HC Deb 14 January 2003 vol 397 cc529-32
3. Sir Sydney Chapman (Chipping Barnet)

If he will make a statement on progress on reducing waiting lists and times in the NHS. [90191]

The Secretary of State for Health (Mr. Alan Milburn)

Waiting lists and waiting times are falling. Waiting lists for primary care and hospitals have fallen, and waiting for in-patient and out-patient appointments has reduced. The biggest reduction in waiting times is that for cancer and heart treatment.

Sir Sydney Chapman

Will the Secretary of State confirm that, within five years of coming to power, the Labour Government failed to reduce waiting lists by the promised 100,000, which was only a reduction of less than 10 per cent? Waiting times are more important than waiting lists. The right hon. Gentleman set a benchmark of reducing waiting time to a maximum of six months by 2005. Does he accept that he failed to achieve the benchmark of a maximum waiting time of 15 months by March this year?

Mr. Milburn

With the greatest respect, I think that the hon. Gentleman is confused. We promised at the time of the general election that we would reduce waiting lists by 100,000 and we have achieved that. It might benefit hon. Members if I read out the figures. In March 1997, 283,000 people waited more than six months for a hospital operation. That figure is down to 230,000. In March 1997, almost 6,000 people waited more than 15 months for a hospital operation; the latest figures show that six people are waiting that length of time.

More than 70,000 people were waiting more than 26 weeks for an out-patient appointment when we came to office; that figure is down to 700. There is a long way to go but waiting times and waiting lists are moving in the right direction for one simple reason: our reforms of the national health service and the resources for which we voted and against which the hon. Gentleman voted.

John Mann (Bassetlaw)

The NHS in my constituency is going from strength to strength according to every indicator except one: that for drug treatment services. Will my right hon. Friend examine the returns on waiting lists that the drug action team for Nottinghamshire provides for my constituency and the rest of the county, and work out why I know people on 12-month waiting lists when the team's results imply a maximum wait of 12 weeks? Will my right hon. Friend consider the specific cases, the details of which I can provide to him, and the way in which the waiting lists for drug treatment services are being fiddled?

Mr. Milburn

My hon. Friend raises an important issue. I appreciate that he takes a passionate interest in issues that involve drugs, such as drug-related crime and drugs treatment. I understand that he mentioned some of them in yesterday's debate. Progress has been made, but, as my hon. Friend knows, the performance of drug action teams varies throughout the country. Some are good and some are unfortunately less good.

When effort has been focused, especially on areas with high street crime, waiting times for treatment have changed remarkably. In some cases, people who obviously needed drug treatment were arrested, but told that they would have to wait many months before they received such treatment. Nowadays, people in high street-crime areas receive treatment almost instantaneously. If we can do it in some areas, we must do it in others. That requires a combination of national and local action.

Dr. Evan Harris (Oxford, West and Abingdon)

Is the Secretary of State aware of the increasing concern about fiddling waiting list figures? I refer not only to the National Audit Office findings of more cases of fiddling but the scandal at St. George's hospital, where it appears that some figures were fiddled. Will he assure us that he is confident that clinical priorities are not being distorted by his obsession with waiting times and waiting lists, and that we are treating the sickest thickest—I mean the sickest quickest? Will he also assure us that he has confidence in the figures on which he relies to demonstrate the claimed improvements in waiting times?

Mr. Milburn

Obviously the hon. Gentleman spent too long in front of the mirror this morning. He claims that the Government are obsessed with waiting times, but it is the public and patients who are rightly obsessed with them. As he knows fine well, by and large the biggest public concern about the national health service today is not the quality of treatment received once people get into the NHS, but how long they have to wait to get into it. We believe passionately that the right way forward is to get the reforms into the national health service—I know that the hon. Gentleman opposes all of them—and to get the resources in as well, so that we can bring down waiting times. Of course, nowadays there is more independent scrutiny of the NHS than there has ever been.

Mr. Kevin Hughes (Doncaster, North)

The reforms are certainly working for us in Doncaster. Of those waiting for treatment for less than six months, nationally the figure is 76 per cent., but in Doncaster it is 88 per cent., which is obviously good. Nationally, 76 per cent. of those waiting for GP referrals are seen within 13 weeks, but in Doncaster the figure is 86 per cent., so the reforms are working. Where there is a will, there is a way. Will my right hon. Friend join me in congratulating the doctors, nurses and management in Doncaster, who are doing an excellent job?

Mr. Milburn

My hon. Friend is quite right, and what he says is true not just in Doncaster. I join him in paying tribute to the Herculean effort on the part of staff and management in Doncaster, but although major problems still exist across the national health service—unsurprisingly so, after literally decades of underinvestment—it is very striking that, for the first time since records began, in-patient and out-patient waiting times are falling, and falling together. The same is true in primary care, and also according to virtually every indicator. What gives me particular pleasure—I know that my hon. Friend will feel the same, particularly since he comes from an area that suffers not just from deprivation but from a high incidence of coronary heart disease—is that the biggest falls in treatment have been in precisely those clinical priority areas of cancer and heart disease.

It is worth saying that when we came to office, heart patients were in some cases being asked to wait more than 18 months for hospital operations. By April of this year, we expect such waiting times to have been halved to a maximum of nine months. There is clearly a long way to go, but the only way to keep the waiting times moving in the right direction—downwards—is to keep on with the reforms, and, most importantly, to keep the resources going in. That is what the Government want to do, and what the Opposition oppose.

Dr. Liam Fox (Woodspring)

What estimate has been made of the number of casualties that the NHS could deal with if there is war in the Gulf, and the number of staff who could be sent there without significantly affecting current levels of NHS activity and, thereby, waiting times?

Mr. Milburn

We obviously have not made estimates of the number of potential casualties, but as my right hon. Friend the Secretary of State for Defence told this House just a week or so ago, we have put in place contingency plans. That is sensible, particularly in the first instance for the call up of reservists. This will affect many NHS hospitals throughout the country, but I expect that, on average, the impact will be limited to two or three members of staff being called up. Sometimes they will be doctors, sometimes they will be nurses, and sometimes they will be allied health professionals such as therapists. In addition, as the hon. Gentleman will be aware, last week a meeting was held in the Department of Health with six of the principal NHS and other hospitals that would be used to deal with casualties in the event of a conflict.

Dr. Fox

Last July, the armed forces said that they had only 195 GPs when 415 were needed, only 23 anaesthetists when 120 were needed, only 11 orthopaedic surgeons when 28 were needed, and only 18 general surgeons when 43 were needed. The whole House will undoubtedly agree that all our troops should have optimal treatment. If we are talking about a deployment of more than 20,000, how will the extra numbers be made up in those areas without having a very significant impact? Of course, that could cause great difficulty to the NHS.

Mr. Milburn

Perhaps uncharacteristically, the hon. Gentleman is being something of a merchant of doom and gloom. The reason why my right hon. Friend the Secretary of State for Defence made that statement in the House—I very much support what he said—was precisely that the national health service has to plan for all contingencies. The House—and, I dare say, Opposition Front Benchers—would be the first to criticise the Government were we not to put in place suitable contingency plans. That is precisely what we have done, in the first instance with reservists. If it is necessary to supplement the statement that my right hon. Friend the Secretary of State for Defence made to the House, we will take any further action that needs to be taken. However, I am surprised that the hon. Gentleman should have taken this tack. It is worth pointing out that the Government who cut the defence medical services in our armed forces were not this Labour Government, but the previous Conservative Government.