National Health Service (Hansard, 25 July 1994)

§ Baroness Cumberlege
No, my Lords.

§ Lord Stoddart of Swindon
My Lords, that Answer is disappointing. Is the noble Baroness aware that the National Health Service is under severe criticism not only from the doctors and nurses, but also from the many others who work in the service including those dentists who still remain within it? Is she further aware that there has been criticism from the health service ombudsman; and even Anatole Kaletsky does not believe that the Government are right in operating a market system within the National Health Service? Does not the noble Baroness accept that the people of this country are confused? They deserve a full-scale inquiry whether by the means I suggest or any other means to ensure that they can be confident that the National Health Service is being run properly.

§ Baroness Cumberlege
My Lords, one must see from where the criticism arises. It is interesting to note that the recent OECD economic survey said that recent national attitude surveys suggest some increase in satisfaction with the way in which the NHS is run, both among recent users of the service and among the population as a whole. The same surveys also point to a decline in dissatisfaction with specific aspects of NHS hospital services since the late 1980s. The point of a Royal Commission is that it must deal with specific problems. The government reforms to the National Health Service are not a problem; they are a success.

§ Lord Rea
My Lords, as the noble Baroness does not feel that such a Royal Commission would be useful, will the Government consider setting up a commission with a much wider remit to look at the disturbing difference in health and mortality between the various social classes? The most under-privileged experience the worst health and make the most impact on the National Health Service. Since the Black Report of 1980, information has steadily accumulated which reveals the primary importance of this great and increasing difference between the health in different social classes in this country.

§ Baroness Cumberlege
No, my Lords.

§ Baroness Gardner of Parkes
My Lords, does not the Minister agree that the problem with the health service is the unlimited demand of improving medical science? Not only in this country but also throughout the world there are only limited resources available.

§ Baroness Cumberlege
My Lords, my noble friend is absolutely right. Every year we treat more and more patients and we know that more and more patients want 522 treatment as the techniques develop that enable us to do the things that we would not have dreamt of doing 10 or 20 years ago.

§ Lord Strabolgi
My Lords, is the noble Baroness aware that one matter into which a Royal Commission could look is the question of research? Is she further aware that when, last Thursday, I asked her about the fact that five distinguished genetic researchers were leaving this country to go abroad because of the troubles and difficulties they were experiencing with the NHS, the noble Baroness—I do not blame her because the question was at short notice—gave the impression that they were leaving to go to other jobs and that it was in the order of things for such distinguished people to move about the world? Has the noble Baroness seen the fuller report in The Times of the following day which said: Genetic researcher blames reforms for NHS exodus"? Another distinguished professor said, What the Government is doing to the NHS is suicidal … They are repudiating its research base". Will the noble Baroness now put the matter right?

§ Baroness Cumberlege
My Lords, two reviews are being conducted. One has been published and that was carried out particularly for the postgraduate special health authorities of London. It was chaired by Sir Michael Thompson and recommended a programme for research to support successor NHS trusts—that is, successors to the special health authorities—of £200 million a year. Another much wider review is taking place under the chairmanship of Professor Cutler and that will be published in due course.

§ Earl Russell
My Lords, in the light of the question posed by the noble Lord, Lord Strabolgi, will the noble Baroness look at the debates on the National Health Service and Community Care Act 1990 and on the Tomlinson Report? Will she take note that the view was then expressed that concentration on hospitals as units for "teaching patients" was leading to ignoring their interest as centres for teaching and research? Does the Minister feel that those fears were justified?

§ Baroness Cumberlege
No, my Lords.

§ Baroness Jay of Paddington
My Lords, is it not clear from the exchanges this afternoon that the force of my noble friend's Question is exactly right? We need a national inquiry into what is happening in the health service. There are clearly many varied views on the matter. Perhaps I may briefly quote from a leading academic, who said: What is required is a thorough policy audit designed to evaluate the effects of the reforms on the main objectives of the NHS: efficiency, effectiveness, equity, comprehensiveness, acceptability". That is surely what we need.

§ Baroness Cumberlege
My Lords, the reforms are very new; they are just getting under way. Already we are seeing some interesting results from those reforms. Trust hospitals are treating more patients than others. They are leading the way. GP fund holders have been praised by many organisations, including the OECD. We are seeing the health of the nation improved through 523 The Health of the Nation strategy. It would be a waste of time and money to review the reforms when we are already seeing such progress being made.