| Previous Section | Index | Home Page |
12.44 pm
Mr. Jon Trickett (Hemsworth): Thank you for calling me, Mr. Deputy Speaker.
I associate myself with the comments made by my hon. Friend the Member for Wakefield (Mr. Hinchliffe) about a number of matters. In a recent meeting between the Members of Parliament for the Wakefield area and executives of several organisations associated with health service provision in the Wakefield area, it became clear to us that there had been a series of secret meetings of various types in Wakefield, at Quarry house in Leeds and probably in London about the future of health care
provision in the Wakefield area. It is also clear that decisions were well advanced in terms of an apparently urgent desire to bring about a fusion of the two trusts in the area.
It was also apparent that decisions had been taken about the personalities--names were known--of the putative chair and chief executive of the new trust. We were told that there would be a public consultation exercise, but it is not due to start until about July and will run through the summer. That is often a convenient time for such public consultation exercises, as many people are preoccupied taking annual leave and vacations, and so on.
We felt that we had been presented with a fait accompli and that we, as elected representatives for the area, had been excluded from the decision-making process. Not many days later, we received through the post documents indicating the early proposals to unify the trust. The documents we received--I have a copy in my hand--a formal expression of interest, are only part of a series of documents that have not yet seen the light of day, proposing the change in the health service arrangements in the Wakefield area.
We were told that it is intended to reduce what is called "duplication of services" and bring about a "centralisation of services" on one site or the other. My hon. Friends and I representing the Wakefield area feel that services will be lost to communities and removed elsewhere in the district or perhaps further afield, and that proper decisions have already been taken about that. I am worried about that and about the way in which the facts have emerged. I am also worried that health service managers in the area appear preoccupied with institutional change, perhaps at the expense of clinical concerns.
My hon. Friend the Member for Wakefield mentioned maternity care. I have in my possession a worrying document, a review of the case of a constituent, which I do not wish to go through in detail now; the Minister may be aware of it. It makes it clear that there are clinical, technical and managerial problems with paediatric care at Pontefract hospital yet, as I understand it, it has been proposed that there be an amalgamation and possibly a concentration of those services at Pontefract.
Consultant paediatricians considering the service in Pontefract have said that they have
They note that there are only three hospital-based consultant paediatricians and only one recently appointed community paediatrician. They say that
They say:
this is the important part of the sentence--
They continue:
The events to which the document refers--I hope to take up the matter with the Minister privately in due course--took place more than two years ago. According to the report that was published only last week, little seems to have been done to improve the situation. However, the local health service has employed highly paid and highly skilled professional managers to organise the planned merger, whose objectives have to do with private capital. The document refers to
The Parliamentary Under-Secretary of State for Health (Mr. John Horam):
I am pleased to have the opportunity to respond to the hon. Member for Wakefield (Mr. Hinchliffe). I congratulate him on, once again, securing time to debate the important subject of health services in the Wakefield metropolitan district. This is the seventh time in five months that he has raised the subject, which reveals his assiduity.
I have noted also the concerns, which the hon. Member mentioned, of the hon. Members for Pontefract and Castleford (Sir G. Lofthouse) and for Normanton (Mr. O'Brien). I welcome the second speech of the day from the hon. Member for Hemsworth (Mr. Trickett), who I gather made a very good maiden speech. I noted his comments about Pontefract and paediatric care.
The hon. Member for Wakefield raised a number of points, and claimed that general practitioner fundholding in Wakefield had resulted in a two-tier system. He referred to increased resources for the national health service in Wakefield, and he and the hon. Member for Hemsworth expressed concern about the possible merger of the two acute trusts in the Wakefield area--the Pinderfields Hospitals NHS trust and the Pontefract Hospitals NHS trust. They questioned whether such a merger would be truly in the interests of patients and of improved health services.
The hon. Member for Wakefield also mentioned maternity services. I acknowledge his local concerns and those of Wakefield metropolitan district council. As he knows, I can claim a little local knowledge: although I am a Lancastrian, I had the good sense to be educated in Yorkshire, at Silcoates school, Wakefield. I therefore know a little about both Pinderfields and Pontefract hospitals.
The hon. Gentleman also asked questions about the resignation of the chief executive of Pinderfields Hospitals NHS trust, Mr. Peter Ward. I stress that that is a matter for the chairman and the board of Pinderfields Hospitals NHS trust, but I shall say more about Pinderfields later.
I shall deal first with resources. In May last year, the hon. Gentleman expressed concern in the House to my predecessor, the present Under-Secretary of State for the Home Department--my hon. Friend the Member for Bolton, West (Mr. Sackville)--about the fact that
health resources for Wakefield health authority and Wakefield metropolitan district were being cut. For the 1996-97 financial year, which has just commenced, the allocation for Wakefield health authority is just more than £140 million--a cash increase of £4.3 million, or 3.2 per cent. It is also an increase in real terms.
The resources that Wakefield health authority will receive this year include, as in the previous financial year, an increase in both cash and real terms. It is wrong to suggest that, because Wakefield is a certain percentage above its weighted capitation target, there may be a cut next year or in any succeeding year. Real growth in health resources will probably continue in the years to come. If so, Wakefield will continue to receive more resources in real terms. I accept the hon. Gentleman's point about market forces, and I assure him that those elements of the capitation formula are kept under review.
Secondly, the hon. Gentleman referred to so-called two-tier services and expressed concern about the way in which the undoubted success of GP fundholding is impacting on patients in Wakefield. I assure him, once again, that there is no question of a two-tier service. We stand by our agreement with the medical profession: all emergencies are seen immediately and all urgent cases that cannot be seen immediately are placed on common waiting lists.
There will always be some variation in waiting times for non-urgent treatment between health authorities, as well as between health authorities and fundholders, because different purchasers set different priorities according to their assessment of local need within the national patients charter guarantees and informed by patients' wishes. It is open to health care purchasers to negotiate the best contracts possible on their patients' behalf. Many fundholders use efficiency savings to fund more hospital services for the benefit of patients of all local GPs. Having a range of purchasers stimulates innovation and the delivery of care for the benefit of all patients.
The NHS executive has followed up cases of suggested two-tierism, which have invariably proved to be cases of fundholders making use of spare capacity, purchasing more services and making more resources available. That benefits all patients. Fundholding is achieving not a two-tier system, but an improved health system. We want our services to be based on the standards achieved by the best, not the worst.
As recently as last Monday, my hon. Friend the Minister for Health visited the new Wakefield health authority to learn about Wakefield's pioneering plans to develop a primary-led NHS. He praised the work of the health authority and of local GPs on total purchasing, which builds on the success of fundholding. In Wakefield, 85 per cent. of GP practices are now fundholders. Fundholding has improved patient care in Wakefield through the provision of new services, including rheumatology, cardiology, a cataract centre and increased day case surgery. It has also had a marked effect on waiting times at the two acute hospitals. At Pinderfields, waiting times have been cut by 50 per cent. for general surgery, and by about 25 per cent. for ophthalmology; at Pontefract, orthopaedic waiting times are down by 42 per cent. That is real success.
"concerns about the overall staffing structure and establishment in the paediatric department".
"there is no continuous safety net cover of an experienced resident paediatrician in Pontefract."
"At the present time, the safety net cover is provided by a Registrar and staff-grade doctor and"--
"for over 50 per cent. of the time there is no safety net provision available."
"The overall staffing levels are inadequate to provide a fully comprehensive children's service to a population of this size, with 200,000 people, 2,300 births and 1,900 acute paediatric admissions per year . . . The absence of a continuous safety net cover does not allow high dependency or intensive care work to be undertaken, and yet we understand that this still takes place on occasion."
3 Apr 1996 : Column 350
"the need to convince the private sector to reinforce to potential private sector partners the commitment to partnership rather than to clinical care".
| Next Section
| Index | Home Page |