§ Mr. RedmondTo ask the Secretary of State for Health if he will list the participants, and the organisations that they represented, who attended the recent conference initiated by his Department, the Royal College of Physicians and the British Medical Association in respect of establishing a national framework for rationing national health service treatment; if he will send the hon. Member for Don Valley a copy of the letter since circulated to participants at the conference by Mr. Alasdair Liddel, giving his assessment of the conference; and if he will make a statement. [41007]
§ Ms HarmanTo ask the Secretary of State for Health (1) what(a) meetings and (b) other consultations he has had with health authorities and health commissions with regard to the introduction of a national framework for health care rationing in the NHS; and if he will make a statement; [40923]
(2) what (a) meetings and (b) other consultations he has had with any organisations representing the medical profession with regard to the introduction of a national framework for health care rationing in the NHS; and if he will make a statement; [40924]
(3) what studies his Department has undertaken regarding the introduction of a national framework for health care rationing in the NHS; [40925]
(4) what plans he has to introduce a national framework of rationing in the NHS; [40926]
(5) what report he has received about the meeting in September initiated by the NHS executive about a national framework for the rationing of health care in the NHS; who proposed that the meeting should take place; if he will list those present; if he will make available the report of the meeting; and if he will make a statement; [40927]
(6) what plans he has to hold meetings to discuss national rationing of health care in the NHS; who will participate; and if he will publish the reports of those meetings. [40928]
§ Mr. Malone[holding answer 2 November 1995]: There are no plans to introduce a national framework for rationing services and no work has taken place to prepare such a framework. In their response earlier this year to the Health Select Committee on priority setting, Cm 2826, the Government set out their approach to priority setting at three levels, in the following terms: 626W
Ministers, advised by the Department of Health, set out the framework of national priorities and targets for improvement. This is done through annual priorities and planning guidance to the NHS and through important policies such as "The Health of the Nation" White Paper and the patient's charter;Health authorities and GP fundholders assess the needs of the people they serve and decide what treatments and services are required to meet those needs. This process should be informed by proper consultation with the public;Individual clinicians decide the most clinically appropriate treatment and clinical priority for each patient, based on their assessment of that patient's needs.Earlier this year, officials in the NHS executive agreed with leaders of the medical profession and senior NHS managers that it would be helpful to meet together to discuss priority setting issues. This meeting took place on 28 September 1995 and involved a wide range of interests including patients' representatives. Views were exchanged on a personal and non-attributable basis. The note sent to participants summarising the discussion was not intended as a public document and to publish the letter would break the undertaking given to the participants.
There was general consensus at the meeting that:
- setting priorities was a necessary part of life in any health care system
- the role of Ministers and the NHS executive in setting a small number of national priorities was acceptable with no dissent about the current set of priorities.
- individual clinicians want to be free to take decisions about individual patients, but do not want to be left taking responsibility in isolation for difficult decisions
- there is scope for spreading good practice in approaches to priority-setting at local (health authority) level.