HC Deb 18 December 1990 vol 183 cc143-4
8. Mr. Stevens

To ask the Secretary of State for Health what initiatives have been or are being undertaken to improve out-patient departments.

Mrs. Virginia Bottomley

We are committed to improving out-patient departments. We have recently issued advice on the physical environment, questions of skill mix and on appointment systems to reduce waiting times at out-patient departments. In addition, we are funding 10 demonstration projects as part of our quality initiative, addressed particularly to out-patient departments.

Mr. Stevens

I am grateful to my hon. Friend for that answer and for the initiatives that have been taken to improve out-patient facilities. The improvements that have been made over the years in North Warwickshire district health authority are very much appreciated. How many new out-patient attendances were there in 1979 and how does that figure compare with those today?

Mrs. Bottomley

There has been a considerable increase in the number of people coming to out-patient departments. There were 36 million out-patient attendances last year, which is 7 per cent. higher than in 1979. In my hon. Friend's health authority, the figures have increased by 20 per cent. over the past four years.

Mr. Cousins

What out-patient facilities does the Minister plan for the over-85s? Six old people's homes have closed in Newcastle as a result of poll tax capping and two long-stay geriatric hospitals are closing as a result of hospital cuts, with the inmates and patients being put up for auction. Clearly, we shall need a lot more facilities at out-patient departments in hospitals to deal with the consequences of that, so what plans does the Minister have?

Mrs. Bottomley

The hon. Gentleman will know that he has a first-rate health authority in Newcastle which is addressing precisely those problems. Its work on implementing community care is going very well. The point that my right hon. Friend the Secretary of State made a moment ago about the need for general practitioners to offer their patients who are over 75 an annual visit to check on their welfare and well-being will also help to improve the quality of care. We are seeing improved services for the elderly. Our community care proposals will challenge health and local authorities to work together successfully to ensure that there is comprehensive and integrated cover.

Mr. Tredinnick

Has not the treatment of out-patients improved immeasurably over the past 10 years? Does my hon. Friend agree that the number of out-patients being treated at the moment in Leicester is at a record level?

Mrs. Bottomley

I think that I can, almost without doubt, confirm the Leicestershire figure, but my hon. Friend will understand that I shall write to him if I am wrong. Out-patient departments are the interface between community services, general practitioners and hospitals. We are concerned that a recent survey found that 15 per cent. of people with out-patient appointments failed to show up in one area. We must be sure that our appointment systems are effective and that people are well treated when they reach the out-patient departments. We must also ensure that we are making proper use of skill mix and that the quality of the environment and experience is as good as it can be. We shall issue further advice to health authorities in the new year on the basis of the lessons that we have learnt from the first six demonstration projects.