HC Deb 25 July 1989 vol 157 cc836-8
2. Mr. Gill

To ask the Secretary of State for Health what action is being taken by individual health authorities to increase the number of operations where their current performance rate falls substantially below the national average.

The Minister of State, Department of Health (Mr. David Mellor)

We expect health authority managers, who now have available to them information on their performance relative to others, to use this to monitor their own performance and then to make any necessary improvements. We have a range of initiatives to help support and sustain such efforts.

Mr. Gill

Does my hon. and learned Friend agree that after the massive increase in spending during the past 10 years on additional staff, new hospitals. other new buildings and modern equipment, the British taxpayer is entitled to ask why we still have a waiting list? Is that not of itself sufficient justification for the Government's reforms of the National Health Service?

Mr. Mellor

Yes, particularly when some recent research showed that if every district health authority was capable of using its operating theatres as efficiently as the average—not even as the best—that would create enough vacant beds to allow everyone on the waiting list to be operated on immediately. That is the precise scope, and there are many other examples of what the added efficiency that we propose in the review will do for the National Health Service.

Mr. Nellist

What does the Minister say to a health authority such as Central Birmingham, which is responsible for the Birmingham children's hospital and which has limited the number of open-heart operations to 320, when the surgeons are capable of carrying out 380, and where the waiting list for children now stands at 140, when a year ago it stood at 110? That was at the time of the tragic deaths of David Barber and Matthew Collier, which my hon. Friend the Member for Coventry, North-East (Mr. Hughes) has raised repeatedly in the Chamber. What does the Minister say to those area health authorities that are putting the lives of bairns at risk? When will they get enough money so that surgeons can carry out the operations?

Mr. Mellor

I have every sympathy with the parents of youngsters awaiting such operations. A great deal of attention has been given to improving the position at Birmingham children's hospital. I am advised that double the number of heart operations on youngsters will be carried out at that hospital this year compared with last year. That marks real progress and I hope that we shall be able to do even more in the months ahead.

Mr. Burt

Will my hon. and learned Friend congratulate my health authority, Bury, on the way in which it has dealt with the issue and is able to treat more patients by increasing the number of consultants by 35 per cent. over the past five years? Will he note that it has achieved that by saving on administration and by putting more services out to tender? Is not that the way that health authorities should go?

Mr. Mellor

What is encouraging is the range of initiatives taken by different health authorities. I applaud what Bury has done and, equally, I applaud other health authorities which, by having a higher proportion of operating cases treated as day cases, have managed to transform their waiting lists. The Coventry and Warwickshire hospital, which I visited last month, has transformed a waiting list of 1,400 to a list of 300 simply by increasing the proportion of day surgery cases from 7 per cent. of the total work load to 43 per cent. We look to such initiatives, and that is the scale of improvement that is possible when people use their ingenuity.

Ms. Harman

Is it not the case that to stay within inadequate budgets, hospital managers are telling doctors to do fewer operations, rather than more? How does the Minister's earlier answer square with a report in yesterday's Daily Mirror that two heart surgeons at Birmingham children's hospital were threatened with disciplinary action because they exceeded by one the ration of heart operations that they were allowed to carry out in May? Does that not show that the Government's real interest lies in saving money, not lives?

Mr. Mellor

This year, over 20 per cent. more in-patient cases will be dealt with in the National Health Service than were dealt with 10 years ago and there will be many more operations than there were last year. It is interesting that although the hon. Member for Livingston (Mr. Cook) made his usual call about underfunding, that was specifically not endorsed at the meeting between regional health authority chairmen and my right hon. and learned Friend the Secretary of State last week. The problems of the National Health Service cannot be explained away by a shortage of resources, but have much to do with improved performance. It is about time that the Opposition played some part in making that clear.