First, I congratulate the hon. Member for Vauxhall (Miss Hoey) on her good fortune in the ballot and also on the way in which she deployed her argument about Health Service underfunding in her area. Her story could be repeated in many parts of England and Wales. Her good fortune also means that those of us who want to comment on cuts in the Health Service can do so in this debate.
It is highly opportune that this debate is taking place tonight because yesterday evening Gwynedd health authority, which covers my constituency, had a meeting, yet again, to try to avert financial disaster. This is not the first time that Gwynedd health authority has been in that position. It has happened every year since at least 1984. During the past two years, particularly since I was elected to the House, I have warned the House and Ministers in the Welsh Office that the authority's chronic financial plight must he sorted out. Hitherto, my plea in the House and elsewhere has fallen on deaf ears.
Last year, I went so far as to call on the Secretary of State for Wales to use his powers under existing legislation to intervene directly in the affairs of Gwynedd health authority. Sadly, on that occasion he refused to do so. The matter is vital because it affects the health care of nearly 250,000 people in north-west Wales.
A year ago I told the House that I was gravely concerned about the financial crisis which then faced Gwynedd health authority. As a result of decisions taken 12 months ago, a number of hospitals in Gwynedd are to close and vital community provision is being cut. I said then, and I repeat, that one of the major reasons why the health authority had to cut back last year was that it suffered chronic underfunding, but I accept that there are other reasons. Unfortunately, for some years, Gwynedd health authority has suffered from poor management control.
When I made these points last year, the Minister of State, Welsh Office, said that, although the health authority had suffered from particular management problems in the past, he believed that significant improvements had been made which would lead to the problems being solved. Unfortunately, this year Gwynedd health authority is in exactly the same position. Therefore, the best that one can say about the Minister's reply is that it was complacent in the extreme.
The difficulty for hon. Members and the public is that the health authority blames the Government for underfunding and the Government blame the health authority for mismanagement. That has already been said in this debate. It does not matter to the patient who is right or wrong. The problem is one of immediate concern to the patient who will not have his or her operation because wards have closed.
This year Gwynedd health authority estimates that unless cuts are made it will overspend by more than £2 million, and that sum will increase to £4 million next year. It blames the Welsh Office for underfunding. The crisis this year has already led to the closure of one ward at Gwynedd hospital in Bangor, which means that 23 operations have had to be cancelled, six of which were hip replacements. Yesterday, the area health authority gave its managers authority to make further cuts which could lead to the loss of 200 jobs and further ward closures in the next few years. That is an absolute scandal and should be stopped.
How can the health authority discharge its duties to provide a comprehensive health service to the people of Gwynedd when, during the past 15 months, it has taken a number of steps: first, to close several community hospitals; secondly, to sack 200 employees; thirdly, to close wards and day centres; fourthly, to freeze vital medical posts; and, fifthly, to cut essential community services. What sort of health authority and what sort of Government allow that to happen? I have a copy of the speech of the Secretary of State for Health to last year's Conservative conference, in which he said:
A lot of small hospitals are very popular and very threatened under the old way of doing things. In future thanks to the new funding arrangements which I propose, popular units and popular cottage hospitals will thrive if they attract patients. That is precisely how the new funding will operate, to provide wider choice and more local say.
I wholeheartedly endorse those sentiments, but how can Gwynedd health authority live up to that sort of statement
if hospitals have already been closed? There is no way in which a health authority can provide community provision if five hospitals in the county have been closed. If the Government are serious about providing decent community hospitals, they must reverse the closures.
The latest decisions on job losses and ward closures were confirmed late yesterday afternoon. The implications are staggering, especially for the elderly and the disabled. Unfortunately, the health authority has a reputation for cutting its community provision as it struggles with the finances of the main acute general hospital at Bangor. There is already a massive shortfall in community nursing, speech therapy, occupational therapy and all the other attendant services. I have no hesitation in saying that something must be done to improve health provision and health care in Gwynedd.
I was astounded to learn that from today no elective orthopaedic surgery is taking place within the NHS in Gwynedd. That is a scandal. The managers already have powers—they were passed through the area health authority yesterday—to close other wards as and when the need arises because there is a shortage of nurses and staff. The Secretary of State for Wales—I am sure that my comments will be passed on to him by the Under-Secretary of State for Health—cannot further abdicate his responsibility. He must intervene now to save the Health Service in Gwynedd.
I shall quote from the document which the health authority provided to its members in reaching the decision for further cuts yesterday. It is very much as the hon. Member for Vauxhall said—that if a few cuts are made here and there during one year, the authority concerned will be in a better position the following year. That is precisely what the Welsh Office told Gwynedd health authority last year. It implemented the cuts which the consultants who were asked by the Welsh Office to examine the Health Service in Gwynedd said that it should make.
Those cuts, however, were not enough. The general manager of the health authority told the members yesterday:
The interim strategy was the Action Plan,"—
the action plan is to close the hospitals—
which has not succeeded in the aim of bringing the Health Authority back into balance. This has largely been due to the accelerating pressures of inflation and under-funding of wage awards and regrading exercises, continued increase in workload and delays in obtaining decisions on the rationalisation proposals.
He also told me that the Welsh Office criteria for providing funding for Gwynedd health authority do not take into account the increase in the workload to meet demands caused by the increase in the elderly population as a proportion of the population as whole.
Is it not appalling that, according to the Western Mail, the general manager of Gwynedd health authority said:
The best way to get more money is a good cholera outbreak while the Welsh Office base their allocation of funds on standard mortality ratios. It is as stupid as that.
If that is the view of the general manager of health services in Gwynedd, it is a sorry state of affairs. Without direct Government intervention, Gwynedd health authority will collapse under the financial strain. I urge the Minister to pass my comments on to his colleagues at the Welsh Office.