Waiting Lists

HC Deb 14 May 1991 vol 191 cc141-2

6. Mr. David Marshall

To ask the Secretary of State for Health what research has been conducted on the relationship between the length of national health service waiting lists and the availability of private practice.

12. Mr. Patchett

To ask the Secretary of State for Health if he will initiate a study into the effects of the availability of private practice on national health service waiting lists.

Mr. Waldegrave

We have not conducted, nor do we plan to conduct, any research into the relationship between private practice and national health service waiting lists. However, we are determined to tackle long waiting times for NHS treatment. The NHS management executive is agreeing tough targets with all 14 regional health authorities for substantial reductions, by March 1992, in the numbers waiting over one year for treatment.

Mr. Marshall

Is not it a disgrace that, three months after John Yates, the Government's former waiting list expert, drew attention to the fact that private practice by national health service consultants may be leading to longer waiting lists for NHS patients, the Government have done nothing about it? The Secretary of State's reply is just not good enough. Will he assure the House that an immediate investigation will be carried out into this matter, or does he simply intend to expand his party's two-tier health service, which means priority for private patients and longer waiting lists for national health service patients?

Mr. Waldegrave

I do not think that the hon. Gentleman has exactly and correctly reported Mr. Yates's views. If the hon. Gentleman will produce evidence to back what he says, I shall look into it. The hon. Gentleman presents yet a further argument in favour of national health service trusts. Those trusts will hold the contracts for their consultants, and it will be open to them to negotiate with their consultants if they wish to see them carrying out more national health service work.

Mr. Patchett

Given the evidence of Mr. John Yates to the Select Committee, does not the Minister recognise the need for a study of this matter and the possible dire consequences to the health service if it is ignored?

Mr. Waldegrave

I think that my previous reply answers the hon. Gentleman's question. If the baying of Opposition Members over the issue of independent practice by doctors were drawn to the attention of the British Medical Association, it might dampen the association's enthusiasm for anything that might lead to a Labour Government.

Mr. Michael Morris

Is my right hon. Friend aware that whenever the Public Accounts Committee has looked at any alleged negative relationship it has found none? Will my right hon. Friend ensure that the whole issue of waiting lists is simplifed so that health authorities who remove people from the waiting lists are paid after they have performed the required service?

Mr. Waldegrave

I confirm that my hon. Friend is right. There has never been any evidence to show what has been alleged. There is unfair reporting of the matter. One of the newspapers that supports the Opposition, the Daily Mirror, reports another of Mr. Yates's ideas, which is to give incentives to doctors who do well in reducing waiting lists. However, the Daily Mirror reports that in most unfair terms as being a dreadful thing to do. I am not sure whether the Labour party is in favour of Mr. Yates or against him.

Mrs. Peacock

Will my right hon. Friend not be drawn along lines that confuse the issue but confirm that the national health service is what it says it is, what it has always been and what it always will be—a service that is available when needed and free at the point of need?

Mr. Waldegrave

I have no difficulty in fully endorsing that. In response to these questions, I re-endorse an element of the policy of the national health service's founding Minister, Mr. Aneurin Bevan, who made a historic compromise with consultants when he allowed them independent practice in NHS hospitals.

Mrs. Dunwoody

Is the Secretary of State aware that the BMA does not represent consultants? If he wants to know what consultants think, he should talk to their representative groups. Would he ask them to explain why, over a recent holiday weekend, the trust in my area simply stopped taking in patients because it did not have a senior registrar available to do the work?

Mr. Waldegrave

I think that Mr. John Chawner would be confused to be described as not representing consultants. He regards that as his job and he certainly represented them when he saw me a few days ago. I am willing to admit that, in the few weeks in which they have been in existence, the trusts have not solved all the problems of the national health service. There are still problems, but I assure the hon. Lady that the management delivered by her NHS trust will be much better than the traditional management, which created these problems in the first place.