HL Deb 02 June 1992 vol 537 cc819-22

2.57 p.m.

Lord Molloy asked Her Majesty's Government:

What action they are taking to reduce hospital waiting lists.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, I am pleased to say that since 1979 in-patient waiting lists in England have fallen by 12 per cent. Over the last year, provisional figures show that this progress is being maintained. In England alone, we will provide a further £39 million this year to continue the drive to reduce waiting lists.

Lord Molloy

My Lords, is the Minister aware that the practice of going back 12 or 15 years all the time irritates people who have relatives who are on waiting lists? They find it highly distasteful to be told what was happening in 1979 when they have loved ones who are on the waiting lists waiting for emergency operations in a hospital. Therefore, can the noble Baroness go a little further and explain what will be done to prevent waiting lists increasing and to ensure that those people already on waiting lists receive priority and have their ailments attended to by the medical profession?

Baroness Cumberlege

My Lords, I agree with the noble Lord. I think that people should be treated as quickly as possible. Half of all hospital admissions are immediate. Of those admitted from waiting lists, half are admitted within five weeks, 80 per cent. within six months and 90 per cent. within a year. We are improving on that. The Patient's Charter, in addition to giving a two-year guarantee for every patient who needs treatment, states that from 1st April 1993 no one will have to wait more than 18 months for a hip or knee replacement or a cataract operation. We wish to improve on those guarantees in the future.

Lord Mellish

My Lords, I am sure that the noble Baroness is certain to agree that this waiting list argument, about which some people know nothing, is in fact divided into two parts: the urgent cases and the non-urgent cases. The latter can wait; they are not important. But as regards the urgent cases, is it not a fact that within the last two or three years such cases have been dealt with more rapidly?

Baroness Cumberlege

My Lords, that is true, and also for the people awaiting admission to hospital. People who have been waiting for over two years now have virtually all been treated. The number of people who have been waiting for between one and two years has gone down by one-third compared to March 1991, and the total number of people waiting has halved over the same period. That is a good record but we wish to improve it further.

Lord Wyatt of Weeford

My Lords, is it not the case that waiting lists could be dramatically cut if, instead of just a few, all hospitals observed the recommendations of the Royal College of Physicians and of the National Audit Commission to do day surgery instead of cluttering up beds unnecessarily by keeping patients in hospital for far longer than they need?

Baroness Cumberlege

My Lords, I agree with that point. We have seen an enormous increase in the number of people treated on a day case basis. That has indeed made a major contribution to the improvement in the figures.

Lord Winstanley

My Lords, while welcoming the steps already taken by the Government with regard to waiting lists for admission to hospital, I ask the noble Baroness whether she agrees that what worries general practitioners and their patients even more is the difficulty of actually getting on to a waiting list because of the length of time spent waiting for an outpatient's appointment. With respect, may I ask the noble Baroness whether she is old enough to remember the time when we did not have appointment schemes and people went direct to outpatients? Perhaps they had to wait five hours but they were seen the same day, whereas now they have to wait five months. I do not expect the Minister to give us figures, but can she assure the House that the Government will attack the problem of waiting times for outpatient appointments with the same vigour as they have applied to waiting times for hospital admissions?

Baroness Cumberlege

My Lords, under the Patient's Charter every single hospital will have to set its own targets for outpatient waiting times. In addition, I should say that over the period from 1979 there has been a great increase in the number of people treated. The figure has risen from 34.1 million in 1979 to 36.1 million in 1991.

Lord Carter

My Lords, in the year to March 1992 the number of people waiting for over two years went down by a welcome 50,000 while the number of people who were waiting for under one year went up by 56,000. Does this not confirm the view that in the run-up to the election the criteria for receiving treatment was based much more on the massaging of statistics than on clinical need? Will the Minister tell the House what are the Government's targets for the current year for reducing the number of people who are waiting for under one year and the number who are waiting for between one and two years?

Baroness Cumberlege

My Lords, the noble Lord is right in that the number of people waiting for under one year increased during the month of March by 1 per cent. But the increase is very small compared to the number of patients treated in the NHS each year and substantially less than the reduction in the number of those waiting for over one year. With a 5 per cent. real terms growth next year, increased activities should more than cope with this. More significantly, the total waiting list is down some 33,000—3.5 per cent.—compared to March 1991.

Lord McColl of Dulwich

My Lords, does my noble friend agree that if this Government were to follow the practice of the last Labour administration and remove from the waiting list all those who have been given a date for their operation, every patient on the list could be given a date, thus reducing the waiting list to zero?

Baroness Cumberlege

My Lords, I agree with my noble friend. The noble Lord is the only person in this Chamber this afternoon who actually owns a waiting list.

Lord Carter

My Lords, is it also not the case that the Government have improved the figures by for the first time adding the number of day cases to the in-patient figure which automatically improves the figure?

Baroness Cumberlege

My Lords, people waiting for day case treatment are still waiting for treatment. It is quite right that they should be included in the figures.

The Countess of Mar

My Lords, does the Minister agree that waiting lists whether for in-patient treatment or for consultancy appointments have always been a form of rationing in the health service? Would it not be an idea for us to open a public debate on rationing so that the general public understand that resources are finite and that various complaints can be dealt with at different speeds?

Baroness Cumberlege

My Lords, I take the view that has just been expressed by my noble friend Lord McColl that in time we should reduce waiting lists to such an extent that people are not left to wait in pain and suffering. That should be the intention of this Government.

Lord Stallard

My Lords, the Minister has mentioned the Patient's Charter once or twice. Can she tell me what redress patients will have over hospitals that fail to reach their charter targets?

Baroness Cumberlege

My Lords, the Patient's Charter is being monitored very closely not only by the immediate staff concerned but also by the management executive. The management executive has a task force that is monitoring what is going on. If people require redress they should write to the chief executive, Duncan Nichol. In addition the Patient's Charter standards are advertised on posters in hospitals and waiting rooms so that people are aware of the standard they should be receiving.

Lord Molloy

My Lords, while I appreciate the Government's acknowledgment of the seriousness of this matter, I ask the noble Baroness whether she agrees that the British Medical Association, the Junior Doctors Association, the Royal College of Nursing and the Confederation of Health Service Employees ought not to be regarded as people who do not know anything about the waiting list problem. Does the Minister also agree that these are the kind of organisations which want to be consulted to give of the best of their experience and ability to assist the Government in the problem that faces the whole of our nation?

Baroness Cumberlege

My Lords, I should be very disappointed if any single person working in the NHS was not aware of the problem of the waiting lists. We have to have a concerted effort to get them down.

Forward to