I have asked for this Adjournment debate following the leaking to The Guardian of a letter sent by Mr. Terry Hunt, the regional manager of North East Thames regional health authority, or NETHRA as it is fondly known, to district managers in the region.

In the letter, Mr. Hunt addresses the problems of NETHRA's huge waiting list, which is the worst for its size in the country, on which no fewer than 65,744 people are waiting for operations. More than 22,109 people have waited for more than a year, which in itself is scandalous.

Among Mr. Hunt's proposals for reducing the waiting list is one that deserves the attention of the whole country as it marks a departure from the principles on which many of us had believed our national health service is based. He proposes that a list of medical conditions are to be deemed inappropriate to place on waiting lists in the future. In other words, those medical conditions will no longer be available for treatment under the national health service.

The conditions to be excluded include varicose vein operations, lumps and bumps, wisdom teeth without symptoms and in vitro fertilisation, unless, he says, there is an overriding clinical need. We are told that other conditions may be added to that list.

The Government repeatedly assure us of their support for the founding principles of the NHS, yet, because of a lack of funding, the principle of a universal and comprehensive health service available to all is being formally abandoned in NETHRA.

I want the Minister to tell the House whether that is Government policy and, if not, what she intends to do about it. Is she prepared to see the NHS become merely a first-aid service or does she believe, as I do, that it should be a comprehensive service? Other questions need to be asked about this decision. Who made it? Who was consulted? Were the community health councils consulted about this major change in policy? Would we have known about it had there not been a leak to a national newspaper?

On the face of it, the decision appears to have been made secretly by an NHS bureaucrat. Bureaucracy in the NHS has largely been abandoned, but it cannot be right that a decision of such significance can be covertly concocted and carried through without scrutiny and behind the closed doors of NHS management.

There are several clinical and social concerns about the list of excluded treatments. Let us consider the example of non-malignant lumps and bumps. A doctor has written to a national newspaper about his concerns. He asks: How will anyone know that lumps are benign if they are not to be treated—and will people cease to seek medical opinion on life threatening conditions once they hear that lumps will no longer be treated by the NHS? Furthermore, there are many lumps and bumps which might not need removing or treating for medical reasons but which are socially and physically disabling nonetheless. I am reminded in particular of one of my constituents who has a lump on her foot. It causes her considerable pain and she had hoped to have it removed. She is a carer. Her husband is suffering from cancer and it is making life even more difficult for her. When her GP referred her to North Middlesex hospital, she was refused treatment because of that new policy, which is quite disgraceful.

Had I the time, I could run through the other prohibited conditions to show that there are similar good, preventive and social reasons why they should remain available through the national health service. However, I shall confine myself to saying how cruel it is to deny women the right to IVF treatment on the NHS. I should like the Minister to visit my constituent Mrs. W. and explain to her why she cannot have IVF treatment. She has been trying to have a child for seven years and had finally begun pre-treatment for IVF. After many months of taking pills she is distraught because she has been told that she will not now receive the treatment.

Mr. Hunt's decision also raises the issue of the relationship between the NHS and the private health sector. It is no coincidence that the private hospitals are thriving on exactly the sort of work that North-East Thames regional health authority is now abandoning. Is it part of Government policy to encourage the private sector by starving the NHS? That is what it is beginning to look like to my constituents.

The trouble is that very few of my constituents can afford to pay £1,000 to have their varicose veins treated or the thousands of pounds involved in having private IVF treatment. To them, Mr. Hunt's ruling means that they will never be able to have the treatment that they need. Frankly, I shudder to think what other treatments will be added to the list. We are going down a very dangerous road when income is the determinant of whether one receives treatment.

I have no doubt that the Minister will reply that the NHS is not funded from a bottomless purse and that priorities must be established. No one would quibble about that or with the need to find constantly more efficient ways to run the NHS. However, Mr. Hunt's decision is a panic measure taken against the background of chronic starvation of funds by the Government to the health authority. It is bringing the NHS in the region to its knees. As elsewhere, managers are struggling to run an underfunded service and at the same time responding to political pressure to keep the waiting lists down by manipulating the figures—in time, no doubt, for a general election.

In the North East Thames regional health authority areas people will not be deceived. In 1989–90, 28,514 operations were cancelled, with a record 8,095 operating sessions not taking place. We have lost 31 hospitals since 1979 and a further 16 have been partially closed. 1[n the same period we have lost 3,295 acute beds.

This year figures will certainly be far worse. Of 28 districts in the regional authority, 13 are making cuts in excess of £1 million this year, including 10 inner London districts, as a result of the foolish insistence of Ministers that they clear all debts before the start of the remodelled NHS in April.

In my district of Haringey, 75,149 people were waiting for operations in March 1990, 31 per cent. of whom had been waiting over a year. That is quite appalling. Yet by August the district was overspent and it has had to find ways of containing a projected £1·8 million overspend in the current year. That meant the closure of the orthopaedic theatre at St. Ann's hospital before Christmas and the closure of the orthopaedic ward at St. Ann's at the beginning of January this year. The work has been moved to the North Middlesex hospital, and the operating time reduced to one half-day session a week, with beds having to be shared with general surgery, which is severely limiting the progress of the general surgery waiting list. The 18-bed infectious diseases ward at St. Ann's has also been closed, to be replaced only by six beds at the North Middlesex. In all, three wards have closed, one operating theatre has been lost, and the building that was supposed to replace the facilities at St. Ann's has been cancelled due to capital shortages.

In October surgeons were told to reduce operations by 50 per cent. and then on 1 December they were told to halt all non-elective surgery altogether until 1 April 1991. I suggest that it will take some skilful manipulation of the figures to disguise the massive increase in the waiting list which will result.

Figures are one thing, but the effect on patients and their families is another. I receive scores of letters from people who are affected by the problem. Let us take, for example, the case of Mr. James Breslin who lives in my constituency. He is 63 and needs a hip replacement badly so that he can continue to work to pay his exorbitant mortgage. After waiting many months he was finally given a date of 16 March 1991. He has now been told that the operation has been cancelled, and that he must expect at least another six months' delay. Mr. Breslin's daughter wrote to me last month and I quote from her letter: He doesn't know yet—we are afraid to tell him. He is in constant excruciating pain. It is terrible to watch him, his face contorts with agony when he tries to get up or sit down, and when he tries to walk. I am afraid of what this news will do to him—the only thing keeping him going was the fact that 16th March was growing nearer. Please help my father. When I wrote to the surgeon, he could only explain that Mr. Breslin was one of 52 of his patients who would not be operated on until next year and many of them had had their operations cancelled twice. He said that it was impossible to plan elective surgery.

In NETHRA, there are thousands of people like Mr. Breslin, who are being short-changed by the NHS. According to the Greater London Association of Community Health Councils, which does such excellent work to represent the views of health service users, with such limited resources, the situation in NETHRA is approaching chaos in many parts of the region.

Districts such as Haringey can no longer look to other neighbouring authorities to tide them over difficult periods, for they are all in the same boat. The picture is one of wards being closed and beds being left empty while people are crying out for the treatment that they so badly need. I am reliably informed of an instance recently when cardiac patients at Bart's were put in armchairs for the day, because emergency medical admissions needed their beds. In the region as a whole, emergency admissions are rocketing and patients are being denied operations until their condition necessitates their admission to hospital on an emergency basis.

I began by expressing my concern about the abandonment of the fundamental principles of the NHS, as exemplified by the decision by the managment of NETHRA to abandon certain kinds of treatment. I should like the Minister to state the principles on which the NHS is currently operating. I hope that she will not attempt to pull the wool over our eyes by quoting bogus statistics to demonstrate that matters are improving. They most definitely are not.

The NHS was created in the spirit of universalism which followed the second world war. I end by quoting from another letter which I recently received, from a pensioner in Tottenham who has also had his operation cancelled and who fought in that war. He wrote: I am now wondering what the hell I fought for. Does the Minister intend to allow our service men and women now fighting in the Gulf to be left asking themselves the same question?