NHS North-West Region: Waiting Lists (Hansard, 26 October 1993)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, the North-West Region is committed to driving down all waiting times. It has already ensured that no patient waits for more than two years for any treatment; and that no patient waits more than 18 months for a knee, hip or cataract operation. The region aims to reduce waiting times for all specialties to 18 months by 31st March 1994. The region has set a target for 97 per cent. of patients to be seen within 26 weeks by 31st March 1994 for their first out-patient appointment. The sum of £6 million has been earmarked in 1994–95 to make progress on those targets and the results will be carefully monitored.

§ Lord Taylor of Blackburn
My Lords, I wish that I could agree with the Minister that that was true. I have had drawn to my attention a lady in her mid-70s who suffers from rheumatoid arthritis. Her appointment to see the consultant will be roughly 24 months after the request was made. That does not tie up with what the Minister said. Will the Minister consider requesting trusts and area health authorities to publish waiting lists consultant by consultant, month by month, so that doctors and patients know exactly how long they are likely to wait?

§ Baroness Cumberlege
My Lords, I fully endorse the noble Lord's suggestion. In fact, some regions are already doing that. The Trent Regional Health Authority publishes details of its waiting lists each month. It is a good suggestion. I believe that that alone would put pressure on health authorities to ensure that waiting times tumble even faster.

§ Baroness Robson of Kiddington
My Lords, is the noble Baroness aware that the North-West Region is not the only area in which people wait a long time to see consultants? To what extent has the fact that one waits a long time to see the consultant in the first place enabled the health authorities and the Government to claim that one waits a slightly shorter time for treatment?

§ Baroness Cumberlege
My Lords, nationally, half of all admissions to hospital are immediate because they are emergency cases. Of those admitted from waiting lists, half are within five weeks and nearly three-quarters within three months.
I understand the noble Baroness's point about out-patient waiting times. The Government have insisted that every region sets its own targets for first 768 appointments for out-patient waiting times. We recognise that there is a crisis of diagnosis as well as of treatment if people have to wait too long.

§ Lord Ennals
My Lords, does the Minister accept that, quite apart from the length of time patients have to wait to see their consultants, there is a continuing and lengthening waiting period until they have their operations? I refer to the figures for last month compared with a year ago. The waiting list figure had increased by 90,000 to a total of 1,034,000. That is the highest waiting list figure since the National Health Service was established.

§ Baroness Cumberlege
My Lords, we are treating more and more people year on year. It is interesting to note that, if one looks at the number of people waiting for treatment it has actually remained at 10 per cent. of the number of patients treated. That figure has been constant for over 20 years. However, the more patients treated, the more the list appears to grow. We have to try to break that link.
The waiting times are reducing. The number of people who need treatment is increasing. But that is not the point. The point is the length of time those people have to wait.

§ Lord Williams of Mostyn
My Lords, does the Minister agree that the most disturbing feature underlying the noble Lord's Question is that the figures for waiting lists in the North-West area have been increasing month on month? Those figures were 95,342 in June; 96,194 in July; and 96,591 in August. In that context, will the Minister indicate the projected waiting list figure for the North-West area on 31st December of this year?

§ Baroness Cumberlege
My Lords, I should like to reiterate to your Lordships' House that it is important to look at how long patients wait, not how many are waiting. Since March 1991 the North-West Region has reduced the number of patients waiting over one year from 14,004 to 7,600 at the end of August 1993. That is a 46 per cent. reduction. I think that that is a tremendous achievement. At one time we thought that waiting lists were here to stay. Through the reforms, the measures we have taken and the amount of money we have invested in the waiting list fund, waiting times are tumbling.

§ Lord McColl of Dulwich
My Lords, does my noble friend agree that, in the days when the noble Lord, Lord Ennals, was Secretary of State, the names of those who were given dates for their operations were removed from the operating lists? Hence the operating lists in those days were shorter.

§ Baroness Cumberlege
My Lords, my noble friend is better at history than 1 am.

§ Lord Ennals
My Lords, does the Minister agree that many people are not being put on lists because they know that they will have to wait such a long time? The figures are therefore being distorted in any case.

§ Baroness Cumberlege
My Lords, that is not true at all.

§ Lord Taylor of Blackburn
My Lords, is the Minister aware that, when my noble friend Lord Ennals was Secretary of State for Health and I was chairman of an HMC, we were in a position to have much shorter waiting lists for the same group than today?

§ Baroness Cumberlege
My Lords, medicine has changed radically during those years. Today we do things that we would never have dreamt of all those years ago. Hip replacements are now becoming almost routine where people used to spend their last days in wheelchairs and even bathchairs, going further back. That is not the case today. Cataract operations ensure that people end their days being able to read the newspaper—I am not sure whether or not that is a good thing! We really cannot compare things with 20 years ago.