§ 5. Mr. David Amess (Southend, West)If he will make a statement about the organisation of the public consultation on the future and reform of the national health service. [122863]
§ The Secretary of State for Health (Mr. Alan Milburn)Last 0month—[Interruption.] Some of my hon. Friends have long memories. Last month, I launched the largest public consultation exercise on health care services that the country has ever seen. Patients and staff across the whole of the country will have the chance to have their say about how best to reform and improve NHS services with the record extra resources that the Government have committed to the NHS.
§ Mr. AmessNever mind about Basildon or Southend, West. Does the Secretary of State have any idea of the anger and outrage that was felt by people all over the country—and particularly by those who have loved ones suffering—when they were asked to fill in a form and to send it back by yesterday? Will he tell the House why, after 18 years in opposition and more than three years in government, the Government have not delivered on any of their promises other than to produce an absolute 148 shambles? Will he also tell us what he intends to do with the forms when he gets them back, particularly if the answer to the question
What would make the NHS better for you and your family?is that this rotten Government should go?
§ Mr. MilburnI am glad that the hon. Gentleman has got that off his chest; I hope that he feels better for it.
On the consultation exercise, it would be pretty bizarre if the Government did not ask the people who use and provide the national health service—the patients and the staff—for their views about it. As for listening to people, the hon. Gentleman listened so hard to the voters of Basildon at the last election that he went on the chicken run to Southend.
§ Mr. Jim Dobbin (Heywood and Middleton)As part of the public consultation process, is my right hon. Friend minded to consult the British Medical Association over consultant contracts? I spent 33 years working in the health service, and I believe that consultants should work full time in the NHS or full time in the private sector.
§ Mr. MilburnAs my hon. Friend is aware, the Government have been in discussion with the British Medical Association for well over a year about a reform of the consultant contract. Both the BMA and the Government believe that such reform is well overdue. It is worth making the point that the overwhelming majority of consultants who work for the national health service do a brilliant job and work extremely hard. It is also true that we have some of the finest doctors in the land. It is important that we make sure that when consultants are working in the NHS, we get the best from each and every one of them.
§ Mr. Nick Harvey (North Devon)Why exactly did the public have to respond to the consultation exercise in five days? As the right hon. Gentleman pointed out, the Government have had a long time to consider their priorities. Why did the public have to respond so quickly? How many of them have done so? What chance did the Secretary of State have to consider the responses before he announced an initiative on consultants yesterday and on nurses today, which he says is in response to public anxiety? With regard to the nurses who are to run the accident and emergency departments, where will the extra nurses come from? We know that there are 17,000 vacancies. Where are the extra nurses who are suddenly to run the accident and emergency departments lurking at present? When will the right hon. Gentleman tell us the results of the consultation?
§ Mr. MilburnThe hon. Gentleman is well aware that there are about 5,000 more nurses working in the NHS than there were a year ago. Of course there are still vacancies in the NHS. Although we have turned the corner on nursing shortages, nobody pretends that there is not a long way to go. That is true, but the big pay awards that we have rightly given to nurses in the past two years have helped to recruit more nurses back into the NHS and, most importantly, are helping to retain nurses in the NHS. The number of nurses is on an upward trend, which is good news. Equally importantly, the number of nurses in training is also on a big upward trend. I remind the 149 hon. Gentleman that when we came to office, the number of nurse training places had been cut. We have now put that right. It is the right thing to do.
It is too early to say how many consultation responses there were. They are still coming in. I know that because one was posted through my letter box at home this morning.
§ Ann Clwyd (Cynon Valley)I know that reform of the General Medical Council is a matter close to my right hon. Friend's heart. Will he consider in particular ways of beefing up the GMC? Three weeks ago I mentioned in the House the case of a cosmetic surgeon against whom there are now 80 written complaints. His fellow doctors have accused him of being a psychopath and not fit to operate on patients. I telephoned the chief executive of the GMC this morning to ask whether the surgeon was still operating. The chief executive replied that he did not know. Surely patients must be better protected than that.
§ Mr. MilburnThe whole House will concur with my hon. Friend's sentiments. There is a gathering consensus not just in Government, but across the House and in the medical profession, that the General Medical Council must be radically reformed. There has been a succession of cases in which the GMC has failed to bite the bullet and to deal with cases in the timely and efficient way that patients would expect.
To give credit to the GMC, I know that it is currently discussing how it can best put its own house in order. I welcome the proposals that it is putting together, but there is no doubt that a real, radical reform of the GMC is needed. I say that not to denigrate any doctor or the GMC's efforts to reform. There is no doubt in my mind that doctors overwhelmingly do a brilliant job for the national health service, but none of us can allow the bad practices of a small minority of doctors to tarnish the good reputation of the medical profession as a whole. It is in the interests of the medical profession as much as it is in the interests of patients for radical reform to take root as quickly as possible.
§ Mr. Christopher Gill (Ludlow)There are hundreds of protesters outside the premises this afternoon. They are campaigning to save their hospital. They are disappointed that the Secretary of State has not found time today to meet them and thus make consultation meaningful. They would like to consult him face to face. They are not convinced by the Prime Minister's assurance that money will be spent on every accident and emergency hospital in the country when their accident and emergency unit is being downgraded. They are not convinced by the Secretary of State's claims that he is opening new hospitals all over the country when their acute services are disappearing. They would have preferred the money that was spent on the consultation exercise to be spent on nurses and doctors and on keeping Kidderminster hospital open.
§ Mr. MilburnI am, of course, aware of the hon. Gentleman's anxieties, and those that have been expressed in Kidderminster. We have held a consultation exercise, which the hon. Gentleman will remember because he participated in it—
§ Mr. Nigel Evans (Ribble Valley)A pointless exercise.
§ Mr. MilburnIt was not. We undertook the consultation and we made decisions about Kidderminster on the basis of the best clinical advice to ensure high quality and, most important, safe services for patients.
§ Mr. Bill Rammell (Harlow)Does my right hon. Friend agree that it is right for a Government to consult people before embarking on major changes in the national health service? Is not the real contrast between this Government, who are trying to do that and the previous Government, who, when they introduced the internal health market, cooked it up behind closed doors and consulted no one?
§ Mr. MilburnMy hon. Friend is right except about one small point. The previous Government consulted some people: not doctors, nurses, managers or patients, but the Adam Smith Institute. Perhaps that explains why they went wrong.
§ Dr. Liam Fox (Woodspring)Last week, no leaflets were readily available in many parts of the country. In Chester, a disabled patient was unable to obtain a leaflet because she is housebound. When she queried that with the Department, she was told that leaflets were available only in a surgery or a supermarket. Yet she regularly uses the NHS. In Buckinghamshire, a GP received only five leaflets, while in Camberwell a single-handed GP was given 2,500 leaflets although he has only 1,200 patients.
I ask the Secretary of State not to be coy or modest today. Was the plan all his idea and down to his competence alone or, in view of claims in The Sun that the Prime Minister has been spending six hours a day considering the matter, should he share the credit for the fiasco?
§ Mr. MilburnI am now not sure what the hon. Gentleman's position is. Last week, he argued—
§ Mr. Peter Luff (Mid-Worcestershire)Answer!
§ Mr. MilburnIs the hon. Gentleman feeling all right?
§ Mr. MilburnHe should keep taking the medicine.
Last week, the hon. Member for Woodspring (Dr. Fox) advocated undertaking less consultation; this week he suggests that we should do more. The hon. Gentleman wants to have his say about the NHS but does not want patients and staff to have theirs. We know the hon. Gentleman's top three reforms of the NHS; he told the Conservative party conference what he would do. No. 1, he said:
The biggest problem that we have in the NHS is that it is not a proper market.No. 2, he said that the NHS required "less and less equipment". [Interruption.] That is what he told the Conservative party conference. No. 3, he said that the Conservative party's health policy would mean that "maximum waiting time is increased". The hon. Gentleman's response to the consultation would therefore 151 be more market, less equipment and longer waits. The Conservative party does not have a national plan for the NHS; it has a secret plan not to modernise but to privatise it.
§ Dr. FoxNow that the Secretary of State has got his first evasion out of the way, let me try to remind him that this is Question Time and that he is supposed to take responsibility for his failures.
From which NHS budget is the £500,000—research or simply public relations? Does the Secretary of State know that one industry analyst has already said that the Government can expect only 0.5 per cent. return from the exercise? That means that each reply will have cost £8. According to MORI, similar results could have been achieved for only £4,000 if a scientifically conducted survey of 2,000 people had been undertaken. Given that the £500,000 would have purchased 50 bypass operations or 500 cataract operations, or paid for more than 30 full-time new nurses, does the Secretary of State believe that he and the Prime Minister are giving NHS patients value for money?
§ Mr. MilburnThere is a simple question for the hon. Gentleman: does he believe in consulting patients and staff in the NHS, or does he not? Frankly, he would be on better ground about wasting public money if his party in office had not wasted billions of pounds of public money on the internal market. I know that he does not want to talk about the speech that he gave at the Conservative party conference; he does not want to be reminded of it, but the country should be, and to ensure that patients and staff throughout the country have the opportunity to read what he said, on the internet—[HON. MEMBERS: "Answer."] Conservative Members do not want to listen because they do not want to hear what he had to say, but the transcript of the hon. Gentleman's speech is widely available today on the internet news pages at www.labour.org.uk so that members of the public can see precisely what his plans are for the NHS—not to modernise it, but to privatise it.
§ Dr. FoxWhat contempt for Parliament; what a pathetic excuse for a Secretary of State. That was the best example ever of the Government's all spin, no substance approach to the NHS. Patients had too little time to reply to the exercise, even if they could get hold of a leaflet. Doctors will be the new scapegoats for the right hon. Gentleman's failures—the latest victims of the Government's blame culture. The day after their latest non-event, so-called health summit, have not he and the Prime Minister shown that they cannot even conduct their own PR stunts competently and that they do not share the same priorities as patients or doctors? In fact, they are so out of touch that they do not even know how long the postal service takes. On the day that waiting lists increased yet again, who will take responsibility and carry the can for this absurd and pathetic fiasco?
§ Mr. MilburnThe hon. Gentleman has to be reminded about what we have done in office during the past three years. I remind him of the abolition of the internal market, which his party opposed; the introduction of primary care groups, which his party opposed; the reduction in waiting lists, which his party opposed; the creation of the National Institute for Clinical Excellence, to tackle the lottery in care, and of the Commission for Health Improvement, 152 which his party opposed; the biggest hospital building programme in the history of the NHS, which his party opposed; and the biggest increase in resources for the NHS, which his party opposed. There are more doctors, more nurses, more casualty departments being modernised and more patients being treated, all of which Conservative Members oppose because they do not support efforts to modernised the NHS; their only agenda is to privatise it.