§ 1. Mr. Blunkett
To ask the Secretary of State for Health what progress has been made in reducing waiting lists in the past 12 months.
§ The Secretary of State for Health (Mr. Kenneth Clarke)
The £31 million waiting list fund for 1989–90 will enable around 100,000 extra in-patients and day cases and 90,000 out-patients to be treated from the waiting lists by the end of March 1990. We have sent a management team into the 22 districts with the longest waiting lists, and as a result waiting lists in those districts have reduced by 12 per cent. and the number of patients waiting over a year by 17 per cent., with further reductions planned. Nationally, provisional figures for September 1989 suggest that waiting lists, in particular the numbers waiting over a year, have fallen since March 1989.
§ Mr. Blunkett
Does the Secretary of State think that, in the interests of open government, it would be sensible for the Government to collect statistics nationally on out-patients awaiting appointments? In audiology, there is often an 18-month or two-year waiting list. Does he agree that the BBC statistics collected recently, which show that massive cuts would have to be made in a third of health authorities if spending is not increased, would be made worse if the true national statistics for waiting lists were available? Those statistics would show what people are experiencing rather than the propaganda put out by the right hon. and learned Gentleman's Department.
§ Mr. Clarke
We keep collecting more statistics on waiting lists and we collect accurate information, which we disseminate. Recently, for example, we added figures on the waiting lists for day-patient treatment, as that treatment now represents a much bigger proportion of work.
The BBC survey to which the hon. Gentleman referred showed no results of the type that he described or anything 762 like that. The statistics show that some districts are having difficulty keeping within their cash limits this year,but all districts are not only spending much more money than in previous years, but treating more patients and expanding their services.
§ Mr. David Howell
My right hon. and learned Friend has shown considerable determination in tackling the waiting list problem. Does he agree that at least part of the problem is caused by short-term budget cuts that must be made in certain hospitals? Is he aware that in my local hospital, the Royal Surrey county hospital, short-term budget cuts have had to be made because no funding is available for the large number of patients who come to that hospital from other districts? Is not it a crazy system that prevents excellent hospitals, such as the Royal Surrey, from providing the patient care of which they are capable, as they cannot get the money, because, apparently, the accounting system does not allow them to do so?
§ Mr. Clarke
It has always been a habit within the National Health Service for some authorities to expand their services rapidly for about 10 months of the year and then, towards the end of the financial year, to start to make short-term changes to try to keep within their cash limas. That demonstrates the failure of the present system to enable people to plan steady expansion of services in line with the steady growth of funds. I agree with my right hon. Friend that, in future, districts will be much more able to match their funds to the growth of patients. Districts that take in many patients from outside because of the quality of their services will find that the necessary funds come with those patients.
§ Ms. Primarolo
Does the Secretary of State accept that the money given to cut the waiting lists represents a blunt instrument? Many district authorities are concerned about the way in which they must allocate their budgets. Yesterday Bristol and Weston district health authority expressed its great concern about how the waiting list money was allocated, as it means that that authority cannot take into consideration pain and suffering or target lists of pain and suffering that may exceed 12 months in the next few months. Will the right hon. and learned Gentleman review that criterion with a view to being much more sensitive about distributing that money?
§ Mr. Clarke
Our waiting list initiative will be overtaken by our White Paper reforms when they are brought into practice. They will have the beneficial effect that I have just described to my right hon. Friend the Member for Guildford (Mr. Howell). In admitting patients, all hospitals take account of the gravity of the case, and the pain and suffering involved. We have to remember that more than half the patients in the National Health Service go for treatment and do not have to wait at all. Of those who go on to waiting lists, about half go into hospital within five weeks. It is not just a queue. People are admitted according to their clinical priority. Where there are serious problems, pain and suffering, we must not alarm people by making them think that waiting lists get in the way.