HC Deb 29 February 2000 vol 345 cc143-5
4. Mr. Christopher Chope (Christchurch)

If he will make a statement about the work of the trolley task force. [110856]

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart)

Last year we set up an accident and emergency modernisation programme team, backed by an investment of £115 million, to spearhead improvements in accident and emergency departments. The programme has a much wider remit than looking at trolley waits. The team produced an interim report last November, which is available in the Library. Its final report will be presented to Ministers within the next three months.

Mr. Chope

That answer shows, in effect, that this is another new Labour broken promise. The Prime Minister addressed a big conference of health administrators on 20 June 1996 and said: Today I want to announce that in Government we will set up a task force to report urgently on how we can end trolley waits in the NHS for good. That has not happened. Will the Minister now set up a task force to look into the delivery of Government policy?

Ms Stuart

I hate to suggest that Opposition Members could be mistaken, but on this occasion I am afraid that I have to do so. As my right hon. Friend the Prime Minister said on his visit to St. Thomas's A and E department, we are witnessing a revolution in critical care and in casualty care. One element of that is the process of how we deal with patients between the ambulance and the A and E department, and then subsequently.

Trolley waits are being studied by the winter planning team and by the A and E modernisation programme team. Chief executives of hospital trusts were given strict instructions over the winter regarding the management of trolley waits. Any wait of more than four hours is directly reported to the hospital's chief executive and any wait of more than 12 hours is reported to the regional director. A senior manager in each hospital has been given personal responsibility for trolley waits. As a result, since October the incidence of trolley waits of more than 12 hours has fallen by 48 per cent., and of more than 24 hours by 90 per cent. Far from breaking our promise, the Government have delivered far more than we initially promised.

Mrs. Louise Ellman (Liverpool, Riverside)

I thank my hon. Friend for the £700,000 spent on accident and emergency at the Royal Liverpool hospital, which virtually eliminated long trolley waits over the Christmas period. I also look forward to the completion of the new medical assessment unit at the hospital. That is being built, at a cost of £1.4 million, to support the work of the A and E services.

However, does my hon. Friend agree that A and E services cannot be addressed in isolation? Does she also agree that we need more investment in our overall hospital services, such as the £15 million that has already been made available for the Broadgreen site in Liverpool? Can she promise that there will be further support for services in Liverpool to remedy the cuts in the years of Tory Government?

Ms Stuart

My hon. Friend is right: the problems in A and E departments cannot be dealt with in isolation. That is why we are reviewing ambulance services and making extra investment available. It is also why, as part of the national beds inquiry, we are reviewing the way that beds are used. That review includes observation units, acute beds and step-down facilities.

My hon. Friend requested more money for her constituency. We shall take that into account when we consider all the other bids.

Dr. Liam Fox (Woodspring)

What was interesting about the Prime Minister's casualty stunt this morning was that there was no mention of how new Labour would abolish trolley waits in accident and emergency departments, nor of the fact that in 1999 patients waited for up to 49 hours on trolleys, nor of the fact that the average wait in casualty has risen to between four and five hours. To be fair to the Prime Minister, however, he did mention that there would be more nurse prescribing in casualty. If that is a real change, and not a stunt, will the Minister say what changes to the Medicines Act 1986 will be required?

Ms Stuart

To assume that an accident and emergency department will never use trolleys is to misunderstand how admissions to such departments work. Patients will always have to wait on trolleys for a certain time while assessments and tests are carried out before a permanent bed can be made available.

The hon. Gentleman asked about the changes that might have to be made to the Medicines Act 1986. We are looking into that matter at the moment.

Dr. Fox

The Minister could not answer my question. Her answer means that Downing street has not yet told the Department of Health what the Department's policy on A and E departments is to be. It is No. 10 that determines health policy, not the Secretary of State and his Ministers.

Today, the Prime Minister promised us that nurses would be able to prescribe and order blood tests and X-rays, both of which are already being done. He also said that major cases would be separated from minor ones in the A and E department, and that too is already being done. We are used to the Government reannouncing financial decisions, but now they appear to want to reannounce what is current medical practice and call that a revolution. Is not the £20,000 that Ministers will spend on replacing the tropical plants in their headquarters likely to be far better window dressing than the Prime Minister's waffle this morning in St. Thomas's?

Ms Stuart

The hon. Gentleman might find it useful to spend some time looking at what happens in the accident and emergency departments in our hospitals around the country. Some of the announcements that were made today are about things that are happening in some parts of the country. The legacy of the previous Government is the huge difference in the services that are being provided across the country. That is why we invested £115 million to ensure that every major hospital that needs improvement will get it. There are some 244 projects for improvement, and about 80 per cent. were finished this summer. It is clear that the previous Government would not have spent £115 million on improving the health service.