Patient Care

HC Deb 16 October 1990 vol 177 cc1046-8

8. Mr. Andrew Mitchell

To ask the Secretary of State for Health what initiatives are being taken to promote a better quality of care for patients.

Mrs. Virginia Bottomley

Better quality of service and care for patients is at the heart of the NHS reforms. Key ways of achieving that will be the devolution of responsibility to local level and agreements between purchasers and providers with clearly specified quality standards.

Mr. Mitchell

Is not my hon. Friend's response an eloquent testimony to this Government's commitment to the National Health Service at a time when an aging population and welcome medical advances mean that there is a great deal to be done? Is not that a contrast to the capital-cutting, hospital building programme-cutting Labour Government who used to be in power?

Mrs. Bottomley

I thank my hon. Friend for his words. In the words of my right hon. Friend the Member for Castle Point (Sir B. Braine), we believe in action, not words, and in putting quality at the forefront of our plans for the health service. My hon. Friend will know that the scheme in his constituency is one of our national demonstration projects, focusing on quality. The children's out-patient department received £110,000 from the Department last year, once again making sure that the patient and the patient's family are at the forefront of health care.

Mr. Kennedy

Given that the Minister is trying to reduce junior hospital doctors' working hours and to improve patient care in that way—as well as the working environment—what will be the effect on that of the national initiative on the opting out of hospitals as they seek self-governing trust status? Will junior hospital doctors be more or less likely to enjoy better working hours and better working conditions?

Mrs. Bottomley

I am pleased that the hon. Gentleman has referred to our determined effort to tackle once and for all the unacceptable problem of some junior hospital doctors working unacceptable hours—unacceptable to them and to patients. Although considerable progress has already been made, we are determined to see further action in the specialties, hospitals and grades where the difficulty persists. I assure the hon. Gentleman that hospitals that become NHS trusts will, of course, abide by the manpower arrangements that have already been established, not only for junior hospital doctors' working hours, but in order to achieve a balance and to meet the safety net requirements.

Dame Jill Knight

Does my hon. Friend concede that there are differing ideas among different patients about what constitutes quality of care, which often have nothing to do with medical care? Some patients want to be in a room by themselves, to have better food or not to be in a mixed ward. How are the proposals progressing that would allow patients to pay something towards achieving those objectives?

Mrs. Bottomley

I greatly appreciate my hon. Friend's contribution. My hon. Friend the Under-Secretary of State recently announced an initiative to allow patients who wish to do so to pay for the extras that make such a difference to their patient care. I remind the House and my hon. Friends of the national quality exhibition that will take place in Birmingham in a fortnight, which will demonstrate practically the many quality initiatives which, above all, seek to make sure that patients, their wishes, interests and concerns will come first and be given the priority that they deserve.

Ms. Harman

Does the Minister accept that a key factor in achieving quality of care for all patients is ensuring that they get the treatment that they need when they need it? Is not the Minister aware that hospitals throughout the country, such as Westminster, are closing wards to all but emergency admissions because of shortage of money? The Minister says that the Government believe in action, not words when it comes to quality health care, but why do the action and the words mean offering cuts to the Treasury instead of saving services for patients who need them?

Mrs. Bottomley

It is rich for the hon. Lady to refer to action, not words. The Conservative party has increased the number of in-patients, and out-patients, and increased the number of day cases. On all fronts, there has been an improvement in the health service, leading to better patient care. However, we want to ensure that we continue to see perinatal mortality at a record low level, and that we see not only a reduction in the number of women dying from cervical cancer, but an increase in the number of coronary artery bypass grafts and kidney treatments. That is why my right hon. and learned Friend the Secretary of State announced last week a programme of health targets to ensure that we continue to focus our efforts on clear, concrete and practical achievements and continue to build a better health service.

Mr. Cormack

Does my hon. Friend accept that one group of patients has, tragically, received bad care? I am referring to the haemophiliac AIDS victims. Does she further accept that if the Government believe in action, not words, we cannot be satisfied with the response that we have received so far?

Mrs. Bottomley

I understand my hon. Friend's words. He will have heard my hon. Friend the Under-Secretary of State in last night's debate. The fact is that there was no case of neglect in those cases. However, we accept the great tragedy and that is why such significant resources have been made available to the families, who were so grievously affected, amounting to an average of £28,000 each. However, we cannot expect that every time there is a tragedy in the health service, when there is no professional neglect, there will be instant compensation, because the implications for us all and for all health care would be enormous.