Health and Social Security

Part of the debate – in the House of Commons at 7:51 pm on 22nd November 1994.

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Photo of Mr Sebastian Coe Mr Sebastian Coe , Falmouth and Camborne 7:51 pm, 22nd November 1994

I am pleased to be able to contribute to what has been a wide-ranging debate. Although I intend to speak about health, I should like first to compliment the hon. Member for Birkenhead (Mr. Field)—not in his seat now—on a speech of substance. It is a great pleasure to watch the faces of the hon. Gentleman's colleagues as he trespasses with such furtive guile into subjects that have remained no-go areas for his party for so many years.

I begin with a remark that runs the risk of sounding trite, but it is a truism all the same to say that the economic and cultural strength of a country, particularly this country, lies in its people: they are its greatest asset. Their health and well-being are at the centre of any discussion on health.

We know this from the stark reality of third world poverty. We know it from the pockets of deprivation in the United Kingdom, which are matched by equally challenging medical difficulties, in densely populated inner cities or in peripheral rural areas. We know it, too, from World Health Organisation statistics, and from the figures of similar agencies.

On no issue more than health does the House have a great responsibility to enter into responsible and dignified debate, and we have had such a debate this evening. It is a prerequisite of such debate that we avoid the anecdotal trail at all costs—the tabloid slogan that panders to scare stories of dubious origin, and even more dubious academic or scientific rigour.

The media have a major responsibility to fulfil. I would have liked to ask the editor of "Panorama", after the programme a few weeks ago that examined health care for the elderly, whether he would have slept as easily after the programme if he had known of the concern expressed to me only some hours later by a constituent about to receive treatment at the Treliske hospital in Truro. The hospital serves many of my constituents very well. He had got in touch with my office in a blind panic. After watching the programme, he feared that he would turn up at the hospital the following day only to be turned away. He thought that everyone over the age of 65 was suddenly going to be refused hospital treatment. His fears were, of course, unfounded.

The hon. Member for Belfast, South (Rev. Martin Smyth)—I am sorry to see that he is not in his place—spoke with erudition and with his long-standing concern about cot deaths. I am very pleased to have been given a son seven weeks ago. During my maiden speech, it was my great pleasure and privilege to thank the staff at Epsom general hospital for the safe birth of my daughter. Tonight, it is a great pleasure to thank them for the safe delivery of my son.

A few days ago in Cornwall, my wife and I switched on with great interest to watch "The Cook Report" on cot deaths and the problems surrounding some of the fire-retarding agents that have supposedly contributed to them. While we should never turn our backs on new information—scientific rigour is all about scrutiny and monitoring—we should also be careful about engendering unnecessary panic. Forty thousand people rang up ITV straight after the programme, and I for one wonder whether the programme makers took great pleasure in the glee with which they were able to announce that fact. Those people were extremely frightened.

I must also question the editorial judgment of any programme that decided to leave in the crass, ludicrous advice to parents of young children that, if they believed their mattresses comprised any of these substances, they should wrap them up in polythene. I am pleased that the Department of Health and the Chief Medical Officer managed to put the lid on that one quite quickly.

Hard evaluation, nationally, locally and at the point of delivery, often tells a story very different from that portrayed by selective editing. The constituent I mentioned, who was so unnecessarily frightened, went on to receive the right treatment. It was successful, and he is recovering. But he is not alone. He is one of the 7.4 per cent. more people who have been treated at Treliske in the past year, and had he needed out-patient treatment, he would have been one of 8.3 per cent. more people going through the system. He is using a hospital that serves the medical needs of my constituents extremely well.

The hospital has just invested £1.4 million in a new dermatology unit, creating 14 more bed spaces and freeing resources in Falmouth community hospital. The hospital has a new public health laboratory—£3.6 million worth of facilities, opened in April and incorporating some of the most modern clinical microbiology provision to be found anywhere in the country. It has a county-wide coronary angiography service. That means that many of my constituents will not now have to travel to London for treatment—a total saving to London hospitals of some 400 patients a year.

Patients now enjoy the reassurance of being treated locally in familiar surroundings, with staff whom they know and with families close at hand. That enhanced service for my constituents, and the other services that will be created locally, are all part of the reordering of priorities from the centre, which have given new life to many of our regions.

If the London reforms mean that none of my constituents has to make a 520-mile round journey to London for treatment, I welcome them with open arms. For my constituents, the importance of health care delivered through community provision is, of course, all-important. They see new and expanding health centres, more practice nurses and well-funded care in the community, which, in Cornwall, is bedding down remarkably well. They see general practitioners who provide a standard of care and commitment that is unrivalled and who strive for continual improvement and, more often than not, achieve it.

My constituents are now part of practices that have more control over local hospitals. Gone are the days of the conversations that I once had with a local GP who, when confronted by one of his patients who had been booked in for a 2.30 appointment at a local hospital, but who was not seen until 6 o'clock, went to see the hospital administrator, who looked askance at him and said, "Well, of course, we book everybody in at 2.30."

There are new initiatives in health centres. Only last Friday in my constituency, I opened Link Line, a computer service that now operates from the Poole health centre, allowing information to be collated and disseminated among my constituents—all in support of care in the community. Health education and, more importantly, health promotion must be central to any national health strategy. There is more evidence in GPs' surgeries than ever before of real developments.

We still have much to do. As we go about our duties in this place over the next week, some 450 people will die from coronary heart disease. As we go about our duties in this place next year, some 40 million days will be lost to that disease. The sadness behind those statistics, behind the tragedies, is that so many of the deaths are preventable—not all of them, but so many. Recent figures highlighted our concerns about the number of women who smoke and who remain resistant to health campaigns. It is certainly no coincidence that coronary heart disease now claims more women than ever before.

We have much to do to remove the embarrassment factor from health promotion—the kind of embarrassment that seems to be behind the inordinately high incidence of prostate cancer, which goes undiagnosed and treated for so long, and which claims so many men.

Some of the major developments in health promotion have been in female diseases: advances in breast screening, cervical cancer screening, not to mention the major step forward in our immunisation programmes.

The right hon. Member for Derby, South (Mrs. Beckett) in part grudgingly accepted, then dismissed, the statistical significance of the recent British social attitudes survey. I must say that I find it more than statistically significant.

Let me return to the anecdotal evidence. I can count on the fingers of both hands the number of letters that I have received from constituents complaining about health services, GPs or hospitals over the course of this year. That is not to say that problems do not exist, but when constituents write, it is often not about a direct experience, but in response to a newspaper article or television programme that may have been badly researched. Very rarely are they from people who have suffered bad patient care.

The British social attitudes survey supports that. Nearly three quarters of those with recent experience of in-patient care are satisfied with that service, as compared with 56 per cent. of those without recent experience.

When the Government tackled the reforms, it was to an institution, a management dynamic that had remained inviolate from any reform for nearly 40 years. There are few institutions in this country about which one could say the same. The national health service still remains the biggest single employer in Europe, at one time employing more people than the Red Army. There was a management sclerosis. It is uncomfortable in some quarters to say that, but it was the case. Few things, if any, were costed—from bandages to serious operations.

The answer, of course, is that organisational change and the pattern of the new relationships that emerge within that change cannot be transformed over night or by the single flourish of the legislative pen. It has taken time, and it will take time, but it is gratifying that the British social attitudes survey is now identifying that transition and the very real advances made on behalf of the British people.