HC Deb 20 November 1990 vol 181 cc123-6
4. Mr. Illsley

To ask the Secretary of State for Health what steps he is taking to avert the closure of hospital beds throughout the United Kingdom.

The Secretary of State for Health (Mr. William Waldegrave)

It is for health authorities to determine the mix of health provision—including the number of hospital beds—which best meets the needs of their local population using the increased resources which the Government have made available to them. Next year will see the largest-ever increase in NHS funding, enabling the health service to continue to treat more people and expand its services.

Mr. Illsley

The Secretary of State is no doubt aware of the recent report of the National Association of Health Authorities and Trusts which forecast some 3,500 bed closures between now and next April. He is probably also aware that all hospital consultants in Sheffield have been told not to prescribe on to general practitioners' budgets in order to save money. Is not it a fact that the Government are passing the buck to health authorities, which are no longer accountable, and are blaming them for the cuts when the Government are simply not providing adequate funding for health authorities to carry out their duties?

Mr. Waldegrave

No, Sir, I do not accept that. As the figures show, the number of people treated goes on increasing from year to year. As the hon. Gentleman knows, the number of day care surgery cases has doubled since 1979 for medical reasons. That is largely why the beds continue to close.

Dame Jill Knight

May I congratulate my right hon. Friend on being appointed to his new position? When considering bed and ward closures, does he recognise that many of us believe that what is important is the treatment of patients, not furniture? Will he assure the House that when wards close and beds are moved, patients who need care will be taken care of elsewhere?

Mr. Waldegrave

I am grateful for my hon. Friend's welcome. The figures support what she says. The national health service, thanks to its employees, who do so well for us, continues to treat more patients every year, including in my hon. Friend's area.

Mr. Kennedy

Does not the Secretary of State realise that the report of the National Association of Health Authorities and Trusts, and the survey carried out by The Independent the day before, showed clearly that, in anticipation of next year's managerial structural changes, health authorities were being forced to close beds? It is quite false for him to say that the key indicator is the number of patients being treated, because all too often health authorities have moved patients from hospital care, sooner than normal, back into the community. Many of them have had to be re-admitted because they did not have sufficient hospital convalescence following surgical treatment. Should not we examine that figure, rather than the platitudes that the Secretary of State is offering?

Mr. Waldegrave

I read the surveys with care. It is worth noting that the report of the National Association of Health Authorities and Trusts to which the hon. Gentleman referred showed, by any inflation indicator, a real increase in resources available for the health service this year. That contradicts what Opposition Members have often said. The medical advice is against the hon. Gentleman. Before we took office the trend was already to keep people in hospital for less time. That is medically right.

Mr. Norris

I join in welcoming my right hon. Friend to his new position and express my pleasure that having me as his Parliamentary Private Secretary did not impede his career for too long—or at least I did not damage him as much as I did some of my other right hon. Friends. The reality of bed closures is often the opposite of that suggested by the hon. Member for Barnsley, Central (Mr. Illsley). Beds have been closed in my health district and much public distress has been expressed as a result. But those bed closures are being announced now to achieve required budget savings by next April. The main reason is not a shortage of funds from the Department of Health but the inadequacies of the management of individual health districts. More health districts should address themselves to the subject.

Mr. Waldegrave

I am grateful for my hon. Friend's kind words. It is true that he has lost one or two Secretaries of State along the way, but he and I had a better relationship. What he says is perfectly true. It would be wrong for well-managed areas—Barnsley health district is managing well within its resources and has closed no beds for financial reasons—to be made to transfer resources to areas that may have tackled their problems with less resolution.

Mr. Robin Cook

May I congratulate the Secretary of State on his appointment to the Cabinet and share the hope that he will still be in it after 6.30 pm? While he is still with us, will he try to face the realities? Has no one told him that some hospitals will not carry out any routine surgery for the rest of the financial year? Has no one told him that the NAHAT survey found that only 2 per cent. of closures were planned rationalisations and that 98 per cent. were emergency closures to balance the books in time for next April's changes? As those changes are doing so much harm to the national health service, why does not he take the opportunity of this interregnum to put back the lid on changes which came in with the present Prime Minister and should go with her?

Mr. Waldegrave

I am grateful for the hon. Gentleman's welcome, although I am not so grateful for the fact that he is playing the old gramophone record which he has been playing for the past two or three years and will continue to play for the next two or three years from the position that he now occupies. Every year the health service goes on treating more people. I shall not deny that in some places in the health service beds are being closed for financial reasons, but it would be wrong for us to say that those who are trying to achieve their planned budget spending should not be encouraged to do so, because that is the basis of a well-managed service.

Mr. Hayes

I warmly welcome my right hon. Friend to his new job and I know that he will be a great success. Does he accept that the best way to prevent bed closures is for the money to travel with the patient—which I hope will happen from next April? Does my right hon. Friend accept that he will have to take some tough decisions, particularly in the Thames region where the capital programmes have collapsed? My right hon. Friend must understand that constituencies such as mine, which has the worst waiting lists in the country and where children's wards are being closed, must be assisted if the excellent reforms that will come on stream next year are to mean anything.

Mr. Waldegrave

My hon. Friend is right. The reforms will help to take the money to where the patients are and will help to reward hospitals that are successful and treat many patients. The present system works in exactly the opposite direction. I am well aware—this is the first thing of which anyone holding my office would be aware—that there is, as usual, a special London problem which has not been sorted out for decades. We shall have to sort it out before too long.