Orthopaedic Operations (Hansard, 25 March 1986)

§ 5. Dr. Marek
asked the Secretary of State for Social Services what is the average length of time patients have to wait for orthopaedic operations.

§ Mr. Hayhoe
In 1983 the estimated median interval between placement on a waiting list and admission for orthopaedic surgery was 13 weeks.

§ Dr. Marek
Is the Minister aware that, for example, in the West Surrey and North-East Hampshire district health authority—the figures are not untypical—the waiting list for orthopaedic operations in December 1983 was 1,027 and in 1985 it was 1,350? That is an increase of 30 per cent. Is he further aware that the waiting time in that district health authority is four to five years? Therefore, does the Minister agree that his figures are fiddled and gerrymandered in the same way as the figures that his Department produced about the so-called growth in the Health Service? The National Health Service, far from being safe in his hands, is dust and ashes in them. It is a disgraceful situation. What does the Minister intend to do about it?

§ Mr. Hayhoe
It is clear that the hon. Gentleman has been carefully selective in his choice of figures, which may or may not be accurate. Between 1978 and 1984, in the trauma and orthopaedic specialty, there have been 75,000 extra cases coming forward—an increase of 17 per cent. The waiting lists, despite that increased load, have remained the same. Perhaps the most important aspect is that the waiting lists for urgent treatment have come down by 14 per cent. compared with the position under the Labour Government.

§ Mr. Michael McNair-Wilson
Does my right hon. Friend think that the private sector can assist in reducing waiting lists, and to what extent is it used to do that?

§ Mr. Hayhoe
Health authorities have freedom to make arrangements with the private sector if it makes cost-effective sense to do so. I know that that has been done to advantage in particular areas.

§ Dr. Roger Thomas
What progress is being made in improving the orthopaedic consultant-registrar proportion, as recommended by the Select Committee three years ago? Has progress been retarded by the new, more stringent rules regarding immigrant doctors staying in this country?

§ Mr. Hayhoe
The new and, as the hon. Gentleman said, more stringent rules that apply to immigrant doctors in the NHS are being warmly welcomed as making a positive contribution to solving the long-standing problem of medical manpower. I am consulting the professions on these issues. I hope that we shall make real progress in resolving what has been a long-standing problem.

§ Mrs. Currie
Is my right hon. Friend aware that some of my constituents in South Derbyshire have been worried by the recent statements of orthopaedic surgeons working at the local hospital in Burton-on-Trent? May I convey to my right hon. Friend the fact that the surgeons are saying that orthopaedic posts cannot be filled in our local hospital because of the Government's ruling on overseas doctors, that money is available and posts exist, but that the home-grown version will not come to our part of the world? Does he agree that that is absolute nonsense, and will he look into the matter?

§ Mr. Hayhoe
I am not aware of the position to which my hon. Friend refers. My superficial reaction is that that does not make sense, because those restrictions do not apply at present, but they will apply some time in future.

§ Mr. Pavitt
Is the Minister aware that at a hospital not far from the Chamber the waiting list for a hip replacement operation is 5¼ years? Is he further aware that the rationalisation of acute beds in district general hospitals meant that last week a teaching hospital telephoned 13 hospitals to take an emergency case, and that only the fourteenth had a bed available? This is a crisis. Will the Minister do something about it?

§ Mr. Hayhoe
I am well aware that compared with the position under the Labour Government—[Interruption.] I realise that the Labour party does not like these comparisons being made, but it ill befits it to criticise us when its performance was so much worse. There has been an increase of about 33 per cent. in the number of hip replacement operations being carried out, and the average or median waiting time for that operation is the same now as it was then, despite the significant increase in the numbers being operated upon.

§ Mrs. Kellett-Bowman
Is it not misleading to refer to the average waiting time for orthopaedic operations when some are so minor that waiting is no hardship, while others are so painful that treatment is urgently required? Is it not true that to have an average covering those two categories is wholly misleading?

§ Mr. Hayhoe
I was giving not averages but medians. [Laughter.] With my engineering background I like to be precise about these matters. The figure that I gave meant that 50 per cent. of people were waiting fewer than 13 weeks and 50 per cent. were waiting longer. That accurately reflects the queues waiting for operations. My hon. Friend is right, and that is why I said that the number of urgent cases on the waiting list had been reduced by 14 per cent. compared with the figure when we came to power in May 1979.

§ Mr. Meadowcroft
Is not one aspect of the problem that the more glamorous, hi-tech operations command a higher proportion of the available resources than their prognosis would warrant—for example, compared with hip replacement operations? What is happening to the idea of a medical audit which would examine the relative prognoses of such operations? Will the Minister ensure that hip replacement operations, which give people much greater activity and pleasure, are carried out, as the hon. Member for Brent, South (Mr. Pavitt) said earlier, without the huge waiting lists that exist in my area, as much as in the hon. Gentleman's area?

§ Mr. Hayhoe
I said that the number of hip replacements had increased significantly since the party that the hon. Gentleman supported in the Division Lobbies and sustained in office was in power. Having said that, of course the hon. Gentleman is right to raise the wider question. The whole of the medical profession ought to be looking at that question so that a proper balanced judgment can be made. It is certainly not for politicians to impose judgments upon the professions in that area.