Tabled by Lord Hunt of Kings Heath To ask His Majesty’s Government
what steps they are taking to improve NHS waiting time performance.
The Lord Speaker (Lord McFall of Alcluith) For the second time in a
week or so, I do not notice the noble Lord in his place but I
believe that the noble Baroness, Lady Merron, will kindly step in
again. Baroness Merron (Lab) With the permission of my noble friend
Lord Hunt of Kings Heath, and on his behalf, I beg leave...Request free trial
Tabled by
To ask His Majesty’s Government what steps they are taking to
improve NHS waiting time performance.
The Lord Speaker ()
For the second time in a week or so, I do not notice the noble
Lord in his place but I believe that the noble Baroness, Lady
Merron, will kindly step in again.
(Lab)
With the permission of my noble friend , and on his
behalf, I beg leave to ask the Question standing in his name on
the Order Paper.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
In February 2022, we published the elective recovery plan,
setting ambitious targets to recover services, backed by more
than £8 billion in funding from 2022-23 to 2024-25 and supported
by a £5.9 billion investment in new beds, equipment and
technology. We are providing an additional £3.3 billion in
2023-24 and 2024-25 to ensure that the NHS can take rapid action
to improve performance, including urgent and emergency care and
getting elective performance back towards pre-pandemic
levels.
(Lab)
My Lords, last week’s report from the National Audit Office laid
waste to the idea that all of the NHS’s current woes are down to
the pandemic. By 2019, NHS England had not met the elective
waiting time performance standard for four years, nor its full
set of eight operational standards for cancer services for six
years. Following the Government’s announcement last week of a
review into NHS efficiency, can the Minister confirm whether the
Government are still committed to their 18-week target between GP
referral and consultant-led treatment, as well as their other
targets around A&E waiting times, ambulance responses and
cancer treatment?
(Con)
I thank the noble Baroness. With reference to past performance,
that is what the spending increases were all about. They were an
acceptance that we need to do more in this space, and we are
doing more. The pandemic clearly brought unprecedented
circumstances and that is why we have announced more funding to
get on top of that in the next few years, tackling all the areas
that the noble Baroness mentioned in terms of A&E wait times,
GPs and all the rest.
(Con)
My Lords, we know that part of the problem is that ambulances are
going to A&E departments but are not able to deposit their
patients in A&E. We know that there is a blockage at the
other end in social care, with people not being able to be
discharged fast enough back into the community or into care
homes. Until that is sorted out, I cannot see how we are ever
going to sort out the waiting lists. Can my noble friend the
Minister tell me what might happen that will perhaps make those
problems better?
(Con)
I thank my noble friend. Adult social care, as many have heard me
say before in this House, is a crucial part of this, because it
is all about the flow. That is why I was delighted that, in
addition to the £500 million discharge fund for this year, we
have secured up to £2.8 billion of funding for next year. That is
in addition to the 7,000 extra beds and the tailored help for the
15 worst-performing hospitals with the ambulances, so we have a
complete answer to all these areas.
(CB)
My Lords, patients with complex and long-term conditions are
finding it increasingly difficult to access the care that they
need, resulting, as the British Heart Foundation report
indicated, in 10,000 excess deaths in people suffering from
chronic cardiac conditions. The Minister referred recently to the
system being a failure. Does he agree that we need a system that
develops care for these patients, one that is accessible and
timely, in community and primary care settings?
(Con)
I agree with the noble Lord that cardiovascular is one important
area in which, over the last few years, patients have not
received the number of check-ups that we want, so it is an area
on which we want to focus—not just through checks in GP centres
but in the community. We all know that it is very easy to take
blood pressure and have blood pressure machines. As a team, we
are looking at precisely those kinds of measures to make sure
that we can get the preventive screening in up front, so we can
identify these people before problems occur.
(LD)
The Minister referred to the worst-performing hospitals and
ambulance trusts, but news from the Health Service Journal today
has shown that the longest waiting times are mainly in rural,
deprived areas, with an elderly population that is much higher
than in the rest of the country. Can the Minister say what
special resources will be provided for those areas—rather than
just using words like “worst”, which punish them
unnecessarily?
(Con)
I thank the noble Baroness. If I have used a poor choice of
words, I apologise. What we are looking at is identifying the
areas where we most need to focus resources to solve wait times.
That might be because it is a rural area or it might be,
candidly, because it is not performing so well. The point that I
was trying to make is that there is targeted support. We spent
£150 million on ambulance performance and new facilities last
year, and it is something that we will continue to do if those
rural areas and other areas need the spend.
(Lab)
My Lords, will the Minister deal with the issue of 18 weeks? Are
the Government still committed to that policy? If they are, when
does he think it will be achieved?
(Con)
We are committed to timely appointments. The whole point about
the community diagnostic centres that were set up—and we have set
up more than 90—is so that patients can be referred straight to
those centres and get their screening and tests straightaway,
getting them more quickly and, I hope, getting peace of mind more
quickly as well.
(CB)
My Lords, I very much welcome the recent change, which enabled
GPs to refer patients direct for assessments instead of having to
refer to a consultant, and for the consultant then to refer,
which I think saved about 30 days. What other procedural changes
are the Government considering that would further reduce waiting
times, without actually costing more money, and save doctors
time—for example, patient self-assessments in the home, which we
pioneered in east London 30 years ago?
(Con)
I thank the noble Baroness. There are a number of areas where we
can do this. I point to the possibility for home testing a lot
more. Covid was a perfect example, whereby it became commonplace.
Rather than samples being sent away to a laboratory, we came up
with lateral flow devices and were able to do it cheaply and
pretty accurately, although not quite as accurately. That is a
perfect example of using technology to do more home-type
diagnosis.
(Con)
My Lords, in learning from best practice in other countries, are
my noble friend, the department or the NHS aware of the
pioneering work of Dr Shetty in Bangalore, who has pioneered
production-line surgery for certain procedures? Are the
Government considering that at the moment? If not, why not?
(Con)
I thank my noble friend for that. While I am not familiar with
that exact case, I saw a very good, probably quite similar,
example in Chase Farm Hospital, which has four operating theatres
in a sort of barn. It has a complete production line for elective
hip replacements and so on to get that capacity and
efficiency.
(CB)
My Lords, I draw noble Lords’ attention to my registered
interests. The Minister will be aware that innovation, be it
therapeutic or in models of care, is essential to improve
efficiency and efficacy in the delivery of NHS services. Is he
content that there is sufficient protection in the NHS budget to
drive that adoption of innovation and ensure that staff are
properly trained for its application?
(Con)
I thank the noble Lord. As I have said previously, innovation,
and being able to back that up with investment, is key. The House
will see that we have protected a lot of the research funds so
that we can do exactly that. That is the direction of travel. The
new hospital programme, which I look after, is very much about
looking at best practice and innovation around the world and
making sure that we employ the best in our new hospitals and
across all our trusts.
(Lab)
My Lords, the Minister is relatively new to his department, but
even in the number of weeks he has been there, he must recognise
that, whatever statistics on inputs he announces at the Dispatch
Box, it is not working. There was a time, two decades ago, when
we managed as a Government to reduce the maximum waiting time
from three years to 18 weeks and the numbers on the waiting list
from 1 million to 500,000. There are now 7.2 million on the
waiting list—incidentally, there were 4.2 million before Covid.
Whatever the Government have been doing for 10 years is not
working and people are remaining in pain for prolonged periods,
quite apart from the effect on the economy. Will the Minister
institute an immediate review centred particularly around patient
choice, which is the only thing that will drive down waiting
times and waiting lists? It should never have been abandoned in
the way it has been by the Government.
(Con)
I believe that customers—call them patients—should drive
performance and improvements. Inputs are important, but I totally
agree that in a performance culture outputs are very important. I
give credit to the work done in the early 2000s, from which I
have tried to learn in the short time I have been here, to really
bear down and create a performance culture to get waiting lists
down by holding trusts, and now the new ICB CEOs, to account.
That is definitely the direction of travel, and I am very happy
to learn from things that have worked well in the past.
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