NHS Hospital Waiting Lists (Hansard, 23 April 1991)

§ Lord Cavendish of Furness
My Lords, information is not collected for individual hospitals. However, the average number of patents waiting for in-patient treatment in each district health authority at September 1990 was 3,564, excluding those patients who asked to have their admission deferred. The average figure is not meaningful because of the variation in the population served by health authorities and by the hospitals within them. What matters, of course, is the time that patients wait. In 1989-90 the number of patients waiting more than a year fell by 7 per cent. and in the first half of 1990-91 it fell by a further 2 per cent.

§ Lord Molloy
My Lords, I thank the Minister for that Answer. Is he aware that the British Medical Association believes that the Government are concealing the true situation? It has published its findings showing that there are 16,000 more people on the waiting list than there were in 1990. Can the Minister comment on that and say whether the Government intend to talk to the BMA about it?
Can the Minister also give consideration to another practice that is causing anxiety within the medical profession and among people who must wait for operations? I refer to local health districts being able to pay for patients in their areas to go to specialist hospitals for specialist operations. Is the Minister aware that many people in the medical profession and many patients believe that to be a form of queue jumping totally alien to the concept of our National Health Service?

§ Lord Cavendish of Furness
My Lords, I contend that the BMA figures are wrong and that ours are right. The figures that I provide at this Dispatch Box are statistically validated unless otherwise stated.
139 I have seen press reports about queue jumping which represent a misunderstanding. In some cases hospitals ask DHAs for money in respect of priority areas; for instance, cancer hospitals may ask for special funds for radiography and chemotherapy.

§ Lord Ennals
My Lords, according to figures published by the Minister's department last week—not by the BMA nor any other body—there was a total of 957,600 people on the waiting list in September 1990. Does the Minister accept that they are the worst September figures ever recorded since the health service was established? What has happened to all the money that we are continually told is being put into the special fund to reduce waiting lists that the lists should be increasing so dramatically?

§ Lord Cavendish of Furness
My Lords, there was a decrease of 1 per cent. in the six months to September but there was an increase of more than 2 per cent. in each of the three previous six-month periods. We are treating 1 per cent. more patients from the list than we were last year and 6 per cent. more than two years ago. That answers the question about the special fund.

§ Lord Thorneycroft
My Lords, is my noble friend aware that, in the private sector, private health insurance companies are negotiating with hospitals abroad with the object of reducing the waiting lists? Can he say what is the mystery that prevents the National Health Service too from seeking to obtain the same advantages by starting negotiations?

§ Lord Cavendish of Furness
My Lords, I have not come to the House prepared to answer that question. However, I shall be pleased to carry out some research and write to my noble friend.

§ Lord Jenkins of Hillhead
My Lords, can the Minister explain the phrase "statistically validated" that he used with great assurance as proving conclusively that the Government's figures are right and the BMA's figures are wrong? Alas, in the past many statistics have turned out not to be wholly valid.

§ Lord Cavendish of Furness
My Lords, that is rather a loose definition. I understand that. The system employed by the department is to receive figures from the regions which then have to be looked at and adjusted. I am telling the House that we are being consistent. Perhaps I may add to that. The latest fast track figures show a further 12 per cent. fall in patients waiting for over a year in the five months to February 1991. By "fast track" I mean that those figures have not been through the normal validation checks.

§ Lord Wade of Chorlton
My Lords, is my noble friend aware that within the Merseyside Health Authority area the number of people waiting over two years has been reduced by 98 per cent. and there are now only 53 people on the waiting list? That has been achieved by carrying out government policy.

§ Lord Cavendish of Furness
My Lords, I am grateful to my noble friend. I agree with those figures. It is an example of what good management can achieve.

§ Lord Sefton of Garston
My Lords, is the Minister aware that government policy has depopulated Liverpool from a figure of 800,000 to 500,000?

§ Lord Cavendish of Furness
My Lords, I believe that that is another Question.

§ Baroness Phillips
My Lords, is the Minister aware that people on a waiting list for two years—and we understand that the figure is now less than it was two years ago—may well have died in the interim, thus no longer necessitating an operation?

§ Lord Cavendish of Furness
My Lords, I must acknowledge that that can happen. However, in 1989–90 7.5 million in-patients from all specialties were treated which was over 24 per cent. more than in 1979. A total of 1.2 million day cases were treated in 1989–90, almost double the number in 1979. It is a pity that noble Lords opposite do not acknowledge the success of the NHS, not because that gives comfort to the Government, which does not matter very much, but because they are undermining the work of hundreds of thousands of workers at the rock face of the service.

§ Lord McColl of Dulwich
My Lords, does my noble friend not agree that the noble Lord, Lord Ennals, gave an excellent reply to a similar Question in another place on 3rd April 1979 when he admitted that the numbers on the waiting lists then were higher than ever before? However, he said that one had to take into account the fact that more patients were being treated then than ever before. Does not my noble friend agree further that the noble Lord, Lord Ennals, made a very good point in the same reply when he said that one of the reasons for long waiting lists was the way in which the waiting lists were managed or not managed?

§ Lord Cavendish of Furness
My Lords, I must agree with my noble friend that that was a good reply. The fact is that we are treating more patients than ever before.

§ Lord Ennals
My Lords, it must be that the memory of the noble Lord, Lord McColl, fails him or that his statistical analysis is wrong. Will the Minister accept that the figure of 140,000 more people on waiting lists than ever before is a figure worse than any announced by any Labour Secretary of State? Will he accept also that the September figures which his department published last week show for the first time a fall of 23,000 in the number of in-patients who have been treated? Therefore, the Government's argument that they are treating more patients has also fallen apart.

§ Lord Cavendish of Furness
My Lords, the figures do not show a worse situation. Many people are on the waiting lists because the service is more active. The number of admissions from the waiting lists in the six months to September 1990 has fallen by 1 per cent. compared with the previous six months. As it happens, that is still higher than the corresponding six months in the previous year. However, such minute fluctuations tell us very little. Since 1979 the annual 141 rate of surgical acute activity, which is so important, has increased steadily with a dip only in 1982 by nearly 30 per cent.

§ Lord Ennals
My Lords, will the noble Lord answer my question? Is it not true that at present the waiting lists are 140,000 higher than they ever were even in the worst months of industrial disputes under the Labour Government?

§ Lord Cavendish of Furness
My Lords, the noble Lord insists upon using the word "worst". The overall figures of those on the waiting lists are higher than they have ever been before. On the other hand, the number of in-patients waiting is lower than when the noble Lord was in office.

§ Lord Elton
My Lords, is my noble friend aware that many people are waiting for treatment and operations which had not been invented and could not have been carried out in 1979? To some extent that is a mark of the affluent and successful society in which we live.

§ Lord Cavendish of Furness
My Lords, my noble friend is entirely correct.

§ Lord Molloy
My Lords, is the noble Lord aware that the British Medical Association and the royal colleges are disturbed at the fact that no less than 4,000 beds were closed last year? They are also worried that due to administrative problems patients are put on the wrong waiting lists. Despite what the noble Lord, Lord Thorneycroft, and other noble Lords have said, because of the Government's action in trying to destroy our National Health Service a number of consultants have resigned.

§ Lord Cavendish of Furness
My Lords, there is no simple relationship between the number of beds and the service we offer. I am not aware of the other problem mentioned by the noble Lord, but I shall look into it.

§ The Lord Privy Seal (Lord Waddington)
My Lords, I must invite your Lordships to move on to the next business because we decided that we should bring Starred Questions to an end after 30 minutes.