Clinical Guidelines (Hansard, 16 July 1991)

§ 7. Mr. Gareth Wardell
To ask the Secretary of State for Health when he last met representatives of the British Medical Association to discuss clinical guidelines; and if he will make a statement.

§ Mr. Waldegrave
Ministers and officials have regular contact with representatives of the British Medical Association and discuss a broad range of issues of mutual interest.

§ Mr. Wardell
Does the Minister accept that, if the resources of the national health service are to be used to the maximum advantage of patients, it is crucial that clinical guidelines are laid down, both for general practitioners and for consultant surgeons, so that patients can have full confidence that the operations undertaken on them do not do them more harm than good, as is plainly the case in a large number of current procedures, including hysterectomies and operations for glue ear, to give just two examples?

§ Mr. Waldegrave
The hon. Gentleman is taking us into deep waters. I would not want the House to be the judge of which medical procedures are correct. We have effective royal colleges which monitor the standards and the Government have greatly strengthened the process of medical and clinical audit, which should further improve standards. If the hon. Gentleman wishes to raise a particular issue with me in relation to a procedure that he fears is being wrongly applied, I shall be happy to put him in touch with the chief medical officer to discuss the issue further.

§ Mr. Michael Morris
The key clinical guideline that all patients want when they see the consultant is to be told the date on which they will be operated on. Will my right hon. Friend put pressure on the NHS executive so that that is the norm in all 14 regions of this country?

§ Mr. Waldegrave
My hon. Friend makes a fair point. It is in some of those spheres of convenience to patients—quite apart from medical standards, which I do not question—that the NHS can do a great deal more. The Government are doing a great deal more both to bring down the waiting times which were left at a high level by the last Labour Government, and to make the service more convenient for patients.

§ Mr. Wigley
What clinical guidelines are given to consultants who identify a patient with an urgent need for an operation, cannot cope with the patient within the NHS for months, yet find time to do the operation privately at their own profit? Is that not a matter which should be regulated by severe clinical guidelines?

§ Mr. Waldegrave
I think the hon. Gentleman knows that urgent cases are admitted—50 per cent. of all cases are admitted at once off the waiting lists in the NHS, and of the remaining cases, the great majority are seen within about five weeks. Recently, the work that we did with the joint consultants committee laid down clear guidelines for the treatment of urgent cases, with the total support of all the professionals involved, including the British Medical Association.