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Information is not regularly collected centrally about cancellations of either in-patient or out-patient appointments. In surveys conducted in 1985 it was estimated that about 2 per cent. of out-patient clinics were cancelled by hospitals and that about 15 per cent. of new out-patients and 19 per cent. of follow-up outpatients did not attend for their appointments. The Welsh Office's waiting list team will be examining the impact of cancelled appointments on waiting lists during the course of its work over the next year.
Is my hon. Friend aware of the survey in south Glamorgan, which estimates that 1,000 patients a week do not turn up, that this is costing the University hospital of Wales £2 million a year, that having everyone ordered to turn up for 10 o'clock in the morning causes a loss of money and ill will among both medical staff and patients, and that something ought to be done about it?
I realise the problems that such cancellations cause and the difficulty for those waiting for appointments. Responsibility for running an efficient appointments system rests with the district health authorities. As long ago as 1985 the Welsh Office asked authorities to validate their waiting lists. This should reduce non-attendance by eliminating those who no longer require treatment. As part of its work of disseminating good practice, the Department's waiting list team will be investigating further the procedures for health authorities in this regard.
Does the Minister agree that it is bad and inefficient when all the out-patients are sent for at one time, either at 10 o'clock in the morning or 2 o'clock in the afternoon? Will he ensure that his Department tells district health authorities that appointments should be staggered? That is one of the reasons why there are so many defaulters.
Once again, it is the responsibility of each health authority to decide how it runs its appointments system. That is precisely why we embarked on the validation exercise and why we are giving the sort of advice to health authorities that we are at present.
Does my hon. Friend agree that the 9 per cent. increase for nurses will do a great deal to improve morale in the Health Service? Does he also agree that it is highly desirable that so much of the funding for that should come not from the area health authorities but from central Government?
I listened carefully to what my hon. Friend said. It is perhaps worth recording that under the previous Labour Government the value of nurses' salaries actually fell by 21 per cent., whereas with this pay award the overall increase in nurses' pay, after allowing for inflation, is 30 per cent.
Would it not be wiser for the Government to tackle the basic problems relating to ill health in Wales—unemployment, substandard housing, inadequate nutrition and a poor environment? Surely such measures would be more beneficial than pressing our general practitioners to distribute glossy Government propaganda.
The one thing that the hon. Gentleman absolutely hates is the truth. The truth is that we have increased total cash resources available to health authorities in Wales in the current year by 7·9 per cent. That is why revenue provision for health authorities has increased by 33 per cent. in real terms since 1979; that is why we have invested £495 million in the capital estate of the Health Service in Wales; that is why the numbers of staff are up by 13·5 per cent. since 1979; and that is why tens of thousands more patients are being cared for in Wales today than was possible in 1979.
The hon. Gentleman gave the House particulars about nurses' salaries under the previous Labour Government, but will he tell us the exact dates with which he makes the comparison, because, if he makes an investigation, he will find that, unfortunately, he has been supplied with misleading figures.
I should like to make a plea on behalf of my constituents and the people of mid-Wales. Will the Minister consider giving extra financial aid to the East Dyfed health authority to enable it to build the urgently needed second phase at Bronglais hospital, Aberystwyth?
I remind the hon. Gentleman that we have given increases to the East Dyfed health authority for its current expenditure—nearly 6 per cent. this year—and for its capital programme. Indeed, at this moment, at a cost of £24 million, we are building a brand new hospital in Llanelli. The local health authority has a continuing capital programme and has many developments and plans within that programme.