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House of Commons

Tuesday 4 May 2004

The House met at half-past Two o'clock

PRAYERS

[Mr. Speaker in the Chair]

Oral Answers to Questions

HEALTH

The Secretary of State was asked—

Accident and Emergency Admissions

1. Brian Cotter (Weston-super-Mare) (LD): What action his Department is taking to help accident and emergency departments cope where there are increases in the number of patients who are admitted for treatment. [169823]

The Minister of State, Department of Health (Ms Rosie Winterton): The Department has set up substantial national support for accident and emergency departments. The latest figures show that more than 90 per cent. of patients were treated, admitted or discharged from accident and emergency in less than four hours, compared with 78 per cent. in December 2002, even though in many areas there has been an increase in the number of patients using the service.

Brian Cotter : I thank the Minister for that reply. Weston-super-Mare has a particular problem, in that a department designed to treat only 25,000 patients in fact treats 45,000. Historically, we have also had problems with fair funding because of our proximity to Bristol. I hope that the Minister will pay special attention to that issue, as we also need assistance for paediatrics and other departments.

Ms Winterton: It is true that the number of patients has increased, and some £240,000 has been provided in the past two years to improve resuscitation services. As I am sure the hon. Gentleman will be aware, the Weston area has put together an action plan to improve the accident and emergency department, in particular by establishing a paediatric minor injuries unit and an urgent care centre. In the past week, Weston NHS trust qualified for a capital incentive payment of £100,000 to be spent on locally determined projects, which should improve the situation.

Phil Sawford (Kettering) (Lab): I thank my hon. Friend for visiting Kettering general hospital a few weeks ago; the members of staff, management and patients to whom she spoke appreciated her visit. If she had been able to stay longer, she could have seen the
 
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refurbished and modernised A and E unit, the new CAT scanner, the new MRI scanner, the new orthopaedic theatre and the new ophthalmic unit—I could go on for ever, if you would allow me to, Mr.   Speaker. Does my hon. Friend agree that that contrasts starkly with the years when wards were closed and padlocked under the previous Government?

Ms Winterton: I thank my hon. Friend for that question. It was a great pleasure to meet the dedicated and committed staff in the A and E department. They were given a £100,000 incentive payment for achieving 94 per cent. of target two weeks ago, and if they continue in the same way—as I am sure they will—they will qualify for some £500,000 in extra funding to improve services locally. My hon. Friend is right: no one can imagine going back to the bad old days of cuts, under-investment and poor staff morale.

Dr. Richard Taylor (Wyre Forest) (Ind): Will the Minister consider supporting the formation of clinical networks in accident and emergency, so that A and E departments can share expertise and staff with local minor injuries units, thereby increasing the scope of minor injuries units and lessening the load on A and E departments?

Ms Winterton: The hon. Gentleman is right to say that such networks can be helpful. We have established emergency services collaboratives, whereby various A and E departments have been able to spread best practice. We are also setting up emergency care networks to consider some of the issues that he mentions. It is important to consider not only A and E departments but the contribution of ambulance trusts, primary care and pharmacists, so that we can build proper choice into the system of emergency care.

Siobhain McDonagh (Mitcham and Morden) (Lab): What weighting is given to A and E numbers when considering the amalgamation or closure of hospitals, especially in built-up urban areas? In my constituency, we are concerned that St. Helier hospital might move to the Sutton hospital site, which we predict would mean an increase of 20,000 to 30,000 extra patients at St. George's.

Ms Winterton: As my hon. Friend will be aware, it is for local primary care trusts, working with strategic health authorities and trusts, to ensure that any reconfiguration of services is not to the detriment of patient care or involves missing any targets. She will know about the four-hour target and about those for ambulance trusts, which are designed to ensure that people receive care within a certain time. Any reconfigurations must take those targets into account, and I hope that that is happening in her local area.

Racial Discrimination

2. Dr. Evan Harris (Oxford, West and Abingdon) (LD): What assessment he has made of racial discrimination in medical careers in the NHS. [169824]
 
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The Minister of State, Department of Health (Mr. John Hutton): The national health service is fully committed to the principle of race equality, both as an employer and as a provider of services. In relation to careers in medicine, new legislation that I expect to come into force later this year will provide new routes to entry on the specialist register for associate specialists and for staff-grade doctors. The postgraduate medical education training board will also oversee the provision of new top-up training, allowing doctors in that group to gain entry to the register.

Dr. Harris : I am grateful to the Minister for that answer. He must be aware that his Department recently had to pay a doctor damages of more than £600,000 for discrimination. The Government did not appeal, on the basis that the tribunal found the Birmingham declaration of 1996, which governs the transition to specialist training in order to become a consultant, to be indirect racial discrimination. Hundreds, perhaps thousands, of other doctors may have been affected. Will the Minister seek them out so that they can be fast-tracked to consultant status with fair treatment, or will he expect each of them to drag the Department to the courts if they are in time to do so?

Mr. Hutton: Obviously, we take all those issues very seriously indeed. The hon. Gentleman is right to draw our attention to that case, but it was complicated by the provisions on permit-free work time that then applied. The arrangements changed subsequently, so I do not think that those problems will be repeated. The key is to get the postgraduate medical education training board up and functioning as soon as possible, and we are committed to doing that. We can then activate article 14 of the new specialist training order, which will allow the postgraduate medical education training board to take a much wider view of work-based experience when assessing whether someone is suitable to go on to the specialist register. I agree that that will take time, but the issues are complicated. I fully accept the hon. Gentleman's premise that it is our responsibility to treat doctors fairly and equally in the NHS, which is precisely why—with that purpose in mind—we have changed the law.

Andrew Selous (South-West Bedfordshire) (Con): We all abhor racial discrimination against NHS staff, but does the Minister think it right that there is so much age discrimination against NHS staff? The policy of one of my local trusts is not to employ people aged over 70, yet there are medical secretaries who want to carry on working and are entirely competent. It is very difficult to recruit such secretaries, so will the Government look into that matter?

Mr. Hutton: Yes, I shall happily look into it for the hon. Gentleman. It is sensible for NHS trusts to adopt a flexible policy in relation to such matters. However, I should point out that he and his hon. Friends constantly complain about ministerial intervention in the decision making of local NHS trusts, so I am not sure that he and his hon. Friends would necessarily be the first to welcome my interference in that case—but perhaps I am wrong.
 
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Medical Students

3. Rob Marris (Wolverhampton, South-West) (Lab): If he will make a statement on the number of students entering medical training schools in (a) the current year and (b) 1997. [169825]

The Secretary of State for Health (Dr. John Reid): In autumn 2003, English medical schools admitted 6,030 students. In 1997, the figure was 3,749. That is an increase of more than 2,250 medical students, or more than 60 per cent. since 1997. It is the largest increase in medical school places since the national health service was established.

Rob Marris : As we say in the black country, those figures are bostin'.

My late father was, for more than 25 years, a consultant radiologist at the hospitals that now form the Royal Wolverhampton hospitals NHS trust, and I, too, worked there. Can my right hon. Friend confirm that the Wolverhampton trust is playing its part in helping to train that record number of doctors, and that NHS funding, especially for training, will be maintained?

Dr. Reid: Indeed, I can. I know that my hon. Friend takes a familial and political interest in these matters as well as a constituency interest, so I took the trouble to check the figures on the Royal Wolverhampton hospitals NHS trust. In 2002, more than 180 medical students undertook practice placements in the trust; in 1997, there was none. The trust has expanded its postgraduate doctor placements by nearly 35,000 in two years. My hon. Friend may also be interested to know that the nearby Birmingham medical school admitted 428 students in autumn last year, compared with 215 in 1997—a 99 per cent. increase.

Mr. David Tredinnick (Bosworth) (Con): The Secretary of State has referred to the increase in the number of medical students, but he has not referred to an increase in training in complementary and alternative medicine for medical students or doctors, in line with the recommendations of the Lords report on alternative and complementary medicine, which even his Department admits is a benchmark. What increase has there been in training in complementary medicine for doctors, and does he plan to increase the percentage?

Dr. Reid: There has been an increase in the training of doctors in almost every single field. [Interruption.] The hon. Gentleman looks rather quizzical, but between 1979 and 1997, when the Conservative Government were responsible, not a single new medical school was opened and, indeed, two dental schools were closed. However, this Government have opened four new medical schools since the autumn of 2002 alone, so there has been a marvellous upsurge in the number of medical places and doctors in practice as well, and that goes right across the field. As the hon. Gentleman knows, unlike the previous Government, provided that there is always reasonable regulation and empirical evidence to substantiate the efficacy of alternative medicine, this Government are intent on extending choice and information to patients in the national health service.
 
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Dr. Andrew Murrison (Westbury) (Con): In the 1970s, the right hon. Gentleman's predecessors got their predictions for our dental work force very badly wrong, and our constituents are living with the consequences. Given that the best guess that the Minister of State, the right hon. Member for Barrow and Furness (Mr. Hutton), was able to reach in European Standing Committee C for the number of doctors that we would have to train to take care of the European working time directive was between 6,000 and 12,000, how much confidence can Ministers have in his predictions for our future medical man force requirements? Will he tell us the net number of doctor hours that will result from those increases by the year 2009?

Dr. Reid: Today is the 25th anniversary of the unfortunate election of Baroness Thatcher. On that date in 1979, the message repeatedly given was that everything was the fault of the Labour Government in the early 1970s. After 25 years, the record has not changed at all. In fact, there are now 2,000 more dentists than there were in 1997, and the reason most of them are not doing as much NHS work as previously is the disastrous contract that the Conservatives introduced in 1992.

On the working time directive, while we do not for a moment diminish the difficulties that two legal judgments have caused, an enormous amount of work is being done to ensure that, both in methodology and numbers, we can cope in the NHS. The hon. Gentleman talks about the 1970s, but Britain, including the British national health service, is working once again, and it would be an absolute disaster to let him and his colleagues ruin it once again.

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