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Mr. Horam: I shall be having a meeting shortly with the chairman and chief executive of the Royal National Orthopaedic hospital trust, which is working up a business case for the redevelopment of the hospital.
Mr. Dykes: I thank my hon. Friend for the thoughtful way in which he has responded to the many submissions on the hospital's future that have been made in recent months and, indeed, years. I shall also be present at that meeting on Tuesday at 4 o'clock. The overwhelming opinion--local and wider opinion--is in favour of the hospital remaining on the same site. To allow the necessary funding to be made available in the future and to ensure that the excess of old buildings is reduced and that the modern footprint and curtilage is properly paid for, will he ensure that the regional health authority speeds up its authorisation decisions to get that money under way?
Mr. Horam: I am interested in what my hon. Friend says, and I look forward to that meeting. The business case is at a fairly early stage. I am conscious of the orthopaedic hospital's extraordinary record over many years. About 30 or 40 per cent. of all the orthopaedic surgeons in the country have been trained at the Stanmore hospital at one time or another. I am sure that my hon. Friend, who strongly supports the hospital, is very proud of that record.
Mr. Burns: New arrangements for national health service responsibilities for continuing health care, which includes rehabilitation and recovery services, were introduced in April 1996. Since that date, all health authorities have been required to have in place local policies and eligibility criteria for continuing health care.
Mr. Burns: No, I do not agree with a word of what the hon. Lady has said, because it is totally divorced from the truth. She seems to forget that the continuing care challenge fund has provided £16 million in the current year, and will next year provide £20 million, plus £40 million of matching funds from local and health authorities, including £11 million for rehabilitation and recovery services. The gimmick that the Labour party has announced in the past month on recuperation is ridiculous. It proposes a pilot scheme costing £500,000, which is the amount that my right hon. Friend the Secretary of State is giving, through the continuing care fund, to the constituency and health authority area of the right hon. Member for Sedgefield (Mr. Blair). That excludes the rest of the country, which will receive the other money.
Mr. Congdon: Would not more resources be available for rehabilitation services and care in the community if local councils, especially those controlled by the Labour party, were prepared to make more use of private residential homes, rather than boost bed usage in their own homes? That costs the taxpayer a lot of money, which could be better used to provide care for more elderly people in the community.
Mr. Burns: My hon. Friend is right. It has been shown that, on average, a place per person per week in a local authority-owned home in England costs £40 more than a place in the private sector. It seems odd that the Labour party is so antagonistic towards getting better value for money while providing the highest quality of care for the elderly, so that more money can be saved and ploughed back into care for the elderly.
Ms Coffey: Does the Minister accept that 9,000 NHS beds for elderly people have been lost since 1990--beds for nursing care, rehabilitation and convalescence? Are not old people in need of care simply seen as bed blockers by hospitals driven to maximise their business income? How can this Government, who have abandoned health care for old people to the market, be trusted with the NHS for a fifth term of office?
Mr. Burns: The hon. Lady seems to be divorced from reality. The Government's policy is being implemented day in, day out--despite the smiles of the hon. Member for Rother Valley (Mr. Barron), who should realise that this is not a funny subject. Care for the elderly is at the highest level possible and record amounts of money are being spent. It is time local authorities--which are mostly Labour-controlled--started to work with health authorities in using the continuity care challenge fund money to undo the problems of bed blocking and finding proper care for the elderly, who deserve it.
Mr. Dorrell: Over the next five years, my right hon. Friend the Prime Minister has pledged that we shall increase the real resources available to the national health service year on year on year on year on year. We challenge Labour to match that pledge.
Mr. Winterton: The House must warmly welcome the commitment given by the present Conservative Government to increase spending for every year of the next Parliament if they are re-elected. Does my right hon. Friend agree that it is not just the amount of money spent on health care that is important--we spend a great deal--but the level of service provided? That service has made the United Kingdom national health service the very best in the world. The Opposition have failed to match our pledge on resources, and they would fail to deliver the best service in the world as well.
Mr. Dorrell: My hon. Friend is right. It is not simply a pledge year on year on year on year on year through the next Parliament. It is the 18 years since 1979--I will not say it 18 times--in which the Government have increased the resources available to the NHS year on year. We have delivered a growing NHS, and a wider range of care is available to patients. More patients are being treated and better-quality care is being provided. That is the Government's record on the NHS and we are pledged to project it through the five years of the next Parliament. The problem that the hon. Member for Islington, South and Finsbury (Mr. Smith) has with Mr. Charlie Whelan is that the hon. Gentleman is unable to match the pledge that my right hon. Friend the Prime Minister has given for the next five years.
Mr. Stevenson: Is the Secretary of State aware that plans for patient care at the North Staffordshire hospital trust have been brought into question by the resignation of the chief executive, Mr. Stuart Gray? The reasons for that resignation are clouded in secrecy. Will the right hon. Gentleman institute an urgent investigation into that departure in the public interest, so that the real reasons can be established?
Mr. Dorrell: Changes in trust management are matters handled in the first instance by the trust's board. What the hon. Gentleman has to explain to the citizens of north Staffordshire--as all Labour Members must explain to their constituents--is how Labour can even begin to talk about support for the NHS when it is not prepared to match its words with real commitments. The Conservative party has shown real commitment in action. The last Government to cut the resources available to the national health service was the Labour Government between 1974 and 1979. Health resources in 1979 were lower than in 1976. The Labour party must explain its record and explain how it turns its words into action.
Mr. Dorrell: Unfortunately for Britain's patients, but fortunately for the Conservative party, the hon. Member for Islington, South and Finsbury (Mr. Smith) has since made it clear which of those policies he supports: a Labour Government would abolish fundholding. Because Labour is committed to the abolition of a scheme that has delivered real improvements to patients, the question about how to deliver real improvements to the patients of the national health service can have only one answer: re-elect a Conservative Government.