Market Power

HC Deb 08 June 1993 vol 226 cc136-8

10. Mr. Cousins

To ask the Secretary of State for Health what plans she has to control abuses of market power in the NHS.

Dr. Mawhinney

There is no evidence of abuse of market powers.

Mr. Cousins

Does the Minister recall that last year in my constituency an experimental and brilliant way of delivering long-term rehabilitation had to be stopped because the bigger providers would not allow it? Does he know about Hertfordshire, where purchasers are strangling the hospitals? Does he know that nurses are on the streets of Newcastle today defending their hospital against the bigger providers who are trying to strip the services? If the Minister is not willing to act, why will not he let the Monopolies and Mergers Commission into the national health service to sort out the abuses and ensure that there is fair play?

Dr. Mawhinney

I will tell the hon. Gentleman what I know about Newcastle. The average general practitioner list size has decreased by more than 6 per cent. I know that the number of child health surveillance patients treated has increased by more than 10 per cent. I know that the number of minor surgical procedures has increased by 164 per cent. What I understand, but the hon. Gentleman does not, is that the health service is not confined to hospitals. It also extends into the community and primary care. The record in his part of the world is as good as it is in the rest of the country. People understand that they do not have to spend time in hospital when treatment and care are frequently available to them in their homes. I should have thought that the hon. Gentleman would welcome the fact that more day surgery is available to his constituents so that they spend less time in hospital. I have news for the hon. Gentleman—that is what his constituents would prefer to do.

Mrs. Roe

Does my hon. Friend agree that the implementation of the national health service reforms has been a great success, resulting in the treatment of more patients, shorter waiting times and better patient care? I congratulate him on taking the reforms forward, particularly in the development of purchasing. Will he give an assurance that that vital work will continue and that we not be deflected by Labour party scaremongering?

Dr. Mawhinney

My hon. Friend is absolutely right. Last year, we treated, in terms of general and acute patients, 13.5 per cent. more than we treated in the year before the reforms were introduced. My hon. Friend will be pleased to know that activity in trusts last year was 7.6 per cent. higher as against 4.5 per cent. in directly managed units.

I can certainly offer my hon. Friend the assurance she seeks. We are moving to the next phase of the reforms, which is to increase and improve purchasing arrangements in this country. Purchasers are the advocates and agents of patients and it is their responsibility to see that an increasing amount of service, and increased quality of service, is made available to patients.

Rev. Martin Smyth

The Minister will agree that while improvements have been made in the national health service, we have not reached heaven yet. So let us return to the question and deal with the abuses. Is not it an abuse for a major pharmaceutical company to use its front-line position to bring pressure on small wholesale chemists to turn them into agents of the company? Is not it an abuse for a health authority to refuse to purchase good-quality services at reasonble cost, thereby trying to shut out a provider?

Dr. Mawhinney

I must tell the hon. Gentleman, as he would expect, that it is for purchasers to determine how they best achieve value for the large amounts of money that are available to them for purchasing good-quality and extensive health care for those for whom they are acting.

The answer to the first part of the hon. Gentleman's supplementary question is that he obviously has a specific example, of which I am not aware, in mind. He might care to bring it to the attention of my noble Friend Lord Arran, who has responsibility for those matters in Northern Ireland.

Mr. Ian Taylor

Does my hon. Friend agree, given that the health service is available to patients free at the time when they need it, that it is in their interest that market forces should operate in the system, that there should he competition between providers and that there can be competition between purchasers? Will he welcome our right hon. Friend's comments about encouraging private sector money into the health service, for the overall benefit of NHS patients?

Dr. Mawhinney

Yes, indeed. My hon. Friend is absolutely right. It is totally spurious to suggest that the Government must choose between being caring on the one hand and being concerned for efficiency and-cost effectiveness on the other. It is in the interests of patients that we run the health service as efficiently as possible. In that way, more patients are able to be cared for and treated with the record amount of resources that are now being made available.

Mr. Rooney

Is the Minister aware that one of the four suppliers of sterilised theatre packs in Britain, Southrim Autoclave Ltd., is in my constituency? Is he further aware that the trust running Leeds general infirmary has placed a contract worth £250,000 direct with a Dutch company without even inviting any of those four British companies to tender? Is not that an abuse of the use of market forces?

Dr. Mawhinney

Purchasers have a responsibility to make the best possible arrangements they can for those on whose behalf they are acting.