§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. Garel-Jones.]
1.50 am§ Mr. Richard Ryder (Mid-Norfolk)I am very grateful to my hon. Friend for being here at this late hour to respond to this debate. I know what a close interest he takes in the National Health Service in East Anglia and elsewhere.
However much money is spent on the NHS in East Anglia or anywhere else, it is unlikely to meet all the demands made upon it or to satisfy all the expectations. That is partly because the astonishing success of medical science over the past 30 years has meant, at one end, that scores of previously untreatable diseases have become treatable and, at the other end, that hips and knees can now be replaced as a matter of course. Yet it should never be forgotten that the amount of money available to the NHS largely depends upon our economic growth rate, which, under the present Government, is one of the highest in western Europe. That is a reason why the NHS now employs about 1 million people. In Europe, only the red army employs more. That is a reason why the Government have been able to increase spending on the NHS by 24 per cent. in real terms to about £17 billion, the equivalent of £850 a year for every household in Britain.
As we know, however, increased spending is not the answer to every need. How has all this affected East Anglia? The recently announced second district hospital to cater for many people living in my constituency which is to be built in Norwich, providing a further 800 beds, will be the fifth district general hospital to be completed in East Anglia since the Government came to office in 1979, the others being the Queen Elizabeth hospital in King's Lynn, the James Paget hospital in Great Yarmouth, the Hinchingbrooke hospital in Huntingdon and the second district hospital in Peterborough. These vital new buildings, in addition to improvements to several existing ones underline the Government's firm commitment to the region. The regional health authority has plans to spend over £230 million on its capital programme over the next eight years. Indeed, it is appropriate to illustrate the Government's commitment by pointing out that by 1990 no less than 90 per cent. of the old stock of buildings in the west Norfolk and Wisbech district health area, which covers part of my constituency, will have been replaced with something better by this Government.
The Government's capital programme is sizeable and continuous. Currently, 22 building projects are under contract throughout East Anglia at a total cost of £26 million. If some claim with shaky logic that extra spending equals net cuts, they are clearly permitting prejudice to interfere with the facts, a practice that may suit their political ends but one that does nothing to enhance their credibility.
Not only have the Government increased spending in East Anglia — although, it should be stressed, from a low base—but they have also, with the co-operation of the regional health authority and the districts, made the NHS more efficient, and I pay tribute and offer thanks to all those working in the service.
Patient waiting times and hospital waiting lists are continuing to fall. Last year they fell by 5 per cent. There are, however, specialties such as orthopaedics where the 985 waiting time remains excessive. To be fair, this is a national problem. But in all specialties, more patients are being treated from a more elderly population than ever before. The age of the East Anglian population as well as its fast growth is significant, and I urge the Minister not to overlook that when allocating resources in future.
The vast majority of acute beds are occupied by people over 65, and, across the region as a whole, the 75-plus age group is projected to shoot up by 12 per cent. in the next eight years and by 18 per cent. in the Great Yarmouth and Waveney district area. This will stretch the capacity of existing facilities.
I draw the Minister's attention to another special feature of the Great Yarmouth and Waveney area. The seasonal burdens can be immense when the population is trebled by holidaymakers in the summer months, yet no additional funding is provided for such tourist centres, despite the seasonal burdens placed on the NHS locally.
It is also crucial to emphasise that the problems of rural areas can be just as severe as those encountered in the inner cities. Indeed, the problems of rural areas can often be more expensive to deal with properly. This applies particularly to ambulance service funding, where the results of the policy were not, I am sure, part of the original intention. I know that the Minister is giving close attention to this issue, and rightly so.
The greater efficiency of the NHS in East Anglia can be gauged in several ways, although we must guard against complacency as a result of progress achieved recently. There is still plenty of scope for improvement, as many doctors and nurses will testify.
Modern line management techniques have been injected into the system and business methods have become the norm. The principle of value for money is now taken more fully into account, which means that more resources can be spent where it matters most—on direct patient care. The RAWP exercise has been of benefit to East Anglia. Growth in revenue allocations from 1978–79 to 1986–87 is 20 per cent. against a national average of 11 per cent.
But it is important for the Minister to consider whether a new incentive mechanism can be built into RAWP by which hospitals and departments which perform well can be adequately rewarded. Commercial firms have better ways of rewarding their successful departments. All managements respond to stimuli and incentives; and in this respect the NHS can learn even more from the private sector.
We in East Anglia are lucky to have Sir Arthur South as chairman of the regional health authority and, as his chief executive, Mr. M. W. King, who has years of experience of how the private sector operates and who is working effectively and harmoniously with the districts. A new computer system costing £38 million will start in 18 months and this should further help to make the East Anglian NHS more efficient.
So far, the NHS in East Anglia has received careful attention from the Government, and I thank them for that. But the overriding purpose of this debate has been to bring home to the Government some of the region's special problems and to highlight the need to maintain our efforts to secure an even better health service for East Anglia in the 1990s.
§ The Parliamentary Under-Secretary of State for Health and Social Security (Mr. Ray Whitney)I am happy to have this opportunity to respond to my hon. Friend the Member for Mid-Norfolk (Mr. Ryder), who has certainly performed another invaluable service both to his constituents and the region of East Anglia, and to our general appreciation of what is happening in the NHS as a whole.
As my hon. Friend said, the story is there to be told and it is a good one. We must set it against the economic imperatives, which we both recognise, and the Government's achievements. Given our record on increasing prosperity, maintaining a firm control on public spending, as is shown in the successful fight against inflation, and on increasing resources for the NHS, we should be proud. As my hon. Friend said, whatever resources we can devote and however successfully we can manage our economy, the demand for increasing health care is well-nigh insatiable, especially for the aging population. I strongly endorse that. Each week I visit two or three hospitals and everywhere I see the elderly occupying acute beds. That is largely to be welcomed in that it is a testimony to our health care. My hon. Friend also referred to the pressures of medical advance and the rightly increasing expectations and aspirations of our people.
Although there is considerable anxiety, we should recognise that a great deal of it is not justified. The final test of the state of the NHS is the quality of the service delivered to patients. Recently, the National Association of Health Authorities conducted a test of opinion and found that of the substantial sample who were asked about their overall opinion of the NHS, 75 per cent. said that it was fairly good, very good or extremely good. That is a reasonable score. When those with experience of treatment in the previous two years were asked for their opinion of that treatment, the poll recorded that 87 per cent. were fairly or very satisfied with their hospital treatment and 88 per cent. with their family doctor. Therefore, the general level of public opinion does not do sufficient justice to the excellence of the service as it is perceived by those who become its patients.
Sadly, much of the blame for that must rest with the media, which all too frequently look for bad news and, in some instances, invent it. One example of that relates to Addenbrooke's hospital in East Anglia. On 14 May, the Daily Mirror under the headline "Yet Another Health Scandal" carried the story that a life support machine had broken down in the middle of an operation on a child. The article alleged that hospital staff had to borrow a spare ventilator from the intensive care unit to carry on the operation. It went on to say that the only suitable machine available in the hospital was eight years old and held together by sticky tape. The newspaper claimed that this was another example of the effect of the Government's cash cuts.
The story was completely untrue. The hospital has no record of a machine breaking down during an operation, or of staff having urgently to borrow one from elsewhere in the middle of an operation. As that was only one of several inaccurate stories about the NHS carried by the newspaper in May, we wrote and asked it to set the record straight, but, sadly, that has not happened. The consultant who was misquoted in the article has written to the 987 newspaper to protest about the story. He felt it would cause unnecessary anxiety to parents of children using the hospital. He pointed out that there were 27 ventilators at the hospital suitable for use on small children, and not one as the article reported.
The article of 14 May accused the Government of ignoring the facts about the Health Service but hon. Members will agree that it was The Mirror that ignored the facts. However, it is not only The Mirror that does that, and not only in this case. There are problems but, happily, the patients themselves understand what is being achieved.
My hon. Friend reminded us of the 24 per cent. increase in real terms that we have recorded. The general success of our economic policies, to which my hon. Friend also referred, is helping because the low inflation that we now enjoy means that we can provide more services in the National Health Service for the amount of money available. In East Anglia, that has meant progress. For example, the revenue allocation to the region increased by 28 per cent. between 1979 and 1986–87.
For the future, if the national growth of 0.5 per cent. is achieved, East Anglia can expect to achieve 1.6 per cent. annual growth in the period to 1993–94. For the next two years, the planning guidelines issued to health authorities show in East Anglia the biggest growth of any region in England — some 2.2 per cent. in 1987–88 and 2.1 per cent. in 1988–89. Those are the tangible benefits of the policy that has been followed.
My hon. Friend spoke about capital. The position there is the same. At national level, something over £900 million will be spent this year to replace and improve hospital stock, and to provide new hospitals and community care facilities. Some 159 new hospitals worth over £2 million each are at present being planned, designed or built in England alone.
We are all aware of the comparison that can be drawn with the dismal Labour record. The Labour Government made cuts in capital expenditure because such cuts were forced on them after they had to go to the International Monetary Fund. That is in eloquent and stark contrast to the record that we can show, and that record is demonstrated in East Anglia.
My hon. Friend spoke about the four new district hospitals planned for Norwich, which will cost over £45 million. This second district general hospital for the city has been approved by the regional health authority and will shortly be submitted to my Department for approval. Of course I cannot prejudge the decision that will be taken, but I can assure my hon. Friend that if the need is clearly demonstrated and the right option is identified, the project will have the full support of the Department.
Our record on staffing is also good and East Anglia matches the national position. For example, over the last six years there has been an increase of 3,140 nurses and midwives, an increase of 26 per cent., and there are now 280 more hospital doctors, a 22 per cent. increase, in the 988 region. All those figures point to an improvement in resources, but the best indicators are the number of people treated and cared for and the quality of treatment. At national level, those figures are good.
The annual number of in-patient cases rose by 15 per cent. to some 800,000 and the annual number of day cases rose by 61 per cent. The annual number of out-patients rose by 3 million, an increase of 9 per cent. Those are considerable increases. Similar increases can be shown in East Anglia, but I will not go into the percentages.
The Government are committed to a policy of community care based upon the needs of individuals. That is aimed at helping them to live as normal a life as they can and to enjoy the ordinary, everyday pursuits, activities and social life that we all take for granted. In that area too, progress has been made. For many people that means the support needed to enable them to live in their own homes, or in the homes of relatives, with dignity and respect, and without placing an intolerable burden on those caring for them. That represents a formidable challenge. It requires close working partnerships between all the agencies—the health authorities, the family practitioner committees, personal social services, housing, education, employment, social security and the voluntary sector.
There is another good story to tell in East Anglia. I warmly endorse the praise that my hon. Friend directed towards the chairman of the regional health authority and his general manager, Mr. King. I have had the privilege of meeting both of them on a number of occasions. I am deeply impressed by them. I believe that East Anglia is well served by them. Everything that I have seen in East Anglia and everything that my hon. Friend has said endorse that view.
As I said in opening, I believe that my hon. Friend has done a great service to East Anglia in this debate. It is important continually to recognise the good things that are achieved. The constant carping and attack, much of which is done for political gain and advantage, is in danger of doing serious harm to the morale of the many people —my hon. Friend mentioned a figure of 1 million—who work in the National Health Service. The vast majority of those people work well. They are making an impressive contribution to the level of health care in this country. It is vital to recognise that service and to understand and appreciate their contribution. It is understood and appreciated by the Government and by Ministers.
It is important that the country recognises that the steady real increase in resources is devoted to health care. East Anglia is getting its appropriate share of those resources. I take note of the special points which my hon. Friend made. I shall examine them in detail when I read his speech. It is important that we recognise what is achieved. There are challenges to be met. I submit that the Government are meeting those challenges.
Question put and agreed to.
Adjourned accordingly at twelve minutes past Two o'clock.