to be included in the choices to be offered to patients? If so, why?
Dr. Reid: The whole point of choice is that patients can choose from a range of options rather than being dictated to in what choice they make. We made it absolutely plain in our last manifesto that, in addition to expanding the national health service at an unprecedented rate, we would also supplement the investment and increase capacity and reform by purchasing operations from the private—the independent—sector. That has had the salutary effect of providing a degree of choice and additional capacity in the national health service. Our approach is always to be at the behest of patients rather than dictating to them where they should place their choice.
Mr. Michael Fallon (Sevenoaks) (Con): Is the Secretary of State aware that my constituent, Mr. Evershed of Swanley, was told by the NHS last week that he would have to wait 72 weeks for a scan? If that
is the best that the NHS can do after all these extra billions, surely the sooner the right hon. Gentleman gets some private sector help organised, the better.
Dr. Reid: I obviously do not know about the case of that constituent, and it is no good the hon. Gentleman waving a piece of paper at me—that does not enlighten me much more. If what he says is happening, the wait is far too long; I agree with him entirely on that. That is why I hope he will agree that more investment should be put into the national health service. He may be interested to know that we are bringing in something like 400,000 more operations, and that 1 million more patients are being treated.
The maximum waiting time under the patients charter under the Government of whom the hon. Gentleman was a Minister was envisaged as being two years. When we came to Government, the maximum waiting time for an operation was 18 months. Now no one is waiting 18 months, 15 months or 12 months, and I hope that by the end of this month no one will be waiting nine months. In other words, we will have halved the maximum waiting time that was extended to patients by his Government.
Mr. David Hinchliffe (Wakefield) (Lab): I was talking to an NHS consultant a little while ago and he did not appear to need free NHS croutons. He told me that he was embarrassed by the amount of money my Government were paying him to treat in the private sector his NHS patients. "Embarrassed" was the word he used. When my right hon. Friend came to the Health Committee, he will recall that the Committee estimated that using the private sector through the concordat was costing the NHS on average 40 per cent. more per item of treatment. It subsequently came out that the figure was 43 per cent. How can my right hon. Friend justify the amount of money that we are paying some consultants? Bearing in mind his comments about additional capacity, if these consultants were not working in the private sector they could actually be doing more hours treating NHS patients in the NHS.
Dr. Reid: My hon. Friend is right—I do not justify the amount of money that we used to pay for operations in the independent sector. That is why we have stopped purchasing them in small amounts at spot prices. For instance, the recent purchase of 40,000 additional cataract operations from the independent sector will result in a huge reduction in waiting time and faster access. They will supplement the NHS. The price at which I am purchasing them is not 40 per cent. above the NHS tariff; it is 10 per cent. below. I envisage that the 250,000-plus operations that we will buy to supplement an expanding NHS will still be only 5 per cent.—perhaps a maximum of 10 or 15 per cent.—of NHS operations. Those operations will not be purchased at anything like 140 per cent. of the NHS tariff. Indeed, when the contracts are renewed, they will be at the NHS tariff or they will not be renewed.
Mr. David Tredinnick (Bosworth) (Con): In considering the private sector providers in the right hon. Gentleman's proposals for patients choice, will he bear in mind that most of the 60,000 practitioners of complementary medicine are still in the private sector? Does he agree that the report that his Department has
just published—and which is signed by the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton)—"Regulation of herbal medicine and acupuncture: Proposals for statutory regulation", is a significant step forward and shows that the Government have finally accepted the importance of all forms of complementary medicine? Very soon, we will have a truly integrated health service that brings in all these practitioners. That will cut bills and make life a lot easier for the Secretary of State.
Dr. Reid: We need two things. We need the regulation of that sector because then we can extend patients choice on using elements of it. It is a huge step forward, together with the other steps that we are making in the national health service, and we go forward together.
I noticed that yesterday, for the first time in seven years, the Opposition acknowledged the progress that is being made. I congratulate the hon. Member for South Suffolk (Mr. Yeo), my opposite number, for saying yesterday that progress has been made to improve both the nation's health and the NHS itself. If the Conservative party publicly recognises that, there must be significant improvements.
James Purnell (Stalybridge and Hyde) (Lab): Does my right hon. Friend agree that we should not be ideological about using choice in the private sector? We should be neither ideologically against it nor for it, because the question is whether it improves the quality of services and equality of access to those services. In that respect, will he tell us whether patients who are offered the choice are exercising it? Will he especially examine transport and consider whether that is undermining some people's ability to exercise choice in the NHS?
Dr. Reid: I very much agree with my hon. Friend that the matter of principle is not who the provider is, but equal access to health care that is free at the point of delivery. That is what distinguishes this side of the House from the other. Conservative Members seem to operate on the principle that people can have choice provided they have enough money in their pockets to pay for half the operation. That is a scandal that would undermine the founding principle of the national health service.
The Department of Health is reviewing patient transport arrangements in the light of the social exclusion unit report "Making the connections". The review will ensure that the implications of choice are taken on board. The Department's guidance on choice at six months provides for patients to be offered transport free of charge, if required, to enable them to take up their choice of hospital. Once again, that represents equal access to improving health care that is free at the point of need and delivery. That is the founding principle of the NHS, and as long as I am Secretary of State and the Government are in power, it will be preserved.
Mr. Tim Yeo (South Suffolk) (Con): Will the Secretary of State confirm that such progress as has been made to reduce waiting lists and waiting times has been achieved largely through the greater use of the private
sector? Now that the Government have belatedly recognised that meeting the needs of patients can be best achieved through promoting a mixed economy in health care, does he think that he might find it easier to persuade his Back Benchers of the merits of the proposal if it were the patient who decided whether to go into the independent sector, rather than a Minister or a public sector bureaucrat?
Dr. Reid: No, I cannot confirm that the progress is largely a result of the supplementary operations that we are purchasing. They are making a significant contribution, but I would not diminish in any way the reforms that have been introduced by the national health service itself and directly employed staff. The hon. Gentleman should remember that more than half of the new treatment centres that are dealing more efficiently with operations and increasing the output of health care have directly employed NHS staff. We must consider primary care, the activity that is now being done by general practitioners, out-patients, the fact that NHS Direct responds to some 6.3 million people, the new walk-in centres and the fact that nurses can now act as nurse consultants and nurse practitioners, because all those measures have been integral to the increased productivity of the NHS.
The hon. Gentleman made a big concession from the Opposition Front Bench last night by admitting for the first time in seven years that there have been significant improvements in the NHS, so I ask him please not to start to step back by saying that they are all attributable to the private sector.
Angela Eagle (Wallasey) (Lab): May I congratulate my right hon. Friend on the extra money that has gone into the NHS? The Clatterbridge centre for oncology has managed to cut waiting lists for radiotherapy treatment from 39 days to a mere 16 days because of investment that has created five new consultants, a 20 per cent. increase in staff, nine new Linex scanners and new technology that means that every hour for which the scanners are available in a day can be properly booked and used. That has led to a massive decrease in waiting lists and an increase in the quality of service for those who have cancer and need it to be treated in the Merseyside and Wirral area.
Dr. Reid: Indeed, attention to treatment for and the number of deaths from cancer when we came to power were, frankly, a scandal in comparison with the position in other nations. We are now spending about £570 million more a year on cancer alone and we have 30 per cent. more consultants. Professor Mike Richards, the national cancer director, announced a fortnight ago that 99 per cent. of people suspected of suffering from cancer are seen by a specialist within two weeks. That is light years away from the position under the previous Government. All that I can say is that the figures speak for themselves. In the 33 years since 1971 there has been a reduction in premature deaths from cancer of 22 per cent., almost half of which was achieved in the first five years of this Government's period in office, when there was a 10.3 per cent. reduction in cancer. If that is not a significant improvement in the national health service and the health of our nation, I do not know what is.
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