NHS Waiting Lists (Hansard, 6 July 1987)

§ Lord Ennals
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, on 30th September 1986, there were 681,901 people on hospital in-patient waiting lists in England. The size of the lists varies within and between regions because of factors such as the size of the resident population. Although there is no obvious correlation between geographical position and the size of lists, the House will be interested to note, as I was, that the average list per 1,000 population for the five northern regional health authorities is below the average for the whole of England.

§ Lord Ennals
My Lords, I thank the noble Lord for his Answer and particularly for the interesting information about geographical distribution, which surprised me as well as him. Does he accept that after eight years of this Government the waiting list figure that he quoted is 73,000 higher than the number just before the end of 1978 and that that is a very disturbing situation? Can he say a little about what the Government are doing to bring down the waiting lists, North and South?

§ Lord Skelmersdale
My Lords, in answering the noble Lord, may I say that I am aware that he has recently been in hospital. I hope that he has fully recovered, not only from the cause for his admission but also from any effects he might have felt about having come out!
As we discussed last week, the number of patients treated in hospital has risen to an extra 1 million persons a year. As to the question asked by the noble Lord concerning what the Government are doing, we are naturally very concerned. As an emergency measure we have set up a waiting list fund. It is a three-year scheme which has a two-year core of money in the middle. An allocation of £25 million was made for the first year of the two-year period. Various schemes have been approved since February, when the money first became available.

§ Lord Kilmarnock
My Lords, perhaps I may congratulate the noble Lord—this being my first opportunity—on his new post. I should also like to ask the noble Lord why he left out the figures for 455 Wales when he gave the figure of 681,901 people on waiting lists? My information is that there were an additional 35,770 people on the waiting list for Wales. I am surprised that there are no signs of alarm on the Opposition Front Bench over that matter. Next, does the Minister not think that it is absurd that in some districts there are long queues for services involving certain specialties, whereas in other districts there are no queues or very short queues? Can he say what the Government are planning to do to encourage cross-boundary flows?

§ Lord Skelmersdale
My Lords, I did not mention Wales or indeed Scotland because, in the time in which I had to prepare for the Question, I was not able to get the figures from the relevant departments. I am grateful to the noble Lord for pointing out the error of my ways. So far as his supplementary question is concerned, yes, I am well aware that one of the major problems is the management problem. That concerns, first, the relationship between general practitioners and consultants and, secondly, the information that the general practitioners need as part of their thinking on referral for a particular consultation in terms of knowing where the waiting list for a particular specialty is lowest.

§ Baroness Seear
My Lords, has the noble Lord been told, as I have, that the difficulty in movement across boundaries is largely a matter of financial bureaucracy?

§ Lord Skelmersdale
My Lords, I have not had it explained to me in quite those terms. I have established that where there is a will, there is a way. I know of one dermatologist who recently managed to reduce his waiting list time from six months to two weeks.

§ Lord Mellish
My Lords, is the Minister aware that the whole question of waiting lists and regions becomes topsy-turvey when one thinks of hospitals such as Guy's, which is brilliant in certain specialties, and whose waiting list covers the whole of southern England? I am aware of that because I used to be governor of that hospital. Most of its patients come from the coastal areas. Therefore, how do we define who is waiting for what, and in what region?

§ Lord Skelmersdale
My Lords, I agree with the noble Lord. I am advised that Moorfields Hospital, which is another specialist hospital, was at one time actively promoting the admission of patients so that they could carry on with their teaching work.

§ Viscount Torrington
My Lords, does my noble friend agree that there is a slight danger in reading too much into hospital waiting lists? When there was no such thing as a hip replacement operation, there were no waiting lists for hip replacement operations.

§ Lord Skelmersdale
My Lords, I agree with my noble friend that the advances in medical science have a bearing on the matter. I shall go further and say that what matters for individual patients is not the size of the list but how long they must wait for treatment.

§ Lord Ennals
My Lords, will the noble Lord accept that he owes the House no apology? My Question concerned England, and it is the responsibility of the Secretary of State for Wales to answer questions concerning the situation in Wales. I have two supplementary questions. The Minister referred to the number of patients treated. I had understood last week that the Minister was not speaking of the number of patients treated but the number of times people have been admitted to hospital. In addition, can the Minister tell me when the £25 million scheme started and whether it is possible to see any results from that expenditure?

§ Lord Skelmersdale
My Lords, the £25 million in the fund to which I referred was first available in February of this year. It is too soon to see any results. So far as the number of patients treated is concerned, I know that the noble Lord has a fixation about the figures being unreliable because of repeat treatments. However, fashions in medicine in some specialties have demanded that in any case. Also, as the noble Lord will know from his weekend's experience, people are not normally in hospital without good reason.

§ Lord Ennals
My Lords, is the noble Lord aware that I have been admitted to hospital six times this year and I am in cracking health, but that I have been registered as being six patients? I am only one man, great though I may be.

§ Lord Skelmersdale
My Lords, I am sorry to hear of the noble Lord's health history. But I suspect that the consultant, the general practitioner or whoever referred him in the first place treated the noble Lord, quite rightly, as a patient for each individual incident.