HL Deb 28 March 1996 vol 570 cc1832-4

3.17 p.m.

Lord Winston asked Her Majesty's Government:

How many of London's health authorities or hospital trusts have this year agreed contracts with private hospitals to treat patients on waiting lists because of bed shortages in the NHS; and how many patients are involved.

Baroness Cumberlege

My Lords, the Department of Health does not routinely collect that information.

Lord Winston

My Lords, it is a fact that a number of NHS patients are being treated in the private sector by NHS staff. Is the noble Baroness aware that, while the Government continue to deny that bed and nursing shortages lead to that situation, it must be cheaper, more efficient and a better use of resources to treat NHS patients on waiting lists in the NHS hospital where they were assessed?

Baroness Cumberlege

My Lords, the NHS has always used the private sector. We only have to look at the purchase of drugs that come through commercial firms, the use of builders and contractors—and in the 1980s the health authority that I used to chair used a private laundry to very good effect—to realise that there has always been a mixed economy in the NHS. It seems right that if we are to reduce the waiting times, as we have so successfully done, when it comes to the peaks it is clearly appropriate that the NHS should use all the facilities in this country and treat people, if that is what they want, in private hospitals.

Baroness Gardner of Parkes

My Lords, is my noble friend able to confirm the statement made to us this morning at a meeting of the North Thames health authority that there has been a dramatic and remarkably good improvement in the waiting list times? Does that apply in the same way in other parts of the country?

Baroness Cumberlege

My Lords, yes. Last year in the London regions we saw a reduction of 16,000 patients waiting over one year for treatment and, for the first time ever, nobody waited 18 months. Nationally, half of all admissions are emergencies; of the remaining 50 per cent., half are admitted within six weeks and nearly three-quarters within three months. We have seen the waiting time fall from an average of nine to four months.

Lord Monkswell

My Lords, given the Government's introduction of an internal market within the National Health Service—presumably to identify the costs of treatment and to promote treatment at the lowest cost—is it not curious that the Government do not possess figures on the use of private medical facilities compared with those of the National Health Service? Are they taking any steps to obtain that information?

Baroness Cumberlege

My Lords, it is a matter for individual health authorities and trusts to decide the best way of meeting the needs of patients within their area or patients who are waiting to go to their hospitals for treatment. On occasions, this may mean that services are purchased through private hospitals. We see nothing wrong in that.

Baroness Nicol

My Lords, are the people on the waiting list those who have seen a specialist and are now waiting for treatment, or does the waiting list include those waiting to see a specialist? Is that information collated separately?

Baroness Cumberlege

My Lords, these are people who are waiting for their operation having seen a specialist; but we recognise the point the noble Baroness makes concerning the waiting time between when the GP sees the patient and referral. That will be included in future.

Baroness Jay of Paddington

My Lords, is the Minister aware that the Fitzhugh Directory of NHS Trusts, which, perhaps unlike the Department of Health, is trying to gauge the national position and is a reputable organisation, this week published figures showing that the vast majority of trust hospitals in the country are making a profit from their use of private patients within hospitals? Surely it would be better, if there is capacity to treat private patients within NHS hospitals, that the hospitals should first of all clear their waiting lists of health service patients rather than using their facilities for private patients.

Baroness Cumberlege

My Lords, if an NHS hospital has a private wing, it is treated totally differently. We ensure that waiting lists are strictly controlled and that no NHS patient is disadvantaged because there is a private wing. I would add that the income to the NHS from providing private services is enormous and that helps NHS patients.

Baroness Jay of Paddington

My Lords, I am very sorry to come back to the Minister, but if the department does not know the position regarding the distribution of waiting lists and beds, as the Minister suggested in her reply to my noble friend Lord Winston, it is difficult to understand how there can be a nationally rational plan for distributing resources in the way she now suggests. Surely one of the problems is that individual trusts wish to make a profit from private patients on their premises and do not clear the waiting lists by using those beds. That is happening particularly in London.

Baroness Cumberlege

My Lords, if they do so they are contravening the guidance. I would want to know individual cases if the noble Baroness feels that is happening.

Baroness Gardner of Parkes

My Lords, is my noble friend aware that in the Royal Free, of which I am chairman, we have a private floor which contributes enormously in income to the National Health Service, but if we need beds for National Health Service patients, they are given those private beds?

Baroness Cumberlege

My Lords, I am grateful to my noble friend for that detailed advice.

Lord Winston

My Lords, I should like to come back to my original Question. In the case of one trust I know NHS patients are being treated for orthopaedic and plastic surgery. The private hospital has to pay extra for the anaesthetist who anaesthetises those patients. The problem is that one cannot have an anaesthetist being on call in an NHS hospital and at the same time operating in a private hospital. Consequently, there is some extra cost to the NHS. Is the Minister aware of that problem?

Baroness Cumberlege

My Lords, we have been determined to reduce the waiting times for patients. I suspect that the noble Lord is referring to the Hammersmith, in which he works. There are 53 patients now being treated at the Royal Masonic Hospital who were on the waiting list at the Hammersmith. I am sure that if he spoke to those patients, they would be extremely grateful to know that they are getting immediate treatment in very good surroundings.

Baroness Hooper

My Lords, does my noble friend agree that private hospitals still provide a very small percentage of healthcare treatment in this country? To my memory it is about 10 per cent. of healthcare. Does she further agree that this treatment provides an important competitive edge for the National Health Service?

Baroness Cumberlege

My Lords, my noble friend is right. This subject comes back to the philosophical point: what is the National Health Service? The National Health Service is one free at the point of delivery to those in clinical need regardless of their means to pay. We totally adhere to that principle. Whether people are treated in a National Health Service Hospital or a private hospital, as long as they get the treatment quickly, the quality is high and the service is efficient, they are very grateful, in my experience, to be treated.