HL Deb 22 February 1984 vol 448 cc759-62

2.37 p.m.

Baroness Faithfull

My Lords, may I first apologise to the House and to my noble friend the Minister for the fact that one word was left out of my Question. It should read: To ask Her Majesty's Government how many hospital patients received treatment… The word "hospital" was left out.

Having said that, I beg leave to ask the Question standing in my name on the Order Paper.

The Question was as follows:

To ask Her Majesty's Government how many hospital patients received treatment in 1982 and 1983 under the National Health Service, and what was the corresponding figure for 1978.

The Parliamentary Under-Secretary of State, Department of health and Social Security (Lord Glenarthur)

My Lords, the information for which my noble friend asks is not available in precisely the form that she requests, but comparing 1982 with 1978, the NHS treated over half a million more in-patients and days cases and over 2 million more out-patient cases.

Baroness Faithfull

My Lords, I thank my noble friend the Minister for that reply. Does he agree—I am sure he does—that his Answer does not indicate an ailing National Health Service? May I further ask him whether the general practitioner committees keep records of how many patients consult general practitioners? Moreover, would he agree that if perhaps more patients attended their GPs and were subject to community services there would be more hospital places for both in-patients and out-patients in the most serious cases?

Lord Glenarthur

My Lords, I would certainly agree with my noble friend that all the evidence clearly shows that the NHS is not ailing. To some extent waiting lists represent the problems of success. The wider range of treatments available, greater life expectancy, and the increasing proportion of old people have all added to people's expectations and thus their demands on the National Health Service.

With regard to the second part of my noble friend's supplementary question, family practitioner committees keep records only of those items of service for which general practitioners are separately remunerated. These items are only a very small part of the GPs' service. In reply to the question about patients going to hospital rather than to their GPs, I would point out that the vast majority of hospital patients are referred by the general practitioner, and there is no reason to suppose that hospital facilities are used inappropriately on any scale.

Lord Wells-Pestell

My Lords, may I ask the noble Lord the Minister whether he will not recognise that, following the advance of medical science in recent years, it is now possible to treat in hospital a considerably larger number of people than ever before? That arises simply because until a few years ago after some operations patients had to remain in hospital for 14 days, whereas now they can be discharged within three or four days. That is more largely due to the advance of medical and technical science than to anything else.

Lord Glenarthur

My Lords, in many ways the noble Lord is quite right. But recently there have come to the fore other operations—I am thinking in particular of hip replacements and other such operations—which take rather longer than the time that the noble Lord mentioned.

Lord Nugent of Guildford

My Lords, is my noble friend aware that it is a great pleasure to all of us to see one noble patient so well recovered and back in the House?

Lord Molloy

My Lords, is the noble Lord aware that among both the professions in the NHS and the general public there is growing concern not so much about the people who are already in hospital but about the ever increasing waiting lists and the anxiety that that fact causes families, would-be patients themselves, and indeed the hospital staffs and the whole range of professions in the health service?

Lord Glenarthur

My Lords, of course we want shorter waiting lists. That is why the Government have concentrated the attention of health authorities on the need to make the best use of all of their resources, and we see this as one of the major tasks of the new management initiative.

Baroness Gaitskell

My Lords, is the Minister aware that people such as myself, who have dealt with the National Health Service in regard to certain matters, have nothing but praise for the medicine we have received and the consultancy services we have been given? They have made us better, and I cannot praise too highly the National Health Service.

Lord Glenarthur

My Lords, I entirely share the noble Baroness's views.

Lord Ennals

My Lords, the noble Lord mentioned the increasing demands of the elderly, and in pressing him on this point I am certainly not referring to any noble Baroness or noble Lord who has received such successful treatment from the National Health Service. However, can he give an indication of what proportion of the total number of patients are elderly? Would he not agree that fewer people would be treated in hospital if the social services could make better provision, which unfortunately they are not able to do because of the cuts which the Government have imposed upon local authority services?

Lord Glenarthur

My Lords, I cannot give without notice the figures for which the noble Lord asks. So far as local authorities and personal social services are concerned, local authorities certainly have difficult decisions to make but there is every indication that they have sought to protect the most vulnerable people, including the disabled and the elderly, in the community. Taking this year's budgeted expenditure into account, personal social services expenditure overall will have risen by 12½ per cent. in real terms over the past five years.

Lord Kilmarnock

My Lords, if it is in order to stick to the noble Baroness's Question as printed on the Order Paper, has the noble Lord comparable figures for community health visits and family practitioner visits?

Lord Glenarthur

My Lords, what I can tell the noble Lord is that nearly half a million more people were visited at home by health visitors or district nurses. As for the other information that the noble Lord seeks, I shall have to provide it for him in writing.

Lord Wallace of Coslany

My Lords, is the noble Lord aware that to assume on the basis of these figures, as the noble Baroness did and as the noble Lord himself did, that everything is all right in the National Health Service would mean that the noble Lord is talking through the back of his neck? If he has any connection with any local area health authority, he will find that they are at their wits' end to provide the services needed mainly due to the Government's policy of denying finance to many authorities, particularly in the South East.

Lord Glenarthur

My Lords, no. I do not share the noble Lord's views. Spending on the National Health Service is at a record level. Since we came to office we have doubled spending on the Health Service from £7¾ billion to some £15½ billion.