HC Deb 07 May 2002 vol 385 cc13-5
6. Mr. John Baron (Billericay)

How many cancelled operations there were in the last year. [52777]

The Parliamentary Under-Secretary of State for Health (Yvette Cooper)

In 2000–01, the last full year for which data are available, there were 77,818 operations cancelled by the hospital for non-clinical reasons when the patient was due to be admitted for treatment.

Mr. Baron

I thank the Minister for that response. Given that there has been a 50 per cent. increase in the number of cancelled operations since 1997, what estimate have the Government made of both the cost to local government and the effect on council tax of their latest policy of fining councils for bed blocking in hospitals?

Yvette Cooper

Clearly, too many people are having their operations cancelled, but the most recent quarterly figures show that the number of cancellations is dropping and progress is being made. It is right that social services departments support the reductions in NHS delayed discharges, and that is exactly why they are getting a substantial increase in their resources—way above the increases that they got under Conservative Governments.

Mrs. Anne Campbell (Cambridge)

Does my hon. Friend make the connection between delayed discharges, cancelled operations and the fact that, in my constituency, Conservative-controlled Cambridgeshire county council is still spending only 85 per cent. of its standard spending assessment on services for elderly people?

Yvette Cooper

Obviously local councils that are not making the right decisions on delayed discharges will have to take responsibility for those decisions. That is why we are effecting reforms, as part of the Budget package. This is about investment and reform: investment that the Conservatives have decided to vote against, and reform that is essential to provide everyone with the incentive to improve NHS care.

Mr. Peter Lilley (Hitchin and Harpenden)

Does the Minister expect that when the Government have increased the proportion of national income spent on health in England to the levels already prevailing in France and Scotland, the number of cancelled operations, waiting lists and other indicators of health performance will have reached French levels or Scottish levels?

Yvette Cooper

Waiting times and cancellations are already falling. Substantial improvements are already being made throughout the NHS as a result of the extra investment. The right hon. Gentleman really must join his party in making a decision on this. Do the Conservatives want the extra investment to go into the NHS to bring down waiting times and improve services for NHS patients throughout the country, or not? They have said that they want to see the improvements, but they will not back the investment that we need.

Dr. Phyllis Starkey (Milton Keynes, South-West)

May I support the Minister's efforts to reduce delayed discharges as a way of reducing cancellations? I draw her attention to the single most effective measure that is being taken in Milton Keynes to deal with delayed discharges, which is a single social care assessment protocol agreed by social services and the NHS. May I urge her to try to make sure that a national social care assessment protocol is agreed, so that all social services and NHS personnel throughout the country can work more effectively to reduce delayed discharges?

Yvette Cooper

Yes, and I can also say that considerable work is being done throughout the country to improve the co-ordination between social services and the NHS. That is part of a broader modernisation programme, including an £8.5 million programme by the modernisation agency to cut cancelled operations.

Sandra Gidley (Romsey)

The Minister will be aware that if an operation is cancelled at the last minute, it should take place within a month, but for 21 per cent. of patients that does not happen. Is the Minister happy with that state of affairs? If not, what is she going to do about it?

Yvette Cooper

That target was introduced on 1 April, and it will be addressed as part of the performance management framework throughout the NHS, including the work of strategic health authorities.

Mr. David Kidney (Stafford)

Given South Staffordshire's success in reducing the number of cancelled operations and cutting waiting times for cataract operations by using modernisation fund money to establish a cataract surgical unit, will my hon. Friend support places such as South Staffordshire in establishing orthopaedic surgical units to enable similar success in cutting the number of cancelled operations and reducing waiting times for hip and other joint replacements?

Yvette Cooper

My hon. Friend is right; changing the way in which services are provided can make a substantial difference, particularly in the separation of emergency care from elective care, which is exactly why we are supporting a substantial number of new diagnostic and treatment centres that are being developed and invested in across the country.

Dr. Liam Fox (Woodspring)

But those appalling figures for cancelled operations are not the whole story, are they? What does the Minister say to the trust which advises that if there is doubt as to whether admissions can be accommodated the following day, the cancellation should occur the day before", as this will enable the Trust to deliver our target of NIL same day cancellations"? Ministers have already been caught fiddling waiting list figures; how many cancelled operations are being hidden by that disgraceful tactic?

Yvette Cooper

The hon. Gentleman knows that that is nonsense. The figures have not been changed; the latest quarterly figures show that the number of cancellations is falling. It is important, however, that we carry on making progress. The hon. Gentleman has to decide whether he wants to support additional investment for the extra beds needed to bring the number of cancellations down; the extra capacity that is needed; and the extra doctors that are needed. Or does he want simply to carry on cutting, as the previous Administration did?

Dr. Fox

Even by this Government's standards on evasive answers, that was fairly appalling. Let me give the Minister another problem and offer her a second chance. Given that bed blocking is one of the major causes of cancelled operations and that the Government's policy is to fine local authorities that have bed blocking in their areas, will she confirm not only that that will cost about £400 million, which will be passed on to the council tax payer, but that it will offer the ultimate perverse incentive? GPs in areas where there is bed blocking will realise that the best way to get patients into a local nursing home is to admit them to hospital, which will increase pressure on hospitals, worsen bed blocking and increase the number of cancelled operations. Will the Minister admit that that is the craziest of all the Government's insane policies on health, and will she stop doing damage now before it gets even worse?

Yvette Cooper

No; clearly there is an issue about delayed discharges, but the proportion of older people waiting to be discharged has fallen in the past few years. Additional investment is going in, and it is right that it should continue to do so, which is why the Budget included proposals for an extra 6 per cent. in real terms for social services, compared with less than 0.5 per cent. under the Conservative Government. The hon. Gentleman has to explain how he expects councils to tackle the issue of delayed discharges with the level of funding provided by the Tories, who year after year managed less than 0.5 per cent., which is pathetic. The hon. Gentleman's party is unable to fund the NHS or social services.