NHS: Surgeons (Hansard, 8 December 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, surgeons have no cause for concern for their future. Their continually developing and evolving skills will always be essential to the National Health Service.

§ Lord Molloy
My Lords, I am grateful for that reply from the Minister. I have been approached by many surgeons and I have been to their hospitals. Is she aware that they are concerned because they do not know just how long the hospital in which they work (such as Bart's or the Royal Marsden) will last? Is she further aware that if they have to leave they will have to take with them their specialised instruments, very specialised screening and other essential items which an ordinary doctor does not require? Surgeons are very specialised people in our National Health Service and they are very anxious at the moment. Does the Minister feel that consultation with them would be to the benefit of her department as well as the NHS?

§ Baroness Cumberlege
My Lords, I am very well aware of the anxiety and uncertainty felt at the moment, especially in London. As I explained to your Lordships' 946 House, if there are changes in hospital services they will go out to consultation and the staff will be involved very closely in that consultation.

§ Lord Ennals
My Lords, will the Minister confirm that one of the reasons why there has been a postponement of the reduction in the hours of junior hospital doctors is that there appears to be a shortage of consultants in post? Can she explain why that is. so and what action she is taking to deal with it?

§ Baroness Cumberlege
My Lords, there are very few areas in which there are shortages in terms of specialties. But there are a few, including paediatrics, anaesthetics and psychiatry. We are addressing those issues, particularly the paediatric shortage, which we believe we shall be able to overcome quite shortly.

§ Lord Finsberg
My Lords, does my noble friend agree that another reason for any possible feelings of insecurity, not merely among surgeons but among nurses and physiotherapists, is the scare stories peddled by UNISON and the Labour Party?

§ Baroness Cumberlege
My Lords, that is absolutely right. A great deal of strife, comment and rumour are circulating at the moment. That is picked up by the press, who enjoy it and use it to sell their newspapers.

§ Lord Ewing of Kirkford
My Lords, does the Minister agree that, without wanting to spread scare stories, uncertainty in the professions in this country is so widespread that the only two professions with any certainty at the present time are undertakers and Members of your Lordships' House? The connection for the moment escapes me.

§ Baroness Cumberlege
My Lords, I am sure that your Lordships are grateful for the second comment made by the noble Lord. The uncertainty is predominantly in London and perhaps there is a little in other major cities. Throughout the rest of the country the National Health Service is in a stable condition.

Lord Bruce of Donington
My Lords, is the noble Baroness aware that there is at any rate one certainty? Those who can pay for (their treatment obtain it promptly. A two-tier service exists now and it is getting worse.

§ Baroness Cumberlege
My Lords, I totally refute that. Waiting times have come down considerably. In London the waiting list has shrunk by 40 per cent. We are giving treatment more quickly to those who need it.

§ Lord Stallard
My Lords, does the Minister accept that the main reason for the uncertainty among the professions is the delay in the announcement with regard to the future of the London hospitals? We were promised that we would hear something before Christmas. Is that still a firm bet?

§ Baroness Cumberlege
My Lords, my right honourable friend the Secretary of State will make an announcement as soon as possible.

§ Lord Howell
My Lords, as regards cities such as Birmingham, is the Minister aware that security for 947 medical staff is not helped by such acts as the Secretary of State carried out recently? She arrived at the headquarters of the West Midlands Health Authority before talking to anybody and before reading the paper drawn up by all the consultants in every hospital in Birmingham. The paper concluded that hospitals were full to overflowing, that there were no empty beds and, in their view, only 1 per cent, of patients should not be in hospital. Before reading that paper the Secretary of State arrived in Birmingham and told the press that there were too many beds, too many hospitals and therefore some had to be closed down. Was that wise action?

§ Baroness Cumberlege
My Lords, services in every city are being considered. That is what the management in the health service is requested to do; it is part of its job. This country is fortunate in having my right honourable friend, who is careful to ensure that she visits services before decisions are taken. She knows the National Health Service better than almost anybody. The fact that she is prepared to make those visits is something that we should all applaud.

§ Baroness Robson of Kiddington
My Lords, does the noble Baroness agree that the feeling of uncertainty among surgeons and others must be much greater for those in the lower echelons of the service, particularly in London hospitals? After all, a surgeon has the chance to move to another hospital which will take over his specialty. We should be much more concerned about the people a long way below the line—the porters, the domestics and cleaners—who will feel the pinch much more.

§ Baroness Cumberlege
My Lords, for consultant and nursing staff, we set up a clearing house in London to enable them to find jobs in other parts of the country. Indeed, on my travels I see some of the people who have moved from London to work in Newcastle, Southampton and other cities. But the noble Baroness is right: it is absolutely essential that when services move we look after the interests of all staff concerned. Many services will not close; they will move to other buildings. But I appreciate, for example, that for people on low incomes that can present a real difficulty.

§ Lord Carter
My Lords, can the Minister say how the department proposes to deal with the problem of operating sessions which are cancelled due to lack of funding, leaving surgeons, trained nurses and equipment idle? Only this week I was told of a consultant whose operating sessions on the NHS were reduced from seven to two per week. He now spends the balance of that time in the private sector.

§ Baroness Cumberlege
My Lords, when one looks at the situation in London, it is interesting to note that the number of consultant staff is twice that in inner city areas in other parts of the country. Over the years we have got out of kilter. We are telling health authorities and hospitals that they must live within their means. If that requires doing less work, then that is what they must do.

§ Lord Carter
My Lords, is the Minister saying that she is satisfied with a situation where "doing less work" means a surgeon who was giving seven sessions a week to the health service is now giving two?

§ Baroness Cumberlege
My Lords, I am saying that the distribution is uneven. That is one of the issues that we are trying to tackle in London. Clearly where surgeons are required in other parts of the country they will be used. We need more surgeons, but at the moment there is a concentration of them in London which presents some of the problems which are so evident.

§ Lord Molloy
My Lords, can the Minister confirm that it is the intention of the Minister of State to visit all NHS top management and leaders of the medical profession? Both bodies agree that that would be helpful and hope that the noble Baroness can confirm that this afternoon. Both the leaders of the medical profession as well as top management believe that it is time that the Minister of State, rather than the Secretary of State, met them to discuss the whole situation. They are happy that that is going to happen. Can the Minister say also whether it is true that a leading London teaching hospital is to sack 500 members of staff to reduce costs? If that is so, specialists, doctors and surgeons believe that the remedy provided by the Government and the department is worse than the disease.

§ Baroness Cumberlege
My Lords, the Minister of State for Health has been both assiduous and diligent in visiting hospitals before any decisions are taken. But we shall see changes in London; we make no bones about that. Clearly we shall see fewer staff working in the health service in the future, as I have already told your Lordships.