HC Deb 05 July 1994 vol 246 cc136-7
5. Mrs. Anne Campbell

To ask the Secretary of State for Health what assessment she has made of the effect of pay beds in the national health service on the principle that treatment is determined by clinical need rather than ability to pay; and if she will make a statement.

Mrs. Virginia Bottomley

Pay beds have existed since the NHS was founded 46 years ago. They have no impact at all on the principle that NHS patients are treated according to clinical need rather than ability to pay. Any private work that a consultant does is additional to his or her NHS duties and is carried out in his or her own time.

Mrs. Campbell

Nevertheless, will the right hon. Lady investigate whether pay beds or private referrals at Addenbrooke's hospital are responsible for one of my constituents, Megan Thompson, being told that she must wait until 1999 to see an orthopaedic consultant?

Mrs. Bottomley

Once again, that is a typical example of scaremongering from the hon. Lady. If she had made the investigations that I have made, she would know that the other orthopaedic surgeons at Addenbrooke's have waiting lists within 18 months. The hon. Lady referred to a particularly popular orthopaedic consultant, who has a longer waiting list. It is a question of freedom of choice for patients: if they insist on seeing a particular consultant, they must wait longer, but they can have an appointment with another within the 18 months.

Mrs. Roe

Does my right hon. Friend agree that pay beds provide an extremely valuable source of extra income for the NHS, but that the Labour party clearly does not appreciate that? Does that not clearly show that despite the soft-focus imaging that the Labour party is undertaking at the moment, it does not permit freedom of choice?

Mrs. Bottomley

My hon. Friend has it exactly right. I am concerned about the dispute in the Labour party. I notice from early-day motion 1436 that the hon. Members for Bristol, South (Ms Primarolo) and for Cambridge (Mrs. Campbell) both support putting an end to NHS pay beds. Is that the political sweetener for the unions about which Barbara Castle used to speak?

Ms Primarolo

Is the Secretary of State aware that the number of private patients treated in the national health service has risen by 10 per cent. since she introduced the internal market? The NHS is subsidising private patients while health service patients are waiting longer for treatment. Will the right hon. Lady agree to establish the full cost of providing private health care, including the training of doctors and staff time in hospitals? Will she also ensure that private patients cannot queue-jump those in greater need?

Mrs. Bottomley

Pay beds bring in £157 million for the NHS—the equivalent of 41,000 hip replacement operations. There are clear rules. There may be no queue-jumping for priority or urgent operations, and the private sector may not disadvantage the NHS. It so happens that most people signed up to private health insurance in the winter of 1979–80 and in 1980–81. As ever, the private sector recruiting sergeant was Labour's stewardship of the NHS and the winter of discontent.

Mr. Patrick Thompson

Bearing in mind the relationship between private medical care and the national health service, and the fact that we are now celebrating 46 years of the health service, does my right hon. Friend recall the attitude of the British Medical Association on the formation of the health service, and will she therefore take with a pinch of salt the sort of nonsense that we are currently hearing?

Mrs. Bottomley

The current BMA conference is the fifth that I have experienced since I have been at the Department of Health. The script varies little from year to year. The doctors' trade union has a job to do, which it has done since 1948. I am pleased that behind the rhetoric there is a great deal of practical progress, such as reducing junior doctors' hours, improving out-of-hours arrangements for general practitioners and progress in other areas. The BMA is not talking about dismantling the reforms, but only about reforming them. That is progress indeed.