I beg to move,
That this House recognises that rationing has always been a part of how the Health Service manages health care resources; expresses its dismay at the comments of the Right honourable Member for Dulwich and West Norwood denying the obvious fact that rationing exists in the Health Service; expresses grave concern at the proposed changes to be effected by Her Majesty's Government, which through bureaucratic bodies such as a National Institute for Clinical Excellence and a Commission for Health Improvement will force clinicians to carry the burden on rationing decisions; recognises that the availability of modern drugs for conditions such as schizophrenia and MS makes clear the reality of rationing in today's Health Service; recognises the fact that waiting lists are a hidden form of rationing; notes that excessive political concentration upon waiting lists has been largely responsible for the continuing winter crisis in the Health Service, over which Her Majesty's Government appears wholly complacent and unconcerned; and urges Her Majesty's Government to acknowledge the concerns of professional bodies such as the BMA over rationing and embark upon a mature debate on the future of the Health Service.
I believe that we need to debate rationing in our health service today more than at any other time in its history. I am greatly encouraged to see that the amendment submitted by the Liberal Democrats is almost the same, word for word, as our main motion. In his endeavours to spin Government reaction before the debate, the Secretary of State for Health told the press that this was some deep-seated right-wing plot. I have many views about the hon. Member for Southwark, North and Bermondsey (Mr. Hughes), but by no stretch of the imagination could he be described as a right-wing plot. Indeed, I would submit that our motion and the hon. Gentleman's amendment are the same in that they strongly reflect the views and concerns of the general public, and their longing for a clear and grown-up debate about rationing.
Our health service is currently embroiled in one of the worst winter crises to hit our hospitals for many years. It is not only the Conservative party that is saying so, but the British Medical Association and the Royal College of Nursing. Now, even the Secretary of State is at last prepared to admit that our hospitals cannot cope with the added pressure that the Government have placed on them.
That sudden rush to accept culpability does not extend to the Prime Minister or his press secretary. Reporting the glad tidings of our Prime Minister's descent on St. Thomas's hospital last week, his spokesman told us that the Prime Minister
did not come away thinking that the Health Service is in a crisis.
"Crisis? What crisis?" seems to be the attitude emanating from Downing street.
The increasing difficulties being experienced in our health service have underlying causes that are far more serious than the recent flu outbreak, which, I remind the Secretary of State, has at no time escalated to epidemic proportions. He will remember that he claimed that in the absence of such an epidemic or an exceptionally harsh winter, the service could look forward to the winter with confidence. Where is that confidence now? The Government's increased rationing of clinical services, coupled with their pressure on hospitals to force through quick, simple waiting list cases, have been a double whammy against the ability of our health service to cope with the wholly predictable increase in winter pressures.
The Secretary of State will remember, because I have reminded him of it, his party's pledge in 1996 to set up a task force on trolleys and to monitor the number of patients forced to wait for treatment in that manner. The Labour party may have broken its pledge, but not to worry because we have been monitoring the situation that caused so many sleepless nights for the right hon. Member for Camberwell and Peckham (Ms Harman). I have to inform the Secretary of State that the situation is far worse than he could ever have imagined in his complacency.
A patient died, waiting in pain, on a trolley at St. George's hospital in London. His consultant described the conditions as the worst that he had seen in 20 years, with the standard of care being worse than in India. An elderly man died of heart failure in Whipps Cross hospital after waiting over 18 hours on a trolley. A child died from meningitis after being left on a trolley for hours in Rotherham general hospital because there was no bed.
Bodies were stacked up in refrigerated lorries at two hospitals in Norwich and at the Derbyshire Royal infirmary because there was nowhere else to keep them. A patient's body was lost for five days in the grounds of Chase Farm hospital, Enfield, after he had walked out of the ward and fallen into a ditch. At two Portsmouth hospitals, relatives were forced to provide basic nursing care for their loved ones for the first time in the history of our health service.
The Prime Minister has the barefaced cheek to deny that that is a crisis. Perhaps he might have been right if his Government had not closed 679 hospital beds in London alone during 1998, after years of telling us that London needed more, not fewer, beds. It is now clear that such decisions and the obsession with Labour's fiddled waiting list pledge have led directly to the shocking events of the past month.
I wonder if the Secretary of State recalls what Baroness Jay said shortly before last winter? She said:
We won't see a return to a situation where people are being helicoptered around the country in search of an Intensive Care bed.
I would be only a few weeks out of season if I said, "Ho, ho, ho." What about the shameful case of the elderly patient at Hemel Hempstead hospital? The right hon. Gentleman obviously finds that case funny; we shall find out whether the rest of the House does. The Secretary of State plans to close that hospital's brand new accident and emergency department. That patient was suffering from a potentially fatal respiratory infection, and had to be airlifted 150 miles in agony all the way to Somerset. How can the right hon. Gentleman even attempt to wriggle out of responsibility for much—not all—of that state of affairs?
It is clear that the concentration of resources on waiting lists and the climate of fear that the Secretary of State has created among clinical and managerial staff has harmed
other sectors of our health service, led to increased rationing and resulted in this disastrous winter. He will be aware that not just we, but the British Medical Association, which for many months and not only with the wisdom of hindsight, has been claiming that his obsession with numbers on waiting lists—not even waiting times—is distorting clinical priorities. In the words of the British Association for Accident and Emergency Medicine,
the principal reason is the emphasis placed on allocating resources to waiting lists, which has resulted in a reduction of beds for emergency cases".
Let us take instead the words of the British Medical Journal.
The government's emphasis on reducing waiting lists… has caused difficulties in coping with emergency cases".
If that is too esoteric for the Secretary of State, let him try the words of a ward manager, nurse Helen Truscott, who works at St. Mary's in Paddington. She said:
There is a crisis in the Health Service, but it's not just in the winter, it is now all the year through. A few years ago we would have had some spare beds on the ward overnight. Now we've got patients left lying on trolleys in casualty.
If the Secretary of State is in any doubt that that is due to his Government—the Government who gave voters before the election 14 days to save the NHS—all he has to do is listen to doctors and nurses, in whose minds there is no doubt about who is responsible.
I shall now be very kind to the Secretary of State. [HON. MEMBERS: "No."] Yes, I shall. He will remember that, a few weeks ago, I made a promise to him. I said that if he abandoned his ridiculous obsession with raw numbers on lists and instead concentrated on waiting times, and if, in addition, he used not just crude cut-off times but made those times relevant to conditions, as the BMA has asked, I would not gloat but say, "Well done" and support him. I renew that promise today—though more in hope than in faith.
I ask the Secretary of State also to face up to reality. We have been saying for some time that there are no easy solutions of the kind that his party promised in opposition. I go so far as to say that, in opposition, his party deceived Britain. His party said that there was nothing wrong with the NHS other than a Tory Government. It said: "All you have to do is change the Government and we, Labour, will put it all right. The NHS will be able to do it all. It will be able to meet expectations and look forward to endless winters with confidence. All you have to do is vote Labour." Let the right hon. Gentleman look around him at the results of voting Labour. There never were easy solutions. A one-eyed concentration on waiting lists has not helped; nor has the complacently late payment of winter pressures money.
However, such matters are not the cause of deep-seated and underlying problems, which the Secretary of State's Government have persistently refused to acknowledge, always pretending that the health service can do it all and that, somehow, it has a magic wand. They have always pretended that the health service can meet every last demand, provide every new treatment and supply all the very latest drugs—all in the face of increasing demand and accelerating technology.
The Government can have no credibility, given that the Minister for Public Health, who is not present, can stand
at the Dispatch Box glibly and fatuously stating that there is no rationing in our health service. I asked her, in perfectly simple terms:
Is there rationing, or is there not?"—[Official Report, 15 December 1998; Vol. 322, c. 746.]
She replied, "No." She did not qualify her answer; she did not enlarge upon it. "No", she said and sat down, looking as though she had said something wonderful.
Far be it from me to embarrass the Minister, especially when she is not present, but it seems that she is so far out of step with medical opinion that even the normally restrained Doctor magazine felt moved to complain that the Government were like—I quote the editorial—[Laughter.] Well, this is the GPs' view. The magazine said that the Government were like
A child hiding under the bedclothes".[Interruption.] I shall repeat that, because Labour Members do not want to hear it. They are going to hear it, and people listening to the debate are going to hear it, because it represents the views of the profession on the absolutely inaccurate statement by the Minister for Public Health.
The profession says that the Government are like
A child hiding under the bedclothes…imagining the problem of rationing is a monster that will go away if it refuses to acknowledge it.
The editorial said that the right hon. Lady was "embracing a laughable pretence", that the Government's denial made them a "laughing stock" and that the Government should be
mature enough to concede that the NHS is not equipped to cope with demand".