HC Deb 10 November 1998 vol 319 cc137-8
8. Mr. Michael Jabez Foster (Hastings and Rye)

What action he is taking to promote booked admission pilots in the NHS. [57356]

The Secretary of State for Health (Mr. Frank Dobson)

On 24 September I announced 24 pilot schemes to develop systems of booked admissions so that patients can arrange to go into hospital at times that suit them. A total of £5 million pounds has been made available this year and £20 million will be provided for further schemes next year. We hope that, eventually, the entire system will go nationwide.

Mr. Foster

I thank my right hon. Friend for that reply. Does he agree that, as my constituents can book their holidays and various appointments by telephone, it is about time that they were also able to book by telephone their hospital appointments, rather than waiting anxiously for that brown paper envelope through the letter box?

Mr. Dobson

I certainly agree with that. It is a strange irony that it is difficult for people to make bookings and other arrangements in the national health service—which, for more than 50 years, has served the United Kingdom 24 hours a day, every day of the year—because of its communications system.

We want to enable people who have been told by their GP, "I think you need an out-patient appointment, because they should do some tests at the hospital," to be able—there and then, from the GP's premises—to book an out-patient appointment that suits them. At an out-patient appointment, if they are told by the specialist, "I think you'd better come in as an in-patient," they should—again, there and then—be able to make a booking, preferably for a day of the week and time of the year that suits them. Such a change would be a good step forward and would in many ways reflect the fact that, although services are available 24 hours a day, every day of the year, the system gives a different impression.

Mr. Philip Hammond (Runnymede and Weybridge)

We welcome development of a booked admissions system. However, booked admissions will help only those who are fortunate enough to have secured a specialist out-patient appointment to get on to the waiting list initially. The Secretary of State has been asked repeatedly to publish figures on the number of people waiting for out-patient appointments. The figures are already collected and reported to the NHS executive by hospital trusts; all he has to do is to add up the figures. Is not the reason why he refuses to publish the figures that they will show that, taken as a whole—elective surgery and specialist out-patient waiting lists together—NHS waiting lists are going up, not down as he would have us believe?

Mr. Dobson

I have heard of people trying to change the goalposts once the match has started, but the hon. Gentleman seems to want to change the stadium. In the first six months of this year, the national health service dealt with 67,000 more out-patients than previously.

Miss Ann Widdecombe (Maidstone and The Weald)

What about out-patients?

Mr. Dobson

If the right hon. Lady would just keep quiet and let those who are supposed to answer the questions do so, and stick to her appointed job of asking questions, we might get somewhere.

There is some evidence of a build-up in the number of people waiting for out-patient appointments. We have never denied that. I am asking managers and others in the national health service to make use of the additional funds that we are providing to deal with waiting lists and the £250 million extra that we are providing to deal with the winter to try to pay more attention to those people.

Hitherto, figures have been collected on a basis established by the previous Government—to show how well the then Government were doing in meeting the patients charter. Those figures have been collected, and they will continue to be published. However, I should like to move towards more detailed and up-to-date figures. It is very revealing that the new Government have not only started publishing monthly in-patient waiting list figures but, for the first time, have started collecting such figures monthly. The hapless crew on the Conservative Benches collected the figures only once every three months.

Dr. Howard Stoate (Dartford)

May I, on behalf of my GP colleagues across the country, welcome my right hon. Friend's initiative in ensuring that patients will be able to book out-patients appointments directly from GPs' surgeries? May I also ask him to ensure that, once the initiative has been implemented, out-patient appointments will be booked on the basis of clinical need, to ensure that patients who need to be seen as soon as possible are fast-tracked through the system—thereby eliminating a very significant cause of waiting?

Mr. Dobson

Ever since we were elected, we have tried to make it clear that clinical need should be the major determinant of how quickly people are treated. I hope that, as the information technology system becomes more sophisticated, doctors' and other clinicians' capacity to express their views, and to have their views heeded, will be improved, as that will be to the benefit of everyone. Both patients and those who treat patients like to know that everyone is being treated fairly. People are comfortable doing something that they believe to be fair, and very uncomfortable if asked to do something that they do not think is fair.