HC Deb 29 June 1976 vol 914 cc180-1
8. Mr. Hal Miller

asked the Secretary of State for Social Services what steps he is taking to reduce the disparity in the average length of stay of hospital patients between different regions.

Dr. Owen

The recent consultative document on priorities for health and social services draws attention to the wide variation in average length of stay and the possible financial saving if it were reduced.

Since all area health authorities will be operating under cash limits it will become increasingly clear that savings within an area health authority budget will be one of the main ways of financing improvements in the service and this should give an incentive to clinicians to review their current clinical practice.

Mr. Miller

Has my right hon. Friend or his Department examined the effects on waiting lists of that disparity, and are they considering that side of the question?

Dr. Owen

The two things are to some extent linked. If one frees more beds, the turnover probably increases but that may lead to bottlenecks in operating theatres or diagnostic facilities. The special grants to the regional health authorities were designed to try to eliminate the problems. Much has and can be done in more areas for out-patient surgery, which has a dramatic impact on waiting lists.

Mr. D. E. Thomas

Is there adequate machinery for the various health authorities in England and Wales to review both the bed occupancy ratio and the waiting lists?

Dr. Owen

I can speak only for the English machinery. The situation in Wales is the responsibility of my right hon. Friend the Secretary of State for Wales. I am not satisfied. The whole area needs to be examined more stringently, but I would prefer that to be done by the medical profession looking at the data, seeing the economic consequences of the actions of various individuals, and mutually persuading each other to try to reduce length of stay.

Mr. Carter-Jones

Will the Minister look carefully at the question of length of stay, as it is related to the community care services in any area where the patient is discharged? Will he take steps to ensure that no patient is discharged to live in conditions that are unfit for a sick person?

Dr. Owen

That is another problem. If one increases the turnover, pressure is put on all the community health services. That is one of the reasons why we say that a higher percentage of the overall budget must go to community care and primary health care facilities. If length of stay is reduced, one must have more support facilities.

Mr. Boscawen

Does the Minister of State agree that some areas have scandalously long waiting lists for non-acute cases? Will he show a much greater sense of urgency about those areas in clearing the lists?

Dr. Owen

I share the hon. Gentleman's concern. It is very difficult to try to persuade people, which is the method we have used. I have no doubt that if, throughout the country, some of the existing best practices were universalised, we would go a long way towards solving the problem of waiting lists. But there are some areas in which lack of a hospital or lack of facilities is causing problems. We are doing what we can to alleviate them.