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Patient Satisfaction

Volume 453: debated on Tuesday 28 November 2006

Forgive me, Mr. Speaker. I thought that another hon. Member was seeking to ask a supplementary on Question 2.

Yesterday, we announced our plans to survey 5 million patients to measure how easy it is for them to see their general practitioner. This the first time that the Government have asked patients directly about their experience of the GP appointments system.

I am very grateful for that answer. Has my right hon. Friend seen the recent survey by the Healthcare Commission, which shows that 92 per cent. of patients rate their experience of the NHS “good” to “excellent”? In the light of that, what can she do about closing the gap in perception between those who use the NHS and those who merely read about it?

That was a supplementary question well worth waiting for. My hon. Friend is absolutely right about what patients say about their experience of the NHS, and I am sure that all of us would want to pay a real tribute to NHS staff. There is a big gap between patients’ experience and public perception, however. I hope that Conservative Members and the media all around the country will continue to pay at least as much attention to all the improvements taking place in the NHS as they pay to the sometimes difficult decisions that have to be made in some areas.

Will the Secretary of State also assess the impact on public satisfaction with the NHS reconfiguration process of, for example, the announcement last week by the hospitals trust in my constituency that it will definitely close one of the maternity units in the trust, despite the fact that the public consultation on that option is not due to start until the middle of January?

No decisions are made on significant changes to services of the sort that the hon. Gentleman describes without full public consultation and the involvement of local councillors through the overview and scrutiny committee. I very much regret that, on occasions, when local primary care trusts and hospitals are considering changes—which are generally driven by the need to keep up with changes in medicine and clinical practice and to give patients even better care—people leap to the conclusion that there are to be cuts or reductions in services and protest before any decision has been made.

In the context of patient satisfaction, is my right hon. Friend aware of the deep vein thrombosis diagnostic service at Leek Moorlands hospital, which last month won the Community Hospitals Association award for innovation in clinical practice? Not only have almost 200 patients been saved a difficult journey to the acute hospital, but emergency capacity has been freed up, saving the local PCT £100,000 a year. The service will now be rolled out across the boundaries of the new reconfigured primary care trusts. Will she congratulate the team on their excellent work in that area?

I am aware of that service, which is absolutely excellent—[Interruption.] Unlike Conservative Members, I want to congratulate all the staff involved in providing an excellent service, which shows how the modern NHS can both improve care for patients and save money, especially on services previously provided in an acute hospital, thus freeing up resources to spend, for instance, on new drugs and other service improvements that patients also need.

Is the Secretary of State aware that 83 per cent. of patients surveyed in a recent breast cancer forum were unaware of the hospital travel costs scheme? Will she consider again whether trusts can be persuaded better to advertise that scheme and to make claiming under it easier?

Of course I will consider the issue raised by the hon. Gentleman. As he indicates, however, it is very much the responsibility of local hospitals to ensure that patients, particularly those such as cancer patients who must have repeated treatment, are aware of the help with travel costs that is available.

Research confirms the high level of public and patient satisfaction with Alder Hey, the Royal Liverpool children’s hospital in my constituency. Will my right hon. Friend ensure that the national burns review takes into account the high level of public satisfaction with the burns treatment available at Alder Hey and at Whiston? Will she also ensure that, alongside other options, the national review seriously considers encouraging burns centres across the north of England to network together to improve burns treatments and therefore support even higher levels of public satisfaction?

My right hon. Friend is absolutely right about the high levels of public satisfaction, which reflect in part that waiting times, for instance, are shorter than ever before. We will consider carefully the review of specialist burns units and its recommendations, but she is right that a network of specialist centres is needed to ensure that those patients with the most serious burns receive the necessary specialist attention, which only a limited number of specialist centres can provide.

A Healthcare Commission survey of patients this year found that more than one in five had had to stay in a mixed-sex room or bay. Given that the 1997 Labour manifesto said that the Government would work towards getting rid of mixed-sex wards, the 2001 manifesto said that they would abolish them, and the 2005 manifesto did not mention the subject at all, when will the promise be kept?

The Healthcare Commission survey to which the hon. Gentleman refers includes patients who had recently been cared for in accident and emergency or medical admissions units. When we set the target for single-sex sleeping accommodation, we asked trusts to report on the wards used for regular admissions, not A and E or medical admissions units, which, as Sir George Alberti, the national clinical director for emergency care, has pointed out, cannot always provide single-sex accommodation, because to do so would mean turning away patients who were critically ill and needed short-term observation. We have achieved 95 per cent., which was the target that we set back in 2004, and 99 per cent. of hospital trusts say that they now provide single-sex accommodation in their general wards along with single-sex bathrooms and toilets.

A couple of the consequences of the massive talking-down of the NHS by the Opposition are massive demoralisation among staff and patients being scared to receive treatment. Will my right hon. Friend please ensure that some of the research and surveys that she has mentioned are widely disseminated to bust the urban myths put out by the Opposition?

I entirely agree with my hon. Friend. We try all the time to put across the good news about what NHS staff are now achieving, backed by record investment that the Conservatives oppose. With waiting times at their shortest and cancer treatment in particular having been transformed over the past 12 months, there are many reasons for patients and the public to be enormously proud of what the NHS is achieving, although there is still more to be done.

In her first answer, the Secretary of State referred to the survey assessing satisfaction with GPs’ services. The Department of Health has added two more questions, about the opening hours of general practices.

It is the Government’s own GP contract that has led to the closure of practices on Saturday mornings. Does the Secretary of State seriously intend to ask patients whether they want surgeries to be open on Saturday mornings—although their surgeries are not commissioned to be open— and subsequently withhold payments from GPs?

The hon. Gentleman must decide whether patients should be asked whether they are satisfied with the arrangements that their local GPs are making. He must also decide whether he thinks GPs should have been given the choice—which we gave them—of whether to provide out-of-hours services. [Interruption.] That was the choice that we gave them in the survey.

The result of the new contract is that GPs are providing better services for patients according to the quality and outcomes framework, and doing much more work on prevention and long-term care. They are also receiving big increases in payments. I think it right for us to ask patients for their views on their local practices, and to adjust payments to general practices accordingly.

It is always rather depressing when it clear that the Secretary of State does not understand. If GPs are not commissioned to open their surgeries on Saturday mornings, there is no basis on which they can do so, and it is therefore difficult to assess them on that ground.

The satisfaction survey ought surely to extend to out-of-hours services, but the Government do not seem to intend that to happen. Will the Secretary of State undertake to extend the survey to those services? Then, perhaps, she will be able to explain why patients have an out-of-hours GP service that is much less satisfactory to them than it used to be, and why the Government are spending not the £105 million that they thought it would cost last year, but £346 million—a quarter of a billion more than they expected.

It is the hon. Gentleman who simply does not understand the new GP contract. The new contract, which has led to primary care services being rated as better in our country than in almost any other advanced country—as is shown in a recent survey by the Commonwealth Fund—allowed GPs to choose whether to provide out-of-hours services, in which case they would receive higher payments, or to hand the responsibility back to the primary care trusts. PCTs commission out-of-hours services where local GPs have decided not to provide them themselves. If all PCTs commissioned those services as efficiently as the best, they would save money on the allocation that we made, rather than overspend.

We do indeed survey patients about their satisfaction with out-of-hours services, and more than 80 per cent. are satisfied or very satisfied with the services that they are receiving.

Choice has also been a major factor in patient satisfaction. Patients in parts of my constituency now have access to their medical records online, which is proving hugely beneficial. Has my right hon. Friend any plans to roll that out so that all my constituents can benefit from it?

My hon. Friend is absolutely right. By extending choice and the control that patients have over their own services, we are in increasing the responsiveness of the NHS to what patients want and contributing to that increased satisfaction. Through the NHS IT programme, we are trying to ensure that patients everywhere will have access to the online services about which some of my hon. Friend’s constituents are already so pleased.

Mid Essex Hospital Services NHS Trust

4. How many compulsory redundancies have been made in the Mid Essex Hospital Services NHS Trust area in the past six months. (103770)

The Mid Essex Hospital Services NHS Trust has announced that 24 members of staff have been made redundant. The trust is making every effort to protect front-line services.

I am staggered by the Minister’s response because a written answer from his Department of only two weeks ago informed me that the figure was 42, rather than the number that he has given. Also, as the Minister should know but might not, on the same day a further 203 jobs were cut in the hospital trust. I am therefore staggered by the Minister’s response. I want him to explain something to me and my constituents. Since those 245 job cuts were announced, the Government have changed the regime for redundancy pay. Given that those job cuts are being made to reduce the deficit in the trust, how do the Government reconcile changing the redundancy arrangements for trusts seeking to cut their deficits?

I will check whether there is that discrepancy between the figures that the hon. Gentleman has brought to my attention, and if there is I will correct it. However, yet again he and other Conservative Members are seeking to spread anxiety by quoting figures that do not reflect the reality. [Interruption.] They seek to create an impression that P45s are being handed out to nurses up and down the country; in reality, that is not the case. [Interruption.] If he or his party continue to try to spread anxiety in that way, that will not reflect well on them.

The hon. Gentleman and his colleagues have been lobbying me about a new hospital for the trust—he goes quiet and listens now that I mention that. If that trust is to get that new hospital, it must of course be financially viable. Although the decisions that have been made are difficult for the staff concerned, I hope that the hon. Gentleman will support my party in helping the trust make the difficult decisions that will get it into a financially stable position, as that will enable it to have the new hospital that he keeps on asking us to provide.

Does the Minister agree that compulsory redundancies are likely to be only part of the cause of staff reductions in that trust and throughout the rest of the NHS? As an example for the rest of the NHS, will he consider breaking down staff reduction figures into compulsory redundancies, voluntary redundancies, retirements and the vacancy factor effect in respect of the 10 per cent. of staff that are turned over every year?

I thank the hon. Gentleman for that constructive question, because he is absolutely right. We want to put correct information into the public domain. There are some who seek to use figures to scare, and spread anxiety in, the national health service, so we fully recognise the need to put accurate figures into the public domain so that people can make their own judgments about the state of work force planning within the system.

The hon. Gentleman is right that there is a need to put out more information, and we have put information into the public domain about voluntary redundancies. On a trust-by-trust basis, trusts are making statements about reducing their use of agency staff. I will constructively take on board the point that the hon. Gentleman has made, and we will of course seek to put accurate information into the public domain as and when we can.