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Mr. Hinchliffe: I have no personal doubt about Wakefield health authority's commitment to offering the care that James Wilkinson and his family need. I am concerned that it has told me that it faces immense difficulties. To its credit, it invited me to a meeting to discuss James's case during the early autumn of last year. It was made clear to me that the health authority feels that it is under immense budgetary pressures because of the demands of one patient for £102,000 of its fairly tight annual budget.

The Minister will know that there other cases nationwide that are causing similar concern. I learnt today of a Minister who has someone in his constituency with a problem similar to that of James Wilkinson, where there is a difficulty with the local health authority budget. Away from James's case, I am saying as a point of principle that it should be recognised that there are health authorities, such as Wakefield, that are facing difficulties, and other constituents are not receiving treatment as a result of the huge resourcing demands of one particular case.

I ask the Minister whether the principle of earmarked funding--top-slicing funding within a budget--to protect the care package for someone like James can be considered by the Government. It is an issue of principle accepted, as the Minister will be aware, by his Department in ring fencing community care funding. It is no different, in my view, from recognising a specific area of need and

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difficulty that may not be properly resourced without some protection. The hon. Gentleman has not really answered the central point in the debate--looking at the way in which the formula will operate in future to secure and protect funding in cases such as James Wilkinson's.

Mr. Sackville: I can say only that the future funding for James Wilkinson is protected by the fact that Wakefield must accept responsibility for providing an appropriate level of care. It now has a budget of £134 million. It is by no means unusual that health authorities should have individual cases that cost a great deal of money: it may be because of the level of nursing care, as in this case; it may be because of very expensive drugs or particular treatments, or because of long periods spent in intensive care, or whatever. We have attempted to find a structure with a smaller number of larger health authorities so that a health authority is able to absorb such costs. As I have also said, James's condition and needs

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may change, and that issue must be reviewed regularly. While he needs that level of care, he will receive it from Wakefield. The hon. Gentleman has my assurance on that.

Mr. Hinchliffe: After he has studied the comments in Hansard tomorrow, will the Minister give an assurance that he will personally discuss with Wakefield health authority its concerns in respect of the principles in James Wilkinson's case and the specific difficulties? It would be helpful if Wakefield said to the Minister directly what it has said to me. Clearly, his brief does not take into account Wakefield's very real concerns about its budget.

Mr. Sackville: Health authorities must provide a wide spectrum of care for many different patients, some of whom have special needs. They must make the commitment to care for all those patients. I will certainly consider what the hon. Gentleman has said.

Question put and agreed to.

Adjourned accordingly at one minute past Eleven o'clock.

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