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英国首相布莱尔99系列演讲之Outpatient Seminar - 13 October

2006-05-26 16:19

  When you ask patients what they think is wrong with the NHS, what tops the list every time is the amount of time spent waiting. Waiting for a doctor's appointment, in casualty, for test results, for an appointment with a consultant or for an operation.

  Most people are happy with their treatment when they receive it, but get frustrated with the length of time they have to wait.

  That is why as a symbol of our intention to reduce all forms of waiting we put forward our pledge at the last election. Let me remind you of it: 'To cut waiting lists by treating an extra 100,000 patients - as a first step by releasing ??100m saved from NHS red tape.'

  We are well on the way to meeting that pledge. We have saved the ??100m from red tape. In fact we have saved more than that - ??240 million so far.

  And waiting lists are now 60,000 lower than when we took office. This pledge is important. It will be delivered.

  I know that some people think it was a foolish pledge. But to those in any doubt, the length of waiting lists does matter. If you are waiting to get through a turnstile into a football ground or through a supermarket checkout you go to the one with the shortest queue!

  Where people are right is in saying that waiting times are also vital. How long you wait in the queue is a key concern for people. Our waiting list initiative has cut average waiting times - as well as the numbers waiting.

  But reducing waiting lists is only one part of our strategy for reducing waiting in all its forms in the NHS.

  We have set up NHS Direct to provide instant health advice round the clock.

  The new NHS walk-in centres we announced in July - 19 of them and with more on the way - will make it easier for people who find it hard to get to their GP during normal surgery hours, to get health care when they need it.

  The 100 million we are spending modernising Accident and Emergency departments will help cut waiting in casualty.

  But there is more to do. You have come here today as GPs, managers, consultants, health professionals and patients to help us improve our performance on outpatient waiting times.

  There is no more anxious time than waiting to see a consultant to find out what is wrong with you and whether you will need an operation. You are people with hands-on experience of cutting through delays.

  The first thing to say is that three-quarters of people get an outpatient appointment within 13 weeks of their GP requesting one. In fact the average time you wait to see a consultant is just over seven weeks.

  But the numbers waiting over 13 weeks have been growing. Some people allege that this is because we are deliberately making people wait longer for an outpatient appointment, in order to slow up the rate at which patients get referred for operations and so keep down the length of in-patient waiting lists.

  That is just plain wrong. Last year - a year when a record extra half a million patients were treated in hospital - the NHS also dealt with a record number of outpatients, including an extra 175,000 new outpatients. So we are treating more new outpatients as well as cutting waiting lists.

  The problems with long out patient waits are much more deep-seated.

  Although the NHS is seeing more outpatients than ever before, patients are being referred to consultants is faster than the rate at which they are being seen. We need to understand why this is and whether we are dealing with this rising demand in the best way.

  There are four main specialities where long waiting times are a particular problem: orthopaedics; ear, nose and throat, opthamology and dermatology. Today we will hear how some parts of the NHS have successfully addressed these problem areas and what lessons we can learn.

  It is unacceptable that some hospitals and GPs are far less efficient at dealing with outpatient appointments than others. This is something we must change.

  So we have a big agenda. It will take time to sort out. But we have already made a good start.

  This year we expect hospitals to provide an extra third of a million first outpatient appointments. Backed by ??30 million from the NHS Modernisation Fund, over 11 million new outpatients seen for the first time.

  We are introducing booked appointments across the NHS. Pre-booking appointments is both more convenient for patients and helps to cut waiting.

  The National Patients Action Team is visiting GPs and hospitals to spread new and better ways of working and helping to reduce outpatient waiting in the same way it has done for inpatient waiting.

  And for cancer, where speed of diagnosis can be so important, we are making sure that everyone who needs to be seen urgently has an appointment within two weeks. Over 15,000 women suspected of having breast cancer have already benefited from this service since it was introduced in April.

  During the year 2000, the two-week standard will cover all other cancers. Delivering this will be a challenge for the NHS. So today I can announce that we are publishing new guidelines and providing an extra ??10 million to help GPs and hospitals prepare for this improved service.

  So work is in hand to cut outpatient waiting times. But we need to do more. We must monitor our performance on outpatients as rigorously as on inpatients. And the best practice of some must be applied everywhere.

  But Ministers and Government have not got all the answers. We need your help. We want the enthusiasm and ideas of NHS staff so that together we can provide the sort of prompt convenient service the public wants.

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