HC Deb 05 July 1994 vol 246 cc132-3
2. Sir Paul Beresford

To ask the Secretary of State for Health what proportion of elective operations are now carried out on a day care basis; and what was the comparable figure 10 years ago.

The Secretary of State for Health (Mrs. Virginia Bottomley)

The number of day cases in the general acute sector has already doubled since 1988–89, the earliest year for which figures are available. In 1993–94, the proportion of elective admissions treated as day cases reached 48 per cent.

Sir Paul Beresford

This type of day care facility is being used as a specialty by many of the high-quality private health clinics and hospitals in Britain. Is there any trend to encourage health authorities to use those services, which are cost effective, to ease their workload?

Mrs. Bottomley

Where such services provide good value, the health authority is certainly free to establish a contract with an independent provider. The key is that day care provides good value for money. However, my hon. Friend will know that his local hospital, the Mayday trust, did the fifth best in the country in terms of cataract extraction: 90 per cent. of its cases are dealt with on a day basis. The hospital received four stars for cataract operations, four stars for arthroscopy, four stars for laparoscopy and three stars for hernia repair. My hon. Friend has a great deal to be proud of in the Mayday trust.

Ms Lynne

Is the Secretary of State aware that no one will believe the assurances that she gives on day surgery or any other aspect of the health service? If it is all sweetness and light in the health service, can she tell us why the British Medical Association, the Royal College of Nursing and a majority of other medical bodies, and now the Bishop of Birmingham, say that the health reforms are not working? They surely cannot be on their own in that. Will the Secretary of State answer that point?

Mrs. Bottomley

Change is always difficult, but it has to be grasped if we are to protect a remarkable achievement. Today, the anniversary of its founding, the national health service is providing treatment available to all on the basis of clinical need. That means embracing new technology, taking difficult decisions and resisting the temptation to scaremonger rather than lead people forward.

Sir Anthony Durant

Following my right hon. Friend's comments on day surgery and cataracts, will she congratulate the unit at Royal Berkshire Trust hospital, which she visited last Friday and which has had great success in day surgery? Will she congratulate the nurses and doctors on the success of that unit?

Mrs. Bottomley

Most certainly I will. I will also report to the House the comments from the patients whom I met when visiting the unit. They said that they were appalled by the scaremongering which suggested, for example, that patients over the age of 65 would not be treated by the NHS. Those patients, many of them well into their 60s and 70s, gave an account of the quality of the care that they received: they went in in the morning and returned home in the evening. Although that hospital got one star in the league tables, it is already achieving 45 per cent. of its cataract operations on a day basis because, since those tables were compiled, it has seen the future and invested in a day unit particularly to deliver day cataract surgery.

Mr. McCartney

First, I congratulate the Secretary of State and the Minister of State on attending their last Health Question Time, as I understand that, like so many acute beds in the NHS, they are about to be closed down and shuffled out of the Department of Health.

Last week, the Secretary of State said that she was giving stars to star performers in her league tables. Why, then, is Manchester's Withington hospital—which achieved 100 per cent. ratings in casualty, in ear, nose and throat, ophthalmology, urology, gynaecology, oral, neurology and general surgery—not being congratulated but being given notice to quit? When such a wonderful hospital is receiving five-star ratings from the right hon. Lady, why is she allowing the regional health authority and the Department to close it down?

Mrs. Bottomley

If the hon. Gentleman has difficulty believing me, he may like to consult The Guardian, which reported that last week's league tables represented a milestone in the NHS and that the Opposition had made fools of themselves in their attitude towards those league tables.

Perhaps I may quote to the hon. Gentleman the following comments: Within the next 20 years, new technology, minimally invasive surgery and new diagnostic and treatment facilities will transform the delivery of health care in the developed world. Those are not my words; they come straight out of the Labour party's own policy document.

Dr. Goodson-Wickes

Does my right hon. Friend agree that the agreeable benefits derived by patients from day care surgery are well supplemented by the Government's initiative on community care, which must be for the good of patients and their families?

Mrs. Bottomley

My hon. Friend is exactly right. Day surgery must be developed in context. The dramatic investment in primary care and the resources committed to community care ensure that those discharged from hospitals are properly supported at home. The idea that we should be in the business of trying to retain hospital beds as our prime preoccupation rather than increasing the number of patients treated conveniently is only the rhetoric espoused by the Opposition parties. We believe in patients, not furniture.