NHS Changes: Public Representations (Hansard, 18 March 1996)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)
My Lords, we receive representations for and against all our policies. We are satisfied that the changes we have introduced into the NHS are improving performance.

§ Lord Molloy
My Lords, I am truly grateful to the Minister for that reply. However, there are views different from what she has said from responsible people such as the Institute of National Affairs, which says that there has been a decline of 10 per cent. in the way that people think of the NHS. They believe it is not as good as it was. British Social Attitudes claims that the NHS, which is reasonably well run, is slowly declining and that action should be taken to redress that. The Minister should address that problem, because it seems that a wonderful service could now be on a nasty decline.

§ Baroness Cumberlege
My Lords, we are improving the health of the nation. Coronary heart disease has fallen by nearly 11 per cent.; strokes by over 5 per cent.; some cancers by over 3 per cent.; and we have nearly eliminated measles, the first country in Europe to do so. For every 100 patients treated before the reforms, we now treat 125. A recent survey of GP fundholders shows real dividends in primary care. The Patient's Charter has halved the average waiting time for elective treatment. Your Lordships, through your report Medical Research and the NHS Reforms, have warmly endorsed the NHS Ramp;D strategy. That is a very, very good record.

§ Baroness Oppenheim-Barnes
My Lords, is my noble friend aware that I have no idea to whom the institute quoted might have spoken to come by that piece of information, because the general view of people, especially those not in large city conurbations, is that the service has improved greatly; that the scope and availability of treatment have greatly improved; and that when there are occasional, widely publicised things which are unacceptable, they form a small minority, not the majority, of what is happening in the health service.

§ Baroness Cumberlege
My Lords, I totally endorse my noble friend's view. A recent survey from the National Association of Health Authorities shows that the satisfaction rate is about 86 per cent. of the general population.

§ Lord Stoddart of Swindon
My Lords, can the Minister tell us about NHS dentistry? Are there more or fewer dentists in the NHS as a result of the recently negotiated contract? Are NHS dentists treating more people these days than they were a few years ago? Have the numbers in the NHS decreased or increased?

§ Baroness Cumberlege
My Lords, we have more dentists in the NHS at the moment. The noble Lord will be aware that they can treat private patients as well as NHS patients. That has been the situation for decades. We now have more registered patients in the NHS than we had five years ago.

§ Lord Geddes
My Lords, I declare an interest as a non-executive director of an NHS hospital trust. Is my noble friend aware that the reaction that this hospital receives from the vast majority of the public is greatly in favour of the changes in the NHS and the standard of care that is being given?

§ Baroness Cumberlege
My Lords, yes; and I believe that that is true of many hospitals up and down the land.

§ Baroness Jay of Paddington
My Lords, does the Minister agree with the reported remarks of the chief executive of the NHS, Mr. Alan Langlands, who said a month ago: The efficiency drive may have gone 'a bit far'… We may need to think about qualitative aspects of care and be less concerned about always increasing throughput"? Is not the chief executive echoing the concerns expressed by my noble friend and many NHS workers and patients that what we need in the NHS is a return to public service values?

§ Baroness Cumberlege
My Lords, the noble Baroness will be aware of the Clinical Standards Advisory Group which ensures that clinical standards are maintained. The evidence-based practice and clinical audit ensures that clinical standards are not just maintained but are improved. There is an issue about efficiency. We have to be careful not to press the NHS too hard. However, patients are grateful that the average waiting time has been so reduced and that we are treating more patients than ever before.

§ Baroness Farrington of Ribbleton
My Lords, does the Minister accept that the reply she gave a few moments ago about the state of the dental service available to people under the NHS is not that experienced by a large and growing number of people? Will she give an assurance that an NHS dental service will be available to every member of the public within a reasonable distance of their homes? Does she agree that that availability has deteriorated over the past 15 years?

§ Baroness Cumberlege
My Lords, if any patient finds difficulty in gaining access to an NHS dentist he or she should approach the Family Health Services Authorities, which will ensure access.