Mr. Mike Hall (Warrington, South): I thank my hon. Friend for raising this issue. I believe that the document has been published, but that the region did not want to release it to me in time for yesterday's debate. It is a cover-up, and the Minister should first apologise and then give a commitment that the report will be placed in the Library. Then we shall all be able to see for ourselves whether that intensive care report submitted to Alan Langlands and the Secretary of State does indeed show that there is a problem in our region.

Mr. Hoyle: I hope that not only that report, but similar reports from every other region, will be released to the Members of Parliament who need to see them. Otherwise, it will be impossible for us to be well informed and to do the job that our constituents sent us here to do. That shows above all else that there must be a crisis in intensive care throughout England and Wales.

10.37 am

Mr. Kevin Barron (Rother Valley): I congratulate my hon. Friend the Member for Leeds, East (Mr. Mudie) on securing a timely debate on an important issue. I thank him for the measured way in which he spoke of a distressing incident involving the death of one of his constituents, whose family obviously took it very hard. I hope that we do not hear more of the accusations of shroud waving that we heard in yesterday's debate. We are all here to represent people and, I hope, the national health service itself. If attention is drawn to the deficiencies in the service, that should not be interpreted as shroud waving. We should be engaging in an honest and earnest debate about the problems in the NHS.

That brings me to what was said yesterday, and what was said today by my hon. Friend the Member for Warrington, North (Mr. Hoyle), about the report on the Warrington intensive care unit that has allegedly been published in the north-west. If that report has indeed been published, it should be available to hon. Members, and also to the public in the north-west, who pay taxes and use the NHS. I hope that, if it has been suppressed internally, the Minister will sort the matter out.

I am sure that hon. Members on both sides of the House have noted the growing concern about what is described as the "winter crisis" in the health service, which has appeared to increase daily. Across the country, intensive care bed capacity has been stretched to the limit because of seasonal upturns in emergency demand. It is clear that there are simply not enough intensive care beds to cope with what most of us would consider to be reasonable demand for this time of year.

Clinicians are unable to perform other surgery in hospitals because intensive care beds are full. Operations are being cancelled, and waiting times are increasing because of insufficient spare capacity in the system to cope with sudden fluctuations in demand for emergency

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The build-up of pressure in the NHS was entirely predictable, because no one should be surprised that winter comes between January and March or that winter increases demand on our health service. The situation is similar to the annual need to grit roads after snowfall, when everyone seems to be caught out and gritting lorries are not ready to deal with the crisis. This year, we should have been ready for increased winter demand on the NHS, as the problem has been flagged up year after year. I see that the Minister is smiling at the analogy, but the problem has caught us out again.

Every year, hard-working doctors and nurses battle against the odds to do their jobs in a winter crisis. On Monday, I was at a district general hospital in north-east England, and people there told me about how staff had voluntarily worked on new year's day because of staff illness and other problems. They had to keep the hospital going, and it was wonderful to see their dedication. Ultimately, however, I can only wonder why, time after time, the same crisis sneaks up on us.

I do not think that the Government's solution to the intensive care bed crisis--as reported in the press at Christmas, although we could detect the crisis developing well before Christmas--is sufficient. I am bothered because the NHS chief executive has

"ordered all casualty and intensive care units to stay open in the run-up to polling day".

Since the new year, there have been numerous problems inside the NHS. Two Surrey hospitals have closed their doors to emergency cases. Two Lancashire consultants announced that they were quitting because of a desperate shortage of hospital beds. The Royal Gwent hospital was accepting only medical emergency cases, and the list goes on. On the situation in London, my hon. Friend the Member for Lewisham, East (Mrs. Prentice) told us that, because of the current winter crisis, all non-urgent surgery has been cancelled in the Lewisham hospital. Patients at St. George's hospital--21 of them at one point--have had to spend nights on trollies. Such an environment is unacceptable to people who work and care for patients in our hospitals, to the British public--who pay taxes to fund the NHS--and to patients and their families, who are under enough stress when a family member is admitted to hospital.

Drawing on 20 years' experience, a consultant at St. George's A and E department said:

"I don't think I have ever seen such a terrible state of affairs."

My hon. Friend the Member for Lewisham, East spoke in detail about the sad death from a heart attack at the beginning of this month of a 69-year-old London woman. A hospital spokesman had said that

"an increase in medical emergencies had put the hospital's intensive care beds under pressure over the New Year."

In his speech, my hon. Friend the Member for Leeds, East went into some detail about a patient being taken from Leeds to Hull. As he said, another patient was transported in the other direction, when a man was taken from Hull to Leeds, where a bed was available. That man died also. Last week, a spokesman for Guy's hospital inadvertently provided the best summation of the Tory crisis. He said:

"Every time we thought an intensive care bed was about to become free, an emergency patient arrived. There was no possibility of transferring"--

As everyone knows, since the internal market was introduced into the NHS, five years ago, we have lost 25 per cent. of NHS beds. That reduction does not help. A fortnight ago, Dr. Sandy Macara, chairman of the British Medical Association, said that the crisis faced by the NHS has occurred because

"There just aren't enough beds, including emergency care, available to deal with what ought to be a predictable and predicted peak demand, and that's because of the way that the internal market works and just not having enough money in the system."

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My hon. Friend the Member for Leeds, East said that St. James's university hospital, in Leeds, was able to set up two extra intensive care beds--although there are still empty bays on the ward. We cannot run away from the fact that one of the problems facing the intensive care service is the lack of nurses available to staff beds, even when the beds are available. No one can question the fact that that problem exists. I have here a Royal College of Nursing brief for today's debate, which states that the Royal Sussex county hospital has 11 vacancies out of an establishment of 65. I have no doubt that is a major problem across the country.

I conclude with a quotation from a study that the Department of Health commissioned from the London School of Hygiene and Tropical Medicine. The report stated:

"The main reasons for patient refusal is lack of ICU facilities; either the unit is full and no bed available, or beds are physically available but there are insufficient staff to provide adequate nursing".