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Management of the National Health Service

Part of Opposition Day — [15th Allotted Day] – in the House of Commons at 7:01 pm on 9th May 2006.

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Photo of Desmond Swayne Desmond Swayne Parliamentary Private Secretary To the Leader of the Opposition 7:01 pm, 9th May 2006

I remain absolutely convinced that my constituents are fortunate indeed to live where they do and to be served by the national health service, and I make no apology for that. Labour Members who have implied that there is no common ground between us and that some of us are not committed to the NHS do themselves, and us, no justice whatsoever.

I caution Labour Members who have quoted reams of statistics at us with the intention of giving the impression that things are much better than they appear. I recall listening to "Yesterday in Parliament" during the late 1970s and mid-1980s, when Mrs. Thatcher was challenged week after week on the state of the NHS. She always answered robustly from the Dispatch Box with reams of statistics saying how many more operations had been carried out and so on. Even in those years, despite the myths that may be spun, the NHS was improving. Nevertheless, it did not work, because it did not match up to the ordinary people's perceptions based on their experiences. That is the problem that my constituents are having at the moment. Their perceptions of what is happening in the NHS are informed by the difficulty, or otherwise, that they face in seeing their doctor or dentist.

I should like to give hon. Members an impression of what it is like in my part of the world. We have a vastly expanding population. As the Deputy Prime Minister's rules, particularly on density, begin to bite in urban centres such as New Milton, and townscapes are changed for ever as family houses are pulled down and replaced with blocks of flats, the population is expanding fast. Yet only one GP practice south of the A337 is still taking on new patients. That outgrew its existing premises some time ago and is short of space, whatever measure one chooses to use, and sometimes the cramped conditions in the waiting room are unacceptable. A few years ago the practice secured the primary care trust's permission in principle to expand its premises, but before it could do so, a directive from the Department of Health instructed that that was not to happen because the funds were to be allocated not to the primary care trust but to Hampshire as a whole. Hampshire's priorities are different; they apparently lie in Portsmouth. There is now not the remotest chance of that practice, or any practice in my constituency, being able to expand its premises.

My constituents write to me in droves complaining that they can make an appointment with their GP only on the same day. It does not suit most people to have to spend hours ringing the surgery in the morning, only to find it engaged, when they would like to organise their lives so as to see the doctor at a time convenient to them, as they used to in the past. They feel that the situation is not as good as it was before. That is entirely a consequence of the targets to which general practitioners have been subjected.

During the election campaign, on the "Question Time" interview, the Prime Minister was confronted with that problem, appeared greatly surprised, and said that he was going to do something about it. I have not noticed any result. I have written to the Secretary of State saying, "Please find enclosed a copy of a letter from my constituent complaining about X, Y or Z. I remember the Prime Minister saying he was going to do something about it—what has happened?" The answer is, "You can rest assured that patient satisfaction will be one of the measures on which general practitioners will be remunerated in future." That does not deal with the perceived deterioration that my constituents experience in booking an appointment.

Let us examine the possibility of booking an appointment with one's dentist. A couple of years ago the situation deteriorated. It got so bad that constituents of mine who were lucky enough to have an NHS dentist were receiving letters telling them that there were not going to be any more NHS dentists, but they were welcome to stay on as private patients if they wished. When I raised that at Prime Minister's Question Time, the Deputy Prime Minister, who was answering on that occasion, said :

"I am well aware of the problem that the hon. Gentleman mentions because I have experienced it. My dentist declared that he was going private and I declared that I could not stay with him. Many of our constituents have faced this problem. As the hon. Gentleman said, each one of us has been confronted with it."—[ Hansard, 9 June 2004; Vol. 422, c. 270.]

That does not actually address the problem. He went on to tell me that it was all the Tories' fault for having closed down the dental schools. A decision by the university grants funding body more than 10 years ago is not germane to our problem now. The problem is that NHS dentists are leaving the NHS. It is not a question of a shortage of dentists but of how they are employed.

The problem got worse. Several constituents wrote to me complaining that they had received a letter from their dentist saying that he was no longer going to be an NHS dentist but would nevertheless continue to treat their children under the NHS as long as they, the parents, remained as private patients with the practice. They did not like being held hostage in that way, but felt fortunate at least to have their children still being treated as NHS patients. The Secretary of State acted to right that perceived wrong. Instructions were issued to primary care trusts whereby they were empowered to prevent dentists from maintaining children-only NHS lists. So in the past few months, parents in my constituency, particularly vulnerable families, have been receiving letters from those self-same dentists saying, in effect, "You will recall my letter of such and such when I undertook to keep your children on as long as you remained as a registered private patient at the practice—well, sorry, that deal is off and your children will either have to find another dentist or stay with me and pay." That is a very worrying letter for the many families with children who have orthodontic requirements and all sorts of work to be done.

As a consequence of the Government's policy, it is much more difficult to secure NHS dental treatment. However, my constituents have been told that the seventh cavalry is on the way, and that some 12,500 new dental registrations will be available to the good people of New Milton. To take advantage of those as yet virtual dental registrations, a new model is to be used to avoid the inconvenience—and, of course, the attendant unpleasant publicity—of long queues forming and being photographed.

The people of New Milton have been invited to telephone a number to secure their dental registration. I have a letter from a constituent who tried that. The announcement was made in February and he began to make telephone calls. The letter states:

"Since then I and friends have telephoned this number many times only to hear an automated voice saying 'The number you called is busy. To ring back please press five'. Furthermore, if you press five a similar voice tells you 'Sorry, there is a fault please try again'."

He writes that he tried the number on 3 April from 1.55 pm to 2.25 pm, from 3.30 pm to 3.50 pm and from 4.43 pm to 4.52 pm. He tried again on 4 April between 1.45 pm and 2.10 pm, and 4.10 pm and 4.35 pm. Each occasion met with the same result. Let that be a measure of the frustration of ordinary constituents in trying to secure the NHS treatment to which they rightly believe that they are entitled. Those perceptions mean that there is an understandable belief that things have got worse.

We have been told that the position on waiting times has changed; the claim was repeated today. We are told that a magnificent improvement has occurred, but that is not the experience of many of my constituents. At previous Health questions, I asked about audiological waits in my constituency. It has a disproportionate number of elderly people, and thus a disproportionate number suffering from poor hearing, which is one of the most socially isolating experiences. As I said in Health questions, there is a significant danger that many patients will die before they secure the hearing aids that they require.

Strangely, I received a letter about the problem today—although it is not an amazing coincidence, because I am afraid that I receive such letters almost every day. My constituent's 17-month wait for a hearing test was over in February. His appointment was on 6 February and the consultant told him that it would take three months for the hearing aids to be made up. My constituent wrote:

"A reliable person tells me it ought to take... say, a fortnight."

He waited and waited. After a further three months, he rang the hospital to find out what had happened to his hearing aids, only to be told that it would take another six months before they were delivered. That is a measure of ordinary people's experience of the health service. Can we blame them if they believe that it is getting worse?

We have five community hospitals in New Forest. We launched a massive campaign in the past year to save them because the primary care trust intended to close them. It backed off and said that it no longer planned to close them, but that it would have to work with the community to find a role for them—exactly the model that the White Paper, which the Secretary of State launched, set out. There was, therefore, progress.

However, community hospital supporters now experience huge frustration and staff morale is low because nothing has emerged from the process. Whatever is suggested about the role of a specific hospital—whether in Fordingbridge, which could be a centre for best practice or nursing excellence, or the hospital in Milford on Sea—the PCT response is that there is a difficulty because it is building a new hospital in Lymington. That is one of the first new hospitals in which the PCT will employ a private supplier to provide the health care. It does not yet know what services will be provided at Lymington, and will not therefore make any commitment about the services that need to be provided in any of the community hospitals. The new hospital in Lymington is due to open in January next year. Is that the way to run a national health service? We are only a few months away from the opening of the new hospital, yet we are told that decisions cannot be made about existing community hospitals because the PCT does not know about the services that it is commissioning at the new one.

I understand my constituents' frustration and anger. They say, "Yes, expenditure on the NHS has increased enormously, as have our taxes—but have we had value for money?"