§ 4. Dr. Gavin Strang (Edinburgh, East and Musselburgh)If he will make a statement on the planned levels of expenditure on hospital services over the next three years. [65828]
§ The Secretary of State for Scotland (Mr. Donald Dewar)We plan to increase net revenue expenditure on hospital and community health services to almost £4 billion a year by 2001–02. That is part of an overall health service expenditure figure of £5.5 billion. We are investing to create a world-class NHS and putting in place the reforms and resources to make that happen.
Of course, from 1 July 1999, this will be a matter for the Scottish Parliament.
§ Dr. StrangI welcome the hundreds of millions of pounds of additional money that Labour is putting into our hospital service. Does my right hon. Friend agree that it takes more than bricks and mortar to make a good hospital? As we await the outcome of the nurses pay review, does he recognise that it is high time that nurses and other hospital staff obtained the recognition that they deserve for the excellent work that they do?
§ Mr. DewarMy hon. Friend will recognise that a pay review body report is pending, and we will know shortly the specific recommendations that the body has made as a result of what I hope has been a careful and sympathetic examination of the situation. Obviously, we will then make an announcement as a Government. I agree about the fundamental importance of staff morale, and about the enormous contribution that not just nurses, but paramedics, the professions allied to medicine, doctors and a range of health service personnel make towards a service that we are determined to keep in first-class order—providing a service on the basis of need, irrespective of the patients income. We are fortunate in Scotland that, in the year 1999–2000, we anticipate spending about £961 per head for every person in Scotland, which is 20 per cent. above the average for the rest of the country.
§ Mr. Michael Moore (Tweeddale, Ettrick and Lauderdale)Will the Secretary of State consider putting some of those resources into the casualty units in Scotland? Is he aware of the survey by the Scottish 128 Association of Health Councils—carried out in casualty units across Scotland yesterday—which came out with alarming statistics showing the length of time that people are having to wait in casualty units, including an 88-year-old patient at the Western infirmary in Glasgow, who waited on a trolley for four hours and ten minutes with a broken leg? Will the right hon. Gentleman consider putting more resources into collecting proper information on casualty units and other difficult issues such as bed blocking, because it looks increasingly that when the Government are embarrassed about an issue, they stop collecting the relevant information?
§ Mr. DewarI assure the hon. Gentleman that we collect the information, which is published periodically. I am sorry that he asked the question in the way that he did. I accept entirely his point about the particular patient and the incident covered in the press release from the Scottish Association of Health Councils. In fairness, the hon. Gentleman should have recorded the fact that although the association pointed to local pressures, it came to this conclusion:
Our survey clearly shows that there are significant problems in some parts of the country but there is no crisis.It would have been fairer, and a little better for the hon. Gentleman's reputation, if he had made that clear.
§ Mr. Tom Clarke (Coatbridge and Chryston)Will my right hon. Friend join me in congratulating Greater Glasgow health board and East Dumbartonshire council on the funding and joint planning arrangement that they have agreed for Lenzie hospital? Given that hospitals service to elderly people, the expansion that is envisaged and the provision of facilities for my constituents and those of my hon. Friends the Members for Strathkelvin and Bearsden (Mr. Galbraith) and for Cumbernauld and Kilsyth (Mrs. McKenna), does he agree that community care can be seen to work if there is a positive attitude, with proper funding and the political will to achieve it?
§ Mr. DewarI agree wholeheartedly. I know that my right hon. Friend, as a local Member of Parliament, has been very much involved in the process whereby the health service, local government and the community have worked together to accommodate change that is right but that, had it not been handled co-operatively, might have led to difficulties, frustrations and problems for individual patients and their families. That co-operative spirit is very important, as is the fact that, if the present plans are carried through—and they certainly will be if Labour Members have anything to do with it—the reforms and modernisation that are required in the health service will take place, against the background of substantial real-terms increases in expenditure, which will mean an enormous amount to patients and health service staff.
§ Mr. Alex Salmond (Banff and Buchan)Will the Secretary of State confirm that Consort Healthcare, the private finance initiative consortium, paid £12 million for the three sites of Edinburgh Royal infirmary, but that the surveyors, D. M. Hall, have estimated the value at £70 million without planning permission or up to £200 million with it? Does he agree that, if those sums were realised, it would be a major scandal? If £70 million 129 were to be realised for the sites, what percentage would be returned to the health trust, in the form of any overage agreement?
§ Mr. DewarThe hon. Gentleman's enthusiasm is running away with him. I assure him that his facts are simply wrong. On the various sites that were part of the package—very sensibly, because they are surplus to requirement and it makes sense to realise their full market value as part of the cost of building the Royal Edinburgh infirmary—there were two valuations, by the district valuer and by Ryden International. In both cases, the price paid was fully in line with the market value of the estimates. The figure mentioned by the hon. Gentleman is totally a figment of his imagination or that of those who—
§ Mr. SalmondIt is in the newspapers.
§ Mr. DewarBefore he quotes newspaper reports, the hon. Gentleman should go to the health board, for example, to discuss the situation and find out the facts. Then he would not be in a position to spread irresponsible scare stories, as he has done. As he would know if he had consulted the contract, if there are unexpected planning gains for those who have taken over the sites, the profits will be capped and there will be a claw back.
§ Mr. Ernie Ross (Dundee, West)My right hon. Friend and his ministerial team are very welcome to come back to Dundee, especially if they make announcements such as the one that was made at the start of the month, which will ensure that the purpose-built palliative care unit at Roxburgh house in Dundee can be replaced at the same time as the day-care centre for cancer patients, giving Dundee and Tayside a modern hospice centre for those who require it.
§ Mr. DewarI am grateful to my hon. Friend and I agree with him entirely. Clearly, in a city such as Dundee, as in every part of Scotland—rural areas are as important as cities—we will do all we can to maintain and, more importantly, improve services and centre them on patients needs. I welcome, for example, the fact that we have a new accident and emergency centre at Ninewells, which will give very good service to Dundee and its people.
§ Dr. Liam Fox (Woodspring)Dr. Brian Potter, the secretary of the British Medical Association in Scotland, has said that NHS management in Scotland is in an unbelievably awful state. Dr. Keith Little, the head of accident and emergency at Edinburgh Royal infirmary, has resigned because he said that his job was impossible. Dr. Rudy Crawford at Glasgow Royal infirmary says that conditions are the worst in living memory. That is the real world of the NHS in Scotland. Does the Secretary of State accept any responsibility for the current situation, or does he intend simply to maintain that everything is all right?
§ Mr. DewarNo, I am not going to maintain that everything is all right. We inherited considerable difficulties and we are setting about improving them. It will take time. As I tried to say in what I hope was a balanced approach to the audit carried out on accident and emergency centres by the Scottish Association of Health Councils, which was press released today, I certainly 130 acknowledge that there are local pressures—there always have been. The idea that people have to wait for treatment longer on occasion than we would like at the height of the winter pressure is something that has happened in the past year and never occurred during the 18 years in which the Conservative party was in charge does not stand even a moments examination. We are now dealing with needs and the SAHC has pointed out that the use of the word crisis is not justified. We must continue to deal with the difficulties.
We have initiated the biggest building programme ever for the national health service in Scotland and we are providing resources on a climbing scale, the like of which the NHS has not seen before. I also hope that in the near future, as a result of the findings of the pay review body, we will be able to do something to help on that side as well. The hon. Gentleman's overstatement, which is a natural ability—almost a compulsive addiction—of his, does nothing to support his case.