§ 10.6 pm
§ Mr. Iain Mills (Meriden)I am most grateful to be called so late to raise a number of matters concerning the National Health Service in the west midlands and their effect upon my constituents and others.
Expenditure on the National Health Service rose by over 20 per cent. in real terms between 1978–79 and 1985–86, and it will continue to rise. It accounts for £18 billion or £19 billion now, compared with £7 billion or £8 billion in 1978–79. That is a considerable increase in expenditure, and I wish to say a few words about the way in which this vastly increased expenditure is affecting the west midlands.
I wish to make some helpful, good and buoyant points on behalf of normally silent colleagues like my hon. Friend the Member for Staffordshire, South-East (Mr. Lightbown), who tells me that the establishment of the first part of the new district general hospital in Tamworth is extremely welcome to his constituents. As I live three or four miles away from that hospital and almost adjoin my hon. Friend's constituency, I, too, welcome it.
My good friend, the normally silent Member of Parliament for Warwickshire, North (Mr. Maude) —an area that I used to represent before the boundary changes — is as pleased as I was, when I represented that constituency, about the extension of facilities at the George Eliot hospital. As a resident of the area, I suppose that it would be the hospital to which I should be taken if I were taken ill. Therefore, I feel even more strongly that the extension of those facilities is most appropriate.
Having represented the area until the boundary changes, l am sure my hon. Friend will not mind my saying how strongly he and I feel that that expansion is extremely good news. It is of direct consequence to my constituents and to those of my hon. Friend the Member for Solihull (Mr. Taylor), as Meriden and Solihull represent the two parts of the borough of Solihull. I ask my hon. Friend the Minister to refer to the splendid news a few months ago about the establishment at last of a district general hospital for Solihull. That news has been received with joy in the villages of Meriden, Hampton-in-Arden, Berkswell, Knowle and Dorridge, who will use that hospital, as well as by the people who live in the urban parts of Solihull who are represented so ably by my hon. Friend the Member for Solihull. The cost involved is more than £20 million. I do not wish to appear mean to my hon. Friend the Minister, but the sooner we get that hospital the better. It is extremely good news.
I wish to pay tribute to those who served in the inadequate facilities of the elderly, existing hospital in Solihull. I am sure that nurses, doctors, patients and those who represent their interests will keenly look forward with much joy to witnessing my hon. Friend the Minister cutting the tape and opening the first of the new wards when the new hospital is established.
The resource allocation — the RAWP formula—has caused some difficulties. In the north of my constituency there is an area known collectively as Chelmsley Wood. It encompasses the council estate area of Chelmsley Wood, the Kingshurst constituency and parts of Castle Bromwich. We have a large population of elderly, socially 1160 deprived and disabled people. Inevitably, their medical needs are large and they must look to east Birmingham as well as Solihull for their treatment.
In the past, I have been critical of the RAWP formula and the way it has coped with cross-boundary flows. I welcome the working party's report and I wonder whether my hon. Friend has any comments on the presentation of cross-boundary flow and the adjustments that may be allowed to cope with an area like Chelmsley Wood. Chelmsley Wood is in the Solihull district health authority to which I pay tribute. The chairman and chief executive of that authority, Mr. Black and Mr. Jackson, do an excellent job.
In the past I have felt that the RAWP calculation did not sufficiently allow for the large number of people who have specialist needs and who must cross to the east Birmingham hospital for treatment. I hasten to add that Birmingham is a friendly area—we are all Birmingham people in the Chamber tonight.
I wish that RAWP could cope with the extra allocation that is needed. That would help east Birmingham hospital which, as the Minister will be aware, has faced great difficulty because of the temporary closure of a number of wards. I was pleased to hear from the Minister that that temporary closure had resulted, not in a turnover of fewer patients per bed, but in the treatment of more patients per bed. That was due to the adjustments that the hospital made in answer to the demands made upon it. The hospital's approach was excellent.
It is important to pay tribute to the regional health authority that has had great difficulties during this period. I congratulate the Government on their allocation of funds, both capital funds and the recently announced increase that will give the west midlands a 6.7 per cent. revenue increase in the resource distribution.
I also pay tribute to Mr. Jim Ackers, the chairman of that authority, and the officials for the way in which they have transformed that authority to the benefit of my constituents who travel to that authority for treatment. The establishment of the Solihull district general hospital is welcome. My hon. Friend the Member for Staffordshire, South-East welcomes the establishment of the first stage of Tamworth hospital. I only hope that the Minister can give us further good news tonight.
I hope that the Minister tikes note of the fact that, in this debate, I have welcomed the establishment of better hospital facilities and pressed for a recalculation of the RAWP and to take account of its effect upon the Chelmsley Wood cross-boundary flow to east Birmingham hospital, but I also ask her carefully to consider the needs of the elderly and disabled who live in Hockley Heath, and their desire for a general practice in that village. Ideally, a pharmacist should also be part of that practice.
How will the RAWP announcement and the recent announcement of extra moneys for the National Health Service in the west midlands affect waiting lists throughout the region? If there is anything that my hon. Friend the Minister can say about that or the capital plan, I should be most grateful.
§ The Parliamentary Under-Secretary of State for Health and Social Security (Mrs. Edwina Currie)I am delighted to have this opportunity to speak a little about the good work of the West Midlands regional health authority and to congratulate my hon. Friend the Member for Meriden 1161 (Mr. Mills) on seizing his opportunity this evening with such alacrity. It is good to see my hon. Friend the Member for Staffordshire, South-East (Mr. Lightbown) present. I know that my hon. Friend the Member for Warwickshire, North (Mr. Maude) wishes to be associated with my hon. Friend's remarks.
I always think it is a great pity that elevation to the Whips Office means that excellent speakers cannot speak in the House as they previously did with such determination on behalf of their constituents. I assure the House, as one who must sign many hundreds of letters to colleagues every week, that they are among the most assiduous. They are undoubtedly looking after their constituents with the greatest determination.
I should like to thank my hon. Friend for his compliment that all hon. Members present were made in Birmingham. Although I am not Birmingham born and bred, I spent 11 years there as a councillor and as a member of various health authorities. I have always been delighted to be known as Brummagemware — a bit brassy, a bit hard, but jolly useful. Whether I have "Made in Birmingham" stamped on me, and where, is another matter.
This morning I had the opportunity to open and was pleased to open in the west midlands the Scott Atkinson centre for the Bromsgrove and Redditch health authority. We all had a thoroughly enjoyable time. The new centre cost more than £200,000 to build and was paid for with money that the health authority had generated from the disposal of surplus land. I congratulate all concerned in the west midlands and in the individual district health authorities for the vigorous way in which they have converted property which is no longer required for service into cash and then into further services for patients.
The centre I visited today is for pre-school children with developmental difficulties and its excellent work will ensure that when those children attend school they will have every chance of progressing normally and not of developing problems in later life. I thought it was excellent. I also had the opportunity to visit a joint funded community home for the mentally handicapped where I had lunch with the residents. That, too, was a delightful experience.
To return to the source of the money for the Scott Atkinson centre, so far land sales in the west midlands have realised £10.5 million and we expect further sales totalling £4.5 million. That is a valuable supplement to the £800 million which the West Midlands regional health authority plans to spend on new capital schemes over the next 10 years, some of which have already been briefly mentioned.
The health services in the west midlands, since I have lived in the region, have improved dramatically and I am sure that my hon. Friends would want to be associated with that remark. Historically the region received substantially less than a fair share of the national cake, taking account of the population and the needs and health requirements of its people. Many local people had to trek to London for health care or, indeed, to do without. As a Member of Parliament who represents a Trent constituency, I put it to my hon. Friends that it was even worse where I now live. However, the west midlands had considerable difficulties.
The Government are committed to redistributing resources to where the patients are. This year, 1986–87, the west midlands has received a cash increase of 8.5 per cent, 1162 which is well above the level of inflation. That has taken its budget to more than £1 billion. Next year—which starts in April—there will be a further cash increase of 6.7 per cent. In addition, many health authorities are releasing additional resources through greater efficiency which they can then spend on priority areas. The growth money is now funding a considerable improvement in services.
I mentioned the capital programme. New hospitals are being built, not only in Solihull and Telford but in Tamworth, Bromsgrove and Redditch. There is also a major rebuilding programme in Birmingham as the old single specialty hospitals close and are replaced with new facilities on district general hospital sites. We shall be sad to see the old accident hospital go. The facilities that we are building for the next century, which we hope our sons and grandchildren will see standing, are being planned and built right now with the money that the Government are providing.
The Health Service in the west midlands is expanding rapidly. The total number of staff employed by health authorities in the region increased by 11 per cent. between 1978 and 1985. The number of direct care staff — doctors, nurses and professional and technical staff — increased by 21 per cent., which included an 18 per cent. increase in the number of doctors and dentists and a 19 per cent. increase in the number of nurses and midwives. The west midlands now employs 4,000 more nurses than it did in 1979. Let it not be said that that was simply because we cut the hours. We did cut the hours, but we funded that with extra hours provided by paid staff. Over and above that, we have also funded growth considerably.
All the categories of hospital activity in the region show significant increases in the number of patients treated. For day cases—patients who until a few years ago may have had to undergo a spell of in-patient care—the increase between 1978 and 1984 was more than 50 per cent. In parallel, the number of in-patients treated increased by 19 per cent. and the number of out-patients increased by 11 per cent.
Solihull health authority covers the constituency of my hon. Friend the Member for Meriden. He is right: some exciting developments are taking place. There has already been considerable growth. The number of in-patient cases treated rose between 1982 and 1985 from just under 17,000 to nearly 21,000. The number of out-patient cases has gone up from 83,000 to 87,000. However many satisfied customers we have in Solihull, there are many more now than there were in 1982 and when the Government took office in 1979. The amount of revenue money allocated to the authority has risen from £21.5 million in 1982–83 to £26.5 million now. That is a considerable increase.
My hon. Friend asked for more details of what is planned in Solihull for the new hospital. Phase 1, which will cost £1.1 million and is due for completion in 1988, will be for diagnostic services, particularly for the district pathology service. The laboratories of our health authorities are assuming a bigger and bigger part in the planning that we have to make. As we increase the importance of prevention and diagnostic and screening services, the laboratory is an essential part of what is happening. We must ensure that our staff are able to work in good, clean and safe facilities. I am glad to see that this is the first stage of that movement.
The main phase, phase 2, which will cost £23.6 million, is due to open in 1993. It will comprise 155 acute beds. 96 1163 geriatric beds, 72 mental illness beds, four theatres and, I understand, seven X-ray and other suites for diagnostic services, as well as the full support services. It will be a showpiece in the west midlands. I suspect that, knowing the calibre of people who will work there, it will be a showplace for the whole country. I am delighted that that development has been announced. We look forward to seeing it go ahead at full speed and providing services to my hon. Friend's constituents.
Many of those services are currently being provided in east Birmingham, the neighbouring district health authority. One of the results has been a build-up of waiting lists in east Birmingham. The long-term solution is to build the new hospital in Solihull. Many patients cannot wait that long. My right hon. Friend the Secretary of State made a major announcement this week about waiting lists and the money to be allocated to them in the two years starting April. The announcements which we have heard this week refer to the year starting in April, and we expect people to get cracking right away. In the West Midlands regional health authority, in March 1986, a year ago, 78,000 people were on the waiting list. The total number waiting over a year was 22,000 people, or about 28 per cent. In our view that was unacceptable, even though the number had been at its peak during the strikes that had been supported by various hon. Members who normally sit on the Opposition Benches, but who are not in attendance tonight.
An allocation of £2.88 million has been made to the west midlands. We understand that this will mean that 12,300 extra in-patients will be treated, which will include, for example, 266 extra joint replacements and 860 extra cataract operations. Discussions are still continuing on the exact allocations in east Birmingham, but I understand that we can expect allocations of about £41,000 for ear, 1164 nose and throat waiting lists and about £70,000 for ophthalmology waiting lists which, of course, will be particularly helpful for elderly people waiting for cataract and other operations. I understand that the authority also gives a high priority to trauma and orthopaedics. It has requested a substantial sum, but the exact allocation is being discussed. Trauma and orthopaedics are major elements in waiting lists all over the country. The excellent facilities throughout the west midlands need to be coordinated to ensure that the best service is given.
As my hon. Friend knows, I am constrained in making any comment about the primary care services in Hockley Heath because of the ways in which the system is functioning and the appellate function of my right hon. Friend the Secretary of State. I was deeply impressed when my hon. Friend the Member for Meriden came with a constituent to talk about these services and discuss his concern that people in villages in his constituency should get the very best service. My hon. Friend is right. I represent a rural area, which is not all that dissimilar from his, and I must say that the people in our villages deserve the best service that we can get for them. The problem is that the Health Service has to pay for all this. Our obligation is to ensure that that money is allocated as efficiently as possible. We therefore take into account everything that has been said by my hon. Friend on behalf of his constituents.
In these ways, therefore, we are ensuring that the west midlands is getting its share of the cake. We expect that the west midlands people will do as they always do and spend that money as efficiently as possible. We look forward to improved health care for all the people of the region.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-seven minutes past Ten o'clock.