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NHS: Hospital Waiting Times

Volume 755: debated on Thursday 10 July 2014

Question

Asked by

To ask Her Majesty’s Government what action they are taking to reduce hospital waiting times.

My Lords, hospital waiting times are low and stable, but there are pressures from a growing and ageing population, and some patients are not receiving their treatment as soon as we would like. NHS England, the NHS Trust Development Authority and Monitor are working with the most challenged providers and commissioners. Operational resilience guidance, published in June, will help the system prepare for winter and improve waiting times sustainably for emergency and elective care.

My Lords, that is a very impressive Answer. The Prime Minister said some time ago that the test will be to get NHS waiting times down. Judged by that test, will the Minister comment on this morning’s statistics from NHS England which showed that over the past year the number of patients waiting six months or longer for treatment has gone up by 20%? Does that not show that the Prime Minister has failed his own test?

My Lords, I do not believe that that is a fair comment. In the past four years, since the Government came to office, we have substantially reduced the numbers of patients waiting longer than 18, 26 and 52 weeks to start treatment. Those numbers are lower than at any time under the previous Government. However, we need to address the build-up in patients waiting and, as a result, we are directing extra support and money for hospitals to do more than 100,000 additional operations over the next few months to meet the extra demand.

My Lords, is it not a fact that the statement made this morning by the new president of the Royal College of Surgeons makes quite a lot of sense, and that most people would agree with it? People who need life-saving operations urgently should have priority, and people who have conditions that will not deteriorate—I am spreading more words than she actually said—may be asked to wait longer to give that priority to the more urgent cases. Does my noble friend not think that that first ever woman president of the Royal College of Surgeons is talking common sense?

Yes, she is. I have known the new president of the royal college for some years. She is a very considerable surgeon, and I agree with what she has said. Clinical priority is the main determinant of when patients should be treated, and should remain so. Clinicians should make decisions about the patient’s treatment and patients should not experience undue delay at any stage of their referral, diagnosis, or indeed treatment. That is why we have moved away from targets to standards—to signal the importance of clinical priorities, which doctors should always feel able to act on.

My Lords, does the noble Earl agree that, whatever he says about targets, the previous Labour Government reduced the maximum waiting time for in-patient treatment from 18 months to 18 weeks? Was that not a substantial reduction? Is the Minister not concerned that if we take a whole raft of measurements, it shows a health service now under great pressure financially and in terms of waiting times?

Yes, of course, the previous Government did an enormous amount to reduce waiting times. I also hope, though, that the noble Lord will give us credit for what we have done to reduce waiting times for those who have been waiting the longest, who were never targeted under the previous Government. I acknowledge that the system is under strain at the moment, but we have plans for the short, medium and long term to address that situation.

My Lords, the Government have stated that there is to be parity of esteem between mental health services and acute services. Will my noble friend the Minister state whether this will include waiting times for the provision of mental health services to both adults and children?

Up to now, mental health has been omitted from the waiting time standards. However, we are looking actively at what might be possible within the bounds of affordability.

My Lords, there seems to be little doubt that waiting lists will grow. Is the noble Earl aware of the recent King’s Fund report, The NHS Productivity Challenge, which shows that the share of the national cake for the NHS, which was above 8% in 2009, is now about 7% and is set to fall to around 6% by 2021. Is there any justification for reducing the share of GDP for health services?

My Lords, the noble Lord knows of the economic constraints that this country has to contend with at the moment. Despite that, the Government are increasing the NHS budget over the course of this Parliament by £12.7 billion. That should indicate to the noble Lord the priority that we are giving to the NHS.

My Lords, the Minister mentioned that the strain on the NHS is due to old people getting older, but is it not true that the strain is due to young people getting fatter and fatter? Is it not true that the Department of Health misled the nation by saying that the obesity epidemic—the worst for 90 years—is due to a lack of exercise when really it is due to people eating too much?

My noble friend is a very eloquent advocate of this particular issue and he is of course right.

Can the Minister tell us how those trusts that do not report on their waiting times, although they are small in number, are dealt with? How can they be held responsible when they do not report?

A handful of trusts are unable to report the full range of figures on their waiting times. They are given support to enable them to do so either by Monitor if they are foundation trusts or by the NHS Trust Development Authority.

My Lords, I do not believe that the House heard the noble Earl address the issue raised by my noble friend Lord Turnberg. It was not about cash but about share. Can he expand a little on why the share of GDP allocated to the National Health Service is set to go down?

The share of GDP is only one measure. We have to take into account the state of the economy. If the party opposite had been elected to office, it had in fact decided that the share of the cake should be less than the one we have allocated. We have had to strike a balance and I believe that we have done so in a responsible way.