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9 May 2006 : Column 230

Like PCTs in other areas, PCTs in my area face reorganisation. Tameside and Glossop PCT is perhaps the only PCT which straddles a regional border—Tameside is the north-west region and Glossop is in the Trent region. Greater Manchester SHA has proposed that Tameside and Glossop should stay together, which recognises the local affinities, the local needs of Glossop, transport connections and travel-to-work areas. Indeed, 1,601 people replied to the public consultation in Glossop, of whom 1,597 supported maintaining the current link. Greater Manchester SHA only consulted on that option, while Trent consulted on four options, two of which would take Glossop back into Derbyshire in order to make a Derbyshire-wide PCT, which would be coterminous with social services. I understand that argument and see why social services and health services should be run according to the same boundaries, where no overriding feature exists. However, because of the geography of Derbyshire, and, in particular, the geography of Glossop, it is essential to maintain the link between Tameside and Glossop, and I hope that the Minister will announce the adoption of the status quo when he makes the announcement in a couple of weeks’ time.

I have already mentioned Corbar maternity unit. For some reason, the whole of High Peak is included in the north-west region, where a number of options are currently being considered for maternity and children’s services. The consultation is open until the end of this week, and the large number of such units will be reduced to eight or nine in the Greater Manchester and north-west area, with the aim of improving staffing, quality, investment and opportunities for excellence.

That idea has come from within the NHS itself—it is not being imposed from elsewhere. I am happy to tell the Minister that I have supported option A, which is already the preferred option, because it not only retains Corbar maternity unit in Buxton—in fact, all the options do that—but is the only one that maintains the maternity services at Tameside.

Having said that, if Ministers find that there is an opportunity to show some flexibility, they might acknowledge that the reduction in choice from 13 or 14 units to around eight is a bit drastic. Perhaps they could consider the possibility of including Macclesfield in option A, because choice is an issue here. As someone who is used to representing a constituency on the fringe of a region, I am aware that one usually does not have as much choice as one does elsewhere.

The NHS has been a huge success under Labour. More staff are employed and they are better paid than ever. There are more community services and more flexible services. There is an imaginative use of private capital to support and expand, not replace, public services, and there will be more to come. In the NHS, change is always difficult and challenge is always complex. Champions of health care, especially in our most deprived communities, are worth their weight in gold. The principles on which the NHS was founded, which, we are told this afternoon, are espoused across the Chamber, are safe with this Government. Equally, the funding that has been championed only on this side of the House is safe with this Government. We have a job to do with the NHS—let us get on and do it so that we have a better NHS for all.

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7.1 pm

Mr. Desmond Swayne (New Forest, West) (Con): I remain absolutely convinced that my constituents are fortunate indeed to live where they do and to be served by the national health service, and I make no apology for that. Labour Members who have implied that there is no common ground between us and that some of us are not committed to the NHS do themselves, and us, no justice whatsoever.

I caution Labour Members who have quoted reams of statistics at us with the intention of giving the impression that things are much better than they appear. I recall listening to “Yesterday in Parliament” during the late 1970s and mid-1980s, when Mrs. Thatcher was challenged week after week on the state of the NHS. She always answered robustly from the Dispatch Box with reams of statistics saying how many more operations had been carried out and so on. Even in those years, despite the myths that may be spun, the NHS was improving. Nevertheless, it did not work, because it did not match up to the ordinary people’s perceptions based on their experiences. That is the problem that my constituents are having at the moment. Their perceptions of what is happening in the NHS are informed by the difficulty, or otherwise, that they face in seeing their doctor or dentist.

I should like to give hon. Members an impression of what it is like in my part of the world. We have a vastly expanding population. As the Deputy Prime Minister’s rules, particularly on density, begin to bite in urban centres such as New Milton, and townscapes are changed for ever as family houses are pulled down and replaced with blocks of flats, the population is expanding fast. Yet only one GP practice south of the A337 is still taking on new patients. That outgrew its existing premises some time ago and is short of space, whatever measure one chooses to use, and sometimes the cramped conditions in the waiting room are unacceptable. A few years ago the practice secured the primary care trust’s permission in principle to expand its premises, but before it could do so, a directive from the Department of Health instructed that that was not to happen because the funds were to be allocated not to the primary care trust but to Hampshire as a whole. Hampshire’s priorities are different; they apparently lie in Portsmouth. There is now not the remotest chance of that practice, or any practice in my constituency, being able to expand its premises.

My constituents write to me in droves complaining that they can make an appointment with their GP only on the same day. It does not suit most people to have to spend hours ringing the surgery in the morning, only to find it engaged, when they would like to organise their lives so as to see the doctor at a time convenient to them, as they used to in the past. They feel that the situation is not as good as it was before. That is entirely a consequence of the targets to which general practitioners have been subjected.

During the election campaign, on the “Question Time” interview, the Prime Minister was confronted with that problem, appeared greatly surprised, and said that he was going to do something about it. I have not noticed any result. I have written to the Secretary of State saying, “Please find enclosed a copy of a letter from my constituent complaining about X, Y or Z. I remember the Prime Minister saying he was going to
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do something about it—what has happened?” The answer is, “You can rest assured that patient satisfaction will be one of the measures on which general practitioners will be remunerated in future.” That does not deal with the perceived deterioration that my constituents experience in booking an appointment.

Let us examine the possibility of booking an appointment with one’s dentist. A couple of years ago the situation deteriorated. It got so bad that constituents of mine who were lucky enough to have an NHS dentist were receiving letters telling them that there were not going to be any more NHS dentists, but they were welcome to stay on as private patients if they wished. When I raised that at Prime Minister’s Question Time, the Deputy Prime Minister, who was answering on that occasion, said :

That does not actually address the problem. He went on to tell me that it was all the Tories’ fault for having closed down the dental schools. A decision by the university grants funding body more than 10 years ago is not germane to our problem now. The problem is that NHS dentists are leaving the NHS. It is not a question of a shortage of dentists but of how they are employed.

The problem got worse. Several constituents wrote to me complaining that they had received a letter from their dentist saying that he was no longer going to be an NHS dentist but would nevertheless continue to treat their children under the NHS as long as they, the parents, remained as private patients with the practice. They did not like being held hostage in that way, but felt fortunate at least to have their children still being treated as NHS patients. The Secretary of State acted to right that perceived wrong. Instructions were issued to primary care trusts whereby they were empowered to prevent dentists from maintaining children-only NHS lists. So in the past few months, parents in my constituency, particularly vulnerable families, have been receiving letters from those self-same dentists saying, in effect, “You will recall my letter of such and such when I undertook to keep your children on as long as you remained as a registered private patient at the practice—well, sorry, that deal is off and your children will either have to find another dentist or stay with me and pay.” That is a very worrying letter for the many families with children who have orthodontic requirements and all sorts of work to be done.

As a consequence of the Government’s policy, it is much more difficult to secure NHS dental treatment. However, my constituents have been told that the seventh cavalry is on the way, and that some 12,500 new dental registrations will be available to the good people of New Milton. To take advantage of those as yet virtual dental registrations, a new model is to be used to avoid the inconvenience—and, of course, the attendant unpleasant publicity—of long queues forming and being photographed.

The people of New Milton have been invited to telephone a number to secure their dental registration. I have a letter from a constituent who tried that. The
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announcement was made in February and he began to make telephone calls. The letter states:

He writes that he tried the number on 3 April from 1.55 pm to 2.25 pm, from 3.30 pm to 3.50 pm and from 4.43 pm to 4.52 pm. He tried again on 4 April between 1.45 pm and 2.10 pm, and 4.10 pm and 4.35 pm. Each occasion met with the same result. Let that be a measure of the frustration of ordinary constituents in trying to secure the NHS treatment to which they rightly believe that they are entitled. Those perceptions mean that there is an understandable belief that things have got worse.

We have been told that the position on waiting times has changed; the claim was repeated today. We are told that a magnificent improvement has occurred, but that is not the experience of many of my constituents. At previous Health questions, I asked about audiological waits in my constituency. It has a disproportionate number of elderly people, and thus a disproportionate number suffering from poor hearing, which is one of the most socially isolating experiences. As I said in Health questions, there is a significant danger that many patients will die before they secure the hearing aids that they require.

Strangely, I received a letter about the problem today—although it is not an amazing coincidence, because I am afraid that I receive such letters almost every day. My constituent’s 17-month wait for a hearing test was over in February. His appointment was on 6 February and the consultant told him that it would take three months for the hearing aids to be made up. My constituent wrote:

He waited and waited. After a further three months, he rang the hospital to find out what had happened to his hearing aids, only to be told that it would take another six months before they were delivered. That is a measure of ordinary people’s experience of the health service. Can we blame them if they believe that it is getting worse?

We have five community hospitals in New Forest. We launched a massive campaign in the past year to save them because the primary care trust intended to close them. It backed off and said that it no longer planned to close them, but that it would have to work with the community to find a role for them—exactly the model that the White Paper, which the Secretary of State launched, set out. There was, therefore, progress.

However, community hospital supporters now experience huge frustration and staff morale is low because nothing has emerged from the process. Whatever is suggested about the role of a specific hospital—whether in Fordingbridge, which could be a centre for best practice or nursing excellence, or the hospital in Milford on Sea—the PCT response is that there is a difficulty because it is building a new hospital in Lymington. That is one of the first new hospitals in which the PCT will employ a private supplier to provide the health care. It does not yet know what services will be provided at Lymington, and will not
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therefore make any commitment about the services that need to be provided in any of the community hospitals. The new hospital in Lymington is due to open in January next year. Is that the way to run a national health service? We are only a few months away from the opening of the new hospital, yet we are told that decisions cannot be made about existing community hospitals because the PCT does not know about the services that it is commissioning at the new one.

I understand my constituents’ frustration and anger. They say, “Yes, expenditure on the NHS has increased enormously, as have our taxes—but have we had value for money?”

Siobhain McDonagh (Mitcham and Morden) (Lab): I am delighted to be able to make a contribution to the debate because my constituents have experienced great improvements in the NHS since the election of a Labour Government in 1997. In contrast to the hon. Member for New Forest, West (Mr. Swayne), I have experienced—as a Member of Parliament, a lifelong resident of my area and, most personally important, the daughter of two very elderly parents—the most fantastic improvements in the local health service.

The improvements are due to the work of dedicated staff, as we have heard, and the investment in facilities, to which the increase in the money spent on the health service has directly led. Those improvements are tangible. The south-west London elective orthopaedic centre in Epsom has ensured that the waiting time for hip and knee replacements is less than six months. I have been a direct beneficiary of that centre because my mother, a nurse who was forced into early retirement by being made redundant in the 1980s, has had two hip replacements in the past three years. Her care has been fantastic and I thank the Government and the doctors and nurses for that treatment.

My father is 82 and, for him, the introduction of targets for waiting times has been fantastic. At accident and emergency in St. George’s hospital, he was seen in less than four hours. Within 48 hours, he was diagnosed with bladder cancer, of which, thanks to the care of Mr. Bailey and his oncology team, he has now been cured. That is Government and staff working together—real people, not bluster or amazing, screaming headlines.

My experience is of not only my parents but my constituents. In my first three years as a Member of Parliament, I received regular letters about St. Helier and St. George’s. Patients said that the wards were dirty and the care was poor. Such letters have, thankfully, reduced to a trickle.

Conservative Members may not like it, but they have so much previous on the health service that my constituents will not forget what they did to it in the 1980s and 1990s. They remember the winter bed crises, the people dying on trolleys and patients forced to wait in pain for two years for their operations. They remember our last local community hospital. I am glad that some Conservative Members have five, but, in 1992, our last community hospital—the Wilson—was closed.

There is a lot of talk these days about health inequalities. I genuinely appreciate that, because we were never allowed to talk about them under the Tories,
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as people’s poverty and working lives supposedly never affected their health. The Tories closed the hospitals in the poorest areas of the country, affecting the most vulnerable people.

Since 1997, the amount of money invested in the NHS each year has doubled, and the number of people serving in the NHS has increased by 300,000. That is a measure of the Labour Government’s commitment to the health service. Instead of having to go to dingy, dirty, run-down hospitals or watch much-loved hospitals such as the Wilson close, my constituents are now experiencing something completely different.

The Wilson is scheduled to reopen, and almost all our GP surgeries have had facelifts or have even been rebuilt as state-of-the-art health centres. Those include Dr. Sheikh’s surgery in Middleton road, Morden, the surgery of Dr. Patel and Dr. Ganesaratnam at Wide Way in Pollards Hill, the Tamworth House medical centre in Longthornton, and Dr. Colborn’s surgery in Figges Marsh in central Mitcham. And only two weeks ago, in the teeth of opposition from Conservative councillors on Merton council, we obtained permission to build a new surgery at Ravensbury Park for Dr. Arulrajah. That will be a great surgery for people who need a new hospital.

Stephen Hammond (Wimbledon) (Con): Will the hon. Lady give way?

Siobhain McDonagh: No.

Most importantly of all, we have recently received the Secretary of State for Health’s support for a new critical care hospital that will be the envy of everyone in our area. If hon. Members want to see an example of how this Government are tackling inequalities, they could do no better than to take a trip to look at health services in Mitcham and Morden. My constituency is probably the most disadvantaged in the whole of Surrey or outer south London. The Tories’ approach to that inequality was to take away our health services, force us to cope with grotty GP surgeries and shut our hospitals. Labour’s attitude involves doubling investment, building brand new GP surgeries and health centres, and reopening and rebuilding our hospitals.

Sadly, however, there are still some who share the ethos of the Tories, who believe that health care should go where the people shout loudest, rather than where the need is greatest. I do not wish to criticise dedicated and hard-working NHS doctors, nurses, ancillary staff and managers who share our commitment. However, there are still a few people in place who take a bureaucratic approach to health care, rather than a human approach.

Mr. Blunt: Will the hon. Lady give way?

Siobhain McDonagh: No.

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