National Health Service

Part of Opposition Day – in the House of Commons at 7:16 pm on 21st January 1997.

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Photo of Mike Hall Mike Hall , Warrington South 7:16 pm, 21st January 1997

No, I shall not give way.

If the Conservative party wants to stick to its claim that the health service is safe in its hands and that it will care for those in need, we should consider how it is dealing with the current crisis in intensive care across the whole country. That is a powerful example of the Government's complacency and shows how they are disintegrating. Last week, the Secretary of State for Health refused to come to the House to answer questions on the crisis in intensive care provision.

If we need confirmation of that complacency, we need only consider the way in which the Prime Minister dealt with the issue at Question Time this afternoon, and the way in which the Secretary of State dealt with it in his opening speech. The Secretary of State refused to recognise that there was any problem with the provision of intensive care, but there are enough examples to prove him wrong. The right hon. Gentleman's strategic intellectual non-intervention does him no credit—although I had some regard for him when, as Chief Secretary to the Treasury, he spoke from the Dispatch Box in a different vein, adopting a far more considered approach.

The Secretary of State should not be surprised that there is a crisis in the health service, because on his desk is a report to Alan Langlands, chief executive of the national health service executive, on emergency care in the north-west region. The report mentions a separate report on intensive care. The report on the north-west region has been published, and was presented to Alan Langlands in September 1996.

I wanted to use the report to strengthen my arguments about the intensive care problems in my town of Warrington, but the north-west regional office refused to give me a copy, saying that it had not been published and was only for internal use. I do not know what the office has to hide, but the document has been published, and should be available to hon. Members. I do not understand why the Department of Health, through its regional office, wants to suppress it; I can conclude only that the information contained in it would be damaging to the Government if quoted in the debate, and would underline my view that Warrington is experiencing a crisis in internal intensive care provision.

To strengthen my argument, therefore, I shall have to refer to the report of which I have a copy, which concerns emergency care in the north-west region. I shall read just one paragraph from the introduction, which is very powerful. It states: Over recent years there has been a steady increasing pressure placed on secondary care services to handle emergency admissions over the winter period. The pressure became so intense at times during 1995/96 that the system was in danger of collapsing. No wonder the Department did not want me to see the report on intensive care in the north-west, as submitted to the chief executive of the health service.

The report confirmed that there had been dramatic bed losses in my region. We know from Government answers placed in the Library that, since 1989–90, 10,510 beds have been lost in the north-west; furthermore, 1,238 acute beds have been lost since then. It also confirmed that there was a crisis in emergency care provision, and predicted peak demand for such provision in November and December last year, adding that no extra resources would be available to meet that demand. Although the report goes some way to admitting that there is a demand and talks of managing resources in the health service to meet that demand, it does not go the extra yard in terms of intensive care provision.

The borough of Warrington is served by Warrington's district general hospital. Warrington's population is 200,000 and growing, but the hospital deals with trauma admissions from a wider population in Halton, in the borough of Widnes and Runcorn, and from Leigh. That catchment area contains 350,000 people.

Warrington hospital has three intensive care beds and one high-dependency bed. Last year, the occupancy rate for those beds was 98.9 per cent. If we use the NHS guidelines on the provision of intensive care beds, according to the rule of thumb there should be 2.2 beds per 100,000 people. If that were applied in Warrington, we would have eight intensive care beds, but at best we have only four. North Cheshire health authority funds only three, however; the hospital provides the money for the other one.

The existence of a crisis is underlined by the fact that, in 1996, there were 142 intensive care admissions and 216 high-dependency admissions. The other side of the coin is the refusal of 83 admissions—but that is not the whole picture. Once doctors know that the intensive care unit is full, they do not even apply for places for their patients. There were 18 transfers from the intensive care unit—out of Warrington—but that, too, does not give the true picture, because transfers from other wards or from the accident and emergency unit are not included. Both the refusal rate and the transfer rate should be higher.

The postponement of elective surgery and the cancellation of operations owing to the lack of beds is also a problem in Warrington hospital. Warrington is developing a very good reputation for treatment of the three major cancers, but when operations are cancelled, patients who are desperate for surgery must go through the trauma of having their appointments cancelled and their treatment delayed—although, as we all know, the earlier patients are treated for cancer, the better are their prospects of recovery. The chief executive of the hospital tells me that it is very difficult to quantify the number of patients who are not scheduled for surgery because of the lack of beds.

It is clear that there is not enough intensive care provision in that hospital, as North Cheshire health authority has recognised. Warrington is a net exporter of intensive care, which means that more patients go out of Warrington for treatment than come in from outside. The consequences have been fatal for at least one of my constituents, and probably more. I refer to the tragic case of Mr. Pitcher, who was admitted to Warrington hospital in September for routine bowel surgery. During post-operative care, he suffered a heart attack and needed an intensive care bed, but no bed was available at the hospital. He was taken by ambulance to Fazakerley hospital, 30 miles away. He died.

At the inquest a couple of weeks ago, the coroner was so concerned about the lack of intensive care at Warrington that, in giving his verdict of death by misadventure, he said that he would refer the case to the Secretary of State for Health. The consultant who had dealt with Mr. Pitcher said that taking him to Fazakerley hospital in an ambulance had not been the treatment that he had deserved, and I am certain that the lack of an intensive care bed in Warrington led directly to his untimely death.

Another case involved a lady who lived in the village of Barnton in mid-Cheshire, just outside my constituency. She had a severe respiratory problem. The doctor telephoned all the hospitals in the area looking for an intensive care bed—Countess of Chester hospital, Warrington hospital, Halton general hospital and others—but no bed was available in the north-west. The lady was transferred by ambulance to Rhyl, but was dead on arrival. I am certain that, if an intensive care bed had been available anywhere in Cheshire, she would be alive today.

In another tragic case, a gentleman called Mr. Wilson was found unconscious in the grounds of Winwick hospital, a mental hospital in north Warrington. He was taken to Warrington's accident and emergency unit, but there was no place for him in intensive care. He was transferred to Trafford general hospital. He then contracted pneumonia, and has been in a coma for nine weeks. I cannot say whether he will regain consciousness, but one thing is certain: the journey from Warrington to Trafford did not do him any good. He is now taking up a bed at Trafford, and preventing others from obtaining the intensive care that they need.

My final example concerns a lady recovering from surgery at Warrington hospital. Her case worsened and she needed intensive care, but, as no bed was available, she had to be taken across the Pennines in an ambulance to Leeds, 60 miles away. There have been problems with intensive care provision in Leeds as well.

Those are just four examples of transfers of people who could not be given the treatment that they should expect from hospitals in their areas. It is clear that intensive care provision in Warrington is inadequate to meet local demand. I was encouraged by the Secretary of State's announcement of challenge funding of £4 million to provide 37 intensive care beds and 53 high-dependency beds. The total number is 90 and not the 100 that the Secretary of State claimed in the debate. However, in his case, a 10 per cent. inaccuracy can be forgiven.

North Cheshire health authority put in a bid on behalf of Warrington hospital for an extra high-dependency bed. The Secretary of State said that such beds would be provided where the need was greatest and Warrington had a demonstrable need. However, on 27 December he announced the bad news that Warrington had not been given the extra bed that it required to bring it even halfway towards the provision that we should expect for it.

North Cheshire health authority, the regional authority and the hospital have decided to put together a package to provide one intensive care bed from 1 April. The health authority will provide £100,000, the regional authority will try to find the same amount and the hospital has been asked to find £50,000 for the provision of that bed. It is a step in the right direction, but it is rather like putting a finger in a dyke because, for straightforward reasons, in six months there will be an increase in demand in Warrington that will not be met.

Warrington has been underfunded for as long as I can remember. It is a growing and prosperous new town in north Cheshire whose population has trebled in the past 25 years. It is surrounded by a motorway network consisting of the M6, the M56 and the M62. Because of geographical features, the trauma admissions to Warrington hospital are the highest in the region.

In the early 1980s, Warrington's two hospitals were merged and, in its so-called wisdom, the health authority decided to use £1 million of revenue to fund part of the capital building at the hospital. That revenue has never been repaid and, on today's figures alone, that is costing the hospital £4 million. Every month the hospital is on red alert. As the Minister will know, that means that its finances are at the absolute limit. It is in danger of overspending every month and its financial position is reported to the regional arm of the executive, yet it has been asked to provide £50,000 towards the provision of intensive care.

The 1997–98 budget for North Cheshire health authority, which is a purchaser, showed the lowest increase in the region and Government constraints mean that any attempts to address the inadequacy of provision in Warrington hospital are resisted.

I am certain that there is a crisis in the health service. I have been told, although I do not know whether it is true, that three weeks ago there was not a spare intensive care bed in the whole of England. If there had been any more admissions for intensive care, the nearest suitable bed would have been in Scotland. Warrington hospital is an example of the crisis in intensive care. Does the Minister of State recognise, even at this late stage, that there is a crisis? If he does, what does he intend to do about it? Does he appreciate the problems that I have outlined in Warrington? If so, what does he intend to do about them? What will he tell me in his winding-up speech so that I can return to my constituents and say that the Secretary of State has taken heed of the problem and is prepared to take steps to ensure that they receive the health service that they deserve?