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Accident and Emergency

9. Mrs. Lorna Fitzsimons (Rochdale) (Lab): What plans he has to reduce waiting times in accident and emergency departments. [202210]

The Secretary of State for Health (Dr. John Reid): Last month, 97 per cent. of patients were seen and diagnosed, and were able to begin treatment, within four hours. The NHS is on track to ensure that, by the end of this month, at least 98 per cent. of patients enjoy the same care. That is a world standard for the NHS.

Mrs. Fitzsimons : May I bring to my right hon. Friend's attention the spectacular turnaround in the accident and emergency department of Rochdale infirmary? Is he aware that the basic ingredients for that turnaround were already in place, although investment was gratefully received? In fact it was the team of clinicians—Don, David, Rip, Selim and Mark, who are the consultants, Ann Rhodes, who was the linchpin as manager and the nursing staff—that galvanised the whole hospital to work together. Can my right hon. Friend assure me that under "Agenda for Change" and with future investment, the key role of medical secretaries, medical record staff and their senior managers will be enhanced and appreciated, because without their pivotal role—

Mr. Speaker: Order. I think that the hon. Lady has made her point. She has a very good hospital.

Dr. Reid: Yes, but no one could blame my hon. Friend for lauding and celebrating the success of the NHS in Rochdale infirmary and more widely. She is right that it is a team effort. It is composed of massive investment by the taxpayer, through the Government, and massive commitment by the team in Rochdale, and others throughout the country, to reach such a world standard of treatment. The whole of the NHS is finding new ways of working, with—I have to say—a degree of leadership at local and national level from managers and chief executives, as well as clinical and administrative staff. The idea that we should throw all that away by cutting the amount of investment or abandoning that leadership and those targets and objectives is crazy, but that is what is on offer from the Opposition.

Dr. Richard Taylor (Wyre Forest) (Ind): Does the Secretary of State agree that where there are still stresses on accident and emergency departments, one way to help would be to increase the range of work undertaken by neighbouring minor injuries units?
 
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Dr. Reid: Yes, I do. The hon. Gentleman is learned in such matters and he appreciates the position. I visited a unit that is establishing a rapid response unit and going even further than providing fast and easy access to accident and emergency services by ensuring that people get a response in their own homes for minor injury. That is another way in which the new ways of working in the national health service are achieving better, more convenient and faster access to health care for everyone.

Mr. Brian Jenkins (Tamworth) (Lab): My right hon. Friend is right. The Staffordshire ambulance force is one of the best in the country, with the most rapid response times. My right hon. Friend will also be aware of the work that the London Ambulance Service is undertaking. It has a system of triage and sends out cars or motorcycles to attend some emergencies. As a result, it has cut tremendously the number of admittances by ambulance to emergency units. That is the way forward, coupled with the stationing of GPs in some accident and emergency departments to treat people who turn up on a Tuesday morning with an injury they suffered on the football field on Saturday. Will my right hon. Friend comment on the support that the Government have given to encourage innovative ways of introducing such systems?

Dr. Reid: My hon. Friend is right. I visited the service that he mentioned with him, and it has achieved astounding results. He is also right that systems are being tried and tested elsewhere in the country. Peter Bradley of the London Ambulance Service is involved in reviewing some of those procedures at the moment. The great thing about all that, which is often omitted from contributions by the Opposition and newspapers, is that huge benefits are bestowed by NHS staff who are prepared to work in ways in which they have never worked before and provide better quality and more convenient health care. A fantastic amount of work is being done to balance those things that do go wrong and the shortages and challenges that remain. I only wish we had more balanced reports on that in the public domain.

Hormone Replacement Therapy

10. Rev. Martin Smyth (Belfast, South) (UUP): What guidance has been given to patients and general practitioners on the long-term use of hormone replacement therapy. [202211]

The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): Advice from the Committee on Safety of Medicines is that the benefits of short-term treatment of menopausal symptoms outweigh the risks in most women. The lowest effective dose should be used for the shortest possible time.

Rev. Martin Smyth: I thank the Minister for her response. She will be aware that even the press has been ambiguous when reporting what should best be done. About 20 years ago, I buried a young woman who had been on HRT. Another young woman who was advised to take it at the time refused to do so; she is still living. Some clear guidance should be given to patients and doctors on how to use HRT.
 
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Miss Johnson: I should like to reassure the hon. Gentleman that advice has been widely communicated to health professionals and patients to support informed choice. That advice it is available on the Medicines and Healthcare products Regulatory Agency website through the Committee on Safety of Medicines.

Hospitals

12. Jonathan Shaw (Chatham and Aylesford) (Lab): What the total investment in NHS hospitals was in (a) 2004–05 and (b) 1996–97. [202213]

The Secretary of State for Health (Dr. John Reid): We do not make a distinction between investment in hospitals and in other NHS facilities. However, in 1996–97, total NHS spend was £33 billion and in 2004–05, planned NHS expenditure is £69.4 billion. Between 1996–97 and 2004–05, capital investment has increased by 170 per cent.

Jonathan Shaw: That money has seen investment in our local hospitals in Kent, resulting, this month, in a reduction of the maximum waiting time for cataract operations to three months. Will he congratulate all the NHS staff who work in our facilities to ensure that that type of service is proving possible?

Dr. Reid: Yes, I am delighted to do so. I know of the distress and anguish caused, especially for elderly people, by waiting for cataract operations. Reductions in waiting times throughout the country—sometimes from 18 months or two years down to three months and, in some cases, weeks—show that people are receiving a fantastically improved NHS locally. Although we are using the same standard for judging waiting times that has been used for decades, and it is legitimate to talk about a vast improvement, that standard is not good enough, because it counts people only from the time after diagnosis. I fully intend—as do the Government, if re-elected—to get rid of hidden waits and to judge the time from the first time people see a GP right through to the treatment centre; in that case, for cataract operations. We shall make it an average of 10 weeks; not the years that people had to wait under the previous Government.

Mr. Bob Blizzard (Waveney) (Lab): I have almost lost track of the number of millions of pounds of new investment at my local hospital, the James Paget NHS trust. One of the best investments was £1 million in new accident and emergency facilities that have enabled my local trust not only to meet all the waiting-time reduction targets for A and E, but to achieve 100 per cent. on Sundays. Will my right hon. Friend congratulate the staff and management of the hospital on putting that extra investment to the best possible use?

Dr. Reid: I have no hesitation in doing so—[Laughter.] Nor, while Opposition Front Benchers laugh at the efforts of NHS staff, do I have any hesitation in saying that those improvements are to the credit of NHS staff; not politicians, pundits or commentators, but the staff themselves. I am delighted that the recent progress report from the national director for emergency access, Sir George Alberti, has
 
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been independently confirmed by the National Audit Office, which, in its report on improving emergency care in England, noted sustained and significant improvements over the past two years. That is due partly to the efforts of the staff, but partly to the investment put in by the taxpayer; the 170 per cent. increase in capital expenditure. It is also due to the fact that, under the Government, 16 hospital schemes of more than £50 million have already become operational; 16, in just seven years. In 18 years—almost three times that figure—of the last Conservative Government, only 10 hospital schemes of that nature were built. That is a significant difference between us. We shall continue to provide all that, free at the point of need, and there is no way that the Government will introduce charges for operations.

Gregory Barker (Bexhill and Battle) (Con): Despite all that extra money, the outlook for breast cancer sufferers and other cancer patients in Kent and East Sussex is far from rosy. When will the Secretary of State put in the necessary investment to the Maidstone oncology centre so that waiting times can start to come down again? They have been rising for the past year or more, up to 15 weeks.

Dr. Reid: I thank the hon. Gentleman for raising this issue, although I did not see him during the rest of Health questions. [Hon. Members: "He was here."] In that case, I apologise, but he is wrong about cancer. In the first six years of this Government, there was a reduction of 12.2 per cent. in premature deaths from cancer, and one of the reasons is that 99 per cent. of people who are diagnosed as having a serious potential cancer are seen by a consultant within two weeks. I fully accept that there is a problem because the throughput of people seeing a consultant is now so fast that there is a bottleneck at the next stage, diagnostics. That is one of the reasons why we have just procured 600,000 extra scans—120,000 a year—from the independent sector. Every time we take a major step forward, other problems arise, but we will tackle them one by one, and the NHS is greatly improved overall.

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