§ 2.44 p.m.
§ Lord MolloyMy 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 what steps they propose to take to ensure that hospitals where efforts have been made to reduce waiting lists are not obliged to close beds due to underfunding of regional health authorities.
§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)My Lords, the Government cannot accept the premise that regional health authorities are underfunded. Nonetheless, there is a huge pent-up demand for health care as shown by the waiting list figures. That is why the Government are providing £25 million this year and £30 million next year for the waiting list initiatives. There are many criteria for applying for this money, the most important of which is that districts and units within them should already have shown that they are tackling the problems within their own resources.
§ Lord MolloyMy Lords, is the Minister aware that the last point he made is vital to my submission? Is he aware, for example, that in the North West Thames region where there are calls for cuts of £9 million, some hospitals, particularly Northwick Park in Harrow, have striven to reduce costs? Northwick Park has a turnround of beds in minor cases under which patients are not one hour more in a hospital bed than they need be. It has, therefore, dramatically reduced its waiting lists; but the only thanks from the regional health authority have been a threat to close a number of wards. Does not the Minister agree that such action upsets and frustrates the medical profession, annoys people who have relatives in hospital and is hardly the policy to encourage hospitals which co-operate with the authorities in reducing expenditure?
§ Lord SkelmersdaleMy Lords, health authorities have a statutory duty to keep within their budgets. Therefore, they have a duty to examine all reasonable options when service reductions have to be made. However, I agree with the noble Lord that it is not helpful if problems are exaggerated and wild proposals mooted which turn out to be totally 5 unnecessary. That is damaging both to staff morale and to public confidence.
§ The Countess of MarMy Lords, is the noble Lord aware of the appalling situation in the West Midlands region at the moment? The Birmingham Children's Hospital, which covers an area bounded by Shrewsbury, Mid-Wales, Hereford, Rugby and Stoke, has precisely four intensive care beds for babies and young children—that is, not just for heart conditions but for the whole hospital. Is the noble Lord aware that 34 children needing urgent operations have been turned away? One child who is urgently in need of heart surgery has been turned away five times. Is the Minister happy that children should suffer and perhaps die because of the situation?
§ Lord SkelmersdaleMy Lords, it would be unreasonable to expect, and the Government do not pretend, that the sums allocated to health authorities should cover all demands on their services. From time to time, pressures may be such that some services must take priority over others and health authorities must balance the cost of service developments and increasing workloads against other calls on available resources. The detailed matters which the noble Countess brings to the attention of the House are of course for the managers and chairmen of the health authorities concerned.
§ Lord EnnalsMy Lords, does the Minister accept that the most recent figures given last week by his noble friend concerning waiting lists are the highest in the history of the National Health Service except for periods of industrial action? Can he say how many beds are now closed purely because of financial shortages?
§ Lord SkelmersdaleMy Lords, under the last Labour Government acute beds fell by an average of some 2,300 per year. They have fallen by 2,245 under the Conservatives. There are 6.4 million cases—that is, over a million more in-patient cases than in 1979—now being treated, a rise of 18.8 per cent. I do not accept that there is a direct relationship between bed closures and waiting lists.
§ Lord EnnalsMy Lords, I did not ask about the number of patients treated or the reduction in the number of beds. I asked about waiting lists. Can the Minister answer my two questions?
§ Lord SkelmersdaleMy Lords, last week the noble Lord asked my noble friend a series of questions on this subject. I believe that my noble friend adequately covered it in his answers.
§ Lord MolloyMy Lords, is the Minister prepared to take into account problems created by the recent storm in London—for example, at St. Bartholomew's Hospital? The hospital suffered massive damage and the staff worked day and night to transfer patients. Should not they be relieved of having to close wards which they saved from the storm? Does not the Minister also agree that hospitals which treat cancer patients say that 6 patients' only hope of a bed is for someone to die so that they can move in?
§ Lord SkelmersdaleMy Lords, as regards the recent storm damage, I understand that the regional health authorities rather than the district health authorities have taken it upon themselves to provide the finance.
The Earl of HalsburyMy Lords, the Minister has not answered the last question put by my noble friend Lady Mar. Is he happy?
§ Lord SkelmersdaleMy Lords, this is a situation where no one can ever be happy. What I sought to point out was that hard decisions constantly have to be made and that is why we have managers in the health service.
§ The Countess of MarMy Lords, in response to two Written Questions which I have asked the Minister has referred me to the managers of the health service. I have not yet had time to receive answers from them. When I do, I expect that they will say that because of the financial limitations placed upon area and regional health authorities they cannot afford the cost. I should like to ask the noble Lord what I should then do to get a response to the situation.
§ Lord SkelmersdaleMy Lords, the question is somewhat hypothetical. When I suggest that noble Lords, wherever they may sit, refer matters in the first instance to the hospital authorities concerned, I am always prepared to take the point on board if a satisfactory answer is not produced.