The National Health Service

Part of the debate – in the House of Lords at 4:44 pm on 2 May 2001.

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Photo of Lord Turnberg Lord Turnberg Labour 4:44, 2 May 2001

My Lords, I apologise to noble Lords for missing some of the earlier speeches, and for missing my slot. I had assumed that I would be speaking rather later. I am grateful for being allowed to speak in the gap, perhaps mercifully in a somewhat abbreviated form.

The pressures of work on doctors and nurses are undoubtedly heavy. It is not just clinical work with patients; many are working at or beyond the limits of their capacity and feel that they are failing their patients. I know that the Government have started the process of reversing this downward trend and we are grateful for that. But it will take time--perhaps 10 years or more--for the effects to be felt. Unfortunately, meanwhile we are beginning to lose the good will and energy of our most precious resources--our disillusioned nurses and doctors.

With noble Lords' permission, I should like to suggest three or four actions which, taken now, might make a more immediate difference. First, I know of many consultants in hospitals who are retiring in their late 50s. They want to be relieved of the burden of full-time responsibility for all that a consultant job now entails but would like to work perhaps part time, concentrating simply on caring for patients and teaching young doctors, free of all other administrative burdens.

The Government have accepted that it is a shameful waste of a precious, trained resource not to take advantage of those people. But in practice I know of many such doctors who are being refused by trusts which say that they cannot afford to re-employ people in this way. What a ridiculous waste of an opportunity when we are trying to reduce waiting lists and to bring in more young doctors from the medical schools to help to plug the gap. We must find a way through the problem.

Secondly, I am told that doctors on the wards are constantly distracted by having to do clerical work: seeking case notes; tracking down X-ray and laboratory results; or phoning for patients to come in. Those are jobs which ward clerks and secretaries could and should do, but in many hospitals there are nowhere near enough of these essential support staff. We need more secretaries, clerks and porters. If we double the current numbers, we shall have a more effective and efficient use of our doctors and nurses as those unnecessary pressures are taken off them.

Thirdly, we should be taking a grip on the computerised IT systems supporting the clinical work at the ward level. Current systems are often either out of date or inadequate. Yet we know that good supportive IT, providing, for example, rapid bedside access to tests results--one might think that that would be fairly simple--would bring welcome relief to staff who spend too much of their precious time phoning around for information.

I realise that different hospitals need many other types of action which, taken now, would have an observable effect perhaps within 10 months rather than the 10 years projected for the major government initiatives in train. I propose that the Government set up yet another task force with the specific remit to develop ideas for short-term--for perhaps a period of one or two years--improvements and efficiency. I suggest that this task force be made up of the great and the good; namely, a ward sister; a non-political doctor in training; a good manager; a GP; and, of course, a patient. They know so much more about how the NHS could be run more effectively at the coalface. I could even suggest some names if the Minister cares to take forward the proposal, as I hope that he will.