National Health Service

Part of Opposition Day – in the House of Commons at 3:43 pm on 19th January 1988.

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Photo of Robin Cook Robin Cook , Livingston 3:43 pm, 19th January 1988

I beg to move, That this House notes that two out of three health authorities anticipate a deficit at the end of the current financial year and that attempts to balance their accounts have produced closures of hospital wards and cancellation of operations; affirms its commitment to the principle of a National Health Service providing comprehensive, free treatment to all citizens on the basis of need, not payment; further notes that current Treasury revenue substantially exceeds expenditure; and therefore calls upon Her Majesty's Government to release additional funds to end the financial crisis in the Health Service, and to drop proposals for new charges for dental examinations and for eyesight tests. This is the second occasion on which the Opposition have named health for their Supply debate within the past two months. I wish to advance three reasons why we took the view that it was not only appropriate but essential that the House should have an opportunity to return to this vital matter today.

The first reason is the evidence, accumulating since we last debated the issue only two months ago, that the NHS is currently in financial crisis. Indeed, the weight of evidence pointing to that financial crisis is now so massive that even the Law Officers of this Government must be considering advising their client to plead guilty. May I produce the witnesses who have come forward in the past two months since we debated the issue to confirm the state of crisis in which they have to operate?

The first witness is the chairman of the consultants' committee of the British Medical Association. Last month he announced that that committee was setting up a survey of the acute specialties and he said: The acute sector is falling apart at the seams. The director of the Association of Community Health Councils published its survey only this month. That survey showed that 56 out of 113 health authorities proposed to close wards — some of them entire hospitals — in this financial year. The director stated: Unless there is action now, some parts of the NHS, already on the brink of collapse, will simply fall apart during 1988. In Oxfordshire, 296 general practitioners signed an advertisement opposing the closure of 140 beds. That advertisement said: These cuts will cause considerable suffering and very possibly hasten death in some patients. Consultants at St. Mary's hospital, Paddington wrote to the press saying: We have a duty to inform the public that the fabric of the NHS is crumbling about us. Consultants at the Birmingham children's hospital wrote to the press stating that they now turn away 30 acute cases every week, and added: We no longer accept that this service is safe in the Government's hands. Most damning of all was a statement, not by any doctor or any nurse or even by Brian Redhead of the BBC, but by the hospital manager of the Manchester royal infirmary last week. He wrote to the 2,500 employees of that hospital advising them that he could no longer pay for drugs and that, by the end of the financial year, he may no longer be able to pay for their wages. He added: To all intents and purposes we are bankrupt. If we were a commercial organisation we would have gone into voluntary liquidation". The Government pride themselves on introducing a commercial ethos into the NHS. They have now achieved a new first — they have introduced the concept of bankruptcy into the NHS. Looking at the amendment in the name of the Prime Minister and her colleagues, I am astonished that it has the nerve to express their support for the dedicated staff of the NHS. If the Government have such respect for the staff of the NHS, they should listen to what those staff are saying to them day after day.

In truth, in the past two months, the Government have sought to pin the blame on the very staff who work in the NHS. Last month, it was the fault of the consultants. Bernard Ingham, the true voice of the Government, briefed the press on the basis that too many consultants were nipping off to do private practice. I find it breathtaking that the Government, who have done everything possible to encourage consultants to do more and more private practice, should now identify that as their excuse. In 1980, the Government even changed the consultants' contracts so that those full-time NHS consultants might carry out private practice in the time when they are paid a full-time salary by the NHS. However, I welcome the Government's repentance and their belated recognition of the fact that, if one extends private medicine, the people who are neglected are the patients on the NHS waiting lists.

Such private practice by consultants is not the major source of the current crisis. At present, all round Britain, health authority managers are telling consultants to slow down and to cut their output. They are being told to go off to the golf course, do a spot of gardening, do anything but increase the rate at which they operate on their waiting list. Indeed, at the Queen Elizabeth hospital in Birmingham some surgeons have been instructed to carry out 10 per cent. fewer operations next year than this year.

Last week a new culprit was discovered. The right hon. Member for Chingford (Mr. Tebbit), who is to grace us with a speech in this debate, discovered that it was not the consultants but the nurses who were to blame—with a little help from the BBC. The right hon. Gentleman informed us that too many nurses were moonlighting. There is a fat lot of support for the dedicated staff of the NHS in that statement. I am not entirely sure that I follow the right hon. Gentleman's logic. Presumably, if those nurses stopped moonlighting, the staffing crisis in our hospitals would be even worse. However, I bow to the right hon. Gentleman's superior knowledge of moonlighting.