How many patients are waiting more than 13 weeks for their first referral to see a consultant. [106242]

At 30 September 1999, 512,000 patients were waiting for more than 13 weeks for a first out-patient appointment following general practitioner referral.

Now that we know that there is a growing waiting list for the waiting list, will the Minister abandon the pledge to cut the waiting list by 100,000 and measure success instead in terms of waiting times? Would it not be better to break a pledge than to force the sickest patients to continue to wait the longest for their treatment?

I am afraid that the hon. Lady is wrong on all of those points. We are not going to abandon our target of reducing in-patient waiting lists because as we have brought down in-patient waiting lists, we have brought down in-patient waiting times. Also, we will tackle the problem of out-patient waiting times—which were rising under the previous Government—into which we are investing an extra £30 million this year and an extra £90 million next year.

There is a big difference between the Government and the Opposition. We are determined not just to invest more in tackling waiting times, but to modernise the system, so that it is not inconceivable—as it was under the Tories—that someone could be offered a convenient appointment or be seen in bright, modern surroundings. The Opposition have a different view. They say that hip and cataract operations will have no waiting times because they will not be available on the NHS. The choice is between the Government, who will invest in modernising and tackling waiting times, and the Opposition, who want to remove those common but essential treatments from the NHS.

Does my hon. Friend recall a report by the Select Committee on Health in 1990-91 which commented on the time spent by NHS consultants in private practice? Will he conduct a review of the impact on waiting lists of private practice work by NHS consultants? Does he agree that if NHS consultants spent more time working in the NHS, waiting lists would be reduced considerably?

Recently, we have reached a heads of agreement with the BMA on a new consultants' contract—the most significant change in that contract since 1948. My view is that we should concentrate on what consultants do in the time that they are paid to work in the NHS. The new contract offers the possibility of ensuring not just that NHS consultants' time is spent effectively in the NHS, but that consultants get professional and proper appraisals, in which their development needs can be met. We will concentrate on investing in consultants to make sure that we get the best deal for the NHS in the time that consultants are paid to work in it.

The Minister will know that an inquiry has been set up at Derriford hospital in Plymouth to look into the way in which waiting lists there have been collated. A number of individuals at the hospital have complained to me of incidents of bullying, racism and failures properly to follow disciplinary procedures. Will the Minister extend the remit of the inquiry to cover those matters, and the culture of the trust generally?

Allegations of that sort are serious and must be looked at carefully. If the hon. Gentleman writes to me, setting out the allegations made to him, I will look into them and make sure that they are dealt with appropriately. The Government have introduced legislation to protect whistle-blowers to ensure that, for the first time, people are able to bring such matters of concern to the attention of the proper authorities, or to the attention of the public if necessary.

What can be done to overcome the problem of GPs referring patients constantly to one particular consultant, even though that consultant may have a longer waiting time than others within the same department? How can we ensure that patients have proper access to all the information about the waiting times and waiting lists of every consultant within a department, so that they can make an informed choice about which consultant they wish to be referred to?

My hon. Friend makes an important point and we are tackling several issues that will help to address those problems. Clinicians have a responsibility to make the appropriate referrals to the right doctor, but there are examples of GPs referring out of habit or past practice, even though another consultant may be more specialised in an area of treatment and it would be more appropriate to refer the patient to them.

Much work is going on between health authorities, primary care groups, hospitals and individual doctors to ensure that doctors are fully aware of the waiting list position and the alternative referrals that are available. That work, backed up by the work that we have asked the National Institute for Clinical Excellence to do to produce referral guidelines for GPs, will help to tackle the problems that my hon. Friend rightly raises.