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Market Testing
4. Mr. Purchase: To ask the Secretary of State for Health how many NHS services have been market tested. [5613]
The Parliamentary Under-Secretary of State for Health (Mr. Simon Burns): The national health service executive market testing database has evidence of 86 services that have been market tested or are planned to be market tested.
Mr. Purchase: Does the Minister recognise that the entire exercise has been characterised by a reduction in services throughout the NHS? In my constituency, an organisation called Trident, which was formerly known as Hospital Services, had to change its name to gain new contracts--hon. Members may speculate about why that was necessary. The contract is failing to deliver promised savings and there has been an attempt to reduce the number of hours worked by people in the service. A constituent who works as a cleaner with the Wolverhampton health service has been forced to clean using water with no additives. Does the Minister believe that market testing is justified in those circumstances?
Mr. Burns: I am afraid that the hon. Gentleman utterly misunderstands the purpose and benefits of market testing. He fails to see that market testing is improving standards, particularly in laundry and other hotel services. By enhancing standards, market testing is saving the health service between £100 million and £150 million, which is then used to provide extra health care for patients. The hon. Gentleman should support that initiative. In addition, the trust that has taken out the contract is more than happy with the service being provided. I suggest that the hon. Gentleman gets a better briefing from UNISON, which seems to be misleading him.
Mr. David Shaw: How much has market testing saved us in terms of additional operations in the health service? Have not efficiency savings led to a considerable increase in the number of patients who are treated through the health service?
Mr. Burns: I am extremely grateful to my hon. Friend, who puts his finger on the most important issue. Market
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testing is resulting in improved services and, since it began in 1983, it has saved the health service about £1 billion--about £100 million to £150 million a year. That means more hip and cataract operations and more acute service provision in the health service.Total Purchasing Initiative
5. Mr. Congdon: To ask the Secretary of State for Health how many general practitioners have expressed an interest in the Government's total purchasing initiative. [5614]
Mr. Malone: There are 82 national total purchasing pilots comprising 322 practices. We understand that many other sites have expressed interest in such pilots. We will consider how to respond to this in the light of the National Health Service (Primary Care) Bill, which is currently before Parliament.
Mr. Congdon: I warmly welcome the growth in fundholding, and its extension via the total purchasing initiative, which is popular with GPs and patients. Given the success of fundholding, does my hon. Friend agree that it would be quite wrong to abolish it, as is proposed by the shadow health spokesman?
Mr. Malone: My hon. Friend is right. At least we have an end to the equivocation about replacing or evolving fundholding: we now know that the Labour party would abolish it. The advantages that have accrued to patients and to general practitioners from total purchasing pilots would be lost if the Opposition had their way. Unlike fundholding under this Government--which is a voluntary principle carried forward in the National Health Service (Primary Care) Bill before the House--Labour would force general practitioners into commissioning groups. It would become chain-gang commissioning, which is anathema to this side of the House.
Community Health Councils
6. Mr. Pike: To ask the Secretary of State for Health what representations his Department has received regarding possible changes in the role and functions of community health councils. [5615]
Mr. Horam: I have received a number of representations regarding the role and functions of community health councils, in connection with the report on the resourcing and performance management of community health councils, which will be published shortly, inviting comments.
I assure the hon. Gentleman that we value the role played by CHCs, as independent statutory bodies, and have no intention of changing either their role or their functions.
Mr. Pike:
Is it true that the performance of CHCs will be reviewed? If so, who will conduct the review and how will that be done? Is it not essential that CHCs continue to be the patients' representatives in the national health service?
Mr. Horam:
I agree entirely with the hon. Gentleman's assertion that CHCs should continue to be the patients'
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Mr. Rowe:
Does my hon. Friend accept that one of the functions of CHCs is to help patients to make complaints? One of my local provider trusts sent out 35,000 invitations to households to attend its annual meeting. Only one patient and his wife attended. Does not that suggest that, contrary to the stories peddled by the Labour party, satisfaction with the way in which the national health service is working is very high?
Mr. Horam:
Indeed it is. As my hon. Friend will be aware, the settlement, particularly as regards Kent, is another feather in the cap of my right hon. Friend, who has fought continuously for extra funds for the national health service.
7. Mr. Hanson:
To ask the Secretary of State for Health if he will make a statement on the number of people currently waiting for NHS operations. [5616]
Mr. Dorrell:
Half of all admissions to hospital are immediate. The latest available provisional figures, for 30 September, show that 1,060,150 people were waiting for admission. Of people waiting for admission, four out of 10 will be admitted within one month, half within six weeks and more than two thirds within three months. Fifteen thousand people--one in 70--were waiting longer than 12 months.
Mr. Hanson:
Will the Secretary of State take this opportunity to welcome the Labour party's pledge to reduce the number of people on waiting lists--particularly for cancer operations--by 100,000? Will he recognise that that will benefit many of my constituents in north Wales, for which he is not responsible, and those who use Clatterbridge hospital in the Wirral? Will he take the opportunity today to recognise the pledge and support it in the House?
Mr. Dorrell:
I do not support the pledge, because everyone who works in the health service knows that what the shadow health spokesman said at the Labour party conference is nonsense. To talk about a waiting list for cancer surgery is to talk about a waiting list that does not exist, and when the Labour party, which voted against the abolition of regional health authorities, talks about £100 million of administrative savings, it convinces nobody. The Government have delivered 25,000 more doctors and 55,000 more nurses to the NHS since 1979. That is why we are treating more patients. We have also cut the average waiting time for waiting list patients from nine months to four months. That is the reality of the Government's record on waiting lists.
Mr. Garnier:
Will my right hon. Friend confirm that the three major acute hospitals in Leicester, which serve
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Mr. Dorrell:
As every Leicestershire Member of Parliament knows--including Labour Members of Parliament in Leicestershire--because we have been told by Leicestershire health authority, there is no proposal to reduce the number of acute hospitals in the city of Leicester. It is blatant scaremongering to suggest otherwise. What is going on is a review of acute service provision in Leicestershire to ensure that we deliver the most effective and efficient health care that we can to the people of Leicestershire. That, I hope, is supported by hon. Members on both sides of the House.
Mr. Barron:
My constituent, Mrs. Walker, who lives in Brinsworth, is 85 years of age. She was told in October that she will have to wait until 17 March 1998 for a hip operation at Rotherham General Hospitals NHS trust. Her surgeon told her that
Mr. Dorrell:
That is the politics of Jennifer's ear. Labour really is bankrupt on health. Now the hon. Gentleman leaps to the Dispatch Box to take up a constituency case. If he writes to me, I will take it up.
Mr. Harry Greenway:
May I welcome the progress being made towards the provision of more single-sex wards in hospitals? Will the national health service, in principle, seek to make a single-sex ward available to any patient who asks for one?
Mr. Dorrell:
As my hon. Friend knows, we have set out clearly the health service's commitment to move towards single sex provision. It is in the patients charter. It is a clear requirement of the management of the health service to deliver the patients charter. We have monitored that requirement, and we shall continue to do so. I assure my hon. Friend that that is an important priority of the management of the health service.
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"due to severe financial constraints"
he is allowed to perform only two operations a week. The hospital told me that it is
"currently exceeding the number of orthopaedic operations for which it is funded".
Is that not a direct consequence of the introduction of the internal market? We all know that the internal market uses hundreds of millions of pounds ever year on bureaucracy. Why does my constituent have to wait until 1998, in pain, for a hip replacement when the hospital, the surgeon and other health professionals are there? The only thing that is stopping it happening is the internal market that the Tories have introduced.
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