Hospital Waiting Lists

HC Deb 03 April 1979 vol 965 cc1143-7

2. Mr. Raison

asked the Secretary of State for Social Services what is his estimate of the effects of recent industrial disputes on the length of National Health Service hospital waiting lists.

6. Mr. Neubert

asked the Secretary of State for Social Services what is his latest estimate of the total number on hospital waiting lists in England and Wales in general and in the North-East Thames region, in particular.

7. Mr. Boscawen

asked the Secretary of State for Social Services what is the latest available figure for people awaiting admission to National Health Service hospitals.

The Secretary of State for Social Services (Mr. David Ennals)

I regret that information on the effect on waiting lists of the recent industrial action by ambulancemen and hospital ancillary workers is not yet available. More than 60,000 planned admissions to hospital were cancelled since the start of the dispute, but it is not possible to say from this what the effect on waiting lists will be.

Mr. Raison

Will the Secretary of State accept that the extension of waiting lists has been dreadful? Has he any plans to bring in an emergency scheme to catch up on the waiting lists, perhaps by using Service and independent hospitals?

Mr. Ennals

We have recently had a seminar in which we looked at good practice in the handling of waiting lists, and we shall publish some of the recommendations that have come from that seminar. There is no doubt that the industrial dispute caused serious additions to the waiting lists. However, we must keep this in proportion. It is interesting to compare this with the 1973 ancillary workers dispute. In that year 30,000 beds were out of action compared with only 7,000 in 1979. Also, about 100,000 patients were added to waiting lists in 1973, more than any responsible estimate for 1979, and about 350,000 days were lost through strike action in 1973 compared with fewer than 250,000 in 1979. It is worth while getting the matter in proportion.

Mr. Neubert

Will the Secretary of State answer my question on the Order Paper? With hospital waiting lists rising to a level higher than at any time since the National Health Service was first established, is it not folly to close down wards and hospitals like the highly praised Victoria hospital in my constituency? Will the Minister issue guidance to area health authorities to give greater priority to reducing the numbers awaiting admission to hospital?

Mr. Ennals

The number of people on hospital waiting lists at present is higher than it has ever been. There is no question about that. But we must also recognise that the service provided for patients is at a higher level than ever before. In the first six months of 1978—the latest period for which figures are available—activities increased in comparison with the first six months of 1977. Discharges and deaths were up by 75,000. Day cases increased by more than 3,000, new outpatients were up by more than 100,000, out-patient attendances increased by nearly half a million, and accident and emergency department attendances were up by more than 64,000. We must compare the level of waiting lists with the standard of service and the amount done for our people through our National Health Service.

Mr. Boscawen

Is it not a matter for shame in a civilised country that nearly three-quarters of a million sick people are awaiting treatment in hospital? Is not the right hon. Member wholly responsible for this? The waiting lists have become worse and worse year after year.

Mr. Ennals

It is quite absurd to say that any one factor is responsible for the lengthening of waiting lists. I do not doubt that the industrial dispute just ended has been an important factor. But over the past years there were never fewer than 400,000 people on our waiting lists since the NHS was started. Waiting lists, as a percentage of the population, have fluctuated between 1.1 per cent. and 1.3 per cent. There are many other factors, including the actual management of waiting lists, that have nothing to do with industrial disputes, that explain why the lists are higher today than ever before. One of the factors is that much more can be done for our patients than has ever been possible before.

Mr. Ioan Evans

What has been the effect on the waiting lists of the latest process by which general practitioners are advised by consultants that NHS patients must wait but that those who pay can get early treatment? Will my right hon. Friend strive to create a National Health Service where the need of the patient is uppermost and not the ability of the patient to pay? Will he resist the demand of the Conservatives to cut public expenditure on the Health Service?

Mr. Ennals

Absolutely. As my hon. Friend knows, there has been a steady increase in expenditure on the NHS in real terms. It has not been as fast as any of us on these Benches would have liked, but I dread to think what the consequences would be if the Conservatives, with all their commitments to cuts in pub- lie expenditure, were returned to power. My hon. Friend will know that we have now taken the first step to introduce common waiting lists for NHS and private patients for urgent cases and for the seriously ill. I hope that not many months will pass before we can introduce common waiting lists across the whole of our Service. That will be an important achievement.

Dr. Vaughan

Does the Secretary of State recognise that for the first time ever patients needing urgent investigation are on waiting lists? Many of them have to wait months for admission to hospital. How does he explain the fact that, despite the figures that he has given, waiting lists went down under a Conservative Government and have gone up steadily under Socialism?

Mr. Ennals

There have been periods when waiting lists have gone down under Labour Governments just as they have gone down under Conservative Governments. There is no doubt that the figure fluctuates. I draw the hon. Member's attention to a recent publication by the Royal Commission on the National Health Service which looked at the attitude of the public and of patients to waiting lists. This showed that more than one-quarter of the patients interviewed were admitted within two weeks of being told that they would have to go into hospital. Two-thirds were admitted within three months of being told, and four-fifths of patients expressed no distress or inconvenience as a result of the wait for admission. I have no doubt that those who have waited for a long time and have been in pain need and deserve our sympathy, but I say to hon. Members who are picking on this issue that this matter must be kept in proportion.

Mr. Flannery

Will my right hon. Friend accept that the Conservatives are so impervious to factual data that no matter what he says they will condemn him? Will he also accept that the Tories are so totally committed to massive public expenditure cuts that if they were returned to power the NHS would be the victim of tremendous cuts in every area?

Mr. Ennals

It is clear to me that under the Tories there would be either very substantial reductions in expenditure on the NHS or substantial increases in charges for seeing general practitioners or specialists or going to hospital. Also there would be great additions to prescription charges which, in my view, would undermine the whole principle on which our National Health Service was created.