I shall not be congratulating the Secretary of State on her speech. Indeed, when she resumed her seat I thought, "Thank goodness we have got to the end of that self-righteous rant."
This month's edition of GP News, referred to by my hon. Friend the Member for Makerfield (Mr. McCartney), contains a report under the headline:
Human toll mounts as reforms fail.
It goes on to say:
Patients have already died waiting for beds.
In that article Dr. Buckman, a member of the General Medical Services Committee, whom the hon. Member for Broxbourne (Mrs. Roe) claims has not written to her, reveals in tragic detail the case of a severely asthmatic girl who nearly died when Barnet general hospital sent her away because no beds were available.
What I say may be dismissed as shroud waving by some Conservative Members. They would not dismiss things so lightly if members of their own families were affected. What would the Secretary of State say if her mother experienced the suffering of a patient cited by Dr. Buckman—an elderly person with a leaking aortic aneurism who died in the ambulance while a row ensued as to who would pay for the treatment? Conservative Members would not want tragedies of that sort to affect their families. Labour Members do not want them to affect anybody at all—that is why we demanded today's debate.
It is time the Conservatives admitted, before more tragedies occur, that the internal market has been an unmitigated disaster for health services in Britain. Dr. Buckman's examples highlight the human cost of the greatest crisis in the hospital service since the NHS was formed.
I do not want to talk simply about headline tragedies. I am anxious to bring attention to bear in the debate on what is happening to the NHS throughout the country. The Secretary of State referred to Calderdale. Halifax is one of the two towns comprising that district. There has been a massive bed closure programme in Halifax. It has been going on for the past 13 years and it has led to many serious problems. Management there will hasten to deny it, but I know from talking to members of staff and patients, and from visits to hospitals, that serious problems exist in Calderdale. The Royal Halifax infirmary recently had no beds available for a two-week period. I understand that panic sets in regularly among managers and consultants who are desperate for beds. I also understand that they regularly discharge patients early.
That brings one to the dreadful business of bedding out, which has not been referred to in the debate so far. Bedding out is the norm in most hospitals nowadays. Does the Secretary of State know what bedding out is all about? A woman who had been pregnant recently wrote to me saying that although she was in danger of losing her baby —she finally lost it—placed in the next bed to her was a psycho-geriatric patient. That happened on the gynaecological ward as she was going through the trauma of losing her baby, and it was distressing for both patients and for staff and relatives.
The Secretary of State might feel differently if she had been moved from an acute medical ward to a surgical ward to make way for new admissions. Such transfers happen on a regular basis. Had she experienced it, she might understand just what a rotten practice bedding out is. Elderly people are regularly suffering dreadfully as they are admitted to casualty and have two or three moves as they are bedded out on to different wards to make way for other patients.
It is widely known in Halifax that psycho-geriatric patients are often admitted to ordinary wards for the elderly because there are not enough specialist beds to cope with patients of that type. That, too, puts great stress on staff. Noisy, disturbed and perhaps doubly incontinent patients require special care. Would the Secretary of State describe such a situation as levelling up or levelling down? I assure her that that sort of thing did not happen when I worked in the service in the 1970s.
For years, we in Halifax have not had any coronary care beds for males. Four beds are coming on stream and should have opened on 1 January. I believe that their opening has been delayed due to lack of cash, though the Tory-appointed administrators will no doubt say that the delay has occurred for other reasons. It is high time that those beds came on stream.
Because of the shortage of beds, a practice known as mixing is taking place. I was recently visiting a friend in a ward for elderly females and noticed that there was one elderly male on the ward. I believe that he died during the following 24 hours. I did not regard it as respectable, dignified or comfortable for people of that age to have to be on a mixed ward. I have spoken to many patients in that position and it is clear that they are not happy in that situation. I ask Conservative Members to ask themselves whether, if they were feeling low, they would like to be on a mixed ward. I would not. That is happening as a result of the Government's bed closure programme, and the Tories are proud of it.
The response of the Secretary of State to the types of situation that I have described has been frankly insulting. She tells my hon. Friend the Member for Sheffield, Brightside (Mr. Blunkett) that he is scaremongering. The criticisms of the British Medical Association are dismissed, the BMA being told that it has said nothing apart from complaining about the NHS being underfunded. The right hon. Lady may say that my hon. Friends and I do not know how the system works, but I accuse her of not understanding what is happening in the NHS. Her highly paid political friends who are now running the service are issuing harsh penalties against anybody who dares to blow the whistle.
We have been made aware of how serious a threat that is to the freedom of staff to speak out. Doctors and nurses are under great pressure not to express their views, as their evidence when trusts were looked into made clear. The Government have devised a special plan for dealing with what one might call the deviant doctor. It is called a rolling contract or a fixed term contract. Tory business managers are casualising the work of doctors. Indeed, they have the ultimate weapon over doctors. As Mr. Chawner of the joint consultative committee with the BMA said:
A doctor is bound to think … his job is coming to an end … unless he complies with some set objective which may not have been set by him or his peers. In fact, at times I have to say I think it may be set for political reasons in that it would be useful to cut a waiting list. That a doctor should be subject to that sort of influence is quite undesirable from the patient's point of view. Doctors should always decide on the basis of an individual patient, in front of him, and not according to whether he is going to please the manager or anyone else.
I would go further than Mr. Chawner. I would call them not rolling or fixed contracts but blackmailing or gagging contracts. Clearly, the present contracts have been well thought out.
Labour Members have time and again said that underfunding is the problem with the NHS. We warned that the Government's guidelines on equal access would be openly flouted. Fast-track patients from GP fund holdings are being canvassed openly and placed at the head of the queue for purely financial reasons. The Secretary of State's excuses on that have been disgraceful.
Because of the 10–minute limit, I do not have time to quote from a letter dated 24 December from the managers of the Bradford trust. They were clearly canvassing GP fund holders in respect of consultants holding waiting lists. That must represent a two-tier system and it should be exposed, as should the waiting list cheating that goes on. Cheating is taking place on a massive scale. The report of the Select Committee and the evidence about trusts makes the position clear. Doctors said that the two-year waiting list was fatally flawed, that people with acute clinical conditions were sometimes unable to get treatment and that they often faced a life and death situation. The Royal College of Nursing says that nurse redundancies are occurring throughout the country, including 300 at Horton psychiatric hospital.
That is happening at a time when political nepotism is the norm. What qualifications does Alan Titterington have to make him a suitable chair for the West Yorkshire ambulance trust? His businesss background is fibre-optics in the music industry—his political background is the chair of a local Conservative association. Nor should we overlook Lord Hayhoe, who yesterday deliberately canvassed for the chair of St. Thomas's and Guy's.
There is only one place for the Tomlinson report, and that is the dustbin. It is disgraceful. I hope that Londoners can get back the feeling of the blitz, recognise who the enemy is, defeat the Government and damn the report.