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Waiting Lists

Volume 178: debated on Saturday 29 December 1990

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6.

To ask the Secretary of State for Wales what review he has undertaken of his Department's policies in respect to waiting lists in Wales; and what fresh initiatives he intends to take.

Since the launch of the waiting list initiative in 1986, over £5 million has been allocated separately to tackle problematic lists and, together with the further £1 million support for the three all-Wales treatment centres, that has resulted in the treatment of an extra 23,000 out-patients and 12,000 in-patients.

I am at present considering how to take forward those initiatives in the context of the new contracting process that will be introduced from 1 April 1991 when all health authorities will need to pay particular attention to waiting lists in the contracts that they negotiate with their providers.

What is the Minister's response to the news that 3,000 additional hospital beds will close before next April to comply with the Government's finance first and patients last policies? Some of the beds are in Wales. Most of them, however, are in London, but they have been used over the years by Welsh patients as an escape route from the disgracefully high waiting lists in Wales. Does it mean that this winter will be the worst ever for waiting and suffering in Wales? Does the Minister have no response except to accelerate the conveyor belt surgery into overdrive?

I am not sure whether the hon. Gentleman is referring to day case treatment as conveyor belt surgery. I hope not. Last year I had a hernia operation and was in hospital for two nights. There is no reason why many cases could not be treated in a day. I should have thought that that was good medical practice. The hon. Gentleman must also know that the number of beds does not denote the number of patients treated. That has increased by 34 per cent. in Wales under this Government, and it has little to do with the number of beds provided.

Is not the Minister concerned about the state of hospital facilities in Gwent? For example, employees and constituents in Caldicot complain about the cut in facilities at Mount Pleasant hospital in Chepstow. There is also considerable criticism of the cuts in facilities on Ingram ward at St. Woolos hospital in Newport. What is the Minister doing about that, particularly as the local authority members of Gwent area health authority have been discarded in favour of local business men? Does not he agree that the local authority representatives would have been more sensitive to what is happening?

The hon. Gentleman has put his finger on at least part of the answer: that this is a matter for the district health authority. I believe, however, that the new district health authority membership is much more suited to the new system for running the national health service. Decisions on value for money and outcomes, not necessarily local parochial pressures, will be the test of a good national health service.

Does my hon. Friend agree that waiting lists are in part a reflection of the success of the NHS? Patients are now queuing up for treatments that previously were not available. My hon. Friend has already said that there has been an increase in the number of patients treated, which is a far better sign of what is happening. Could not that number be further improved if only the best practice in treating day patients were applied universally?

Absolutely. That is the Audit Commission's view, too. It is also the opinion of most people in the medical profession. My hon. Friend is right about the increase in the number of treatments. That is why, for instance, Rhydlafar specialises in hip replacements, an operation which, not so many years ago, was looked on as being at the frontiers of medical science.