Health and Social Care Bill

Baroness Armstrong of Hill Top Excerpts

Monday 7th November 2011 Lords Chamber

As a working consultant until just three years ago I would say this. We used to have a system in the NHS whereby we had block booking for outpatient appointments. Four patients would be booked at 9 am, another four patients at 9.05 am, another four patients at 9.10 am and so it went on until all the patients were booked in until 11 am. Clearly, they did not have two minutes each. Patients were left sitting in the clinics waiting and waiting and waiting until they could be seen. I decided after some time that that was not acceptable and made the point of giving my NHS patients appointments in exactly the same way as my private patients. They all had 15 minutes each. It was exactly the same as in the private sector. Some private patients might just have a mole so it might take me only five or 10 minutes to make a diagnosis. For someone with bowel cancer it could take 30 minutes. That way, you can manage your practice. There is a requirement for individual consultants to be conscious of the fact that they must deliver the same standard of care irrespective of how that patient finances their treatment.

[Baroness Armstrong of Hill Top]

I intervene to dispel the view that it has always been even and equal for private and non-private patients in the NHS. When I was an Opposition Member of Parliament, before the 1997 election, the largest complaint that I had, which I had regularly, surgery after surgery, was from people who had some serious condition. They had eventually got in to see the consultant, frequently having had to wait a long time. Then they were told, “Yes, you need an operation but the waiting list is 18, 20 or 24 months. However, if you come in to see me next week in my private practice, I can do the operation in two weeks’ time”. People found that offensive.

That is why, during the passage of the Bill on foundation trusts, there was outrage on the Back Benches that we were going to revert to the situation where it seemed not to matter whether people were public or private patients.. That came because Back-Benchers insisted that they did not want to return to the old system.

I am actually in favour of varying the cap and the noble Lords who tabled the amendment actually had the right idea. But for us to pretend in this House that there was once a glorious age where everyone was treated equally is quite honestly offensive to all those people who knew that they were getting a poor service and were not getting adequate access to the healthcare they needed and had the right to receive.

[Lord Patel]

I rise briefly to comment on this amendment. As far as declaring an interest is concerned, I have not seen private patients because my contracts were such that academics did not do private practice. I have a family member who is a consultant. My daughter is a consultant at the Marsden where I hear there is a high percentage of private patients. I have no idea whether she does private practice or not. I have not seen any benefits of it. Maybe they will come.

However, I remember when I was a student and was training in King Edward VII Hospital in Windsor, in Ascot and other places there were private wings in the same hospital. Yes, the care provided was equal for NHS and private patients. However, one difference today is that NHS patients now receive quite a significant part of their care provided by doctors in training. If we are to ask for equality in how patients are looked after, we must say not only that those patients in private wings cannot jump the queue but that there must be the same quality of care provided by all the medical staff who work in the NHS.

I have one other question, which I would like to put to the noble Lord, Lord Phillips of Sudbury. How would we manage his amendment when there are to be qualified providers, which might provide care not only for NHS patients but for private patients under their own terms and conditions? How would we manage those qualified providers to ensure that they behave in the same way in dealing with NHS patients?

--- Later in debate ---

[Earl Howe]

The noble Lord, Lord Hunt, should be a little bit careful before he comes to this Committee and speaks as though it were Second Reading and as though he were not chairman of the Heart of England trust, which I do not doubt has a goodly number of private patients in its midst. He should bear in mind that it was the last Labour Government who introduced private sector involvement into the NHS in 2007; the independent sector was paid on average 11 per cent more than the NHS price.

[Baroness Armstrong of Hill Top]

My Lords—

[Earl Howe]

I am sorry, but I am going to finish. The private sector was paid £250 million for operations that never happened. I have a very interesting quote here:

“The private sector puts its capacity into the NHS for the benefit of NHS patients, which I think most people in this country would celebrate”.—[Official Report, Commons, 15/5/07; col. 250WH.]

That is a quote from none other than Andy Burnham. It is absolute hypocrisy on the part of the noble Lord, Lord Hunt, to introduce matters to this amendment that have nothing to do with my noble friend’s point. My noble friend’s point was quite separate from the point that the noble Lord was talking about.