HC Deb 04 May 1999 vol 330 cc699-701
15. Mr. Desmond Swayne (New Forest, West)

If he will make a statement on the priorities for clinical treatment in the NHS. [81823]

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

Clinicians make decisions about clinical priorities, in consultation with patients and based on the clinician's assessment of need. These decisions should be taken within the broad framework of priorities which the Government have set out in the national priorities guidance, and from now on should reflect guidance from the National Institute for Clinical Excellence and, as they are established, national service frameworks covering coronary heart disease, mental health, the care of old people and diabetes.

Mr. Swayne

Does the right hon. Gentleman agree that the increase of some 200,000 in the number of patients who have to wait more than 13 weeks to get a first appointment with a consultant is a worrying denial of any clinical priority?

Mr. Dobson

The last advice that was issued to the national health service on clinical priorities—under the present Government on 18 July 1997—said: Clinical priority must be the main determinant of when patients are seen as outpatients or admitted as inpatients. The first service priority of the NHS is to treat emergency cases quickly and appropriately. For elective patients consistent principles must be applied when planning outpatient clinics … and inpatient … admissions to ensure that patients with the greatest need are seen first. That is what the clinicians should be doing and are doing.

Kali Mountford (Colne Valley)

I am glad that my right hon. Friend thinks that appropriate decisions should be taken by clinicians. Given that, two weeks ago, a report was published that throws doubt on the use of oral contraception by young women, will he ensure that it is clinicians who advise young women about the use of oral contraception, so that there is no repeat of the problems that we had some five years ago when, following the publication of a similar report, women were forced to resort to abortion or unwanted pregnancies?

Mr. Dobson

It is always important to ensure that reports on any existing form of treatment are carefully written by the people who produce them. Sometimes, unfortunately, even people who claim to be scientists or clinicians go for their 15 minutes of fame, rather than a proper, balanced presentation of the research that they have undertaken. They should always bear in mind the possible adverse impact of trying to gain publicity for its own sake.

Mr. David Davis (Haltemprice and Howden)

In the past two weeks, there have been two independent reports on stroke and cancer treatment, which indicate that 5,000 unnecessary deaths occur each year and that several thousand more people are invalided in one way or another as a result of being unable to get proper treatment on the national health service. Will there be a change in the Secretary of State's policy priorities on clinical treatment to reflect that?

Mr. Dobson

There has been a huge change in policy priorities under this Government, which are intended to deal with the historic situation described in those reports. We recognise that there are massive variations in the availability of services across the country. It is preposterous that in some cases, people are more likely to get treatment the nearer they live to the specialist hospital that provides such treatment. That is an absurd situation. We are giving top priority to the reduction of coronary heart disease and strokes, and to dealing with cancer.

We also recognise, as the previous Government utterly failed to do, the inequalities in health. It is clear that poor people are ill more often, die sooner and frequently get less good treatment from the national health service than they should. We must do something about that. The previous Government did nothing about it. We have changed the priorities.