HL Deb 13 November 1989 vol 512 cc1077-9

Lord Ennals asked Her Majesty's Government:

Whether they will publish the numbers of patients treated in National Health Service hospitals in March 1988 and 1989 and the number of available beds on the same dates.

The Parliamentary Under-Secretary of State, Department of Social Security (Lord Henley)

My Lords, data for the financial year ending 31st March 1989 are not yet available. In the financial year ending 31st March 1988 8.2 million in-patient cases were treated in NHS hospitals in the United Kingdom. The average daily number of available beds was 388,000.

The Government hope to publish the data for England in a statistical bulletin within the next two months.

Lord Ennals

My Lords, I am grateful to the Minister for that Answer. The figures were certainly published in some form and were quoted by his honourable friend Mr. Mellor in another place. Will the Minister confirm that the total number of patients awaiting treatment in March 1989 was 922,000—that is the worst figure for six years—and that there was a fall in the number of patients treated and the number of beds available on that date? Why does the performance in those respects appear to be getting worse within the National Health Service?

Lord Henley

My Lords, I shall not confirm the figures because I believe that they are provisional. I ask the noble Lord to wait for two or three months until we have better figures. However, waiting times are more important than waiting lists. Half of all patients are admitted to hospital immediately. Of those admitted from waiting lists half are admitted within five weeks or less. We accept that in some areas patients have to wait too long for treatment. It is on that small but worrying proportion that we wish to concentrate our effort.

Lord Ennals

My Lords, can the Minister explain why his honourable friend Mr. Mellor made comments and referred to certain statistics? He said that the latest statistics are impressive by anyone's standards. Can the Minister explain why he does not have the same figures?

Lord Henley

My Lords, I do not know from what my honourable friend was quoting but I understand that the figures are provisional. It would be safer to wait until the actual figures for England are published in about two months' time.

Lord Mellish

My Lords, is the Minister aware that during the past 15 to 20 years there has been a dramatic change in the demand for hospital beds? For example, 20 years ago the replacement of hips was unknown, as were heart transplants and so forth. There has been a tremendous advance in medical science. Does that change of demand which is now prevalent in the National Health Service have anything to do with the figures which he has been talking about —or not been talking about?

Lord Henley

My Lords, it is relevant and I accept the fact that the number of beds has fallen over the past 10 years. However, the usage of the beds has increased dramatically. In 1987–88 there were 21 in-patient cases per bed whereas 10 years ago the figure was approximately 14. Similarly, the average length of stay in the acute sector fell from 9.4 days in 1978 to seven days in 1987–88. That is due to changes in medical technology and in the forms of treatment offered.

Viscount Hanworth

My Lords, I believe that my question comes within the scope of that on the Order Paper. Does the Minister agree that the time now spent waiting to see a specialist has risen to six or more weeks and that it is appalling to have to wait so long for a diagnosis?

Lord Henley

My Lords, I have no figures showing the length of time that people must wait in order to see a specialist. We do not believe that the numbers on the waiting lists are relevant but rather the speed with which they are admitted. The mean waiting time is now approximately five weeks.

Lord Wallace of Coslany

My Lords, is the Minister aware that the serious situation which is developing throughout the country, particularly in the South-East, is due to the fact that many authorities are trying to balance their budgets? Therefore, in order to make ends meet they are cutting down the number of wards and thereby reducing the number of beds. I am particularly concerned about Queen Mary's Hospital, Sidcup, where the situation is almost beyond belief.

Lord Henley

My Lords, I do not see that the question is relevant to that on the Order Paper. As I have stated, the usage of beds is increasing because changes in medical technology mean that consultants are able to discharge patients sooner.

Lord Gridley

My Lords, does the Minister agree that the demand for beds may depend on the state of health of the nation or on an epidemic at any one time? Does he also agree that it is extremely difficult to make a comparison concerning the demand for beds or for treatment?

Lord Henley

My Lords, I accept that. The number of in-patient cases treated has risen over the past 10 years from about 6,706,000 to about 8,200,000 in 1987–88.

Lord John-Mackie

My Lords, the Minister is speaking of weeks and months. My head taxi driver had to wait two and a half years for a hip operation and he had that done last year. Is that not quite ridiculous?

Lord Henley

My Lords, I accepted that there were problems. I cannot comment on individual cases, but if the noble Lord will write to me no doubt I shall look into the matter. We have accepted that on some occasions there are problems and we are doing what we can to reduce those times.

Lord Nugent of Guildford

My Lords, can my noble friend tell us what is the increase in the use of day beds? Is that one factor which is increasing the curing of patients with less use of beds?

Lord Henley

My Lords, I have no figures for increased use of day beds. Of course, the facility is available for doctors to make greater use of day beds rather than keeping people in hospital. That would be a matter for an individual consultant if he felt that that facility was right for a particular patient.

Lord Ennals

My Lords, is the Minister aware that the number of out-patients treated fell for the first time in years and the number treated as day cases is more than 16 per cent. lower than in the previous annual figures? I know that the Minister said that he does not have the figures but they are published in the Health and Personal Social Services Statistics for England, 1989 edition. For £10.25, at the expense of Her Majesty's Government, he could have the same figures as I have.

Lord Henley

My Lords, according to my figures the number of out-patients has increased. As I said, I do not have the figures for 1988–89. They are provisional.

Lord Orr-Ewing

My Lords, when there are cuts in the availability of hospital beds is that not done in order to preserve the very large expansion of non-medical staff; that is, ancillary staff? Is it not a shame that that is a priority rather than the reverse?

Lord Henley

My Lords, as I explained earlier, my noble friend is right in saying that the number of beds has fallen, but the number of people we have treated has increased because there is a greater throughput of people using the beds.

Lord Ennals

My Lords, until this year.

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