HL Deb 05 November 1986 vol 481 cc1099-101
Lord Campbell of Croy

My Lords, 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 hip replacement operations were carried out in the United Kingdom in 1955 and in 1985, and how many in each case were within the National Health Service.

Lord Hesketh

My Lords, the estimated number of hip replacement operations in National Health Service hospitals in the United Kingdom in 1972, the earliest year for which figures are available, was 21,680. In 1984, the latest year for which information is available centrally, the figure was 45,030. We do not have information on the numbers of operations performed in private hospitals.

Lord Campbell of Croy

My Lords, I thank my noble friend for his reply. Is he aware that within 30 years this ingenious operation has come to the relief of many who would otherwise be severely handicapped or in pain, largely thanks to the dedicated work of the late Sir John Charnley and others? Do not this and other new and expensive forms of treatment add substantially to the costs of the National Health Service in a way which was simply not anticipated in the 1940s when the health service was being introduced?

Lord Hesketh

My Lords, my noble friend Lord Campbell is absolutely right. Hip replacements are an example of an operation that was virtually unheard of 30 years ago but is now widespread. More patients can be treated in a way which greatly enhances the quality of their lives. There are many other examples of this same feature, among them coronary artery by-pass grafts. The opportunities for expansion in treatment are almost limitless, but resources never can be. Priorities have to be set. Hip replacements are one such.

Lord Bottomley

My Lords, can the noble Lord recollect that his honourable friend said on 15th October that from 1979 to 1985 there had been an increase of 24 in the number of consultant rheumatologists? Can he confirm that in the same period there was a reduction of seven in the number of senior registrar rheumatologists? If the Secretary of State is to reach the target, which he promised at the Conservative Party conference, of 50,000 operations a year by 1990, much more must be done to recruit rheumatologists. What are the Government going to do about it?

Lord Hesketh

My Lords, I thank the noble Lord for his question. I am afraid that I am unable to answer the first part, but will note it and will hope to be able to provide an answer for him at a later time. However, in 1978 32,000 hip replacements were carried out. The figure for 1984 was 45,000, which is an increase of 40 per cent. under this Government.

The Lord Bishop of Manchester

My Lords, does the noble Lord agree that the very beneficial effects of this remarkable development in hip operations—my wife is just recovering from one—also underlines the need to persuade people to pay more taxes to improve the health service?

Lord Hesketh

My Lords, I am very grateful for the question. However, I think it is slightly beyond the remit which I have.

Lord Orr-Ewing

My Lords, has my noble friend noticed since his promotion to the Front Bench and taking up his effective ministerial responsibilities that whenever we ask for statistics in this House the time taken to get them together gets longer and longer, while computers get faster and faster? Why are the latest available figures for 1984 in an area where the technique is advancing so fast? We want up-to-date figures, not figures that are three years old or even one year old. Should it not be possible to have in every field of government more accurate information in areas where decisions are currently being taken?

Lord Hesketh

My Lords, I am very grateful to my noble friend for his question. His question to me is very similar to the one which I ask myself. I hope that we shall be able to benefit from computerisation and be able to provide much more accurate and up-to-date information as soon as possible.

Lord Ennals

My Lords, may I congratulate the noble Lord and also his noble friend Lord Orr-Ewing on asking the right questions? Does the noble Lord agree that it is important to have up-to-date statistics? When he asks himself the question, can he also try to find out what is the balance between the National Health Service and the private sector? Does he agree that, inevitably, as we see such new developments coming in, there has to be a steadily rising income for the National Health Service to meet them?

Lord Hesketh

My Lords, I am again grateful for the question. With regard to the first part of it, I must remind the noble Lord that there is a point of diminishing returns with acquiring facts and information because we may finish up with more people counting outside the operating theatres than people going in. With regard to the second part, it is a very similar question to the one which I asked. The answer I was given was that until this time it has never been thought that there should be any reason why the private sector should report to the National Health Service on the numbers. I am sure that that matter will be reviewed.

Lord Winstanley

My Lords, while the number of these hip operations has increased greatly, which is of course to the credit of all those concerned, including the department, is not the waiting list for such operations growing at a faster rate than the operations are being performed?

Lord Hesketh

My Lords, to the best of my knowledge waiting lists are actually falling. However, the figures, if noble Lords would like them, are these. On 30th September 1985, the latest date for which we have a figure, 154,000 people were awaiting in-patient treatment in the specialty of trauma and orthopaedic surgery, many of them waiting for hip replacements. Unfortunately, at the moment we do not have a breakdown of those who are waiting for hip replacements or other forms of this type of surgery.

Baroness Macleod of Borve

My Lords, can my noble friend the Minister tell the House how much each hip replacement operation costs the National Health Service?

Lord Hesketh

My Lords, I am grateful to my noble friend for that question, which I can answer very simply. The average is £3,000.

Lord Wallace of Coslany

My Lords, can the noble Lord explain why figures are not available from the private sector? Is it not in the Government's interests, and in the country's interests, that these vital statistics are obtained for comparison purposes?

Lord Hesketh

My Lords, as I replied to a similar question earlier, it has never before been thought necessary to have these figures available. However, I am sure that in the not-too-distant future I shall be able to answer that question.

Lord Ironside

My Lords, in view of the fact that this is now a very popular type of operation and that people are beginning to return for a second replacement, can my noble friend say what proportion of the 45.000 operations in 1984 were actual replacement operations?

Lord Hesketh

My Lords, I thank my noble friend for that question but, unfortunately, I cannot give the break-down figure.

Lord Campbell of Croy

My Lords, can my noble friend confirm that it is correct to say that at the time of the Beveridge Report it was thought that the cost of the National Health Service would decrease because the nation's health would improve? Is it not correct that, in the event, medical and scientific advances have introduced new treatments and operations requiring very expensive equipment?

Lord Hesketh

My Lords, I can only confirm what my noble friend Lord Campbell has said and agree with him.

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