§ Mr. Gwilym Jones
To ask the Secretary of State for Wales what assessment he has made of the impact of new health technology on surgical procedures and treatments in Welsh hospitals.
§ Mr. Nicholas Bennett
The NHS in Wales continually assesses the costs and benefits of new health technology.
As part of this process, in 1990 the Welsh health planning forum commissioned an expert report on the 453W possible impact of emerging and future technologies on the delivery of health care. It was circulated widely and prompted a useful debate between scientists, clinicians and managers in NHS Wales.
Building on this, the planning forum, in partnership with the World Health Organisation and the King's Fund college, held a conference in Cardiff in October this year focusing on the potential for shifting care from the hospital to the home. It brought together international experts and raised awareness of technology's potential for creating a more people-centred and community-based health care service.
The conference pointed up the opportunities for de-institutionalising health care in an environment where before too long perhaps up to 60 per cent. of surgery will be performed on a day basis with over 80 per cent. being bloodless.
The use of endoscopy is transforming clinical practice in the fields of gynaecology, orthopaedic and general surgery. Endoscopes are flexible tubes used to examine, photograph and take biopsies from the body's cavities and organs without the trauma of surgery, and often while the patient is conscious.
Similarly, lasers have superseded some more traditional surgical approaches to treating skin, eye and gynaecological disorders and a wide range of other conditions.
In addition, new techniques commonly referred to as key-hole surgery are becoming widely used. Laparoscopic cholycystectomies—lap-cholies—are replacing open abdomen gall stone operations. In the field of orthopaedic surgery, a damaged knee cartilage can be removed without opening the knee joint. Recovering from these operations is much quicker than the earlier kind and people do not need to stay in hospital so long. Some coronary artery bypass surgery can be avoided by using balloon angiography. This technique passes a balloon into the artery in a catheter. The balloon is then inflated to enlarge the artery, remove blockages and allow the blood to flow freely.
These and similar developments are having a profound effect on the size and nature of our hospitals. What counts is not hospital bed numbers but providing people with the right services in the right settings.