HL Deb 12 November 1987 vol 489 cc1465-7

3.13 p.m.

Lord Ennals

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

The Question was as follows:

To ask Her Majesty's Government what progress is being made towards fulfilling their commitment to reduce hospital waiting lists.

The Earl of Arran

My Lords, our continued determination to pursue our drive for significant improvements in waiting times, backed by additional funding, has not lessened. Most of the 350 projects currently being supported from the first £25 million allocation of the waiting list fund are now under way. These projects involve the treatment of some 100,000 additional patients from the waiting list. Many have already been treated. For next year we have increased the waiting list fund to £30 million.

Lord Ennals

My Lords, I welcome the statement that has been made. I very much hope that in answer to this supplementary question the Minister will say what the current figures are on the waiting list. Is the noble Earl aware that in March of this year there was a significant increase over the previous year? Is the Minister also aware that there are health authorities across the country which are having to reduce the number of beds available or close wards or close units? In the case of one of the London hospitals, it is necessary to close theatre units for one week in five. Is not the noble Earl aware that this is a growing problem across the country, and is he satisfied that the announcement which the Minister has made is going to bring the long waiting lists steadily down?

The Earl of Arran

My Lords, we shall never be satisfied with the numbers on the waiting lists until we have been successful in reducing them further.

In reply to the noble Lord, Lord Ennals, perhaps I may say that the latest figures, for March 1987, show that on waiting times (which is what matters most to the individual patient) we are continuing to make progress. The number of people on the list for over a year fell by 2,085 since September 1986. It is the lowest proportion since this figure was collected. At the same time, however, the total list size rose by just under 1 per cent. These figures emphasise the need for our continuing commitment to make improvements. They reflect the position before the start of the projects we are supporting from the waiting list fund. Those will be treating, as I have said, an extra 100,000 waiting list cases in 1987–88.

Lord Kilmarnock My Lords, it is good news that the Secretary of State has increased the waiting list fund to £30 million per annum. Can the noble Earl say whether any encouragement has been given out of that fund to cross-boundary trading between health authorities? Is he aware that one of the difficulties here is the extreme delays in the financial compensations for cross-boundary flows? If those can be speeded up, much more of that traffic could take place in the manner pioneered by St. Thomas' Hospital and Guy's Hospital. Can the noble Earl say a word about that?

The Earl of Arran

My Lords, the answer to the noble Lord's question is that among the regional health authorities there is a competitive spirit from the point of view of tendering and where the money would be most appropriately spent.

Lord Kilmarnock

My Lords, will the Government stimulate this process out of the fund which the Secretary of State has set aside for this purpose?

The Earl of Arran

My Lords, I can only take note of the noble Lord's comments.

Lord Thorneycroft

My Lords, would the noble Earl agree that some contribution to this difficult problem might be made if health authorities were encouraged to make fuller use of beds in private hospitals, many of which are not filled at the present time?

The Earl of Arran

My Lords, we are funding a number of projects proposed by regions involved in the private sector. The cost-effective use of private facilities will allow NHS patients to be treated more quickly than would otherwise be the case. That clearly makes sense.

Lord Marsh

My Lords, does the Minister agree that the original Question and the supplementary questions are only examples of a whole range of areas where the National Health Service is demonstrably unable in its present form to cope with the growing problems which face it? Is there not now a case for a complete and fundamental re-think of the whole National Health Service going back to first principles and ignoring the herds of sacred cows that roam around it?

The Earl of Arran

My Lords, with respect, I think that is somewhat wide of the Question.

Lord Stallard

My Lords, I refer to the Minister's reply about waiting times. He is perfectly right of course that the waiting times are more important. Has the noble Earl had an opportunity to read recent press reports about waiting times at the Manchester Royal Eye Hospital, where there are something like 2,500 people waiting for surgery? That means a two-year wait. There are a further 3,100 people waiting for first appointments. The estimated time for a first appointment is anything up to 60 weeks. Does that not knock holes in the Minister's argument about the Government's attempts to reduce waiting lists to an acceptable degree? Will the noble Earl look at the question of the Manchester Royal Eye Hospital?

The Earl of Arran

My Lords, I am not aware of the particular circumstances to which the noble Lord refers. Of course the situation is regrettable. Each area has its own individual problems and I shall draw the comments of the noble Lord to the attention of my right honourable friend the Secretary of State.

Lord Campbell of Alloway

My Lords, can my noble friend the Minister say why he says that the question put by the noble Lord, Lord Marsh, is wide of the Question on the Order Paper?

The Earl of Arran

My Lords, with respect, because I deemed it to be so.

Lord Underhill

My Lords, is not the point of my noble friend's original Question illustrated by the sad news, which was announced on a radio programme this morning, of the young lad who has been called for an operation on five occasions. Five times the operation could not be carried out because, although the consultants and technical staff were available, there were insufficient nursing staff in the emergency wards. Is not that one of the problems raised by my noble friend's Question?

The Earl of Arran

My Lords, I regret I do not know the exact and precise circumstances of the case which is mentioned. Of course it is regrettable, but once again I must repeat that there are regrettable circumstances across the country. Each district authority is aware of them and is doing its best to put them right.

Lord Wallace of Coslany

My Lords, further to the point made by my noble friend, is the Minister not aware that the problem of waiting lists will never be properly solved until adequate steps are taken to provide good accommodation, pay and conditions for nurses and a stop is put on the wastage of NHS-trained nurses to the private sector?

The Earl of Arran

My Lords, I think it is clearly understood that everyone is aware of the nurses' situation. At all times my right honourable friend the Secretary of State is looking at those particular circumstances to see whether, and if so what, improvements can be made.

Noble Lords

Next Question!

Lord Wells-Pestell

My Lords, does the Minister accept that there is a vast army of men, women and children awaiting operations who should have been operated on not weeks ago but months ago?

The Earl of Arran

My Lords, the situation is this. Of those who require admission into hospital 50 per cent. are admitted immediately and the remaining 50 per cent. are admitted within eight weeks. It is the final 50 per cent. to which we are giving special attention.