§ 5. Mr. Phil Sawford (Kettering)
How many accident and emergency departments will receive funds for improvements this year; and if he will make a statement. 
§ The Secretary of State for Health (Mr. Frank Dobson)
Seventy-nine accident and emergency departments in all parts of the country will be upgraded in the coming year with money from the NHS modernisation fund. That is a third of all A and E departments in England. It will mean better and quicker services for patients, and better and safer working conditions for staff. That extra investment from the modernisation fund augments the upgrading that is already being funded as part of the general increase in capital for the NHS which this Government have introduced.
§ Mr. Sawford
I thank my right hon. Friend for that answer and welcome his massive investment of funds in our national health service. However, is he aware that many NHS trusts, including Kettering general hospital in my constituency, have already modernised their accident and emergency units and fear that, as a result, they may lose out on Government funding? Is it his intention that all future modernisation funding will be earmarked for specific purposes, or will there be some discretionary funding for local projects identified as meeting local needs?
§ Mr. Dobson
The straight answer is that there will be a mixture. Some of the extra capital funds will be entirely at the discretion of the local trust; some of the money that comes from the ordinary allocation of funds will have some priorities given to it by me; and some of it, from the modernisation fund, will be specifically laid down from the centre.
We believe that it was right and proper, for instance, to try to bring all accident and emergency departments up to the standard that prevails in Kettering, because we believe that a good standard should apply everywhere. When that has been done, additional funds will go elsewhere.
However, I have said that the national health service management, with the extra capital that it is getting this year, must give priority to replacing unreliable equipment that goes on the blink and breaks down. That is very bad for patients. One of the most frustrating aspects of 866 working in the national health service is to have to work with the clapped-out old equipment on which the previous Government spent no money over the past 19 years.
§ Mr. Simon Hughes (Southwark, North and Bermondsey)
When will there be enough money for our accident and emergency and other hospital departments to ensure—and to employ the necessary staff—that we reduce the number of people who have seen their consultants and are waiting to get into hospital to below the level that the Government inherited; to reduce the number of those waiting to see their consultants—which is 200,000 more than when the Government came to office—below the number that they inherited; and to ensure that our A and E departments treat the recommended number of 100,000 a year, not 150,000 a year, which is the number of people expected to go through the doors of St. Thomas's hospital when Guy's hospital closes later this year, thanks to the right hon. Gentleman's decision?
§ Mr. Dobson
Just in case the hon. Gentleman causes any more Liberal hairs to rise, Guy's hospital is not going to close. The A and E department will close because, in the opinion of the people whom we have consulted—who know more about accidents and emergencies than even the Liberal party—the alternative arrangements that we are making, as recommended by Sir Leslie Turnberg in his report, will be satisfactory. However, as the hon. Gentleman knows, and should have said if he is prepared to be straightforward about this matter, I have said that we shall keep a very close eye on that.
We must recruit more staff, and we are doing so; we must improve equipment; we must make layouts safer; and we must install closed circuit television to stop the yobbos beating up nurses. Indeed, we are doing all those things, but the management must also improve in many places.
We have insisted on getting admissions wards into every district general hospital. When we took over, almost half the district general hospitals in this country had no admissions ward to back up the accident and emergency department; now, only 20 do not have one.
§ Mr. Dennis Turner (Wolverhampton, South-East)
As my right hon. Friend knows, one beneficiary of the improvement programme is New Cross hospital in Wolverhampton. At the cost of making him blush, may I tell him that the improvements to and upgrading of our A and E department and the provision of an extra 22 beds are most welcome? Can he confirm that that is further evidence that Labour is keeping its promises? I say on behalf of Wolverhampton, thank you very much.
§ Mr. Dobson
My hon. Friend, with his mastery of understatement, only repeats what many doctors and nurses told me in his presence last time I was in Wolverhampton.
One thing that we are doing with the extra money for modernising A and E departments is to put an extra £600,000 into modernising that department at Whipps Cross hospital in east London, and we shall sort out its management as well. That hospital needs a better A and 867 E department, and it needs to be better run than it is at present if we are to avoid the scandalous things that happened there this winter.
§ Mr. Gerald Howarth (Aldershot)
Is the Secretary of State aware that, when the Prime Minister was grinning on the steps of Basingstoke hospital while announcing the proposed investment in A and E facilities, one of my constituents, just 20 miles down the road at Yateley in Hampshire, was suffering from a lack of Government funding? That constituent had an operation in 1995 at a specialist London hospital outside his area, followed by three check-ups, but has now been denied a further appointment there. He has been told by the local health authority that, in common with many others, it is experiencing severe financial difficulties. It states:We are desperately trying to ensure that we continue to provide the best quality care for all our residents but, regrettably, do not have the financial resources to allow for freedom of choice for individuals.It went on to say that, unless more taxpayers' money was made available, it would not be able to deliver the service.
Is not the truth that the Secretary of State castigated the Conservatives when he was sitting on the Opposition Benches, but has failed to deliver patient care in government?
§ Mr. Dobson
If the hon. Gentleman sends me the details of that case, I shall look into it. From bitter experience at the Dispatch Box since I have had this job, I do not give full credence to what Tory Members read out. However, what he says may be correct.
When my right hon. Friend the Prime Minister was mobbed by delighted hospital staff, he was at Basingstoke hospital to mark the effort to bring its A and E department at Basingstoke up to the sort of level that we need for the next century, including the introduction of an X-ray machine specifically for that department, which will be better for the patients and speed up the process altogether. I should have thought that the hon. Gentleman might just have welcomed that, but of course he cannot really welcome it without a touch of hypocrisy because the shadow Chancellor says that we are spending too much on the health service.
§ Audrey Wise (Preston)
In welcoming the announcement, may I draw my right hon. Friend's attention to the fact that although many A and E patients are children, many A and E departments make no special provision for them? Will my right hon. Friend check on the position of the 79 A and E departments and ensure that the modest changes that are necessary properly to receive and reassure children are put in place as part of the upgrading?
§ Mr. Dobson
That is certainly the case; my hon. Friend makes a valuable point. It would be wholly reasonable for me to add that one of the changes in Basingstoke is to provide a specific area for children in the A and E department, just as the £882,000 that we are giving to the Central Manchester trust will create separate children's A and E areas in the central Manchester hospitals.
§ Rev. Martin Smyth (Belfast, South)
The Secretary of State will be aware that many A and E departments are used as drop-in centres, preventing the staff from doing 868 their main work. Is there any further development in the creation of specialist trauma centres to deal with the most serious accidents, which was part of the earlier policy?
§ Mr. Dobson
As the hon. Gentleman knows, there is almost a theological dispute among trauma experts about whether we should have trauma centres or A and E departments as we have at present, and some places are moving more towards trauma departments than others. I have some sympathy with people who use their local A and E departments as a drop-in centre if they are feeling off colour. That has certainly been a characteristic of the major inner-city teaching hospitals of all our great cities.
Although that use poses burdens, I believe that the national health service should provide what local people clearly want of their hospitals. In quite a few areas, GPs are used to provide that service as part of the accident and emergency unit. If that suits the needs of local people—usually people from a deprived area around one of the old teaching hospitals—that is probably as good a use of NHS funds as any.