§ 8. Sir Sydney Chapman (Chipping Barnet)
If he will make a statement about the Government's policy on clinical priorities in relation to the reduction of NHS waiting lists. 
§ The Secretary of State for Health (Mr. Alan Milburn)
The very clear guidance that we have issued states thatclinical priority must be the main determinant of when patients are seen as out-patients or admitted as in-patients.As waiting lists fall, so waiting times, too, will fall. The NHS plan sets out how waiting times will be cut, from a maximum 18 months for in-patient treatment today, to six months by 2005, and from six months for out-patient treatment today, to three months by 2005. Our eventual aim is that there should be waits of weeks rather than months.
§ Sir Sydney Chapman
I am grateful to the Secretary of State for that information. Will he confirm that, in 80 per cent. of health authority areas, the number of patients waiting more than 12 months for operations has increased since his party took office, and that for the first time in 25 years, the number of heart bypass operations has decreased? Does not that underline the fact that the right hon. Gentleman has managed to get his in-patient 119 waiting lists down only by postponing complex surgical procedures and pushing through the simpler operations as well as keeping people off the waiting lists for longer?
§ Mr. Milburn
No, that is not true. The hon. Gentleman has heard me say before that the allegation from Tory Back-Bench Members that the number of coronary artery bypass grafts and of heart operations in general has fallen is not true. The number of operations is rising. Of course, we need to do more. That is why I have already made the extra earmarked cash available to ensure that we can carry out an extra 3,000 more heart operations this year and next year. I expect to be able to exceed that, largely because of the hard work done by NHS trusts, hospitals, cardiothoracic surgeons, theatre nurses and others up and down the country who have used the money to good effect.
Let me remind the hon. Gentleman of one thing before he starts raising some legitimate concerns that he and his hon. Friend the Member for Ribble Valley (Mr. Evans) raised earlier about access to heart surgery. It is important to remember that, under the Government whom he supported and of whom he was a member, there was no earmarked cash available for heart operations. It was only when this Government took office that we earmarked cash for cancer and heart disease, which are what many hon. Members, and people throughout the country, would regard as the top clinical priorities.
§ Mr. Clive Efford (Eltham)
My right hon. Friend will be aware that increased demand can put pressure on waiting lists during the winter, particularly as a result of people suffering from flu. I congratulate my right hon. Friend on the success of his advertising campaign in increasing the number of people taking advantage of the flu vaccine. [Interruption.] There is some evidence in my area that demand is outstripping supply.
What is the Department doing to increase awareness of the disease in terms of what precautions can be taken in the household and the workplace to minimise the number of people who contract the disease? There is a myth about how the disease is contracted which the Department could do something to dispel.
§ Mr. Milburn
As my hon. Friend is aware, there is a TV advertising campaign and other types of advertisement precisely to inform the public about what they can do. It is most important to ensure that those at the highest risk of serious illness if they contract the flu take advantage of the facilities that the Government have made available to them, which is to get a free flu jab. [Interruption.] I hear Tory Members alleging that the flu vaccine is not available. That is not true. This year we have ordered 11 million doses of flu vaccine, compared with under 8 million last year. We have also extended the range of people who are able to get access to the free flu jab. It is important that, in every part of the country, the free flu jab is offered to pensioners and others, and that people who want to take advantage of it do so as soon as possible by visiting their GP's surgery for their free jab on the national health service.
§ Sir Nicholas Lyell (North-East Bedfordshire)
On the issue of clinical priorities, is the Secretary of State aware that Addenbrooke's hospital has now had to cancel the prostate operation on one of my elderly constituents for 120 the fourth time? That is not because of a shortage of surgeons or nurses but because two and a half wards are blocked with elderly patients who cannot be discharged home and because there is a shortage of some 300 private sector nursing home beds in the Cambridgeshire area. Will the right hon. Gentleman liaise with the Secretary of State for social services to get the Government to help solve that problem?
§ Mr. Milburn
I am the Secretary of State for social services, so I shall do my best, depending on what sort of day I am having, of course—so far, so good. The right hon. and learned Gentleman raises an extremely important point, which is that, as we now know, what happens in a hospital is directly affected by and directly affects what happens in social services, primary care, community care and, as we heard earlier, ambulance services. That is why we have to encourage much greater co-operation in the local health service. That is also the precise reason why the Government got rid of the internal market, which the right hon. and learned Gentleman supported.