HC Deb 18 February 1992 vol 204 cc163-4
2. Mr. Jim Marshall

To ask the Secretary of State for Health what assessment he has made of the adequacy of the internal market as the mechanism to determine the future pattern of health services in London.

Mr. Waldegrave

Information derived from the national health service internal market on general practitioner and patient preferences and on comparative costs will help the service to plan sensibly for the future, in London as elsewhere.

Mr. Marshall

Is the Secretary of State prepared to recognise that the Government's reforms have added to the difficulties of health care provision in the capital? Will he confirm or deny that the Tomlinson inquiry is likely to show that two directly managed units and one trust are in serious trouble? May I beg him to stop making political capital out of the health of the citizens of the capital and concentrate on the real issues?

Mr. Waldegrave

Putting around scares such as that, which have no foundation in fact, is the worst kind of playing politics with health. The Government were the first to undertake the far too long postponed replanning of services in London. That was why I appointed Sir Bernard Tomlinson. I should have thought that the hon. Gentleman, who cares about these things, would welcome that. It goes as far back as to when Lord Ennals was Secretary of State. All those years ago he knew things and said that services should be replanned in London, but did nothing whatever about it.

Mr. Michael Morris

Is my right hon. Friend aware that the need for a review in London goes back much further than Lord Ennals? My right hon. Friend's agreement to such a review and initiative is greatly to be welcomed. Will he ensure that in the review by Sir Bernard Tomlinson, the key point about London—its specialist abilities serving constituencies such as mine in Northampton—remains a focal point? I visited the neurology department at the Middlesex hospital this morning. Such services, which are available to my constituents and others elsewhere in the country, are vital for the future of our health service.

Mr. Waldegrave

I agree with my hon. Friend. Many people within those marvellous specialist services in London believe that attracting patients from around the country, and the money that will come with them as the reforms develop, will strengthen those outstanding services. For example, many people at the Royal Brompton and National Heart hospital tell me that some of the special health authorities should be allowed to win new patients and the money that comes with them by being allowed to work in the internal market. There is no contradiction between paying tribute to those specialist services in London and pressing ahead with the reforms.

Ms. Harman

The Secretary of State said that the internal market was sensible. Does he regard as sensible the position revealed by Graham Jackson, the cardiologist at Guy's opted-out hospital, where local people are unable to be treated because the local district health authority's contract has run out? Local people are left waiting while less urgent cases from outside the district are treated because they bring money in with them. Is the right hon. Gentleman aware that six local people have had to go private to avoid waiting and 40 remain on the waiting list with no prospect of being considered until the next financial year? One person has already died. Is not this a case of your money or your life in the internal market?

Mr. Waldegrave

I am glad that the Labour party second-rate advertising agency is now writing the hon. Lady's interventions in the House. The old system to which the hon. Lady and the hon. Member for Livingston (Mr. Cook) wish to return us was far more unsatisfactory, as she well knows. Under that system budgets were given to hospitals. They ran out two thirds of the way through the year. As the hon. Member for Livingston can promise his hon. Friends nothing about money, he could not prevent that from happening if he returned to the old system. We are moving to a system in which patients are accompanied by the money to finance their treatment. That is far more sensible.