NHS (60th Anniversary)

Let me explain two things to the hon. Lady. First, many clinicians to whom I have spoken over many years, as well as their representative organisations, have made it clear that the impact of a waiting time target is less about delivering reductions in waiting times than it is about distorting clinical practice and the clinical judgments that have to be made. Waiting time targets can thereby have a damaging overall impact on health outcomes. Clinicians want to focus on outcomes and be held to account for some of the performance measures that go into delivering high-quality care for patients. There is no doubt that clinicians know that their local hospital should be responsible for publishing referral-to-treatment times and that patients and commissioners should hold them to account for that. That is performance management; it is part of the contract and nobody is proposing that we get rid of it. However, the hon. Lady must recognise the truth about imposing a national, one-size-fits-all, 18-week referral-to-treatment target. Almost every clinician to whom I have spoken says, ““This is nonsense. There is no clinical evidence for this and it distorts.”” Indeed, we can see that happening already, with hospitals having to pay well over the tariff to access private sector providers and deliver the target. Another thing that I would like to say to the hon. Lady is that the staff at her local hospital, Chase Farm, are saying, ““Don't take away our maternity services and our A and E services””. The people of Enfield care about services at Chase Farm, and I wish that she had got up to tell the House about that, instead of making a party political point.