§ 8. Mr. Matthew Banks
To ask the Secretary of State for Health how many junior doctor posts entailing more than 83 hours remain in the North West region; and if she will make a statement.
§ Mrs. Virginia Bottomley
All posts contracted for more than 83 hours a week in the South Thames and North West regions have been eliminated. That is a remarkable achievement as there were more than 3,300 such posts in those two regions in September 1990.
§ Mrs. Lait
I thank my right hon. Friend for that most encouraging news and I congratulate her on the success of a policy that she initiated when she was Minister for Health. Is she aware that reports are emerging of a significant reduction in the number of applications for doctors' jobs in 745 my region? Will she comment on the fact that Conservatives cut junior doctors' hours while the Labour party cut their pay?
§ Mrs. Bottomley
I take note of my hon. Friend's comments. The way in which juniors are trained—their rotations and accommodation and many other conditions—requires further consideration. I welcome the discussions that we have with the junior doctors to ensure that we continue to train and support some of the best junior doctors so that they can help the health service. Their pay has increased substantially during our term of office. I am pleased, however, that there have been such significant cuts in their hours.
§ Mr. Matthew Banks
Will my right hon. Friend join me in paying tribute to the Southport and Formby community health service trust which, in March this year, met its important 1994 target of reducing the number of hours worked by junior doctors? Will she give me an assurance that, as the acute trust continues to make progress in that important sector, it will continue to have the support of the regional task force?
§ Mrs. Bottomley
I certainly pay tribute to the Southport and Formby community health service trust and can assure my hon. Friend that the task force will continue to play a crucial part. I know his region well and have met junior doctors from there. Only three years ago, when I was in Blackpool for a certain purpose, a number of the juniors came to see me and my hon. Friend the Member for Wyre (Mr. Mans). Two years later, we were able to visit them on their night shift at the Blackpool Victoria hospital to talk about the new systems, the way in which shifts have been introduced and the fact that extra resources have been put to good effect and the junior doctors' hours reduced.
§ Mr. Austin-Walker
Is the Secretary of State aware that one of the arguments advanced for the closure of the Brook hospital in the South Thames region is the requirement to meet the junior doctors' hours? Is she further aware that the future plans of the health authority depend on the acquisition of the Queen Elizabeth military hospital from the Ministry of Defence? Is she aware that the national health service may be gazumped by a private bidder? What steps will she take to ensure that that hospital remains in the public sector?
§ Mrs. Bottomley
I am aware of the facts of that situation, but the hon. Gentleman will understand that the Minister for Health deals with those matters as I have a close personal relationship with one of the hon. Gentleman's neighbouring Members of Parliament—that is in the Register of Members' Interests. I am aware that the effects of the reductions in junior hospital doctors' hours have implications for service delivery. It is extremely costly to provide juniors on duty overnight in a great number of establishments and we have to look carefully at that aspect. We also want to safeguard patient care and the quality of doctors' training. The dialogue that we have established between Ministers, the junior doctors' leaders and the NHS is leading to sensible outcomes, and improvements for juniors and the service.
§ Mr. Purchase
Is the Secretary of State aware that some of the reductions—which are by no means universal—have been achieved by some grades of nurses having to take on tasks formerly performed by junior doctors? That has led to considerable stress, especially in hospitals in 746 Wolverhampton where, I understand, the Minister has imposed a block on further recruitments of junior doctors. Will the Secretary of State respond to that?
§ Mrs. Bottomley
The hon. Gentleman will understand that the recruitment of junior doctors is connected with a long-standing agreement with the profession over the number of juniors trained for the number of consultant posts available. I hope that we may move towards more flexibility in some of those matters as time goes by, but there has been a steady increase—of 3 per cent. a year—in the number of consultants in the health service and that is a significant achievement in itself. The hon. Gentleman rightly points to the part played by nurses in taking on some of those tasks. Managers, much denigrated by the Labour party, and administrative support staff have also taken on some of the tasks previously done by junior doctors.
We need a pragmatic approach that ensures that juniors are well used for the tasks for which they are trained, and that their hours are not excessive. I think that we are making great progress.
§ Mr. Nicholas Winterton
Does my right hon. Friend remember the case of my constituent, Alan Massie, a talented young junior hospital doctor at Warrington district general hospital who died some months ago? Is she aware that the coroner's report has now found that he died from stress and overwork because of the abnormal number of hours that he was forced to work? Will she therefore keep the matter of junior hospital doctors' hours under continual review, to ensure that young, talented people such as my constituent do not die because of their commitment to the health service?
§ Mrs. Bottomley
I well understand the case to which my hon. Friend refers. The stress of being a junior doctor is associated with a number of factors, not least rotations. I was interested in a scheme being developed in New Zealand, where there is talk of a mentoring system to give support to junior doctors in training. Reducing the number of hours has been a clear priority. In 1990, 13,000 doctors were working rotations of more than 83 hours: none are now. There has been a fall of one quarter in the number of hard-pressed posts involving more than 72 hours. We want to do very much better than that by the end of the year; it is an important priority for us all.