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Access to NHS Services

Part of Opposition Day — [15th Allotted Day] – in the House of Commons at 7:20 pm on 3rd July 2007.

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Photo of Ben Bradshaw Ben Bradshaw Minister of State (Regional Affairs) (South West), The Minister of State, Department of Health 7:20 pm, 3rd July 2007

Certainly not. I very much regret that not all Back Benchers were able to contribute to the debate because the Opposition went on for too long. I will not give way in the 10 minutes that I have left to respond to the very important points that Back Benchers have made.

The Government accept that the transition that we have put through since 1997 has been delivered at some cost to staff engagement and some measure of public confidence. Those who use the NHS testify in ever greater numbers to its excellent treatment and improved resources, but the public as a whole are not yet persuaded. Deficits in some health trusts place unwanted additional strain on hard-working NHS staff.

I now come to some of the points that have been made in the debate. Norman Lamb was absolutely right when he said that health inequalities remain a major challenge. Access to GPs, for example, differs widely even within regions of the country. In the north-east, there are 133 per 100,000 of population in Northumberland compared with 25 per 100,000 in neighbouring Redcar and Cleveland. He is right to say that we have more to do on that, and we are doing so through the fairness in primary care procurement. We have been working with the 30 primary care trusts with the fewest GPs for their populations, and contracts with new providers should improve access to services for thousands of people living in those areas. Advertisements for the initial four—Hartlepool, Nottinghamshire County Teaching, County Durham, and Yarmouth and Waveney—were placed in April. Advertisements for a further six PCTs were published for Ashton, Leigh and Wigan, Bolton, East Lancashire, Luton Teaching, Manchester and Trafford.

The hon. Gentleman is also right to point to the problems that we still face in audiology. We acknowledge that waits for hearing aids are still too long and we published a framework for tackling the problem in May. The Under-Secretary of State for Health, my hon. Friend Mr. Lewis, will publish the Government's response to the Health Committee's recent report shortly.

I can reassure the hon. Gentleman that there will be no change in the Government's approach to independent sector treatment centres, and he is also right to say that challenges remain in orthodontics. As he will know, the old system led to huge variations in the provision of orthodontic services, because orthodontists could decide for themselves where to set up practice and how much work to do for the NHS. Last year's reforms will address that issue, but I have to point out that the NHS spends more on orthodontic services per head of population than any other state-funded system in the world.

Sandra Gidley said that she thought that the provision of dentistry was getting worse. That is not the case. NHS dentistry is expanding nationally. PCTs are now commissioning more dental services than the year before the reforms, and in March 2007 there were more than 21,000 dentists on NHS lists, an increase of 4,000 since 1997.

Most of the points made by Conservative Members seemed to focus on the configuration of hospital services, and community hospitals and community services in particular. The configuration of hospital services must be a matter for the local national health service. We do not believe that it is central Government's role to micro-manage every local health economy. As my hon. Friends the Members for Wakefield (Mary Creagh) and for South Swindon (Anne Snelgrove) and my new hon. Friend Mr. Davies, in an excellent contribution, made absolutely clear, reconfiguration in their constituencies has led to considerable benefits in terms of health service provision.

As the hon. Member for North Norfolk pointed out, the implications of the Conservative party's policy are more closures of community hospitals being decided not at local level but by a national quango. That is not the route that we intend to go down. Far from closing hospitals, this Government have delivered the biggest hospital-building programme ever, with 109 new hospitals open or under construction since 1997. The reconfigurations are taking place because doctors are telling us that specialist care needs to be concentrated in centres of excellence so that clinicians with the right expertise, experience and equipment can treat the sickest patients safely and conveniently.

Conservative Members also asked what the Government's approach to targets would be and how many targets we have got rid of. My information is that targets have reduced in number over the past three strategic reviews from 108 to 20. The 18-week wait is the only remaining target when it comes to access.

We were presented with a paper by the official Opposition and, as my right hon. Friend the Secretary of State said, we will take a look at it. On the face of it, either the things that they are proposing are already under way, or we do not believe that they are necessary to achieve the improvements that we all want. As Mr. Bone acknowledged in the Cornerstone paper, a large bulk of the Conservative party want private health insurance to pay for tax cuts.

As we move to the next phase of the NHS transformation, we agree that there should be much greater focus not on top-down reforms, but on stimulating change among patients and practitioners. The policy framework that we set out will be right only if the views of staff and patients are properly incorporated. A modern NHS must move from a public sector monopoly to a truly patient-led public service. The previous ministerial team, to whom I also pay tribute, took significant steps towards creating an independent, self-improving NHS, steadily removing powers from the hands of politicians and transferring it to clinicians. Increased transparency and independence have brought undoubted improvements, but have also had a short-term effect on confidence. However, we were right to introduce those changes.

Patients need staff to take the time to explain the condition and treatment options, and citizens need to know what is going on and to be properly involved in collective decisions. We introduced national targets to eradicate the unacceptably long waiting lists, and without those targets, the NHS would not have seen the transformation of services that I described earlier. But the treatment needed for the NHS then, when the whole system was in intensive care, is not the same as the treatment it needs now. We are determined to move away from targets as we transform the NHS from a top-down bureaucracy to a bottom-up, self-improving organisation with power in the hands of patients, their advocates and, crucially, GPs and others in primary care and the staff.

Waiting lists and waiting times are at record low levels. The Government are on course to hit next year their 18-week target for the waiting time from GP referral to treatment. We have seen huge falls in deaths from heart disease and cancer. There are 80,000 more nurses and 35,000 more doctors, and there is better pay for our brilliant NHS staff. There are more than 100 new hospitals. That is what the Labour Government meant when we promised to save the NHS after 18 years of Tory neglect. Of course we must learn from mistakes and listen to our critics and, in particular, to those who work on the front line, but our overriding principle must be what is in the best interests of patients. It is absurd to deny that our health service is in immeasurably better shape than it was 10 years ago. Under this Labour Government, it will continue to get better.