NHS Modernisation

Part of the debate – in the House of Commons at 3:30 pm on 15th March 1999.

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Photo of Frank Dobson Frank Dobson The Secretary of State for Health 3:30 pm, 15th March 1999

Much of the national health service that we inherited from the previous Government was run down and shabby. Much of its investment in information technology had been an expensive failure. Much of its equipment was unreliable and let down both patients and staff. Patients waiting on trolleys had become a commonplace feature of the service. That is why one of the top priorities of the new Government is to modernise the national health service, build new hospitals, replace outdated and unreliable equipment and give patients quicker, easier and more modern access to health services.

We are already committed to investing an extra £21 billion in the NHS over the next three years. The biggest hospital building programme in the history of the health service is already under way. This coming year, at least £350 million will be invested in upgrading and replacing outdated equipment.

Today, I can give the House details of an additional £200 million to be invested in the coming year to speed up our programme to modernise the health service. That is made up of £100 million to be invested in modernising accident and emergency departments and, drawing on the example of NHS Direct, in improving rapid access to professional advice and help for patients. The second £100 million will come from the national lottery and will be used to step up the fight against cancer by helping to provide new and replacement equipment, such as linear accelerators, diagnostic machines and scanners, as well as extending the services provided by hospices. What better use could there be for national lottery money?

Earlier this year, I was able to announce that £30 million was to be invested to improve 79 accident and emergency departments around the country. That will be funded from the NHS modernisation fund. Last Tuesday, my right hon. Friend the Chancellor announced in his Budget that £430 million from the Government's capital modernisation fund had been earmarked for investment in the NHS, and that £100 million of that would be made available this coming year to modernise the health service. Between £70 million and £80 million of that money will be invested to modernise all those A and E departments that remain in need of improvement.

Those improvements will include special areas for children and easier access to X-ray, pathology and pharmacy services. The layout and furnishing of A and E departments will he improved to make them more pleasant and more secure. Video surveillance and alarm systems will bring greater efficiency and add to the security of both patients and staff. Some modernised A and E departments may incorporate an NHS Direct telephone point. All A and E departments that need improvement will benefit from some or all of those changes.

A survey by the Royal College of Physicians published early in 1997, before the last election, showed that less than half the hospitals with A and E departments had an admissions ward. Since that survey, the number of such hospitals without either an admissions ward or observation unit has been reduced to 22 out of 202. By the end of this initiative, only five will not have an admissions or observation unit—and all five have good hard reasons for not having one.

Proposals that are likely to be funded under the new accident and emergency initiative include the extension of the children's service at Royal Liverpool hospital and improvements at Sheffield children's hospital and in children's facilities at North Staffordshire hospital. In Ipswich, a major scheme includes improvements to resuscitation facilities and a separate children's area, and in Luton there are to be more resuscitation facilities and closed circuit television.

A total of £250,000 worth of improvements are intended at the Royal London hospital in the east end and a similar sum is to go to the Mayday hospital, Croydon. Large-scale improvements are intended at Southampton general hospital and a new observation unit and better facilities for the general practitioner co-operative are planned for Frenchay hospital, Bristol. Those are just a few examples of what is planned for hospitals in every part of the country.

This is the biggest programme of investment in accident and emergency services in the history of the NHS and it will cover every part of the country. By April 2000, every A and E department will have been modernised, or work will be well under way. It should ensure that patients are treated more quickly, more effectively and with greater privacy than ever before.

I am determined to ensure that both patients and staff get maximum benefit from the accident and emergency modernisation programme, so it is not just a matter of new buildings, new plant and new equipment. We have to ensure that the new and better ways of organising accident and emergency, such as emergency nurse practitioners and greater use of telemedicine, are taken up throughout the country. We need to speed up the spread of best practice, so I am setting up a team of professionals to spearhead that work. I can announce today that the team will be led by Mike Lambert, accident and emergency consultant at Norfolk and Norwich hospital.

The accident and emergency modernisation programme will be good not only for patients and staff, but for jobs—for builders who do the work on site and for firms that supply building materials and specialist fittings. Let me give just one example. The accident and emergency department at Portsmouth has just been refurbished at a cost of just over £1 million. It used materials that were supplied by more than 20 firms from all over the country. Orders, large and small, included locks from Walsall, paint from Darwen, weather-proofing from Slough, carpets from Swindon, wash basins from Rugeley, partition walls from Loughborough, wall units from Broadstairs—and the specialist security reception desk came from Glasgow. The accident and emergency modernisation programme will reflect such orders a hundredfold in the coming year.

The remainder of the £100 million from the Government's capital moderninisation fund will be invested in improving direct access to the health service. The popularity of NHS Direct, the nurse-led 24-hour helpline, has demonstrated the public demand for rapid direct access to professional advice and help from the NHS. Following the success of the pilot schemes, NHS Direct has already been extended since Christmas to cover 5 million extra people in the black country, Essex, Nottingham and west London, and will cover 20 million people by Easter. Its success has shown that, given the chance, the talented staff of the NHS can do a brilliant job, supplying what the public want. We are now considering an NHS on-line service to provide a website with on-line access to a wide range of health information.

Between £20 million and £30 million is being made available in the coming year to finance capital investment in further developments in direct access to the NHS, including pilot schemes for walk-in services. Those could include services that are provided by GPs or practice nurses located in or near A and E departments, out-of-hours services provided by GP co-operatives, and services in main streets or shopping malls.

As with NHS Direct, we want to work with the professionals to try out direct access, walk-in services in places and at times that are particularly convenient to patients. Some schemes may be confined to providing advice or directing patients to existing services for treatment or care. Others, particularly those associated with A and E departments, may provide treatment and care, there and then. That is intended not to replace general practice, but to augment it. All those ideas will go with the grain of both modern living and what the health professionals are already developing. The new Government are determined to give impetus to all that to help to create a new NHS for the new century.

That brings me to the extra £100 million that will begin to be invested in the coming year to augment existing NHS investment in the fight against cancer. In line with our election promise, we have set up the new opportunities fund to ensure that more money from the national lottery is spent on the causes on which people want it to be spent. Every time there is a discussion about what to do with lottery money, thoughtful people ask why some of it is not being used to combat cancer. Well, from now on it will be. Over the next three years, £150 million from the new opportunities fund will be invested in tackling cancer in the United Kingdom as a whole. In England, we want to make a major start this year by investing in new equipment.

The order making that possible was laid last week by my right hon. Friend the Secretary of State for Culture, Media and Sport. The direction that he issued at the same time makes it clear that the focus of the initiative in England will be on augmenting voluntary efforts to raise funds to provide new and better equipment, including breast-screening units, scanners and linear accelerators, and also on helping hospices and those providing palliative care. The aim is to provide additional equipment and to replace unreliable equipment. The money is likely to help to fund, for example, replacement linear accelerators at Christie hospital in Manchester, or new equipment for the diagnosis and treatment of cancer of the colon at Lewisham hospital, which my right hon. Friend and I visited this morning.

All that money comes on top of the extra funds already announced for the NHS, and will help the NHS in every part of the country to catch up with more modern standards of cancer diagnosis and treatment. The initiative has the strong support of Macmillan Cancer Relief, Marie Curie Cancer Care and the National Council for Hospice and Specialist Palliative Care Services. It is in addition to the extra £30 million that we have invested in breast and colorectal cancer services over the past 18 months, the further £40 million that we are making available in the coming year to combat breast, colorectal and lung cancer, and our commitment to speeding up specialist attention for people suspected of suffering from cancer.

The commitments that I have announced today will speed up the renewal and modernisation of the health service. They will make services more readily available and more dependable. At the same time, they will make it easier for the dedicated staff of the health service to provide quicker and better-quality services. That is possible only because we have a Government who invest public money wisely, and who have the right priorities.