HC Deb 25 January 1994 vol 236 cc152-5
7. Mr. Hunter

To ask the Secretary of State for Health what has been the change in the number of NHS patients waiting (a) over one year and (b) over two years since March 1991; and if she will make a statement.

Mrs. Virginia Bottomley

The number of patients waiting over one year for hospital treatment has fallen by 58 per cent. since March 1991—from 169,761 to 71,022. There were more than 51,000 patients waiting over two years in March 1991; two-year "waiters" have now all but been eliminated.

Mr. Hunter

Does my right hon. Friend agree that waiting lists reflect the ever-growing demand for services, that what matters to the waiting patient is how long he or she must wait, not how many other people are on the list, and that her answer shows that the health reforms—especially those involving the internal market—are having a positive impact on waiting lists?

Mrs. Bottomley

Indeed. Waiting lists are almost inherent in a health service that is free at the point of use. The number of people on the list as a percentage of those who are treated has remained fairly steady for the past 20 years. What matters to an individual patient, however, is how long he or she must wait. In that regard, our achievements have been dramatic, enabling everyone to benefit from the NHS reforms. Those reforms will continue and develop, and patients will benefit further.

Mr. Skinner

Will the Secretary of State give us the complete waiting list figures, not just those relating to one year or two years? If doctors and nurses are doing such a wonderful job—which they are—will the Secretary of State give a guarantee that she will tell the Treasury that the pay review recommendations for doctors and nurses should be met in full? If they are not met in full, will she resign?

Mrs. Bottomley

Doctors and nurses are, indeed, doing a magnificent job in reducing waiting times. Before the reforms, the average waiting time was about nine months; now, it is about five months, and there will be further improvements. Doctors and nurses should note what the Government have already achieved. Doctors' pay has increased by 34 per cent., while nurses' pay has increased by 52 per cent. That contrasts sharply with Labour's record.

The review bodies have undertaken their work in the normal way this year, and the Government will consider their recommendations in the normal way.

Mr. Day

Does my right hon. Friend agree that the way to reduce waiting lists is to increase the number of patients who are treated? That is precisely what has happened when trust hospitals have worked in conjunction with fundholding general practices. Is it not strange that the Opposition wish to abolish the most successful part of the NHS? Far from abolishing trusts and GP fundholders, should we not extend the benefits of those institutions throughout the health service?

Mrs. Bottomley

Most certainly we should. GP fundholders have been able to innovate and to pioneer new forms of treatment, and all family doctors are benefiting from their new procedures. The trusts are going from strength to strength and I shall shortly announce the full number of the fourth wave, which will be the largest wave yet. That is the programme of reform that we have set in hand. During the 1980s, there was a 2.5 per cent. increase in the number of patients treated, but, since the reforms have been in place, the figure has risen to an average of 5 per cent. When the Labour Government were in power, they were struggling along at annual rates of 1 per cent.

Mrs. Dunwoody

Is the Secretary of State aware that in my area we are sick to death of the con trick, of being told that the Government have dealt with the waiting lists while at the same time cutting the money allowed for the running of the general hospital? The Government have cut £3 million from the budget of a district general hospital while pretending that they have dealt with the waiting list —it is an insult to the community's intelligence.

Mrs. Bottomley

The hon. Lady comes from a part of the country which has seen a magnificent achievement in terms of the quality and quantity of patient treatment and it reflects the sharp contrast to the attitude of the hon. Member for Manchester, Withington (Mr. Bradley), who asked the first question about social services in that part of the world. If other public services were run with the skill of the health service in that area, there would be many improvements. Progress is being made in the number of in-patients and out-patients treated, but there is more to do.

Mr. John Marshall

Will my right hon. Friend pay tribute to the work of the Royal Free hospital trust, which serves many patients in my constituency? Since it became a trust hospital, it has substantially reduced waiting lists and increased the number of patients that it serves. Should not that be commended instead of criticised, as it often is by the Opposition?

Mrs. Bottomley

The Royal Free is an excellent example of the opportunities to be had in becoming a trust hospital. It was one of the first wave. As we move to the fourth wave, we hope that ever-greater numbers of hospitals will develop the same skills. Last year, trust hospitals increased the number of patients treated by an average of 5.3 per cent., whereas other hospitals increased the number by 4.3 per cent.

Ms Lynne

Following the Government's continual claims that more patients than ever are being treated, will the Secretary of State explain why waiting lists are higher than ever? Could it be because the Government count finished consultant episodes instead of patients treated?

Mrs. Bottomley

The Liberal Democrats seek to undermine the figures produced by the national health service in any way that they can. The figures are an accurate reflection of the work undertaken by the service. There was one change when we moved from the Korner figures to finished consultant episodes, but since then the proportions have remained steady and stable. The hon. Lady is seeking any excuse not to pay tribute not only to the managers who have established the reforms but to the doctors and nurses who are reducing the time that patients have to wait.

Mr. Streeter

I welcome the excellent figures that my right hon. Friend gave at the beginning of her reply. None the less, does she agree that the people of Devon and Cornwall would have to wait an even shorter time for their operations if some of the resources currently locked away in the London specialist hospitals were released for the benefit of the country as a whole? When will the unfair imbalance cease?

Mrs. Bottomley

My hon. Friend will know that we are seeking an end to the imbalance which has bedevilled the national health service for many decades. We spend 20 per cent. of the money on 15 per cent. of the people, but we have to proceed with care and full consultation. We must consider not only the questions of service but the important elements of research and education. I hope soon to be able to make further announcements which will ensure a more balanced health service and ensure that London releases resources to other parts of the country which are supporting London to the tune of £100 million this year.

Mr. Blunkett

Is it a fact that the number of people on waiting lists has risen by a third since the Government took office, while the number of beds available has dropped by a third, that the number of people waiting for more than a year rose by 25 per cent. in the first half of this financial year and that those waiting for the first crucial out-patient appointment to see a consultant are not counted at all?

Is the right hon. Lady aware that in the Mersey region, about which the fact is paraded that no one waits for more than a year, the Royal Liverpool hospital had just sent out a notice, saying that the waiting list for out-patient appointments for the spinal clinic now exceeds 18 months? Are not there lies, damned lies and Department of Health statistics?

Mrs. Bottomley

It is hard for the Labour party to speak of waiting lists, as every Labour Government have left office, with longer waiting lists than when they took office. I recommend that the hon. Gentleman study the Audit Commission report on the use of beds, which suggests that if all did as well as the top 25 per cent., the health service could do with fewer beds than we have now. We have to ensure that we make balanced progress.

Once again, Labour Members seek to pour scorn on the Mersey region. They may be interested to know that not only has Mersey tackled the subject of all its one-year waiters but it is now setting a target time of six months maximum for out-patient appointments and hopes to ensure that 90 per cent. of out-patients are seen within three months. It is such a shame that the Labour party cannot listen and watch and observe those regions that have made outstanding progress. Together, we should seek to apply those lessons to other parts of the country that are not yet doing so well.