National Health Service — 29 Jun 2000

That this House deplores the Government's continued distortion of priorities in the National Health Service through its focus on political targets rather than clinical outcomes, its waste of scarce NHS resources, which would be better spent treating patients, on propaganda exercises, the bogus "national consultation" and a new logo, its manipulation of the appointments system within the NHS and its continued political interference in day to day management, creating a climate of fear and frustration which is driving good NHS managers out of the Service, and its failure to live up to its promises to end post-code rationing and to put patients first; and notes the huge gap between Labour's promises on health at the last General Election and the reality today, which is that, for the great majority of the British people, the NHS has got worse, not better, under this Labour Government.

Publication of a damning report into a care in the community patient who killed his girlfriend in London has been postponed in a Government attempt to control bad news.

Independent experts were instructed by the Department of Health to delay the inquiry report, which was due out today, because it would clash with a "big news day" on health, with Health Secretary Alan Milburn expected to make a major announcement.

One particularly damaging development in the Conservative years has been the emergence of a culture of fear in the NHS . . . We believe that all staff should be able to speak their minds.

Substantial cuts in the budgets of health programmes for some of Britain's poorest communities--

have been agreed by Ministers.

The Independent reports that another letter said:

Since the abolition of Extra Contractual Referrals in 1999 many patients with conditions such as movement disorders, spinal injuries and severe chronic pain syndromes are no longer able to benefit from treatment outside their local area. The current funding arrangement, known as Out of Area Treatment Allocations . . . operates under a fixed annual budget regardless of demand for operations. No mechanism now exists for the transfer of funds from Local Health Authorities to specialist centres.

We are told that since the abolition of ECRs no mechanism exists for the transfer of funds to follow the patients that urgently need our help. Consequently our waiting lists continue to grow and we are

unable to treat these patients with the procedures they need. We have gone backwards since last year and the year before. This is unacceptable.

Those who continue to rely on the NHS for their health needs should not expect an analogous level of care.

The plans will require substantial extra work from staff at a time when we are facing disintegration through the loss of mental health services, community hospitals and community services.

computers, printers, financial forms and stationery will be changed and new equipment for cashiers, vending machines and car parks required.

It is likely that management consultants may be needed to support the process.

the current waiting time for heart surgery is 12 months.

To get to the point, my father recently died in Wycombe General Hospital of a hospital-acquired infection, MRSA septicaemia--

PS. The money spent on the recent NHS publicity stunt could have been better spent on some mops and disinfectant for hospitals.

Ministers should not be issuing endless circulars on everything from cleaning to catering.

He opposed having cleaning standards yesterday, but today he wants cleaning standards.

There is absolutely no ideological barrier to using private beds. If there is a policy which prevents this, it should be removed. I will look into this.

We want to abolish the private sector altogether. I would love to see it go altogether

we are not prepared to trade off being free and fair for efficiency and responsiveness to the demands of patients.

I am a G.P. in Wolverhampton. I went straight from a State School to Cambridge University, much the same background as some of the Labour Government's M.P.s, though I gather some went from public school, a privilege my farming parents could not afford for me.

I thought the Labour Government would reward our changes. . . I have never felt like resigning from the N.H.S. before. I knew that Labour would not change the N.H.S. and education as per election promise, but I never expected to be blamed myself for their failure.

I am disgusted with Mr. Milburn's lack of respect for me and my team. You have got to get this across to him, he has to stop bashing doctors and the N.H.S. just because Labour hasn't delivered. All our efforts . . . are rubbished by him.

I met Mr. Dobson. I believe he was "passionately" committed to the N.H.S. which is why Mr. Blair got rid of him when he realised that Doctor-bashing was the political answer to their problems.

I am now worried that I will leave the N.H.S. if Labour is returned at the next election. I fear that other forward-thinking practitioners who have that option will also go. This will wreck Primary Care. My patients and others need to know the consequence of voting Labour. Tell them. I will tell my patients.

I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:

'welcomes the decision to prepare a National Plan for the NHS in England, bringing together doctors, nurses, patients' organisations and others working in the NHS to set out priorities for the modernisation of the NHS; welcomes the largest sustained increase in funding in the history of the NHS; and rejects the use of taxpayers' money to subsidise private medical insurance.'

My departure from the front bench followed a high-octane row about my affirmation that there are distinct limits to the scope for private provision in healthcare. I trust no-one suspects me of plotting wholesale privatisation.

The biggest problem that we have in the NHS is that it is not a proper market.

hip and knee replacements, and cataract and hernia operations

It is not important to us where treatment is carried out--simply that it is carried out in the appropriate time and of the appropriate quality. We must also ensure that the system works effectively to deal with debilitating if not life-threatening conditions such as patients requiring hip replacements or cataract surgery. One of the solutions is to have stand-alone surgical units dedicated to these procedures without the pressures of having to deal with emergencies. It is an attractive idea which I hope the Government might include in the national plan.

people would look to the NHS to provide them with service when they had serious, life-threatening conditions--

and we have no argument about that. He went on to say that people

would look to their private insurance to help them with those things where the NHS has to ask them to wait a little bit longer.

where the NHS has to ask them to wait a little bit longer?

£345,000 to pay for GPs' late surgeries

I want to go to the hospital of my choice, on the day I want, at the time I want. And I want it on the NHS.

There is now less choice than ever in the history of the NHS.

since the abolition of extra-contractual referrals no mechanism exists to transfer funds to follow the patients that urgently need our help. Consequently, our waiting lists continue to grow and we are unable to treat these patients with the procedures they need.

Everyone who has access to other forms of healthcare should be encouraged to use them.

We see this as the first major step to putting the health service on a sound long-term funding basis.

Surely it is time to get away from the sterile battle lines of public and private and instead look to how the two can best work together in the interests of the citizen--and in the interests of all citizens, at that.

There is a myth in the Labour movement that any form of health provision from outside the national health service is by definition tainted by with capitalism or private profit. There is more to it than that.

The first is to settle how the NHS raises its funds. We live in an age when most voters are not keen to increase income tax. Practically all voters see national insurance contributions as an insurance payment and not a tax. The Government should commit itself to transferring tax-based NHS expenditure to a national insurance base.

We've tended to take a pride in how idiosyncratic we are. This is a very doctor-centred view of our function--it's as though we are entertaining ourselves rather than providing care.

If you need a hip replacement or other major operations you will have to go private. If you need to see a GP you will be charged under the Conservatives.

This is how much the Tories want you to pay.

Health Privatisation. Guaranteed. The Tories would make patients go private for hip and knee replacements and other major operations.

Expressions which are unparliamentary and call for prompt interference include:

The imputation of false or unavowed motives.

The misrepresentation of the language of another and the accusation of misrepresentation.

performance . . . is shown to compare unfavourably with that of many other countries in several respects . . . there is inadequate finance both in regard to capital and running costs . . . the imperfections of our health service are clearly visible . . . staffing is deficient at all levels and many sections are underpaid . . . it appears probable that Britain must think in terms of additional expenditure on medical care of an order which no government has ever contemplated . . .

if the Conservatives are elected again there may well not be an NHS in five years' time--either national nor comprehensive.

Our fundamental purpose is simple but hugely important: to restore the NHS as a public service working co-operatively for patients, not a commercial business driven by competition.

gradually deteriorating because we blame everything on the previous government.

Another doctor working in the national health service--Margaret Cook, the former wife of the Foreign Secretary--said:

The NHS is still grossly underfunded and Labour have done not a thing.

national waiting list diverts attention away from the issues that matter most to patients. By focusing simply on the number of people waiting for treatment after seeing a hospital consultant, the list ignores the time people are waiting and the severity of their need.

Relatives and friends of patients in Portsmouth hospital are being asked to help wash and feed their loved ones because of a drastic shortage of nurses.

Notices are being handed out at Queen Alexandra Hospital, Cosham, and St. Mary's Hospital, Milton, asking for help to wash, shave and feed patients.

It is the first time Portsmouth Hospitals NHS Trust, which runs QA and St. Mary's, has approached relatives, friends and carers for help in this way.

This is the worst winter I remember in terms of pressure.

Everybody's thoroughly fed up. Staff are leaving in droves because they have had enough.

Patients and their relatives keep moaning at us all the time when we're struggling to make the best of a bad job.

Staff are absolutely exhausted. I don't know how they can carry on at the pace they are. Some nurses are going off-duty in tears because they can't give the care they want to give.

The news comes as new Patient's Charter figures for Portsmouth hospitals show the worst recorded performance in two-and-a-half years--

There were 251 operations cancelled at Portsmouth hospitals from last December to March. Earlier this year The News reported Portsmouth hospitals were suffering their worst beds shortage for 25 years . . . spokeswoman . . . Mrs Forsyth, said both hospitals were still on red alert--an emergency status to show a lack of beds. They have been on red alert since mid-December which is a record.

Tax relief for private health insurance would in many cases help those who could already afford private cover and so fail to deliver a net increase in private sector provision.

If we simply boost demand, for example by tax concessions to the private sector, without improving supply, the result would not be so much growth in private health care, but higher prices.

It's the only thing I've found that really unwinds me.

So there we are. That treatment is available in the House of Commons, but not in the nation as whole. I am glad to see the hon. Member for Rother Valley (Mr. Barron) nodding; I do not think that he has ever nodded in favour of any of my speeches in the past.

Early life . . . Social inclusion . . . Addiction.

Improving and integrating services, to increase their effectiveness efficiency and responsiveness;

Developing the infrastructure to underpin the HAZ.

is associated with reductions in acute bed provision of about 30% and cuts in operating and staff numbers of up to 25%. In the 11 first-wave schemes financed through the initiative over 2,500 beds will be lost over the next five years.

We'll reimburse them within 24 hours and also split the difference with them of the higher insurance price we'd expect to be charged. But it's ridiculous that this system occurs. There's no doubt in my mind that many charges rendered for private medicine are excessive.

I've got to confess to you. In 1996, we really thought that things couldn't get any worse, but we found out we were wrong.

cast a shadow of fear over millions of homes

come down like a ton of bricks on anyone who co-operated with the private sector.

Following the Budget announcement in March, the Prime Minister offered to include us in the policy-making process . . .

fundamental shift in government thinking that has given us the opportunity to help shape policy and have a say in how the significant extra investment in the NHS pledged in the Budget will be spent.

Tony Blair has challenged us to deliver change in return for extra investment. We are more than willing to meet that challenge.

Mr. Blair, your plan is eagerly awaited by every doctor in this conference hall and every doctor on the NHS frontline.

He--the Chancellor--can either reduce taxes or he can increase public spending. What I would recommend is that he use the money to reduce taxes.

Question , That the Question be now put, put and agreed to.

Question put accordingly, That the original words stand part of the Question:--

The House divided: Ayes 122, Noes 278.

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