HL Deb 01 February 1988 vol 492 cc825-7
Viscount Hanworth

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 taking action to reduce the delays for hip replacement operations on the National Health Service.

The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)

My Lords, increasing the number of hip replacement operations is one of the National Health Service's priorities. The waiting list fund for 1987–88 is allowing several thousand more of these operations to be done.

Viscount Hanworth

My Lords, I thank the Minister for his Answer. Is he aware that, for example, in Guildford there is a two-and-a-half year waiting list for hip operations, and that many people suffer acute pain night and day and are taking increasing amounts of drugs? Will the Minister consider whether it is possible to make it easier for people to transfer to a waiting list in another area where there is less delay?

Lord Skelmersdale

My Lords, the noble Viscount was good enough to inform me earlier about the length of delay for this specialty in the Guildford area, which is considerably worse than the last year for which I have figures regarding the time between people being seen and diagnosed as needing a hip replacement and their admission for treatment. The average in 1985 was 21 weeks in England. I regret that I do not have more up-to-date figures.

Where individual patients go for various operations is entirely in the hands of the general practitioner who refers them to the consultant. My right honourable friend's objective is that general practitioners should have better information as to the lengths of waiting lists in local hospitals for various specialties.

Lord Mellish

My Lords, I speak as one who was chairman of a hospital management committee for 14 years. In the 1950s, I had never heard of this operation. Will the Minister tell us, as a matter of interest, when this operation started? It is a truly remarkable operation and shows the advance of medical technology.

Lord Skelmersdale

My Lords, I do not have the facts in front of me. But, judging from memory, my father considered having the operation in the early 1960s and was told that he would have to wait at least until the late 1960s before he would be able to have it.

Lord Campbell of Croy

My Lords, is my noble friend aware that I tabled a Question on that very point within the last year or two? The Answer indicated that there were very few, if any, such operations 30 years ago. Is my noble friend also aware that we all owe a debt to Professor Sir John Charnley, who started those operations in Wigan?

Lord Skelmersdale

My Lords, I agree with my noble friend. I seem to remember that the professor also operated at Haslemere Hospital.

Lord Hunter of Newington

My Lords, are the Government prepared to make funds available so that people who, except for financial reasons could go to another area, would be able to have their operation there?

Lord Skelmersdale

My Lords, that is certainly one of the points at which we shall need to look. But, returning to hip operations, the objective is that by 1990 there will be 1,050 such operations carried out per million of the population. We intend that some 48,000 will take place each year by that time. It looks as though we are on stream towards achieving that aim.

Lord Nugent of Guildford

My Lords, I also take an interest in the position at the Guildford hospitals. A patient in whom I was interested was operated on for a hip replacement within six weeks of my making an inquiry on her behalf. Is the Minister aware that as a result of my inquiry she was transferred from one consultant to another whose waiting list was years shorter than that of the first one? Does the Minister know that there is a great deal of variation in this picture? We too often hear of bad cases; there are also good cases.

Lord Skelmersdale

My Lords, I was not aware of the case just referred to by my noble friend. As I said, the figure of 21 weeks in England in 1985 was an average figure. It is vital that general practitioners have the information so that we can have an average waiting list for the various specialties across the country.

Lord Bottomley

My Lords, is the Minister aware that the problem is not confined to Guildford? It is pretty general. Can the noble Lord give some assurance that something will be done to ease the situation? The number of hip operations which need to be performed is getting greater and greater, not less.

Lord Skelmersdale

My Lords, yes. That is why, first of all, hip operations are one of the series of operations which are countenanced for extra funds under the waiting list initiative. Secondly, that is why I said that by 1990 we intended that 1,050 operations per 1 million of the population would be carried out.

Lord Ennals

My Lords, would the Minister agree that it should not depend upon the generous intervention of a noble Lord to ensure that someone gets his operation instead of having to wait for three years? Is it not the case that in very many areas and districts right now the length of the waiting list for this operation is increasing? Does he not agree with Dr. John Havard, Secretary of the BMA, yesterday, that the National Health Service is being systematically starved of the resources it needs? Is the noble Lord aware that there was a similar statement this morning by Mr. Trevor Clay, the General Secretary of the Royal College of Nursing? Is this not mainly an issue of finance and staff?

Lord Skelmersdale

My Lords, not so far as concerns orthopaedics. An additional nine posts will be implemented by the end of the current financial year; a further six by the end of 1988–89; one post the following year; and one by 1991–92. That gives an additional 17 posts.

Baroness Seear

My Lords, did I understand the Minister to say in reply to the noble Viscount, Lord Hanworth, that where the patient was treated was a matter for a general practitioner? Did he mean that that was regardless of the patient's health authority? Is it possible to move people from one authority to another at the wish of the general practitioner? That is what I understood from the Minister's reply.

Lord Skelmersdale

My Lords, I was talking about the district within which the general practitioner operates. There is certainly discussion going on through the offices of the district health authorities concerning the point that there should he an opportunity for referring to different districts. However, that has not yet come to fruition.

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