HL Deb 18 November 1987 vol 490 cc188-92

2.48 p.m.

The Countess of Mar

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 whether they are aware of the proposal by the Central Birmingham District Health Authority to ban new dialysis treatments in the renal unit at the Queen Elizabeth Hospital until April 1988 as a cost-cutting exercise; and what advice should be given, should the ban proceed, to patients outside the catchment area of the district health authority who would normally be treated at this hospital.

The Earl of Arran

My Lords, I understand that on 15th September Central Birmingham Health Authority decided, for financial reasons, not to accept new patients for renal dialysis for the remainder of the financial year. However, following discussions with my honourable friend the Minister for Health, the chairman of the West Midlands Regional Health Authority announced on 30th October that an additional £250,000 would be earmarked this year for the renal units in Central and East Birmingham Health Authorities to enable them to continue to take on new patients. This has come out of the waiting list money that the department has already allocated to the West Midlands region.

The Countess of Mar

My Lords, I thank the noble Earl for his Answer to that Question. I am indeed very grateful as are up to 100 kidney patients in the West Midlands area.

Perhaps I may ask the noble Earl whether he still agrees with the Secretary of State's responsibility under the 1977 National Health Service Act as outlined in Section 1 of Part I? That section states: It is the Secretary of State's duty to continue the promotion in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of those countries; and in the prevention, diagnosis and treatment of illness". Section 3 of that Act states: It is the Secretary of State's duty to provide throughout England and Wales, to such extent as he considers necessary to meet all reasonable requirements"—

Noble Lords

Reading!

The Countess of Mar

—I am reading from the Act, my Lords. May I please quote this because it is very important?

Noble Lords

Too long! Question.

The Countess of Mar

My Lords, the Secretary of State, is required to provide hospital accommodation and medical services. Does the noble Earl consider that the concern which has been expressed in the West Midlands Regional Health Authority area is not outwith the Secretary of State's responsibility to provide health services for everybody in England and Wales? Is he aware, as seen in the Birmingham Post this morning, that the area health authority is complaining that it has not had enough information from its offices—

Noble Lords

Order!

The Countess of Mar

—and that it will have to find another £2 million through cuts? Is the noble Earl satisfied that the health service is being provided for these people?

The Earl of Arran

My Lords, with respect, that was a somewhat long Question. I shall just answer one of the points raised by the noble Countess on the basis, as I interpret it, of robbing Peter to pay Paul. Any increase in funding for one specialty must mean less for another. This year, however, the West Midlands is receiving over £3 million from the national waiting list fund. Even by diverting some money to renal services, I am confident that West Midlands will build on its record of reducing waiting lists. Good progress has been made here, with a 12 per cent. reduction since 1979 in the number of patients waiting for treatment and a 31 per cent. reduction over the same period in the numbers waiting for over a year.

Lord Molloy

My Lords, is the Minister aware that people will be grateful for his reply to the noble Countess and that it is a very good thing in so far as it means that regional authorities, who think that they are the apex of the NHS. in reality are not so? Is it not the DHSS which makes the ultimate decision? This time it made the right decision and it should be thanked for doing so. Is the Minister aware that this decision will bring so much relief and contentment to those who are suffering? That is something that I feel I should say in this House?

The Earl of Arran

I apologise, my Lords, but I am not too aware of the question that the noble Lord put.

Lord Ennals

My Lords, if, as the noble Earl said, this very serious problem raised by the noble Countess has been solved by digging into the waiting list money, what will happen next year? Will there be another freeze on cardiac patients being treated over a very large area? Will there be no funds to relieve waiting lists? Or will the Government provide some money to enable the health authorities to do their job? Will the Minister explain the situation so that we ensure that such tragic stories which have been repeated across the country are not heard again next year?

The Earl of Arran

My Lords, in response to the noble Lord, Lord Ennals, I feel that the noble Lord forecasts a somewhat alarmist situation. All these considerations, if indeed they happen, will be taken into account at the time.

Baroness Masham of Ilton

My Lords, is the Minister aware that two weeks ago when we had a debate on children in hospital I brought up this very same question concerning leukaemia children in Leeds? Is he aware that it is a problem across the country with regional services landing in one particular district? Sometimes that district is not able to fund them. Will he seriously look into this question and perhaps answer my question by letter?

The Earl of Arran

My Lords, of course I am aware of the comments of the noble Baroness. Indeed I shall write to her along those lines.

Lord Molloy

My Lords, is the Minister aware that the department and he should be congratulated for reversing a very bad decision? They do it only once in a blue moon, but this time they have picked on the right issue to assert themselves by not letting regional or local authorities think that they rule the roost.

The Earl of Arran

My Lords, with respect, I am still not totally clear about the question.

Lord Underhill

My Lords, is the Minister interested to know that I have received a communication from a patient in the Queen Elizabeth Hospital, Birmingham—the subject of this Question—who is himself a renal patient on dialysis and an officer of the Kidney Patient Support Association? These patients are concerned not with the next few months, but that support will be given not only for present months but for future years. Is the Minister aware that my noble friend's Question is very important for sufferers in this area?

The Earl of Arran

Once again, my Lords, I am not sure of the question posed.

Lord Molloy

Then resign, my Lords.

Lord Underhill

My Lords, I should have thought that the simple point of my question is clear. It is not sufficient to give promised assistance for the next few months. The people who are patients in this area—and there will continue to be dialysis patients in this area—want to know what will be available in the future, next year and the year afterwards? That is what we are asking the Minister to tell us.

The Earl of Arran

My Lords, to make a decision now based on next year and the year after is a little too early. If any problems that have been outlined do arise, they will be considered at the correct moment in time.

Baroness Seear

My Lords, I am sure that the noble Earl realises that this is literally a life and death matter for dialysis patients. What developments, if any, have been made in transferring people across the boundaries of health authorities because there are shorter lists in some places than in others? In so doing is he aware that that will be reducing the costs? Is the noble Earl aware that it was as regards this unit that I was told that there was no difficulty in such a move except the restraint of financial bureaucracy?

The Earl of Arran

My Lords, I thank the noble Baroness for her question. I am just as sensitive and as deeply aware of the deep misfortune that such patients suffer. During the time of the ban patients were referred to one of the other six centres in the region at East Birmingham, Stoke, Coventry, Dudley, Luckfield and Wolverhampton. The regional health authority is keen to develop other renal centres in the region so as to relieve pressure on the Queen Elizabeth unit.

The Countess of Mar

My Lords, is the noble Earl aware that kidney patients in this area were told that they could not be treated because the regional health authority could not afford to pay the fees for transferring them from one region to another? Is he also aware that Sir James Ackers on Midland Television News last week said that next year they are heading for a £17 million deficit in the region? Do the Government propose to support the National Health Service in the West Midlands area or not?

The Earl of Arran

My Lords, of course the Government propose to help the West Midlands Health Authority at all times like all other health authorities. If such fearful problems pose themselves they will be looked at immediately and the correct remedies taken.

Lord Prys-Davies

My Lords, is the Minister satisfied that the Queen Elizabeth Hospital renal dialysis unit is adequately funded to provide services in accordance with the DHSS criteria?

The Earl of Arran

My Lords, the unit which the noble Lord, Lord Prys-Davies, mentions, is only one of seven in the region. It is for the regional health authority to determine how much money to invest in each unit. The authority is investing £640,000 of new money in its renal programme this year.