NHS Waiting Lists (Hansard, 6 December 2001)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Hunt of Kings Heath)
My Lords, the number of in-patients waiting over 12 months peaked in June 1998 and has now been reduced by over one-third since that date. At the end of September 2001, the number of patients waiting over 12 months was 44,700: that is 13,000 fewer than for the same period in 1997 and 13,600 higher than in March 1997.

§ Earl Howe
My Lords, I thank the Minister for that reply. Should not the Government be absolutely candid about the extent of the deterioration that has occurred in waiting times over the past four years? Can the Minister confirm that, in addition to those waiting over one year to receive treatment in hospital, the number of people waiting longer than 13 weeks even to see a consultant—the so-called "waiting list for the waiting list"—stands at some 400,000, which is a 60 per cent increase on when the Government first took office? Do the Government recognise that that represents a very substantial pent-up demand for secondary care? How can the limited measures announced so far make any appreciable inroads into the increasingly widespread distress experienced by patients?

§ Lord Hunt of Kings Heath
My Lords, as regards out-patient waiting lists, the noble Earl is right in relation to the figures for waits lasting over 13 weeks. However, he has ignored the fact that, for 26-week waits, the figure has come down from 113,000 to 93,000. As they have with regard to in-patient waiting times, the Government have taken a number of steps to improve the position on out-patient waits. Targets have been set for the NHS over the next three years to bring those figures down. It is also worth noting that in regard to general in-patient waiting figures, the number of patients treated by the NHS over the past four years has gone up, while since the 1998 waiting time peak, the figures have consistently come down. Furthermore, an announcement was made earlier today by my right honourable friend in another place concerning the patient choice programme which will, 940 I believe, have a dramatic effect not only on waiting times but also on the ability of patients to exercise choice.

§ Lord Clement-Jones
My Lords, contrary to what the Minister has just said, the department is slipping backwards in certain areas such as accident and emergency services, as demonstrated by the recent Audit Commission report. Nevertheless, the Government remain obsessed with structures. Only recently Mr Adair Turner has been commissioned to produce another report on the structure of the NHS. Is it not time that the Government stopped tinkering with the structure of the NHS and allowed health service staff to get on with the job?

§ Lord Hunt of Kings Heath
My Lords, that is exactly what we are doing with the changes that are being introduced. The balance of decision making is being shifted to the local level. We shall announce shortly the names and numbers of strategic health authorities that will be established. Those authorities will not be commissioning organisations, as is the case with the present health authorities. By 2004, some three-quarters of the NHS budget will he handled at the primary care level, where surely it should be.
As regards A&E services, the Government responded to the Audit Commission report by ensuring that in the future, patients will be streamed between urgent and non-urgent cases in A&E departments. That will mean that non-urgent cases will be seen according to arrangements laid down, and they will not be affected when sudden emergencies come into the departments. As specialist practitioner nurses are brought into use, we will see distinct improvements in A&E service provision.

§ Viscount Waverley
My Lords, perhaps I may remind the Minister of representations made by the Sheffield NHS Trust to bring in Chinese nurses to help to fill its staffing void. What is the Government's policy on NHS trusts being permitted to conduct their affairs without having to wait for government guidelines?

§ Lord Hunt of Kings Heath
My Lords, we are anxious to conclude discussions with the Chinese authorities and we are working with a number of trusts in this country to enable nurses from China to come to work in the NHS. So far as concerns the Sheffield NHS Trust, I was glad to meet with representatives from the trust through the noble Viscount. I have arranged for officials from the department to have further talks with those representatives. Obviously I am anxious to ensure that the trust can take advantage of its initiative as much as possible.

§ Lord Elton
My Lords, was the noble Lord able to hear the Radio 4 "Today" programme report at 8.20 this morning when it was announced that anyone who had been waiting for longer than six months for an operation could choose in which hospital they wished to have their operation, whether or not the hospital 941 was in the National Health Service? Furthermore, if the noble Lord heard the programme, was he not as surprised as I was to hear Mr Alan Milburn answering questions about the new policy on the air before he could respond to questions about it in the House of Commons?

§ Lord Hunt of Kings Heath
My Lords, I think that my right honourable friend was giving brief details, while the full details were announced in his Statement made in another place. I regret that the Opposition parties decided not to accept a similar Statement in your Lordships' House this afternoon.

§ Baroness Noakes
My Lords, while it is greatly to be appreciated that in-patient waiting lists are showing a marginal improvement, does the Minister agree that mean waiting times vary between regions and that, in particular, they have deteriorated in the South of England? Does this mean that the Government are introducing postcode waiting?

§ Lord Hunt of Kings Heath
My Lords, of course we are not introducing postcode waiting. Clearly, circumstances differ throughout the National Health Service, but that has always been a feature. We need to ensure that progress is made in all regions. As announced in the Statement made by my right honourable friend today about NHS allocations to health authorities, we are providing resources and the capability to enable the NHS to effect improvements in the waiting time position.

§ Lord Rotherwick
My Lords, it used to be possible to see a doctor within a couple of hours when one went into an accident and emergency department as an accident case. In my experience most recently—

Noble Lords
Question!

§ Lord Rotherwick
My Lords, I was coming to that, but thank you for reminding me. In my recent experience you may have to wait for up to seven or nine hours to see a doctor.

Noble Lords
Question!

§ Lord Rotherwick
My Lords, it is coming. Patience. What are the Government going to do to reverse this trend?

§ Lord Hunt of Kings Heath
My Lords, the question was well worth waiting for. The Audit Commission report on A&E waiting times, to which the noble Lord, Lord Clement-Jones, referred, identified some of the problems in A&E. It is inescapable that there has been a huge increase in the number of people using A&E departments. The first aim is to ensure that only people who need to come to A&E do so. We need to work with primary care to improve out-of-hours facilities in primary care, and to use NHS Direct as far as possible. As far as concerns A&E services, the streaming of 942 urgent and non-urgent patients is the right answer. Nurse practitioners can provide an excellent service to non-urgent patients, which will allow doctors to focus on people who really need to be seen by doctors.

§ Baroness Strange
My Lords, is the Minister aware that on Tuesday, when I went into the Lambeth accident and emergency department in St Thomas's, I saw an excellent nurse practitioner within an hour. Her name was Anne—she would not tell me the rest of her name—and she was very good indeed. I was taken there by the very kind sister in this House, for which I am very grateful. Is the Minister aware of that?

§ Lord Hunt of Kings Heath
My Lords, I was not aware, but I am very glad to be aware now.